Add to Chrome
Add to Firefox
Add to EdgeAdapTime: Enabling Adaptive Temporal Reasoning in Large Language Models
Apr 27, 2026
Large language models have demonstrated strong reasoning capabilities in general knowledge question answering. However, their ability to handle temporal information remains limited. To address this limitation, existing approaches often involve external tools or manual verification and are tailored to specific scenarios, leading to poor generalizability. Moreover, these methods apply a fixed pipeline to all questions, overlooking the fact that different types of temporal questions require distinct reasoning strategies, which leads to unnecessary processing for simple cases and inadequate reasoning for complex ones. To this end, we propose AdapTime, an adaptive temporal reasoning method that dynamically executes reasoning steps based on the input context. Specifically, it involves three temporal reasoning actions: reformulate, rewrite and review, with an LLM planner guiding the reasoning process. AdapTime integrates seamlessly with state-of-the-art LLMs and significantly enhances their temporal reasoning capabilities without relying on external support. Extensive experiments demonstrate the effectiveness of our approach.
MultiDx: A Multi-Source Knowledge Integration Framework towards Diagnostic Reasoning
Apr 27, 2026Diagnostic prediction and clinical reasoning are critical tasks in healthcare applications. While Large Language Models (LLMs) have shown strong capabilities in commonsense reasoning, they still struggle with diagnostic reasoning due to limited domain knowledge. Existing approaches often rely on internal model knowledge or static knowledge bases, resulting in knowledge insufficiency and limited adaptability, which hinder their capacity to perform diagnostic reasoning. Moreover, these methods focus solely on the accuracy of final predictions, overlooking alignment with standard clinical reasoning trajectories. To this end, we propose MultiDx, a two-stage diagnostic reasoning framework that performs differential diagnosis by analyzing evidence collected from multiple knowledge sources. Specifically, it first generates suspected diagnoses and reasoning paths by leveraging knowledge from web search, SOAP-formatted case, and clinical case database. Then it integrates multi-perspective evidence through matching, voting, and differential diagnosis to generate the final prediction.~Extensive experiments on two public benchmarks demonstrate the effectiveness of our approach.
Tandem: Riding Together with Large and Small Language Models for Efficient Reasoning
Apr 26, 2026Recent advancements in large language models (LLMs) have catalyzed the rise of reasoning-intensive inference paradigms, where models perform explicit step-by-step reasoning before generating final answers. While such approaches improve answer quality and interpretability, they incur substantial computational overhead due to the prolonged generation sequences. In this paper, we propose Tandem, a novel collaborative framework that synergizes large and small language models (LLMs and SLMs) to achieve high-quality reasoning with significantly reduced computational cost. Specifically, the LLM serves as a strategic coordinator, efficiently generating a compact set of critical reasoning insights. These insights are then used to guide a smaller, more efficient SLM in executing the full reasoning process and delivering the final response. To balance efficiency and reliability, Tandem introduces a cost-aware termination mechanism that adaptively determines when sufficient reasoning guidance has been accumulated, enabling early stopping of the LLM's generation. Experiments on mathematical reasoning and code generation benchmarks demonstrate that Tandem reduces computational costs by approximately 40% compared to standalone LLM reasoning, while achieving superior or competitive performance. Furthermore, the sufficiency classifier trained on one domain transfers effectively to others without retraining. The code is available at: https://github.com/Applied-Machine-Learning-Lab/ACL2026_Tandem.
Radiology Report Generation for Low-Quality X-Ray Images
Apr 11, 2026Vision-Language Models (VLMs) have significantly advanced automated Radiology Report Generation (RRG). However, existing methods implicitly assume high-quality inputs, overlooking the noise and artifacts prevalent in real-world clinical environments. Consequently, current models exhibit severe performance degradation when processing suboptimal images. To bridge this gap, we propose a robust report generation framework explicitly designed for image quality variations. We first introduce an Automated Quality Assessment Agent (AQAA) to identify low-quality samples within the MIMIC-CXR dataset and establish the Low-quality Radiology Report Generation (LRRG) benchmark. To tackle degradation-induced shifts, we propose a novel Dual-loop Training Strategy leveraging bi-level optimization and gradient consistency. This approach ensures the model learns quality-agnostic diagnostic features by aligning gradient directions across varying quality regimes. Extensive experiments demonstrate that our approach effectively mitigates model performance degradation caused by image quality deterioration. The code and data will be released upon acceptance.
Guaranteeing Knowledge Integration with Joint Decoding for Retrieval-Augmented Generation
Apr 09, 2026Retrieval-Augmented Generation (RAG) significantly enhances Large Language Models (LLMs) by providing access to external knowledge. However, current research primarily focuses on retrieval quality, often overlooking the critical ''integration bottleneck'': even when relevant documents are retrieved, LLMs frequently fail to utilize them effectively due to conflicts with their internal parametric knowledge. In this paper, we argue that implicitly resolving this conflict in a single generation pass is suboptimal. We introduce GuarantRAG, a framework that explicitly decouples reasoning from evidence integration. First, we generate an ''Inner-Answer'' based solely on parametric knowledge to capture the model's reasoning flow. Second, to guarantee faithful evidence extraction, we generate a ''Refer-Answer'' using a novel Contrastive DPO objective. This objective treats the parametric Inner-Answer as a negative constraint and the retrieved documents as positive ground truth, forcing the model to suppress internal hallucinations in favor of external evidence during this phase. Finally, rather than naive concatenation or using the DPO trained model directly, we propose a joint decoding mechanism that dynamically fuses the logical coherence of the Inner-Answer with the factual precision of the Refer-Answer at the token level. Experiments on five QA benchmarks demonstrate that GuarantRAG improves accuracy by up to 12.1% and reduces hallucinations by 16.3% compared to standard and dynamic RAG baselines.
Bi-CRCL: Bidirectional Conservative-Radical Complementary Learning with Pre-trained Foundation Models for Class-incremental Medical Image Analysis
Mar 24, 2026Class-incremental learning (CIL) in medical image-guided diagnosis requires retaining prior diagnostic knowledge while adapting to newly emerging disease categories, which is critical for scalable clinical deployment. This problem is particularly challenging due to heterogeneous data and privacy constraints that prevent memory replay. Although pretrained foundation models (PFMs) have advanced general-domain CIL, their potential in medical imaging remains underexplored, where domain-specific adaptation is essential yet difficult due to anatomical complexity and inter-institutional heterogeneity. To address this gap, we conduct a systematic benchmark of recent PFM-based CIL methods and propose Bidirectional Conservative-Radical Complementary Learning (Bi-CRCL), a dual-learner framework inspired by complementary learning systems. Bi-CRCL integrates a conservative learner that preserves prior knowledge through stability-oriented updates and a radical learner that rapidly adapts to new categories via plasticity-oriented learning. A bidirectional interaction mechanism enables forward transfer and backward consolidation, allowing continual integration of new knowledge while mitigating catastrophic forgetting. During inference, outputs from both learners are adaptively fused for robust predictions. Experiments on five medical imaging datasets demonstrate consistent improvements over state-of-the-art methods under diverse settings, including cross-dataset shifts and varying task configurations.
InViC: Intent-aware Visual Cues for Medical Visual Question Answering
Mar 17, 2026Medical visual question answering (Med-VQA) aims to answer clinically relevant questions grounded in medical images. However, existing multimodal large language models (MLLMs) often exhibit shortcut answering, producing plausible responses by exploiting language priors or dataset biases while insufficiently attending to visual evidence. This behavior undermines clinical reliability, especially when subtle imaging findings are decisive. We propose a lightweight plug-in framework, termed Intent-aware Visual Cues (InViC), to explicitly enhance image-based answer generation in medical VQA. InViC introduces a Cue Tokens Extraction (CTE) module that distills dense visual tokens into a compact set of K question-conditioned cue tokens, which serve as structured visual intermediaries injected into the LLM decoder to promote intent-aligned visual evidence. To discourage bypassing of visual information, we further design a two-stage fine-tuning strategy with a cue-bottleneck attention mask. In Stage I, we employ an attention mask to block the LLM's direct view of raw visual features, thereby funneling all visual evidence through the cue pathway. In Stage II, standard causal attention is restored to train the LLM to jointly exploit the visual and cue tokens. We evaluate InViC on three public Med-VQA benchmarks (VQA-RAD, SLAKE, and ImageCLEF VQA-Med 2019) across multiple representative MLLMs. InViC consistently improves over zero-shot inference and standard LoRA fine-tuning, demonstrating that intent-aware visual cues with bottlenecked training is a practical and effective strategy for improving trustworthy Med-VQA.
Topology-Guided Biomechanical Profiling: A White-Box Framework for Opportunistic Screening of Spinal Instability on Routine CT
Mar 17, 2026Routine oncologic computed tomography (CT) presents an ideal opportunity for screening spinal instability, yet prophylactic stabilization windows are frequently missed due to the complex geometric reasoning required by the Spinal Instability Neoplastic Score (SINS). Automating SINS is fundamentally hindered by metastatic osteolysis, which induces topological ambiguity that confounds standard segmentation and black-box AI. We propose Topology-Guided Biomechanical Profiling (TGBP), an auditable white-box framework decoupling anatomical perception from structural reasoning. TGBP anchors SINS assessment on two deterministic geometric innovations: (i) canal-referenced partitioning to resolve posterolateral boundary ambiguity, and (ii) context-aware morphometric normalization via covariance-based oriented bounding boxes (OBB) to quantify vertebral collapse. Integrated with auxiliary radiomic and large language model (LLM) modules, TGBP provides an end-to-end, interpretable SINS evaluation. Validated on a multi-center, multi-cancer cohort ($N=482$), TGBP achieved 90.2\% accuracy in 3-tier stability triage. In a blinded reader study ($N=30$), TGBP significantly outperformed medical oncologists on complex structural features ($κ=0.857$ vs.\ $0.570$) and prevented compounding errors in Total Score estimation ($κ=0.625$ vs.\ $0.207$), democratizing expert-level opportunistic screening.
Step-CoT: Stepwise Visual Chain-of-Thought for Medical Visual Question Answering
Mar 14, 2026Chain-of-thought (CoT) reasoning has advanced medical visual question answering (VQA), yet most existing CoT rationales are free-form and fail to capture the structured reasoning process clinicians actually follow. This work asks: Can traceable, multi-step reasoning supervision improve reasoning accuracy and the interpretability of Medical VQA? To this end, we introduce Step-CoT, a large-scale medical reasoning dataset with expert-curated, structured multi-step CoT aligned to clinical diagnostic workflows, implicitly grounding the model's reasoning in radiographic evidence. Step-CoT comprises more than 10K real clinical cases and 70K VQA pairs organized around diagnostic workflows, providing supervised intermediate steps that guide models to follow valid reasoning trajectories. To effectively learn from Step-CoT, we further introduce a teacher-student framework with a dynamic graph-structured focusing mechanism that prioritizes diagnostically informative steps while filtering out less relevant contexts. Our experiments show that using Step-CoT can improve reasoning accuracy and interpretability. Benchmark: github.com/hahaha111111/Step-CoT. Dataset Card: huggingface.co/datasets/fl-15o/Step-CoT
MedPruner: Training-Free Hierarchical Token Pruning for Efficient 3D Medical Image Understanding in Vision-Language Models
Mar 12, 2026While specialized Medical Vision-Language Models (VLMs) have achieved remarkable success in interpreting 2D and 3D medical modalities, their deployment for 3D volumetric data remains constrained by significant computational inefficiencies. Current architectures typically suffer from massive anatomical redundancy due to the direct concatenation of consecutive 2D slices and lack the flexibility to handle heterogeneous information densities across different slices using fixed pruning ratios. To address these challenges, we propose MedPruner, a training-free and model-agnostic hierarchical token pruning framework specifically designed for efficient 3D medical image understanding. MedPruner introduces a two-stage mechanism: an Inter-slice Anchor-based Filtering module to eliminate slice-level temporal redundancy, followed by a Dynamic Information Nucleus Selection strategy that achieves adaptive token-level compression by quantifying cumulative attention weights. Extensive experiments on three 3D medical benchmarks and across three diverse medical VLMs reveal massive token redundancy in existing architectures. Notably, MedPruner enables models such as MedGemma to maintain or even exceed their original performance while retaining fewer than 5% of visual tokens, thereby drastically reducing computational overhead and validating the necessity of dynamic token selection for practical clinical deployment. Our code will be released.