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Aug 14

MedExpQA: Multilingual Benchmarking of Large Language Models for Medical Question Answering

Large Language Models (LLMs) have the potential of facilitating the development of Artificial Intelligence technology to assist medical experts for interactive decision support, which has been demonstrated by their competitive performances in Medical QA. However, while impressive, the required quality bar for medical applications remains far from being achieved. Currently, LLMs remain challenged by outdated knowledge and by their tendency to generate hallucinated content. Furthermore, most benchmarks to assess medical knowledge lack reference gold explanations which means that it is not possible to evaluate the reasoning of LLMs predictions. Finally, the situation is particularly grim if we consider benchmarking LLMs for languages other than English which remains, as far as we know, a totally neglected topic. In order to address these shortcomings, in this paper we present MedExpQA, the first multilingual benchmark based on medical exams to evaluate LLMs in Medical Question Answering. To the best of our knowledge, MedExpQA includes for the first time reference gold explanations written by medical doctors which can be leveraged to establish various gold-based upper-bounds for comparison with LLMs performance. Comprehensive multilingual experimentation using both the gold reference explanations and Retrieval Augmented Generation (RAG) approaches show that performance of LLMs still has large room for improvement, especially for languages other than English. Furthermore, and despite using state-of-the-art RAG methods, our results also demonstrate the difficulty of obtaining and integrating readily available medical knowledge that may positively impact results on downstream evaluations for Medical Question Answering. So far the benchmark is available in four languages, but we hope that this work may encourage further development to other languages.

Medical mT5: An Open-Source Multilingual Text-to-Text LLM for The Medical Domain

Research on language technology for the development of medical applications is currently a hot topic in Natural Language Understanding and Generation. Thus, a number of large language models (LLMs) have recently been adapted to the medical domain, so that they can be used as a tool for mediating in human-AI interaction. While these LLMs display competitive performance on automated medical texts benchmarks, they have been pre-trained and evaluated with a focus on a single language (English mostly). This is particularly true of text-to-text models, which typically require large amounts of domain-specific pre-training data, often not easily accessible for many languages. In this paper, we address these shortcomings by compiling, to the best of our knowledge, the largest multilingual corpus for the medical domain in four languages, namely English, French, Italian and Spanish. This new corpus has been used to train Medical mT5, the first open-source text-to-text multilingual model for the medical domain. Additionally, we present two new evaluation benchmarks for all four languages with the aim of facilitating multilingual research in this domain. A comprehensive evaluation shows that Medical mT5 outperforms both encoders and similarly sized text-to-text models for the Spanish, French, and Italian benchmarks, while being competitive with current state-of-the-art LLMs in English.

Multi-OphthaLingua: A Multilingual Benchmark for Assessing and Debiasing LLM Ophthalmological QA in LMICs

Current ophthalmology clinical workflows are plagued by over-referrals, long waits, and complex and heterogeneous medical records. Large language models (LLMs) present a promising solution to automate various procedures such as triaging, preliminary tests like visual acuity assessment, and report summaries. However, LLMs have demonstrated significantly varied performance across different languages in natural language question-answering tasks, potentially exacerbating healthcare disparities in Low and Middle-Income Countries (LMICs). This study introduces the first multilingual ophthalmological question-answering benchmark with manually curated questions parallel across languages, allowing for direct cross-lingual comparisons. Our evaluation of 6 popular LLMs across 7 different languages reveals substantial bias across different languages, highlighting risks for clinical deployment of LLMs in LMICs. Existing debiasing methods such as Translation Chain-of-Thought or Retrieval-augmented generation (RAG) by themselves fall short of closing this performance gap, often failing to improve performance across all languages and lacking specificity for the medical domain. To address this issue, We propose CLARA (Cross-Lingual Reflective Agentic system), a novel inference time de-biasing method leveraging retrieval augmented generation and self-verification. Our approach not only improves performance across all languages but also significantly reduces the multilingual bias gap, facilitating equitable LLM application across the globe.

xMEN: A Modular Toolkit for Cross-Lingual Medical Entity Normalization

Objective: To improve performance of medical entity normalization across many languages, especially when fewer language resources are available compared to English. Materials and Methods: We introduce xMEN, a modular system for cross-lingual medical entity normalization, which performs well in both low- and high-resource scenarios. When synonyms in the target language are scarce for a given terminology, we leverage English aliases via cross-lingual candidate generation. For candidate ranking, we incorporate a trainable cross-encoder model if annotations for the target task are available. We also evaluate cross-encoders trained in a weakly supervised manner based on machine-translated datasets from a high resource domain. Our system is publicly available as an extensible Python toolkit. Results: xMEN improves the state-of-the-art performance across a wide range of multilingual benchmark datasets. Weakly supervised cross-encoders are effective when no training data is available for the target task. Through the compatibility of xMEN with the BigBIO framework, it can be easily used with existing and prospective datasets. Discussion: Our experiments show the importance of balancing the output of general-purpose candidate generators with subsequent trainable re-rankers, which we achieve through a rank regularization term in the loss function of the cross-encoder. However, error analysis reveals that multi-word expressions and other complex entities are still challenging. Conclusion: xMEN exhibits strong performance for medical entity normalization in multiple languages, even when no labeled data and few terminology aliases for the target language are available. Its configuration system and evaluation modules enable reproducible benchmarks. Models and code are available online at the following URL: https://github.com/hpi-dhc/xmen

The Bitter Lesson Learned from 2,000+ Multilingual Benchmarks

As large language models (LLMs) continue to advance in linguistic capabilities, robust multilingual evaluation has become essential for promoting equitable technological progress. This position paper examines over 2,000 multilingual (non-English) benchmarks from 148 countries, published between 2021 and 2024, to evaluate past, present, and future practices in multilingual benchmarking. Our findings reveal that, despite significant investments amounting to tens of millions of dollars, English remains significantly overrepresented in these benchmarks. Additionally, most benchmarks rely on original language content rather than translations, with the majority sourced from high-resource countries such as China, India, Germany, the UK, and the USA. Furthermore, a comparison of benchmark performance with human judgments highlights notable disparities. STEM-related tasks exhibit strong correlations with human evaluations (0.70 to 0.85), while traditional NLP tasks like question answering (e.g., XQuAD) show much weaker correlations (0.11 to 0.30). Moreover, translating English benchmarks into other languages proves insufficient, as localized benchmarks demonstrate significantly higher alignment with local human judgments (0.68) than their translated counterparts (0.47). This underscores the importance of creating culturally and linguistically tailored benchmarks rather than relying solely on translations. Through this comprehensive analysis, we highlight six key limitations in current multilingual evaluation practices, propose the guiding principles accordingly for effective multilingual benchmarking, and outline five critical research directions to drive progress in the field. Finally, we call for a global collaborative effort to develop human-aligned benchmarks that prioritize real-world applications.

BRIDGE: Benchmarking Large Language Models for Understanding Real-world Clinical Practice Text

Large language models (LLMs) hold great promise for medical applications and are evolving rapidly, with new models being released at an accelerated pace. However, current evaluations of LLMs in clinical contexts remain limited. Most existing benchmarks rely on medical exam-style questions or PubMed-derived text, failing to capture the complexity of real-world electronic health record (EHR) data. Others focus narrowly on specific application scenarios, limiting their generalizability across broader clinical use. To address this gap, we present BRIDGE, a comprehensive multilingual benchmark comprising 87 tasks sourced from real-world clinical data sources across nine languages. We systematically evaluated 52 state-of-the-art LLMs (including DeepSeek-R1, GPT-4o, Gemini, and Llama 4) under various inference strategies. With a total of 13,572 experiments, our results reveal substantial performance variation across model sizes, languages, natural language processing tasks, and clinical specialties. Notably, we demonstrate that open-source LLMs can achieve performance comparable to proprietary models, while medically fine-tuned LLMs based on older architectures often underperform versus updated general-purpose models. The BRIDGE and its corresponding leaderboard serve as a foundational resource and a unique reference for the development and evaluation of new LLMs in real-world clinical text understanding.

Towards Evaluating and Building Versatile Large Language Models for Medicine

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.

CUPCase: Clinically Uncommon Patient Cases and Diagnoses Dataset

Medical benchmark datasets significantly contribute to developing Large Language Models (LLMs) for medical knowledge extraction, diagnosis, summarization, and other uses. Yet, current benchmarks are mainly derived from exam questions given to medical students or cases described in the medical literature, lacking the complexity of real-world patient cases that deviate from classic textbook abstractions. These include rare diseases, uncommon presentations of common diseases, and unexpected treatment responses. Here, we construct Clinically Uncommon Patient Cases and Diagnosis Dataset (CUPCase) based on 3,562 real-world case reports from BMC, including diagnoses in open-ended textual format and as multiple-choice options with distractors. Using this dataset, we evaluate the ability of state-of-the-art LLMs, including both general-purpose and Clinical LLMs, to identify and correctly diagnose a patient case, and test models' performance when only partial information about cases is available. Our findings show that general-purpose GPT-4o attains the best performance in both the multiple-choice task (average accuracy of 87.9%) and the open-ended task (BERTScore F1 of 0.764), outperforming several LLMs with a focus on the medical domain such as Meditron-70B and MedLM-Large. Moreover, GPT-4o was able to maintain 87% and 88% of its performance with only the first 20% of tokens of the case presentation in multiple-choice and free text, respectively, highlighting the potential of LLMs to aid in early diagnosis in real-world cases. CUPCase expands our ability to evaluate LLMs for clinical decision support in an open and reproducible manner.

BiMediX: Bilingual Medical Mixture of Experts LLM

In this paper, we introduce BiMediX, the first bilingual medical mixture of experts LLM designed for seamless interaction in both English and Arabic. Our model facilitates a wide range of medical interactions in English and Arabic, including multi-turn chats to inquire about additional details such as patient symptoms and medical history, multiple-choice question answering, and open-ended question answering. We propose a semi-automated English-to-Arabic translation pipeline with human refinement to ensure high-quality translations. We also introduce a comprehensive evaluation benchmark for Arabic medical LLMs. Furthermore, we introduce BiMed1.3M, an extensive Arabic-English bilingual instruction set covering 1.3 Million diverse medical interactions, resulting in over 632 million healthcare specialized tokens for instruction tuning. Our BiMed1.3M dataset includes 250k synthesized multi-turn doctor-patient chats and maintains a 1:2 Arabic-to-English ratio. Our model outperforms state-of-the-art Med42 and Meditron by average absolute gains of 2.5% and 4.1%, respectively, computed across multiple medical evaluation benchmarks in English, while operating at 8-times faster inference. Moreover, our BiMediX outperforms the generic Arabic-English bilingual LLM, Jais-30B, by average absolute gains of 10% on our Arabic medical benchmark and 15% on bilingual evaluations across multiple datasets. Our project page with source code and trained model is available at https://github.com/mbzuai-oryx/BiMediX .

Bridging the Gap: Enhancing LLM Performance for Low-Resource African Languages with New Benchmarks, Fine-Tuning, and Cultural Adjustments

Large Language Models (LLMs) have shown remarkable performance across various tasks, yet significant disparities remain for non-English languages, and especially native African languages. This paper addresses these disparities by creating approximately 1 million human-translated words of new benchmark data in 8 low-resource African languages, covering a population of over 160 million speakers of: Amharic, Bambara, Igbo, Sepedi (Northern Sotho), Shona, Sesotho (Southern Sotho), Setswana, and Tsonga. Our benchmarks are translations of Winogrande and three sections of MMLU: college medicine, clinical knowledge, and virology. Using the translated benchmarks, we report previously unknown performance gaps between state-of-the-art (SOTA) LLMs in English and African languages. Finally, using results from over 400 fine-tuned models, we explore several methods to reduce the LLM performance gap, including high-quality dataset fine-tuning (using an LLM-as-an-Annotator), cross-lingual transfer, and cultural appropriateness adjustments. Key findings include average mono-lingual improvements of 5.6% with fine-tuning (with 5.4% average mono-lingual improvements when using high-quality data over low-quality data), 2.9% average gains from cross-lingual transfer, and a 3.0% out-of-the-box performance boost on culturally appropriate questions. The publicly available benchmarks, translations, and code from this study support further research and development aimed at creating more inclusive and effective language technologies.

BiMediX2: Bio-Medical EXpert LMM for Diverse Medical Modalities

This paper introduces BiMediX2, a bilingual (Arabic-English) Bio-Medical EXpert Large Multimodal Model (LMM) with a unified architecture that integrates text and visual modalities, enabling advanced image understanding and medical applications. BiMediX2 leverages the Llama3.1 architecture and integrates text and visual capabilities to facilitate seamless interactions in both English and Arabic, supporting text-based inputs and multi-turn conversations involving medical images. The model is trained on an extensive bilingual healthcare dataset consisting of 1.6M samples of diverse medical interactions for both text and image modalities, mixed in Arabic and English. We also propose the first bilingual GPT-4o based medical LMM benchmark named BiMed-MBench. BiMediX2 is benchmarked on both text-based and image-based tasks, achieving state-of-the-art performance across several medical benchmarks. It outperforms recent state-of-the-art models in medical LLM evaluation benchmarks. Our model also sets a new benchmark in multimodal medical evaluations with over 9% improvement in English and over 20% in Arabic evaluations. Additionally, it surpasses GPT-4 by around 9% in UPHILL factual accuracy evaluations and excels in various medical Visual Question Answering, Report Generation, and Report Summarization tasks. The project page including source code and the trained model, is available at https://github.com/mbzuai-oryx/BiMediX2.

Explanatory Argument Extraction of Correct Answers in Resident Medical Exams

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.

LongHealth: A Question Answering Benchmark with Long Clinical Documents

Background: Recent advancements in large language models (LLMs) offer potential benefits in healthcare, particularly in processing extensive patient records. However, existing benchmarks do not fully assess LLMs' capability in handling real-world, lengthy clinical data. Methods: We present the LongHealth benchmark, comprising 20 detailed fictional patient cases across various diseases, with each case containing 5,090 to 6,754 words. The benchmark challenges LLMs with 400 multiple-choice questions in three categories: information extraction, negation, and sorting, challenging LLMs to extract and interpret information from large clinical documents. Results: We evaluated nine open-source LLMs with a minimum of 16,000 tokens and also included OpenAI's proprietary and cost-efficient GPT-3.5 Turbo for comparison. The highest accuracy was observed for Mixtral-8x7B-Instruct-v0.1, particularly in tasks focused on information retrieval from single and multiple patient documents. However, all models struggled significantly in tasks requiring the identification of missing information, highlighting a critical area for improvement in clinical data interpretation. Conclusion: While LLMs show considerable potential for processing long clinical documents, their current accuracy levels are insufficient for reliable clinical use, especially in scenarios requiring the identification of missing information. The LongHealth benchmark provides a more realistic assessment of LLMs in a healthcare setting and highlights the need for further model refinement for safe and effective clinical application. We make the benchmark and evaluation code publicly available.

MEDEC: A Benchmark for Medical Error Detection and Correction in Clinical Notes

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.

Named Clinical Entity Recognition Benchmark

This technical report introduces a Named Clinical Entity Recognition Benchmark for evaluating language models in healthcare, addressing the crucial natural language processing (NLP) task of extracting structured information from clinical narratives to support applications like automated coding, clinical trial cohort identification, and clinical decision support. The leaderboard provides a standardized platform for assessing diverse language models, including encoder and decoder architectures, on their ability to identify and classify clinical entities across multiple medical domains. A curated collection of openly available clinical datasets is utilized, encompassing entities such as diseases, symptoms, medications, procedures, and laboratory measurements. Importantly, these entities are standardized according to the Observational Medical Outcomes Partnership (OMOP) Common Data Model, ensuring consistency and interoperability across different healthcare systems and datasets, and a comprehensive evaluation of model performance. Performance of models is primarily assessed using the F1-score, and it is complemented by various assessment modes to provide comprehensive insights into model performance. The report also includes a brief analysis of models evaluated to date, highlighting observed trends and limitations. By establishing this benchmarking framework, the leaderboard aims to promote transparency, facilitate comparative analyses, and drive innovation in clinical entity recognition tasks, addressing the need for robust evaluation methods in healthcare NLP.

Polish Medical Exams: A new dataset for cross-lingual medical knowledge transfer assessment

Large Language Models (LLMs) have demonstrated significant potential in handling specialized tasks, including medical problem-solving. However, most studies predominantly focus on English-language contexts. This study introduces a novel benchmark dataset based on Polish medical licensing and specialization exams (LEK, LDEK, PES) taken by medical doctor candidates and practicing doctors pursuing specialization. The dataset was web-scraped from publicly available resources provided by the Medical Examination Center and the Chief Medical Chamber. It comprises over 24,000 exam questions, including a subset of parallel Polish-English corpora, where the English portion was professionally translated by the examination center for foreign candidates. By creating a structured benchmark from these existing exam questions, we systematically evaluate state-of-the-art LLMs, including general-purpose, domain-specific, and Polish-specific models, and compare their performance against human medical students. Our analysis reveals that while models like GPT-4o achieve near-human performance, significant challenges persist in cross-lingual translation and domain-specific understanding. These findings underscore disparities in model performance across languages and medical specialties, highlighting the limitations and ethical considerations of deploying LLMs in clinical practice.

MedAgentsBench: Benchmarking Thinking Models and Agent Frameworks for Complex Medical Reasoning

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.

MedBookVQA: A Systematic and Comprehensive Medical Benchmark Derived from Open-Access Book

The accelerating development of general medical artificial intelligence (GMAI), powered by multimodal large language models (MLLMs), offers transformative potential for addressing persistent healthcare challenges, including workforce deficits and escalating costs. The parallel development of systematic evaluation benchmarks emerges as a critical imperative to enable performance assessment and provide technological guidance. Meanwhile, as an invaluable knowledge source, the potential of medical textbooks for benchmark development remains underexploited. Here, we present MedBookVQA, a systematic and comprehensive multimodal benchmark derived from open-access medical textbooks. To curate this benchmark, we propose a standardized pipeline for automated extraction of medical figures while contextually aligning them with corresponding medical narratives. Based on this curated data, we generate 5,000 clinically relevant questions spanning modality recognition, disease classification, anatomical identification, symptom diagnosis, and surgical procedures. A multi-tier annotation system categorizes queries through hierarchical taxonomies encompassing medical imaging modalities (42 categories), body anatomies (125 structures), and clinical specialties (31 departments), enabling nuanced analysis across medical subdomains. We evaluate a wide array of MLLMs, including proprietary, open-sourced, medical, and reasoning models, revealing significant performance disparities across task types and model categories. Our findings highlight critical capability gaps in current GMAI systems while establishing textbook-derived multimodal benchmarks as essential evaluation tools. MedBookVQA establishes textbook-derived benchmarking as a critical paradigm for advancing clinical AI, exposing limitations in GMAI systems while providing anatomically structured performance metrics across specialties.

This is the way: designing and compiling LEPISZCZE, a comprehensive NLP benchmark for Polish

The availability of compute and data to train larger and larger language models increases the demand for robust methods of benchmarking the true progress of LM training. Recent years witnessed significant progress in standardized benchmarking for English. Benchmarks such as GLUE, SuperGLUE, or KILT have become de facto standard tools to compare large language models. Following the trend to replicate GLUE for other languages, the KLEJ benchmark has been released for Polish. In this paper, we evaluate the progress in benchmarking for low-resourced languages. We note that only a handful of languages have such comprehensive benchmarks. We also note the gap in the number of tasks being evaluated by benchmarks for resource-rich English/Chinese and the rest of the world. In this paper, we introduce LEPISZCZE (the Polish word for glew, the Middle English predecessor of glue), a new, comprehensive benchmark for Polish NLP with a large variety of tasks and high-quality operationalization of the benchmark. We design LEPISZCZE with flexibility in mind. Including new models, datasets, and tasks is as simple as possible while still offering data versioning and model tracking. In the first run of the benchmark, we test 13 experiments (task and dataset pairs) based on the five most recent LMs for Polish. We use five datasets from the Polish benchmark and add eight novel datasets. As the paper's main contribution, apart from LEPISZCZE, we provide insights and experiences learned while creating the benchmark for Polish as the blueprint to design similar benchmarks for other low-resourced languages.

Better to Ask in English: Cross-Lingual Evaluation of Large Language Models for Healthcare Queries

Large language models (LLMs) are transforming the ways the general public accesses and consumes information. Their influence is particularly pronounced in pivotal sectors like healthcare, where lay individuals are increasingly appropriating LLMs as conversational agents for everyday queries. While LLMs demonstrate impressive language understanding and generation proficiencies, concerns regarding their safety remain paramount in these high-stake domains. Moreover, the development of LLMs is disproportionately focused on English. It remains unclear how these LLMs perform in the context of non-English languages, a gap that is critical for ensuring equity in the real-world use of these systems.This paper provides a framework to investigate the effectiveness of LLMs as multi-lingual dialogue systems for healthcare queries. Our empirically-derived framework XlingEval focuses on three fundamental criteria for evaluating LLM responses to naturalistic human-authored health-related questions: correctness, consistency, and verifiability. Through extensive experiments on four major global languages, including English, Spanish, Chinese, and Hindi, spanning three expert-annotated large health Q&A datasets, and through an amalgamation of algorithmic and human-evaluation strategies, we found a pronounced disparity in LLM responses across these languages, indicating a need for enhanced cross-lingual capabilities. We further propose XlingHealth, a cross-lingual benchmark for examining the multilingual capabilities of LLMs in the healthcare context. Our findings underscore the pressing need to bolster the cross-lingual capacities of these models, and to provide an equitable information ecosystem accessible to all.

MultiLoKo: a multilingual local knowledge benchmark for LLMs spanning 31 languages

We present MultiLoKo, a new benchmark for evaluating multilinguality in LLMs covering 31 languages. MultiLoKo consists of three partitions: a main partition consisting of 500 questions per language, separately sourced to be locally relevant to the specific language, and two translated partitions, containing human-authored translations from 30 non-English languages to English and vice versa. For comparison, we also release corresponding machine-authored translations. The data is equally distributed over two splits: a dev split and a blind, out-of-distribution test split. MultiLoKo can be used to study a variety of questions regarding the multilinguality of LLMs as well as meta-questions about multilingual benchmark creation. We compute MultiLoKo scores for 11 base and chat models marketed to be multilingual and study their average performance, their performance parity across languages, how much their ability to answer questions depends on the question language, and which languages are most difficult. None of the models we studied performs well on MultiLoKo, as indicated by low average scores as well as large differences between the best and worst scoring languages. Furthermore, we find a substantial effect of the question language, indicating sub-optimal knowledge transfer between languages. Lastly, we find that using local vs English-translated data can result in differences more than 20 points for the best performing models, drastically change the estimated difficulty of some languages. For using machines instead of human translations, we find a weaker effect on ordering of language difficulty, a larger difference in model rankings, and a substantial drop in estimated performance for all models.

Zero-shot Benchmarking: A Framework for Flexible and Scalable Automatic Evaluation of Language Models

As language models improve and become capable of performing more complex tasks across modalities, evaluating them automatically becomes increasingly challenging. Developing strong and robust task-specific automatic metrics gets harder, and human-annotated test sets -- which are expensive to create -- saturate more quickly. A compelling alternative is to design reliable strategies to automate the creation of test data and evaluation, but previous attempts either rely on pre-existing data, or focus solely on individual tasks. We present Zero-shot Benchmarking (ZSB), a framework for creating high-quality benchmarks for any task by leveraging language models for both synthetic test data creation and evaluation. ZSB is simple and flexible: it requires only the creation of a prompt for data generation and one for evaluation; it is scalable to tasks and languages where collecting real-world data is costly or impractical; it is model-agnostic, allowing the creation of increasingly challenging benchmarks as models improve. To assess the effectiveness of our framework, we create benchmarks for five text-only tasks and a multi-modal one: general capabilities in four languages (English, Chinese, French, and Korean), translation, and general vision-language capabilities in English. We then rank a broad range of open and closed systems on our benchmarks. ZSB rankings consistently correlate strongly with human rankings, outperforming widely-adopted standard benchmarks. Through ablations, we find that strong benchmarks can be created with open models, and that judge model size and dataset variety are crucial drivers of performance. We release all our benchmarks, and code to reproduce our experiments and to produce new benchmarks.

GMAI-MMBench: A Comprehensive Multimodal Evaluation Benchmark Towards General Medical AI

Large Vision-Language Models (LVLMs) are capable of handling diverse data types such as imaging, text, and physiological signals, and can be applied in various fields. In the medical field, LVLMs have a high potential to offer substantial assistance for diagnosis and treatment. Before that, it is crucial to develop benchmarks to evaluate LVLMs' effectiveness in various medical applications. Current benchmarks are often built upon specific academic literature, mainly focusing on a single domain, and lacking varying perceptual granularities. Thus, they face specific challenges, including limited clinical relevance, incomplete evaluations, and insufficient guidance for interactive LVLMs. To address these limitations, we developed the GMAI-MMBench, the most comprehensive general medical AI benchmark with well-categorized data structure and multi-perceptual granularity to date. It is constructed from 285 datasets across 39 medical image modalities, 18 clinical-related tasks, 18 departments, and 4 perceptual granularities in a Visual Question Answering (VQA) format. Additionally, we implemented a lexical tree structure that allows users to customize evaluation tasks, accommodating various assessment needs and substantially supporting medical AI research and applications. We evaluated 50 LVLMs, and the results show that even the advanced GPT-4o only achieves an accuracy of 52%, indicating significant room for improvement. Moreover, we identified five key insufficiencies in current cutting-edge LVLMs that need to be addressed to advance the development of better medical applications. We believe that GMAI-MMBench will stimulate the community to build the next generation of LVLMs toward GMAI. Project Page: https://uni-medical.github.io/GMAI-MMBench.github.io/

IberBench: LLM Evaluation on Iberian Languages

Large Language Models (LLMs) remain difficult to evaluate comprehensively, particularly for languages other than English, where high-quality data is often limited. Existing benchmarks and leaderboards are predominantly English-centric, with only a few addressing other languages. These benchmarks fall short in several key areas: they overlook the diversity of language varieties, prioritize fundamental Natural Language Processing (NLP) capabilities over tasks of industrial relevance, and are static. With these aspects in mind, we present IberBench, a comprehensive and extensible benchmark designed to assess LLM performance on both fundamental and industry-relevant NLP tasks, in languages spoken across the Iberian Peninsula and Ibero-America. IberBench integrates 101 datasets from evaluation campaigns and recent benchmarks, covering 22 task categories such as sentiment and emotion analysis, toxicity detection, and summarization. The benchmark addresses key limitations in current evaluation practices, such as the lack of linguistic diversity and static evaluation setups by enabling continual updates and community-driven model and dataset submissions moderated by a committee of experts. We evaluate 23 LLMs ranging from 100 million to 14 billion parameters and provide empirical insights into their strengths and limitations. Our findings indicate that (i) LLMs perform worse on industry-relevant tasks than in fundamental ones, (ii) performance is on average lower for Galician and Basque, (iii) some tasks show results close to random, and (iv) in other tasks LLMs perform above random but below shared task systems. IberBench offers open-source implementations for the entire evaluation pipeline, including dataset normalization and hosting, incremental evaluation of LLMs, and a publicly accessible leaderboard.

MMTEB: Massive Multilingual Text Embedding Benchmark

Text embeddings are typically evaluated on a limited set of tasks, which are constrained by language, domain, and task diversity. To address these limitations and provide a more comprehensive evaluation, we introduce the Massive Multilingual Text Embedding Benchmark (MMTEB) - a large-scale, community-driven expansion of MTEB, covering over 500 quality-controlled evaluation tasks across 250+ languages. MMTEB includes a diverse set of challenging, novel tasks such as instruction following, long-document retrieval, and code retrieval, representing the largest multilingual collection of evaluation tasks for embedding models to date. Using this collection, we develop several highly multilingual benchmarks, which we use to evaluate a representative set of models. We find that while large language models (LLMs) with billions of parameters can achieve state-of-the-art performance on certain language subsets and task categories, the best-performing publicly available model is multilingual-e5-large-instruct with only 560 million parameters. To facilitate accessibility and reduce computational cost, we introduce a novel downsampling method based on inter-task correlation, ensuring a diverse selection while preserving relative model rankings. Furthermore, we optimize tasks such as retrieval by sampling hard negatives, creating smaller but effective splits. These optimizations allow us to introduce benchmarks that drastically reduce computational demands. For instance, our newly introduced zero-shot English benchmark maintains a ranking order similar to the full-scale version but at a fraction of the computational cost.

3MDBench: Medical Multimodal Multi-agent Dialogue Benchmark

Large Vision-Language Models (LVLMs) are increasingly being explored for applications in telemedicine, yet their ability to engage with diverse patient behaviors remains underexplored. We introduce 3MDBench (Medical Multimodal Multi-agent Dialogue Benchmark), an open-source evaluation framework designed to assess LLM-driven medical consultations. Unlike existing benchmarks, 3MDBench simulates real-world patient variability by incorporating four temperament-driven Patient Agents and an Assessor Agent that evaluates diagnostic accuracy and dialogue quality. The benchmark integrates textual and image-based patient data across 34 common diagnoses, mirroring real-world telemedicine interactions. Under different diagnostic strategies, we evaluate state-of-the-art LVLMs. Our findings demonstrate that incorporating dialogue improves the F1 score from 50.4 to 54.2 compared to non-dialogue settings, underscoring the value of context-driven, information-seeking questioning. Additionally, we demonstrate that multimodal inputs enhance diagnostic efficiency. Image-supported models outperform text-only counterparts by raising the diagnostic F1 score from 52.8 to 54.2 in a similar dialogue setting. Finally, we suggest an approach that improves the diagnostic F1-score to 70.3 by training the CNN model on the diagnosis prediction task and incorporating its top-3 predictions into the LVLM context. 3MDBench provides a reproducible and extendable evaluation framework for AI-driven medical assistants. It offers insights into how patient temperament, dialogue strategies, and multimodal reasoning influence diagnosis quality. By addressing real-world complexities in telemedicine, our benchmark paves the way for more empathetic, reliable, and context-aware AI-driven healthcare solutions. The source code of our benchmark is publicly available: https://github.com/univanxx/3mdbench

Are Large Language Models True Healthcare Jacks-of-All-Trades? Benchmarking Across Health Professions Beyond Physician Exams

Recent advancements in Large Language Models (LLMs) have demonstrated their potential in delivering accurate answers to questions about world knowledge. Despite this, existing benchmarks for evaluating LLMs in healthcare predominantly focus on medical doctors, leaving other critical healthcare professions underrepresented. To fill this research gap, we introduce the Examinations for Medical Personnel in Chinese (EMPEC), a pioneering large-scale healthcare knowledge benchmark in traditional Chinese. EMPEC consists of 157,803 exam questions across 124 subjects and 20 healthcare professions, including underrepresented occupations like Optometrists and Audiologists. Each question is tagged with its release time and source, ensuring relevance and authenticity. We conducted extensive experiments on 17 LLMs, including proprietary, open-source models, general domain models and medical specific models, evaluating their performance under various settings. Our findings reveal that while leading models like GPT-4 achieve over 75\% accuracy, they still struggle with specialized fields and alternative medicine. Surprisingly, general-purpose LLMs outperformed medical-specific models, and incorporating EMPEC's training data significantly enhanced performance. Additionally, the results on questions released after the models' training cutoff date were consistent with overall performance trends, suggesting that the models' performance on the test set can predict their effectiveness in addressing unseen healthcare-related queries. The transition from traditional to simplified Chinese characters had a negligible impact on model performance, indicating robust linguistic versatility. Our study underscores the importance of expanding benchmarks to cover a broader range of healthcare professions to better assess the applicability of LLMs in real-world healthcare scenarios.

CliBench: Multifaceted Evaluation of Large Language Models in Clinical Decisions on Diagnoses, Procedures, Lab Tests Orders and Prescriptions

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.

Biomedical Large Languages Models Seem not to be Superior to Generalist Models on Unseen Medical Data

Large language models (LLMs) have shown potential in biomedical applications, leading to efforts to fine-tune them on domain-specific data. However, the effectiveness of this approach remains unclear. This study evaluates the performance of biomedically fine-tuned LLMs against their general-purpose counterparts on a variety of clinical tasks. We evaluated their performance on clinical case challenges from the New England Journal of Medicine (NEJM) and the Journal of the American Medical Association (JAMA) and on several clinical tasks (e.g., information extraction, document summarization, and clinical coding). Using benchmarks specifically chosen to be likely outside the fine-tuning datasets of biomedical models, we found that biomedical LLMs mostly perform inferior to their general-purpose counterparts, especially on tasks not focused on medical knowledge. While larger models showed similar performance on case tasks (e.g., OpenBioLLM-70B: 66.4% vs. Llama-3-70B-Instruct: 65% on JAMA cases), smaller biomedical models showed more pronounced underperformance (e.g., OpenBioLLM-8B: 30% vs. Llama-3-8B-Instruct: 64.3% on NEJM cases). Similar trends were observed across the CLUE (Clinical Language Understanding Evaluation) benchmark tasks, with general-purpose models often performing better on text generation, question answering, and coding tasks. Our results suggest that fine-tuning LLMs to biomedical data may not provide the expected benefits and may potentially lead to reduced performance, challenging prevailing assumptions about domain-specific adaptation of LLMs and highlighting the need for more rigorous evaluation frameworks in healthcare AI. Alternative approaches, such as retrieval-augmented generation, may be more effective in enhancing the biomedical capabilities of LLMs without compromising their general knowledge.

R2MED: A Benchmark for Reasoning-Driven Medical Retrieval

Current medical retrieval benchmarks primarily emphasize lexical or shallow semantic similarity, overlooking the reasoning-intensive demands that are central to clinical decision-making. In practice, physicians often retrieve authoritative medical evidence to support diagnostic hypotheses. Such evidence typically aligns with an inferred diagnosis rather than the surface form of a patient's symptoms, leading to low lexical or semantic overlap between queries and relevant documents. To address this gap, we introduce R2MED, the first benchmark explicitly designed for reasoning-driven medical retrieval. It comprises 876 queries spanning three tasks: Q&A reference retrieval, clinical evidence retrieval, and clinical case retrieval. These tasks are drawn from five representative medical scenarios and twelve body systems, capturing the complexity and diversity of real-world medical information needs. We evaluate 15 widely-used retrieval systems on R2MED and find that even the best model achieves only 31.4 nDCG@10, demonstrating the benchmark's difficulty. Classical re-ranking and generation-augmented retrieval methods offer only modest improvements. Although large reasoning models improve performance via intermediate inference generation, the best results still peak at 41.4 nDCG@10. These findings underscore a substantial gap between current retrieval techniques and the reasoning demands of real clinical tasks. We release R2MED as a challenging benchmark to foster the development of next-generation medical retrieval systems with enhanced reasoning capabilities. Data and code are available at https://github.com/R2MED/R2MED

A Modular Approach for Clinical SLMs Driven by Synthetic Data with Pre-Instruction Tuning, Model Merging, and Clinical-Tasks Alignment

High computation costs and latency of large language models such as GPT-4 have limited their deployment in clinical settings. Small language models (SLMs) offer a cost-effective alternative, but their limited capacity requires biomedical domain adaptation, which remains challenging. An additional bottleneck is the unavailability and high sensitivity of clinical data. To address these challenges, we propose a novel framework for adapting SLMs into high-performing clinical models. We introduce the MediPhi collection of 3.8B-parameter SLMs developed with our novel framework: pre-instruction tuning of experts on relevant medical and clinical corpora (PMC, Medical Guideline, MedWiki, etc.), model merging, and clinical-tasks alignment. To cover most clinical tasks, we extended the CLUE benchmark to CLUE+, doubling its size. Our expert models deliver relative improvements on this benchmark over the base model without any task-specific fine-tuning: 64.3% on medical entities, 49.5% on radiology reports, and 44% on ICD-10 coding (outperforming GPT-4-0125 by 14%). We unify the expert models into MediPhi via model merging, preserving gains across benchmarks. Furthermore, we built the MediFlow collection, a synthetic dataset of 2.5 million high-quality instructions on 14 medical NLP tasks, 98 fine-grained document types, and JSON format support. Alignment of MediPhi using supervised fine-tuning and direct preference optimization achieves further gains of 18.9% on average.

All Languages Matter: Evaluating LMMs on Culturally Diverse 100 Languages

Existing Large Multimodal Models (LMMs) generally focus on only a few regions and languages. As LMMs continue to improve, it is increasingly important to ensure they understand cultural contexts, respect local sensitivities, and support low-resource languages, all while effectively integrating corresponding visual cues. In pursuit of culturally diverse global multimodal models, our proposed All Languages Matter Benchmark (ALM-bench) represents the largest and most comprehensive effort to date for evaluating LMMs across 100 languages. ALM-bench challenges existing models by testing their ability to understand and reason about culturally diverse images paired with text in various languages, including many low-resource languages traditionally underrepresented in LMM research. The benchmark offers a robust and nuanced evaluation framework featuring various question formats, including true/false, multiple choice, and open-ended questions, which are further divided into short and long-answer categories. ALM-bench design ensures a comprehensive assessment of a model's ability to handle varied levels of difficulty in visual and linguistic reasoning. To capture the rich tapestry of global cultures, ALM-bench carefully curates content from 13 distinct cultural aspects, ranging from traditions and rituals to famous personalities and celebrations. Through this, ALM-bench not only provides a rigorous testing ground for state-of-the-art open and closed-source LMMs but also highlights the importance of cultural and linguistic inclusivity, encouraging the development of models that can serve diverse global populations effectively. Our benchmark is publicly available.

SCALE: Scaling up the Complexity for Advanced Language Model Evaluation

Recent strides in Large Language Models (LLMs) have saturated many NLP benchmarks (even professional domain-specific ones), emphasizing the need for novel, more challenging novel ones to properly assess LLM capabilities. In this paper, we introduce a novel NLP benchmark that poses challenges to current LLMs across four key dimensions: processing long documents (up to 50K tokens), utilizing domain specific knowledge (embodied in legal texts), multilingual understanding (covering five languages), and multitasking (comprising legal document to document Information Retrieval, Court View Generation, Leading Decision Summarization, Citation Extraction, and eight challenging Text Classification tasks). Our benchmark comprises diverse legal NLP datasets from the Swiss legal system, allowing for a comprehensive study of the underlying Non-English, inherently multilingual, federal legal system. Despite recent advances, efficiently processing long documents for intense review/analysis tasks remains an open challenge for language models. Also, comprehensive, domain-specific benchmarks requiring high expertise to develop are rare, as are multilingual benchmarks. This scarcity underscores our contribution's value, considering most public models are trained predominantly on English corpora, while other languages remain understudied, particularly for practical domain-specific NLP tasks. Our benchmark allows for testing and advancing the state-of-the-art LLMs. As part of our study, we evaluate several pre-trained multilingual language models on our benchmark to establish strong baselines as a point of reference. Despite the large size of our datasets (tens to hundreds of thousands of examples), existing publicly available models struggle with most tasks, even after in-domain pretraining. We publish all resources (benchmark suite, pre-trained models, code) under a fully permissive open CC BY-SA license.

Eir: Thai Medical Large Language Models

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%

ClinBench-HPB: A Clinical Benchmark for Evaluating LLMs in Hepato-Pancreato-Biliary Diseases

Hepato-pancreato-biliary (HPB) disorders represent a global public health challenge due to their high morbidity and mortality. Although large language models (LLMs) have shown promising performance in general medical question-answering tasks, the current evaluation benchmarks are mostly derived from standardized examinations or manually designed questions, lacking HPB coverage and clinical cases. To address these issues, we systematically eatablish an HPB disease evaluation benchmark comprising 3,535 closed-ended multiple-choice questions and 337 open-ended real diagnosis cases, which encompasses all the 33 main categories and 465 subcategories of HPB diseases defined in the International Statistical Classification of Diseases, 10th Revision (ICD-10). The multiple-choice questions are curated from public datasets and synthesized data, and the clinical cases are collected from prestigious medical journals, case-sharing platforms, and collaborating hospitals. By evalauting commercial and open-source general and medical LLMs on our established benchmark, namely ClinBench-HBP, we find that while commercial LLMs perform competently on medical exam questions, they exhibit substantial performance degradation on HPB diagnosis tasks, especially on complex, inpatient clinical cases. Those medical LLMs also show limited generalizability to HPB diseases. Our results reveal the critical limitations of current LLMs in the domain of HPB diseases, underscoring the imperative need for future medical LLMs to handle real, complex clinical diagnostics rather than simple medical exam questions. The benchmark will be released at https://clinbench-hpb.github.io.

TableEval: A Real-World Benchmark for Complex, Multilingual, and Multi-Structured Table Question Answering

LLMs have shown impressive progress in natural language processing. However, they still face significant challenges in TableQA, where real-world complexities such as diverse table structures, multilingual data, and domain-specific reasoning are crucial. Existing TableQA benchmarks are often limited by their focus on simple flat tables and suffer from data leakage. Furthermore, most benchmarks are monolingual and fail to capture the cross-lingual and cross-domain variability in practical applications. To address these limitations, we introduce TableEval, a new benchmark designed to evaluate LLMs on realistic TableQA tasks. Specifically, TableEval includes tables with various structures (such as concise, hierarchical, and nested tables) collected from four domains (including government, finance, academia, and industry reports). Besides, TableEval features cross-lingual scenarios with tables in Simplified Chinese, Traditional Chinese, and English. To minimize the risk of data leakage, we collect all data from recent real-world documents. Considering that existing TableQA metrics fail to capture semantic accuracy, we further propose SEAT, a new evaluation framework that assesses the alignment between model responses and reference answers at the sub-question level. Experimental results have shown that SEAT achieves high agreement with human judgment. Extensive experiments on TableEval reveal critical gaps in the ability of state-of-the-art LLMs to handle these complex, real-world TableQA tasks, offering insights for future improvements. We make our dataset available here: https://github.com/wenge-research/TableEval.

SemiHVision: Enhancing Medical Multimodal Models with a Semi-Human Annotated Dataset and Fine-Tuned Instruction Generation

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.

Multilingual Translation with Extensible Multilingual Pretraining and Finetuning

Recent work demonstrates the potential of multilingual pretraining of creating one model that can be used for various tasks in different languages. Previous work in multilingual pretraining has demonstrated that machine translation systems can be created by finetuning on bitext. In this work, we show that multilingual translation models can be created through multilingual finetuning. Instead of finetuning on one direction, a pretrained model is finetuned on many directions at the same time. Compared to multilingual models trained from scratch, starting from pretrained models incorporates the benefits of large quantities of unlabeled monolingual data, which is particularly important for low resource languages where bitext is not available. We demonstrate that pretrained models can be extended to incorporate additional languages without loss of performance. We double the number of languages in mBART to support multilingual machine translation models of 50 languages. Finally, we create the ML50 benchmark, covering low, mid, and high resource languages, to facilitate reproducible research by standardizing training and evaluation data. On ML50, we demonstrate that multilingual finetuning improves on average 1 BLEU over the strongest baselines (being either multilingual from scratch or bilingual finetuning) while improving 9.3 BLEU on average over bilingual baselines from scratch.

HealthQA-BR: A System-Wide Benchmark Reveals Critical Knowledge Gaps in Large Language Models

The evaluation of Large Language Models (LLMs) in healthcare has been dominated by physician-centric, English-language benchmarks, creating a dangerous illusion of competence that ignores the interprofessional nature of patient care. To provide a more holistic and realistic assessment, we introduce HealthQA-BR, the first large-scale, system-wide benchmark for Portuguese-speaking healthcare. Comprising 5,632 questions from Brazil's national licensing and residency exams, it uniquely assesses knowledge not only in medicine and its specialties but also in nursing, dentistry, psychology, social work, and other allied health professions. We conducted a rigorous zero-shot evaluation of over 20 leading LLMs. Our results reveal that while state-of-the-art models like GPT 4.1 achieve high overall accuracy (86.6%), this top-line score masks alarming, previously unmeasured deficiencies. A granular analysis shows performance plummets from near-perfect in specialties like Ophthalmology (98.7%) to barely passing in Neurosurgery (60.0%) and, most notably, Social Work (68.4%). This "spiky" knowledge profile is a systemic issue observed across all models, demonstrating that high-level scores are insufficient for safety validation. By publicly releasing HealthQA-BR and our evaluation suite, we provide a crucial tool to move beyond single-score evaluations and toward a more honest, granular audit of AI readiness for the entire healthcare team.

MedAgentBench: A Realistic Virtual EHR Environment to Benchmark Medical LLM Agents

Recent large language models (LLMs) have demonstrated significant advancements, particularly in their ability to serve as agents thereby surpassing their traditional role as chatbots. These agents can leverage their planning and tool utilization capabilities to address tasks specified at a high level. However, a standardized dataset to benchmark the agent capabilities of LLMs in medical applications is currently lacking, making the evaluation of LLMs on complex tasks in interactive healthcare environments challenging. To address this gap, we introduce MedAgentBench, a broad evaluation suite designed to assess the agent capabilities of large language models within medical records contexts. MedAgentBench encompasses 300 patient-specific clinically-derived tasks from 10 categories written by human physicians, realistic profiles of 100 patients with over 700,000 data elements, a FHIR-compliant interactive environment, and an accompanying codebase. The environment uses the standard APIs and communication infrastructure used in modern EMR systems, so it can be easily migrated into live EMR systems. MedAgentBench presents an unsaturated agent-oriented benchmark that current state-of-the-art LLMs exhibit some ability to succeed at. The best model (Claude 3.5 Sonnet v2) achieves a success rate of 69.67%. However, there is still substantial space for improvement which gives the community a next direction to optimize. Furthermore, there is significant variation in performance across task categories. MedAgentBench establishes this and is publicly available at https://github.com/stanfordmlgroup/MedAgentBench , offering a valuable framework for model developers to track progress and drive continuous improvements in the agent capabilities of large language models within the medical domain.

MedCalc-Bench: Evaluating Large Language Models for Medical Calculations

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.

Large Language Models Encode Clinical Knowledge

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-IF: Benchmarking LLMs on Multi-Turn and Multilingual Instructions Following

Large Language Models (LLMs) have demonstrated impressive capabilities in various tasks, including instruction following, which is crucial for aligning model outputs with user expectations. However, evaluating LLMs' ability to follow instructions remains challenging due to the complexity and subjectivity of human language. Current benchmarks primarily focus on single-turn, monolingual instructions, which do not adequately reflect the complexities of real-world applications that require handling multi-turn and multilingual interactions. To address this gap, we introduce Multi-IF, a new benchmark designed to assess LLMs' proficiency in following multi-turn and multilingual instructions. Multi-IF, which utilizes a hybrid framework combining LLM and human annotators, expands upon the IFEval by incorporating multi-turn sequences and translating the English prompts into another 7 languages, resulting in a dataset of 4,501 multilingual conversations, where each has three turns. Our evaluation of 14 state-of-the-art LLMs on Multi-IF reveals that it presents a significantly more challenging task than existing benchmarks. All the models tested showed a higher rate of failure in executing instructions correctly with each additional turn. For example, o1-preview drops from 0.877 at the first turn to 0.707 at the third turn in terms of average accuracy over all languages. Moreover, languages with non-Latin scripts (Hindi, Russian, and Chinese) generally exhibit higher error rates, suggesting potential limitations in the models' multilingual capabilities. We release Multi-IF prompts and the evaluation code base to encourage further research in this critical area.

MEXA: Multilingual Evaluation of English-Centric LLMs via Cross-Lingual Alignment

English-centric large language models (LLMs) often show strong multilingual capabilities. However, the multilingual performance of these models remains unclear and is not thoroughly evaluated for many languages. Most benchmarks for multilinguality focus on classic NLP tasks, or cover a minimal number of languages. We introduce MEXA, a method for assessing the multilingual capabilities of pre-trained English-centric LLMs using parallel sentences, which are available for more languages than existing downstream tasks. MEXA leverages the fact that English-centric LLMs use English as a kind of pivot language in their intermediate layers. It computes the alignment between English and non-English languages using parallel sentences to evaluate the transfer of language understanding from English to other languages. This alignment can be used to estimate model performance in other languages. We conduct studies using various parallel datasets (FLORES-200 and Bible), models (Llama family, Gemma family, Mistral, and OLMo), and established downstream tasks (Belebele, m-MMLU, and m-ARC). We explore different methods to compute embeddings in decoder-only models. Our results show that MEXA, in its default settings, achieves a statistically significant average Pearson correlation of 0.90 with three established downstream tasks across nine models and two parallel datasets. This suggests that MEXA is a reliable method for estimating the multilingual capabilities of English-centric LLMs, providing a clearer understanding of their multilingual potential and the inner workings of LLMs. Leaderboard: https://huggingface.co/spaces/cis-lmu/Mexa, Code: https://github.com/cisnlp/Mexa.

Advancing the Evaluation of Traditional Chinese Language Models: Towards a Comprehensive Benchmark Suite

The evaluation of large language models is an essential task in the field of language understanding and generation. As language models continue to advance, the need for effective benchmarks to assess their performance has become imperative. In the context of Traditional Chinese, there is a scarcity of comprehensive and diverse benchmarks to evaluate the capabilities of language models, despite the existence of certain benchmarks such as DRCD, TTQA, CMDQA, and FGC dataset. To address this gap, we propose a novel set of benchmarks that leverage existing English datasets and are tailored to evaluate language models in Traditional Chinese. These benchmarks encompass a wide range of tasks, including contextual question-answering, summarization, classification, and table understanding. The proposed benchmarks offer a comprehensive evaluation framework, enabling the assessment of language models' capabilities across different tasks. In this paper, we evaluate the performance of GPT-3.5, Taiwan-LLaMa-v1.0, and Model 7-C, our proprietary model, on these benchmarks. The evaluation results highlight that our model, Model 7-C, achieves performance comparable to GPT-3.5 with respect to a part of the evaluated capabilities. In an effort to advance the evaluation of language models in Traditional Chinese and stimulate further research in this field, we have open-sourced our benchmark and opened the model for trial.

TransBench: Benchmarking Machine Translation for Industrial-Scale Applications

Machine translation (MT) has become indispensable for cross-border communication in globalized industries like e-commerce, finance, and legal services, with recent advancements in large language models (LLMs) significantly enhancing translation quality. However, applying general-purpose MT models to industrial scenarios reveals critical limitations due to domain-specific terminology, cultural nuances, and stylistic conventions absent in generic benchmarks. Existing evaluation frameworks inadequately assess performance in specialized contexts, creating a gap between academic benchmarks and real-world efficacy. To address this, we propose a three-level translation capability framework: (1) Basic Linguistic Competence, (2) Domain-Specific Proficiency, and (3) Cultural Adaptation, emphasizing the need for holistic evaluation across these dimensions. We introduce TransBench, a benchmark tailored for industrial MT, initially targeting international e-commerce with 17,000 professionally translated sentences spanning 4 main scenarios and 33 language pairs. TransBench integrates traditional metrics (BLEU, TER) with Marco-MOS, a domain-specific evaluation model, and provides guidelines for reproducible benchmark construction. Our contributions include: (1) a structured framework for industrial MT evaluation, (2) the first publicly available benchmark for e-commerce translation, (3) novel metrics probing multi-level translation quality, and (4) open-sourced evaluation tools. This work bridges the evaluation gap, enabling researchers and practitioners to systematically assess and enhance MT systems for industry-specific needs.

Uhura: A Benchmark for Evaluating Scientific Question Answering and Truthfulness in Low-Resource African Languages

Evaluations of Large Language Models (LLMs) on knowledge-intensive tasks and factual accuracy often focus on high-resource languages primarily because datasets for low-resource languages (LRLs) are scarce. In this paper, we present Uhura -- a new benchmark that focuses on two tasks in six typologically-diverse African languages, created via human translation of existing English benchmarks. The first dataset, Uhura-ARC-Easy, is composed of multiple-choice science questions. The second, Uhura-TruthfulQA, is a safety benchmark testing the truthfulness of models on topics including health, law, finance, and politics. We highlight the challenges creating benchmarks with highly technical content for LRLs and outline mitigation strategies. Our evaluation reveals a significant performance gap between proprietary models such as GPT-4o and o1-preview, and Claude models, and open-source models like Meta's LLaMA and Google's Gemma. Additionally, all models perform better in English than in African languages. These results indicate that LMs struggle with answering scientific questions and are more prone to generating false claims in low-resource African languages. Our findings underscore the necessity for continuous improvement of multilingual LM capabilities in LRL settings to ensure safe and reliable use in real-world contexts. We open-source the Uhura Benchmark and Uhura Platform to foster further research and development in NLP for LRLs.

NeoBabel: A Multilingual Open Tower for Visual Generation

Text-to-image generation advancements have been predominantly English-centric, creating barriers for non-English speakers and perpetuating digital inequities. While existing systems rely on translation pipelines, these introduce semantic drift, computational overhead, and cultural misalignment. We introduce NeoBabel, a novel multilingual image generation framework that sets a new Pareto frontier in performance, efficiency and inclusivity, supporting six languages: English, Chinese, Dutch, French, Hindi, and Persian. The model is trained using a combination of large-scale multilingual pretraining and high-resolution instruction tuning. To evaluate its capabilities, we expand two English-only benchmarks to multilingual equivalents: m-GenEval and m-DPG. NeoBabel achieves state-of-the-art multilingual performance while retaining strong English capability, scoring 0.75 on m-GenEval and 0.68 on m-DPG. Notably, it performs on par with leading models on English tasks while outperforming them by +0.11 and +0.09 on multilingual benchmarks, even though these models are built on multilingual base LLMs. This demonstrates the effectiveness of our targeted alignment training for preserving and extending crosslingual generalization. We further introduce two new metrics to rigorously assess multilingual alignment and robustness to code-mixed prompts. Notably, NeoBabel matches or exceeds English-only models while being 2-4x smaller. We release an open toolkit, including all code, model checkpoints, a curated dataset of 124M multilingual text-image pairs, and standardized multilingual evaluation protocols, to advance inclusive AI research. Our work demonstrates that multilingual capability is not a trade-off but a catalyst for improved robustness, efficiency, and cultural fidelity in generative AI.

NeurIPS 2025 E2LM Competition : Early Training Evaluation of Language Models

Existing benchmarks have proven effective for assessing the performance of fully trained large language models. However, we find striking differences in the early training stages of small models, where benchmarks often fail to provide meaningful or discriminative signals. To explore how these differences arise, this competition tackles the challenge of designing scientific knowledge evaluation tasks specifically tailored for measuring early training progress of language models. Participants are invited to develop novel evaluation methodologies or adapt existing benchmarks to better capture performance differences among language models. To support this effort, we provide three pre-trained small models (0.5B, 1B, and 3B parameters), along with intermediate checkpoints sampled during training up to 200B tokens. All experiments and development work can be run on widely available free cloud-based GPU platforms, making participation accessible to researchers with limited computational resources. Submissions will be evaluated based on three criteria: the quality of the performance signal they produce, the consistency of model rankings at 1 trillion tokens of training, and their relevance to the scientific knowledge domain. By promoting the design of tailored evaluation strategies for early training, this competition aims to attract a broad range of participants from various disciplines, including those who may not be machine learning experts or have access to dedicated GPU resources. Ultimately, this initiative seeks to make foundational LLM research more systematic and benchmark-informed from the earliest phases of model development.

MEDIC: Towards a Comprehensive Framework for Evaluating LLMs in Clinical Applications

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.

DiagnosisArena: Benchmarking Diagnostic Reasoning for Large Language Models

The emergence of groundbreaking large language models capable of performing complex reasoning tasks holds significant promise for addressing various scientific challenges, including those arising in complex clinical scenarios. To enable their safe and effective deployment in real-world healthcare settings, it is urgently necessary to benchmark the diagnostic capabilities of current models systematically. Given the limitations of existing medical benchmarks in evaluating advanced diagnostic reasoning, we present DiagnosisArena, a comprehensive and challenging benchmark designed to rigorously assess professional-level diagnostic competence. DiagnosisArena consists of 1,113 pairs of segmented patient cases and corresponding diagnoses, spanning 28 medical specialties, deriving from clinical case reports published in 10 top-tier medical journals. The benchmark is developed through a meticulous construction pipeline, involving multiple rounds of screening and review by both AI systems and human experts, with thorough checks conducted to prevent data leakage. Our study reveals that even the most advanced reasoning models, o3-mini, o1, and DeepSeek-R1, achieve only 45.82%, 31.09%, and 17.79% accuracy, respectively. This finding highlights a significant generalization bottleneck in current large language models when faced with clinical diagnostic reasoning challenges. Through DiagnosisArena, we aim to drive further advancements in AIs diagnostic reasoning capabilities, enabling more effective solutions for real-world clinical diagnostic challenges. We provide the benchmark and evaluation tools for further research and development https://github.com/SPIRAL-MED/DiagnosisArena.

CliniQ: A Multi-faceted Benchmark for Electronic Health Record Retrieval with Semantic Match Assessment

Electronic Health Record (EHR) retrieval plays a pivotal role in various clinical tasks, but its development has been severely impeded by the lack of publicly available benchmarks. In this paper, we introduce a novel public EHR retrieval benchmark, CliniQ, to address this gap. We consider two retrieval settings: Single-Patient Retrieval and Multi-Patient Retrieval, reflecting various real-world scenarios. Single-Patient Retrieval focuses on finding relevant parts within a patient note, while Multi-Patient Retrieval involves retrieving EHRs from multiple patients. We build our benchmark upon 1,000 discharge summary notes along with the ICD codes and prescription labels from MIMIC-III, and collect 1,246 unique queries with 77,206 relevance judgments by further leveraging powerful LLMs as annotators. Additionally, we include a novel assessment of the semantic gap issue in EHR retrieval by categorizing matching types into string match and four types of semantic matches. On our proposed benchmark, we conduct a comprehensive evaluation of various retrieval methods, ranging from conventional exact match to popular dense retrievers. Our experiments find that BM25 sets a strong baseline and performs competitively to the dense retrievers, and general domain dense retrievers surprisingly outperform those designed for the medical domain. In-depth analyses on various matching types reveal the strengths and drawbacks of different methods, enlightening the potential for targeted improvement. We believe that our benchmark will stimulate the research communities to advance EHR retrieval systems.

IrokoBench: A New Benchmark for African Languages in the Age of Large Language Models

Despite the widespread adoption of Large language models (LLMs), their remarkable capabilities remain limited to a few high-resource languages. Additionally, many low-resource languages (e.g. African languages) are often evaluated only on basic text classification tasks due to the lack of appropriate or comprehensive benchmarks outside of high-resource languages. In this paper, we introduce IrokoBench -- a human-translated benchmark dataset for 16 typologically-diverse low-resource African languages covering three tasks: natural language inference~(AfriXNLI), mathematical reasoning~(AfriMGSM), and multi-choice knowledge-based QA~(AfriMMLU). We use IrokoBench to evaluate zero-shot, few-shot, and translate-test settings~(where test sets are translated into English) across 10 open and four proprietary LLMs. Our evaluation reveals a significant performance gap between high-resource languages~(such as English and French) and low-resource African languages. We observe a significant performance gap between open and proprietary models, with the highest performing open model, Aya-101 only at 58\% of the best-performing proprietary model GPT-4o performance. Machine translating the test set to English before evaluation helped to close the gap for larger models that are English-centric, like LLaMa 3 70B. These findings suggest that more efforts are needed to develop and adapt LLMs for African languages.

AutoCodeBench: Large Language Models are Automatic Code Benchmark Generators

Large Language Models (LLMs) have demonstrated remarkable capabilities across various domains, with code generation emerging as a key area of focus. While numerous benchmarks have been proposed to evaluate their code generation abilities, these benchmarks face several critical limitations. First, they often rely on manual annotations, which are time-consuming and difficult to scale across different programming languages and problem complexities. Second, most existing benchmarks focus primarily on Python, while the few multilingual benchmarks suffer from limited difficulty and uneven language distribution. To address these challenges, we propose AutoCodeGen, an automated method for generating high-difficulty multilingual code generation datasets without manual annotations. AutoCodeGen ensures the correctness and completeness of test cases by generating test inputs with LLMs and obtaining test outputs through a multilingual sandbox, while achieving high data quality through reverse-order problem generation and multiple filtering steps. Using this novel method, we introduce AutoCodeBench, a large-scale code generation benchmark comprising 3,920 problems evenly distributed across 20 programming languages. It is specifically designed to evaluate LLMs on challenging, diverse, and practical multilingual tasks. We evaluate over 30 leading open-source and proprietary LLMs on AutoCodeBench and its simplified version AutoCodeBench-Lite. The results show that even the most advanced LLMs struggle with the complexity, diversity, and multilingual nature of these tasks. Besides, we introduce AutoCodeBench-Complete, specifically designed for base models to assess their few-shot code generation capabilities. We hope the AutoCodeBench series will serve as a valuable resource and inspire the community to focus on more challenging and practical multilingual code generation scenarios.

PersianMedQA: Language-Centric Evaluation of LLMs in the Persian Medical Domain

Large Language Models (LLMs) have achieved remarkable performance on a wide range of NLP benchmarks, often surpassing human-level accuracy. However, their reliability in high-stakes domains such as medicine, particularly in low-resource languages, remains underexplored. In this work, we introduce PersianMedQA, a large-scale, expert-validated dataset of multiple-choice Persian medical questions, designed to evaluate LLMs across both Persian and English. We benchmark over 40 state-of-the-art models, including general-purpose, Persian fine-tuned, and medical LLMs, in zero-shot and chain-of-thought (CoT) settings. Our results show that closed-source general models (e.g., GPT-4.1) consistently outperform all other categories, achieving 83.3% accuracy in Persian and 80.7% in English, while Persian fine-tuned models such as Dorna underperform significantly (e.g., 35.9% in Persian), often struggling with both instruction-following and domain reasoning. We also analyze the impact of translation, showing that while English performance is generally higher, Persian responses are sometimes more accurate due to cultural and clinical contextual cues. Finally, we demonstrate that model size alone is insufficient for robust performance without strong domain or language adaptation. PersianMedQA provides a foundation for evaluating multilingual and culturally grounded medical reasoning in LLMs. The PersianMedQA dataset can be accessed at: https://huggingface.co/datasets/MohammadJRanjbar/PersianMedQA](https://huggingface.co/datasets/MohammadJRanjbar/PersianMedQA

Expert-level validation of AI-generated medical text with scalable language models

With the growing use of language models (LMs) in clinical environments, there is an immediate need to evaluate the accuracy and safety of LM-generated medical text. Currently, such evaluation relies solely on manual physician review. However, detecting errors in LM-generated text is challenging because 1) manual review is costly and 2) expert-composed reference outputs are often unavailable in real-world settings. While the "LM-as-judge" paradigm (a LM evaluating another LM) offers scalable evaluation, even frontier LMs can miss subtle but clinically significant errors. To address these challenges, we propose MedVAL, a self-supervised framework that leverages synthetic data to train evaluator LMs to assess whether LM-generated medical outputs are factually consistent with inputs, without requiring physician labels or reference outputs. To evaluate LM performance, we introduce MedVAL-Bench, a dataset containing 840 outputs annotated by physicians, following a physician-defined taxonomy of risk levels and error categories. Across 6 diverse medical tasks and 10 state-of-the-art LMs spanning open-source, proprietary, and medically adapted models, MedVAL fine-tuning significantly improves (p < 0.001) alignment with physicians on both seen and unseen tasks, increasing average F1 scores from 66% to 83%, with per-sample safety classification scores up to 86%. MedVAL improves the performance of even the best-performing proprietary LM (GPT-4o) by 8%. To support a scalable, risk-aware pathway towards clinical integration, we open-source the 1) codebase ( https://github.com/StanfordMIMI/MedVAL ), 2) MedVAL-Bench ( https://huggingface.co/datasets/stanfordmimi/MedVAL-Bench ), and 3) MedVAL-4B ( https://huggingface.co/stanfordmimi/MedVAL-4B ), the best-performing open-source LM. Our research provides the first evidence of LMs approaching expert-level validation ability for medical text.

Rephrasing natural text data with different languages and quality levels for Large Language Model pre-training

Recently published work on rephrasing natural text data for pre-training LLMs has shown promising results when combining the original dataset with the synthetically rephrased data. We build upon previous work by replicating existing results on C4 and extending them with our optimized rephrasing pipeline to the English, German, Italian, and Spanish Oscar subsets of CulturaX. Our pipeline leads to increased performance on standard evaluation benchmarks in both the mono- and multilingual setup. In addition, we provide a detailed study of our pipeline, investigating the choice of the base dataset and LLM for the rephrasing, as well as the relationship between the model size and the performance after pre-training. By exploring data with different perceived quality levels, we show that gains decrease with higher quality. Furthermore, we find the difference in performance between model families to be bigger than between different model sizes. This highlights the necessity for detailed tests before choosing an LLM to rephrase large amounts of data. Moreover, we investigate the effect of pre-training with synthetic data on supervised fine-tuning. Here, we find increasing but inconclusive results that highly depend on the used benchmark. These results (again) highlight the need for better benchmarking setups. In summary, we show that rephrasing multilingual and low-quality data is a very promising direction to extend LLM pre-training data.

No Language Left Behind: Scaling Human-Centered Machine Translation

Driven by the goal of eradicating language barriers on a global scale, machine translation has solidified itself as a key focus of artificial intelligence research today. However, such efforts have coalesced around a small subset of languages, leaving behind the vast majority of mostly low-resource languages. What does it take to break the 200 language barrier while ensuring safe, high quality results, all while keeping ethical considerations in mind? In No Language Left Behind, we took on this challenge by first contextualizing the need for low-resource language translation support through exploratory interviews with native speakers. Then, we created datasets and models aimed at narrowing the performance gap between low and high-resource languages. More specifically, we developed a conditional compute model based on Sparsely Gated Mixture of Experts that is trained on data obtained with novel and effective data mining techniques tailored for low-resource languages. We propose multiple architectural and training improvements to counteract overfitting while training on thousands of tasks. Critically, we evaluated the performance of over 40,000 different translation directions using a human-translated benchmark, Flores-200, and combined human evaluation with a novel toxicity benchmark covering all languages in Flores-200 to assess translation safety. Our model achieves an improvement of 44% BLEU relative to the previous state-of-the-art, laying important groundwork towards realizing a universal translation system. Finally, we open source all contributions described in this work, accessible at https://github.com/facebookresearch/fairseq/tree/nllb.

MedCaseReasoning: Evaluating and learning diagnostic reasoning from clinical case reports

Doctors and patients alike increasingly use Large Language Models (LLMs) to diagnose clinical cases. However, unlike domains such as math or coding, where correctness can be objectively defined by the final answer, medical diagnosis requires both the outcome and the reasoning process to be accurate. Currently, widely used medical benchmarks like MedQA and MMLU assess only accuracy in the final answer, overlooking the quality and faithfulness of the clinical reasoning process. To address this limitation, we introduce MedCaseReasoning, the first open-access dataset for evaluating LLMs on their ability to align with clinician-authored diagnostic reasoning. The dataset includes 14,489 diagnostic question-and-answer cases, each paired with detailed reasoning statements derived from open-access medical case reports. We evaluate state-of-the-art reasoning LLMs on MedCaseReasoning and find significant shortcomings in their diagnoses and reasoning: for instance, the top-performing open-source model, DeepSeek-R1, achieves only 48% 10-shot diagnostic accuracy and mentions only 64% of the clinician reasoning statements (recall). However, we demonstrate that fine-tuning LLMs on the reasoning traces derived from MedCaseReasoning significantly improves diagnostic accuracy and clinical reasoning recall by an average relative gain of 29% and 41%, respectively. The open-source dataset, code, and models are available at https://github.com/kevinwu23/Stanford-MedCaseReasoning.

TurkishMMLU: Measuring Massive Multitask Language Understanding in Turkish

Multiple choice question answering tasks evaluate the reasoning, comprehension, and mathematical abilities of Large Language Models (LLMs). While existing benchmarks employ automatic translation for multilingual evaluation, this approach is error-prone and potentially introduces culturally biased questions, especially in social sciences. We introduce the first multitask, multiple-choice Turkish QA benchmark, TurkishMMLU, to evaluate LLMs' understanding of the Turkish language. TurkishMMLU includes over 10,000 questions, covering 9 different subjects from Turkish high-school education curricula. These questions are written by curriculum experts, suitable for the high-school curricula in Turkey, covering subjects ranging from natural sciences and math questions to more culturally representative topics such as Turkish Literature and the history of the Turkish Republic. We evaluate over 20 LLMs, including multilingual open-source (e.g., Gemma, Llama, MT5), closed-source (GPT 4o, Claude, Gemini), and Turkish-adapted (e.g., Trendyol) models. We provide an extensive evaluation, including zero-shot and few-shot evaluation of LLMs, chain-of-thought reasoning, and question difficulty analysis along with model performance. We provide an in-depth analysis of the Turkish capabilities and limitations of current LLMs to provide insights for future LLMs for the Turkish language. We publicly release our code for the dataset and evaluation: https://github.com/ArdaYueksel/TurkishMMLU.

Capabilities of GPT-4 on Medical Challenge Problems

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.

CXReasonBench: A Benchmark for Evaluating Structured Diagnostic Reasoning in Chest X-rays

Recent progress in Large Vision-Language Models (LVLMs) has enabled promising applications in medical tasks, such as report generation and visual question answering. However, existing benchmarks focus mainly on the final diagnostic answer, offering limited insight into whether models engage in clinically meaningful reasoning. To address this, we present CheXStruct and CXReasonBench, a structured pipeline and benchmark built on the publicly available MIMIC-CXR-JPG dataset. CheXStruct automatically derives a sequence of intermediate reasoning steps directly from chest X-rays, such as segmenting anatomical regions, deriving anatomical landmarks and diagnostic measurements, computing diagnostic indices, and applying clinical thresholds. CXReasonBench leverages this pipeline to evaluate whether models can perform clinically valid reasoning steps and to what extent they can learn from structured guidance, enabling fine-grained and transparent assessment of diagnostic reasoning. The benchmark comprises 18,988 QA pairs across 12 diagnostic tasks and 1,200 cases, each paired with up to 4 visual inputs, and supports multi-path, multi-stage evaluation including visual grounding via anatomical region selection and diagnostic measurements. Even the strongest of 10 evaluated LVLMs struggle with structured reasoning and generalization, often failing to link abstract knowledge with anatomically grounded visual interpretation. The code is available at https://github.com/ttumyche/CXReasonBench

MedFuzz: Exploring the Robustness of Large Language Models in Medical Question Answering

Large language models (LLM) have achieved impressive performance on medical question-answering benchmarks. However, high benchmark accuracy does not imply that the performance generalizes to real-world clinical settings. Medical question-answering benchmarks rely on assumptions consistent with quantifying LLM performance but that may not hold in the open world of the clinic. Yet LLMs learn broad knowledge that can help the LLM generalize to practical conditions regardless of unrealistic assumptions in celebrated benchmarks. We seek to quantify how well LLM medical question-answering benchmark performance generalizes when benchmark assumptions are violated. Specifically, we present an adversarial method that we call MedFuzz (for medical fuzzing). MedFuzz attempts to modify benchmark questions in ways aimed at confounding the LLM. We demonstrate the approach by targeting strong assumptions about patient characteristics presented in the MedQA benchmark. Successful "attacks" modify a benchmark item in ways that would be unlikely to fool a medical expert but nonetheless "trick" the LLM into changing from a correct to an incorrect answer. Further, we present a permutation test technique that can ensure a successful attack is statistically significant. We show how to use performance on a "MedFuzzed" benchmark, as well as individual successful attacks. The methods show promise at providing insights into the ability of an LLM to operate robustly in more realistic settings.

BenchX: A Unified Benchmark Framework for Medical Vision-Language Pretraining on Chest X-Rays

Medical Vision-Language Pretraining (MedVLP) shows promise in learning generalizable and transferable visual representations from paired and unpaired medical images and reports. MedVLP can provide useful features to downstream tasks and facilitate adapting task-specific models to new setups using fewer examples. However, existing MedVLP methods often differ in terms of datasets, preprocessing, and finetuning implementations. This pose great challenges in evaluating how well a MedVLP method generalizes to various clinically-relevant tasks due to the lack of unified, standardized, and comprehensive benchmark. To fill this gap, we propose BenchX, a unified benchmark framework that enables head-to-head comparison and systematical analysis between MedVLP methods using public chest X-ray datasets. Specifically, BenchX is composed of three components: 1) Comprehensive datasets covering nine datasets and four medical tasks; 2) Benchmark suites to standardize data preprocessing, train-test splits, and parameter selection; 3) Unified finetuning protocols that accommodate heterogeneous MedVLP methods for consistent task adaptation in classification, segmentation, and report generation, respectively. Utilizing BenchX, we establish baselines for nine state-of-the-art MedVLP methods and found that the performance of some early MedVLP methods can be enhanced to surpass more recent ones, prompting a revisiting of the developments and conclusions from prior works in MedVLP. Our code are available at https://github.com/yangzhou12/BenchX.

MediConfusion: Can you trust your AI radiologist? Probing the reliability of multimodal medical foundation models

Multimodal Large Language Models (MLLMs) have tremendous potential to improve the accuracy, availability, and cost-effectiveness of healthcare by providing automated solutions or serving as aids to medical professionals. Despite promising first steps in developing medical MLLMs in the past few years, their capabilities and limitations are not well-understood. Recently, many benchmark datasets have been proposed that test the general medical knowledge of such models across a variety of medical areas. However, the systematic failure modes and vulnerabilities of such models are severely underexplored with most medical benchmarks failing to expose the shortcomings of existing models in this safety-critical domain. In this paper, we introduce MediConfusion, a challenging medical Visual Question Answering (VQA) benchmark dataset, that probes the failure modes of medical MLLMs from a vision perspective. We reveal that state-of-the-art models are easily confused by image pairs that are otherwise visually dissimilar and clearly distinct for medical experts. Strikingly, all available models (open-source or proprietary) achieve performance below random guessing on MediConfusion, raising serious concerns about the reliability of existing medical MLLMs for healthcare deployment. We also extract common patterns of model failure that may help the design of a new generation of more trustworthy and reliable MLLMs in healthcare.

MIRAGE-Bench: Automatic Multilingual Benchmark Arena for Retrieval-Augmented Generation Systems

Traditional Retrieval-Augmented Generation (RAG) benchmarks rely on different heuristic-based metrics for evaluation, but these require human preferences as ground truth for reference. In contrast, arena-based benchmarks, where two models compete each other, require an expensive Large Language Model (LLM) as a judge for a reliable evaluation. We present an easy and efficient technique to get the best of both worlds. The idea is to train a learning to rank model as a "surrogate" judge using RAG-based evaluation heuristics as input, to produce a synthetic arena-based leaderboard. Using this idea, We develop MIRAGE-Bench, a standardized arena-based multilingual RAG benchmark for 18 diverse languages on Wikipedia. The benchmark is constructed using MIRACL, a retrieval dataset, and extended for multilingual generation evaluation. MIRAGE-Bench evaluates RAG extensively coupling both heuristic features and LLM as a judge evaluator. In our work, we benchmark 19 diverse multilingual-focused LLMs, and achieve a high correlation (Kendall Tau (tau) = 0.909) using our surrogate judge learned using heuristic features with pairwise evaluations and between GPT-4o as a teacher on the MIRAGE-Bench leaderboard using the Bradley-Terry framework. We observe proprietary and large open-source LLMs currently dominate in multilingual RAG. MIRAGE-Bench is available at: https://github.com/vectara/mirage-bench.

MultiMed: Massively Multimodal and Multitask Medical Understanding

Biomedical data is inherently multimodal, consisting of electronic health records, medical imaging, digital pathology, genome sequencing, wearable sensors, and more. The application of artificial intelligence tools to these multifaceted sensing technologies has the potential to revolutionize the prognosis, diagnosis, and management of human health and disease. However, current approaches to biomedical AI typically only train and evaluate with one or a small set of medical modalities and tasks. This limitation hampers the development of comprehensive tools that can leverage the rich interconnected information across many heterogeneous biomedical sensors. To address this challenge, we present MultiMed, a benchmark designed to evaluate and enable large-scale learning across a wide spectrum of medical modalities and tasks. MultiMed consists of 2.56 million samples across ten medical modalities such as medical reports, pathology, genomics, and protein data, and is structured into eleven challenging tasks, including disease prognosis, protein structure prediction, and medical question answering. Using MultiMed, we conduct comprehensive experiments benchmarking state-of-the-art unimodal, multimodal, and multitask models. Our analysis highlights the advantages of training large-scale medical models across many related modalities and tasks. Moreover, MultiMed enables studies of generalization across related medical concepts, robustness to real-world noisy data and distribution shifts, and novel modality combinations to improve prediction performance. MultiMed will be publicly available and regularly updated and welcomes inputs from the community.

AutoBencher: Creating Salient, Novel, Difficult Datasets for Language Models

Evaluation is critical for assessing capabilities, tracking scientific progress, and informing model selection. In this paper, we present three desiderata for a good benchmark for language models: (i) salience (e.g., knowledge about World War II is more salient than a random day in history), (ii) novelty (i.e., the benchmark reveals new trends in model rankings not shown by previous benchmarks), and (iii) difficulty (i.e., the benchmark should be difficult for existing models, leaving headroom for future improvement). We operationalize these three desiderata and cast benchmark creation as a search problem, that of finding benchmarks that that satisfy all three desiderata. To tackle this search problem, we present AutoBencher, which uses a language model to automatically search for datasets that meet the three desiderata. AutoBencher uses privileged information (e.g. relevant documents) to construct reliable datasets, and adaptivity with reranking to optimize for the search objective. We use AutoBencher to create datasets for math, multilingual, and knowledge-intensive question answering. The scalability of AutoBencher allows it to test fine-grained categories and tail knowledge, creating datasets that are on average 27% more novel and 22% more difficult than existing benchmarks. A closer investigation of our constructed datasets shows that we can identify specific gaps in LM knowledge in language models that are not captured by existing benchmarks, such as Gemini Pro performing much worse on question answering about the Permian Extinction and Fordism, while OpenAGI-7B performing surprisingly well on QA about COVID-19.

Lingshu: A Generalist Foundation Model for Unified Multimodal Medical Understanding and Reasoning

Multimodal Large Language Models (MLLMs) have demonstrated impressive capabilities in understanding common visual elements, largely due to their large-scale datasets and advanced training strategies. However, their effectiveness in medical applications remains limited due to the inherent discrepancies between data and tasks in medical scenarios and those in the general domain. Concretely, existing medical MLLMs face the following critical limitations: (1) limited coverage of medical knowledge beyond imaging, (2) heightened susceptibility to hallucinations due to suboptimal data curation processes, (3) lack of reasoning capabilities tailored for complex medical scenarios. To address these challenges, we first propose a comprehensive data curation procedure that (1) efficiently acquires rich medical knowledge data not only from medical imaging but also from extensive medical texts and general-domain data; and (2) synthesizes accurate medical captions, visual question answering (VQA), and reasoning samples. As a result, we build a multimodal dataset enriched with extensive medical knowledge. Building on the curated data, we introduce our medical-specialized MLLM: Lingshu. Lingshu undergoes multi-stage training to embed medical expertise and enhance its task-solving capabilities progressively. Besides, we preliminarily explore the potential of applying reinforcement learning with verifiable rewards paradigm to enhance Lingshu's medical reasoning ability. Additionally, we develop MedEvalKit, a unified evaluation framework that consolidates leading multimodal and textual medical benchmarks for standardized, fair, and efficient model assessment. We evaluate the performance of Lingshu on three fundamental medical tasks, multimodal QA, text-based QA, and medical report generation. The results show that Lingshu consistently outperforms the existing open-source multimodal models on most tasks ...

Multilingual Large Language Models: A Systematic Survey

This paper provides a comprehensive survey of the latest research on multilingual large language models (MLLMs). MLLMs not only are able to understand and generate language across linguistic boundaries, but also represent an important advancement in artificial intelligence. We first discuss the architecture and pre-training objectives of MLLMs, highlighting the key components and methodologies that contribute to their multilingual capabilities. We then discuss the construction of multilingual pre-training and alignment datasets, underscoring the importance of data quality and diversity in enhancing MLLM performance. An important focus of this survey is on the evaluation of MLLMs. We present a detailed taxonomy and roadmap covering the assessment of MLLMs' cross-lingual knowledge, reasoning, alignment with human values, safety, interpretability and specialized applications. Specifically, we extensively discuss multilingual evaluation benchmarks and datasets, and explore the use of LLMs themselves as multilingual evaluators. To enhance MLLMs from black to white boxes, we also address the interpretability of multilingual capabilities, cross-lingual transfer and language bias within these models. Finally, we provide a comprehensive review of real-world applications of MLLMs across diverse domains, including biology, medicine, computer science, mathematics and law. We showcase how these models have driven innovation and improvements in these specialized fields while also highlighting the challenges and opportunities in deploying MLLMs within diverse language communities and application scenarios. We listed the paper related in this survey and publicly available at https://github.com/tjunlp-lab/Awesome-Multilingual-LLMs-Papers.

Varco Arena: A Tournament Approach to Reference-Free Benchmarking Large Language Models

The rapid advancement of Large Language Models (LLMs) necessitates robust evaluation methodologies. Current benchmarking approaches often rely on comparing model outputs against predefined prompts and reference outputs. Relying on predefined reference outputs hinders flexible adaptation of benchmarks to the rapidly evolving capabilities of LLMs. This limitation necessitates periodic efforts to prepare new benchmarks. To keep pace with rapidly evolving LLM capabilities, we propose a more flexible benchmarking approach. Our method, \textbf{Varco Arena}, provides reference-free benchmarking of LLMs in tournament style. \textbf{Varco Arena} directly compares LLM outputs across a diverse set of prompts, determining model rankings through a single-elimination tournament structure. This direct pairwise comparison offers two key advantages: (1) Direct comparison, unmediated by reference text, more effectively orders competing LLMs, resulting in more reliable rankings, and (2) reference-free approach to benchmarking adds flexibility in updating benchmark prompts by eliminating the need for quality references. Our empirical results, supported by simulation experiments, demonstrate that the \textbf{Varco Arena} tournament approach aligns better with the current Elo model for benchmarking LLMs. The alignment is measured in terms of Spearman correlation, showing improvement over current practice of benchmarking that use reference outputs as comparison anchors.

HuatuoGPT, towards Taming Language Model to Be a Doctor

In this paper, we present HuatuoGPT, a large language model (LLM) for medical consultation. The core recipe of HuatuoGPT is to leverage both distilled data from ChatGPT and real-world data from doctors in the supervised fine-tuned stage. The responses of ChatGPT are usually detailed, well-presented and informative while it cannot perform like a doctor in many aspects, e.g. for integrative diagnosis. We argue that real-world data from doctors would be complementary to distilled data in the sense the former could tame a distilled language model to perform like doctors. To better leverage the strengths of both data, we train a reward model to align the language model with the merits that both data bring, following an RLAIF (reinforced learning from AI feedback) fashion. To evaluate and benchmark the models, we propose a comprehensive evaluation scheme (including automatic and manual metrics). Experimental results demonstrate that HuatuoGPT achieves state-of-the-art results in performing medical consultation among open-source LLMs in GPT-4 evaluation, human evaluation, and medical benchmark datasets. It is worth noting that by using additional real-world data and RLAIF, the distilled language model (i.e., HuatuoGPT) outperforms its teacher model ChatGPT in most cases. Our code, data, and models are publicly available at https://github.com/FreedomIntelligence/HuatuoGPT. The online demo is available at https://www.HuatuoGPT.cn/.

Can open source large language models be used for tumor documentation in Germany? -- An evaluation on urological doctors' notes

Tumor documentation in Germany is largely done manually, requiring reading patient records and entering data into structured databases. Large language models (LLMs) could potentially enhance this process by improving efficiency and reliability. This evaluation tests eleven different open source LLMs with sizes ranging from 1-70 billion model parameters on three basic tasks of the tumor documentation process: identifying tumor diagnoses, assigning ICD-10 codes, and extracting the date of first diagnosis. For evaluating the LLMs on these tasks, a dataset of annotated text snippets based on anonymized doctors' notes from urology was prepared. Different prompting strategies were used to investigate the effect of the number of examples in few-shot prompting and to explore the capabilities of the LLMs in general. The models Llama 3.1 8B, Mistral 7B, and Mistral NeMo 12 B performed comparably well in the tasks. Models with less extensive training data or having fewer than 7 billion parameters showed notably lower performance, while larger models did not display performance gains. Examples from a different medical domain than urology could also improve the outcome in few-shot prompting, which demonstrates the ability of LLMs to handle tasks needed for tumor documentation. Open source LLMs show a strong potential for automating tumor documentation. Models from 7-12 billion parameters could offer an optimal balance between performance and resource efficiency. With tailored fine-tuning and well-designed prompting, these models might become important tools for clinical documentation in the future. The code for the evaluation is available from https://github.com/stefan-m-lenz/UroLlmEval. We also release the dataset as a new valuable resource that addresses the shortage of authentic and easily accessible benchmarks in German-language medical NLP.

Towards Generalist Biomedical AI

Medicine is inherently multimodal, with rich data modalities spanning text, imaging, genomics, and more. Generalist biomedical artificial intelligence (AI) systems that flexibly encode, integrate, and interpret this data at scale can potentially enable impactful applications ranging from scientific discovery to care delivery. To enable the development of these models, we first curate MultiMedBench, a new multimodal biomedical benchmark. MultiMedBench encompasses 14 diverse tasks such as medical question answering, mammography and dermatology image interpretation, radiology report generation and summarization, and genomic variant calling. We then introduce Med-PaLM Multimodal (Med-PaLM M), our proof of concept for a generalist biomedical AI system. Med-PaLM M is a large multimodal generative model that flexibly encodes and interprets biomedical data including clinical language, imaging, and genomics with the same set of model weights. Med-PaLM M reaches performance competitive with or exceeding the state of the art on all MultiMedBench tasks, often surpassing specialist models by a wide margin. We also report examples of zero-shot generalization to novel medical concepts and tasks, positive transfer learning across tasks, and emergent zero-shot medical reasoning. To further probe the capabilities and limitations of Med-PaLM M, we conduct a radiologist evaluation of model-generated (and human) chest X-ray reports and observe encouraging performance across model scales. In a side-by-side ranking on 246 retrospective chest X-rays, clinicians express a pairwise preference for Med-PaLM M reports over those produced by radiologists in up to 40.50% of cases, suggesting potential clinical utility. While considerable work is needed to validate these models in real-world use cases, our results represent a milestone towards the development of generalist biomedical AI systems.

A Preliminary Study of o1 in Medicine: Are We Closer to an AI Doctor?

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.