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May 20

TruthPrInt: Mitigating LVLM Object Hallucination Via Latent Truthful-Guided Pre-Intervention

Object Hallucination (OH) has been acknowledged as one of the major trustworthy challenges in Large Vision-Language Models (LVLMs). Recent advancements in Large Language Models (LLMs) indicate that internal states, such as hidden states, encode the "overall truthfulness" of generated responses. However, it remains under-explored how internal states in LVLMs function and whether they could serve as "per-token" hallucination indicators, which is essential for mitigating OH. In this paper, we first conduct an in-depth exploration of LVLM internal states in relation to OH issues and discover that (1) LVLM internal states are high-specificity per-token indicators of hallucination behaviors. Moreover, (2) different LVLMs encode universal patterns of hallucinations in common latent subspaces, indicating that there exist "generic truthful directions" shared by various LVLMs. Based on these discoveries, we propose Truthful-Guided Pre-Intervention (TruthPrInt) that first learns the truthful direction of LVLM decoding and then applies truthful-guided inference-time intervention during LVLM decoding. We further propose ComnHallu to enhance both cross-LVLM and cross-data hallucination detection transferability by constructing and aligning hallucination latent subspaces. We evaluate TruthPrInt in extensive experimental settings, including in-domain and out-of-domain scenarios, over popular LVLMs and OH benchmarks. Experimental results indicate that TruthPrInt significantly outperforms state-of-the-art methods. Codes will be available at https://github.com/jinhaoduan/TruthPrInt.

  • 9 authors
·
Mar 13, 2025 2

Neural FOXP2 -- Language Specific Neuron Steering for Targeted Language Improvement in LLMs

LLMs are multilingual by training, yet their lingua franca is often English, reflecting English language dominance in pretraining. Other languages remain in parametric memory but are systematically suppressed. We argue that language defaultness is governed by a sparse, low-rank control circuit, language neurons, that can be mechanistically isolated and safely steered. We introduce Neural FOXP2, that makes a chosen language (Hindi or Spanish) primary in a model by steering language-specific neurons. Neural FOXP2 proceeds in three stages: (i) Localize: We train per-layer SAEs so each activation decomposes into a small set of active feature components. For every feature, we quantify English vs. Hindi/Spanish selectivity overall logit-mass lift toward the target-language token set. Tracing the top-ranked features back to their strongest contributing units yields a compact language-neuron set. (ii) Steering directions: We localize controllable language-shift geometry via a spectral low-rank analysis. For each layer, we build English to target activation-difference matrices and perform layerwise SVD to extract the dominant singular directions governing language change. The eigengap and effective-rank spectra identify a compact steering subspace and an empirically chosen intervention window (where these directions are strongest and most stable). (iii) Steer: We apply a signed, sparse activation shift targeted to the language neurons. Concretely, within low to mid layers we add a positive steering along the target-language dominant directions and a compensating negative shift toward the null space for the English neurons, yielding controllable target-language defaultness.

  • 5 authors
·
Jan 31

AI-Powered Assistive Technologies for Visual Impairment

Artificial Intelligence (AI) is revolutionizing assistive technologies. It offers innovative solutions to enhance the quality of life for individuals with visual impairments. This review examines the development, applications, and impact of AI-powered tools in key domains, such as computer vision, natural language processing (NLP), and wearable devices. Specific advancements include object recognition for identifying everyday items, scene description for understanding surroundings, and NLP-driven text-to-speech systems for accessing digital information. Assistive technologies like smart glasses, smartphone applications, and AI-enabled navigation aids are discussed, demonstrating their ability to support independent travel, facilitate social interaction, and increase access to education and employment opportunities. The integration of deep learning models, multimodal interfaces, and real-time data processing has transformed the functionality and usability of these tools, fostering inclusivity and empowerment. This article also addresses critical challenges, including ethical considerations, affordability, and adaptability in diverse environments. Future directions highlight the need for interdisciplinary collaboration to refine these technologies, ensuring equitable access and sustainable innovation. By providing a comprehensive overview, this review underscores AI's transformative potential in promoting independence, enhancing accessibility, and fostering social inclusion for visually impaired individuals.

  • 5 authors
·
Jan 13, 2025

A Course Correction in Steerability Evaluation: Revealing Miscalibration and Side Effects in LLMs

Despite advances in large language models (LLMs) on reasoning and instruction-following benchmarks, it remains unclear whether they can reliably produce outputs aligned with a broad variety of user goals, a concept we refer to as steerability. The abundance of methods proposed to modify LLM behavior makes it unclear whether current LLMs are already steerable, or require further intervention. In particular, LLMs may exhibit (i) poor coverage, where rare user goals are underrepresented; (ii) miscalibration, where models overshoot requests; and (iii) side effects, where changes to one dimension of text inadvertently affect others. To systematically evaluate these failures, we introduce a framework based on a multi-dimensional goal space that models user goals and LLM outputs as vectors with dimensions corresponding to text attributes (e.g., reading difficulty). Applied to a text-rewriting task, we find that current LLMs struggle with steerability, as side effects are persistent. Interventions to improve steerability, such as prompt engineering, best-of-N sampling, and reinforcement learning fine-tuning, have varying effectiveness, yet side effects remain problematic. Our findings suggest that even strong LLMs struggle with steerability, and existing alignment strategies may be insufficient. We open-source our steerability evaluation framework at https://github.com/MLD3/steerability.

  • 4 authors
·
May 27, 2025

Faithful Bi-Directional Model Steering via Distribution Matching and Distributed Interchange Interventions

Intervention-based model steering offers a lightweight and interpretable alternative to prompting and fine-tuning. However, by adapting strong optimization objectives from fine-tuning, current methods are susceptible to overfitting and often underperform, sometimes generating unnatural outputs. We hypothesize that this is because effective steering requires the faithful identification of internal model mechanisms, not the enforcement of external preferences. To this end, we build on the principles of distributed alignment search (DAS), the standard for causal variable localization, to propose a new steering method: Concept DAS (CDAS). While we adopt the core mechanism of DAS, distributed interchange intervention (DII), we introduce a novel distribution matching objective tailored for the steering task by aligning intervened output distributions with counterfactual distributions. CDAS differs from prior work in two main ways: first, it learns interventions via weak-supervised distribution matching rather than probability maximization; second, it uses DIIs that naturally enable bi-directional steering and allow steering factors to be derived from data, reducing the effort required for hyperparameter tuning and resulting in more faithful and stable control. On AxBench, a large-scale model steering benchmark, we show that CDAS does not always outperform preference-optimization methods but may benefit more from increased model scale. In two safety-related case studies, overriding refusal behaviors of safety-aligned models and neutralizing a chain-of-thought backdoor, CDAS achieves systematic steering while maintaining general model utility. These results indicate that CDAS is complementary to preference-optimization approaches and conditionally constitutes a robust approach to intervention-based model steering. Our code is available at https://github.com/colored-dye/concept_das.

  • 10 authors
·
Feb 4

GUIDE: A Guideline-Guided Dataset for Instructional Video Comprehension

There are substantial instructional videos on the Internet, which provide us tutorials for completing various tasks. Existing instructional video datasets only focus on specific steps at the video level, lacking experiential guidelines at the task level, which can lead to beginners struggling to learn new tasks due to the lack of relevant experience. Moreover, the specific steps without guidelines are trivial and unsystematic, making it difficult to provide a clear tutorial. To address these problems, we present the GUIDE (Guideline-Guided) dataset, which contains 3.5K videos of 560 instructional tasks in 8 domains related to our daily life. Specifically, we annotate each instructional task with a guideline, representing a common pattern shared by all task-related videos. On this basis, we annotate systematic specific steps, including their associated guideline steps, specific step descriptions and timestamps. Our proposed benchmark consists of three sub-tasks to evaluate comprehension ability of models: (1) Step Captioning: models have to generate captions for specific steps from videos. (2) Guideline Summarization: models have to mine the common pattern in task-related videos and summarize a guideline from them. (3) Guideline-Guided Captioning: models have to generate captions for specific steps under the guide of guideline. We evaluate plenty of foundation models with GUIDE and perform in-depth analysis. Given the diversity and practicality of GUIDE, we believe that it can be used as a better benchmark for instructional video comprehension.

  • 10 authors
·
Jun 26, 2024

"When I lost it, they dragged me out": How Care Encounters Empower Marginalized Young Adults' Aspiration and Mental Health Care-Seeking

Mental health care-seeking among marginalized young adults has received limited attention in CSCW research. Through in-depth interviews and visual elicitation methods with 18 diverse U.S. participants, our study reveals how marginalized identities shape mental health care-seeking journeys, often characterized by low aspirations and passive care-seeking influenced by lived experiences of marginalization. However, we found the transformative function of "care encounters" - serendipitous interactions with mental health resources that occur when individuals are not actively seeking support. These encounters serve as critical turning points, catalyzing shifts in aspiration and enabling more proactive care-seeking behaviors. Our analysis identifies both the infrastructural conditions that enable transformative care encounters and the aspiration breakdowns that impede care-seeking processes. This work makes conceptual contributions by supplementing traditional motivation-based care-seeking models with a reconceptualization of "care encounters" that accounts for the infrastructural and serendipitous nature of mental health access. We advance understanding of how marginalized identity uniquely influences care-seeking behaviors while providing actionable design implications for embedding technology-mediated "care encounters" into socio-technical interventions that can better support mental health care access for vulnerable populations.

  • 2 authors
·
Feb 16, 2025

Examining the Impact of Income Inequality and Gender on School Completion in Malaysia: A Machine Learning Approach Utilizing Malaysia's Public Sector Open Data

This study examines the relationship between income inequality, gender, and school completion rates in Malaysia using machine learning techniques. The dataset utilized is from the Malaysia's Public Sector Open Data Portal, covering the period 2016-2022. The analysis employs various machine learning techniques, including K-means clustering, ARIMA modeling, Random Forest regression, and Prophet for time series forecasting. These models are used to identify patterns, trends, and anomalies in the data, and to predict future school completion rates. Key findings reveal significant disparities in school completion rates across states, genders, and income levels. The analysis also identifies clusters of states with similar completion rates, suggesting potential regional factors influencing educational outcomes. Furthermore, time series forecasting models accurately predict future completion rates, highlighting the importance of ongoing monitoring and intervention strategies. The study concludes with recommendations for policymakers and educators to address the observed disparities and improve school completion rates in Malaysia. These recommendations include targeted interventions for specific states and demographic groups, investment in early childhood education, and addressing the impact of income inequality on educational opportunities. The findings of this study contribute to the understanding of the factors influencing school completion in Malaysia and provide valuable insights for policymakers and educators to develop effective strategies to improve educational outcomes.

  • 1 authors
·
Jan 30, 2025

LINA: Learning INterventions Adaptively for Physical Alignment and Generalization in Diffusion Models

Diffusion models (DMs) have achieved remarkable success in image and video generation. However, they still struggle with (1) physical alignment and (2) out-of-distribution (OOD) instruction following. We argue that these issues stem from the models' failure to learn causal directions and to disentangle causal factors for novel recombination. We introduce the Causal Scene Graph (CSG) and the Physical Alignment Probe (PAP) dataset to enable diagnostic interventions. This analysis yields three key insights. First, DMs struggle with multi-hop reasoning for elements not explicitly determined in the prompt. Second, the prompt embedding contains disentangled representations for texture and physics. Third, visual causal structure is disproportionately established during the initial, computationally limited denoising steps. Based on these findings, we introduce LINA (Learning INterventions Adaptively), a novel framework that learns to predict prompt-specific interventions, which employs (1) targeted guidance in the prompt and visual latent spaces, and (2) a reallocated, causality-aware denoising schedule. Our approach enforces both physical alignment and OOD instruction following in image and video DMs, achieving state-of-the-art performance on challenging causal generation tasks and the Winoground dataset. Our project page is at https://opencausalab.github.io/LINA.

  • 2 authors
·
Dec 15, 2025

Towards Steering without Sacrifice: Principled Training of Steering Vectors for Prompt-only Interventions

Recently, steering vectors (SVs) have emerged as an effective and lightweight approach to steer behaviors of large language models (LLMs), among which fine-tuned SVs are more effective than optimization-free ones. However, current approaches to fine-tuned SVs suffer from two limitations. First, they require careful selection of steering factors on a per-SV basis to balance steering effectiveness and generation quality at inference time. Second, they operate as full-sequence SVs (FSSVs), which can sacrifice generation quality regardless of factor selection due to excessive intervention on the model generation process. To address the first limitation, we propose joint training of steering factors and directions, such that post-hoc factor selection is no longer required. Using neural network scaling theory, we find that moderately large initialization sizes and learning rates for steering factors are essential for stability and efficiency of joint training. To tackle the second limitation, we draw inspiration from representation fine-tuning and introduce Prompt-only SV (PrOSV), an SV that intervenes only on a few prompt tokens. Our empirical results show that PrOSV outperforms traditional FSSVs on AxBench when using our joint training scheme. We also find that PrOSV achieves a better tradeoff between general model utility and adversarial robustness than FSSV.

  • 9 authors
·
May 6

The Right Answer, the Wrong Direction: Why Transformers Fail at Counting and How to Fix It

Large language models often fail at simple counting tasks, even when the items to count are explicitly present in the prompt. We investigate whether this failure occurs because transformers do not represent counts internally, or because they cannot convert those representations into the correct output tokens. Across three model families, Pythia, Qwen3, and Mistral, ranging from 0.4B to 14B parameters, we find strong evidence for the second explanation. Linear probes recover the correct count from intermediate layers with near-perfect accuracy (R^2>0.99), showing that the information is present. However, the internal directions that encode counts are nearly orthogonal to the output-head rows for digit tokens (|cos|leq0.032). In other words, the model stores the count in a form that the digit logits do not naturally read out. We localize this failure with two interventions. Updating only the digit rows of the output head (36,864 parameters) substantially improves constrained next-token digit prediction (60.7 to 100.0% across four tasks), but it does not fix autoregressive generation. By contrast, a small LoRA intervention on attention Q/V weights (7.67M parameters) improves upstream routing and achieves 83.1% +/- 7.2% in true greedy autoregressive generation. Logit-lens measurements confirm the mechanism: the correct digit's vocabulary rank drops from 55,980 to 1, a 50,000x improvement. Additional norm, logit-lens, and cross-task analyses show that the bottleneck generalizes across character counting, addition, and list length, while remaining absent from broader multi-step reasoning benchmarks, including MMLU, GSM8K, and DROP. These results identify counting failure as a geometric readout bottleneck rather than a failure of internal representation: the model knows the count but the output pathway is geometrically misaligned with the tokens needed to express it.

  • 1 authors
·
May 4

The Truthfulness Spectrum Hypothesis

Large language models (LLMs) have been reported to linearly encode truthfulness, yet recent work questions this finding's generality. We reconcile these views with the truthfulness spectrum hypothesis: the representational space contains directions ranging from broadly domain-general to narrowly domain-specific. To test this hypothesis, we systematically evaluate probe generalization across five truth types (definitional, empirical, logical, fictional, and ethical), sycophantic and expectation-inverted lying, and existing honesty benchmarks. Linear probes generalize well across most domains but fail on sycophantic and expectation-inverted lying. Yet training on all domains jointly recovers strong performance, confirming that domain-general directions exist despite poor pairwise transfer. The geometry of probe directions explains these patterns: Mahalanobis cosine similarity between probes near-perfectly predicts cross-domain generalization (R^2=0.98). Concept-erasure methods further isolate truth directions that are (1) domain-general, (2) domain-specific, or (3) shared only across particular domain subsets. Causal interventions reveal that domain-specific directions steer more effectively than domain-general ones. Finally, post-training reshapes truth geometry, pushing sycophantic lying further from other truth types, suggesting a representational basis for chat models' sycophantic tendencies. Together, our results support the truthfulness spectrum hypothesis: truth directions of varying generality coexist in representational space, with post-training reshaping their geometry. Code for all experiments is provided in https://github.com/zfying/truth_spec.

Latent Compass: Creation by Navigation

In Marius von Senden's Space and Sight, a newly sighted blind patient describes the experience of a corner as lemon-like, because corners "prick" sight like lemons prick the tongue. Prickliness, here, is a dimension in the feature space of sensory experience, an effect of the perceived on the perceiver that arises where the two interact. In the account of the newly sighted, an effect familiar from one interaction translates to a novel context. Perception serves as the vehicle for generalization, in that an effect shared across different experiences produces a concrete abstraction grounded in those experiences. Cezanne and the post-impressionists, fluent in the language of experience translation, realized that the way to paint a concrete form that best reflected reality was to paint not what they saw, but what it was like to see. We envision a future of creation using AI where what it is like to see is replicable, transferrable, manipulable - part of the artist's palette that is both grounded in a particular context, and generalizable beyond it. An active line of research maps human-interpretable features onto directions in GAN latent space. Supervised and self-supervised approaches that search for anticipated directions or use off-the-shelf classifiers to drive image manipulation in embedding space are limited in the variety of features they can uncover. Unsupervised approaches that discover useful new directions show that the space of perceptually meaningful directions is nowhere close to being fully mapped. As this space is broad and full of creative potential, we want tools for direction discovery that capture the richness and generalizability of human perception. Our approach puts creators in the discovery loop during real-time tool use, in order to identify directions that are perceptually meaningful to them, and generate interpretable image translations along those directions.

  • 3 authors
·
Dec 19, 2020

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

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

  • 1 authors
·
May 15, 2024

Decomposing MLP Activations into Interpretable Features via Semi-Nonnegative Matrix Factorization

A central goal for mechanistic interpretability has been to identify the right units of analysis in large language models (LLMs) that causally explain their outputs. While early work focused on individual neurons, evidence that neurons often encode multiple concepts has motivated a shift toward analyzing directions in activation space. A key question is how to find directions that capture interpretable features in an unsupervised manner. Current methods rely on dictionary learning with sparse autoencoders (SAEs), commonly trained over residual stream activations to learn directions from scratch. However, SAEs often struggle in causal evaluations and lack intrinsic interpretability, as their learning is not explicitly tied to the computations of the model. Here, we tackle these limitations by directly decomposing MLP activations with semi-nonnegative matrix factorization (SNMF), such that the learned features are (a) sparse linear combinations of co-activated neurons, and (b) mapped to their activating inputs, making them directly interpretable. Experiments on Llama 3.1, Gemma 2 and GPT-2 show that SNMF derived features outperform SAEs and a strong supervised baseline (difference-in-means) on causal steering, while aligning with human-interpretable concepts. Further analysis reveals that specific neuron combinations are reused across semantically-related features, exposing a hierarchical structure in the MLP's activation space. Together, these results position SNMF as a simple and effective tool for identifying interpretable features and dissecting concept representations in LLMs.

  • 3 authors
·
Jun 12, 2025 2

Compared to What? Baselines and Metrics for Counterfactual Prompting

Counterfactual prompting (i.e., perturbing a single factor and measuring output change) is widely used to evaluate things like LLM bias and CoT faithfulness. But in this work we argue that observed effects cannot be attributed to the targeted factor without accounting for baseline ``meaning-preserving'' modifications to text that establish general model sensitivity. This is because every counterfactual edit is a compound treatment that bundles the variable of interest with incidental surface-form variation; this violates treatment variation irrelevance. We observe prediction flip rates on MedQA of 14.9% when we surgically change patient gender. However, this is statistically indistinguishable from the flip rates induced by simply paraphrasing inputs (14.1%). In this case, it would therefore be unwarranted to conclude that the LLM is especially sensitive to patient gender. To account for this and robustly measure the effects of targeted interventions, we propose a framework in which we compare (via statistical testing) differences observed under target interventions to those induced by paraphrasing inputs. We then use this framework to revisit a analysis done on the MedPerturb dataset, which reported evidence of model sensitivity to patient demographics and stylistic cues. We find that these effects largely dissipate when we account for general model sensitivity, with only 5 of 120 tests reaching statistical significance. Applying the same framework to occupational biography classification, we detect clearly significant directional gender bias, showing that the framework identifies real directional effects even when they are small. We evaluate a range of metrics -- aggregate, per-sample distributional, and regression -- and find that per-sample metrics are dramatically more powerful than aggregate metrics and regression powerfully and uniquely characterizes effect direction and magnitude.

  • 4 authors
·
Apr 30

Guiding Large Language Models via Directional Stimulus Prompting

We introduce Directional Stimulus Prompting, a novel framework for guiding black-box large language models (LLMs) toward specific desired outputs. Instead of directly adjusting LLMs, our method employs a small tunable policy model (e.g., T5) to generate an auxiliary directional stimulus prompt for each input instance. These directional stimulus prompts act as nuanced, instance-specific hints and clues to guide LLMs in generating desired outcomes, such as including specific keywords in the generated summary. Our approach sidesteps the challenges of direct LLM tuning by optimizing the policy model to explore directional stimulus prompts that align LLMs with desired behaviors. The policy model can be optimized through 1) supervised fine-tuning using labeled data and 2) reinforcement learning from offline or online rewards based on the LLM's output. We assess our method across summarization, dialogue response generation, and chain-of-thought reasoning tasks. Our experiments demonstrate that the framework consistently improves LLMs' (e.g., ChatGPT, Codex, InstructGPT) performance on these supervised tasks using minimal labeled data. Notably, using just 80 dialogues on the MultiWOZ dataset, our approach enhances ChatGPT's performance by an impressive 41.4%, matching or surpassing some fully supervised start-of-the-art models. Additionally, the instance-specific chain-of-thought prompt generated by our approach improves InstructGPT's reasoning accuracy compared to human-crafted or automatically generated prompts. The code and data are publicly available at https://github.com/Leezekun/Directional-Stimulus-Prompting.

  • 6 authors
·
Feb 22, 2023

An Analysis of Causal Effect Estimation using Outcome Invariant Data Augmentation

The technique of data augmentation (DA) is often used in machine learning for regularization purposes to better generalize under i.i.d. settings. In this work, we present a unifying framework with topics in causal inference to make a case for the use of DA beyond just the i.i.d. setting, but for generalization across interventions as well. Specifically, we argue that when the outcome generating mechanism is invariant to our choice of DA, then such augmentations can effectively be thought of as interventions on the treatment generating mechanism itself. This can potentially help to reduce bias in causal effect estimation arising from hidden confounders. In the presence of such unobserved confounding we typically make use of instrumental variables (IVs) -- sources of treatment randomization that are conditionally independent of the outcome. However, IVs may not be as readily available as DA for many applications, which is the main motivation behind this work. By appropriately regularizing IV based estimators, we introduce the concept of IV-like (IVL) regression for mitigating confounding bias and improving predictive performance across interventions even when certain IV properties are relaxed. Finally, we cast parameterized DA as an IVL regression problem and show that when used in composition can simulate a worst-case application of such DA, further improving performance on causal estimation and generalization tasks beyond what simple DA may offer. This is shown both theoretically for the population case and via simulation experiments for the finite sample case using a simple linear example. We also present real data experiments to support our case.

  • 5 authors
·
Oct 28, 2025 1

Learning What Matters: Adaptive Information-Theoretic Objectives for Robot Exploration

Designing learnable information-theoretic objectives for robot exploration remains challenging. Such objectives aim to guide exploration toward data that reduces uncertainty in model parameters, yet it is often unclear what information the collected data can actually reveal. Although reinforcement learning (RL) can optimize a given objective, constructing objectives that reflect parametric learnability is difficult in high-dimensional robotic systems. Many parameter directions are weakly observable or unidentifiable, and even when identifiable directions are selected, omitted directions can still influence exploration and distort information measures. To address this challenge, we propose Quasi-Optimal Experimental Design (Q{\footnotesize OED}), an adaptive information objective grounded in optimal experimental design. Q{\footnotesize OED} (i) performs eigenspace analysis of the Fisher information matrix to identify an observable subspace and select identifiable parameter directions, and (ii) modifies the exploration objective to emphasize these directions while suppressing nuisance effects from non-critical parameters. Under bounded nuisance influence and limited coupling between critical and nuisance directions, Q{\footnotesize OED} provides a constant-factor approximation to the ideal information objective that explores all parameters. We evaluate Q{\footnotesize OED} on simulated and real-world navigation and manipulation tasks, where identifiable-direction selection and nuisance suppression yield performance improvements of 35.23{\percent} and 21.98{\percent}, respectively. When integrated as an exploration objective in model-based policy optimization, Q{\footnotesize OED} further improves policy performance over established RL baselines.

  • 5 authors
·
May 11

Coping with Information Loss and the Use of Auxiliary Sources of Data: A Report from the NISS Ingram Olkin Forum Series on Unplanned Clinical Trial Disruptions

Clinical trials disruption has always represented a non negligible part of the ending of interventional studies. While the SARS-CoV-2 (COVID-19) pandemic has led to an impressive and unprecedented initiation of clinical research, it has also led to considerable disruption of clinical trials in other disease areas, with around 80% of non-COVID-19 trials stopped or interrupted during the pandemic. In many cases the disrupted trials will not have the planned statistical power necessary to yield interpretable results. This paper describes methods to compensate for the information loss arising from trial disruptions by incorporating additional information available from auxiliary data sources. The methods described include the use of auxiliary data on baseline and early outcome data available from the trial itself and frequentist and Bayesian approaches for the incorporation of information from external data sources. The methods are illustrated by application to the analysis of artificial data based on the Primary care pediatrics Learning Activity Nutrition (PLAN) study, a clinical trial assessing a diet and exercise intervention for overweight children, that was affected by the COVID-19 pandemic. We show how all of the methods proposed lead to an increase in precision relative to use of complete case data only.

  • 12 authors
·
Jun 22, 2022

Vision-Braille: An End-to-End Tool for Chinese Braille Image-to-Text Translation

Visually impaired people are a large group who can only use braille for reading and writing. However, the lack of special educational resources is the bottleneck for educating them. Educational equity is a reflection of the level of social civilization, cultural equality, and individual dignity. Facilitating and improving lifelong learning channels for the visually impaired is of great significance. Their written braille homework or exam papers cannot be understood by sighted teachers, because of the lack of a highly accurate braille translation system, especially in Chinese which has tone marks. braille writers often omit tone marks to save space, leading to confusion when braille with the same consonants and vowels is translated into Chinese. Previous algorithms were insufficient in extracting contextual information, resulting in low accuracy of braille translations into Chinese. This project informatively fine-tuned the mT5 model with an Encoder-decoder architecture for braille to Chinese character conversion. This research created a training set of braille and corresponding Chinese text from the Leipzig Corpora. This project significantly reduced the confusion in braille, achieving 62.4 and 62.3 BLEU scores in the validation and test sets, with a curriculum learning fine-tuning method. By incorporating the braille recognition algorithm, this project is the first publicly available braille translation system and can benefit lots of visually impaired students and families who are preparing for the Chinese College Test and help to propel their college dreams in the future. There is a demo on our homepage\url{https://vision-braille.com/}.

  • 3 authors
·
Jul 8, 2024

Integrating Earth Observation Data into Causal Inference: Challenges and Opportunities

Observational studies require adjustment for confounding factors that are correlated with both the treatment and outcome. In the setting where the observed variables are tabular quantities such as average income in a neighborhood, tools have been developed for addressing such confounding. However, in many parts of the developing world, features about local communities may be scarce. In this context, satellite imagery can play an important role, serving as a proxy for the confounding variables otherwise unobserved. In this paper, we study confounder adjustment in this non-tabular setting, where patterns or objects found in satellite images contribute to the confounder bias. Using the evaluation of anti-poverty aid programs in Africa as our running example, we formalize the challenge of performing causal adjustment with such unstructured data -- what conditions are sufficient to identify causal effects, how to perform estimation, and how to quantify the ways in which certain aspects of the unstructured image object are most predictive of the treatment decision. Via simulation, we also explore the sensitivity of satellite image-based observational inference to image resolution and to misspecification of the image-associated confounder. Finally, we apply these tools in estimating the effect of anti-poverty interventions in African communities from satellite imagery.

InT: Self-Proposed Interventions Enable Credit Assignment in LLM Reasoning

Outcome-reward reinforcement learning (RL) has proven effective at improving the reasoning capabilities of large language models (LLMs). However, standard RL assigns credit only at the level of the final answer, penalizing entire reasoning traces when the outcome is incorrect and uniformly reinforcing all steps when it is correct. As a result, correct intermediate steps may be discouraged in failed traces, while spurious steps may be reinforced in successful ones. We refer to this failure mode as the problem of credit assignment. While a natural remedy is to train a process reward model, accurately optimizing such models to identify corrective reasoning steps remains challenging. We introduce Intervention Training (InT), a training paradigm in which the model performs fine-grained credit assignment on its own reasoning traces by proposing short, targeted corrections that steer trajectories toward higher reward. Using reference solutions commonly available in mathematical reasoning datasets and exploiting the fact that verifying a model-generated solution is easier than generating a correct one from scratch, the model identifies the first error in its reasoning and proposes a single-step intervention to redirect the trajectory toward the correct solution. We then apply supervised fine-tuning (SFT) to the on-policy rollout up to the point of error concatenated with the intervention, localizing error to the specific step that caused failure. We show that the resulting model serves as a far better initialization for RL training. After running InT and subsequent fine-tuning with RL, we improve accuracy by nearly 14% over a 4B-parameter base model on IMO-AnswerBench, outperforming larger open-source models such as gpt-oss-20b.

Image-based Treatment Effect Heterogeneity

Randomized controlled trials (RCTs) are considered the gold standard for estimating the average treatment effect (ATE) of interventions. One use of RCTs is to study the causes of global poverty -- a subject explicitly cited in the 2019 Nobel Memorial Prize awarded to Duflo, Banerjee, and Kremer "for their experimental approach to alleviating global poverty." Because the ATE is a population summary, anti-poverty experiments often seek to unpack the effect variation around the ATE by conditioning (CATE) on tabular variables such as age and ethnicity that were measured during the RCT data collection. Although such variables are key to unpacking CATE, using only such variables may fail to capture historical, geographical, or neighborhood-specific contributors to effect variation, as tabular RCT data are often only observed near the time of the experiment. In global poverty research, when the location of the experiment units is approximately known, satellite imagery can provide a window into such factors important for understanding heterogeneity. However, there is no method that specifically enables applied researchers to analyze CATE from images. In this paper, using a deep probabilistic modeling framework, we develop such a method that estimates latent clusters of images by identifying images with similar treatment effects distributions. Our interpretable image CATE model also includes a sensitivity factor that quantifies the importance of image segments contributing to the effect cluster prediction. We compare the proposed methods against alternatives in simulation; also, we show how the model works in an actual RCT, estimating the effects of an anti-poverty intervention in northern Uganda and obtaining a posterior predictive distribution over effects for the rest of the country where no experimental data was collected. We make all models available in open-source software.

Towards Bidirectional Human-AI Alignment: A Systematic Review for Clarifications, Framework, and Future Directions

Recent advancements in general-purpose AI have highlighted the importance of guiding AI systems towards the intended goals, ethical principles, and values of individuals and groups, a concept broadly recognized as alignment. However, the lack of clarified definitions and scopes of human-AI alignment poses a significant obstacle, hampering collaborative efforts across research domains to achieve this alignment. In particular, ML- and philosophy-oriented alignment research often views AI alignment as a static, unidirectional process (i.e., aiming to ensure that AI systems' objectives match humans) rather than an ongoing, mutual alignment problem [429]. This perspective largely neglects the long-term interaction and dynamic changes of alignment. To understand these gaps, we introduce a systematic review of over 400 papers published between 2019 and January 2024, spanning multiple domains such as Human-Computer Interaction (HCI), Natural Language Processing (NLP), Machine Learning (ML), and others. We characterize, define and scope human-AI alignment. From this, we present a conceptual framework of "Bidirectional Human-AI Alignment" to organize the literature from a human-centered perspective. This framework encompasses both 1) conventional studies of aligning AI to humans that ensures AI produces the intended outcomes determined by humans, and 2) a proposed concept of aligning humans to AI, which aims to help individuals and society adjust to AI advancements both cognitively and behaviorally. Additionally, we articulate the key findings derived from literature analysis, including discussions about human values, interaction techniques, and evaluations. To pave the way for future studies, we envision three key challenges for future directions and propose examples of potential future solutions.

  • 24 authors
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Jun 13, 2024

Early warning signals: The charted and uncharted territories

The realization that complex systems such as ecological communities can collapse or shift regimes suddenly and without rapid external forcing poses a serious challenge to our understanding and management of the natural world. The potential to identify early warning signals that would allow researchers and managers to predict such events before they happen has therefore been an invaluable discovery that offers a way forward in spite of such seemingly unpredictable behavior. Research into early warning signals has demonstrated that it is possible to define and detect such early warning signals in advance of a transition in certain contexts. Here we describe the pattern emerging as research continues to explore just how far we can generalize these results. A core of examples emerges that shares three properties: the phenomenon of rapid regime shifts, a pattern of 'critical slowing down' that can be used to detect the approaching shift, and a mechanism of bifurcation driving the sudden change. As research has expanded beyond these core examples, it is becoming clear that not all systems that show regime shifts exhibit critical slowing down, or vice versa. Even when systems exhibit critical slowing down, statistical detection is a challenge. We review the literature that explores these edge cases and highlight the need for (a) new early warning behaviors that can be used in cases where rapid shifts do not exhibit critical slowing down, (b) the development of methods to identify which behavior might be an appropriate signal when encountering a novel system; bearing in mind that a positive indication for some systems is a negative indication in others, and (c) statistical methods that can distinguish between signatures of early warning behaviors and noise.

  • 3 authors
·
May 29, 2013

Guidance Source Matters: How Guidance from AI, Expert, or a Group of Analysts Impacts Visual Data Preparation and Analysis

The progress in generative AI has fueled AI-powered tools like co-pilots and assistants to provision better guidance, particularly during data analysis. However, research on guidance has not yet examined the perceived efficacy of the source from which guidance is offered and the impact of this source on the user's perception and usage of guidance. We ask whether users perceive all guidance sources as equal, with particular interest in three sources: (i) AI, (ii) human expert, and (iii) a group of human analysts. As a benchmark, we consider a fourth source, (iv) unattributed guidance, where guidance is provided without attribution to any source, enabling isolation of and comparison with the effects of source-specific guidance. We design a five-condition between-subjects study, with one condition for each of the four guidance sources and an additional (v) no-guidance condition, which serves as a baseline to evaluate the influence of any kind of guidance. We situate our study in a custom data preparation and analysis tool wherein we task users to select relevant attributes from an unfamiliar dataset to inform a business report. Depending on the assigned condition, users can request guidance, which the system then provides in the form of attribute suggestions. To ensure internal validity, we control for the quality of guidance across source-conditions. Through several metrics of usage and perception, we statistically test five preregistered hypotheses and report on additional analysis. We find that the source of guidance matters to users, but not in a manner that matches received wisdom. For instance, users utilize guidance differently at various stages of analysis, including expressing varying levels of regret, despite receiving guidance of similar quality. Notably, users in the AI condition reported both higher post-task benefit and regret.

  • 3 authors
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Feb 2, 2025

Selective Steering: Norm-Preserving Control Through Discriminative Layer Selection

Despite significant progress in alignment, large language models (LLMs) remain vulnerable to adversarial attacks that elicit harmful behaviors. Activation steering techniques offer a promising inference-time intervention approach, but existing methods suffer from critical limitations: activation addition requires careful coefficient tuning and is sensitive to layer-specific norm variations, while directional ablation provides only binary control. Recent work on Angular Steering introduces continuous control via rotation in a 2D subspace, but its practical implementation violates norm preservation, causing distribution shift and generation collapse, particularly in models below 7B parameters. We propose Selective Steering, which addresses these limitations through two key innovations: (1) a mathematically rigorous norm-preserving rotation formulation that maintains activation distribution integrity, and (2) discriminative layer selection that applies steering only where feature representations exhibit opposite-signed class alignment. Experiments across nine models demonstrate that Selective Steering achieves 5.5x higher attack success rates than prior methods while maintaining zero perplexity violations and approximately 100\% capability retention on standard benchmarks. Our approach provides a principled, efficient framework for controllable and stable LLM behavior modification. Code: https://github.com/knoveleng/steering

Steer2Edit: From Activation Steering to Component-Level Editing

Steering methods influence Large Language Model behavior by identifying semantic directions in hidden representations, but are typically realized through inference-time activation interventions that apply a fixed, global modification to the model's internal states. While effective, such interventions often induce unfavorable attribute-utility trade-offs under strong control, as they ignore the fact that many behaviors are governed by a small and heterogeneous subset of model components. We propose Steer2Edit, a theoretically grounded, training-free framework that transforms steering vectors from inference-time control signals into diagnostic signals for component-level rank-1 weight editing. Instead of uniformly injecting a steering direction during generation, Steer2Edit selectively redistributes behavioral influence across individual attention heads and MLP neurons, yielding interpretable edits that preserve the standard forward pass and remain compatible with optimized parallel inference. Across safety alignment, hallucination mitigation, and reasoning efficiency, Steer2Edit consistently achieves more favorable attribute-utility trade-offs: at matched downstream performance, it improves safety by up to 17.2%, increases truthfulness by 9.8%, and reduces reasoning length by 12.2% on average. Overall, Steer2Edit provides a principled bridge between representation steering and weight editing by translating steering signals into interpretable, training-free parameter updates.

Étude cognitive des processus de construction d'une requête dans un système de gestion de connaissances médicales

This article presents the Cogni-CISMeF project, which aims at improving medical information search in the CISMeF system (Catalog and Index of French-language health resources) by including a conversational agent to interact with the user in natural language. To study the cognitive processes involved during the information search, a bottom-up methodology was adopted. Experimentation has been set up to obtain human dialogs between a user (playing the role of patient) dealing with medical information search and a CISMeF expert refining the request. The analysis of these dialogs underlined the use of discursive evidence: vocabulary, reformulation, implicit or explicit expression of user intentions, conversational sequences, etc. A model of artificial agent is proposed. It leads the user in its information search by proposing to him examples, assistance and choices. This model was implemented and integrated in the CISMeF system. ---- Cet article d\'ecrit le projet Cogni-CISMeF qui propose un module de dialogue Homme-Machine \`a int\'egrer dans le syst\`eme d'indexation de connaissances m\'edicales CISMeF (Catalogue et Index des Sites M\'edicaux Francophones). Nous avons adopt\'e une d\'emarche de mod\'elisation cognitive en proc\'edant \`a un recueil de corpus de dialogues entre un utilisateur (jouant le r\^ole d'un patient) d\'esirant une information m\'edicale et un expert CISMeF af inant cette demande pour construire la requ\^ete. Nous avons analys\'e la structure des dialogues ainsi obtenus et avons \'etudi\'e un certain nombre d'indices discursifs : vocabulaire employ\'e, marques de reformulation, commentaires m\'eta et \'epilinguistiques, expression implicite ou explicite des intentions de l'utilisateur, encha\^inement conversationnel, etc. De cette analyse, nous avons construit un mod\`ele d'agent artificiel dot\'e de capacit\'es cognitives capables d'aider l'utilisateur dans sa t\^ache de recherche d'information. Ce mod\`ele a \'et\'e impl\'ement\'e et int\'egr\'e dans le syst\`eme CISMeF.

  • 5 authors
·
Feb 10, 2014

MLLMs Know Where to Look: Training-free Perception of Small Visual Details with Multimodal LLMs

Multimodal Large Language Models (MLLMs) have experienced rapid progress in visual recognition tasks in recent years. Given their potential integration into many critical applications, it is important to understand the limitations of their visual perception. In this work, we study whether MLLMs can perceive small visual details as effectively as large ones when answering questions about images. We observe that their performance is very sensitive to the size of the visual subject of the question, and further show that this effect is in fact causal by conducting an intervention study. Next, we study the attention patterns of MLLMs when answering visual questions, and intriguingly find that they consistently know where to look, even when they provide the wrong answer. Based on these findings, we then propose training-free visual intervention methods that leverage the internal knowledge of any MLLM itself, in the form of attention and gradient maps, to enhance its perception of small visual details. We evaluate our proposed methods on two widely-used MLLMs and seven visual question answering benchmarks and show that they can significantly improve MLLMs' accuracy without requiring any training. Our results elucidate the risk of applying MLLMs to visual recognition tasks concerning small details and indicate that visual intervention using the model's internal state is a promising direction to mitigate this risk.

  • 4 authors
·
Feb 24, 2025 2

CLaS-Bench: A Cross-Lingual Alignment and Steering Benchmark

Understanding and controlling the behavior of large language models (LLMs) is an increasingly important topic in multilingual NLP. Beyond prompting or fine-tuning, , i.e.,~manipulating internal representations during inference, has emerged as a more efficient and interpretable technique for adapting models to a target language. Yet, no dedicated benchmarks or evaluation protocols exist to quantify the effectiveness of steering techniques. We introduce CLaS-Bench, a lightweight parallel-question benchmark for evaluating language-forcing behavior in LLMs across 32 languages, enabling systematic evaluation of multilingual steering methods. We evaluate a broad array of steering techniques, including residual-stream DiffMean interventions, probe-derived directions, language-specific neurons, PCA/LDA vectors, Sparse Autoencoders, and prompting baselines. Steering performance is measured along two axes: language control and semantic relevance, combined into a single harmonic-mean steering score. We find that across languages simple residual-based DiffMean method consistently outperforms all other methods. Moreover, a layer-wise analysis reveals that language-specific structure emerges predominantly in later layers and steering directions cluster based on language family. CLaS-Bench is the first standardized benchmark for multilingual steering, enabling both rigorous scientific analysis of language representations and practical evaluation of steering as a low-cost adaptation alternative.

  • 8 authors
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Jan 13

What Makes Digital Support Effective? How Therapeutic Skills Affect Clinical Well-Being

Online mental health support communities have grown in recent years for providing accessible mental and emotional health support through volunteer counselors. Despite millions of people participating in chat support on these platforms, the clinical effectiveness of these communities on mental health symptoms remains unknown. Furthermore, although volunteers receive some training based on established therapeutic skills studied in face-to-face environments such as active listening and motivational interviewing, it remains understudied how the usage of these skills in this online context affects people's mental health status. In our work, we collaborate with one of the largest online peer support platforms and use both natural language processing and machine learning techniques to measure how one-on-one support chats affect depression and anxiety symptoms. We measure how the techniques and characteristics of support providers, such as using affirmation, empathy, and past experience on the platform, affect support-seekers' mental health changes. We find that online peer support chats improve both depression and anxiety symptoms with a statistically significant but relatively small effect size. Additionally, support providers' techniques such as emphasizing the autonomy of the client lead to better mental health outcomes. However, we also found that some behaviors (e.g. persuading) are actually harmful to depression and anxiety outcomes. Our work provides key understanding for mental health care in the online setting and designing training systems for online support providers.

  • 7 authors
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Dec 17, 2023

Research-based assessment affordances and constraints: Perceptions of physics faculty

To help faculty use research-based materials in a more significant way, we learn about their perceived needs and desires and use this information to suggest ways for the Physics Education Research community to address these needs. When research-based resources are well aligned with the perceived needs of faculty, faculty members will more readily take them up. We used phenomenographic interviews of ordinary physics faculty and department chairs to identify four families of issues that faculty have around research-based assessments (RBA). First, many faculty are interested in using RBAs but have practical needs around how to do so: how to find them, which ones there are, and how to administer them. They want help addressing these needs. Second, at the same time, many faculty think that RBAs are limited and don't measure many of the things they care about, or aren't applicable in their classes. They want assessments to measure skills, perceptions, and specific concepts. Third, many faculty want to turn to communities of other faculty and experts to help them interpret their assessment results and suggest other ways to do assessment. They want to norm their assessment results by comparing to others and interacting with faculty from other schools to learn about how they do assessment. Fourth, many faculty consider their courses in the broader contexts of accountability and their departments. They want help with assessment in these broader contexts. We also discuss how faculty members role in their department and type of institution influence their perceived wants and needs around assessment.

  • 5 authors
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Jan 6, 2015

Training Models to Extract Treatment Plans from Clinical Notes Using Contents of Sections with Headings

Objective: Using natural language processing (NLP) to find sentences that state treatment plans in a clinical note, would automate plan extraction and would further enable their use in tools that help providers and care managers. However, as in the most NLP tasks on clinical text, creating gold standard to train and test NLP models is tedious and expensive. Fortuitously, sometimes but not always clinical notes contain sections with a heading that identifies the section as a plan. Leveraging contents of such labeled sections as a noisy training data, we assessed accuracy of NLP models trained with the data. Methods: We used common variations of plan headings and rule-based heuristics to find plan sections with headings in clinical notes, and we extracted sentences from them and formed a noisy training data of plan sentences. We trained Support Vector Machine (SVM) and Convolutional Neural Network (CNN) models with the data. We measured accuracy of the trained models on the noisy dataset using ten-fold cross validation and separately on a set-aside manually annotated dataset. Results: About 13% of 117,730 clinical notes contained treatment plans sections with recognizable headings in the 1001 longitudinal patient records that were obtained from Cleveland Clinic under an IRB approval. We were able to extract and create a noisy training data of 13,492 plan sentences from the clinical notes. CNN achieved best F measures, 0.91 and 0.97 in the cross-validation and set-aside evaluation experiments respectively. SVM slightly underperformed with F measures of 0.89 and 0.96 in the same experiments. Conclusion: Our study showed that the training supervised learning models using noisy plan sentences was effective in identifying them in all clinical notes. More broadly, sections with informal headings in clinical notes can be a good source for generating effective training data.

  • 3 authors
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Jun 27, 2019

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

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

  • 2 authors
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May 30, 2024

Zero-Shot Vision-and-Language Navigation with Collision Mitigation in Continuous Environment

We propose the zero-shot Vision-and-Language Navigation with Collision Mitigation (VLN-CM), which takes these considerations. VLN-CM is composed of four modules and predicts the direction and distance of the next movement at each step. We utilize large foundation models for each modules. To select the direction, we use the Attention Spot Predictor (ASP), View Selector (VS), and Progress Monitor (PM). The ASP employs a Large Language Model (e.g. ChatGPT) to split navigation instructions into attention spots, which are objects or scenes at the location to move to (e.g. a yellow door). The VS selects from panorama images provided at 30-degree intervals the one that includes the attention spot, using CLIP similarity. We then choose the angle of the selected image as the direction to move in. The PM uses a rule-based approach to decide which attention spot to focus on next, among multiple spots derived from the instructions. If the similarity between the current attention spot and the visual observations decreases consecutively at each step, the PM determines that the agent has passed the current spot and moves on to the next one. For selecting the distance to move, we employed the Open Map Predictor (OMP). The OMP uses panorama depth information to predict an occupancy mask. We then selected a collision-free distance in the predicted direction based on the occupancy mask. We evaluated our method using the validation data of VLN-CE. Our approach showed better performance than several baseline methods, and the OPM was effective in mitigating collisions for the agent.

  • 4 authors
·
Oct 7, 2024

The Impact of Medication Non-adherence on Adverse Outcomes: Evidence from Schizophrenia Patients via Survival Analysis

This study quantifies the association between non-adherence to antipsychotic medications and adverse outcomes in individuals with schizophrenia. We frame the problem using survival analysis, focusing on the time to the earliest of several adverse events (early death, involuntary hospitalization, jail booking). We extend standard causal inference methods (T-learner, S-learner, nearest neighbor matching) to utilize various survival models to estimate individual and average treatment effects, where treatment corresponds to medication non-adherence. Analyses are repeated using different amounts of longitudinal information (3, 6, 9, and 12 months). Using data from Allegheny County in western Pennsylvania, we find strong evidence that non-adherence advances adverse outcomes by approximately 1 to 4 months. Ablation studies confirm that county-provided risk scores adjust for key confounders, as their removal amplifies the estimated effects. Subgroup analyses by medication formulation (injectable vs. oral) and medication type consistently show that non-adherence is associated with earlier adverse events. These findings highlight the clinical importance of adherence in delaying psychiatric crises and show that integrating survival analysis with causal inference tools can yield policy-relevant insights. We caution that although we apply causal inference, we only make associative claims and discuss assumptions needed for causal interpretation.

Bayesian aggregation of average data: An application in drug development

Throughout the different phases of a drug development program, randomized trials are used to establish the tolerability, safety, and efficacy of a candidate drug. At each stage one aims to optimize the design of future studies by extrapolation from the available evidence at the time. This includes collected trial data and relevant external data. However, relevant external data are typically available as averages only, for example from trials on alternative treatments reported in the literature. Here we report on such an example from a drug development for wet age-related macular degeneration. This disease is the leading cause of severe vision loss in the elderly. While current treatment options are efficacious, they are also a substantial burden for the patient. Hence, new treatments are under development which need to be compared against existing treatments. The general statistical problem this leads to is meta-analysis, which addresses the question of how we can combine datasets collected under different conditions. Bayesian methods have long been used to achieve partial pooling. Here we consider the challenge when the model of interest is complex (hierarchical and nonlinear) and one dataset is given as raw data while the second dataset is given as averages only. In such a situation, common meta-analytic methods can only be applied when the model is sufficiently simple for analytic approaches. When the model is too complex, for example nonlinear, an analytic approach is not possible. We provide a Bayesian solution by using simulation to approximately reconstruct the likelihood of the external summary and allowing the parameters in the model to vary under the different conditions. We first evaluate our approach using fake-data simulations and then report results for the drug development program that motivated this research.

  • 6 authors
·
May 12, 2020

VR for Acupuncture? Exploring Needs and Opportunities for Acupuncture Training and Treatment in Virtual Reality

Acupuncture is a form of medicine that involves inserting needles into targeted areas of the body and requires knowledge of both Traditional Chinese Medicine (TCM) and Evidence-Based Medicine (EBM). The process of acquiring such knowledge and using it for practical treatment is challenging due to the need for a deep understanding of human anatomy and the ability to apply both TCM and EBM approaches. Visual aids have been introduced to aid in understanding the alignment of acupuncture points with key elements of the human body, and are indispensable tools for both learners and expert acupuncturists. However, they are often not enough to enable effective practice and fail to fully support the learning process. Novel approaches based on immersive visualization and Virtual Reality (VR) have shown promise in many healthcare settings due to their unique advantages in terms of realism and interactions, but it is still unknown whether and how VR can possibly be beneficial to acupuncture training and treatment. Following participatory design protocols such as observations and semi-structured interviews with eight doctors and nine students, we explore the needs and pain points of current acupuncture workflows at the intersection of EBM and TCM in China and the United States. We highlight opportunities for introducing VR in today's acupuncture training and treatment workflows, and discuss two design approaches that build on 11 specific challenges spanning education, diagnosis, treatment, and communication.

  • 4 authors
·
Dec 12, 2023

Iterative Service-Learning: A Computing-Based Case-study Applied to Small Rural Organizations

This paper describes the iterative use of service learning to develop, review, and improve computing-based artifacts. It is well-known that computing students benefit from service-learning experiences as do the community partners. It is also well-known that computing artifacts rarely function well long-term without versioning and updates. Service-learning projects are often one-time engagements, completed by single teams of students over the course of a semester course. This limits the benefit for community partners that do not have the expertise or resources to review and update a project on their own. Over several years, teams of undergraduate students in a capstone course created tailored social media plans for numerous small rural organizations. The projects were required to meet client specific needs, with identified audiences, measurable goals, and strategies and tactics to reach the identified goals. This paper builds on previously results for 60 projects conducted over several years. Nine clients were selected to participate in the iterative follow-up process, where new student teams conducted client interviews, reviewed the initial plans, and analyzed metrics from the current strategies and tactics to provide updated, improved artifacts. Using ABET learning objectives as a basis, clients reviewed the student teams and artifacts. This longitudinal study discusses the impact of this intervention to increase implementation and sustained use rates of computing artifacts developed through service learning. Both students and clients reported high satisfaction levels, and clients were particularly satisfied with the iterative improvement process. This research demonstrates an innovative practice for creating and maintaining computing artifacts through iterative service learning, while addressing the resource constraints of small organizations.

  • 1 authors
·
Jun 21, 2024