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Feb 12

SemanticControl: A Training-Free Approach for Handling Loosely Aligned Visual Conditions in ControlNet

ControlNet has enabled detailed spatial control in text-to-image diffusion models by incorporating additional visual conditions such as depth or edge maps. However, its effectiveness heavily depends on the availability of visual conditions that are precisely aligned with the generation goal specified by text prompt-a requirement that often fails in practice, especially for uncommon or imaginative scenes. For example, generating an image of a cat cooking in a specific pose may be infeasible due to the lack of suitable visual conditions. In contrast, structurally similar cues can often be found in more common settings-for instance, poses of humans cooking are widely available and can serve as rough visual guides. Unfortunately, existing ControlNet models struggle to use such loosely aligned visual conditions, often resulting in low text fidelity or visual artifacts. To address this limitation, we propose SemanticControl, a training-free method for effectively leveraging misaligned but semantically relevant visual conditions. Our approach adaptively suppresses the influence of the visual condition where it conflicts with the prompt, while strengthening guidance from the text. The key idea is to first run an auxiliary denoising process using a surrogate prompt aligned with the visual condition (e.g., "a human playing guitar" for a human pose condition) to extract informative attention masks, and then utilize these masks during the denoising of the actual target prompt (e.g., cat playing guitar). Experimental results demonstrate that our method improves performance under loosely aligned conditions across various conditions, including depth maps, edge maps, and human skeletons, outperforming existing baselines. Our code is available at https://mung3477.github.io/semantic-control.

  • 3 authors
·
Sep 26, 2025

Causal Judge Evaluation: Calibrated Surrogate Metrics for LLM Systems

LLM-as-judge evaluation has become the de facto standard for scaling model assessment, but the practice is statistically unsound: uncalibrated scores can invert preferences, naive confidence intervals on uncalibrated scores achieve near-0% coverage, and importance-weighted estimators collapse under limited overlap despite high effective sample size (ESS). We introduce Causal Judge Evaluation (CJE), a framework that fixes all three failures. On n=4,961 Chatbot Arena prompts (after filtering from 5k), CJE achieves 99% pairwise ranking accuracy at full sample size (94% averaged across configurations), matching oracle quality, at 14x lower cost (for ranking 5 policies) by calibrating a 16x cheaper judge on just 5% oracle labels (~250 labels). CJE combines three components: (i) AutoCal-R, reward calibration via mean-preserving isotonic regression; (ii) SIMCal-W, weight stabilization via stacking of S-monotone candidates; and (iii) Oracle-Uncertainty Aware (OUA) inference that propagates calibration uncertainty into confidence intervals. We formalize the Coverage-Limited Efficiency (CLE) diagnostic, which explains why IPS-style estimators fail even when ESS exceeds 90%: the logger rarely visits regions where target policies concentrate. Key findings: SNIPS inverts rankings even with reward calibration (38% pairwise, negative Kendall's tau) due to weight instability; calibrated IPS remains near-random (47%) despite weight stabilization, consistent with CLE; OUA improves coverage from near-0% to ~86% (Direct) and ~96% (stacked-DR), where naive intervals severely under-cover.

  • 1 authors
·
Dec 11, 2025 2

NeuroStrike: Neuron-Level Attacks on Aligned LLMs

Safety alignment is critical for the ethical deployment of large language models (LLMs), guiding them to avoid generating harmful or unethical content. Current alignment techniques, such as supervised fine-tuning and reinforcement learning from human feedback, remain fragile and can be bypassed by carefully crafted adversarial prompts. Unfortunately, such attacks rely on trial and error, lack generalizability across models, and are constrained by scalability and reliability. This paper presents NeuroStrike, a novel and generalizable attack framework that exploits a fundamental vulnerability introduced by alignment techniques: the reliance on sparse, specialized safety neurons responsible for detecting and suppressing harmful inputs. We apply NeuroStrike to both white-box and black-box settings: In the white-box setting, NeuroStrike identifies safety neurons through feedforward activation analysis and prunes them during inference to disable safety mechanisms. In the black-box setting, we propose the first LLM profiling attack, which leverages safety neuron transferability by training adversarial prompt generators on open-weight surrogate models and then deploying them against black-box and proprietary targets. We evaluate NeuroStrike on over 20 open-weight LLMs from major LLM developers. By removing less than 0.6% of neurons in targeted layers, NeuroStrike achieves an average attack success rate (ASR) of 76.9% using only vanilla malicious prompts. Moreover, Neurostrike generalizes to four multimodal LLMs with 100% ASR on unsafe image inputs. Safety neurons transfer effectively across architectures, raising ASR to 78.5% on 11 fine-tuned models and 77.7% on five distilled models. The black-box LLM profiling attack achieves an average ASR of 63.7% across five black-box models, including the Google Gemini family.

ReasoningBomb: A Stealthy Denial-of-Service Attack by Inducing Pathologically Long Reasoning in Large Reasoning Models

Large reasoning models (LRMs) extend large language models with explicit multi-step reasoning traces, but this capability introduces a new class of prompt-induced inference-time denial-of-service (PI-DoS) attacks that exploit the high computational cost of reasoning. We first formalize inference cost for LRMs and define PI-DoS, then prove that any practical PI-DoS attack should satisfy three properties: (1) a high amplification ratio, where each query induces a disproportionately long reasoning trace relative to its own length; (ii) stealthiness, in which prompts and responses remain on the natural language manifold and evade distribution shift detectors; and (iii) optimizability, in which the attack supports efficient optimization without being slowed by its own success. Under this framework, we present ReasoningBomb, a reinforcement-learning-based PI-DoS framework that is guided by a constant-time surrogate reward and trains a large reasoning-model attacker to generate short natural prompts that drive victim LRMs into pathologically long and often effectively non-terminating reasoning. Across seven open-source models (including LLMs and LRMs) and three commercial LRMs, ReasoningBomb induces 18,759 completion tokens on average and 19,263 reasoning tokens on average across reasoning models. It outperforms the the runner-up baseline by 35% in completion tokens and 38% in reasoning tokens, while inducing 6-7x more tokens than benign queries and achieving 286.7x input-to-output amplification ratio averaged across all samples. Additionally, our method achieves 99.8% bypass rate on input-based detection, 98.7% on output-based detection, and 98.4% against strict dual-stage joint detection.

  • 8 authors
·
Jan 29

Model-free Approach to Evaluate a Censored Intermediate Outcome as a Surrogate for Overall Survival

Clinical trials or studies oftentimes require long-term and/or costly follow-up of participants to evaluate a novel treatment/drug/vaccine. There has been increasing interest in the past few decades in using short-term surrogate outcomes as a replacement of the primary outcome i.e., in using the surrogate outcome, which can potentially be observed sooner, to make inference about the treatment effect on the long-term primary outcome. Very few of the available statistical methods to evaluate a surrogate are applicable to settings where both the surrogate and the primary outcome are time-to-event outcomes subject to censoring. Methods that can handle this setting tend to require parametric assumptions or be limited to assessing only the restricted mean survival time. In this paper, we propose a non-parametric approach to evaluate a censored surrogate outcome, such as time to progression, when the primary outcome is also a censored time-to-event outcome, such as time to death, and the treatment effect of interest is the difference in overall survival. Specifically, we define the proportion of the treatment effect on the primary outcome that is explained (PTE) by the censored surrogate outcome in this context, and estimate this proportion by defining and deriving an optimal transformation of the surrogate information. Our approach provides the added advantage of relaxed assumptions to guarantee that the true PTE is within (0,1), along with being model-free. Finite sample performance of our estimators are illustrated via extensive simulation studies and a real data application examining progression-free survival as a surrogate for overall survival for patients with metastatic colorectal cancer.

  • 4 authors
·
Dec 18, 2024

A Systematic Survey of Prompt Engineering on Vision-Language Foundation Models

Prompt engineering is a technique that involves augmenting a large pre-trained model with task-specific hints, known as prompts, to adapt the model to new tasks. Prompts can be created manually as natural language instructions or generated automatically as either natural language instructions or vector representations. Prompt engineering enables the ability to perform predictions based solely on prompts without updating model parameters, and the easier application of large pre-trained models in real-world tasks. In past years, Prompt engineering has been well-studied in natural language processing. Recently, it has also been intensively studied in vision-language modeling. However, there is currently a lack of a systematic overview of prompt engineering on pre-trained vision-language models. This paper aims to provide a comprehensive survey of cutting-edge research in prompt engineering on three types of vision-language models: multimodal-to-text generation models (e.g. Flamingo), image-text matching models (e.g. CLIP), and text-to-image generation models (e.g. Stable Diffusion). For each type of model, a brief model summary, prompting methods, prompting-based applications, and the corresponding responsibility and integrity issues are summarized and discussed. Furthermore, the commonalities and differences between prompting on vision-language models, language models, and vision models are also discussed. The challenges, future directions, and research opportunities are summarized to foster future research on this topic.

  • 10 authors
·
Jul 24, 2023

Synthetic Patients: Simulating Difficult Conversations with Multimodal Generative AI for Medical Education

Problem: Effective patient-centered communication is a core competency for physicians. However, both seasoned providers and medical trainees report decreased confidence in leading conversations on sensitive topics such as goals of care or end-of-life discussions. The significant administrative burden and the resources required to provide dedicated training in leading difficult conversations has been a long-standing problem in medical education. Approach: In this work, we present a novel educational tool designed to facilitate interactive, real-time simulations of difficult conversations in a video-based format through the use of multimodal generative artificial intelligence (AI). Leveraging recent advances in language modeling, computer vision, and generative audio, this tool creates realistic, interactive scenarios with avatars, or "synthetic patients." These synthetic patients interact with users throughout various stages of medical care using a custom-built video chat application, offering learners the chance to practice conversations with patients from diverse belief systems, personalities, and ethnic backgrounds. Outcomes: While the development of this platform demanded substantial upfront investment in labor, it offers a highly-realistic simulation experience with minimal financial investment. For medical trainees, this educational tool can be implemented within programs to simulate patient-provider conversations and can be incorporated into existing palliative care curriculum to provide a scalable, high-fidelity simulation environment for mastering difficult conversations. Next Steps: Future developments will explore enhancing the authenticity of these encounters by working with patients to incorporate their histories and personalities, as well as employing the use of AI-generated evaluations to offer immediate, constructive feedback to learners post-simulation.

  • 2 authors
·
May 30, 2024

Can Generalist Foundation Models Outcompete Special-Purpose Tuning? Case Study in Medicine

Generalist foundation models such as GPT-4 have displayed surprising capabilities in a wide variety of domains and tasks. Yet, there is a prevalent assumption that they cannot match specialist capabilities of fine-tuned models. For example, most explorations to date on medical competency benchmarks have leveraged domain-specific training, as exemplified by efforts on BioGPT and Med-PaLM. We build on a prior study of GPT-4's capabilities on medical challenge benchmarks in the absence of special training. Rather than using simple prompting to highlight the model's out-of-the-box capabilities, we perform a systematic exploration of prompt engineering. We find that prompting innovation can unlock deeper specialist capabilities and show that GPT-4 easily tops prior leading results for medical benchmarks. The prompting methods we explore are general purpose, and make no specific use of domain expertise, removing the need for expert-curated content. Our experimental design carefully controls for overfitting during the prompt engineering process. We introduce Medprompt, based on a composition of several prompting strategies. With Medprompt, GPT-4 achieves state-of-the-art results on all nine of the benchmark datasets in the MultiMedQA suite. The method outperforms leading specialist models such as Med-PaLM 2 by a significant margin with an order of magnitude fewer calls to the model. Steering GPT-4 with Medprompt achieves a 27% reduction in error rate on the MedQA dataset over the best methods to date achieved with specialist models and surpasses a score of 90% for the first time. Beyond medical problems, we show the power of Medprompt to generalize to other domains and provide evidence for the broad applicability of the approach via studies of the strategy on exams in electrical engineering, machine learning, philosophy, accounting, law, nursing, and clinical psychology.

  • 18 authors
·
Nov 27, 2023

Human-in-the-loop Embodied Intelligence with Interactive Simulation Environment for Surgical Robot Learning

Surgical robot automation has attracted increasing research interest over the past decade, expecting its potential to benefit surgeons, nurses and patients. Recently, the learning paradigm of embodied intelligence has demonstrated promising ability to learn good control policies for various complex tasks, where embodied AI simulators play an essential role to facilitate relevant research. However, existing open-sourced simulators for surgical robot are still not sufficiently supporting human interactions through physical input devices, which further limits effective investigations on how the human demonstrations would affect policy learning. In this work, we study human-in-the-loop embodied intelligence with a new interactive simulation platform for surgical robot learning. Specifically, we establish our platform based on our previously released SurRoL simulator with several new features co-developed to allow high-quality human interaction via an input device. We showcase the improvement of our simulation environment with the designed new features, and validate effectiveness of incorporating human factors in embodied intelligence through the use of human demonstrations and reinforcement learning as a representative example. Promising results are obtained in terms of learning efficiency. Lastly, five new surgical robot training tasks are developed and released, with which we hope to pave the way for future research on surgical embodied intelligence. Our learning platform is publicly released and will be continuously updated in the website: https://med-air.github.io/SurRoL.

  • 5 authors
·
Jan 1, 2023

Towards Unifying Medical Vision-and-Language Pre-training via Soft Prompts

Medical vision-and-language pre-training (Med-VLP) has shown promising improvements on many downstream medical tasks owing to its applicability to extracting generic representations from medical images and texts. Practically, there exist two typical types, i.e., the fusion-encoder type and the dual-encoder type, depending on whether a heavy fusion module is used. The former is superior at multi-modal tasks owing to the sufficient interaction between modalities; the latter is good at uni-modal and cross-modal tasks due to the single-modality encoding ability. To take advantage of these two types, we propose an effective yet straightforward scheme named PTUnifier to unify the two types. We first unify the input format by introducing visual and textual prompts, which serve as a feature bank that stores the most representative images/texts. By doing so, a single model could serve as a foundation model that processes various tasks adopting different input formats (i.e., image-only, text-only, and image-text-pair). Furthermore, we construct a prompt pool (instead of static ones) to improve diversity and scalability. Experimental results show that our approach achieves state-of-the-art results on a broad range of tasks, spanning uni-modal tasks (i.e., image/text classification and text summarization), cross-modal tasks (i.e., image-to-text generation and image-text/text-image retrieval), and multi-modal tasks (i.e., visual question answering), demonstrating the effectiveness of our approach. Note that the adoption of prompts is orthogonal to most existing Med-VLP approaches and could be a beneficial and complementary extension to these approaches.

  • 5 authors
·
Feb 17, 2023

Incorporating Surrogate Gradient Norm to Improve Offline Optimization Techniques

Offline optimization has recently emerged as an increasingly popular approach to mitigate the prohibitively expensive cost of online experimentation. The key idea is to learn a surrogate of the black-box function that underlines the target experiment using a static (offline) dataset of its previous input-output queries. Such an approach is, however, fraught with an out-of-distribution issue where the learned surrogate becomes inaccurate outside the offline data regimes. To mitigate this, existing offline optimizers have proposed numerous conditioning techniques to prevent the learned surrogate from being too erratic. Nonetheless, such conditioning strategies are often specific to particular surrogate or search models, which might not generalize to a different model choice. This motivates us to develop a model-agnostic approach instead, which incorporates a notion of model sharpness into the training loss of the surrogate as a regularizer. Our approach is supported by a new theoretical analysis demonstrating that reducing surrogate sharpness on the offline dataset provably reduces its generalized sharpness on unseen data. Our analysis extends existing theories from bounding generalized prediction loss (on unseen data) with loss sharpness to bounding the worst-case generalized surrogate sharpness with its empirical estimate on training data, providing a new perspective on sharpness regularization. Our extensive experimentation on a diverse range of optimization tasks also shows that reducing surrogate sharpness often leads to significant improvement, marking (up to) a noticeable 9.6% performance boost. Our code is publicly available at https://github.com/cuong-dm/IGNITE

  • 4 authors
·
Mar 6, 2025

Automatic Prompt Optimization Techniques: Exploring the Potential for Synthetic Data Generation

Artificial Intelligence (AI) advancement is heavily dependent on access to large-scale, high-quality training data. However, in specialized domains such as healthcare, data acquisition faces significant constraints due to privacy regulations, ethical considerations, and limited availability. While synthetic data generation offers a promising solution, conventional approaches typically require substantial real data for training generative models. The emergence of large-scale prompt-based models presents new opportunities for synthetic data generation without direct access to protected data. However, crafting effective prompts for domain-specific data generation remains challenging, and manual prompt engineering proves insufficient for achieving output with sufficient precision and authenticity. We review recent developments in automatic prompt optimization, following PRISMA guidelines. We analyze six peer-reviewed studies published between 2020 and 2024 that focus on automatic data-free prompt optimization methods. Our analysis reveals three approaches: feedback-driven, error-based, and control-theoretic. Although all approaches demonstrate promising capabilities in prompt refinement and adaptation, our findings suggest the need for an integrated framework that combines complementary optimization techniques to enhance synthetic data generation while minimizing manual intervention. We propose future research directions toward developing robust, iterative prompt optimization frameworks capable of improving the quality of synthetic data. This advancement can be particularly crucial for sensitive fields and in specialized domains where data access is restricted, potentially transforming how we approach synthetic data generation for AI development.

  • 4 authors
·
Feb 5, 2025

Two Case Studies of Experience Prototyping Machine Learning Systems in the Wild

Throughout the course of my Ph.D., I have been designing the user experience (UX) of various machine learning (ML) systems. In this workshop, I share two projects as case studies in which people engage with ML in much more complicated and nuanced ways than the technical HCML work might assume. The first case study describes how cardiology teams in three hospitals used a clinical decision-support system that helps them decide whether and when to implant an artificial heart to a heart failure patient. I demonstrate that physicians cannot draw on their decision-making experience by seeing only patient data on paper. They are also confused by some fundamental premises upon which ML operates. For example, physicians asked: Are ML predictions made based on clinicians' best efforts? Is it ethical to make decisions based on previous patients' collective outcomes? In the second case study, my collaborators and I designed an intelligent text editor, with the goal of improving authors' writing experience with NLP (Natural Language Processing) technologies. We prototyped a number of generative functionalities where the system provides phrase-or-sentence-level writing suggestions upon user request. When writing with the prototype, however, authors shared that they need to "see where the sentence is going two paragraphs later" in order to decide whether the suggestion aligns with their writing; Some even considered adopting machine suggestions as plagiarism, therefore "is simply wrong". By sharing these unexpected and intriguing responses from these real-world ML users, I hope to start a discussion about such previously-unknown complexities and nuances of -- as the workshop proposal states -- "putting ML at the service of people in a way that is accessible, useful, and trustworthy to all".

  • 1 authors
·
Oct 20, 2019

Surgical tool classification and localization: results and methods from the MICCAI 2022 SurgToolLoc challenge

The ability to automatically detect and track surgical instruments in endoscopic videos can enable transformational interventions. Assessing surgical performance and efficiency, identifying skilled tool use and choreography, and planning operational and logistical aspects of OR resources are just a few of the applications that could benefit. Unfortunately, obtaining the annotations needed to train machine learning models to identify and localize surgical tools is a difficult task. Annotating bounding boxes frame-by-frame is tedious and time-consuming, yet large amounts of data with a wide variety of surgical tools and surgeries must be captured for robust training. Moreover, ongoing annotator training is needed to stay up to date with surgical instrument innovation. In robotic-assisted surgery, however, potentially informative data like timestamps of instrument installation and removal can be programmatically harvested. The ability to rely on tool installation data alone would significantly reduce the workload to train robust tool-tracking models. With this motivation in mind we invited the surgical data science community to participate in the challenge, SurgToolLoc 2022. The goal was to leverage tool presence data as weak labels for machine learning models trained to detect tools and localize them in video frames with bounding boxes. We present the results of this challenge along with many of the team's efforts. We conclude by discussing these results in the broader context of machine learning and surgical data science. The training data used for this challenge consisting of 24,695 video clips with tool presence labels is also being released publicly and can be accessed at https://console.cloud.google.com/storage/browser/isi-surgtoolloc-2022.

  • 71 authors
·
May 11, 2023

Med-PerSAM: One-Shot Visual Prompt Tuning for Personalized Segment Anything Model in Medical Domain

Leveraging pre-trained models with tailored prompts for in-context learning has proven highly effective in NLP tasks. Building on this success, recent studies have applied a similar approach to the Segment Anything Model (SAM) within a ``one-shot" framework, where only a single reference image and its label are employed. However, these methods face limitations in the medical domain, primarily due to SAM's essential requirement for visual prompts and the over-reliance on pixel similarity for generating them. This dependency may lead to (1) inaccurate prompt generation and (2) clustering of point prompts, resulting in suboptimal outcomes. To address these challenges, we introduce Med-PerSAM, a novel and straightforward one-shot framework designed for the medical domain. Med-PerSAM uses only visual prompt engineering and eliminates the need for additional training of the pretrained SAM or human intervention, owing to our novel automated prompt generation process. By integrating our lightweight warping-based prompt tuning model with SAM, we enable the extraction and iterative refinement of visual prompts, enhancing the performance of the pre-trained SAM. This advancement is particularly meaningful in the medical domain, where creating visual prompts poses notable challenges for individuals lacking medical expertise. Our model outperforms various foundational models and previous SAM-based approaches across diverse 2D medical imaging datasets.

  • 4 authors
·
Nov 25, 2024

Intent-based Prompt Calibration: Enhancing prompt optimization with synthetic boundary cases

Prompt engineering is a challenging and important task due to the high sensitivity of Large Language Models (LLMs) to the given prompt and the inherent ambiguity of a textual task instruction. Automatic prompt engineering is essential to achieve optimized performance from LLMs. Recent studies have demonstrated the capabilities of LLMs to automatically conduct prompt engineering by employing a meta-prompt that incorporates the outcomes of the last trials and proposes an improved prompt. However, this requires a high-quality benchmark to compare different prompts, which is difficult and expensive to acquire in many real-world use cases. In this work, we introduce a new method for automatic prompt engineering, using a calibration process that iteratively refines the prompt to the user intent. During the optimization process, the system jointly generates synthetic data of boundary use cases and optimizes the prompt according to the generated dataset. We demonstrate the effectiveness of our method with respect to strong proprietary models on real-world tasks such as moderation and generation. Our method outperforms state-of-the-art methods with a limited number of annotated samples. Furthermore, we validate the advantages of each one of the system's key components. Our system is built in a modular way, facilitating easy adaptation to other tasks. The code is available https://github.com/Eladlev/AutoPrompt{here}.

  • 3 authors
·
Feb 5, 2024

SynLLM: A Comparative Analysis of Large Language Models for Medical Tabular Synthetic Data Generation via Prompt Engineering

Access to real-world medical data is often restricted due to privacy regulations, posing a significant barrier to the advancement of healthcare research. Synthetic data offers a promising alternative; however, generating realistic, clinically valid, and privacy-conscious records remains a major challenge. Recent advancements in Large Language Models (LLMs) offer new opportunities for structured data generation; however, existing approaches frequently lack systematic prompting strategies and comprehensive, multi-dimensional evaluation frameworks. In this paper, we present SynLLM, a modular framework for generating high-quality synthetic medical tabular data using 20 state-of-the-art open-source LLMs, including LLaMA, Mistral, and GPT variants, guided by structured prompts. We propose four distinct prompt types, ranging from example-driven to rule-based constraints, that encode schema, metadata, and domain knowledge to control generation without model fine-tuning. Our framework features a comprehensive evaluation pipeline that rigorously assesses generated data across statistical fidelity, clinical consistency, and privacy preservation. We evaluate SynLLM across three public medical datasets, including Diabetes, Cirrhosis, and Stroke, using 20 open-source LLMs. Our results show that prompt engineering significantly impacts data quality and privacy risk, with rule-based prompts achieving the best privacy-quality balance. SynLLM establishes that, when guided by well-designed prompts and evaluated with robust, multi-metric criteria, LLMs can generate synthetic medical data that is both clinically plausible and privacy-aware, paving the way for safer and more effective data sharing in healthcare research.

  • 3 authors
·
Aug 11, 2025

A Systematic Survey of Prompt Engineering in Large Language Models: Techniques and Applications

Prompt engineering has emerged as an indispensable technique for extending the capabilities of large language models (LLMs) and vision-language models (VLMs). This approach leverages task-specific instructions, known as prompts, to enhance model efficacy without modifying the core model parameters. Rather than updating the model parameters, prompts allow seamless integration of pre-trained models into downstream tasks by eliciting desired model behaviors solely based on the given prompt. Prompts can be natural language instructions that provide context to guide the model or learned vector representations that activate relevant knowledge. This burgeoning field has enabled success across various applications, from question-answering to commonsense reasoning. However, there remains a lack of systematic organization and understanding of the diverse prompt engineering methods and techniques. This survey paper addresses the gap by providing a structured overview of recent advancements in prompt engineering, categorized by application area. For each prompting approach, we provide a summary detailing the prompting methodology, its applications, the models involved, and the datasets utilized. We also delve into the strengths and limitations of each approach and include a taxonomy diagram and table summarizing datasets, models, and critical points of each prompting technique. This systematic analysis enables a better understanding of this rapidly developing field and facilitates future research by illuminating open challenges and opportunities for prompt engineering.

  • 6 authors
·
Feb 5, 2024 1

Evaluation of GPT-3.5 and GPT-4 for supporting real-world information needs in healthcare delivery

Despite growing interest in using large language models (LLMs) in healthcare, current explorations do not assess the real-world utility and safety of LLMs in clinical settings. Our objective was to determine whether two LLMs can serve information needs submitted by physicians as questions to an informatics consultation service in a safe and concordant manner. Sixty six questions from an informatics consult service were submitted to GPT-3.5 and GPT-4 via simple prompts. 12 physicians assessed the LLM responses' possibility of patient harm and concordance with existing reports from an informatics consultation service. Physician assessments were summarized based on majority vote. For no questions did a majority of physicians deem either LLM response as harmful. For GPT-3.5, responses to 8 questions were concordant with the informatics consult report, 20 discordant, and 9 were unable to be assessed. There were 29 responses with no majority on "Agree", "Disagree", and "Unable to assess". For GPT-4, responses to 13 questions were concordant, 15 discordant, and 3 were unable to be assessed. There were 35 responses with no majority. Responses from both LLMs were largely devoid of overt harm, but less than 20% of the responses agreed with an answer from an informatics consultation service, responses contained hallucinated references, and physicians were divided on what constitutes harm. These results suggest that while general purpose LLMs are able to provide safe and credible responses, they often do not meet the specific information need of a given question. A definitive evaluation of the usefulness of LLMs in healthcare settings will likely require additional research on prompt engineering, calibration, and custom-tailoring of general purpose models.

  • 18 authors
·
Apr 26, 2023

Clinical Prompt Learning with Frozen Language Models

Prompt learning is a new paradigm in the Natural Language Processing (NLP) field which has shown impressive performance on a number of natural language tasks with common benchmarking text datasets in full, few-shot, and zero-shot train-evaluation setups. Recently, it has even been observed that large but frozen pre-trained language models (PLMs) with prompt learning outperform smaller but fine-tuned models. However, as with many recent NLP trends, the performance of even the largest PLMs such as GPT-3 do not perform well on specialized domains (e.g. medical text), and the common practice to achieve State of the Art (SoTA) results still consists of pre-training and fine-tuning the PLMs on downstream tasks. The reliance on fine-tuning large PLMs is problematic in clinical settings where data is often held in non-GPU environments, and more resource efficient methods of training specialized domain models is crucial. We investigated the viability of prompt learning on clinically meaningful decision tasks and directly compared with more traditional fine-tuning methods. Results are partially in line with the prompt learning literature, with prompt learning able to match or improve on traditional fine-tuning with substantially fewer trainable parameters and requiring less training data. We argue that prompt learning therefore provides lower computational resource costs applicable to clinical settings, that can serve as an alternative to fine-tuning ever increasing in size PLMs. Complementary code to reproduce experiments presented in this work can be found at: https://github.com/NtaylorOX/Public_Clinical_Prompt.

  • 5 authors
·
May 11, 2022

A Tutorial on Bayesian Optimization

Bayesian optimization is an approach to optimizing objective functions that take a long time (minutes or hours) to evaluate. It is best-suited for optimization over continuous domains of less than 20 dimensions, and tolerates stochastic noise in function evaluations. It builds a surrogate for the objective and quantifies the uncertainty in that surrogate using a Bayesian machine learning technique, Gaussian process regression, and then uses an acquisition function defined from this surrogate to decide where to sample. In this tutorial, we describe how Bayesian optimization works, including Gaussian process regression and three common acquisition functions: expected improvement, entropy search, and knowledge gradient. We then discuss more advanced techniques, including running multiple function evaluations in parallel, multi-fidelity and multi-information source optimization, expensive-to-evaluate constraints, random environmental conditions, multi-task Bayesian optimization, and the inclusion of derivative information. We conclude with a discussion of Bayesian optimization software and future research directions in the field. Within our tutorial material we provide a generalization of expected improvement to noisy evaluations, beyond the noise-free setting where it is more commonly applied. This generalization is justified by a formal decision-theoretic argument, standing in contrast to previous ad hoc modifications.

  • 1 authors
·
Jul 8, 2018

Target-based Surrogates for Stochastic Optimization

We consider minimizing functions for which it is expensive to compute the (possibly stochastic) gradient. Such functions are prevalent in reinforcement learning, imitation learning and adversarial training. Our target optimization framework uses the (expensive) gradient computation to construct surrogate functions in a target space (e.g. the logits output by a linear model for classification) that can be minimized efficiently. This allows for multiple parameter updates to the model, amortizing the cost of gradient computation. In the full-batch setting, we prove that our surrogate is a global upper-bound on the loss, and can be (locally) minimized using a black-box optimization algorithm. We prove that the resulting majorization-minimization algorithm ensures convergence to a stationary point of the loss. Next, we instantiate our framework in the stochastic setting and propose the SSO algorithm, which can be viewed as projected stochastic gradient descent in the target space. This connection enables us to prove theoretical guarantees for SSO when minimizing convex functions. Our framework allows the use of standard stochastic optimization algorithms to construct surrogates which can be minimized by any deterministic optimization method. To evaluate our framework, we consider a suite of supervised learning and imitation learning problems. Our experiments indicate the benefits of target optimization and the effectiveness of SSO.

  • 5 authors
·
Feb 6, 2023

The impact of using an AI chatbot to respond to patient messages

Documentation burden is a major contributor to clinician burnout, which is rising nationally and is an urgent threat to our ability to care for patients. Artificial intelligence (AI) chatbots, such as ChatGPT, could reduce clinician burden by assisting with documentation. Although many hospitals are actively integrating such systems into electronic medical record systems, AI chatbots utility and impact on clinical decision-making have not been studied for this intended use. We are the first to examine the utility of large language models in assisting clinicians draft responses to patient questions. In our two-stage cross-sectional study, 6 oncologists responded to 100 realistic synthetic cancer patient scenarios and portal messages developed to reflect common medical situations, first manually, then with AI assistance. We find AI-assisted responses were longer, less readable, but provided acceptable drafts without edits 58% of time. AI assistance improved efficiency 77% of time, with low harm risk (82% safe). However, 7.7% unedited AI responses could severely harm. In 31% cases, physicians thought AI drafts were human-written. AI assistance led to more patient education recommendations, fewer clinical actions than manual responses. Results show promise for AI to improve clinician efficiency and patient care through assisting documentation, if used judiciously. Monitoring model outputs and human-AI interaction remains crucial for safe implementation.

  • 15 authors
·
Oct 26, 2023

Self-regulating Prompts: Foundational Model Adaptation without Forgetting

Prompt learning has emerged as an efficient alternative for fine-tuning foundational models, such as CLIP, for various downstream tasks. Conventionally trained using the task-specific objective, i.e., cross-entropy loss, prompts tend to overfit downstream data distributions and find it challenging to capture task-agnostic general features from the frozen CLIP. This leads to the loss of the model's original generalization capability. To address this issue, our work introduces a self-regularization framework for prompting called PromptSRC (Prompting with Self-regulating Constraints). PromptSRC guides the prompts to optimize for both task-specific and task-agnostic general representations using a three-pronged approach by: (a) regulating prompted representations via mutual agreement maximization with the frozen model, (b) regulating with self-ensemble of prompts over the training trajectory to encode their complementary strengths, and (c) regulating with textual diversity to mitigate sample diversity imbalance with the visual branch. To the best of our knowledge, this is the first regularization framework for prompt learning that avoids overfitting by jointly attending to pre-trained model features, the training trajectory during prompting, and the textual diversity. PromptSRC explicitly steers the prompts to learn a representation space that maximizes performance on downstream tasks without compromising CLIP generalization. We perform extensive experiments on 4 benchmarks where PromptSRC overall performs favorably well compared to the existing methods. Our code and pre-trained models are publicly available at: https://github.com/muzairkhattak/PromptSRC.

  • 6 authors
·
Jul 13, 2023

Am I eligible? Natural Language Inference for Clinical Trial Patient Recruitment: the Patient's Point of View

Recruiting patients to participate in clinical trials can be challenging and time-consuming. Usually, participation in a clinical trial is initiated by a healthcare professional and proposed to the patient. Promoting clinical trials directly to patients via online recruitment might help to reach them more efficiently. In this study, we address the case where a patient is initiating their own recruitment process and wants to determine whether they are eligible for a given clinical trial, using their own language to describe their medical profile. To study whether this creates difficulties in the patient trial matching process, we design a new dataset and task, Natural Language Inference for Patient Recruitment (NLI4PR), in which patient language profiles must be matched to clinical trials. We create it by adapting the TREC 2022 Clinical Trial Track dataset, which provides patients' medical profiles, and rephrasing them manually using patient language. We also use the associated clinical trial reports where the patients are either eligible or excluded. We prompt several open-source Large Language Models on our task and achieve from 56.5 to 71.8 of F1 score using patient language, against 64.7 to 73.1 for the same task using medical language. When using patient language, we observe only a small loss in performance for the best model, suggesting that having the patient as a starting point could be adopted to help recruit patients for clinical trials. The corpus and code bases are all freely available on our Github and HuggingFace repositories.

  • 3 authors
·
Mar 19, 2025

Prompt2Perturb (P2P): Text-Guided Diffusion-Based Adversarial Attacks on Breast Ultrasound Images

Deep neural networks (DNNs) offer significant promise for improving breast cancer diagnosis in medical imaging. However, these models are highly susceptible to adversarial attacks--small, imperceptible changes that can mislead classifiers--raising critical concerns about their reliability and security. Traditional attacks rely on fixed-norm perturbations, misaligning with human perception. In contrast, diffusion-based attacks require pre-trained models, demanding substantial data when these models are unavailable, limiting practical use in data-scarce scenarios. In medical imaging, however, this is often unfeasible due to the limited availability of datasets. Building on recent advancements in learnable prompts, we propose Prompt2Perturb (P2P), a novel language-guided attack method capable of generating meaningful attack examples driven by text instructions. During the prompt learning phase, our approach leverages learnable prompts within the text encoder to create subtle, yet impactful, perturbations that remain imperceptible while guiding the model towards targeted outcomes. In contrast to current prompt learning-based approaches, our P2P stands out by directly updating text embeddings, avoiding the need for retraining diffusion models. Further, we leverage the finding that optimizing only the early reverse diffusion steps boosts efficiency while ensuring that the generated adversarial examples incorporate subtle noise, thus preserving ultrasound image quality without introducing noticeable artifacts. We show that our method outperforms state-of-the-art attack techniques across three breast ultrasound datasets in FID and LPIPS. Moreover, the generated images are both more natural in appearance and more effective compared to existing adversarial attacks. Our code will be publicly available https://github.com/yasamin-med/P2P.

  • 5 authors
·
Dec 13, 2024 2

PromptAgent: Strategic Planning with Language Models Enables Expert-level Prompt Optimization

Highly effective, task-specific prompts are often heavily engineered by experts to integrate detailed instructions and domain insights based on a deep understanding of both instincts of large language models (LLMs) and the intricacies of the target task. However, automating the generation of such expert-level prompts remains elusive. Existing prompt optimization methods tend to overlook the depth of domain knowledge and struggle to efficiently explore the vast space of expert-level prompts. Addressing this, we present PromptAgent, an optimization method that autonomously crafts prompts equivalent in quality to those handcrafted by experts. At its core, PromptAgent views prompt optimization as a strategic planning problem and employs a principled planning algorithm, rooted in Monte Carlo tree search, to strategically navigate the expert-level prompt space. Inspired by human-like trial-and-error exploration, PromptAgent induces precise expert-level insights and in-depth instructions by reflecting on model errors and generating constructive error feedback. Such a novel framework allows the agent to iteratively examine intermediate prompts (states), refine them based on error feedbacks (actions), simulate future rewards, and search for high-reward paths leading to expert prompts. We apply PromptAgent to 12 tasks spanning three practical domains: BIG-Bench Hard (BBH), as well as domain-specific and general NLP tasks, showing it significantly outperforms strong Chain-of-Thought and recent prompt optimization baselines. Extensive analyses emphasize its capability to craft expert-level, detailed, and domain-insightful prompts with great efficiency and generalizability.

  • 9 authors
·
Oct 25, 2023

A Benchmark Time Series Dataset for Semiconductor Fabrication Manufacturing Constructed using Component-based Discrete-Event Simulation Models

Advancements in high-computing devices increase the necessity for improved and new understanding and development of smart manufacturing factories. Discrete-event models with simulators have been shown to be critical to architect, designing, building, and operating the manufacturing of semiconductor chips. The diffusion, implantation, and lithography machines have intricate processes due to their feedforward and feedback connectivity. The dataset collected from simulations of the factory models holds the promise of generating valuable machine-learning models. As surrogate data-based models, their executions are highly efficient compared to the physics-based counterpart models. For the development of surrogate models, it is beneficial to have publicly available benchmark simulation models that are grounded in factory models that have concise structures and accurate behaviors. Hence, in this research, a dataset is devised and constructed based on a benchmark model of an Intel semiconductor fabrication factory. The model is formalized using the Parallel Discrete-Event System Specification and executed using the DEVS-Suite simulator. The time series dataset is constructed using discrete-event time trajectories. This dataset is further analyzed and used to develop baseline univariate and multivariate machine learning models. The dataset can also be utilized in the machine learning community for behavioral analysis based on formalized and scalable component-based discrete-event models and simulations.

  • 4 authors
·
Aug 17, 2024

CAP-IQA: Context-Aware Prompt-Guided CT Image Quality Assessment

Prompt-based methods, which encode medical priors through descriptive text, have been only minimally explored for CT Image Quality Assessment (IQA). While such prompts can embed prior knowledge about diagnostic quality, they often introduce bias by reflecting idealized definitions that may not hold under real-world degradations such as noise, motion artifacts, or scanner variability. To address this, we propose the Context-Aware Prompt-guided Image Quality Assessment (CAP-IQA) framework, which integrates text-level priors with instance-level context prompts and applies causal debiasing to separate idealized knowledge from factual, image-specific degradations. Our framework combines a CNN-based visual encoder with a domain-specific text encoder to assess diagnostic visibility, anatomical clarity, and noise perception in abdominal CT images. The model leverages radiology-style prompts and context-aware fusion to align semantic and perceptual representations. On the 2023 LDCTIQA challenge benchmark, CAP-IQA achieves an overall correlation score of 2.8590 (sum of PLCC, SROCC, and KROCC), surpassing the top-ranked leaderboard team (2.7427) by 4.24%. Moreover, our comprehensive ablation experiments confirm that prompt-guided fusion and the simplified encoder-only design jointly enhance feature alignment and interpretability. Furthermore, evaluation on an in-house dataset of 91,514 pediatric CT images demonstrates the true generalizability of CAP-IQA in assessing perceptual fidelity in a different patient population.

  • 3 authors
·
Jan 4

IPO: Interpretable Prompt Optimization for Vision-Language Models

Pre-trained vision-language models like CLIP have remarkably adapted to various downstream tasks. Nonetheless, their performance heavily depends on the specificity of the input text prompts, which requires skillful prompt template engineering. Instead, current approaches to prompt optimization learn the prompts through gradient descent, where the prompts are treated as adjustable parameters. However, these methods tend to lead to overfitting of the base classes seen during training and produce prompts that are no longer understandable by humans. This paper introduces a simple but interpretable prompt optimizer (IPO), that utilizes large language models (LLMs) to generate textual prompts dynamically. We introduce a Prompt Optimization Prompt that not only guides LLMs in creating effective prompts but also stores past prompts with their performance metrics, providing rich in-context information. Additionally, we incorporate a large multimodal model (LMM) to condition on visual content by generating image descriptions, which enhance the interaction between textual and visual modalities. This allows for thae creation of dataset-specific prompts that improve generalization performance, while maintaining human comprehension. Extensive testing across 11 datasets reveals that IPO not only improves the accuracy of existing gradient-descent-based prompt learning methods but also considerably enhances the interpretability of the generated prompts. By leveraging the strengths of LLMs, our approach ensures that the prompts remain human-understandable, thereby facilitating better transparency and oversight for vision-language models.

  • 3 authors
·
Oct 20, 2024

SurgRAW: Multi-Agent Workflow with Chain-of-Thought Reasoning for Surgical Intelligence

Integration of Vision-Language Models (VLMs) in surgical intelligence is hindered by hallucinations, domain knowledge gaps, and limited understanding of task interdependencies within surgical scenes, undermining clinical reliability. While recent VLMs demonstrate strong general reasoning and thinking capabilities, they still lack the domain expertise and task-awareness required for precise surgical scene interpretation. Although Chain-of-Thought (CoT) can structure reasoning more effectively, current approaches rely on self-generated CoT steps, which often exacerbate inherent domain gaps and hallucinations. To overcome this, we present SurgRAW, a CoT-driven multi-agent framework that delivers transparent, interpretable insights for most tasks in robotic-assisted surgery. By employing specialized CoT prompts across five tasks: instrument recognition, action recognition, action prediction, patient data extraction, and outcome assessment, SurgRAW mitigates hallucinations through structured, domain-aware reasoning. Retrieval-Augmented Generation (RAG) is also integrated to external medical knowledge to bridge domain gaps and improve response reliability. Most importantly, a hierarchical agentic system ensures that CoT-embedded VLM agents collaborate effectively while understanding task interdependencies, with a panel discussion mechanism promotes logical consistency. To evaluate our method, we introduce SurgCoTBench, the first reasoning-based dataset with structured frame-level annotations. With comprehensive experiments, we demonstrate the effectiveness of proposed SurgRAW with 29.32% accuracy improvement over baseline VLMs on 12 robotic procedures, achieving the state-of-the-art performance and advancing explainable, trustworthy, and autonomous surgical assistance.

  • 7 authors
·
Mar 13, 2025

Ask Me Anything: A simple strategy for prompting language models

Large language models (LLMs) transfer well to new tasks out-of-the-box simply given a natural language prompt that demonstrates how to perform the task and no additional training. Prompting is a brittle process wherein small modifications to the prompt can cause large variations in the model predictions, and therefore significant effort is dedicated towards designing a painstakingly "perfect prompt" for a task. To mitigate the high degree of effort involved in prompt-design, we instead ask whether producing multiple effective, yet imperfect, prompts and aggregating them can lead to a high quality prompting strategy. Our observations motivate our proposed prompting method, ASK ME ANYTHING (AMA). We first develop an understanding of the effective prompt formats, finding that question-answering (QA) prompts, which encourage open-ended generation ("Who went to the park?") tend to outperform those that restrict the model outputs ("John went to the park. Output True or False."). Our approach recursively uses the LLM itself to transform task inputs to the effective QA format. We apply the collected prompts to obtain several noisy votes for the input's true label. We find that the prompts can have very different accuracies and complex dependencies and thus propose to use weak supervision, a procedure for combining the noisy predictions, to produce the final predictions for the inputs. We evaluate AMA across open-source model families (e.g., EleutherAI, BLOOM, OPT, and T0) and model sizes (125M-175B parameters), demonstrating an average performance lift of 10.2% over the few-shot baseline. This simple strategy enables the open-source GPT-J-6B model to match and exceed the performance of few-shot GPT3-175B on 15 of 20 popular benchmarks. Averaged across these tasks, the GPT-J-6B model outperforms few-shot GPT3-175B. We release our code here: https://github.com/HazyResearch/ama_prompting

  • 9 authors
·
Oct 5, 2022

AI-Facilitated Analysis of Abstracts and Conclusions: Flagging Unsubstantiated Claims and Ambiguous Pronouns

We present and evaluate a suite of proof-of-concept (PoC), structured workflow prompts designed to elicit human-like hierarchical reasoning while guiding Large Language Models (LLMs) in the high-level semantic and linguistic analysis of scholarly manuscripts. The prompts target two non-trivial analytical tasks within academic summaries (abstracts and conclusions): identifying unsubstantiated claims (informational integrity) and flagging semantically confusing ambiguous pronoun references (linguistic clarity). We conducted a systematic, multi-run evaluation on two frontier models (Gemini Pro 2.5 Pro and ChatGPT Plus o3) under varied context conditions. Our results for the informational integrity task reveal a significant divergence in model performance: while both models successfully identified an unsubstantiated head of a noun phrase (95% success), ChatGPT consistently failed (0% success) to identify an unsubstantiated adjectival modifier that Gemini correctly flagged (95% success), raising a question regarding the potential influence of the target's syntactic role. For the linguistic analysis task, both models performed well (80-90% success) with full manuscript context. Surprisingly, in a summary-only setting, Gemini's performance was substantially degraded, while ChatGPT achieved a perfect (100%) success rate. Our findings suggest that while structured prompting is a viable methodology for complex textual analysis, prompt performance may be highly dependent on the interplay between the model, task type, and context, highlighting the need for rigorous, model-specific testing.

  • 1 authors
·
Jun 16, 2025 2

Promptor: A Conversational and Autonomous Prompt Generation Agent for Intelligent Text Entry Techniques

Text entry is an essential task in our day-to-day digital interactions. Numerous intelligent features have been developed to streamline this process, making text entry more effective, efficient, and fluid. These improvements include sentence prediction and user personalization. However, as deep learning-based language models become the norm for these advanced features, the necessity for data collection and model fine-tuning increases. These challenges can be mitigated by harnessing the in-context learning capability of large language models such as GPT-3.5. This unique feature allows the language model to acquire new skills through prompts, eliminating the need for data collection and fine-tuning. Consequently, large language models can learn various text prediction techniques. We initially showed that, for a sentence prediction task, merely prompting GPT-3.5 surpassed a GPT-2 backed system and is comparable with a fine-tuned GPT-3.5 model, with the latter two methods requiring costly data collection, fine-tuning and post-processing. However, the task of prompting large language models to specialize in specific text prediction tasks can be challenging, particularly for designers without expertise in prompt engineering. To address this, we introduce Promptor, a conversational prompt generation agent designed to engage proactively with designers. Promptor can automatically generate complex prompts tailored to meet specific needs, thus offering a solution to this challenge. We conducted a user study involving 24 participants creating prompts for three intelligent text entry tasks, half of the participants used Promptor while the other half designed prompts themselves. The results show that Promptor-designed prompts result in a 35% increase in similarity and 22% in coherence over those by designers.

  • 5 authors
·
Oct 12, 2023

Evolving Prompts In-Context: An Open-ended, Self-replicating Perspective

We propose a novel prompt design paradigm that challenges conventional wisdom in large language model (LLM) prompting. While conventional wisdom prioritizes well-crafted instructions and demonstrations for in-context learning (ICL), we show that pruning random demonstrations into seemingly incoherent "gibberish" can remarkably improve performance across diverse tasks. Notably, the "gibberish" always matches or surpasses state-of-the-art automatic prompt optimization techniques, achieving substantial gains regardless of LLM alignment. Nevertheless, discovering an effective pruning strategy is non-trivial, as existing attribution methods and prompt compression algorithms fail to deliver robust results, let alone human intuition. In terms of this, we propose a self-discover prompt optimization framework, PromptQuine, an evolutionary search framework that automatically searches for the pruning strategy by itself using only low-data regimes. Much like the emergent complexity in nature--such as symbiosis and self-organization--arising in response to resource constraints, our framework evolves and refines unconventional yet highly effective prompts by leveraging only the tokens present within the context. We demonstrate its effectiveness across classification, multi-choice question answering, generation and math reasoning tasks across LLMs, while achieving decent runtime efficiency. We hope our findings can guide mechanistic studies on in-context learning, and provide a call to action, to pave the way for more open-ended search algorithms for more effective LLM prompting.

  • 3 authors
·
Jun 22, 2025 2

Understanding prompt engineering may not require rethinking generalization

Zero-shot learning in prompted vision-language models, the practice of crafting prompts to build classifiers without an explicit training process, has achieved impressive performance in many settings. This success presents a seemingly surprising observation: these methods suffer relatively little from overfitting, i.e., when a prompt is manually engineered to achieve low error on a given training set (thus rendering the method no longer actually zero-shot), the approach still performs well on held-out test data. In this paper, we show that we can explain such performance well via recourse to classical PAC-Bayes bounds. Specifically, we show that the discrete nature of prompts, combined with a PAC-Bayes prior given by a language model, results in generalization bounds that are remarkably tight by the standards of the literature: for instance, the generalization bound of an ImageNet classifier is often within a few percentage points of the true test error. We demonstrate empirically that this holds for existing handcrafted prompts and prompts generated through simple greedy search. Furthermore, the resulting bound is well-suited for model selection: the models with the best bound typically also have the best test performance. This work thus provides a possible justification for the widespread practice of prompt engineering, even if it seems that such methods could potentially overfit the training data.

  • 4 authors
·
Oct 5, 2023

BiomedCoOp: Learning to Prompt for Biomedical Vision-Language Models

Recent advancements in vision-language models (VLMs), such as CLIP, have demonstrated substantial success in self-supervised representation learning for vision tasks. However, effectively adapting VLMs to downstream applications remains challenging, as their accuracy often depends on time-intensive and expertise-demanding prompt engineering, while full model fine-tuning is costly. This is particularly true for biomedical images, which, unlike natural images, typically suffer from limited annotated datasets, unintuitive image contrasts, and nuanced visual features. Recent prompt learning techniques, such as Context Optimization (CoOp) intend to tackle these issues, but still fall short in generalizability. Meanwhile, explorations in prompt learning for biomedical image analysis are still highly limited. In this work, we propose BiomedCoOp, a novel prompt learning framework that enables efficient adaptation of BiomedCLIP for accurate and highly generalizable few-shot biomedical image classification. Our approach achieves effective prompt context learning by leveraging semantic consistency with average prompt ensembles from Large Language Models (LLMs) and knowledge distillation with a statistics-based prompt selection strategy. We conducted comprehensive validation of our proposed framework on 11 medical datasets across 9 modalities and 10 organs against existing state-of-the-art methods, demonstrating significant improvements in both accuracy and generalizability. The code is publicly available at https://github.com/HealthX-Lab/BiomedCoOp.

  • 4 authors
·
Nov 21, 2024

Comparing the Efficacy of GPT-4 and Chat-GPT in Mental Health Care: A Blind Assessment of Large Language Models for Psychological Support

Background: Rapid advancements in natural language processing have led to the development of large language models with the potential to revolutionize mental health care. These models have shown promise in assisting clinicians and providing support to individuals experiencing various psychological challenges. Objective: This study aims to compare the performance of two large language models, GPT-4 and Chat-GPT, in responding to a set of 18 psychological prompts, to assess their potential applicability in mental health care settings. Methods: A blind methodology was employed, with a clinical psychologist evaluating the models' responses without knowledge of their origins. The prompts encompassed a diverse range of mental health topics, including depression, anxiety, and trauma, to ensure a comprehensive assessment. Results: The results demonstrated a significant difference in performance between the two models (p > 0.05). GPT-4 achieved an average rating of 8.29 out of 10, while Chat-GPT received an average rating of 6.52. The clinical psychologist's evaluation suggested that GPT-4 was more effective at generating clinically relevant and empathetic responses, thereby providing better support and guidance to potential users. Conclusions: This study contributes to the growing body of literature on the applicability of large language models in mental health care settings. The findings underscore the importance of continued research and development in the field to optimize these models for clinical use. Further investigation is necessary to understand the specific factors underlying the performance differences between the two models and to explore their generalizability across various populations and mental health conditions.

  • 1 authors
·
May 15, 2024

OVERT: A Benchmark for Over-Refusal Evaluation on Text-to-Image Models

Text-to-Image (T2I) models have achieved remarkable success in generating visual content from text inputs. Although multiple safety alignment strategies have been proposed to prevent harmful outputs, they often lead to overly cautious behavior -- rejecting even benign prompts -- a phenomenon known as over-refusal that reduces the practical utility of T2I models. Despite over-refusal having been observed in practice, there is no large-scale benchmark that systematically evaluates this phenomenon for T2I models. In this paper, we present an automatic workflow to construct synthetic evaluation data, resulting in OVERT (OVEr-Refusal evaluation on Text-to-image models), the first large-scale benchmark for assessing over-refusal behaviors in T2I models. OVERT includes 4,600 seemingly harmful but benign prompts across nine safety-related categories, along with 1,785 genuinely harmful prompts (OVERT-unsafe) to evaluate the safety-utility trade-off. Using OVERT, we evaluate several leading T2I models and find that over-refusal is a widespread issue across various categories (Figure 1), underscoring the need for further research to enhance the safety alignment of T2I models without compromising their functionality. As a preliminary attempt to reduce over-refusal, we explore prompt rewriting; however, we find it often compromises faithfulness to the meaning of the original prompts. Finally, we demonstrate the flexibility of our generation framework in accommodating diverse safety requirements by generating customized evaluation data adapting to user-defined policies.

  • 7 authors
·
May 27, 2025

Distilled Prompt Learning for Incomplete Multimodal Survival Prediction

The integration of multimodal data including pathology images and gene profiles is widely applied in precise survival prediction. Despite recent advances in multimodal survival models, collecting complete modalities for multimodal fusion still poses a significant challenge, hindering their application in clinical settings. Current approaches tackling incomplete modalities often fall short, as they typically compensate for only a limited part of the knowledge of missing modalities. To address this issue, we propose a Distilled Prompt Learning framework (DisPro) to utilize the strong robustness of Large Language Models (LLMs) to missing modalities, which employs two-stage prompting for compensation of comprehensive information for missing modalities. In the first stage, Unimodal Prompting (UniPro) distills the knowledge distribution of each modality, preparing for supplementing modality-specific knowledge of the missing modality in the subsequent stage. In the second stage, Multimodal Prompting (MultiPro) leverages available modalities as prompts for LLMs to infer the missing modality, which provides modality-common information. Simultaneously, the unimodal knowledge acquired in the first stage is injected into multimodal inference to compensate for the modality-specific knowledge of the missing modality. Extensive experiments covering various missing scenarios demonstrated the superiority of the proposed method. The code is available at https://github.com/Innse/DisPro.

  • 6 authors
·
Mar 3, 2025

Bayesian Prompt Flow Learning for Zero-Shot Anomaly Detection

Recently, vision-language models (e.g. CLIP) have demonstrated remarkable performance in zero-shot anomaly detection (ZSAD). By leveraging auxiliary data during training, these models can directly perform cross-category anomaly detection on target datasets, such as detecting defects on industrial product surfaces or identifying tumors in organ tissues. Existing approaches typically construct text prompts through either manual design or the optimization of learnable prompt vectors. However, these methods face several challenges: 1) handcrafted prompts require extensive expert knowledge and trial-and-error; 2) single-form learnable prompts struggle to capture complex anomaly semantics; and 3) an unconstrained prompt space limits generalization to unseen categories. To address these issues, we propose Bayesian Prompt Flow Learning (Bayes-PFL), which models the prompt space as a learnable probability distribution from a Bayesian perspective. Specifically, a prompt flow module is designed to learn both image-specific and image-agnostic distributions, which are jointly utilized to regularize the text prompt space and improve the model's generalization on unseen categories. These learned distributions are then sampled to generate diverse text prompts, effectively covering the prompt space. Additionally, a residual cross-model attention (RCA) module is introduced to better align dynamic text embeddings with fine-grained image features. Extensive experiments on 15 industrial and medical datasets demonstrate our method's superior performance. The code is available at https://github.com/xiaozhen228/Bayes-PFL.

  • 8 authors
·
Mar 13, 2025

ConES: Concept Embedding Search for Parameter Efficient Tuning Large Vision Language Models

Large pre-trained vision-language models have shown great prominence in transferring pre-acquired knowledge to various domains and downstream tasks with appropriate prompting or tuning. Existing prevalent tuning methods can be generally categorized into three genres: 1) prompt engineering by creating suitable prompt texts, which is time-consuming and requires domain expertise; 2) or simply fine-tuning the whole model, which is extremely inefficient; 3) prompt tuning through parameterized prompt embeddings with the text encoder. Nevertheless, all methods rely on the text encoder for bridging the modality gap between vision and language. In this work, we question the necessity of the cumbersome text encoder for a more lightweight and efficient tuning paradigm as well as more representative prompt embeddings closer to the image representations. To achieve this, we propose a Concept Embedding Search (ConES) approach by optimizing prompt embeddings -- without the need of the text encoder -- to capture the 'concept' of the image modality through a variety of task objectives. By dropping the text encoder, we are able to significantly speed up the learning process, \eg, from about an hour to just ten minutes in our experiments for personalized text-to-image generation without impairing the generation quality. Moreover, our proposed approach is orthogonal to current existing tuning methods since the searched concept embeddings can be further utilized in the next stage of fine-tuning the pre-trained large models for boosting performance. Extensive experiments show that our approach can beat the prompt tuning and textual inversion methods in a variety of downstream tasks including objection detection, instance segmentation, and image generation. Our approach also shows better generalization capability for unseen concepts in specialized domains, such as the medical domain.

  • 8 authors
·
May 30, 2023

ChatGPT4PCG 2 Competition: Prompt Engineering for Science Birds Level Generation

This paper presents the second ChatGPT4PCG competition at the 2024 IEEE Conference on Games. In this edition of the competition, we follow the first edition, but make several improvements and changes. We introduce a new evaluation metric along with allowing a more flexible format for participants' submissions and making several improvements to the evaluation pipeline. Continuing from the first edition, we aim to foster and explore the realm of prompt engineering (PE) for procedural content generation (PCG). While the first competition saw success, it was hindered by various limitations; we aim to mitigate these limitations in this edition. We introduce diversity as a new metric to discourage submissions aimed at producing repetitive structures. Furthermore, we allow submission of a Python program instead of a prompt text file for greater flexibility in implementing advanced PE approaches, which may require control flow, including conditions and iterations. We also make several improvements to the evaluation pipeline with a better classifier for similarity evaluation and better-performing function signatures. We thoroughly evaluate the effectiveness of the new metric and the improved classifier. Additionally, we perform an ablation study to select a function signature to instruct ChatGPT for level generation. Finally, we provide implementation examples of various PE techniques in Python and evaluate their preliminary performance. We hope this competition serves as a resource and platform for learning about PE and PCG in general.

  • 8 authors
·
Mar 4, 2024

From Medprompt to o1: Exploration of Run-Time Strategies for Medical Challenge Problems and Beyond

Run-time steering strategies like Medprompt are valuable for guiding large language models (LLMs) to top performance on challenging tasks. Medprompt demonstrates that a general LLM can be focused to deliver state-of-the-art performance on specialized domains like medicine by using a prompt to elicit a run-time strategy involving chain of thought reasoning and ensembling. OpenAI's o1-preview model represents a new paradigm, where a model is designed to do run-time reasoning before generating final responses. We seek to understand the behavior of o1-preview on a diverse set of medical challenge problem benchmarks. Following on the Medprompt study with GPT-4, we systematically evaluate the o1-preview model across various medical benchmarks. Notably, even without prompting techniques, o1-preview largely outperforms the GPT-4 series with Medprompt. We further systematically study the efficacy of classic prompt engineering strategies, as represented by Medprompt, within the new paradigm of reasoning models. We found that few-shot prompting hinders o1's performance, suggesting that in-context learning may no longer be an effective steering approach for reasoning-native models. While ensembling remains viable, it is resource-intensive and requires careful cost-performance optimization. Our cost and accuracy analysis across run-time strategies reveals a Pareto frontier, with GPT-4o representing a more affordable option and o1-preview achieving state-of-the-art performance at higher cost. Although o1-preview offers top performance, GPT-4o with steering strategies like Medprompt retains value in specific contexts. Moreover, we note that the o1-preview model has reached near-saturation on many existing medical benchmarks, underscoring the need for new, challenging benchmarks. We close with reflections on general directions for inference-time computation with LLMs.

  • 7 authors
·
Nov 5, 2024 1

Red Teaming for Generative AI, Report on a Copyright-Focused Exercise Completed in an Academic Medical Center

Background: Generative artificial intelligence (AI) deployment in academic medical settings raises copyright compliance concerns. Dana-Farber Cancer Institute implemented GPT4DFCI, an internal generative AI tool utilizing OpenAI models, that is approved for enterprise use in research and operations. Given (1) the exceptionally broad adoption of the tool in our organization, (2) our research mission, and (3) the shared responsibility model required to benefit from Customer Copyright Commitment in Azure OpenAI Service products, we deemed rigorous copyright compliance testing necessary. Case Description: We conducted a structured red teaming exercise in Nov. 2024, with 42 participants from academic, industry, and government institutions. Four teams attempted to extract copyrighted content from GPT4DFCI across four domains: literary works, news articles, scientific publications, and access-restricted clinical notes. Teams successfully extracted verbatim book dedications and near-exact passages through various strategies. News article extraction failed despite jailbreak attempts. Scientific article reproduction yielded only high-level summaries. Clinical note testing revealed appropriate privacy safeguards. Discussion: The successful extraction of literary content indicates potential copyrighted material presence in training data, necessitating inference-time filtering. Differential success rates across content types suggest varying protective mechanisms. The event led to implementation of a copyright-specific meta-prompt in GPT4DFCI; this mitigation has been in production since Jan. 2025. Conclusion: Systematic red teaming revealed specific vulnerabilities in generative AI copyright compliance, leading to concrete mitigation strategies. Academic medical institutions deploying generative AI should implement continuous testing protocols to ensure legal and ethical compliance.

  • 41 authors
·
Jun 26, 2025

PRE: Vision-Language Prompt Learning with Reparameterization Encoder

Large pre-trained vision-language models such as CLIP have demonstrated great potential in zero-shot transferability to downstream tasks. However, to attain optimal performance, the manual selection of prompts is necessary to improve alignment between the downstream image distribution and the textual class descriptions. This manual prompt engineering is the major challenge for deploying such models in practice since it requires domain expertise and is extremely time-consuming. To avoid non-trivial prompt engineering, recent work Context Optimization (CoOp) introduced the concept of prompt learning to the vision domain using learnable textual tokens. While CoOp can achieve substantial improvements over manual prompts, its learned context is worse generalizable to wider unseen classes within the same dataset. In this work, we present Prompt Learning with Reparameterization Encoder (PRE) - a simple and efficient method that enhances the generalization ability of the learnable prompt to unseen classes while maintaining the capacity to learn Base classes. Instead of directly optimizing the prompts, PRE employs a prompt encoder to reparameterize the input prompt embeddings, enhancing the exploration of task-specific knowledge from few-shot samples. Experiments and extensive ablation studies on 8 benchmarks demonstrate that our approach is an efficient method for prompt learning. Specifically, PRE achieves a notable enhancement of 5.60% in average accuracy on New classes and 3% in Harmonic mean compared to CoOp in the 16-shot setting, all achieved within a good training time.

  • 3 authors
·
Sep 14, 2023

Teacher algorithms for curriculum learning of Deep RL in continuously parameterized environments

We consider the problem of how a teacher algorithm can enable an unknown Deep Reinforcement Learning (DRL) student to become good at a skill over a wide range of diverse environments. To do so, we study how a teacher algorithm can learn to generate a learning curriculum, whereby it sequentially samples parameters controlling a stochastic procedural generation of environments. Because it does not initially know the capacities of its student, a key challenge for the teacher is to discover which environments are easy, difficult or unlearnable, and in what order to propose them to maximize the efficiency of learning over the learnable ones. To achieve this, this problem is transformed into a surrogate continuous bandit problem where the teacher samples environments in order to maximize absolute learning progress of its student. We present a new algorithm modeling absolute learning progress with Gaussian mixture models (ALP-GMM). We also adapt existing algorithms and provide a complete study in the context of DRL. Using parameterized variants of the BipedalWalker environment, we study their efficiency to personalize a learning curriculum for different learners (embodiments), their robustness to the ratio of learnable/unlearnable environments, and their scalability to non-linear and high-dimensional parameter spaces. Videos and code are available at https://github.com/flowersteam/teachDeepRL.

  • 4 authors
·
Oct 16, 2019

Adaptive Testing Environment Generation for Connected and Automated Vehicles with Dense Reinforcement Learning

The assessment of safety performance plays a pivotal role in the development and deployment of connected and automated vehicles (CAVs). A common approach involves designing testing scenarios based on prior knowledge of CAVs (e.g., surrogate models), conducting tests in these scenarios, and subsequently evaluating CAVs' safety performances. However, substantial differences between CAVs and the prior knowledge can significantly diminish the evaluation efficiency. In response to this issue, existing studies predominantly concentrate on the adaptive design of testing scenarios during the CAV testing process. Yet, these methods have limitations in their applicability to high-dimensional scenarios. To overcome this challenge, we develop an adaptive testing environment that bolsters evaluation robustness by incorporating multiple surrogate models and optimizing the combination coefficients of these surrogate models to enhance evaluation efficiency. We formulate the optimization problem as a regression task utilizing quadratic programming. To efficiently obtain the regression target via reinforcement learning, we propose the dense reinforcement learning method and devise a new adaptive policy with high sample efficiency. Essentially, our approach centers on learning the values of critical scenes displaying substantial surrogate-to-real gaps. The effectiveness of our method is validated in high-dimensional overtaking scenarios, demonstrating that our approach achieves notable evaluation efficiency.

  • 6 authors
·
Feb 29, 2024

vMFCoOp: Towards Equilibrium on a Unified Hyperspherical Manifold for Prompting Biomedical VLMs

Recent advances in context optimization (CoOp) guided by large language model (LLM)-distilled medical semantic priors offer a scalable alternative to manual prompt engineering and full fine-tuning for adapting biomedical CLIP-based vision-language models (VLMs). However, prompt learning in this context is challenged by semantic misalignment between LLMs and CLIP variants due to divergent training corpora and model architectures; it further lacks scalability across continuously evolving families of foundation models. More critically, pairwise multimodal alignment via conventional Euclidean-space optimization lacks the capacity to model unified representations or apply localized geometric constraints, which tends to amplify modality gaps in complex biomedical imaging and destabilize few-shot adaptation. In this work, we propose vMFCoOp, a framework that inversely estimates von Mises-Fisher (vMF) distributions on a shared Hyperspherical Manifold, aligning semantic biases between arbitrary LLMs and CLIP backbones via Unified Semantic Anchors to achieve robust biomedical prompting and superior few-shot classification. Grounded in three complementary constraints, vMFCoOp demonstrates consistent improvements across 14 medical datasets, 12 medical imaging modalities, and 13 anatomical regions, outperforming state-of-the-art methods in accuracy, generalization, and clinical applicability. This work aims to continuously expand to encompass more downstream applications, and the corresponding resources are intended to be shared through https://github.com/VinyehShaw/UniEqui.

  • 6 authors
·
Nov 12, 2025

A Reliable Knowledge Processing Framework for Combustion Science using Foundation Models

This research explores the integration of large language models (LLMs) into scientific data assimilation, focusing on combustion science as a case study. Leveraging foundational models integrated with Retrieval-Augmented Generation (RAG) framework, the study introduces an approach to process diverse combustion research data, spanning experimental studies, simulations, and literature. The multifaceted nature of combustion research emphasizes the critical role of knowledge processing in navigating and extracting valuable information from a vast and diverse pool of sources. The developed approach minimizes computational and economic expenses while optimizing data privacy and accuracy. It incorporates prompt engineering and offline open-source LLMs, offering user autonomy in selecting base models. The study provides a thorough examination of text segmentation strategies, conducts comparative studies between LLMs, and explores various optimized prompts to demonstrate the effectiveness of the framework. By incorporating an external database, the framework outperforms a conventional LLM in generating accurate responses and constructing robust arguments. Additionally, the study delves into the investigation of optimized prompt templates for the purpose of efficient extraction of scientific literature. The research addresses concerns related to hallucinations and false research articles by introducing a custom workflow developed with a detection algorithm to filter out inaccuracies. Despite identified areas for improvement, the framework consistently delivers accurate domain-specific responses with minimal human oversight. The prompt-agnostic approach introduced holds promise for future deliberations. The study underscores the significance of integrating LLMs and knowledge processing techniques in scientific research, providing a foundation for advancements in data assimilation and utilization.

  • 2 authors
·
Dec 31, 2023