Daily Papers

Large Language Models (LLMs) have shown impressive performance on existing medical question-answering benchmarks. This high performance makes it increasingly difficult to meaningfully evaluate and differentiate advanced methods. We present MedAgentsBench, a benchmark that focuses on challenging medical questions requiring multi-step clinical reasoning, diagnosis formulation, and treatment planning-scenarios where current models still struggle despite their strong performance on standard tests. Drawing from seven established medical datasets, our benchmark addresses three key limitations in existing evaluations: (1) the prevalence of straightforward questions where even base models achieve high performance, (2) inconsistent sampling and evaluation protocols across studies, and (3) lack of systematic analysis of the interplay between performance, cost, and inference time. Through experiments with various base models and reasoning methods, we demonstrate that the latest thinking models, DeepSeek R1 and OpenAI o3, exhibit exceptional performance in complex medical reasoning tasks. Additionally, advanced search-based agent methods offer promising performance-to-cost ratios compared to traditional approaches. Our analysis reveals substantial performance gaps between model families on complex questions and identifies optimal model selections for different computational constraints. Our benchmark and evaluation framework are publicly available at https://github.com/gersteinlab/medagents-benchmark.

Reasoning is central to a wide range of intellectual activities, and while the capabilities of large language models (LLMs) continue to advance, their performance in reasoning tasks remains limited. The processes and mechanisms underlying reasoning are not yet fully understood, but key elements include path exploration, selection of relevant knowledge, and multi-step inference. Problems are solved through the synthesis of these components. In this paper, we propose a benchmark that focuses on a specific aspect of reasoning ability: the direct evaluation of multi-step inference. To this end, we design a special reasoning task where multi-step inference is specifically focused by largely eliminating path exploration and implicit knowledge utilization. Our dataset comprises pairs of explicit instructions and corresponding questions, where the procedures necessary for solving the questions are entirely detailed within the instructions. This setup allows models to solve problems solely by following the provided directives. By constructing problems that require varying numbers of steps to solve and evaluating responses at each step, we enable a thorough assessment of state-of-the-art LLMs' ability to follow instructions. To ensure the robustness of our evaluation, we include multiple distinct tasks. Furthermore, by comparing accuracy across tasks, utilizing step-aware metrics, and applying separately defined measures of complexity, we conduct experiments that offer insights into the capabilities and limitations of LLMs in reasoning tasks. Our findings have significant implications for the development of LLMs and highlight areas for future research in advancing their reasoning abilities. Our dataset is available at https://huggingface.co/datasets/ifujisawa/procbench and code at https://github.com/ifujisawa/proc-bench.

Clinical diagnosis is critical in medical practice, typically requiring a continuous and evolving process that includes primary diagnosis, differential diagnosis, and final diagnosis. However, most existing clinical diagnostic tasks are single-step processes, which does not align with the complex multi-step diagnostic procedures found in real-world clinical settings. In this paper, we propose a multi-step diagnostic task and annotate a clinical diagnostic dataset (MSDiagnosis). This dataset includes primary diagnosis, differential diagnosis, and final diagnosis questions. Additionally, we propose a novel and effective framework. This framework combines forward inference, backward inference, reflection, and refinement, enabling the LLM to self-evaluate and adjust its diagnostic results. To assess the effectiveness of our proposed method, we design and conduct extensive experiments. The experimental results demonstrate the effectiveness of the proposed method. We also provide a comprehensive experimental analysis and suggest future research directions for this task.

Although contemporary large language models (LMs) demonstrate impressive question-answering capabilities, their answers are typically the product of a single call to the model. This entails an unwelcome degree of opacity and compromises performance, especially on problems that are inherently multi-step. To address these limitations, we show how LMs can be made to perform faithful multi-step reasoning via a process whose causal structure mirrors the underlying logical structure of the problem. Our approach works by chaining together reasoning steps, where each step results from calls to two fine-tuned LMs, one for selection and one for inference, to produce a valid reasoning trace. Our method carries out a beam search through the space of reasoning traces to improve reasoning quality. We demonstrate the effectiveness of our model on multi-step logical deduction and scientific question-answering, showing that it outperforms baselines on final answer accuracy, and generates humanly interpretable reasoning traces whose validity can be checked by the user.

Large Language Models (LLMs) have attained human-level accuracy on medical question-answer (QA) benchmarks. However, their limitations in navigating open-ended clinical scenarios have recently been shown, raising concerns about the robustness and generalizability of LLM reasoning across diverse, real-world medical tasks. To probe potential LLM failure modes in clinical problem-solving, we present the medical abstraction and reasoning corpus (M-ARC). M-ARC assesses clinical reasoning through scenarios designed to exploit the Einstellung effect -- the fixation of thought arising from prior experience, targeting LLM inductive biases toward inflexible pattern matching from their training data rather than engaging in flexible reasoning. We find that LLMs, including current state-of-the-art o1 and Gemini models, perform poorly compared to physicians on M-ARC, often demonstrating lack of commonsense medical reasoning and a propensity to hallucinate. In addition, uncertainty estimation analyses indicate that LLMs exhibit overconfidence in their answers, despite their limited accuracy. The failure modes revealed by M-ARC in LLM medical reasoning underscore the need to exercise caution when deploying these models in clinical settings.

Building upon our previous investigations of O1 replication (Part 1: Journey Learning [Qin et al., 2024] and Part 2: Distillation [Huang et al., 2024]), this work explores the potential of inference-time scaling in large language models (LLMs) for medical reasoning tasks, ranging from diagnostic decision-making to treatment planning. Through extensive experiments on medical benchmarks of varying complexity (MedQA, Medbullets, and JAMA Clinical Challenges), our investigation reveals several key insights: (1) Increasing inference time does lead to improved performance. With a modest training set of 500 samples, our model yields substantial performance improvements of 6%-11%. (2) Task complexity directly correlates with the required length of reasoning chains, confirming the necessity of extended thought processes for challenging problems. (3) The differential diagnoses generated by our model adhere to the principles of the hypothetico-deductive method, producing a list of potential conditions that may explain a patient's symptoms and systematically narrowing these possibilities by evaluating the evidence. These findings demonstrate the promising synergy between inference-time scaling and journey learning in advancing LLMs' real-world clinical reasoning capabilities.

Reasoning is a fundamental capability for solving complex multi-step problems, particularly in visual contexts where sequential step-wise understanding is essential. Existing approaches lack a comprehensive framework for evaluating visual reasoning and do not emphasize step-wise problem-solving. To this end, we propose a comprehensive framework for advancing step-by-step visual reasoning in large language models (LMMs) through three key contributions. First, we introduce a visual reasoning benchmark specifically designed to evaluate multi-step reasoning tasks. The benchmark presents a diverse set of challenges with eight different categories ranging from complex visual perception to scientific reasoning with over 4k reasoning steps in total, enabling robust evaluation of LLMs' abilities to perform accurate and interpretable visual reasoning across multiple steps. Second, we propose a novel metric that assesses visual reasoning quality at the granularity of individual steps, emphasizing both correctness and logical coherence. The proposed metric offers deeper insights into reasoning performance compared to traditional end-task accuracy metrics. Third, we present a new multimodal visual reasoning model, named LlamaV-o1, trained using a multi-step curriculum learning approach, where tasks are progressively organized to facilitate incremental skill acquisition and problem-solving. The proposed LlamaV-o1 is designed for multi-step reasoning and learns step-by-step through a structured training paradigm. Extensive experiments show that our LlamaV-o1 outperforms existing open-source models and performs favorably against close-source proprietary models. Compared to the recent Llava-CoT, our LlamaV-o1 achieves an average score of 67.3 with an absolute gain of 3.8\% across six benchmarks while being 5 times faster during inference scaling. Our benchmark, model, and code are publicly available.

Large language models (LLMs) have exhibited remarkable capabilities across various domains and tasks, pushing the boundaries of our knowledge in learning and cognition. The latest model, OpenAI's o1, stands out as the first LLM with an internalized chain-of-thought technique using reinforcement learning strategies. While it has demonstrated surprisingly strong capabilities on various general language tasks, its performance in specialized fields such as medicine remains unknown. To this end, this report provides a comprehensive exploration of o1 on different medical scenarios, examining 3 key aspects: understanding, reasoning, and multilinguality. Specifically, our evaluation encompasses 6 tasks using data from 37 medical datasets, including two newly constructed and more challenging question-answering (QA) tasks based on professional medical quizzes from the New England Journal of Medicine (NEJM) and The Lancet. These datasets offer greater clinical relevance compared to standard medical QA benchmarks such as MedQA, translating more effectively into real-world clinical utility. Our analysis of o1 suggests that the enhanced reasoning ability of LLMs may (significantly) benefit their capability to understand various medical instructions and reason through complex clinical scenarios. Notably, o1 surpasses the previous GPT-4 in accuracy by an average of 6.2% and 6.6% across 19 datasets and two newly created complex QA scenarios. But meanwhile, we identify several weaknesses in both the model capability and the existing evaluation protocols, including hallucination, inconsistent multilingual ability, and discrepant metrics for evaluation. We release our raw data and model outputs at https://ucsc-vlaa.github.io/o1_medicine/ for future research.

We introduce MedXpertQA, a highly challenging and comprehensive benchmark to evaluate expert-level medical knowledge and advanced reasoning. MedXpertQA includes 4,460 questions spanning 17 specialties and 11 body systems. It includes two subsets, Text for text evaluation and MM for multimodal evaluation. Notably, MM introduces expert-level exam questions with diverse images and rich clinical information, including patient records and examination results, setting it apart from traditional medical multimodal benchmarks with simple QA pairs generated from image captions. MedXpertQA applies rigorous filtering and augmentation to address the insufficient difficulty of existing benchmarks like MedQA, and incorporates specialty board questions to improve clinical relevance and comprehensiveness. We perform data synthesis to mitigate data leakage risk and conduct multiple rounds of expert reviews to ensure accuracy and reliability. We evaluate 16 leading models on MedXpertQA. Moreover, medicine is deeply connected to real-world decision-making, providing a rich and representative setting for assessing reasoning abilities beyond mathematics and code. To this end, we develop a reasoning-oriented subset to facilitate the assessment of o1-like models.

As opposed to evaluating computation and logic-based reasoning, current benchmarks for evaluating large language models (LLMs) in medicine are primarily focused on question-answering involving domain knowledge and descriptive reasoning. While such qualitative capabilities are vital to medical diagnosis, in real-world scenarios, doctors frequently use clinical calculators that follow quantitative equations and rule-based reasoning paradigms for evidence-based decision support. To this end, we propose MedCalc-Bench, a first-of-its-kind dataset focused on evaluating the medical calculation capability of LLMs. MedCalc-Bench contains an evaluation set of over 1000 manually reviewed instances from 55 different medical calculation tasks. Each instance in MedCalc-Bench consists of a patient note, a question requesting to compute a specific medical value, a ground truth answer, and a step-by-step explanation showing how the answer is obtained. While our evaluation results show the potential of LLMs in this area, none of them are effective enough for clinical settings. Common issues include extracting the incorrect entities, not using the correct equation or rules for a calculation task, or incorrectly performing the arithmetic for the computation. We hope our study highlights the quantitative knowledge and reasoning gaps in LLMs within medical settings, encouraging future improvements of LLMs for various clinical calculation tasks.

The meaningful use of electronic health records (EHR) continues to progress in the digital era with clinical decision support systems augmented by artificial intelligence. A priority in improving provider experience is to overcome information overload and reduce the cognitive burden so fewer medical errors and cognitive biases are introduced during patient care. One major type of medical error is diagnostic error due to systematic or predictable errors in judgment that rely on heuristics. The potential for clinical natural language processing (cNLP) to model diagnostic reasoning in humans with forward reasoning from data to diagnosis and potentially reduce the cognitive burden and medical error has not been investigated. Existing tasks to advance the science in cNLP have largely focused on information extraction and named entity recognition through classification tasks. We introduce a novel suite of tasks coined as Diagnostic Reasoning Benchmarks, DR.BENCH, as a new benchmark for developing and evaluating cNLP models with clinical diagnostic reasoning ability. The suite includes six tasks from ten publicly available datasets addressing clinical text understanding, medical knowledge reasoning, and diagnosis generation. DR.BENCH is the first clinical suite of tasks designed to be a natural language generation framework to evaluate pre-trained language models. Experiments with state-of-the-art pre-trained generative language models using large general domain models and models that were continually trained on a medical corpus demonstrate opportunities for improvement when evaluated in DR. BENCH. We share DR. BENCH as a publicly available GitLab repository with a systematic approach to load and evaluate models for the cNLP community.

Exploiting large language models (LLMs) to tackle deductive reasoning has garnered growing attention. It still remains highly challenging to achieve satisfactory results in complex deductive problems, characterized by plenty of premises (i.e., facts or rules) entailing intricate relationships among entities and requiring multi-hop reasoning. One intuitive solution is to decompose the original task into smaller sub-tasks, and then chain the multiple casual reasoning steps together in a forward (e.g., Selection-Inference) or backward (e.g., LAMBADA) direction. However, these techniques inevitably necessitate a large number of overall stages, leading to computationally expensive operations and a higher possibility of making misleading steps. In addition to stage-by-stage decomposition, we draw inspiration from another aspect of human problem-solving. Humans tend to distill the most relevant information and organize their thoughts systematically (e.g., creating mind maps), which assists them in answering questions or drawing conclusions precisely and quickly. In light of this, we propose a novel reasoning approach named Concise and Organized Perception (COP). COP carefully analyzes the given statements to efficiently identify the most pertinent information while eliminating redundancy. It then prompts the LLMs in a more organized form that adapts to the model's inference process. By perceiving concise and organized proofs, the deductive reasoning abilities of LLMs can be better elicited, and the risk of acquiring errors caused by excessive reasoning stages is mitigated. Furthermore, our approach can be combined with the aforementioned ones to further boost their performance. Extensive experimental results on three popular deductive benchmarks (i.e., ProofWriter, PrOntoQA and PrOntoQA-OOD) show that COP significantly outperforms previous state-of-the-art methods.

In response to the pressing need for advanced clinical problem-solving tools in healthcare, we introduce BooksMed, a novel framework based on a Large Language Model (LLM). BooksMed uniquely emulates human cognitive processes to deliver evidence-based and reliable responses, utilizing the GRADE (Grading of Recommendations, Assessment, Development, and Evaluations) framework to effectively quantify evidence strength. For clinical decision-making to be appropriately assessed, an evaluation metric that is clinically aligned and validated is required. As a solution, we present ExpertMedQA, a multispecialty clinical benchmark comprised of open-ended, expert-level clinical questions, and validated by a diverse group of medical professionals. By demanding an in-depth understanding and critical appraisal of up-to-date clinical literature, ExpertMedQA rigorously evaluates LLM performance. BooksMed outperforms existing state-of-the-art models Med-PaLM 2, Almanac, and ChatGPT in a variety of medical scenarios. Therefore, a framework that mimics human cognitive stages could be a useful tool for providing reliable and evidence-based responses to clinical inquiries.

There are two main barriers to using large language models (LLMs) in clinical reasoning. Firstly, while LLMs exhibit significant promise in Natural Language Processing (NLP) tasks, their performance in complex reasoning and planning falls short of expectations. Secondly, LLMs use uninterpretable methods to make clinical decisions that are fundamentally different from the clinician's cognitive processes. This leads to user distrust. In this paper, we present a multi-agent framework called ArgMed-Agents, which aims to enable LLM-based agents to make explainable clinical decision reasoning through interaction. ArgMed-Agents performs self-argumentation iterations via Argumentation Scheme for Clinical Discussion (a reasoning mechanism for modeling cognitive processes in clinical reasoning), and then constructs the argumentation process as a directed graph representing conflicting relationships. Ultimately, use symbolic solver to identify a series of rational and coherent arguments to support decision. We construct a formal model of ArgMed-Agents and present conjectures for theoretical guarantees. ArgMed-Agents enables LLMs to mimic the process of clinical argumentative reasoning by generating explanations of reasoning in a self-directed manner. The setup experiments show that ArgMed-Agents not only improves accuracy in complex clinical decision reasoning problems compared to other prompt methods, but more importantly, it provides users with decision explanations that increase their confidence.

Mathematical reasoning, a core ability of human intelligence, presents unique challenges for machines in abstract thinking and logical reasoning. Recent large pre-trained language models such as GPT-3 have achieved remarkable progress on mathematical reasoning tasks written in text form, such as math word problems (MWP). However, it is unknown if the models can handle more complex problems that involve math reasoning over heterogeneous information, such as tabular data. To fill the gap, we present Tabular Math Word Problems (TabMWP), a new dataset containing 38,431 open-domain grade-level problems that require mathematical reasoning on both textual and tabular data. Each question in TabMWP is aligned with a tabular context, which is presented as an image, semi-structured text, and a structured table. There are two types of questions: free-text and multi-choice, and each problem is annotated with gold solutions to reveal the multi-step reasoning process. We evaluate different pre-trained models on TabMWP, including the GPT-3 model in a few-shot setting. As earlier studies suggest, since few-shot GPT-3 relies on the selection of in-context examples, its performance is unstable and can degrade to near chance. The unstable issue is more severe when handling complex problems like TabMWP. To mitigate this, we further propose a novel approach, PromptPG, which utilizes policy gradient to learn to select in-context examples from a small amount of training data and then constructs the corresponding prompt for the test example. Experimental results show that our method outperforms the best baseline by 5.31% on the accuracy metric and reduces the prediction variance significantly compared to random selection, which verifies its effectiveness in selecting in-context examples.

We study the task of prompting large-scale language models to perform multi-step reasoning. Existing work shows that when prompted with a chain of thoughts (CoT), sequences of short sentences describing intermediate reasoning steps towards a final answer, large language models can generate new reasoning chains and predict answers for new inputs. A central question is which reasoning examples make the most effective prompts. In this work, we propose complexity-based prompting, a simple and effective example selection scheme for multi-step reasoning. We show that prompts with higher reasoning complexity, i.e., chains with more reasoning steps, achieve substantially better performance on multi-step reasoning tasks over strong baselines. We further extend our complexity-based criteria from prompting (selecting inputs) to decoding (selecting outputs), where we sample multiple reasoning chains from the model, then choose the majority of generated answers from complex reasoning chains (over simple chains). When used to prompt GPT-3 and Codex, our approach substantially improves multi-step reasoning accuracy and achieves new state-of-the-art (SOTA) performance on three math benchmarks (GSM8K, MultiArith, and MathQA) and two BigBenchHard tasks (Date Understanding and Penguins), with an average +5.3 and up to +18 accuracy improvements. Compared with existing example selection schemes like manual tuning or retrieval-based selection, selection based on reasoning complexity is intuitive, easy to implement, and annotation-efficient. Further results demonstrate the robustness of performance gains from complex prompts under format perturbation and distribution shift.

The rapid development of Large Language Models (LLMs) for healthcare applications has spurred calls for holistic evaluation beyond frequently-cited benchmarks like USMLE, to better reflect real-world performance. While real-world assessments are valuable indicators of utility, they often lag behind the pace of LLM evolution, likely rendering findings obsolete upon deployment. This temporal disconnect necessitates a comprehensive upfront evaluation that can guide model selection for specific clinical applications. We introduce MEDIC, a framework assessing LLMs across five critical dimensions of clinical competence: medical reasoning, ethics and bias, data and language understanding, in-context learning, and clinical safety. MEDIC features a novel cross-examination framework quantifying LLM performance across areas like coverage and hallucination detection, without requiring reference outputs. We apply MEDIC to evaluate LLMs on medical question-answering, safety, summarization, note generation, and other tasks. Our results show performance disparities across model sizes, baseline vs medically finetuned models, and have implications on model selection for applications requiring specific model strengths, such as low hallucination or lower cost of inference. MEDIC's multifaceted evaluation reveals these performance trade-offs, bridging the gap between theoretical capabilities and practical implementation in healthcare settings, ensuring that the most promising models are identified and adapted for diverse healthcare applications.

Mathematical reasoning is regarded as a necessary ability for Language Models (LMs). Recent works demonstrate large LMs' impressive performance in solving math problems. The success is attributed to their Chain-of-Thought (CoT) reasoning abilities, i.e., the ability to decompose complex questions into step-by-step reasoning chains, but such ability seems only to emerge from models with abundant parameters. This work investigates how to incorporate relatively small LMs with the capabilities of multi-step reasoning. We propose to inject such abilities by continually pre-training LMs on a synthetic dataset MsAT which is composed of Multi-step Arithmetic Tasks. Our experiments on four math word problem datasets show the effectiveness of the proposed method in enhancing LMs' math reasoning abilities.

Recent large language models (LLMs) have witnessed significant advancement in various tasks, including mathematical reasoning and theorem proving. As these two tasks require strict and formal multi-step inference, they are appealing domains for exploring the reasoning ability of LLMs but still face important challenges. Previous studies such as Chain-of-Thought (CoT) have revealed the effectiveness of intermediate steps guidance. However, such step-wise annotation requires heavy labor, leading to insufficient training steps for current benchmarks. To fill this gap, this work introduces MUSTARD, a data generation framework that masters uniform synthesis of theorem and proof data of high quality and diversity. MUSTARD synthesizes data in three stages: (1) It samples a few mathematical concept seeds as the problem category. (2) Then, it prompts a generative language model with the sampled concepts to obtain both the problems and their step-wise formal solutions. (3) Lastly, the framework utilizes a proof assistant (e.g., Lean Prover) to filter the valid proofs. With the proposed MUSTARD, we present a theorem-and-proof benchmark MUSTARDSAUCE with 5,866 valid data points. Each data point contains an informal statement, an informal proof, and a translated formal proof that passes the prover validation. We perform extensive analysis and demonstrate that MUSTARD generates validated high-quality step-by-step data. We further apply the MUSTARDSAUCE for fine-tuning smaller language models. The fine-tuned Llama 2-7B achieves a 15.41% average relative performance gain in automated theorem proving, and 8.18% in math word problems. Codes and data are available at https://github.com/Eleanor-H/MUSTARD.

Although large language models (LLMs) often produce impressive outputs, it remains unclear how they perform in real-world scenarios requiring strong reasoning skills and expert domain knowledge. We set out to investigate whether close- and open-source models (GPT-3.5, LLama-2, etc.) can be applied to answer and reason about difficult real-world-based questions. We focus on three popular medical benchmarks (MedQA-USMLE, MedMCQA, and PubMedQA) and multiple prompting scenarios: Chain-of-Thought (CoT, think step-by-step), few-shot and retrieval augmentation. Based on an expert annotation of the generated CoTs, we found that InstructGPT can often read, reason and recall expert knowledge. Last, by leveraging advances in prompt engineering (few-shot and ensemble methods), we demonstrated that GPT-3.5 not only yields calibrated predictive distributions, but also reaches the passing score on three datasets: MedQA-USMLE 60.2%, MedMCQA 62.7% and PubMedQA 78.2%. Open-source models are closing the gap: Llama-2 70B also passed the MedQA-USMLE with 62.5% accuracy.

Recent advancements in the field of large language models, particularly through the Chain of Thought (CoT) approach, have demonstrated significant improvements in solving complex problems. However, existing models either tend to sacrifice detailed reasoning for brevity due to user preferences, or require extensive and expensive training data to learn complicated reasoning ability, limiting their potential in solving complex tasks. To bridge this gap, following the concept of scaling test-time, we propose a simple method by encouraging models to adopt a more patient reasoning style without the need of introducing new knowledge or skills. To employ a preference optimization approach, we generate detailed reasoning processes as positive examples and simple answers as negative examples, thereby training the model to favor thoroughness in its responses. Our results demonstrate a performance increase of up to 6.7% on GSM8k with training just on a lightweight dataset.

Advanced models such as OpenAI o1 exhibit impressive problem-solving capabilities through step-by-step reasoning. However, they may still falter on more complex problems, making errors that disrupt their reasoning paths. We attribute this to the expansive solution space, where each step has the risk of diverging into mistakes. To enhance language model reasoning, we introduce a specialized training framework called Reasoning Paths Optimization (RPO), which enables learning to reason and explore from diverse paths. Our approach encourages favorable branches at each reasoning step while penalizing unfavorable ones, enhancing the model's overall problem-solving performance. Reasoning Paths Optimization does not rely on large-scale human-annotated rationales or outputs from closed-source models, making it scalable and data-efficient. We focus on multi-step reasoning tasks, such as math word problems and science-based exam questions. The experiments demonstrate that our framework significantly enhances the reasoning performance of large language models, with up to 3.1% and 4.3% improvement on GSM8K and MMLU (STEM) respectively. Our data and code can be found at https://reasoning-paths.github.io.

Pretrained large language models (LLMs) are increasingly utilized across a wide range of natural language processing (NLP) tasks due to their impressive capabilities as few-shot learners. Recent techniques, such as chain-of-thought (CoT) prompting, have significantly advanced multi-step reasoning by introducing step-by-step decomposition, achieving state-of-the-art results on complex reasoning benchmarks. However, these approaches often rely on static prompting templates that do not adapt to task complexity or errors during the reasoning process. In this work, we introduce Adaptive Prompting, a dynamic and iterative framework designed to enhance reasoning by incorporating real-time adjustments to prompt structures and validation mechanisms.Experimental results demonstrate that Adaptive Prompting significantly improves performance on diverse reasoning benchmarks, including arithmetic reasoning (GSM8K, MultiArith), logical reasoning and commonsense tasks, achieving substantial accuracy gains compared to static prompting baselines. By integrating guided prompts, intermediate validation, and self-corrective steps, our approach enables smaller models to achieve competitive performance with larger counterparts, such as GPT-4, while maintaining computational efficiency. The framework achieves this without requiring fine-tuning or task-specific training data, highlighting the untapped potential of iterative reasoning methods.

Large language models (LLMs), particularly those with reasoning capabilities, have rapidly advanced in recent years, demonstrating significant potential across a wide range of applications. However, their deployment in healthcare, especially in disease reasoning tasks, is hindered by the challenge of acquiring expert-level cognitive data. In this paper, we introduce Citrus, a medical language model that bridges the gap between clinical expertise and AI reasoning by emulating the cognitive processes of medical experts. The model is trained on a large corpus of simulated expert disease reasoning data, synthesized using a novel approach that accurately captures the decision-making pathways of clinicians. This approach enables Citrus to better simulate the complex reasoning processes involved in diagnosing and treating medical conditions.To further address the lack of publicly available datasets for medical reasoning tasks, we release the last-stage training data, including a custom-built medical diagnostic dialogue dataset. This open-source contribution aims to support further research and development in the field. Evaluations using authoritative benchmarks such as MedQA, covering tasks in medical reasoning and language understanding, show that Citrus achieves superior performance compared to other models of similar size. These results highlight Citrus potential to significantly enhance medical decision support systems, providing a more accurate and efficient tool for clinical decision-making.

Scaling up language models to billions of parameters has opened up possibilities for in-context learning, allowing instruction tuning and few-shot learning on tasks that the model was not specifically trained for. This has achieved breakthrough performance on language tasks such as translation, summarization, and question-answering. Furthermore, in addition to these associative "System 1" tasks, recent advances in Chain-of-thought prompt learning have demonstrated strong "System 2" reasoning abilities, answering a question in the field of artificial general intelligence whether LLMs can reason. The field started with the question whether LLMs can solve grade school math word problems. This paper reviews the rapidly expanding field of prompt-based reasoning with LLMs. Our taxonomy identifies different ways to generate, evaluate, and control multi-step reasoning. We provide an in-depth coverage of core approaches and open problems, and we propose a research agenda for the near future. Finally, we highlight the relation between reasoning and prompt-based learning, and we discuss the relation between reasoning, sequential decision processes, and reinforcement learning. We find that self-improvement, self-reflection, and some metacognitive abilities of the reasoning processes are possible through the judicious use of prompts. True self-improvement and self-reasoning, to go from reasoning with LLMs to reasoning by LLMs, remains future work.

The breakthrough of OpenAI o1 highlights the potential of enhancing reasoning to improve LLM. Yet, most research in reasoning has focused on mathematical tasks, leaving domains like medicine underexplored. The medical domain, though distinct from mathematics, also demands robust reasoning to provide reliable answers, given the high standards of healthcare. However, verifying medical reasoning is challenging, unlike those in mathematics. To address this, we propose verifiable medical problems with a medical verifier to check the correctness of model outputs. This verifiable nature enables advancements in medical reasoning through a two-stage approach: (1) using the verifier to guide the search for a complex reasoning trajectory for fine-tuning LLMs, (2) applying reinforcement learning (RL) with verifier-based rewards to enhance complex reasoning further. Finally, we introduce HuatuoGPT-o1, a medical LLM capable of complex reasoning, which outperforms general and medical-specific baselines using only 40K verifiable problems. Experiments show complex reasoning improves medical problem-solving and benefits more from RL. We hope our approach inspires advancements in reasoning across medical and other specialized domains.

Large language models (LLMs) have demonstrated impressive capabilities in natural language understanding and generation, but the quality bar for medical and clinical applications is high. Today, attempts to assess models' clinical knowledge typically rely on automated evaluations on limited benchmarks. There is no standard to evaluate model predictions and reasoning across a breadth of tasks. To address this, we present MultiMedQA, a benchmark combining six existing open question answering datasets spanning professional medical exams, research, and consumer queries; and HealthSearchQA, a new free-response dataset of medical questions searched online. We propose a framework for human evaluation of model answers along multiple axes including factuality, precision, possible harm, and bias. In addition, we evaluate PaLM (a 540-billion parameter LLM) and its instruction-tuned variant, Flan-PaLM, on MultiMedQA. Using a combination of prompting strategies, Flan-PaLM achieves state-of-the-art accuracy on every MultiMedQA multiple-choice dataset (MedQA, MedMCQA, PubMedQA, MMLU clinical topics), including 67.6% accuracy on MedQA (US Medical License Exam questions), surpassing prior state-of-the-art by over 17%. However, human evaluation reveals key gaps in Flan-PaLM responses. To resolve this we introduce instruction prompt tuning, a parameter-efficient approach for aligning LLMs to new domains using a few exemplars. The resulting model, Med-PaLM, performs encouragingly, but remains inferior to clinicians. We show that comprehension, recall of knowledge, and medical reasoning improve with model scale and instruction prompt tuning, suggesting the potential utility of LLMs in medicine. Our human evaluations reveal important limitations of today's models, reinforcing the importance of both evaluation frameworks and method development in creating safe, helpful LLM models for clinical applications.

Multi-modal Large Language Models (MLLMs) are increasingly prominent in the field of artificial intelligence. These models not only excel in traditional vision-language tasks but also demonstrate impressive performance in contemporary multi-modal benchmarks. Although many of these benchmarks attempt to holistically evaluate MLLMs, they typically concentrate on basic reasoning tasks, often yielding only simple yes/no or multi-choice responses. These methods naturally lead to confusion and difficulties in conclusively determining the reasoning capabilities of MLLMs. To mitigate this issue, we manually curate a benchmark dataset specifically designed for MLLMs, with a focus on complex reasoning tasks. Our benchmark comprises three key reasoning categories: deductive, abductive, and analogical reasoning. The queries in our dataset are intentionally constructed to engage the reasoning capabilities of MLLMs in the process of generating answers. For a fair comparison across various MLLMs, we incorporate intermediate reasoning steps into our evaluation criteria. In instances where an MLLM is unable to produce a definitive answer, its reasoning ability is evaluated by requesting intermediate reasoning steps. If these steps align with our manual annotations, appropriate scores are assigned. This evaluation scheme resembles methods commonly used in human assessments, such as exams or assignments, and represents what we consider a more effective assessment technique compared with existing benchmarks. We evaluate a selection of representative MLLMs using this rigorously developed open-ended multi-step elaborate reasoning benchmark, designed to challenge and accurately measure their reasoning capabilities. The code and data will be released at https://core-mm.github.io/

Chain of Thought (CoT) of multi-step benefits from the logical structure of the reasoning steps and task-specific actions, significantly enhancing the mathematical reasoning capabilities of large language models. As the prevalence of long CoT, the number of reasoning steps exceeds manageable token limits and leads to higher computational demands. Inspired by the fundamental logic of human cognition, ``derive, then reduce'', we conceptualize the standard multi-step CoT as a novel Markov Chain of Thought (MCoT). In this study, we consider the mathematical reasoning task, defining each reasoning step as text accompanied by a Python code snippet. To facilitate a longer reasoning path, self-correction is enabled through interactions with the code interpreter. Our MCoT aims to compress previous reasoning steps into a simplified question, enabling efficient next-step inference without relying on a lengthy KV cache. In our experiments, we curate the MCoTInstruct dataset, and the empirical results indicate that MCoT not only significantly enhances efficiency but also maintains comparable accuracy. While much remains to be explored, this work paves the way for exploring the long CoT reasoning abilities of LLMs.

LLMs have demonstrated impressive performance in answering medical questions, such as passing scores on medical licensing examinations. However, medical board exam questions or general clinical questions do not capture the complexity of realistic clinical cases. Moreover, the lack of reference explanations means we cannot easily evaluate the reasoning of model decisions, a crucial component of supporting doctors in making complex medical decisions. To address these challenges, we construct two new datasets: JAMA Clinical Challenge and Medbullets. JAMA Clinical Challenge consists of questions based on challenging clinical cases, while Medbullets comprises USMLE Step 2&3 style clinical questions. Both datasets are structured as multiple-choice question-answering tasks, where each question is accompanied by an expert-written explanation. We evaluate four LLMs on the two datasets using various prompts. Experiments demonstrate that our datasets are harder than previous benchmarks. The inconsistency between automatic and human evaluations of model-generated explanations highlights the need to develop new metrics to support future research on explainable medical QA.

Large language models (LLMs) have shown increasing in-context learning capabilities through scaling up model and data size. Despite this progress, LLMs are still unable to solve algorithmic reasoning problems. While providing a rationale with the final answer has led to further improvements in multi-step reasoning problems, Anil et al. 2022 showed that even simple algorithmic reasoning tasks such as parity are far from solved. In this work, we identify and study four key stages for successfully teaching algorithmic reasoning to LLMs: (1) formulating algorithms as skills, (2) teaching multiple skills simultaneously (skill accumulation), (3) teaching how to combine skills (skill composition) and (4) teaching how to use skills as tools. We show that it is possible to teach algorithmic reasoning to LLMs via in-context learning, which we refer to as algorithmic prompting. We evaluate our approach on a variety of arithmetic and quantitative reasoning tasks, and demonstrate significant boosts in performance over existing prompting techniques. In particular, for long parity, addition, multiplication and subtraction, we achieve an error reduction of approximately 10x, 9x, 5x and 2x respectively compared to the best available baselines.

Using Large Language Models for complex mathematical reasoning is difficult, primarily due to the complexity of multi-step reasoning. The main challenges of this process include (1) selecting critical intermediate results to advance the procedure, and (2) limited exploration of potential solutions. To address these issues, we introduce a novel algorithm, namely Stepwise Self-Consistent Chain-of-Thought (SSC-CoT). SSC-CoT employs a strategy of selecting intermediate steps based on the intersection of various reasoning chains. Additionally, SSC-CoT enables the model to discover critical intermediate steps by querying a knowledge graph comprising relevant domain knowledge. To validate SSC-CoT, we present a new dataset, TriMaster100, tailored for complex trigonometry problems. This dataset contains 100 questions, with each solution broken down into scored intermediate steps, facilitating a comprehensive evaluation of the mathematical reasoning process. On TriMaster100, SSC-CoT triples the effectiveness of the state-of-the-art methods. Furthermore, we benchmark SSC-CoT on the widely recognized complex mathematical question dataset, MATH level 5, and it surpasses the second-best method by 7.2% in accuracy. Code and the TriMaster100 dataset can be found at: https://github.com/zhao-zilong/ssc-cot.

Biomedical knowledge is uniquely complex and structured, requiring distinct reasoning strategies compared to other scientific disciplines like physics or chemistry. Biomedical scientists do not rely on a single approach to reasoning; instead, they use various strategies, including rule-based, prototype-based, and case-based reasoning. This diversity calls for flexible approaches that accommodate multiple reasoning strategies while leveraging in-domain knowledge. We introduce KGARevion, a knowledge graph (KG) based agent designed to address the complexity of knowledge-intensive medical queries. Upon receiving a query, KGARevion generates relevant triplets by using the knowledge base of the LLM. These triplets are then verified against a grounded KG to filter out erroneous information and ensure that only accurate, relevant data contribute to the final answer. Unlike RAG-based models, this multi-step process ensures robustness in reasoning while adapting to different models of medical reasoning. Evaluations on four gold-standard medical QA datasets show that KGARevion improves accuracy by over 5.2%, outperforming 15 models in handling complex medical questions. To test its capabilities, we curated three new medical QA datasets with varying levels of semantic complexity, where KGARevion achieved a 10.4% improvement in accuracy.

Recent advancements in large language models (LLMs) have shown promise in medical applications such as disease diagnosis and treatment planning. However, most existing medical LLMs struggle with the advanced reasoning required for complex clinical scenarios, such as differential diagnosis or personalized treatment suggestions. We proposed FineMedLM-o1, which leverages high-quality synthetic medical data and long-form reasoning data for Supervised Fine-Tuning (SFT) and Direct Preference Optimization (DPO), enabling advanced dialogue and deep reasoning capabilities. Additionally, we introduced Test-Time Training (TTT) in the medical domain for the first time, facilitating domain adaptation and ensuring reliable, accurate reasoning. Experimental results demonstrate that FineMedLM-o1 achieves a 23% average performance improvement over prior models on key medical benchmarks. Furthermore, the introduction of TTT provides an additional 14% performance boost, highlighting its effectiveness in enhancing medical reasoning capabilities. To support this process, we also proposed a novel method for synthesizing medical dialogue. Compared to other open-source datasets, our dataset stands out as superior in both quality and complexity. The project and data will be released on GitHub.

Many challenging reasoning tasks require not just rapid, intuitive responses, but a more deliberate, multi-step approach. Recent progress in large language models (LLMs) highlights an important shift from the "System 1" way of quick reactions to the "System 2" style of reflection-and-correction problem solving. However, current benchmarks heavily rely on the final-answer accuracy, leaving much of a model's intermediate reasoning steps unexamined. This fails to assess the model's ability to reflect and rectify mistakes within the reasoning process. To bridge this gap, we introduce FINEREASON, a logic-puzzle benchmark for fine-grained evaluation of LLMs' reasoning capabilities. Each puzzle can be decomposed into atomic steps, making it ideal for rigorous validation of intermediate correctness. Building on this, we introduce two tasks: state checking, and state transition, for a comprehensive evaluation of how models assess the current situation and plan the next move. To support broader research, we also provide a puzzle training set aimed at enhancing performance on general mathematical tasks. We show that models trained on our state checking and transition data demonstrate gains in math reasoning by up to 5.1% on GSM8K.

With the rapid development of artificial intelligence, large language models (LLMs) have shown promising capabilities in mimicking human-level language comprehension and reasoning. This has sparked significant interest in applying LLMs to enhance various aspects of healthcare, ranging from medical education to clinical decision support. However, medicine involves multifaceted data modalities and nuanced reasoning skills, presenting challenges for integrating LLMs. This paper provides a comprehensive review on the applications and implications of LLMs in medicine. It begins by examining the fundamental applications of general-purpose and specialized LLMs, demonstrating their utilities in knowledge retrieval, research support, clinical workflow automation, and diagnostic assistance. Recognizing the inherent multimodality of medicine, the review then focuses on multimodal LLMs, investigating their ability to process diverse data types like medical imaging and EHRs to augment diagnostic accuracy. To address LLMs' limitations regarding personalization and complex clinical reasoning, the paper explores the emerging development of LLM-powered autonomous agents for healthcare. Furthermore, it summarizes the evaluation methodologies for assessing LLMs' reliability and safety in medical contexts. Overall, this review offers an extensive analysis on the transformative potential of LLMs in modern medicine. It also highlights the pivotal need for continuous optimizations and ethical oversight before these models can be effectively integrated into clinical practice. Visit https://github.com/mingze-yuan/Awesome-LLM-Healthcare for an accompanying GitHub repository containing latest papers.

Chain of Thought (CoT) is significant in improving the reasoning abilities of large language models (LLMs). However, the correlation between the effectiveness of CoT and the length of reasoning steps in prompts remains largely unknown. To shed light on this, we have conducted several empirical experiments to explore the relations. Specifically, we design experiments that expand and compress the rationale reasoning steps within CoT demonstrations, while keeping all other factors constant. We have the following key findings. First, the results indicate that lengthening the reasoning steps in prompts, even without adding new information into the prompt, considerably enhances LLMs' reasoning abilities across multiple datasets. Alternatively, shortening the reasoning steps, even while preserving the key information, significantly diminishes the reasoning abilities of models. This finding highlights the importance of the number of steps in CoT prompts and provides practical guidance to make better use of LLMs' potential in complex problem-solving scenarios. Second, we also investigated the relationship between the performance of CoT and the rationales used in demonstrations. Surprisingly, the result shows that even incorrect rationales can yield favorable outcomes if they maintain the requisite length of inference. Third, we observed that the advantages of increasing reasoning steps are task-dependent: simpler tasks require fewer steps, whereas complex tasks gain significantly from longer inference sequences.

Logical reading comprehension is a challenging task that entails grasping the underlying semantics of text and applying reasoning to deduce the correct answer. Prior researches have primarily focused on enhancing logical reasoning capabilities through Chain-of-Thought (CoT) or data augmentation. However, previous work constructing chain-of-thought rationales concentrates solely on analyzing correct options, neglecting the incorrect alternatives. Addtionally, earlier efforts on data augmentation by altering contexts rely on rule-based methods, which result in generated contexts that lack diversity and coherence. To address these issues, we propose a Premise-Oriented Data Augmentation (PODA) framework. This framework can generate CoT rationales including analyses for both correct and incorrect options, while constructing diverse and high-quality counterfactual contexts from incorrect candidate options. We integrate summarizing premises and identifying premises for each option into rationales. Subsequently, we employ multi-step prompts with identified premises to construct counterfactual context. To facilitate the model's capabilities to better differentiate the reasoning process associated with each option, we introduce a novel thought-path contrastive learning method that compares reasoning paths between the original and counterfactual samples. Experimental results on three representative LLMs demonstrate that our method can improve the baselines substantially across two challenging logical reasoning benchmarks (ReClor and LogiQA 2.0). The data and code are released at https://github.com/lalalamdbf/TPReasoner.

Recent work has shown that language models (LMs) have strong multi-step (i.e., procedural) reasoning capabilities. However, it is unclear whether LMs perform these tasks by cheating with answers memorized from pretraining corpus, or, via a multi-step reasoning mechanism. In this paper, we try to answer this question by exploring a mechanistic interpretation of LMs for multi-step reasoning tasks. Concretely, we hypothesize that the LM implicitly embeds a reasoning tree resembling the correct reasoning process within it. We test this hypothesis by introducing a new probing approach (called MechanisticProbe) that recovers the reasoning tree from the model's attention patterns. We use our probe to analyze two LMs: GPT-2 on a synthetic task (k-th smallest element), and LLaMA on two simple language-based reasoning tasks (ProofWriter & AI2 Reasoning Challenge). We show that MechanisticProbe is able to detect the information of the reasoning tree from the model's attentions for most examples, suggesting that the LM indeed is going through a process of multi-step reasoning within its architecture in many cases.

Large language models (LLMs) have recently been shown to deliver impressive performance in various NLP tasks. To tackle multi-step reasoning tasks, few-shot chain-of-thought (CoT) prompting includes a few manually crafted step-by-step reasoning demonstrations which enable LLMs to explicitly generate reasoning steps and improve their reasoning task accuracy. To eliminate the manual effort, Zero-shot-CoT concatenates the target problem statement with "Let's think step by step" as an input prompt to LLMs. Despite the success of Zero-shot-CoT, it still suffers from three pitfalls: calculation errors, missing-step errors, and semantic misunderstanding errors. To address the missing-step errors, we propose Plan-and-Solve (PS) Prompting. It consists of two components: first, devising a plan to divide the entire task into smaller subtasks, and then carrying out the subtasks according to the plan. To address the calculation errors and improve the quality of generated reasoning steps, we extend PS prompting with more detailed instructions and derive PS+ prompting. We evaluate our proposed prompting strategy on ten datasets across three reasoning problems. The experimental results over GPT-3 show that our proposed zero-shot prompting consistently outperforms Zero-shot-CoT across all datasets by a large margin, is comparable to or exceeds Zero-shot-Program-of-Thought Prompting, and has comparable performance with 8-shot CoT prompting on the math reasoning problem. The code can be found at https://github.com/AGI-Edgerunners/Plan-and-Solve-Prompting.

Large language models have exhibited exceptional performance on various Natural Language Processing (NLP) tasks, leveraging techniques such as the pre-training, and instruction fine-tuning. Despite these advances, their effectiveness in medical applications is limited, due to challenges such as factual inaccuracies, reasoning abilities, and lack grounding in real-world experience. In this study, we present ClinicalGPT, a language model explicitly designed and optimized for clinical scenarios. By incorporating extensive and diverse real-world data, such as medical records, domain-specific knowledge, and multi-round dialogue consultations in the training process, ClinicalGPT is better prepared to handle multiple clinical task. Furthermore, we introduce a comprehensive evaluation framework that includes medical knowledge question-answering, medical exams, patient consultations, and diagnostic analysis of medical records. Our results demonstrate that ClinicalGPT significantly outperforms other models in these tasks, highlighting the effectiveness of our approach in adapting large language models to the critical domain of healthcare.

This paper introduces MedMCQA, a new large-scale, Multiple-Choice Question Answering (MCQA) dataset designed to address real-world medical entrance exam questions. More than 194k high-quality AIIMS \& NEET PG entrance exam MCQs covering 2.4k healthcare topics and 21 medical subjects are collected with an average token length of 12.77 and high topical diversity. Each sample contains a question, correct answer(s), and other options which requires a deeper language understanding as it tests the 10+ reasoning abilities of a model across a wide range of medical subjects \& topics. A detailed explanation of the solution, along with the above information, is provided in this study.

Several recent works seek to develop foundation models specifically for medical applications, adapting general-purpose large language models (LLMs) and vision-language models (VLMs) via continued pretraining on publicly available biomedical corpora. These works typically claim that such domain-adaptive pretraining (DAPT) improves performance on downstream medical tasks, such as answering medical licensing exam questions. In this paper, we compare seven public "medical" LLMs and two VLMs against their corresponding base models, arriving at a different conclusion: all medical VLMs and nearly all medical LLMs fail to consistently improve over their base models in the zero-/few-shot prompting regime for medical question-answering (QA) tasks. For instance, across the tasks and model pairs we consider in the 3-shot setting, medical LLMs only outperform their base models in 12.1% of cases, reach a (statistical) tie in 49.8% of cases, and are significantly worse than their base models in the remaining 38.2% of cases. Our conclusions are based on (i) comparing each medical model head-to-head, directly against the corresponding base model; (ii) optimizing the prompts for each model separately; and (iii) accounting for statistical uncertainty in comparisons. While these basic practices are not consistently adopted in the literature, our ablations show that they substantially impact conclusions. Our findings suggest that state-of-the-art general-domain models may already exhibit strong medical knowledge and reasoning capabilities, and offer recommendations to strengthen the conclusions of future studies.

Vision-Language Models (VLM) can support clinicians by analyzing medical images and engaging in natural language interactions to assist in diagnostic and treatment tasks. However, VLMs often exhibit "hallucinogenic" behavior, generating textual outputs not grounded in contextual multimodal information. This challenge is particularly pronounced in the medical domain, where we do not only require VLM outputs to be accurate in single interactions but also to be consistent with clinical reasoning and diagnostic pathways throughout multi-turn conversations. For this purpose, we propose a new alignment algorithm that uses symbolic representations of clinical reasoning to ground VLMs in medical knowledge. These representations are utilized to (i) generate GPT-4-guided visual instruction tuning data at scale, simulating clinician-VLM conversations with demonstrations of clinical reasoning, and (ii) create an automatic reward function that evaluates the clinical validity of VLM generations throughout clinician-VLM interactions. Our algorithm eliminates the need for human involvement in training data generation or reward model construction, reducing costs compared to standard reinforcement learning with human feedback (RLHF). We apply our alignment algorithm to develop Dr-LLaVA, a conversational VLM finetuned for analyzing bone marrow pathology slides, demonstrating strong performance in multi-turn medical conversations.

Several recent works seek to develop foundation models specifically for medical applications, adapting general-purpose large language models (LLMs) and vision-language models (VLMs) via continued pretraining on publicly available biomedical corpora. These works typically claim that such domain-adaptive pretraining (DAPT) improves performance on downstream medical tasks, such as answering medical licensing exam questions. In this paper, we compare ten public "medical" LLMs and two VLMs against their corresponding base models, arriving at a different conclusion: all medical VLMs and nearly all medical LLMs fail to consistently improve over their base models in the zero-/few-shot prompting and supervised fine-tuning regimes for medical question-answering (QA). For instance, across all tasks and model pairs we consider in the 3-shot setting, medical LLMs only outperform their base models in 22.7% of cases, reach a (statistical) tie in 36.8% of cases, and are significantly worse than their base models in the remaining 40.5% of cases. Our conclusions are based on (i) comparing each medical model head-to-head, directly against the corresponding base model; (ii) optimizing the prompts for each model separately in zero-/few-shot prompting; and (iii) accounting for statistical uncertainty in comparisons. While these basic practices are not consistently adopted in the literature, our ablations show that they substantially impact conclusions. Meanwhile, we find that after fine-tuning on specific QA tasks, medical LLMs can show performance improvements, but the benefits do not carry over to tasks based on clinical notes. Our findings suggest that state-of-the-art general-domain models may already exhibit strong medical knowledge and reasoning capabilities, and offer recommendations to strengthen the conclusions of future studies.

Question-answering datasets require a broad set of reasoning skills. We show how to use question decompositions to teach language models these broad reasoning skills in a robust fashion. Specifically, we use widely available QDMR representations to programmatically create hard-to-cheat synthetic contexts for real questions in six multi-step reasoning datasets. These contexts are carefully designed to avoid reasoning shortcuts prevalent in real contexts that prevent models from learning the right skills. This results in a pretraining dataset, named TeaBReaC, containing 525K multi-step questions (with associated formal programs) covering about 900 reasoning patterns. We show that pretraining standard language models (LMs) on TeaBReaC before fine-tuning them on target datasets improves their performance by up to 13 F1 points across 4 multi-step QA datasets, with up to 21 point gain on more complex questions. The resulting models also demonstrate higher robustness, with a 5-8 F1 point improvement on two contrast sets. Furthermore, TeaBReaC pretraining substantially improves model performance and robustness even when starting with numerate LMs pretrained using recent methods (e.g., PReasM, POET). Our work thus shows how to effectively use decomposition-guided contexts to robustly teach multi-step reasoning.

Explaining Artificial Intelligence (AI) decisions is a major challenge nowadays in AI, in particular when applied to sensitive scenarios like medicine and law. However, the need to explain the rationale behind decisions is a main issue also for human-based deliberation as it is important to justify why a certain decision has been taken. Resident medical doctors for instance are required not only to provide a (possibly correct) diagnosis, but also to explain how they reached a certain conclusion. Developing new tools to aid residents to train their explanation skills is therefore a central objective of AI in education. In this paper, we follow this direction, and we present, to the best of our knowledge, the first multilingual dataset for Medical Question Answering where correct and incorrect diagnoses for a clinical case are enriched with a natural language explanation written by doctors. These explanations have been manually annotated with argument components (i.e., premise, claim) and argument relations (i.e., attack, support), resulting in the Multilingual CasiMedicos-Arg dataset which consists of 558 clinical cases in four languages (English, Spanish, French, Italian) with explanations, where we annotated 5021 claims, 2313 premises, 2431 support relations, and 1106 attack relations. We conclude by showing how competitive baselines perform over this challenging dataset for the argument mining task.

We introduce HRMCR (HAE-RAE Multi-Step Commonsense Reasoning), a benchmark designed to evaluate large language models' ability to perform multi-step reasoning in culturally specific contexts, focusing on Korean. The questions are automatically generated via templates and algorithms, requiring LLMs to integrate Korean cultural knowledge into sequential reasoning steps. Consistent with prior observations on emergent abilities, our experiments reveal that models trained on fewer than \(2 \cdot 10^{25}\) training FLOPs struggle to solve any questions, showing near-zero performance. Beyond this threshold, performance improves sharply. State-of-the-art models (e.g., O1) still score under 50\%, underscoring the difficulty of our tasks. Notably, stepwise analysis suggests the observed emergent behavior may stem from compounding errors across multiple steps rather than reflecting a genuinely new capability. We publicly release the benchmark and commit to regularly updating the dataset to prevent contamination.

Large Language Models (LLMs) significantly benefit from Chain-of-Thought (CoT) prompting in performing various reasoning tasks. While CoT allows models to produce more comprehensive reasoning processes, its emphasis on intermediate reasoning steps can inadvertently introduce hallucinations and accumulated errors, thereby limiting models' ability to solve complex reasoning tasks. Inspired by how humans engage in careful and meticulous deductive logical reasoning processes to solve tasks, we seek to enable language models to perform explicit and rigorous deductive reasoning, and also ensure the trustworthiness of their reasoning process through self-verification. However, directly verifying the validity of an entire deductive reasoning process is challenging, even with advanced models like ChatGPT. In light of this, we propose to decompose a reasoning verification process into a series of step-by-step subprocesses, each only receiving their necessary context and premises. To facilitate this procedure, we propose Natural Program, a natural language-based deductive reasoning format. Our approach enables models to generate precise reasoning steps where subsequent steps are more rigorously grounded on prior steps. It also empowers language models to carry out reasoning self-verification in a step-by-step manner. By integrating this verification process into each deductive reasoning stage, we significantly enhance the rigor and trustfulness of generated reasoning steps. Along this process, we also improve the answer correctness on complex reasoning tasks. Code will be released at https://github.com/lz1oceani/verify_cot.

Chain-of-Thought (CoT) prompting can dramatically improve the multi-step reasoning abilities of large language models (LLMs). CoT explicitly encourages the LLM to generate intermediate rationales for solving a problem, by providing a series of reasoning steps in the demonstrations. Despite its success, there is still little understanding of what makes CoT prompting effective and which aspects of the demonstrated reasoning steps contribute to its performance. In this paper, we show that CoT reasoning is possible even with invalid demonstrations - prompting with invalid reasoning steps can achieve over 80-90% of the performance obtained using CoT under various metrics, while still generating coherent lines of reasoning during inference. Further experiments show that other aspects of the rationales, such as being relevant to the query and correctly ordering the reasoning steps, are much more important for effective CoT reasoning. Overall, these findings both deepen our understanding of CoT prompting, and open up new questions regarding LLMs' capability to learn to reason in context.

While recent advancements in commercial large language models (LM) have shown promising results in medical tasks, their closed-source nature poses significant privacy and security concerns, hindering their widespread use in the medical field. Despite efforts to create open-source models, their limited parameters often result in insufficient multi-step reasoning capabilities required for solving complex medical problems. To address this, we introduce Meerkat-7B, a novel medical AI system with 7 billion parameters. Meerkat-7B was trained using our new synthetic dataset consisting of high-quality chain-of-thought reasoning paths sourced from 18 medical textbooks, along with diverse instruction-following datasets. Our system achieved remarkable accuracy across seven medical benchmarks, surpassing GPT-3.5 by 13.1%, as well as outperforming the previous best 7B models such as MediTron-7B and BioMistral-7B by 13.4% and 9.8%, respectively. Notably, it surpassed the passing threshold of the United States Medical Licensing Examination (USMLE) for the first time for a 7B-parameter model. Additionally, our system offered more detailed free-form responses to clinical queries compared to existing 7B and 13B models, approaching the performance level of GPT-3.5. This significantly narrows the performance gap with large LMs, showcasing its effectiveness in addressing complex medical challenges.

The chain-of-though (CoT) prompting methods were successful in various natural language processing (NLP) tasks thanks to their ability to unveil the underlying complex reasoning processes. Such reasoning processes typically exhibit implicitly structured steps. Recent efforts also started investigating methods to encourage more explicitly structured reasoning procedures to be captured. In this work, we propose Tab-CoT, a novel tabular-format CoT prompting method, which allows the complex reasoning process to be explicitly modelled in a highly structured manner. Despite its simplicity, we show that our approach is capable of performing reasoning across multiple dimensions (i.e., both rows and columns). We demonstrate our approach's strong zero-shot and few-shot capabilities through extensive experiments on a range of reasoning tasks.

Large language models (LLMs) have demonstrated remarkable capabilities in natural language understanding and generation across various domains, including medicine. We present a comprehensive evaluation of GPT-4, a state-of-the-art LLM, on medical competency examinations and benchmark datasets. GPT-4 is a general-purpose model that is not specialized for medical problems through training or engineered to solve clinical tasks. Our analysis covers two sets of official practice materials for the USMLE, a three-step examination program used to assess clinical competency and grant licensure in the United States. We also evaluate performance on the MultiMedQA suite of benchmark datasets. Beyond measuring model performance, experiments were conducted to investigate the influence of test questions containing both text and images on model performance, probe for memorization of content during training, and study probability calibration, which is of critical importance in high-stakes applications like medicine. Our results show that GPT-4, without any specialized prompt crafting, exceeds the passing score on USMLE by over 20 points and outperforms earlier general-purpose models (GPT-3.5) as well as models specifically fine-tuned on medical knowledge (Med-PaLM, a prompt-tuned version of Flan-PaLM 540B). In addition, GPT-4 is significantly better calibrated than GPT-3.5, demonstrating a much-improved ability to predict the likelihood that its answers are correct. We also explore the behavior of the model qualitatively through a case study that shows the ability of GPT-4 to explain medical reasoning, personalize explanations to students, and interactively craft new counterfactual scenarios around a medical case. Implications of the findings are discussed for potential uses of GPT-4 in medical education, assessment, and clinical practice, with appropriate attention to challenges of accuracy and safety.

The surprising ability of Large Language Models (LLMs) to perform well on complex reasoning with only few-shot chain-of-thought prompts is believed to emerge only in very large-scale models (100+ billion parameters). We show that such abilities can, in fact, be distilled down from GPT-3.5 (ge 175B) to T5 variants (le 11B). We propose model specialization, to specialize the model's ability towards a target task. The hypothesis is that large models (commonly viewed as larger than 100B) have strong modeling power, but are spread on a large spectrum of tasks. Small models (commonly viewed as smaller than 10B) have limited model capacity, but if we concentrate their capacity on a specific target task, the model can achieve a decent improved performance. We use multi-step math reasoning as our testbed because it is a very typical emergent ability. We show two important aspects of model abilities: (1). there exists a very complex balance/ tradeoff between language models' multi-dimensional abilities; (2). by paying the price of decreased generic ability, we can clearly lift up the scaling curve of models smaller than 10B towards a specialized multi-step math reasoning ability. We further give comprehensive discussions about important design choices for better generalization, including the tuning data format, the start model checkpoint, and a new model selection method. We hope our practice and discoveries can serve as an important attempt towards specialized smaller models in the new research paradigm set by LLMs.

Online medical consultation (OMC) restricts doctors to gathering patient information solely through inquiries, making the already complex sequential decision-making process of diagnosis even more challenging. Recently, the rapid advancement of large language models has demonstrated a significant potential to transform OMC. However, most studies have primarily focused on improving diagnostic accuracy under conditions of relatively sufficient information, while paying limited attention to the "inquiry" phase of the consultation process. This lack of focus has left the relationship between "inquiry" and "diagnosis" insufficiently explored. In this paper, we first extract real patient interaction strategies from authentic doctor-patient conversations and use these strategies to guide the training of a patient simulator that closely mirrors real-world behavior. By inputting medical records into our patient simulator to simulate patient responses, we conduct extensive experiments to explore the relationship between "inquiry" and "diagnosis" in the consultation process. Experimental results demonstrate that inquiry and diagnosis adhere to the Liebig's law: poor inquiry quality limits the effectiveness of diagnosis, regardless of diagnostic capability, and vice versa. Furthermore, the experiments reveal significant differences in the inquiry performance of various models. To investigate this phenomenon, we categorize the inquiry process into four types: (1) chief complaint inquiry; (2) specification of known symptoms; (3) inquiry about accompanying symptoms; and (4) gathering family or medical history. We analyze the distribution of inquiries across the four types for different models to explore the reasons behind their significant performance differences. We plan to open-source the weights and related code of our patient simulator at https://github.com/LIO-H-ZEN/PatientSimulator.

Chain-of-Thought (CoT) prompting reveals that large language models are capable of performing complex reasoning via intermediate steps. CoT prompting is primarily categorized into three approaches. The first approach utilizes straightforward prompts like ``Let's think step by step'' to generate a sequential thought process before yielding an answer. The second approach makes use of human-crafted, step-by-step demonstrations to guide the model's reasoning process. The third automates the generation of reasoned demonstrations with the 'Let's think step by step'.This approach sometimes leads to reasoning errors, highlighting the need to diversify demonstrations to mitigate its misleading effects. However, diverse demonstrations pose challenges for effective representations. In this work, we propose ECHO, a self-harmonized chain-of-thought prompting method. It consolidates diverse solution paths into a uniform and effective solution pattern.ECHO demonstrates the best overall performance across three reasoning domains.

Step-by-step reasoning is widely used to enhance the reasoning ability of large language models (LLMs) in complex problems. Evaluating the quality of reasoning traces is crucial for understanding and improving LLM reasoning. However, the evaluation criteria remain highly unstandardized, leading to fragmented efforts in developing metrics and meta-evaluation benchmarks. To address this gap, this survey provides a comprehensive overview of step-by-step reasoning evaluation, proposing a taxonomy of evaluation criteria with four top-level categories (groundedness, validity, coherence, and utility). We then categorize metrics based on their implementations, survey which metrics are used for assessing each criterion, and explore whether evaluator models can transfer across different criteria. Finally, we identify key directions for future research.

Large language models (LLMs) have recently demonstrated remarkable success in mathematical reasoning. Despite progress in methods like chain-of-thought prompting and self-consistency sampling, these advances often focus on final correctness without ensuring that the underlying reasoning process is coherent and reliable. This paper introduces Step-KTO, a training framework that combines process-level and outcome-level binary feedback to guide LLMs toward more trustworthy reasoning trajectories. By providing binary evaluations for both the intermediate reasoning steps and the final answer, Step-KTO encourages the model to adhere to logical progressions rather than relying on superficial shortcuts. Our experiments on challenging mathematical benchmarks show that Step-KTO significantly improves both final answer accuracy and the quality of intermediate reasoning steps. For example, on the MATH-500 dataset, Step-KTO achieves a notable improvement in Pass@1 accuracy over strong baselines. These results highlight the promise of integrating stepwise process feedback into LLM training, paving the way toward more interpretable and dependable reasoning capabilities.

Large language models (LLMs) have shown remarkable reasoning capabilities given chain-of-thought prompts (examples with intermediate reasoning steps). Existing benchmarks measure reasoning ability indirectly, by evaluating accuracy on downstream tasks such as mathematical reasoning. However, it is unclear how these models obtain the answers and whether they rely on simple heuristics rather than the generated chain-of-thought. To enable systematic exploration of the reasoning ability of LLMs, we present a new synthetic question-answering dataset called PrOntoQA, where each example is generated from a synthetic world model represented in first-order logic. This allows us to parse the generated chain-of-thought into symbolic proofs for formal analysis. Our analysis on InstructGPT and GPT-3 shows that LLMs are quite capable of making correct individual deduction steps, and so are generally capable of reasoning, even in fictional contexts. However, they have difficulty with proof planning: When multiple valid deduction steps are available, they are not able to systematically explore the different options.

Math word problem (MWP) solving requires generating a reasoning path based on a given problem description that often contains irrelevant conditions. Existing chain-of-thought (CoT) prompting methods elicited multi-step reasoning abilities of large language models (LLMs) to solve MWPs. However, they were seriously confused by the irrelevant conditions, resulting in low accuracy. In this paper, we propose a novel approach named I^3C that instructs LLMs to identify and ignore irrelevant conditions. It identifies a set of irrelevant condition candidates that have a weak semantic relevance with the question. Then it prompts LLMs to verify the irrelevant conditions. Lastly it instructs the LLMs with the verification on relevant and irrelevant conditions to avoid confusion and improve reasoning paths. Moreover, we propose to select (problem, reasoning paths) pairs as demonstrations to enhance I^3C with few-shot reasoning. We develop I^3C-Select that selects the most confusing problems based on the semantic relevance measurement. We conduct extensive experiments on eight MWP datasets. I^3C can be combined with any CoT prompting methods to improve the performance of solving MWPs. Notably, with GPT-3.5-Turbo and I^3C-Select, we achieve an accuracy of 96.0 and 94.1 on GSM-IC2-1K and GSM-ICM-1K, respectively, significantly outperforming the state-of-the-art few-shot prompting method Complex-CoT by +11.7 and +11.1. Our implementation is made publicly available at https://wzy6642.github.io/I3C.github.io/.

Large language models (LLMs) have demonstrated outstanding performance across various tasks, yet they still exhibit limitations such as hallucination, unfaithful reasoning, and toxic content. One potential approach to mitigate these issues is learning from human or external feedback (e.g. tools). In this paper, we introduce an intrinsic self-correct reasoning framework for LLMs that eliminates the need for human feedback, external tools, and handcraft prompts. The proposed framework, based on a multi-step reasoning paradigm Learning from Correctness (LeCo), improves reasoning performance without needing to learn from errors. This paradigm prioritizes learning from correct reasoning steps, and a unique method to measure confidence for each reasoning step based on generation logits. Experimental results across various multi-step reasoning tasks demonstrate the effectiveness of the framework in improving reasoning performance with reduced token consumption.

Chain-of-Thought (CoT) prompting empowers the reasoning abilities of Large Language Models (LLMs), eliciting them to solve complex reasoning tasks step-by-step. However, with the success of CoT methods, the ability to deliver multi-step reasoning remains limited to English due to the imbalance in the distribution of the pre-training data, making the other languages a barrier. In this work, we propose a Cross-lingual multi-step reasoning approach, aiming to align reasoning processes across different languages. In particular, our method, through a Self-consistent Cross-lingual prompting mechanism inspired by the Tree-of-Thoughts approach, delivers multi-step reasoning paths in different languages that, during the steps, lead to the final solution. Our experimental evaluations show that our method significantly outperforms existing prompting methods, reducing the number of interactions and achieving state-of-the-art performance.

Recent advancements in large language models (LLMs) have demonstrated their impressive abilities in various reasoning and decision-making tasks. However, the quality and coherence of the reasoning process can still benefit from enhanced introspection and self-reflection. In this paper, we introduce Multiplex CoT (Chain of Thought), a method that enables LLMs to simulate a form of self-review while reasoning, by initiating double Chain of Thought (CoT) thinking. Multiplex CoT leverages the power of iterative reasoning, where the model generates an initial chain of thought and subsequently critiques and refines this reasoning with a second round of thought generation. This recursive approach allows for more coherent, logical, and robust answers, improving the overall decision-making process. We demonstrate how this method can be effectively implemented using simple prompt engineering in existing LLM architectures, achieving an effect similar to that of the Learning-Refinement Model (LRM) without the need for additional training. Additionally, we present a practical guide for implementing the method in Google Colab, enabling easy integration into real-world applications.

Several studies showed that Large Language Models (LLMs) can answer medical questions correctly, even outperforming the average human score in some medical exams. However, to our knowledge, no study has been conducted to assess the ability of language models to validate existing or generated medical text for correctness and consistency. In this paper, we introduce MEDEC (https://github.com/abachaa/MEDEC), the first publicly available benchmark for medical error detection and correction in clinical notes, covering five types of errors (Diagnosis, Management, Treatment, Pharmacotherapy, and Causal Organism). MEDEC consists of 3,848 clinical texts, including 488 clinical notes from three US hospital systems that were not previously seen by any LLM. The dataset has been used for the MEDIQA-CORR shared task to evaluate seventeen participating systems [Ben Abacha et al., 2024]. In this paper, we describe the data creation methods and we evaluate recent LLMs (e.g., o1-preview, GPT-4, Claude 3.5 Sonnet, and Gemini 2.0 Flash) for the tasks of detecting and correcting medical errors requiring both medical knowledge and reasoning capabilities. We also conducted a comparative study where two medical doctors performed the same task on the MEDEC test set. The results showed that MEDEC is a sufficiently challenging benchmark to assess the ability of models to validate existing or generated notes and to correct medical errors. We also found that although recent LLMs have a good performance in error detection and correction, they are still outperformed by medical doctors in these tasks. We discuss the potential factors behind this gap, the insights from our experiments, the limitations of current evaluation metrics, and share potential pointers for future research.

Mathematical reasoning has been challenging for large language models (LLMs). However, the introduction of step-by-step Chain-of-Thought (CoT) inference has significantly advanced the mathematical capabilities of LLMs. Despite this progress, current approaches either necessitate extensive inference datasets for training or depend on few-shot methods that frequently compromise computational accuracy. To address these bottlenecks in mathematical reasoning, we propose a novel method called Step Guidied Reasoning, which is more stable and generalizable than few-shot methods and does not involve further fine-tuning of the model. In this approach, LLMs reflect on small reasoning steps, similar to how humans deliberate and focus attention on what to do next. By incorporating this reflective process into the inference stage, LLMs can effectively guide their reasoning from one step to the next. Through extensive experiments, we demonstrate the significant effect of Step Guidied Reasoning in augmenting mathematical performance in state-of-the-art language models. Qwen2-72B-Instruct outperforms its math-specific counterpart, Qwen2.5-72B-Math-Instruct, on MMLU- STEM with a score of 90.9%, compared to 87.3%. The average scores of Qwen2-7B-Instruct and Qwen2-72B-Instruct increase from 27.1% to 36.3% and from 36.5% to 47.4% on the mathematics domain, respectively.

Modern systems for multi-hop question answering (QA) typically break questions into a sequence of reasoning steps, termed chain-of-thought (CoT), before arriving at a final answer. Often, multiple chains are sampled and aggregated through a voting mechanism over the final answers, but the intermediate steps themselves are discarded. While such approaches improve performance, they do not consider the relations between intermediate steps across chains and do not provide a unified explanation for the predicted answer. We introduce Multi-Chain Reasoning (MCR), an approach which prompts large language models to meta-reason over multiple chains of thought, rather than aggregating their answers. MCR examines different reasoning chains, mixes information between them and selects the most relevant facts in generating an explanation and predicting the answer. MCR outperforms strong baselines on 7 multi-hop QA datasets. Moreover, our analysis reveals that MCR explanations exhibit high quality, enabling humans to verify its answers.

Large Language Models (LLMs) have shown the potential to significantly contribute to patient care, diagnostics, and administrative processes. Emerging biomedical LLMs address healthcare-specific challenges, including privacy demands and computational constraints. However, evaluation of these models has primarily been limited to non-clinical tasks, which do not reflect the complexity of practical clinical applications. Additionally, there has been no thorough comparison between biomedical and general-domain LLMs for clinical tasks. To fill this gap, we present the Clinical Language Understanding Evaluation (CLUE), a benchmark tailored to evaluate LLMs on real-world clinical tasks. CLUE includes two novel datasets derived from MIMIC IV discharge letters and four existing tasks designed to test the practical applicability of LLMs in healthcare settings. Our evaluation covers several biomedical and general domain LLMs, providing insights into their clinical performance and applicability. CLUE represents a step towards a standardized approach to evaluating and developing LLMs in healthcare to align future model development with the real-world needs of clinical application. We publish our evaluation and data generation scripts: https://github.com/dadaamin/CLUE

Large language models have been shown to struggle with limited context memory and multi-step reasoning. We propose a simple method for solving both of these problems by allowing the model to take Self-Notes. Unlike recent scratchpad approaches, the model can deviate from the input context at any time to explicitly think. This allows the model to recall information and perform reasoning on the fly as it reads the context, thus extending its memory and enabling multi-step reasoning. Our experiments on multiple tasks demonstrate that our method can successfully generalize to longer and more complicated instances from their training setup by taking Self-Notes at inference time.

Reasoning is a critical frontier for advancing medical image analysis, where transparency and trustworthiness play a central role in both clinician trust and regulatory approval. Although Medical Visual Language Models (VLMs) show promise for radiological tasks, most existing VLMs merely produce final answers without revealing the underlying reasoning. To address this gap, we introduce MedVLM-R1, a medical VLM that explicitly generates natural language reasoning to enhance transparency and trustworthiness. Instead of relying on supervised fine-tuning (SFT), which often suffers from overfitting to training distributions and fails to foster genuine reasoning, MedVLM-R1 employs a reinforcement learning framework that incentivizes the model to discover human-interpretable reasoning paths without using any reasoning references. Despite limited training data (600 visual question answering samples) and model parameters (2B), MedVLM-R1 boosts accuracy from 55.11% to 78.22% across MRI, CT, and X-ray benchmarks, outperforming larger models trained on over a million samples. It also demonstrates robust domain generalization under out-of-distribution tasks. By unifying medical image analysis with explicit reasoning, MedVLM-R1 marks a pivotal step toward trustworthy and interpretable AI in clinical practice.

Large language models (LLMs) often fail to ask effective questions under uncertainty, making them unreliable in domains where proactive information-gathering is essential for decisionmaking. We present ALFA, a framework that improves LLM question-asking by (i) decomposing the notion of a "good" question into a set of theory-grounded attributes (e.g., clarity, relevance), (ii) controllably synthesizing attribute-specific question variations, and (iii) aligning models via preference-based optimization to explicitly learn to ask better questions along these fine-grained attributes. Focusing on clinical reasoning as a case study, we introduce the MediQ-AskDocs dataset, composed of 17k real-world clinical interactions augmented with 80k attribute-specific preference pairs of follow-up questions, as well as a novel expert-annotated interactive healthcare QA task to evaluate question-asking abilities. Models aligned with ALFA reduce diagnostic errors by 56.6% on MediQ-AskDocs compared to SOTA instruction-tuned LLMs, with a question-level win-rate of 64.4% and strong generalizability. Our findings suggest that explicitly guiding question-asking with structured, fine-grained attributes offers a scalable path to improve LLMs, especially in expert application domains.

Artificial intelligence has advanced in Medical Visual Question Answering (Med-VQA), but prevalent research tends to focus on the accuracy of the answers, often overlooking the reasoning paths and interpretability, which are crucial in clinical settings. Besides, current Med-VQA algorithms, typically reliant on singular models, lack the robustness needed for real-world medical diagnostics which usually require collaborative expert evaluation. To address these shortcomings, this paper presents MedCoT, a novel hierarchical expert verification reasoning chain method designed to enhance interpretability and accuracy in biomedical imaging inquiries. MedCoT is predicated on two principles: The necessity for explicit reasoning paths in Med-VQA and the requirement for multi-expert review to formulate accurate conclusions. The methodology involves an Initial Specialist proposing diagnostic rationales, followed by a Follow-up Specialist who validates these rationales, and finally, a consensus is reached through a vote among a sparse Mixture of Experts within the locally deployed Diagnostic Specialist, which then provides the definitive diagnosis. Experimental evaluations on four standard Med-VQA datasets demonstrate that MedCoT surpasses existing state-of-the-art approaches, providing significant improvements in performance and interpretability.

Large language models (LLMs) represent a transformative class of AI tools capable of revolutionizing various aspects of healthcare by generating human-like responses across diverse contexts and adapting to novel tasks following human instructions. Their potential application spans a broad range of medical tasks, such as clinical documentation, matching patients to clinical trials, and answering medical questions. In this primer paper, we propose an actionable guideline to help healthcare professionals more efficiently utilize LLMs in their work, along with a set of best practices. This approach consists of several main phases, including formulating the task, choosing LLMs, prompt engineering, fine-tuning, and deployment. We start with the discussion of critical considerations in identifying healthcare tasks that align with the core capabilities of LLMs and selecting models based on the selected task and data, performance requirements, and model interface. We then review the strategies, such as prompt engineering and fine-tuning, to adapt standard LLMs to specialized medical tasks. Deployment considerations, including regulatory compliance, ethical guidelines, and continuous monitoring for fairness and bias, are also discussed. By providing a structured step-by-step methodology, this tutorial aims to equip healthcare professionals with the tools necessary to effectively integrate LLMs into clinical practice, ensuring that these powerful technologies are applied in a safe, reliable, and impactful manner.

Multimodal reasoning is a challenging task that requires models to reason across multiple modalities to answer questions. Existing approaches have made progress by incorporating language and visual modalities into a two-stage reasoning framework, separating rationale generation from answer inference. However, these approaches often fall short due to the inadequate quality of the generated rationales. In this work, we delve into the importance of rationales in model reasoning. We observe that when rationales are completely accurate, the model's accuracy significantly improves, highlighting the need for high-quality rationale generation. Motivated by this, we propose MC-CoT, a self-consistency training strategy that generates multiple rationales and answers, subsequently selecting the most accurate through a voting process. This approach not only enhances the quality of generated rationales but also leads to more accurate and robust answers. Through extensive experiments, we demonstrate that our approach significantly improves model performance across various benchmarks. Remarkably, we show that even smaller base models, when equipped with our proposed approach, can achieve results comparable to those of larger models, illustrating the potential of our approach in harnessing the power of rationales for improved multimodal reasoning. The code is available at https://github.com/chengtan9907/mc-cot.

Summarization of clinical narratives is a long-standing research problem. Here, we introduce the task of hospital-course summarization. Given the documentation authored throughout a patient's hospitalization, generate a paragraph that tells the story of the patient admission. We construct an English, text-to-text dataset of 109,000 hospitalizations (2M source notes) and their corresponding summary proxy: the clinician-authored "Brief Hospital Course" paragraph written as part of a discharge note. Exploratory analyses reveal that the BHC paragraphs are highly abstractive with some long extracted fragments; are concise yet comprehensive; differ in style and content organization from the source notes; exhibit minimal lexical cohesion; and represent silver-standard references. Our analysis identifies multiple implications for modeling this complex, multi-document summarization task.

When leveraging language models for reasoning tasks, generating explicit chain-of-thought (CoT) steps often proves essential for achieving high accuracy in final outputs. In this paper, we investigate if models can be taught to internalize these CoT steps. To this end, we propose a simple yet effective method for internalizing CoT steps: starting with a model trained for explicit CoT reasoning, we gradually remove the intermediate steps and finetune the model. This process allows the model to internalize the intermediate reasoning steps, thus simplifying the reasoning process while maintaining high performance. Our approach enables a GPT-2 Small model to solve 9-by-9 multiplication with up to 99% accuracy, whereas standard training cannot solve beyond 4-by-4 multiplication. Furthermore, our method proves effective on larger language models, such as Mistral 7B, achieving over 50% accuracy on GSM8K without producing any intermediate steps.

Large Language Models (LLMs) have shown outstanding performance across wide range of downstream tasks. This competency is attributed to their substantial parameter size and pre-training on extensive corpus. Moreover, LLMs have exhibited enhanced reasoning capabilities in tackling complex reasoning tasks, owing to the utilization of a method named ``Chain-of-Thought (CoT) prompting''. This method is designed to generate intermediate reasoning steps that guide the inference of the final answer. However, it is essential to highlight that these advanced reasoning abilities appear to emerge in models with a minimum of 10 billion parameters, thereby limiting its efficacy in situations where computational resources are constrained. In this paper, we investigate the possibility of transferring the reasoning capabilities of LLMs to smaller models via knowledge distillation. Specifically, we propose Sci-CoT, a two-stage framework that separates the processes of generating rationales and inferring answers. This method enables a more efficient use of rationales during the answer inference stage, leading to improved performance on scientific question-answering tasks. Utilizing Sci-CoT, our 80-million parameter model is able to exceed the performance of BLOOM-176B in the ARC-Easy dataset under the few shot setting.

Large Language Models (LLMs) hold great promise to revolutionize current clinical systems for their superior capacities on medical text processing tasks and medical licensing exams. Meanwhile, traditional ML models such as SVM and XGBoost have still been mainly adopted in clinical prediction tasks. An emerging question is Can LLMs beat traditional ML models in clinical prediction? Thus, we build a new benchmark ClinicalBench to comprehensively study the clinical predictive modeling capacities of both general-purpose and medical LLMs, and compare them with traditional ML models. ClinicalBench embraces three common clinical prediction tasks, two databases, 14 general-purpose LLMs, 8 medical LLMs, and 11 traditional ML models. Through extensive empirical investigation, we discover that both general-purpose and medical LLMs, even with different model scales, diverse prompting or fine-tuning strategies, still cannot beat traditional ML models in clinical prediction yet, shedding light on their potential deficiency in clinical reasoning and decision-making. We call for caution when practitioners adopt LLMs in clinical applications. ClinicalBench can be utilized to bridge the gap between LLMs' development for healthcare and real-world clinical practice.

Large language models (LLMs) can perform complex reasoning by generating intermediate reasoning steps. Providing these steps for prompting demonstrations is called chain-of-thought (CoT) prompting. CoT prompting has two major paradigms. One leverages a simple prompt like "Let's think step by step" to facilitate step-by-step thinking before answering a question. The other uses a few manual demonstrations one by one, each composed of a question and a reasoning chain that leads to an answer. The superior performance of the second paradigm hinges on the hand-crafting of task-specific demonstrations one by one. We show that such manual efforts may be eliminated by leveraging LLMs with the "Let's think step by step" prompt to generate reasoning chains for demonstrations one by one, i.e., let's think not just step by step, but also one by one. However, these generated chains often come with mistakes. To mitigate the effect of such mistakes, we find that diversity matters for automatically constructing demonstrations. We propose an automatic CoT prompting method: Auto-CoT. It samples questions with diversity and generates reasoning chains to construct demonstrations. On ten public benchmark reasoning tasks with GPT-3, Auto-CoT consistently matches or exceeds the performance of the CoT paradigm that requires manual designs of demonstrations. Code is available at https://github.com/amazon-research/auto-cot

We present Eir Thai Medical LLM, a large language model with 8 billion parameters, specifically designed to enhance the accuracy of handling medical tasks in the Thai language. This model focuses on providing clear and easy-to-understand answers for both healthcare professionals and patients, thereby improving the efficiency of diagnosis and treatment processes. Human evaluation was conducted to ensure that the model adheres to care standards and provides unbiased answers. To prioritize data security, the model is deployed within the hospital's internal network, ensuring both high security and faster processing speeds. The internal API connection is secured with encryption and strict authentication measures to prevent data leaks and unauthorized access. We evaluated several open-source large language models with 8 billion parameters on four medical benchmarks: MedQA, MedMCQA, PubMedQA, and the medical subset of MMLU. The best-performing baselines were used to develop Eir Thai Medical LLM. Our evaluation employed multiple questioning strategies, including zero-shot, few-shot, chain-of-thought reasoning, and ensemble/self-consistency voting methods. Our model outperformed commercially available Thai-language large language models by more than 10%. In addition, we developed enhanced model testing tailored for clinical use in Thai across 18 clinical tasks, where our model exceeded GPT-4o performance by more than 11%

This study presents a novel learning approach designed to enhance both mathematical reasoning and problem-solving abilities of Large Language Models (LLMs). We focus on integrating the Chain-of-Thought (CoT) and the Program-of-Thought (PoT) learning, hypothesizing that prioritizing the learning of mathematical reasoning ability is helpful for the amplification of problem-solving ability. Thus, the initial learning with CoT is essential for solving challenging mathematical problems. To this end, we propose a sequential learning approach, named SAAS (Solving Ability Amplification Strategy), which strategically transitions from CoT learning to PoT learning. Our empirical study, involving an extensive performance comparison using several benchmarks, demonstrates that our SAAS achieves state-of-the-art (SOTA) performance. The results underscore the effectiveness of our sequential learning approach, marking a significant advancement in the field of mathematical reasoning in LLMs.

We present Multi-expert Prompting, a novel enhancement of ExpertPrompting (Xu et al., 2023), designed to improve the large language model (LLM) generation. Specifically, it guides an LLM to fulfill an input instruction by simulating multiple experts, aggregating their responses, and selecting the best among individual and aggregated responses. This process is performed in a single chain of thoughts through our seven carefully designed subtasks derived from the Nominal Group Technique (Ven and Delbecq, 1974), a well-established decision-making framework. Our evaluations demonstrate that Multi-expert Prompting significantly outperforms ExpertPrompting and comparable baselines in enhancing the truthfulness, factuality, informativeness, and usefulness of responses while reducing toxicity and hurtfulness. It further achieves state-of-the-art truthfulness by outperforming the best baseline by 8.69% with ChatGPT. Multi-expert Prompting is efficient, explainable, and highly adaptable to diverse scenarios, eliminating the need for manual prompt construction.

To achieve faithful reasoning that aligns with human expectations, large language models (LLMs) need to ground their reasoning to real-world knowledge (e.g., web facts, math and physical rules). Tools help LLMs access this external knowledge, but there remains challenges for fine-tuning LLM agents (e.g., Toolformer) to invoke tools in multi-step reasoning problems, where inter-connected tool calls require holistic and efficient tool usage planning. In this work, we propose a new method for LLMs to better leverage tools in multi-step reasoning. Our method, Chain-of-Abstraction (CoA), trains LLMs to first decode reasoning chains with abstract placeholders, and then call domain tools to reify each reasoning chain by filling in specific knowledge. This planning with abstract chains enables LLMs to learn more general reasoning strategies, which are robust to shifts of domain knowledge (e.g., math results) relevant to different reasoning questions. It also allows LLMs to perform decoding and calling of external tools in parallel, which avoids the inference delay caused by waiting for tool responses. In mathematical reasoning and Wiki QA domains, we show that our method consistently outperforms previous chain-of-thought and tool-augmented baselines on both in-distribution and out-of-distribution test sets, with an average ~6% absolute QA accuracy improvement. LLM agents trained with our method also show more efficient tool use, with inference speed being on average ~1.4x faster than baseline tool-augmented LLMs.

Multi-hop question answering (MHQA) requires a model to retrieve and integrate information from multiple passages to answer a complex question. Recent systems leverage the power of large language models and integrate evidence retrieval with reasoning prompts (e.g., chain-of-thought reasoning) for the MHQA task. However, the complexities in the question types (bridge v.s. comparison questions) and the reasoning types (sequential v.s. parallel reasonings) require more novel and fine-grained prompting methods to enhance the performance of MHQA under the zero-shot setting. In this paper, we propose STOC-TOT, a stochastic tree-of-thought reasoning prompting method with constrained decoding for MHQA and conduct a detailed comparison with other reasoning prompts on different question types and reasoning types. Specifically, we construct a tree-like reasoning structure by prompting the model to break down the original question into smaller sub-questions to form different reasoning paths. In addition, we prompt the model to provide a probability estimation for each reasoning path at each reasoning step. At answer time, we conduct constrained decoding on the model to generate more grounded answers and reduce hallucination. Experiments comparing STOC-TOT with two MHQA datasets and five large language models showed that our framework outperforms other reasoning prompts by a significant margin.

Recently, large language model (LLM) based artificial intelligence (AI) systems have demonstrated remarkable capabilities in natural language understanding and generation. However, these models face a significant challenge when it comes to sensitive applications, such as reasoning over medical knowledge and answering medical questions in a physician-like manner. Prior studies attempted to overcome this challenge by increasing the model size (>100B) to learn more general medical knowledge, while there is still room for improvement in LLMs with smaller-scale model sizes (<100B). In this work, we start from a pre-trained general LLM model (AntGLM-10B) and fine-tune it from a medical beginner towards a medical expert (called AntGLM-Med-10B), which leverages a 3-stage optimization procedure, i.e., general medical knowledge injection, medical domain instruction tuning, and specific medical task adaptation. Our contributions are threefold: (1) We specifically investigate how to adapt a pre-trained general LLM in medical domain, especially for a specific medical task. (2) We collect and construct large-scale medical datasets for each stage of the optimization process. These datasets encompass various data types and tasks, such as question-answering, medical reasoning, multi-choice questions, and medical conversations. (3) Specifically for multi-choice questions in the medical domain, we propose a novel Verification-of-Choice approach for prompting engineering, which significantly enhances the reasoning ability of LLMs. Remarkably, by combining the above approaches, our AntGLM-Med-10B model can outperform the most of LLMs on PubMedQA, including both general and medical LLMs, even when these LLMs have larger model size.

Reasoning, as an essential ability for complex problem-solving, can provide back-end support for various real-world applications, such as medical diagnosis, negotiation, etc. This paper provides a comprehensive survey of cutting-edge research on reasoning with language model prompting. We introduce research works with comparisons and summaries and provide systematic resources to help beginners. We also discuss the potential reasons for emerging such reasoning abilities and highlight future research directions. Resources are available at https://github.com/zjunlp/Prompt4ReasoningPapers (updated periodically).

Prompting-based large language models (LLMs) are surprisingly powerful at generating natural language reasoning steps or Chains-of-Thoughts (CoT) for multi-step question answering (QA). They struggle, however, when the necessary knowledge is either unavailable to the LLM or not up-to-date within its parameters. While using the question to retrieve relevant text from an external knowledge source helps LLMs, we observe that this one-step retrieve-and-read approach is insufficient for multi-step QA. Here, what to retrieve depends on what has already been derived, which in turn may depend on what was previously retrieved. To address this, we propose IRCoT, a new approach for multi-step QA that interleaves retrieval with steps (sentences) in a CoT, guiding the retrieval with CoT and in turn using retrieved results to improve CoT. Using IRCoT with GPT3 substantially improves retrieval (up to 21 points) as well as downstream QA (up to 15 points) on four datasets: HotpotQA, 2WikiMultihopQA, MuSiQue, and IIRC. We observe similar substantial gains in out-of-distribution (OOD) settings as well as with much smaller models such as Flan-T5-large without additional training. IRCoT reduces model hallucination, resulting in factually more accurate CoT reasoning. Code, data, and prompts are available at https://github.com/stonybrooknlp/ircot

Chain of Thought (CoT) was introduced in recent research as a method for improving step-by-step reasoning in Large Language Models. However, CoT has limited applications such as its need for hand-crafted few-shot exemplar prompts and no capability to adjust itself to different queries. In this work, we propose a system to automatically generate rationales using CoT. Our method improves multi-step implicit reasoning capabilities by decomposing the implicit query into several explicit questions. This provides interpretability for the model, improving reasoning in weaker LLMs. We test our approach with two Q\&A datasets: StrategyQA and HotpotQA. We show an increase in accuracy with both, especially on StrategyQA. To facilitate further research in this field, the complete source code for this study has been made publicly available on GitHub: https://github.com/miralab-ai/autoreason.

Large language models (LLMs) have shown remarkable progress in encoding clinical knowledge and responding to complex medical queries with appropriate clinical reasoning. However, their applicability in subspecialist or complex medical settings remains underexplored. In this work, we probe the performance of AMIE, a research conversational diagnostic AI system, in the subspecialist domain of breast oncology care without specific fine-tuning to this challenging domain. To perform this evaluation, we curated a set of 50 synthetic breast cancer vignettes representing a range of treatment-naive and treatment-refractory cases and mirroring the key information available to a multidisciplinary tumor board for decision-making (openly released with this work). We developed a detailed clinical rubric for evaluating management plans, including axes such as the quality of case summarization, safety of the proposed care plan, and recommendations for chemotherapy, radiotherapy, surgery and hormonal therapy. To improve performance, we enhanced AMIE with the inference-time ability to perform web search retrieval to gather relevant and up-to-date clinical knowledge and refine its responses with a multi-stage self-critique pipeline. We compare response quality of AMIE with internal medicine trainees, oncology fellows, and general oncology attendings under both automated and specialist clinician evaluations. In our evaluations, AMIE outperformed trainees and fellows demonstrating the potential of the system in this challenging and important domain. We further demonstrate through qualitative examples, how systems such as AMIE might facilitate conversational interactions to assist clinicians in their decision making. However, AMIE's performance was overall inferior to attending oncologists suggesting that further research is needed prior to consideration of prospective uses.

This paper investigates the mathematical reasoning capabilities of large language models (LLMs) using 50 newly constructed high-school-level word problems. Unlike prior studies that focus solely on answer correctness, we rigorously analyze both final answers and solution steps to identify reasoning failures. Evaluating eight state-of-the-art models - including Mixtral, Llama, Gemini, GPT-4o, and OpenAI's o1 variants - we find that while newer models (e.g., o3-mini, deepseek-r1) achieve higher accuracy, all models exhibit errors in spatial reasoning, strategic planning, and arithmetic, sometimes producing correct answers through flawed logic. Common failure modes include unwarranted assumptions, over-reliance on numerical patterns, and difficulty translating physical intuition into mathematical steps. Manual analysis reveals that models struggle with problems requiring multi-step deduction or real-world knowledge, despite possessing broad mathematical knowledge. Our results underscore the importance of evaluating reasoning processes, not just answers, and caution against overestimating LLMs' problem-solving proficiency. The study highlights persistent gaps in LLMs' generalization abilities, emphasizing the need for targeted improvements in structured reasoning and constraint handling.

Large Language Models (LLMs) have succeeded remarkably in various natural language processing (NLP) tasks, yet their reasoning capabilities remain a fundamental challenge. While LLMs exhibit impressive fluency and factual recall, their ability to perform complex reasoning-spanning logical deduction, mathematical problem-solving, commonsense inference, and multi-step reasoning-often falls short of human expectations. This survey provides a comprehensive review of emerging techniques enhancing reasoning in LLMs. We categorize existing methods into key approaches, including prompting strategies (e.g., Chain-of-Thought reasoning, Self-Consistency, and Tree-of-Thought reasoning), architectural innovations (e.g., retrieval-augmented models, modular reasoning networks, and neuro-symbolic integration), and learning paradigms (e.g., fine-tuning with reasoning-specific datasets, reinforcement learning, and self-supervised reasoning objectives). Additionally, we explore evaluation frameworks used to assess reasoning in LLMs and highlight open challenges, such as hallucinations, robustness, and reasoning generalization across diverse tasks. By synthesizing recent advancements, this survey aims to provide insights into promising directions for future research and practical applications of reasoning-augmented LLMs.

We explore multi-step reasoning in vision-language models (VLMs). The problem is challenging, as reasoning data consisting of multiple steps of visual and language processing are barely available. To overcome the challenge, we first introduce a least-to-most visual reasoning paradigm, which interleaves steps of decomposing a question into sub-questions and invoking external tools for resolving sub-questions. Based on the paradigm, we further propose a novel data synthesis approach that can automatically create questions and multi-step reasoning paths for an image in a bottom-up manner. Our approach divides the complex synthesis task into a few simple sub-tasks, and (almost entirely) relies on open-sourced models to accomplish the sub-tasks. Therefore, the entire synthesis process is reproducible and cost-efficient, and the synthesized data is quality guaranteed. With the approach, we construct 50k visual reasoning examples. Then, we develop a visual reasoner through supervised fine-tuning, which is capable of generally enhancing the reasoning abilities of a wide range of existing VLMs in a plug-and-play fashion. Extensive experiments indicate that the visual reasoner can consistently and significantly improve four VLMs on four VQA benchmarks. Our code and dataset are available at https://github.com/steven-ccq/VisualReasoner.

Multimodal large language models (MLLMs) have made significant strides, yet they face challenges in the medical domain due to limited specialized knowledge. While recent medical MLLMs demonstrate strong performance in lab settings, they often struggle in real-world applications, highlighting a substantial gap between research and practice. In this paper, we seek to address this gap at various stages of the end-to-end learning pipeline, including data collection, model fine-tuning, and evaluation. At the data collection stage, we introduce SemiHVision, a dataset that combines human annotations with automated augmentation techniques to improve both medical knowledge representation and diagnostic reasoning. For model fine-tuning, we trained PMC-Cambrian-8B-AN over 2400 H100 GPU hours, resulting in performance that surpasses public medical models like HuatuoGPT-Vision-34B (79.0% vs. 66.7%) and private general models like Claude3-Opus (55.7%) on traditional benchmarks such as SLAKE and VQA-RAD. In the evaluation phase, we observed that traditional benchmarks cannot accurately reflect realistic clinical task capabilities. To overcome this limitation and provide more targeted guidance for model evaluation, we introduce the JAMA Clinical Challenge, a novel benchmark specifically designed to evaluate diagnostic reasoning. On this benchmark, PMC-Cambrian-AN achieves state-of-the-art performance with a GPT-4 score of 1.29, significantly outperforming HuatuoGPT-Vision-34B (1.13) and Claude3-Opus (1.17), demonstrating its superior diagnostic reasoning abilities.

State-of-the-art Large Language Models (LLMs) are accredited with an increasing number of different capabilities, ranging from reading comprehension, over advanced mathematical and reasoning skills to possessing scientific knowledge. In this paper we focus on their multi-hop reasoning capability: the ability to identify and integrate information from multiple textual sources. Given the concerns with the presence of simplifying cues in existing multi-hop reasoning benchmarks, which allow models to circumvent the reasoning requirement, we set out to investigate, whether LLMs are prone to exploiting such simplifying cues. We find evidence that they indeed circumvent the requirement to perform multi-hop reasoning, but they do so in more subtle ways than what was reported about their fine-tuned pre-trained language model (PLM) predecessors. Motivated by this finding, we propose a challenging multi-hop reasoning benchmark, by generating seemingly plausible multi-hop reasoning chains, which ultimately lead to incorrect answers. We evaluate multiple open and proprietary state-of-the-art LLMs, and find that their performance to perform multi-hop reasoning is affected, as indicated by up to 45% relative decrease in F1 score when presented with such seemingly plausible alternatives. We conduct a deeper analysis and find evidence that while LLMs tend to ignore misleading lexical cues, misleading reasoning paths indeed present a significant challenge.

Recently, slow-thinking reasoning systems, such as o1, have demonstrated remarkable capabilities in solving complex reasoning tasks. These systems typically engage in an extended thinking process before responding to a query, allowing them to generate more thorough, accurate, and well-reasoned solutions. These systems are primarily developed and maintained by industry, with their core techniques not publicly disclosed. In response, an increasing number of studies from the research community aim to explore the technical foundations underlying these powerful reasoning systems. Building on these prior efforts, this paper presents a reproduction report on implementing o1-like reasoning systems. We introduce an "imitate, explore, and self-improve" framework as our primary technical approach to train the reasoning model. In the initial phase, we use distilled long-form thought data to fine-tune the reasoning model, enabling it to invoke a slow-thinking mode. The model is then encouraged to explore challenging problems by generating multiple rollouts, which can result in increasingly more high-quality trajectories that lead to correct answers. Furthermore, the model undergoes self-improvement by iteratively refining its training dataset. To verify the effectiveness of this approach, we conduct extensive experiments on three challenging benchmarks. The experimental results demonstrate that our approach achieves competitive performance compared to industry-level reasoning systems on these benchmarks.

Reasoning is a fundamental aspect of human intelligence that plays a crucial role in activities such as problem solving, decision making, and critical thinking. In recent years, large language models (LLMs) have made significant progress in natural language processing, and there is observation that these models may exhibit reasoning abilities when they are sufficiently large. However, it is not yet clear to what extent LLMs are capable of reasoning. This paper provides a comprehensive overview of the current state of knowledge on reasoning in LLMs, including techniques for improving and eliciting reasoning in these models, methods and benchmarks for evaluating reasoning abilities, findings and implications of previous research in this field, and suggestions on future directions. Our aim is to provide a detailed and up-to-date review of this topic and stimulate meaningful discussion and future work.

Although recent advances in scaling large language models (LLMs) have resulted in improvements on many NLP tasks, it remains unclear whether these models trained primarily with general web text are the right tool in highly specialized, safety critical domains such as clinical text. Recent results have suggested that LLMs encode a surprising amount of medical knowledge. This raises an important question regarding the utility of smaller domain-specific language models. With the success of general-domain LLMs, is there still a need for specialized clinical models? To investigate this question, we conduct an extensive empirical analysis of 12 language models, ranging from 220M to 175B parameters, measuring their performance on 3 different clinical tasks that test their ability to parse and reason over electronic health records. As part of our experiments, we train T5-Base and T5-Large models from scratch on clinical notes from MIMIC III and IV to directly investigate the efficiency of clinical tokens. We show that relatively small specialized clinical models substantially outperform all in-context learning approaches, even when finetuned on limited annotated data. Further, we find that pretraining on clinical tokens allows for smaller, more parameter-efficient models that either match or outperform much larger language models trained on general text. We release the code and the models used under the PhysioNet Credentialed Health Data license and data use agreement.

In recent advancements, multimodal large language models (MLLMs) have been fine-tuned on specific medical image datasets to address medical visual question answering (Med-VQA) tasks. However, this common approach of task-specific fine-tuning is costly and necessitates separate models for each downstream task, limiting the exploration of zero-shot capabilities. In this paper, we introduce MC-CoT, a modular cross-modal collaboration Chain-of-Thought (CoT) framework designed to enhance the zero-shot performance of MLLMs in Med-VQA by leveraging large language models (LLMs). MC-CoT improves reasoning and information extraction by integrating medical knowledge and task-specific guidance, where LLM provides various complex medical reasoning chains and MLLM provides various observations of medical images based on instructions of the LLM. Our experiments on datasets such as SLAKE, VQA-RAD, and PATH-VQA show that MC-CoT surpasses standalone MLLMs and various multimodality CoT frameworks in recall rate and accuracy. These findings highlight the importance of incorporating background information and detailed guidance in addressing complex zero-shot Med-VQA tasks.

Multimodal reasoning stands as a pivotal capability for large vision-language models (LVLMs). The integration with Domain-Specific Languages (DSL), offering precise visual representations, equips these models with the opportunity to execute more accurate reasoning in complex and professional domains. However, the vanilla Chain-of-Thought (CoT) prompting method faces challenges in effectively leveraging the unique strengths of visual and DSL representations, primarily due to their differing reasoning mechanisms. Additionally, it often falls short in addressing critical steps in multi-step reasoning tasks. To mitigate these challenges, we introduce the Bi-Modal Behavioral Alignment (BBA) prompting method, designed to maximize the potential of DSL in augmenting complex multi-modal reasoning tasks. This method initiates by guiding LVLMs to create separate reasoning chains for visual and DSL representations. Subsequently, it aligns these chains by addressing any inconsistencies, thus achieving a cohesive integration of behaviors from different modalities. Our experiments demonstrate that BBA substantially improves the performance of GPT-4V(ision) on geometry problem solving (28.34% to 34.22%), chess positional advantage prediction (42.08% to 46.99%) and molecular property prediction (77.47% to 83.52%).

Pretrained large language models (LLMs) are widely used in many sub-fields of natural language processing (NLP) and generally known as excellent few-shot learners with task-specific exemplars. Notably, chain of thought (CoT) prompting, a recent technique for eliciting complex multi-step reasoning through step-by-step answer examples, achieved the state-of-the-art performances in arithmetics and symbolic reasoning, difficult system-2 tasks that do not follow the standard scaling laws for LLMs. While these successes are often attributed to LLMs' ability for few-shot learning, we show that LLMs are decent zero-shot reasoners by simply adding "Let's think step by step" before each answer. Experimental results demonstrate that our Zero-shot-CoT, using the same single prompt template, significantly outperforms zero-shot LLM performances on diverse benchmark reasoning tasks including arithmetics (MultiArith, GSM8K, AQUA-RAT, SVAMP), symbolic reasoning (Last Letter, Coin Flip), and other logical reasoning tasks (Date Understanding, Tracking Shuffled Objects), without any hand-crafted few-shot examples, e.g. increasing the accuracy on MultiArith from 17.7% to 78.7% and GSM8K from 10.4% to 40.7% with large InstructGPT model (text-davinci-002), as well as similar magnitudes of improvements with another off-the-shelf large model, 540B parameter PaLM. The versatility of this single prompt across very diverse reasoning tasks hints at untapped and understudied fundamental zero-shot capabilities of LLMs, suggesting high-level, multi-task broad cognitive capabilities may be extracted by simple prompting. We hope our work not only serves as the minimal strongest zero-shot baseline for the challenging reasoning benchmarks, but also highlights the importance of carefully exploring and analyzing the enormous zero-shot knowledge hidden inside LLMs before crafting finetuning datasets or few-shot exemplars.

Large Language Models, such as Generative Pre-trained Transformer 3 (aka. GPT-3), have been developed to understand language through the analysis of extensive text data, allowing them to identify patterns and connections between words. While LLMs have demonstrated impressive performance across various text-related tasks, they encounter challenges in tasks associated with reasoning. To address this challenge, Chain of Thought(CoT) prompting method has been proposed as a means to enhance LLMs' proficiency in complex reasoning tasks like solving math word problems and answering questions based on logical argumentative reasoning. The primary aim of this research is to assess how well four language models can grade reflective essays of third-year medical students. The assessment will specifically target the evaluation of critical thinking skills using CoT prompting. The research will provide the following contributions; to introduce and educate on the process of instructing models to evaluate reflective essays from a dataset they have not been previously trained on; to illustrate the use of CoT prompting as an instructional approach for training large models to carry out particular tasks. Our results suggest that among all the models, Llama-7b performs the least effectively, displaying the highest mean squared error. Conversely, ChatGPT emerges as the superior model, boasting a higher Cohen kappa score value of 0.53. Lastly, it's important to note that the selected models do prioritise user privacy by allowing users to delete their own conducted conversations.

Humans have a powerful and mysterious capacity to reason. By working through a series of purely mental steps, we can make inferences we would not be capable of making directly -- despite the fact that we get no additional data from the world. Similarly, when large language models generate a series of intermediate steps (a chain of thought) before answering a question, they often produce better answers than they otherwise would. We investigate why and how chain-of-thought reasoning is useful in language models, testing the hypothesis that reasoning is effective when training data consists of local clusters of variables that influence each other strongly. These training conditions enable the chaining of accurate local inferences in order to estimate relationships between variables that were not seen together in training. We prove that there will exist a "reasoning gap", where reasoning through intermediate variables improves inference, for the simple case of an autoregressive density estimator trained on local samples from a chain-structured probabilistic model. We then test our hypothesis empirically in more complex models, training an autoregressive language model on samples from Bayes nets but only including a subset of variables in each sample. We test language models' ability to match conditional probabilities with and without intermediate reasoning steps, finding that intermediate steps are only helpful when the training data is locally structured with respect to dependencies between variables and that the combination of locally-structured observations and reasoning is much more data-efficient than training on all variables. Our results illustrate how the effectiveness of reasoning step by step is rooted in the local statistical structure of the training data.

Multi-hop reasoning (i.e., reasoning across two or more documents) is a key ingredient for NLP models that leverage large corpora to exhibit broad knowledge. To retrieve evidence passages, multi-hop models must contend with a fast-growing search space across the hops, represent complex queries that combine multiple information needs, and resolve ambiguity about the best order in which to hop between training passages. We tackle these problems via Baleen, a system that improves the accuracy of multi-hop retrieval while learning robustly from weak training signals in the many-hop setting. To tame the search space, we propose condensed retrieval, a pipeline that summarizes the retrieved passages after each hop into a single compact context. To model complex queries, we introduce a focused late interaction retriever that allows different parts of the same query representation to match disparate relevant passages. Lastly, to infer the hopping dependencies among unordered training passages, we devise latent hop ordering, a weak-supervision strategy in which the trained retriever itself selects the sequence of hops. We evaluate Baleen on retrieval for two-hop question answering and many-hop claim verification, establishing state-of-the-art performance.

Medical language models (MLMs) have become pivotal in advancing medical natural language processing. However, prior models that rely on pre-training or supervised fine-tuning often exhibit low data efficiency and limited practicality in real-world clinical applications. While OpenAIs O1 highlights test-time scaling in mathematics, attempts to replicate this approach in medicine typically distill responses from GPT-series models to open-source models, focusing primarily on multiple-choice tasks. This strategy, though straightforward, neglects critical concerns like data privacy and realistic deployment in clinical settings. In this work, we present a deployable, small-scale medical language model, \mone, designed for long-chain reasoning in clinical tasks using a self-evolution paradigm. Starting with a seed dataset of around 8,000 instances spanning five domains and 16 datasets, we prompt a base policy model to perform Monte Carlo Tree Search (MCTS) to construct verifiable reasoning chains. Each reasoning step is assigned an evolution rollout value, allowing verified trajectories to train the policy model and the reward model. During inference, the policy model generates multiple responses, and the reward model selects the one with the highest reward score. Experiments on eleven evaluation datasets demonstrate that \mone outperforms prior open-source models by 2 points, with the addition of the reward model further boosting performance (sim13 points), surpassing GPT-4o-mini. Code and data are available at https://github.com/pixas/MedSSS.

In recent years, there have been significant breakthroughs in the field of natural language processing, particularly with the development of large language models (LLMs). These LLMs have showcased remarkable capabilities on various benchmarks. In the healthcare field, the exact role LLMs and other future AI models will play remains unclear. There is a potential for these models in the future to be used as part of adaptive physician training, medical co-pilot applications, and digital patient interaction scenarios. The ability of AI models to participate in medical training and patient care will depend in part on their mastery of the knowledge content of specific medical fields. This study investigated the medical knowledge capability of LLMs, specifically in the context of internal medicine subspecialty multiple-choice test-taking ability. We compared the performance of several open-source LLMs (Koala 7B, Falcon 7B, Stable-Vicuna 13B, and Orca Mini 13B), to GPT-4 and Claude 2 on multiple-choice questions in the field of Nephrology. Nephrology was chosen as an example of a particularly conceptually complex subspecialty field within internal medicine. The study was conducted to evaluate the ability of LLM models to provide correct answers to nephSAP (Nephrology Self-Assessment Program) multiple-choice questions. The overall success of open-sourced LLMs in answering the 858 nephSAP multiple-choice questions correctly was 17.1% - 25.5%. In contrast, Claude 2 answered 54.4% of the questions correctly, whereas GPT-4 achieved a score of 73.3%. We show that current widely used open-sourced LLMs do poorly in their ability for zero-shot reasoning when compared to GPT-4 and Claude 2. The findings of this study potentially have significant implications for the future of subspecialty medical training and patient care.

We study whether Large Language Models (LLMs) latently perform multi-hop reasoning with complex prompts such as "The mother of the singer of 'Superstition' is". We look for evidence of a latent reasoning pathway where an LLM (1) latently identifies "the singer of 'Superstition'" as Stevie Wonder, the bridge entity, and (2) uses its knowledge of Stevie Wonder's mother to complete the prompt. We analyze these two hops individually and consider their co-occurrence as indicative of latent multi-hop reasoning. For the first hop, we test if changing the prompt to indirectly mention the bridge entity instead of any other entity increases the LLM's internal recall of the bridge entity. For the second hop, we test if increasing this recall causes the LLM to better utilize what it knows about the bridge entity. We find strong evidence of latent multi-hop reasoning for the prompts of certain relation types, with the reasoning pathway used in more than 80% of the prompts. However, the utilization is highly contextual, varying across different types of prompts. Also, on average, the evidence for the second hop and the full multi-hop traversal is rather moderate and only substantial for the first hop. Moreover, we find a clear scaling trend with increasing model size for the first hop of reasoning but not for the second hop. Our experimental findings suggest potential challenges and opportunities for future development and applications of LLMs.

Large Language Models (LLMs), despite their remarkable progress across various general domains, encounter significant barriers in medicine and healthcare. This field faces unique challenges such as domain-specific terminologies and the reasoning over specialized knowledge. To address these obstinate issues, we propose a novel Multi-disciplinary Collaboration (MC) framework for the medical domain that leverages role-playing LLM-based agents who participate in a collaborative multi-round discussion, thereby enhancing LLM proficiency and reasoning capabilities. This training-free and interpretable framework encompasses five critical steps: gathering domain experts, proposing individual analyses, summarising these analyses into a report, iterating over discussions until a consensus is reached, and ultimately making a decision. Our work particularly focuses on the zero-shot scenario, our results on nine data sets (MedQA, MedMCQA, PubMedQA, and six subtasks from MMLU) establish that our proposed MC framework excels at mining and harnessing the medical expertise in LLMs, as well as extending its reasoning abilities. Based on these outcomes, we further conduct a human evaluation to pinpoint and categorize common errors within our method, as well as ablation studies aimed at understanding the impact of various factors on overall performance. Our code can be found at https://github.com/gersteinlab/MedAgents.

Chain-of-Thought(CoT) prompting and its variants explore equipping large language models (LLMs) with high-level reasoning abilities by emulating human-like linear cognition and logic. However, the human mind is complicated and mixed with both linear and nonlinear thinking. In this work, we propose Inferential Exclusion Prompting (IEP), a novel prompting that combines the principles of elimination and inference in order to guide LLMs to think non-linearly. IEP guides LLMs to plan and then utilize Natural Language Inference (NLI) to deduce each possible solution's entailment relation with context, commonsense, or facts, therefore yielding a broader perspective by thinking back for inferring. This forward planning and backward eliminating process allows IEP to better simulate the complex human thinking processes compared to other CoT-based methods, which only reflect linear cognitive processes. We conducted a series of empirical studies and have corroborated that IEP consistently outperforms CoT across various tasks. Additionally, we observe that integrating IEP and CoT further improves the LLMs' performance on certain tasks, highlighting the necessity of equipping LLMs with mixed logic processes. Moreover, to better evaluate comprehensive features inherent in human logic, we introduce Mental-Ability Reasoning Benchmark (MARB). The benchmark comprises six novel subtasks with a total of 9,115 questions, among which 1,685 are developed with hand-crafted rationale references. We believe both IEP and MARB can serve as a promising direction for unveiling LLMs' logic and verbal reasoning abilities and drive further advancements. MARB will be available at ~anonymity link soon.

Step-by-step reasoning approaches like chain of thought (CoT) have proved to be very effective in inducing reasoning capabilities in large language models. However, the success of the CoT approach is fundamentally tied to the model size, and billion parameter-scale models are often needed to get CoT to work. In this paper, we propose a knowledge distillation approach that leverages the step-by-step CoT reasoning capabilities of larger models and distills these abilities into smaller models. In this work, we propose an alternative reasoning scheme, Socratic CoT, that learns a decomposition of the original problem into a sequence of subproblems and uses it to guide the intermediate reasoning steps. We use Socratic CoT to train a combination of two small distilled models: a problem decomposer and a subproblem solver. In practice, given a new problem, the two distilled models work in sync to decompose and solve complex problems. On multiple reasoning datasets (GSM8K, StrategyQA, and SVAMP), our proposed distillation strategies boosts the performance of smaller models over 70% compared to the baselines. Finally, we investigate when Socratic CoT is an effective alternative to CoT, demonstrating cases where a much smaller model (GPT-2 large) can outperform a 10X larger model (GPT-3 6B). Our code is available here: https://github.com/kumar-shridhar/Distiiling-LM

We present MedConceptsQA, a dedicated open source benchmark for medical concepts question answering. The benchmark comprises of questions of various medical concepts across different vocabularies: diagnoses, procedures, and drugs. The questions are categorized into three levels of difficulty: easy, medium, and hard. We conducted evaluations of the benchmark using various Large Language Models. Our findings show that pre-trained clinical Large Language Models achieved accuracy levels close to random guessing on this benchmark, despite being pre-trained on medical data. However, GPT-4 achieves an absolute average improvement of nearly 27%-37% (27% for zero-shot learning and 37% for few-shot learning) when compared to clinical Large Language Models. Our benchmark serves as a valuable resource for evaluating the understanding and reasoning of medical concepts by Large Language Models. Our benchmark is available at https://huggingface.co/datasets/ofir408/MedConceptsQA

This study focuses on improving the performance of lightweight Large Language Models (LLMs) in mathematical reasoning tasks. We introduce a novel method for measuring mathematical logic similarity and design an automatic screening mechanism to construct a set of reference problems that integrate both semantic and logical similarity. By employing carefully crafted positive and negative example prompts, we guide the model towards adopting sound reasoning logic. To the best of our knowledge, this is the first attempt to utilize retrieval-enhanced generation for mathematical problem-solving. Experimental results demonstrate that our method achieves a 15.8% improvement over the Chain of Thought approach on the SVAMP dataset and a 21.5 % improvement on the GSM8K dataset. Further application of this method to a large-scale model with 175 billion parameters yields performance comparable to the best results on both aforementioned datasets. Finally, we conduct an analysis of errors during the reasoning process, providing valuable insights and directions for future research on reasoning tasks using large language models.

Prompting language models to provide step-by-step answers (e.g., "Chain-of-Thought") is the prominent approach for complex reasoning tasks, where more accurate reasoning chains typically improve downstream task performance. Recent literature discusses automatic methods to verify reasoning steps to evaluate and improve their correctness. However, no fine-grained step-level datasets are available to enable thorough evaluation of such verification methods, hindering progress in this direction. We introduce Reveal: Reasoning Verification Evaluation, a new dataset to benchmark automatic verifiers of complex Chain-of-Thought reasoning in open-domain question answering settings. Reveal includes comprehensive labels for the relevance, attribution to evidence passages, and logical correctness of each reasoning step in a language model's answer, across a wide variety of datasets and state-of-the-art language models.

Large language models (LLMs) have demonstrated impressive performance in various natural language processing tasks, yet their ability to perform multi-step logical reasoning remains an open challenge. Although Chain-of-Thought prompting has improved logical reasoning by enabling models to generate intermediate steps, it lacks mechanisms to assess the coherence of these logical transitions. In this paper, we propose a novel, lightweight evaluation strategy for logical reasoning that uses query-key alignments inside transformer attention heads. By computing a single forward pass and extracting a "QK-score" from carefully chosen heads, our method reveals latent representations that reliably separate valid from invalid inferences, offering a scalable alternative to traditional ablation-based techniques. We also provide an empirical validation on multiple logical reasoning benchmarks, demonstrating improved robustness of our evaluation method against distractors and increased reasoning depth. The experiments were conducted on a diverse set of models, ranging from 1.5B to 70B parameters.

Artificial intelligence (AI) and large language models (LLMs) in healthcare require advanced clinical skills (CS), yet current benchmarks fail to evaluate these comprehensively. We introduce MedQA-CS, an AI-SCE framework inspired by medical education's Objective Structured Clinical Examinations (OSCEs), to address this gap. MedQA-CS evaluates LLMs through two instruction-following tasks, LLM-as-medical-student and LLM-as-CS-examiner, designed to reflect real clinical scenarios. Our contributions include developing MedQA-CS, a comprehensive evaluation framework with publicly available data and expert annotations, and providing the quantitative and qualitative assessment of LLMs as reliable judges in CS evaluation. Our experiments show that MedQA-CS is a more challenging benchmark for evaluating clinical skills than traditional multiple-choice QA benchmarks (e.g., MedQA). Combined with existing benchmarks, MedQA-CS enables a more comprehensive evaluation of LLMs' clinical capabilities for both open- and closed-source LLMs.

Few-shot prompting is a surprisingly powerful way to use Large Language Models (LLMs) to solve various tasks. However, this approach struggles as the task complexity increases or when the individual reasoning steps of the task themselves are hard to learn, especially when embedded in more complex tasks. To address this, we propose Decomposed Prompting, a new approach to solve complex tasks by decomposing them (via prompting) into simpler sub-tasks that can be delegated to a library of prompting-based LLMs dedicated to these sub-tasks. This modular structure allows each prompt to be optimized for its specific sub-task, further decomposed if necessary, and even easily replaced with more effective prompts, trained models, or symbolic functions if desired. We show that the flexibility and modularity of Decomposed Prompting allows it to outperform prior work on few-shot prompting using GPT3. On symbolic reasoning tasks, we can further decompose sub-tasks that are hard for LLMs into even simpler solvable sub-tasks. When the complexity comes from the input length, we can recursively decompose the task into the same task but with smaller inputs. We also evaluate our approach on textual multi-step reasoning tasks: on long-context multi-hop QA task, we can more effectively teach the sub-tasks via our separate sub-tasks prompts; and on open-domain multi-hop QA, we can incorporate a symbolic information retrieval within our decomposition framework, leading to improved performance on both tasks. Datasets, Code and Prompts available at https://github.com/allenai/DecomP.

The advancement of natural language processing (NLP) systems in healthcare hinges on language model ability to interpret the intricate information contained within clinical notes. This process often requires integrating information from various time points in a patient's medical history. However, most earlier clinical language models were pretrained with a context length limited to roughly one clinical document. In this study, We introduce ClinicalMamba, a specialized version of the Mamba language model, pretrained on a vast corpus of longitudinal clinical notes to address the unique linguistic characteristics and information processing needs of the medical domain. ClinicalMamba, with 130 million and 2.8 billion parameters, demonstrates a superior performance in modeling clinical language across extended text lengths compared to Mamba and clinical Llama. With few-shot learning, ClinicalMamba achieves notable benchmarks in speed and accuracy, outperforming existing clinical language models and general domain large models like GPT-4 in longitudinal clinical notes information extraction tasks.

Recent research has shown that rationales, or step-by-step chains of thought, can be used to improve performance in multi-step reasoning tasks. We reconsider rationale-augmented prompting for few-shot in-context learning, where (input -> output) prompts are expanded to (input, rationale -> output) prompts. For rationale-augmented prompting we demonstrate how existing approaches, which rely on manual prompt engineering, are subject to sub-optimal rationales that may harm performance. To mitigate this brittleness, we propose a unified framework of rationale-augmented ensembles, where we identify rationale sampling in the output space as the key component to robustly improve performance. This framework is general and can easily be extended to common natural language processing tasks, even those that do not traditionally leverage intermediate steps, such as question answering, word sense disambiguation, and sentiment analysis. We demonstrate that rationale-augmented ensembles achieve more accurate and interpretable results than existing prompting approaches--including standard prompting without rationales and rationale-based chain-of-thought prompting--while simultaneously improving interpretability of model predictions through the associated rationales.

Medical systematic reviews can be very costly and resource intensive. We explore how Large Language Models (LLMs) can support and be trained to perform literature screening when provided with a detailed set of selection criteria. Specifically, we instruction tune LLaMA and Guanaco models to perform abstract screening for medical systematic reviews. Our best model, Bio-SIEVE, outperforms both ChatGPT and trained traditional approaches, and generalises better across medical domains. However, there remains the challenge of adapting the model to safety-first scenarios. We also explore the impact of multi-task training with Bio-SIEVE-Multi, including tasks such as PICO extraction and exclusion reasoning, but find that it is unable to match single-task Bio-SIEVE's performance. We see Bio-SIEVE as an important step towards specialising LLMs for the biomedical systematic review process and explore its future developmental opportunities. We release our models, code and a list of DOIs to reconstruct our dataset for reproducibility.

While Pre-trained Language Models (PLMs) internalize a great amount of world knowledge, they have been shown incapable of recalling these knowledge to solve tasks requiring complex & multi-step reasoning. Similar to how humans develop a "chain of thought" for these tasks, how can we equip PLMs with such abilities? In this work, we explore an iterative prompting framework, a new prompting paradigm which progressively elicits relevant knowledge from PLMs for multi-step inference. We identify key limitations of existing prompting methods, namely they are either restricted to queries with a single identifiable relation/predicate, or being agnostic to input contexts, which makes it difficult to capture variabilities across different inference steps. We propose an iterative context-aware prompter, which addresses these limitations by learning to dynamically synthesize prompts conditioned on the current step's contexts. Experiments on three datasets involving multi-step reasoning show the effectiveness of the iterative scheme and the context-aware prompter design.

Few-shot learning is a challenging task that requires language models to generalize from limited examples. Large language models like GPT-3 and PaLM have made impressive progress in this area, but they still face difficulties in reasoning tasks such as GSM8K, a benchmark for arithmetic problems. To improve their reasoning skills, previous work has proposed to guide the language model with prompts that elicit a series of reasoning steps before giving the final answer, achieving a significant improvement on GSM8K from 17.9% to 58.1% in problem-solving rate. In this paper, we present DIVERSE (Diverse Verifier on Reasoning Step), a novel approach that further enhances the reasoning capability of language models. DIVERSE has three main components: first, it generates diverse prompts to explore different reasoning paths for the same question; second, it uses a verifier to filter out incorrect answers based on a weighted voting scheme; and third, it verifies each reasoning step individually instead of the whole chain. We evaluate DIVERSE on the latest language model code-davinci-002 and show that it achieves new state-of-the-art results on six of eight reasoning benchmarks (e.g., GSM8K 74.4% to 83.2%).

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.

Chain-of-Thought (CoT) Prompting is a dominant paradigm in Large Language Models (LLMs) to enhance complex reasoning. It guides LLMs to present multi-step reasoning, rather than generating the final answer directly. However, CoT encounters difficulties when key information required for reasoning is implicit or missing. This occurs because CoT emphasizes the sequence of reasoning steps while overlooking the early extraction of essential information. We propose a pre-prompting method called Iterative Summarization Pre-Prompting (ISP^2) to refine LLM reasoning when key information is not explicitly provided. First, entities and their corresponding descriptions are extracted to form potential key information pairs. Next, we use a reliability rating to assess these pairs, then merge the two lowest-ranked pairs into a new entity description. This process is repeated until a unique key information pair is obtained. Finally, that pair, along with the original question, is fed into LLMs to produce the answer. Extensive experiments demonstrate a 7.1% improvement compared to existing methods. Unlike traditional prompting, ISP^2 adopts an inductive approach with pre-prompting, offering flexible integration into diverse reasoning frameworks. The code is available at https://github.com/zdhgreat/ISP-2.

Emergent chain-of-thought (CoT) reasoning capabilities promise to improve performance and explainability of large language models (LLMs). However, uncertainties remain about how reasoning strategies formulated for previous model generations generalize to new model generations and different datasets. In this small-scale study, we compare different reasoning strategies induced by zero-shot prompting across six recently released LLMs (davinci-002, davinci-003, GPT-3.5-turbo, GPT-4, Flan-T5-xxl and Cohere command-xlarge) on a mixture of six question-answering datasets, including datasets from scientific and medical domains. Our findings demonstrate that while some variations in effectiveness occur, gains from CoT reasoning strategies remain robust across different models and datasets. GPT-4 has the most benefit from current state-of-the-art reasoning strategies and exhibits the best performance by applying a prompt previously discovered through automated discovery.

Multi-step multimodal reasoning tasks pose significant challenges for multimodal large language models (MLLMs), and finding effective ways to enhance their performance in such scenarios remains an unresolved issue. In this paper, we propose AR-MCTS, a universal framework designed to progressively improve the reasoning capabilities of MLLMs through Active Retrieval (AR) and Monte Carlo Tree Search (MCTS). Our approach begins with the development of a unified retrieval module that retrieves key supporting insights for solving complex reasoning problems from a hybrid-modal retrieval corpus. To bridge the gap in automated multimodal reasoning verification, we employ the MCTS algorithm combined with an active retrieval mechanism, which enables the automatic generation of step-wise annotations. This strategy dynamically retrieves key insights for each reasoning step, moving beyond traditional beam search sampling to improve the diversity and reliability of the reasoning space. Additionally, we introduce a process reward model that aligns progressively to support the automatic verification of multimodal reasoning tasks. Experimental results across three complex multimodal reasoning benchmarks confirm the effectiveness of the AR-MCTS framework in enhancing the performance of various multimodal models. Further analysis demonstrates that AR-MCTS can optimize sampling diversity and accuracy, yielding reliable multimodal reasoning.

Most existing multi-hop datasets are extractive answer datasets, where the answers to the questions can be extracted directly from the provided context. This often leads models to use heuristics or shortcuts instead of performing true multi-hop reasoning. In this paper, we propose a new multi-hop dataset, MoreHopQA, which shifts from extractive to generative answers. Our dataset is created by utilizing three existing multi-hop datasets: HotpotQA, 2WikiMultihopQA, and MuSiQue. Instead of relying solely on factual reasoning, we enhance the existing multi-hop questions by adding another layer of questioning that involves one, two, or all three of the following types of reasoning: commonsense, arithmetic, and symbolic. Our dataset is created through a semi-automated process, resulting in a dataset with 1,118 samples that have undergone human verification. We then use our dataset to evaluate five different large language models: Mistral 7B, Gemma 7B, Llama 3 (8B and 70B), and GPT-4. We also design various cases to analyze the reasoning steps in the question-answering process. Our results show that models perform well on initial multi-hop questions but struggle with our extended questions, indicating that our dataset is more challenging than previous ones. Our analysis of question decomposition reveals that although models can correctly answer questions, only a portion - 38.7% for GPT-4 and 33.4% for Llama3-70B - achieve perfect reasoning, where all corresponding sub-questions are answered correctly. Evaluation code and data are available at https://github.com/Alab-NII/morehopqa

Cognitive textual and visual reasoning tasks, such as puzzles, series, and analogies, demand the ability to quickly reason, decipher, and evaluate patterns both textually and spatially. While LLMs and VLMs, through extensive training on large amounts of human-curated data, have attained a high level of pseudo-human intelligence in some common sense reasoning tasks, they still struggle with more complex reasoning tasks that require cognitive understanding. In this work, we introduce a new dataset, NTSEBench, designed to evaluate the cognitive multi-modal reasoning and problem-solving skills of large models. The dataset comprises 2,728 multiple-choice questions comprising of a total of 4,642 images across 26 categories sampled from the NTSE examination conducted nationwide in India, featuring both visual and textual general aptitude questions that do not rely on rote learning. We establish baselines on the dataset using state-of-the-art LLMs and VLMs. To facilitate a comparison between open source and propriety models, we propose four distinct modeling strategies to handle different modalities (text and images) in the dataset instances.

Large language models (LLMs) can perform complex reasoning in few- and zero-shot settings by generating intermediate chain of thought (CoT) reasoning steps. Further, each reasoning step can rely on external tools to support computation beyond the core LLM capabilities (e.g. search/running code). Prior work on CoT prompting and tool use typically requires hand-crafting task-specific demonstrations and carefully scripted interleaving of model generations with tool use. We introduce Automatic Reasoning and Tool-use (ART), a framework that uses frozen LLMs to automatically generate intermediate reasoning steps as a program. Given a new task to solve, ART selects demonstrations of multi-step reasoning and tool use from a task library. At test time, ART seamlessly pauses generation whenever external tools are called, and integrates their output before resuming generation. ART achieves a substantial improvement over few-shot prompting and automatic CoT on unseen tasks in the BigBench and MMLU benchmarks, and matches performance of hand-crafted CoT prompts on a majority of these tasks. ART is also extensible, and makes it easy for humans to improve performance by correcting errors in task-specific programs or incorporating new tools, which we demonstrate by drastically improving performance on select tasks with minimal human intervention.

Multi-modal Large Language Models (MLLMs) exhibit impressive problem-solving abilities in various domains, but their visual comprehension and abstract reasoning skills remain under-evaluated. To this end, we present PolyMATH, a challenging benchmark aimed at evaluating the general cognitive reasoning abilities of MLLMs. PolyMATH comprises 5,000 manually collected high-quality images of cognitive textual and visual challenges across 10 distinct categories, including pattern recognition, spatial reasoning, and relative reasoning. We conducted a comprehensive, and quantitative evaluation of 15 MLLMs using four diverse prompting strategies, including Chain-of-Thought and Step-Back. The best scores achieved on PolyMATH are ~41%, ~36%, and ~27%, obtained by Claude-3.5 Sonnet, GPT-4o and Gemini-1.5 Pro respectively - highlighting the logical and visual complexity of these questions. A further fine-grained error analysis reveals that these models struggle to understand spatial relations and perform drawn-out, high-level reasoning. This is further strengthened by our ablation study estimating MLLM performance when given textual descriptions in place of diagrams. As evidenced by ~4% improvement over textual descriptions as opposed to actual images, we discover that models do not truly comprehend visual diagrams and the spatial information therein, and are thus prone to logical errors. Finally, we evaluate the OpenAI o1 models and find that their performance only matches the human baseline, highlighting the difficulty of the benchmark. The results on PolyMATH highlight the room for improvement in multi-modal reasoning and provide unique insights to guide the development of future MLLMs.

How do we most effectively treat a disease or condition? Ideally, we could consult a database of evidence gleaned from clinical trials to answer such questions. Unfortunately, no such database exists; clinical trial results are instead disseminated primarily via lengthy natural language articles. Perusing all such articles would be prohibitively time-consuming for healthcare practitioners; they instead tend to depend on manually compiled systematic reviews of medical literature to inform care. NLP may speed this process up, and eventually facilitate immediate consult of published evidence. The Evidence Inference dataset was recently released to facilitate research toward this end. This task entails inferring the comparative performance of two treatments, with respect to a given outcome, from a particular article (describing a clinical trial) and identifying supporting evidence. For instance: Does this article report that chemotherapy performed better than surgery for five-year survival rates of operable cancers? In this paper, we collect additional annotations to expand the Evidence Inference dataset by 25\%, provide stronger baseline models, systematically inspect the errors that these make, and probe dataset quality. We also release an abstract only (as opposed to full-texts) version of the task for rapid model prototyping. The updated corpus, documentation, and code for new baselines and evaluations are available at http://evidence-inference.ebm-nlp.com/.

In recent years, the application of Large Language Models (LLMs) in healthcare has shown significant promise in improving the accessibility and dissemination of medical knowledge. This paper presents a detailed study of various LLMs trained on the MedQuAD medical question-answering dataset, with a focus on identifying the most effective model for providing accurate medical information. Among the models tested, the Sentence-t5 combined with Mistral 7B demonstrated superior performance, achieving a precision score of 0.762. This model's enhanced capabilities are attributed to its advanced pretraining techniques, robust architecture, and effective prompt construction methodologies. By leveraging these strengths, the Sentence-t5 + Mistral 7B model excels in understanding and generating precise medical answers. Our findings highlight the potential of integrating sophisticated LLMs in medical contexts to facilitate efficient and accurate medical knowledge retrieval, thus significantly enhancing patient education and support.

Open-source multimodal large language models (MLLMs) excel in various tasks involving textual and visual inputs but still struggle with complex multimodal mathematical reasoning, lagging behind proprietary models like GPT-4V(ision) and Gemini-Pro. Although fine-tuning with intermediate steps (i.e., rationales) elicits some mathematical reasoning skills, the resulting models still fall short in visual comprehension due to inadequate visual-centric supervision, which leads to inaccurate interpretation of math figures. To address this issue, we propose a two-step training pipeline VCAR, which emphasizes the Visual Comprehension training in Addition to mathematical Reasoning learning. It first improves the visual comprehension ability of MLLMs through the visual description generation task, followed by another training step on generating rationales with the assistance of descriptions. Experimental results on two popular benchmarks demonstrate that VCAR substantially outperforms baseline methods solely relying on rationale supervision, especially on problems with high visual demands.

Chain of Thought prompting strategy has enhanced the performance of Large Language Models (LLMs) across various NLP tasks. However, it still has shortcomings when dealing with complex reasoning tasks, following~cot_wei, including understanding errors, calculation errors and process errors (e.g. missing-step and hallucinations). Subsequently, Our in-depth analysis of various error types has found that deeply understanding the whole problem is critical in addressing complicated reasoning tasks. In this paper, we proposed a novel prompt strategy called Deeply Understanding the Problems (DUP) prompting, inspired by how humans solve complex reasoning problems, designed to enhance the comprehensive understanding of problems by LLMs. It consists of three stages: 1) extract the core question; 2) find out problem-solving information based on the core question; 3) generate and extract answers by LLMs. We evaluate the performance of DUP prompting on ten diverse reasoning datasets. Experimental results suggest that DUP prompting significantly outperforms Zero-Shot CoT ~kojima2022large across all datasets. Notably, DUP achieves state-of-the-art on SVAMP (90.4\% to 94.2\%) and GSM8K (94.6\% to 97.1\%).

In this study, we present MedS-Bench, a comprehensive benchmark designed to evaluate the performance of large language models (LLMs) in clinical contexts. Unlike existing benchmarks that focus on multiple-choice question answering, MedS-Bench spans 11 high-level clinical tasks, including clinical report summarization, treatment recommendations, diagnosis, named entity recognition, and medical concept explanation, among others. We evaluated six leading LLMs, e.g., MEDITRON, Mistral, InternLM 2, Llama 3, GPT-4, and Claude-3.5 using few-shot prompting, and found that even the most sophisticated models struggle with these complex tasks. To address these limitations, we developed MedS-Ins, a large-scale instruction tuning dataset for medicine. MedS-Ins comprises 58 medically oriented language corpora, totaling 13.5 million samples across 122 tasks. To demonstrate the dataset's utility, we conducted a proof-of-concept experiment by performing instruction tuning on a lightweight, open-source medical language model. The resulting model, MMedIns-Llama 3, significantly outperformed existing models across nearly all clinical tasks. To promote further advancements in the application of LLMs to clinical challenges, we have made the MedS-Ins dataset fully accessible and invite the research community to contribute to its expansion.Additionally, we have launched a dynamic leaderboard for MedS-Bench, which we plan to regularly update the test set to track progress and enhance the adaptation of general LLMs to the medical domain. Leaderboard: https://henrychur.github.io/MedS-Bench/. Github: https://github.com/MAGIC-AI4Med/MedS-Ins.

Composing knowledge from multiple pieces of texts is a key challenge in multi-hop question answering. We present a multi-hop reasoning dataset, Question Answering via Sentence Composition(QASC), that requires retrieving facts from a large corpus and composing them to answer a multiple-choice question. QASC is the first dataset to offer two desirable properties: (a) the facts to be composed are annotated in a large corpus, and (b) the decomposition into these facts is not evident from the question itself. The latter makes retrieval challenging as the system must introduce new concepts or relations in order to discover potential decompositions. Further, the reasoning model must then learn to identify valid compositions of these retrieved facts using common-sense reasoning. To help address these challenges, we provide annotation for supporting facts as well as their composition. Guided by these annotations, we present a two-step approach to mitigate the retrieval challenges. We use other multiple-choice datasets as additional training data to strengthen the reasoning model. Our proposed approach improves over current state-of-the-art language models by 11% (absolute). The reasoning and retrieval problems, however, remain unsolved as this model still lags by 20% behind human performance.

Large language models (LLMs) have been shown to be capable of impressive few-shot generalisation to new tasks. However, they still tend to perform poorly on multi-step logical reasoning problems. Here we carry out a comprehensive evaluation of LLMs on 50 tasks that probe different aspects of logical reasoning. We show that language models tend to perform fairly well at single step inference or entailment tasks, but struggle to chain together multiple reasoning steps to solve more complex problems. In light of this, we propose a Selection-Inference (SI) framework that exploits pre-trained LLMs as general processing modules, and alternates between selection and inference to generate a series of interpretable, casual reasoning steps leading to the final answer. We show that a 7B parameter LLM used within the SI framework in a 5-shot generalisation setting, with no fine-tuning, yields a performance improvement of over 100% compared to an equivalent vanilla baseline on a suite of 10 logical reasoning tasks. The same model in the same setting even outperforms a significantly larger 280B parameter baseline on the same suite of tasks. Moreover, answers produced by the SI framework are accompanied by a causal natural-language-based reasoning trace, which has important implications for the safety and trustworthiness of the system.

Solving complex mathematical problems via system-2 reasoning is a natural human skill, yet it remains a significant challenge for current large language models (LLMs). We identify the scarcity of deliberate multi-step reasoning data as a primary limiting factor. To this end, we introduce Enriched Instruction Tuning (EIT), a method that enriches existing human-annotated mathematical datasets by synergizing human and AI feedback to create fine-grained reasoning trajectories. These datasets are then used to fine-tune open-source LLMs, enhancing their mathematical reasoning abilities without reliance on any symbolic verification program. Concretely, EIT is composed of two critical steps: Enriching with Reasoning Plan (ERP) and Enriching with Reasoning Step (ERS). The former generates a high-level plan that breaks down complex instructions into a sequence of simpler objectives, while ERS fills in reasoning contexts often overlooked by human annotators, creating a smoother reasoning trajectory for LLM fine-tuning. Unlike existing CoT prompting methods that generate reasoning chains only depending on LLM's internal knowledge, our method leverages human-annotated initial answers as ``meta-knowledge'' to help LLMs generate more detailed and precise reasoning processes, leading to a more trustworthy LLM expert for complex mathematical problems. In experiments, EIT achieves an accuracy of 84.1% on GSM8K and 32.5% on MATH, surpassing state-of-the-art fine-tuning and prompting methods, and even matching the performance of tool-augmented methods.

Advances in large language models (LLMs) have empowered a variety of applications. However, there is still a significant gap in research when it comes to understanding and enhancing the capabilities of LLMs in the field of mental health. In this work, we present the first comprehensive evaluation of multiple LLMs, including Alpaca, Alpaca-LoRA, FLAN-T5, GPT-3.5, and GPT-4, on various mental health prediction tasks via online text data. We conduct a broad range of experiments, covering zero-shot prompting, few-shot prompting, and instruction fine-tuning. The results indicate a promising yet limited performance of LLMs with zero-shot and few-shot prompt designs for the mental health tasks. More importantly, our experiments show that instruction finetuning can significantly boost the performance of LLMs for all tasks simultaneously. Our best-finetuned models, Mental-Alpaca and Mental-FLAN-T5, outperform the best prompt design of GPT-3.5 (25 and 15 times bigger) by 10.9% on balanced accuracy and the best of GPT-4 (250 and 150 times bigger) by 4.8%. They further perform on par with the state-of-the-art task-specific language model. We also conduct an exploratory case study on LLMs' capability on the mental health reasoning tasks, illustrating the promising capability of certain models such as GPT-4. We summarize our findings into a set of action guidelines for potential methods to enhance LLMs' capability for mental health tasks. Meanwhile, we also emphasize the important limitations before achieving deployability in real-world mental health settings, such as known racial and gender bias. We highlight the important ethical risks accompanying this line of research.

Most Reading Comprehension methods limit themselves to queries which can be answered using a single sentence, paragraph, or document. Enabling models to combine disjoint pieces of textual evidence would extend the scope of machine comprehension methods, but currently there exist no resources to train and test this capability. We propose a novel task to encourage the development of models for text understanding across multiple documents and to investigate the limits of existing methods. In our task, a model learns to seek and combine evidence - effectively performing multi-hop (alias multi-step) inference. We devise a methodology to produce datasets for this task, given a collection of query-answer pairs and thematically linked documents. Two datasets from different domains are induced, and we identify potential pitfalls and devise circumvention strategies. We evaluate two previously proposed competitive models and find that one can integrate information across documents. However, both models struggle to select relevant information, as providing documents guaranteed to be relevant greatly improves their performance. While the models outperform several strong baselines, their best accuracy reaches 42.9% compared to human performance at 74.0% - leaving ample room for improvement.

Recently, with the chain of thought (CoT) prompting, large language models (LLMs), e.g., GPT-3, have shown strong reasoning ability in several natural language processing tasks such as arithmetic, commonsense, and logical reasoning. However, LLMs with CoT require multi-step prompting and multi-token prediction, which is highly sensitive to individual mistakes and vulnerable to error accumulation. The above issues make the LLMs need the ability to verify the answers. In fact, after inferring conclusions in some thinking decision tasks, people often check them by re-verifying steps to avoid some mistakes. In this paper, we propose and prove that LLMs also have similar self-verification abilities. We take the conclusion obtained by CoT as one of the conditions for solving the original problem. By taking turns masking the original conditions and predicting their results, we calculate an explainable answer verification score based on whether the re-predicted conditions are correct. Experimental results demonstrate that the proposed method can improve the reasoning performance on various arithmetic, commonsense, and logical reasoning datasets. Our code is publicly available at: https://github.com/WENGSYX/Self-Verification.

Clinical notes contain information about patients that goes beyond structured data like lab values and medications. However, clinical notes have been underused relative to structured data, because notes are high-dimensional and sparse. This work develops and evaluates representations of clinical notes using bidirectional transformers (ClinicalBERT). ClinicalBERT uncovers high-quality relationships between medical concepts as judged by humans. ClinicalBert outperforms baselines on 30-day hospital readmission prediction using both discharge summaries and the first few days of notes in the intensive care unit. Code and model parameters are available.

Large language models (LLMs) have achieved impressive performance on various reasoning tasks. To further improve the performance, we propose MultiTool-CoT, a novel framework that leverages chain-of-thought (CoT) prompting to incorporate multiple external tools, such as a calculator and a knowledge retriever, during the reasoning process. We apply MultiTool-CoT to the Task 2 dataset of NumGLUE, which requires both numerical reasoning and domain-specific knowledge. The experiments show that our method significantly outperforms strong baselines and achieves state-of-the-art performance.

Large language models (LLMs) have shown increasing capability in problem-solving and decision-making, largely based on the step-by-step chain-of-thought reasoning processes. However, it has been increasingly challenging to evaluate the reasoning capability of LLMs. Concretely, existing outcome-based benchmarks begin to saturate and become less sufficient to monitor the progress. To this end, we present a process-based benchmark MR-BEN that demands a meta reasoning skill, where LMs are asked to locate and analyse potential errors in automatically generated reasoning steps. MR-BEN is a comprehensive benchmark comprising 5,975 questions collected from human experts, covering various subjects such as physics, chemistry, logic, coding, and more. Through our designed metrics for assessing meta-reasoning on this benchmark, we identify interesting limitations and weaknesses of current LLMs (open-source and closed-source models). For example, open-source models are seemingly comparable to GPT-4 on outcome-based benchmarks, but they lag far behind on our benchmark, revealing the underlying reasoning capability gap between them. Our dataset and codes are available on https://randolph-zeng.github.io/Mr-Ben.github.io/.

When provided with sufficient explanatory context, smaller Language Models have been shown to exhibit strong reasoning ability on challenging short-answer question-answering tasks where the questions are unseen in training. We evaluate two methods for further improvement in this setting. Both methods focus on combining rationales generated by a larger Language Model with longer contexts created from a multi-hop dense retrieval system. The first method (RR) involves training a Rationale Ranking model to score both generated rationales and retrieved contexts with respect to relevance and truthfulness. We then use the scores to derive combined contexts from both knowledge sources using a number of combinatory strategies. For the second method (RATD) we utilise retrieval-augmented training datasets developed by Hartill et al. 2023 to train a smaller Reasoning model such that it becomes proficient at utilising relevant information from longer text sequences that may be only partially evidential and frequently contain many irrelevant sentences. We find that both methods significantly improve results. Our single best Reasoning model materially improves upon strong comparable prior baselines for unseen evaluation datasets (StrategyQA 58.9 rightarrow 61.7 acc., CommonsenseQA 63.6 rightarrow 72.7 acc., ARC-DA 31.6 rightarrow 52.1 F1, IIRC 25.5 rightarrow 27.3 F1) and a version utilising our prior knowledge of each type of question in selecting a context combination strategy does even better. Our proposed models also generally outperform direct prompts against much larger models (BLOOM 175B and StableVicuna 13B) in both few-shot chain-of-thought and standard few-shot settings.

Reasoning is a distinctive human capacity, enabling us to address complex problems by breaking them down into a series of manageable cognitive steps. Yet, complex logical reasoning is still cumbersome for language models. Based on the dual process theory in cognitive science, we are the first to unravel the cognitive reasoning abilities of language models. Our framework employs an iterative methodology to construct a Cognitive Tree (CogTree). The root node of this tree represents the initial query, while the leaf nodes consist of straightforward questions that can be answered directly. This construction involves two main components: the implicit extraction module (referred to as the intuitive system) and the explicit reasoning module (referred to as the reflective system). The intuitive system rapidly generates multiple responses by utilizing in-context examples, while the reflective system scores these responses using comparative learning. The scores guide the intuitive system in its subsequent generation step. Our experimental results on two popular and challenging reasoning tasks indicate that it is possible to achieve a performance level comparable to that of GPT-3.5 (with 175B parameters), using a significantly smaller language model that contains fewer parameters (<=7B) than 5% of GPT-3.5.

Large-language models have recently demonstrated impressive zero-shot capabilities in a variety of natural language tasks such as summarization, dialogue generation, and question-answering. Despite many promising applications in clinical medicine, adoption of these models in real-world settings has been largely limited by their tendency to generate incorrect and sometimes even toxic statements. In this study, we develop Almanac, a large language model framework augmented with retrieval capabilities for medical guideline and treatment recommendations. Performance on a novel dataset of clinical scenarios (n = 130) evaluated by a panel of 5 board-certified and resident physicians demonstrates significant increases in factuality (mean of 18% at p-value < 0.05) across all specialties, with improvements in completeness and safety. Our results demonstrate the potential for large language models to be effective tools in the clinical decision-making process, while also emphasizing the importance of careful testing and deployment to mitigate their shortcomings.

Although Large Language Models (LLMs) achieve remarkable performance across various tasks, they often struggle with complex reasoning tasks, such as answering mathematical questions. Recent efforts to address this issue have primarily focused on leveraging mathematical datasets through supervised fine-tuning or self-improvement techniques. However, these methods often depend on high-quality datasets that are difficult to prepare, or they require substantial computational resources for fine-tuning. Inspired by findings that LLMs know how to produce the right answer but struggle to select the correct reasoning path, we propose a purely inference-based searching method -- MindStar (M*). This method formulates reasoning tasks as searching problems and proposes two search ideas to identify the optimal reasoning paths. We evaluate the M* framework on both the GSM8K and MATH datasets, comparing its performance with existing open and closed-source LLMs. Our results demonstrate that M* significantly enhances the reasoning abilities of open-source models, such as Llama-2-13B and Mistral-7B, and achieves comparable performance to GPT-3.5 and Grok-1, but with substantially reduced model size and computational costs.

Mathematical understanding and reasoning are crucial tasks for assessing the capabilities of artificial intelligence (AI). However, existing benchmarks either require just a few steps of reasoning, or only contain a small amount of data in one specific topic, making it hard to analyse AI's behaviour with reference to different problems within a specific topic in detail. In this work, we propose Conic10K, a challenging math problem dataset on conic sections in Chinese senior high school education. Our dataset contains various problems with different reasoning depths, while only the knowledge from conic sections is required. Since the dataset only involves a narrow range of knowledge, it is easy to separately analyse the knowledge a model possesses and the reasoning ability it has. For each problem, we provide a high-quality formal representation, the reasoning steps, and the final solution. Experiments show that existing large language models, including GPT-4, exhibit weak performance on complex reasoning. We hope that our findings could inspire more advanced techniques for precise natural language understanding and reasoning. Our dataset and codes are available at https://github.com/whyNLP/Conic10K.

Logical reasoning is fundamental for humans yet presents a substantial challenge in the domain of Artificial Intelligence. Initially, researchers used Knowledge Representation and Reasoning (KR) systems that did not scale and required non trivial manual effort. Recently, the emergence of large language models (LLMs) has demonstrated the ability to overcome various limitations of formal Knowledge Representation (KR) systems. Consequently, there is a growing interest in using LLMs for logical reasoning via natural language. This work strives to understand the proficiency of LLMs in logical reasoning by offering a brief review of the latest progress in this area; with a focus on the logical reasoning datasets, tasks, and the methods adopted to utilize LLMs for reasoning. To offer a thorough analysis, we have compiled a benchmark titled LogiGLUE. This includes 24 varied datasets encompassing deductive, abductive, and inductive reasoning. We have standardized these datasets into Seq2Seq tasks to facilitate straightforward training and evaluation for future research. Utilizing LogiGLUE as a foundation, we have trained an instruction fine tuned language model, resulting in LogiT5. We study single task training, multi task training, and a chain of thought knowledge distillation fine tuning technique to assess the performance of model across the different logical reasoning categories. By this comprehensive process, we aim to shed light on the capabilities and potential pathways for enhancing logical reasoning proficiency in LLMs, paving the way for more advanced and nuanced developments in this critical field.

Large Language Models (LLMs) have showcased impressive reasoning capabilities, particularly when guided by specifically designed prompts in complex reasoning tasks such as math word problems. These models typically solve tasks using a chain-of-thought approach, which not only bolsters their reasoning abilities but also provides valuable insights into their problem-solving process. However, there is still significant room for enhancing the reasoning abilities of LLMs. Some studies suggest that the integration of an LLM output verifier can boost reasoning accuracy without necessitating additional model training. In this paper, we follow these studies and introduce a novel graph-based method to further augment the reasoning capabilities of LLMs. We posit that multiple solutions to a reasoning task, generated by an LLM, can be represented as a reasoning graph due to the logical connections between intermediate steps from different reasoning paths. Therefore, we propose the Reasoning Graph Verifier (RGV) to analyze and verify the solutions generated by LLMs. By evaluating these graphs, models can yield more accurate and reliable results.Our experimental results show that our graph-based verification method not only significantly enhances the reasoning abilities of LLMs but also outperforms existing verifier methods in terms of improving these models' reasoning performance.

Large Language Models (LLMs) have exhibited an impressive capability to perform reasoning tasks, especially if they are encouraged to generate a sequence of intermediate steps. Reasoning performance can be improved by suitably combining multiple LLM responses, generated either in parallel in a single query, or via sequential interactions with LLMs throughout the reasoning process. Existing strategies for combination, such as self-consistency and progressive-hint-prompting, make inefficient usage of the LLM responses. We present Hint Marginalization, a novel and principled algorithmic framework to enhance the reasoning capabilities of LLMs. Our approach can be viewed as an iterative sampling strategy for forming a Monte Carlo approximation of an underlying distribution of answers, with the goal of identifying the mode the most likely answer. Empirical evaluation on several benchmark datasets for arithmetic reasoning demonstrates the superiority of the proposed approach.

Despite strong performance on vision-language tasks, Multimodal Large Language Models (MLLMs) struggle with mathematical problem-solving, with both open-source and state-of-the-art models falling short of human performance on visual-math benchmarks. To systematically examine visual-mathematical reasoning in MLLMs, we (1) evaluate their understanding of geometric primitives, (2) test multi-step reasoning, and (3) explore a potential solution to improve visual reasoning capabilities. Our findings reveal fundamental shortcomings in shape recognition, with top models achieving under 50% accuracy in identifying regular polygons. We analyze these failures through the lens of dual-process theory and show that MLLMs rely on System 1 (intuitive, memorized associations) rather than System 2 (deliberate reasoning). Consequently, MLLMs fail to count the sides of both familiar and novel shapes, suggesting they have neither learned the concept of sides nor effectively process visual inputs. Finally, we propose Visually Cued Chain-of-Thought (VC-CoT) prompting, which enhances multi-step mathematical reasoning by explicitly referencing visual annotations in diagrams, boosting GPT-4o's accuracy on an irregular polygon side-counting task from 7% to 93%. Our findings suggest that System 2 reasoning in MLLMs remains an open problem, and visually-guided prompting is essential for successfully engaging visual reasoning. Code available at: https://github.com/rsinghlab/Shape-Blind.

Recent advances in large language models have led to renewed interest in natural language processing in healthcare using the free text of clinical notes. One distinguishing characteristic of clinical notes is their long time span over multiple long documents. The unique structure of clinical notes creates a new design choice: when the context length for a language model predictor is limited, which part of clinical notes should we choose as the input? Existing studies either choose the inputs with domain knowledge or simply truncate them. We propose a framework to analyze the sections with high predictive power. Using MIMIC-III, we show that: 1) predictive power distribution is different between nursing notes and discharge notes and 2) combining different types of notes could improve performance when the context length is large. Our findings suggest that a carefully selected sampling function could enable more efficient information extraction from clinical notes.

This paper introduces MedExQA, a novel benchmark in medical question-answering, to evaluate large language models' (LLMs) understanding of medical knowledge through explanations. By constructing datasets across five distinct medical specialties that are underrepresented in current datasets and further incorporating multiple explanations for each question-answer pair, we address a major gap in current medical QA benchmarks which is the absence of comprehensive assessments of LLMs' ability to generate nuanced medical explanations. Our work highlights the importance of explainability in medical LLMs, proposes an effective methodology for evaluating models beyond classification accuracy, and sheds light on one specific domain, speech language pathology, where current LLMs including GPT4 lack good understanding. Our results show generation evaluation with multiple explanations aligns better with human assessment, highlighting an opportunity for a more robust automated comprehension assessment for LLMs. To diversify open-source medical LLMs (currently mostly based on Llama2), this work also proposes a new medical model, MedPhi-2, based on Phi-2 (2.7B). The model outperformed medical LLMs based on Llama2-70B in generating explanations, showing its effectiveness in the resource-constrained medical domain. We will share our benchmark datasets and the trained model.

Clinical natural language processing requires methods that can address domain-specific challenges, such as complex medical terminology and clinical contexts. Recently, large language models (LLMs) have shown promise in this domain. Yet, their direct deployment can lead to privacy issues and are constrained by resources. To address this challenge, we delve into synthetic clinical text generation using LLMs for clinical NLP tasks. We propose an innovative, resource-efficient approach, ClinGen, which infuses knowledge into the process. Our model involves clinical knowledge extraction and context-informed LLM prompting. Both clinical topics and writing styles are drawn from external domain-specific knowledge graphs and LLMs to guide data generation. Our extensive empirical study across 7 clinical NLP tasks and 16 datasets reveals that ClinGen consistently enhances performance across various tasks, effectively aligning the distribution of real datasets and significantly enriching the diversity of generated training instances. We will publish our code and all the generated data in https://github.com/ritaranx/ClinGen.

Daily progress notes are common types in the electronic health record (EHR) where healthcare providers document the patient's daily progress and treatment plans. The EHR is designed to document all the care provided to patients, but it also enables note bloat with extraneous information that distracts from the diagnoses and treatment plans. Applications of natural language processing (NLP) in the EHR is a growing field with the majority of methods in information extraction. Few tasks use NLP methods for downstream diagnostic decision support. We introduced the 2022 National NLP Clinical Challenge (N2C2) Track 3: Progress Note Understanding - Assessment and Plan Reasoning as one step towards a new suite of tasks. The Assessment and Plan Reasoning task focuses on the most critical components of progress notes, Assessment and Plan subsections where health problems and diagnoses are contained. The goal of the task was to develop and evaluate NLP systems that automatically predict causal relations between the overall status of the patient contained in the Assessment section and its relation to each component of the Plan section which contains the diagnoses and treatment plans. The goal of the task was to identify and prioritize diagnoses as the first steps in diagnostic decision support to find the most relevant information in long documents like daily progress notes. We present the results of 2022 n2c2 Track 3 and provide a description of the data, evaluation, participation and system performance.

Developing the required technology to assist medical experts in their everyday activities is currently a hot topic in the Artificial Intelligence research field. Thus, a number of large language models (LLMs) and automated benchmarks have recently been proposed with the aim of facilitating information extraction in Evidence-Based Medicine (EBM) using natural language as a tool for mediating in human-AI interaction. The most representative benchmarks are limited to either multiple-choice or long-form answers and are available only in English. In order to address these shortcomings, in this paper we present a new dataset which, unlike previous work: (i) includes not only explanatory arguments for the correct answer, but also arguments to reason why the incorrect answers are not correct; (ii) the explanations are written originally by medical doctors to answer questions from the Spanish Residency Medical Exams. Furthermore, this new benchmark allows us to setup a novel extractive task which consists of identifying the explanation of the correct answer written by medical doctors. An additional benefit of our setting is that we can leverage the extractive QA paradigm to automatically evaluate performance of LLMs without resorting to costly manual evaluation by medical experts. Comprehensive experimentation with language models for Spanish shows that sometimes multilingual models fare better than monolingual ones, even outperforming models which have been adapted to the medical domain. Furthermore, results across the monolingual models are mixed, with supposedly smaller and inferior models performing competitively. In any case, the obtained results show that our novel dataset and approach can be an effective technique to help medical practitioners in identifying relevant evidence-based explanations for medical questions.

With the continuous advancement of large language models (LLMs), it is essential to create new benchmarks to effectively evaluate their expanding capabilities and identify areas for improvement. This work focuses on multi-image reasoning, an emerging capability in state-of-the-art LLMs. We introduce ReMI, a dataset designed to assess LLMs' ability to Reason with Multiple Images. This dataset encompasses a diverse range of tasks, spanning various reasoning domains such as math, physics, logic, code, table/chart understanding, and spatial and temporal reasoning. It also covers a broad spectrum of characteristics found in multi-image reasoning scenarios. We have benchmarked several cutting-edge LLMs using ReMI and found a substantial gap between their performance and human-level proficiency. This highlights the challenges in multi-image reasoning and the need for further research. Our analysis also reveals the strengths and weaknesses of different models, shedding light on the types of reasoning that are currently attainable and areas where future models require improvement. To foster further research in this area, we are releasing ReMI publicly: https://huggingface.co/datasets/mehrankazemi/ReMI.

Excellence in a wide variety of medical applications poses considerable challenges for AI, requiring advanced reasoning, access to up-to-date medical knowledge and understanding of complex multimodal data. Gemini models, with strong general capabilities in multimodal and long-context reasoning, offer exciting possibilities in medicine. Building on these core strengths of Gemini, we introduce Med-Gemini, a family of highly capable multimodal models that are specialized in medicine with the ability to seamlessly use web search, and that can be efficiently tailored to novel modalities using custom encoders. We evaluate Med-Gemini on 14 medical benchmarks, establishing new state-of-the-art (SoTA) performance on 10 of them, and surpass the GPT-4 model family on every benchmark where a direct comparison is viable, often by a wide margin. On the popular MedQA (USMLE) benchmark, our best-performing Med-Gemini model achieves SoTA performance of 91.1% accuracy, using a novel uncertainty-guided search strategy. On 7 multimodal benchmarks including NEJM Image Challenges and MMMU (health & medicine), Med-Gemini improves over GPT-4V by an average relative margin of 44.5%. We demonstrate the effectiveness of Med-Gemini's long-context capabilities through SoTA performance on a needle-in-a-haystack retrieval task from long de-identified health records and medical video question answering, surpassing prior bespoke methods using only in-context learning. Finally, Med-Gemini's performance suggests real-world utility by surpassing human experts on tasks such as medical text summarization, alongside demonstrations of promising potential for multimodal medical dialogue, medical research and education. Taken together, our results offer compelling evidence for Med-Gemini's potential, although further rigorous evaluation will be crucial before real-world deployment in this safety-critical domain.

Recently, Chain-of-Thought (CoT) prompting has delivered success on complex reasoning tasks, which aims at designing a simple prompt like ``Let's think step by step'' or multiple in-context exemplars with well-designed rationales to elicit Large Language Models (LLMs) to generate intermediate reasoning steps. However, the generated rationales often come with mistakes, making unfactual and unfaithful reasoning chains. To mitigate this brittleness, we propose a novel Chain-of-Knowledge (CoK) prompting, where we aim at eliciting LLMs to generate explicit pieces of knowledge evidence in the form of structure triple. This is inspired by our human behaviors, i.e., we can draw a mind map or knowledge map as the reasoning evidence in the brain before answering a complex question. Benefiting from CoK, we additionally introduce a F^2-Verification method to estimate the reliability of the reasoning chains in terms of factuality and faithfulness. For the unreliable response, the wrong evidence can be indicated to prompt the LLM to rethink. Extensive experiments demonstrate that our method can further improve the performance of commonsense, factual, symbolic, and arithmetic reasoning tasks.

This survey paper proposes a clearer view of natural language reasoning in the field of Natural Language Processing (NLP), both conceptually and practically. Conceptually, we provide a distinct definition for natural language reasoning in NLP, based on both philosophy and NLP scenarios, discuss what types of tasks require reasoning, and introduce a taxonomy of reasoning. Practically, we conduct a comprehensive literature review on natural language reasoning in NLP, mainly covering classical logical reasoning, natural language inference, multi-hop question answering, and commonsense reasoning. The paper also identifies and views backward reasoning, a powerful paradigm for multi-step reasoning, and introduces defeasible reasoning as one of the most important future directions in natural language reasoning research. We focus on single-modality unstructured natural language text, excluding neuro-symbolic techniques and mathematical reasoning.

The capabilities and limitations of Large Language Models have been sketched out in great detail in recent years, providing an intriguing yet conflicting picture. On the one hand, LLMs demonstrate a general ability to solve problems. On the other hand, they show surprising reasoning gaps when compared to humans, casting doubt on the robustness of their generalisation strategies. The sheer volume of data used in the design of LLMs has precluded us from applying the method traditionally used to measure generalisation: train-test set separation. To overcome this, we study what kind of generalisation strategies LLMs employ when performing reasoning tasks by investigating the pretraining data they rely on. For two models of different sizes (7B and 35B) and 2.5B of their pretraining tokens, we identify what documents influence the model outputs for three simple mathematical reasoning tasks and contrast this to the data that are influential for answering factual questions. We find that, while the models rely on mostly distinct sets of data for each factual question, a document often has a similar influence across different reasoning questions within the same task, indicating the presence of procedural knowledge. We further find that the answers to factual questions often show up in the most influential data. However, for reasoning questions the answers usually do not show up as highly influential, nor do the answers to the intermediate reasoning steps. When we characterise the top ranked documents for the reasoning questions qualitatively, we confirm that the influential documents often contain procedural knowledge, like demonstrating how to obtain a solution using formulae or code. Our findings indicate that the approach to reasoning the models use is unlike retrieval, and more like a generalisable strategy that synthesises procedural knowledge from documents doing a similar form of reasoning.

To augment language models with the ability to reason, researchers usually prompt or finetune them to produce chain of thought reasoning steps before producing the final answer. However, although people use natural language to reason effectively, it may be that LMs could reason more effectively with some intermediate computation that is not in natural language. In this work, we explore an alternative reasoning approach: instead of explicitly producing the chain of thought reasoning steps, we use the language model's internal hidden states to perform implicit reasoning. The implicit reasoning steps are distilled from a teacher model trained on explicit chain-of-thought reasoning, and instead of doing reasoning "horizontally" by producing intermediate words one-by-one, we distill it such that the reasoning happens "vertically" among the hidden states in different layers. We conduct experiments on a multi-digit multiplication task and a grade school math problem dataset and find that this approach enables solving tasks previously not solvable without explicit chain-of-thought, at a speed comparable to no chain-of-thought.

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.

Large language models have shown impressive results for multi-hop mathematical reasoning when the input question is only textual. Many mathematical reasoning problems, however, contain both text and image. With the ever-increasing adoption of vision language models (VLMs), understanding their reasoning abilities for such problems is crucial. In this paper, we evaluate the reasoning capabilities of VLMs along various axes through the lens of geometry problems. We procedurally create a synthetic dataset of geometry questions with controllable difficulty levels along multiple axes, thus enabling a systematic evaluation. The empirical results obtained using our benchmark for state-of-the-art VLMs indicate that these models are not as capable in subjects like geometry (and, by generalization, other topics requiring similar reasoning) as suggested by previous benchmarks. This is made especially clear by the construction of our benchmark at various depth levels, since solving higher-depth problems requires long chains of reasoning rather than additional memorized knowledge. We release the dataset for further research in this area.

Generating accurate step-by-step reasoning is essential for Large Language Models (LLMs) to address complex problems and enhance robustness and interpretability. Despite the flux of research on developing advanced reasoning approaches, systematically analyzing the diverse LLMs and reasoning strategies in generating reasoning chains remains a significant challenge. The difficulties stem from the lack of two key elements: (1) an automatic method for evaluating the generated reasoning chains on different tasks, and (2) a unified formalism and implementation of the diverse reasoning approaches for systematic comparison. This paper aims to close the gap: (1) We introduce AutoRace for fully automated reasoning chain evaluation. Existing metrics rely on expensive human annotations or pre-defined LLM prompts not adaptable to different tasks. In contrast, AutoRace automatically creates detailed evaluation criteria tailored for each task, and uses GPT-4 for accurate evaluation following the criteria. (2) We develop LLM Reasoners, a library for standardized modular implementation of existing and new reasoning algorithms, under a unified formulation of the search, reward, and world model components. With the new evaluation and library, (3) we conduct extensive study of different reasoning approaches (e.g., CoT, ToT, RAP). The analysis reveals interesting findings about different factors contributing to reasoning, including the reward-guidance, breadth-vs-depth in search, world model, and prompt formats, etc.

Language models (LMs) have demonstrated expert-level reasoning and recall abilities in medicine. However, computational costs and privacy concerns are mounting barriers to wide-scale implementation. We introduce a parsimonious adaptation of phi-3-mini, MedMobile, a 3.8 billion parameter LM capable of running on a mobile device, for medical applications. We demonstrate that MedMobile scores 75.7% on the MedQA (USMLE), surpassing the passing mark for physicians (~60%), and approaching the scores of models 100 times its size. We subsequently perform a careful set of ablations, and demonstrate that chain of thought, ensembling, and fine-tuning lead to the greatest performance gains, while unexpectedly retrieval augmented generation fails to demonstrate significant improvements

Large language models (LLMs) have been routinely used to solve various tasks using step-by-step reasoning. However, the structure of intermediate reasoning steps, or thoughts, is rigid and unidirectional, such as chains, trees, or acyclic-directed graphs. Consequently, the resulting inflexible and forward-only reasoning may not address challenging tasks and fail when the LLM frequently gives false responses, i.e., ``hallucinations''. This paper proposes a new reasoning framework, called Thought Rollback (TR), allowing LLMs to adaptively build thought structure while maintaining effective reasoning toward problem-solving under ``hallucinations''. The core mechanism of TR is rolling back thoughts, which allows LLMs to perform error analysis on thoughts, and thus roll back to any previously mistaken thought for revision. Subsequently, by including such trial-and-error in the prompt to guide the LLM, each rollback leads to one more reliable reasoning path. Therefore, starting with a simple prompt without human annotations, LLM with TR adaptively and gradually explores thoughts for a correct solution. Comprehensive experiments on mathematical problems and multi-task reasoning demonstrate the state-of-the-art performance of TR in terms of problem-solving rate and interaction cost. For instance, the solving rate of GPT-4 with TR outperforms the current best by 9% on the MATH dataset.

Large language models (LLMs) often struggle with maintaining accuracy across a sequence of intermediate reasoning steps in mathematical reasoning, leading to error propagation that undermines the final result. The current methodology to mitigate this issue primarily involves using a verifier model to assess the correctness of generated solution candidates, focusing either on the overall reasoning path or on an incomplete reasoning path. By rethinking this approach, we argue that assessing potentials of incomplete reasoning paths could be more advantageous as it guides towards correct final answers, transforming the task into a planning problem. Our proposed verifier, the Outcome-supervision Value Model (OVM), employs outcome supervision for training, offering an efficient and intuitive method for planning by prioritizing steps that lead to accurate conclusions over mere per-step correctness. Furthermore, the OVM eschews the need for labor-intensive annotations on step-level correctness, enhancing its scalability. Our experiments on two multi-step mathematical reasoning datasets, GSM8K and Game of 24, demonstrate the superior performance of the OVM model. Notably, in GSM8K, our OVM-7B model achieves state-of-the-art results among LLMs up to 13B parameters; especially it does not utilize GPT-4 or code execution. These findings offer a novel perspective on the role of outcome supervision in training verifiers for multi-step reasoning tasks and provide theoretical justification for its advantage in value estimation for planning.

This work introduces BioLORD, a new pre-training strategy for producing meaningful representations for clinical sentences and biomedical concepts. State-of-the-art methodologies operate by maximizing the similarity in representation of names referring to the same concept, and preventing collapse through contrastive learning. However, because biomedical names are not always self-explanatory, it sometimes results in non-semantic representations. BioLORD overcomes this issue by grounding its concept representations using definitions, as well as short descriptions derived from a multi-relational knowledge graph consisting of biomedical ontologies. Thanks to this grounding, our model produces more semantic concept representations that match more closely the hierarchical structure of ontologies. BioLORD establishes a new state of the art for text similarity on both clinical sentences (MedSTS) and biomedical concepts (MayoSRS).

The advent of large language models (LLMs) and their adoption by the legal community has given rise to the question: what types of legal reasoning can LLMs perform? To enable greater study of this question, we present LegalBench: a collaboratively constructed legal reasoning benchmark consisting of 162 tasks covering six different types of legal reasoning. LegalBench was built through an interdisciplinary process, in which we collected tasks designed and hand-crafted by legal professionals. Because these subject matter experts took a leading role in construction, tasks either measure legal reasoning capabilities that are practically useful, or measure reasoning skills that lawyers find interesting. To enable cross-disciplinary conversations about LLMs in the law, we additionally show how popular legal frameworks for describing legal reasoning -- which distinguish between its many forms -- correspond to LegalBench tasks, thus giving lawyers and LLM developers a common vocabulary. This paper describes LegalBench, presents an empirical evaluation of 20 open-source and commercial LLMs, and illustrates the types of research explorations LegalBench enables.

When presented with questions involving visual thinking, humans naturally switch reasoning modalities, often forming mental images or drawing visual aids. Large language models have shown promising results in arithmetic and symbolic reasoning by expressing intermediate reasoning in text as a chain of thought, yet struggle to extend this capability to answer text queries that are easily solved by visual reasoning, even with extensive multimodal pretraining. We introduce a simple method, whiteboard-of-thought prompting, to unlock the visual reasoning capabilities of multimodal large language models across modalities. Whiteboard-of-thought prompting provides multimodal large language models with a metaphorical `whiteboard' to draw out reasoning steps as images, then returns these images back to the model for further processing. We find this can be accomplished with no demonstrations or specialized modules, instead leveraging models' existing ability to write code with libraries such as Matplotlib and Turtle. This simple approach shows state-of-the-art results on four difficult natural language tasks that involve visual and spatial reasoning. We identify multiple settings where GPT-4o using chain-of-thought fails dramatically, including more than one where it achieves 0% accuracy, while whiteboard-of-thought enables up to 92% accuracy in these same settings. We present a detailed exploration of where the technique succeeds as well as its sources of error.

The zero-shot chain of thought (CoT) approach is often used in question answering (QA) by language models (LMs) for tasks that require multiple reasoning steps, typically enhanced by the prompt "Let's think step by step." However, some QA tasks hinge more on accessing relevant knowledge than on chaining reasoning steps. We introduce a simple general prompting technique, called PREP, that involves using two instances of LMs: the first (LM1) generates relevant information, and the second (LM2) answers the question based on this information. PREP is designed to be general and independent of the user's domain knowledge, making it applicable across various QA tasks without the need for specialized prompt engineering. To evaluate the effectiveness of our prompting method, we create a dataset of 100 binary-choice questions, derived from an extensive schematic dataset on artifact parts and material composition. These questions ask which of two artifacts is less likely to share materials with another artifact. Such questions probe the LM's knowledge of shared materials in the part structure of different artifacts. We test our method on our dataset and three published commonsense reasoning datasets. The average accuracy of our method is consistently higher than that of all the other tested methods across all the tested datasets.

We introduce a new task, Video-and-Language Inference, for joint multimodal understanding of video and text. Given a video clip with aligned subtitles as premise, paired with a natural language hypothesis based on the video content, a model needs to infer whether the hypothesis is entailed or contradicted by the given video clip. A new large-scale dataset, named Violin (VIdeO-and-Language INference), is introduced for this task, which consists of 95,322 video-hypothesis pairs from 15,887 video clips, spanning over 582 hours of video. These video clips contain rich content with diverse temporal dynamics, event shifts, and people interactions, collected from two sources: (i) popular TV shows, and (ii) movie clips from YouTube channels. In order to address our new multimodal inference task, a model is required to possess sophisticated reasoning skills, from surface-level grounding (e.g., identifying objects and characters in the video) to in-depth commonsense reasoning (e.g., inferring causal relations of events in the video). We present a detailed analysis of the dataset and an extensive evaluation over many strong baselines, providing valuable insights on the challenges of this new task.

We introduce RJUA-QA, a novel medical dataset for question answering (QA) and reasoning with clinical evidence, contributing to bridge the gap between general large language models (LLMs) and medical-specific LLM applications. RJUA-QA is derived from realistic clinical scenarios and aims to facilitate LLMs in generating reliable diagnostic and advice. The dataset contains 2,132 curated Question-Context-Answer pairs, corresponding about 25,000 diagnostic records and clinical cases. The dataset covers 67 common urological disease categories, where the disease coverage exceeds 97.6\% of the population seeking medical services in urology. Each data instance in RJUA-QA comprises: (1) a question mirroring real patient to inquiry about clinical symptoms and medical conditions, (2) a context including comprehensive expert knowledge, serving as a reference for medical examination and diagnosis, (3) a doctor response offering the diagnostic conclusion and suggested examination guidance, (4) a diagnosed clinical disease as the recommended diagnostic outcome, and (5) clinical advice providing recommendations for medical examination. RJUA-QA is the first medical QA dataset for clinical reasoning over the patient inquiries, where expert-level knowledge and experience are required for yielding diagnostic conclusions and medical examination advice. A comprehensive evaluation is conducted to evaluate the performance of both medical-specific and general LLMs on the RJUA-QA dataset.

This research tests the role of Large Language Models (LLMs) as formal second opinion tools in professional decision-making, particularly focusing on complex medical cases where even experienced physicians seek peer consultation. The work analyzed 183 challenging medical cases from Medscape over a 20-month period, testing multiple LLMs' performance against crowd-sourced physician responses. A key finding was the high overall score possible in the latest foundational models (>80% accuracy compared to consensus opinion), which exceeds most human metrics reported on the same clinical cases (450 pages of patient profiles, test results). The study rates the LLMs' performance disparity between straightforward cases (>81% accuracy) and complex scenarios (43% accuracy), particularly in these cases generating substantial debate among human physicians. The research demonstrates that LLMs may be valuable as generators of comprehensive differential diagnoses rather than as primary diagnostic tools, potentially helping to counter cognitive biases in clinical decision-making, reduce cognitive loads, and thus remove some sources of medical error. The inclusion of a second comparative legal dataset (Supreme Court cases, N=21) provides added empirical context to the AI use to foster second opinions, though these legal challenges proved considerably easier for LLMs to analyze. In addition to the original contributions of empirical evidence for LLM accuracy, the research aggregated a novel benchmark for others to score highly contested question and answer reliability between both LLMs and disagreeing human practitioners. These results suggest that the optimal deployment of LLMs in professional settings may differ substantially from current approaches that emphasize automation of routine tasks.

Clinical question answering systems have the potential to provide clinicians with relevant and timely answers to their questions. Nonetheless, despite the advances that have been made, adoption of these systems in clinical settings has been slow. One issue is a lack of question-answering datasets which reflect the real-world needs of health professionals. In this work, we present RealMedQA, a dataset of realistic clinical questions generated by humans and an LLM. We describe the process for generating and verifying the QA pairs and assess several QA models on BioASQ and RealMedQA to assess the relative difficulty of matching answers to questions. We show that the LLM is more cost-efficient for generating "ideal" QA pairs. Additionally, we achieve a lower lexical similarity between questions and answers than BioASQ which provides an additional challenge to the top two QA models, as per the results. We release our code and our dataset publicly to encourage further research.

The integration of Artificial Intelligence (AI), especially Large Language Models (LLMs), into the clinical diagnosis process offers significant potential to improve the efficiency and accessibility of medical care. While LLMs have shown some promise in the medical domain, their application in clinical diagnosis remains underexplored, especially in real-world clinical practice, where highly sophisticated, patient-specific decisions need to be made. Current evaluations of LLMs in this field are often narrow in scope, focusing on specific diseases or specialties and employing simplified diagnostic tasks. To bridge this gap, we introduce CliBench, a novel benchmark developed from the MIMIC IV dataset, offering a comprehensive and realistic assessment of LLMs' capabilities in clinical diagnosis. This benchmark not only covers diagnoses from a diverse range of medical cases across various specialties but also incorporates tasks of clinical significance: treatment procedure identification, lab test ordering and medication prescriptions. Supported by structured output ontologies, CliBench enables a precise and multi-granular evaluation, offering an in-depth understanding of LLM's capability on diverse clinical tasks of desired granularity. We conduct a zero-shot evaluation of leading LLMs to assess their proficiency in clinical decision-making. Our preliminary results shed light on the potential and limitations of current LLMs in clinical settings, providing valuable insights for future advancements in LLM-powered healthcare.

Chain-of-thought prompting~(CoT) and tool augmentation have been validated in recent work as effective practices for improving large language models~(LLMs) to perform step-by-step reasoning on complex math-related tasks. However, most existing math reasoning datasets may be not able to fully evaluate and analyze the ability of LLMs in manipulating tools and performing reasoning, as they may only require very few invocations of tools or miss annotations for evaluating intermediate reasoning steps. To address the issue, we construct CARP, a new Chinese dataset consisting of 4,886 computation-intensive algebra problems with formulated annotations on intermediate steps. In CARP, we test four LLMs with CoT prompting, and find that they are all prone to make mistakes at the early steps of the solution, leading to wrong answers. Based on this finding, we propose a new approach that can deliberate the reasoning steps with tool interfaces, namely DELI. In DELI, we first initialize a step-by-step solution based on retrieved exemplars, then iterate two deliberation procedures that check and refine the intermediate steps of the generated solution, from the perspectives of tool manipulation and natural language reasoning, until obtaining converged solutions or reaching the maximum turn. Experimental results on CARP and six other datasets show that the proposed DELI mostly outperforms competitive baselines, and can further boost the performance of existing CoT methods. Our data and code are available in https://github.com/RUCAIBox/CARP.

There is increasing interest in the application large language models (LLMs) to the medical field, in part because of their impressive performance on medical exam questions. While promising, exam questions do not reflect the complexity of real patient-doctor interactions. In reality, physicians' decisions are shaped by many complex factors, such as patient compliance, personal experience, ethical beliefs, and cognitive bias. Taking a step toward understanding this, our hypothesis posits that when LLMs are confronted with clinical questions containing cognitive biases, they will yield significantly less accurate responses compared to the same questions presented without such biases. In this study, we developed BiasMedQA, a benchmark for evaluating cognitive biases in LLMs applied to medical tasks. Using BiasMedQA we evaluated six LLMs, namely GPT-4, Mixtral-8x70B, GPT-3.5, PaLM-2, Llama 2 70B-chat, and the medically specialized PMC Llama 13B. We tested these models on 1,273 questions from the US Medical Licensing Exam (USMLE) Steps 1, 2, and 3, modified to replicate common clinically-relevant cognitive biases. Our analysis revealed varying effects for biases on these LLMs, with GPT-4 standing out for its resilience to bias, in contrast to Llama 2 70B-chat and PMC Llama 13B, which were disproportionately affected by cognitive bias. Our findings highlight the critical need for bias mitigation in the development of medical LLMs, pointing towards safer and more reliable applications in healthcare.

Recent large language models (LLMs) have shown indications of mathematical reasoning ability. However it has not been clear how they would fare on more challenging competition-level problems. And while self-generated verbalizations of intermediate reasoning steps (i.e., chain-of-thought prompting) have been shown to be helpful, whether LLMs can make use of helpful side information such as problem-specific hints has not been investigated before. In this paper, we propose a challenging benchmark dataset for enabling such analyses. The Concept and Hint-Annotated Math Problems (CHAMP) consists of high school math competition problems, annotated with concepts, or general math facts, and hints, or problem-specific tricks. These annotations allow us to explore the effects of additional information, such as relevant hints, misleading concepts, or related problems. This benchmark is difficult, with the best model only scoring 58.1% in standard settings. With concepts and hints, performance sometimes improves, indicating that some models can make use of such side information. We further annotate model-generated solutions for their correctness. Using this corpus, we find that models often arrive at the correct final answer through wrong reasoning steps. In addition, we test whether models are able to verify these solutions, and find that most models struggle. The dataset and code are available on the project website.