Daily Papers

Electrocardiograms (ECGs) are non-invasive diagnostic tools crucial for detecting cardiac arrhythmic diseases in clinical practice. While ECG Self-supervised Learning (eSSL) methods show promise in representation learning from unannotated ECG data, they often overlook the clinical knowledge that can be found in reports. This oversight and the requirement for annotated samples for downstream tasks limit eSSL's versatility. In this work, we address these issues with the Multimodal ECG Representation Learning (MERL}) framework. Through multimodal learning on ECG records and associated reports, MERL is capable of performing zero-shot ECG classification with text prompts, eliminating the need for training data in downstream tasks. At test time, we propose the Clinical Knowledge Enhanced Prompt Engineering (CKEPE) approach, which uses Large Language Models (LLMs) to exploit external expert-verified clinical knowledge databases, generating more descriptive prompts and reducing hallucinations in LLM-generated content to boost zero-shot classification. Based on MERL, we perform the first benchmark across six public ECG datasets, showing the superior performance of MERL compared against eSSL methods. Notably, MERL achieves an average AUC score of 75.2% in zero-shot classification (without training data), 3.2% higher than linear probed eSSL methods with 10\% annotated training data, averaged across all six datasets. Code and models are available at https://github.com/cheliu-computation/MERL

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

Recent advancements in machine learning and natural language processing have led to the rapid development of artificial intelligence (AI) as a valuable tool in the healthcare industry. Using large language models (LLMs) as conversational agents or chatbots has the potential to assist doctors in diagnosing patients, detecting early symptoms of diseases, and providing health advice to patients. This paper focuses on the role of chatbots in healthcare and explores the use of avatars to make AI interactions more appealing to patients. A framework of a general-purpose AI avatar application is demonstrated by using a three-category prompt dictionary and prompt improvement mechanism. A two-phase approach is suggested to fine-tune a general-purpose AI language model and create different AI avatars to discuss medical issues with users. Prompt engineering enhances the chatbot's conversational abilities and personality traits, fostering a more human-like interaction with patients. Ultimately, the injection of personality into the chatbot could potentially increase patient engagement. Future directions for research include investigating ways to improve chatbots' understanding of context and ensuring the accuracy of their outputs through fine-tuning with specialized medical data sets.

Large Language Models (LLMs) have demonstrated significant potential in transforming clinical applications. In this study, we investigate the efficacy of four techniques in adapting LLMs for clinical use-cases: continuous pretraining, instruct fine-tuning, NEFTune, and prompt engineering. We employ these methods on Mistral 7B and Mixtral 8x7B models, leveraging a large-scale clinical pretraining dataset of 50 billion tokens and an instruct fine-tuning dataset of 500 million tokens. Our evaluation across various clinical tasks reveals the impact of each technique. While continuous pretraining beyond 250 billion tokens yields marginal improvements on its own, it establishes a strong foundation for instruct fine-tuning. Notably, NEFTune, designed primarily to enhance generation quality, surprisingly demonstrates additional gains on our benchmark. Complex prompt engineering methods further enhance performance. These findings show the importance of tailoring fine-tuning strategies and exploring innovative techniques to optimize LLM performance in the clinical domain.

Prompt engineering is an essential technique for enhancing the abilities of large language models (LLMs) by providing explicit and specific instructions. It enables LLMs to excel in various tasks, such as arithmetic reasoning, question answering, summarization, relation extraction, machine translation, and sentiment analysis. Researchers have been actively exploring different prompt engineering strategies, such as Chain of Thought (CoT), Zero-CoT, and In-context learning. However, an unresolved problem arises from the fact that current approaches lack a solid theoretical foundation for determining optimal prompts. To address this issue in prompt engineering, we propose a new and effective approach called Prompt Space. Our methodology utilizes text embeddings to obtain basis vectors by matrix decomposition, and then constructs a space for representing all prompts. Prompt Space significantly outperforms state-of-the-art prompt paradigms on ten public reasoning benchmarks. Notably, without the help of the CoT method and the prompt "Let's think step by step", Prompt Space shows superior performance over the few-shot method. Overall, our approach provides a robust and fundamental theoretical framework for selecting simple and effective prompts. This advancement marks a significant step towards improving prompt engineering for a wide variety of applications in LLMs.

The emergence of advanced reasoning capabilities in Large Language Models (LLMs) marks a transformative development in healthcare applications. Beyond merely expanding functional capabilities, these reasoning mechanisms enhance decision transparency and explainability-critical requirements in medical contexts. This survey examines the transformation of medical LLMs from basic information retrieval tools to sophisticated clinical reasoning systems capable of supporting complex healthcare decisions. We provide a thorough analysis of the enabling technological foundations, with a particular focus on specialized prompting techniques like Chain-of-Thought and recent breakthroughs in Reinforcement Learning exemplified by DeepSeek-R1. Our investigation evaluates purpose-built medical frameworks while also examining emerging paradigms such as multi-agent collaborative systems and innovative prompting architectures. The survey critically assesses current evaluation methodologies for medical validation and addresses persistent challenges in field interpretation limitations, bias mitigation strategies, patient safety frameworks, and integration of multimodal clinical data. Through this survey, we seek to establish a roadmap for developing reliable LLMs that can serve as effective partners in clinical practice and medical research.

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

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

We explore the potential of ChatGPT (3.5-turbo and 4) to generate conversations focused on self-care strategies for African-American heart failure patients -- a domain with limited specialized datasets. To simulate patient-health educator dialogues, we employed four prompting strategies: domain, African American Vernacular English (AAVE), Social Determinants of Health (SDOH), and SDOH-informed reasoning. Conversations were generated across key self-care domains of food, exercise, and fluid intake, with varying turn lengths (5, 10, 15) and incorporated patient-specific SDOH attributes such as age, gender, neighborhood, and socioeconomic status. Our findings show that effective prompt design is essential. While incorporating SDOH and reasoning improves dialogue quality, ChatGPT still lacks the empathy and engagement needed for meaningful healthcare communication.

This paper delves into the pivotal role of prompt engineering in unleashing the capabilities of Large Language Models (LLMs). Prompt engineering is the process of structuring input text for LLMs and is a technique integral to optimizing the efficacy of LLMs. This survey elucidates foundational principles of prompt engineering, such as role-prompting, one-shot, and few-shot prompting, as well as more advanced methodologies such as the chain-of-thought and tree-of-thoughts prompting. The paper sheds light on how external assistance in the form of plugins can assist in this task, and reduce machine hallucination by retrieving external knowledge. We subsequently delineate prospective directions in prompt engineering research, emphasizing the need for a deeper understanding of structures and the role of agents in Artificial Intelligence-Generated Content (AIGC) tools. We discuss how to assess the efficacy of prompt methods from different perspectives and using different methods. Finally, we gather information about the application of prompt engineering in such fields as education and programming, showing its transformative potential. This comprehensive survey aims to serve as a friendly guide for anyone venturing through the big world of LLMs and prompt engineering.

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

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

The proliferation of Large Language Models (LLMs) in medicine has enabled impressive capabilities, yet a critical gap remains in their ability to perform systematic, transparent, and verifiable reasoning, a cornerstone of clinical practice. This has catalyzed a shift from single-step answer generation to the development of LLMs explicitly designed for medical reasoning. This paper provides the first systematic review of this emerging field. We propose a taxonomy of reasoning enhancement techniques, categorized into training-time strategies (e.g., supervised fine-tuning, reinforcement learning) and test-time mechanisms (e.g., prompt engineering, multi-agent systems). We analyze how these techniques are applied across different data modalities (text, image, code) and in key clinical applications such as diagnosis, education, and treatment planning. Furthermore, we survey the evolution of evaluation benchmarks from simple accuracy metrics to sophisticated assessments of reasoning quality and visual interpretability. Based on an analysis of 60 seminal studies from 2022-2025, we conclude by identifying critical challenges, including the faithfulness-plausibility gap and the need for native multimodal reasoning, and outlining future directions toward building efficient, robust, and sociotechnically responsible medical AI.

Clinical Question Answering (QA) systems enable doctors to quickly access patient information from electronic health records (EHRs). However, training these systems requires significant annotated data, which is limited due to the expertise needed and the privacy concerns associated with clinical data. This paper explores generating Clinical QA data using large language models (LLMs) in a zero-shot setting. We find that naive prompting often results in easy questions that do not reflect the complexity of clinical scenarios. To address this, we propose two prompting strategies: 1) instructing the model to generate questions that do not overlap with the input context, and 2) summarizing the input record using a predefined schema to scaffold question generation. Experiments on two Clinical QA datasets demonstrate that our method generates more challenging questions, significantly improving fine-tuning performance over baselines. We compare synthetic and gold data and find a gap between their training efficacy resulting from the quality of synthetically generated answers.

Prompt engineering is an increasingly important skill set needed to converse effectively with large language models (LLMs), such as ChatGPT. Prompts are instructions given to an LLM to enforce rules, automate processes, and ensure specific qualities (and quantities) of generated output. Prompts are also a form of programming that can customize the outputs and interactions with an LLM. This paper describes a catalog of prompt engineering techniques presented in pattern form that have been applied to solve common problems when conversing with LLMs. Prompt patterns are a knowledge transfer method analogous to software patterns since they provide reusable solutions to common problems faced in a particular context, i.e., output generation and interaction when working with LLMs. This paper provides the following contributions to research on prompt engineering that apply LLMs to automate software development tasks. First, it provides a framework for documenting patterns for structuring prompts to solve a range of problems so that they can be adapted to different domains. Second, it presents a catalog of patterns that have been applied successfully to improve the outputs of LLM conversations. Third, it explains how prompts can be built from multiple patterns and illustrates prompt patterns that benefit from combination with other prompt patterns.

Prompt engineering is a powerful tool used to enhance the performance of pre-trained models on downstream tasks. For example, providing the prompt ``Let's think step by step" improved GPT-3's reasoning accuracy to 63% on MutiArith while prompting ``a photo of" filled with a class name enables CLIP to achieve 80\% zero-shot accuracy on ImageNet. While previous research has explored prompt learning for the visual modality, analyzing what constitutes a good visual prompt specifically for image recognition is limited. In addition, existing visual prompt tuning methods' generalization ability is worse than text-only prompting tuning. This paper explores our key insight: synthetic text images are good visual prompts for vision-language models! To achieve that, we propose our LoGoPrompt, which reformulates the classification objective to the visual prompt selection and addresses the chicken-and-egg challenge of first adding synthetic text images as class-wise visual prompts or predicting the class first. Without any trainable visual prompt parameters, experimental results on 16 datasets demonstrate that our method consistently outperforms state-of-the-art methods in few-shot learning, base-to-new generalization, and domain generalization.

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

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

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

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

Prompting ChatGPT to achieve complex goals (e.g., creating a customer support chatbot) often demands meticulous prompt engineering, including aspects like fluent writing and chain-of-thought techniques. While emerging prompt optimizers can automatically refine many of these aspects, we argue that clearly conveying customized requirements (e.g., how to handle diverse inputs) remains a human-centric challenge. In this work, we introduce Requirement-Oriented Prompt Engineering (ROPE), a paradigm that focuses human attention on generating clear, complete requirements during prompting. We implement ROPE through an assessment and training suite that provides deliberate practice with LLM-generated feedback. In a study with 30 novices, we show that requirement-focused training doubles novices' prompting performance, significantly outperforming conventional prompt engineering training and prompt optimization. We also demonstrate that high-quality LLM outputs are directly tied to the quality of input requirements. Our work paves the way for more effective task delegation in human-LLM collaborative prompting.

Medical image classification in radiology faces significant challenges, particularly in generalizing to unseen pathologies. In contrast, CLIP offers a promising solution by leveraging multimodal learning to improve zero-shot classification performance. However, in the medical domain, lesions can be small and might not be well represented in the embedding space. Therefore, in this paper, we explore the potential of visual prompt engineering to enhance the capabilities of Vision Language Models (VLMs) in radiology. Leveraging BiomedCLIP, trained on extensive biomedical image-text pairs, we investigate the impact of embedding visual markers directly within radiological images to guide the model's attention to critical regions. Our evaluation on the JSRT dataset, focusing on lung nodule malignancy classification, demonstrates that incorporating visual prompts x2013 such as arrows, circles, and contours x2013 significantly improves classification metrics including AUROC, AUPRC, F1 score, and accuracy. Moreover, the study provides attention maps, showcasing enhanced model interpretability and focus on clinically relevant areas. These findings underscore the efficacy of visual prompt engineering as a straightforward yet powerful approach to advance VLM performance in medical image analysis.

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

Visual prompt engineering is a fundamental technology in the field of visual and image Artificial General Intelligence, serving as a key component for achieving zero-shot capabilities. As the development of large vision models progresses, the importance of prompt engineering becomes increasingly evident. Designing suitable prompts for specific visual tasks has emerged as a meaningful research direction. This review aims to summarize the methods employed in the computer vision domain for large vision models and visual prompt engineering, exploring the latest advancements in visual prompt engineering. We present influential large models in the visual domain and a range of prompt engineering methods employed on these models. It is our hope that this review provides a comprehensive and systematic description of prompt engineering methods based on large visual models, offering valuable insights for future researchers in their exploration of this field.

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

Large language models (LLMs) have shown remarkable performance on many different Natural Language Processing (NLP) tasks. Prompt engineering plays a key role in adding more to the already existing abilities of LLMs to achieve significant performance gains on various NLP tasks. Prompt engineering requires composing natural language instructions called prompts to elicit knowledge from LLMs in a structured way. Unlike previous state-of-the-art (SoTA) models, prompt engineering does not require extensive parameter re-training or fine-tuning based on the given NLP task and thus solely operates on the embedded knowledge of LLMs. Additionally, LLM enthusiasts can intelligently extract LLMs' knowledge through a basic natural language conversational exchange or prompt engineering, allowing more and more people even without deep mathematical machine learning background to experiment with LLMs. With prompt engineering gaining popularity in the last two years, researchers have come up with numerous engineering techniques around designing prompts to improve accuracy of information extraction from the LLMs. In this paper, we summarize different prompting techniques and club them together based on different NLP tasks that they have been used for. We further granularly highlight the performance of these prompting strategies on various datasets belonging to that NLP task, talk about the corresponding LLMs used, present a taxonomy diagram and discuss the possible SoTA for specific datasets. In total, we read and present a survey of 44 research papers which talk about 39 different prompting methods on 29 different NLP tasks of which most of them have been published in the last two years.

Large language models (LLMs) have shown promise in medical question answering, yet they often overlook the domain-specific expertise that professionals depend on, such as the clinical subject areas (e.g., trauma, airway) and the certification level (e.g., EMT, Paramedic). Existing approaches typically apply general-purpose prompting or retrieval strategies without leveraging this structured context, limiting performance in high-stakes settings. We address this gap with EMSQA, an 24.3K-question multiple-choice dataset spanning 10 clinical subject areas and 4 certification levels, accompanied by curated, subject area-aligned knowledge bases (40K documents and 2M tokens). Building on EMSQA, we introduce (i) Expert-CoT, a prompting strategy that conditions chain-of-thought (CoT) reasoning on specific clinical subject area and certification level, and (ii) ExpertRAG, a retrieval-augmented generation pipeline that grounds responses in subject area-aligned documents and real-world patient data. Experiments on 4 LLMs show that Expert-CoT improves up to 2.05% over vanilla CoT prompting. Additionally, combining Expert-CoT with ExpertRAG yields up to a 4.59% accuracy gain over standard RAG baselines. Notably, the 32B expertise-augmented LLMs pass all the computer-adaptive EMS certification simulation exams.

Prompt engineering is a challenging yet crucial task for optimizing the performance of large language models (LLMs). It requires complex reasoning to examine the model's errors, hypothesize what is missing or misleading in the current prompt, and communicate the task with clarity. While recent works indicate that LLMs can be meta-prompted to perform automatic prompt engineering, their potentials may not be fully untapped due to the lack of sufficient guidance to elicit complex reasoning capabilities in LLMs in the meta-prompt. In this work, we investigate the problem of "prompt engineering a prompt engineer" -- constructing a meta-prompt that more effectively guides LLMs to perform automatic prompt engineering. We introduce and analyze key components, such as a step-by-step reasoning template and context specification, which lead to improved performance. In addition, inspired by common optimization concepts such as batch size, step size and momentum, we introduce their verbalized counterparts to the meta-prompt and investigate their effects. Our final method, named PE2, finds a prompt that outperforms "let's think step by step" by 6.3% on the MultiArith dataset and 3.1% on the GSM8K dataset. To demonstrate its versatility, we apply PE2 to the Instruction Induction benchmark, a suite of counterfactual tasks, and a lengthy, real-world industrial prompt. In these settings, PE2 achieves strong performance and outperforms prior automatic prompt engineering baselines. Further, we show that PE2 makes meaningful and targeted prompt edits, amends erroneous or incomplete prompts, and presents non-trivial counterfactual reasoning abilities.

Large language models (LLMs) excel at text generation, but their ability to handle clinical classification tasks involving structured data, such as time series, remains underexplored. In this work, we adapt instruction-tuned LLMs using DSPy-based prompt optimization to process clinical notes and structured EHR inputs jointly. Our results show that this approach achieves performance on par with specialized multimodal systems while requiring less complexity and offering greater adaptability across tasks.

Multimodal large language models (MLLMs) hold considerable promise for applications in healthcare. However, their deployment in safety-critical settings is hindered by two key limitations: (i) sensitivity to prompt design, and (ii) a tendency to generate incorrect responses with high confidence. As clinicians may rely on a model's stated confidence to gauge the reliability of its predictions, it is especially important that when a model expresses high confidence, it is also highly accurate. We introduce Prompt4Trust, the first reinforcement learning (RL) framework for prompt augmentation targeting confidence calibration in MLLMs. A lightweight LLM is trained to produce context-aware auxiliary prompts that guide a downstream task MLLM to generate responses in which the expressed confidence more accurately reflects predictive accuracy. Unlike conventional calibration techniques, Prompt4Trust specifically prioritizes aspects of calibration most critical for safe and trustworthy clinical decision-making. Beyond improvements driven by this clinically motivated calibration objective, our proposed method also improves task accuracy, achieving state-of-the-art medical visual question answering (VQA) performance on the PMC-VQA benchmark, which is composed of multiple-choice questions spanning diverse medical imaging modalities. Moreover, our framework trained with a small downstream task MLLM showed promising zero-shot generalization to larger MLLMs in our experiments, suggesting the potential for scalable calibration without the associated computational costs. This work demonstrates the potential of automated yet human-aligned prompt engineering for improving the the trustworthiness of MLLMs in safety critical settings. Our codebase can be found at https://github.com/xingbpshen/prompt4trust.

This study is dedicated to exploring the application of prompt learning methods to advance Named Entity Recognition (NER) within the medical domain. In recent years, the emergence of large-scale models has driven significant progress in NER tasks, particularly with the introduction of the BioBERT language model, which has greatly enhanced NER capabilities in medical texts. Our research introduces the Prompt-bioMRC model, which integrates both hard template and soft prompt designs aimed at refining the precision and efficiency of medical entity recognition. Through extensive experimentation across diverse medical datasets, our findings consistently demonstrate that our approach surpasses traditional models. This enhancement not only validates the efficacy of our methodology but also highlights its potential to provide reliable technological support for applications like intelligent diagnosis systems. By leveraging advanced NER techniques, this study contributes to advancing automated medical data processing, facilitating more accurate medical information extraction, and supporting efficient healthcare decision-making processes.

Multimodal Large Language Models (MLLMs) are set to transform how machines process and generate human-like responses by integrating diverse modalities such as text, images, and code. Yet, effectively harnessing their capabilities hinges on optimal prompt engineering. We present a comprehensive experimental evaluation of seven prompt engineering methods applied to 13 open-source MLLMs over 24 tasks spanning Reasoning and Compositionality, Multimodal Understanding and Alignment, Complex Code Generation and Execution, and Knowledge Retrieval and Integration. Our approach stratifies models by parameter count into Small (<4B), Medium (4B-10B), and Large (>10B) categories and compares prompting techniques including Zero-Shot, One-Shot, Few-Shot, Chain-of-Thought, Analogical, Generated Knowledge, and Tree-of-Thought. While Large MLLMs excel in structured tasks such as code generation, achieving accuracies up to 96.88% under Few-Shot prompting, all models struggle with complex reasoning and abstract understanding, often yielding accuracies below 60% and high hallucination rates. Structured reasoning prompts frequently increased hallucination up to 75% in small models and led to longer response times (over 20 seconds in Large MLLMs), while simpler prompting methods provided more concise and efficient outputs. No single prompting method uniformly optimises all task types. Instead, adaptive strategies combining example-based guidance with selective structured reasoning are essential to enhance robustness, efficiency, and factual accuracy. Our findings offer practical recommendations for prompt engineering and support more reliable deployment of MLLMs across applications including AI-assisted coding, knowledge retrieval, and multimodal content understanding.

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

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

Large Language Models (LLMs) have demonstrated profound impact on Natural Language Processing (NLP) tasks. However, their effective deployment across diverse domains often require domain-specific adaptation strategies, as generic models may underperform when faced with specialized data distributions. Recent advances in prompt engineering (PE) offer a promising alternative to extensive retraining by refining input instructions to align LLM outputs with task objectives. This paradigm has emerged as a rapid and versatile approach for model fine-tuning. Despite its potential, manual prompt design remains labor-intensive and heavily depends on specialized expertise, often requiring iterative human effort to achieve optimal formulations. To address this limitation, automated prompt engineering methodologies have been developed to systematically generate task-specific prompts. However, current implementations predominantly employ static update rules and lack mechanisms for dynamic strategy selection, resulting in suboptimal adaptation to varying NLP task requirements. Furthermore, most methods treat and update the whole prompts at each step, without considering editing prompt sections at a finer granularity. At last, in particular, the problem of how to recycle experience in LLM is still underexplored. To this end, we propose the PromptFlow, a modular training framework inspired by TensorFlow, which integrates meta-prompts, operators, optimization, and evaluator. Our framework can be equipped with the latest optimization methods and autonomously explores optimal prompt refinement trajectories through gradient-based meta-learning, requiring minimal task-specific training data. Specifically, we devise a reinforcement learning method to recycle experience for LLM in the PE process. Finally, we conduct extensive experiments on various datasets, and demonstrate the effectiveness of PromptFlow.

With the advent of artificial intelligence (AI), many researchers are attempting to extract structured information from document-level biomedical literature by fine-tuning large language models (LLMs). However, they face significant challenges such as the need for expensive hardware, like high-performance GPUs and the high labor costs associated with annotating training datasets, especially in biomedical realm. Recent research on LLMs, such as GPT-4 and Llama3, has shown promising performance in zero-shot settings, inspiring us to explore a novel approach to achieve the same results from unannotated full documents using general LLMs with lower hardware and labor costs. Our approach combines two major stages: named entity recognition (NER) and relation extraction (RE). NER identifies chemical, disease and gene entities from the document with synonym and hypernym extraction using an LLM with a crafted prompt. RE extracts relations between entities based on predefined relation schemas and prompts. To enhance the effectiveness of prompt, we propose a five-part template structure and a scenario-based prompt design principles, along with evaluation method to systematically assess the prompts. Finally, we evaluated our approach against fine-tuning and pre-trained models on two biomedical datasets: ChemDisGene and CDR. The experimental results indicate that our proposed method can achieve comparable accuracy levels to fine-tuning and pre-trained models but with reduced human and hardware expenses.

Objective To solve major clinical natural language processing (NLP) tasks using a unified text-to-text learning architecture based on a generative large language model (LLM) via prompt tuning. Methods We formulated 7 key clinical NLP tasks as text-to-text learning and solved them using one unified generative clinical LLM, GatorTronGPT, developed using GPT-3 architecture and trained with up to 20 billion parameters. We adopted soft prompts (i.e., trainable vectors) with frozen LLM, where the LLM parameters were not updated (i.e., frozen) and only the vectors of soft prompts were updated, known as prompt tuning. We added additional soft prompts as a prefix to the input layer, which were optimized during the prompt tuning. We evaluated the proposed method using 7 clinical NLP tasks and compared them with previous task-specific solutions based on Transformer models. Results and Conclusion The proposed approach achieved state-of-the-art performance for 5 out of 7 major clinical NLP tasks using one unified generative LLM. Our approach outperformed previous task-specific transformer models by ~3% for concept extraction and 7% for relation extraction applied to social determinants of health, 3.4% for clinical concept normalization, 3.4~10% for clinical abbreviation disambiguation, and 5.5~9% for natural language inference. Our approach also outperformed a previously developed prompt-based machine reading comprehension (MRC) model, GatorTron-MRC, for clinical concept and relation extraction. The proposed approach can deliver the ``one model for all`` promise from training to deployment using a unified generative LLM.

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

At the heart of medicine lies the physician-patient dialogue, where skillful history-taking paves the way for accurate diagnosis, effective management, and enduring trust. Artificial Intelligence (AI) systems capable of diagnostic dialogue could increase accessibility, consistency, and quality of care. However, approximating clinicians' expertise is an outstanding grand challenge. Here, we introduce AMIE (Articulate Medical Intelligence Explorer), a Large Language Model (LLM) based AI system optimized for diagnostic dialogue. AMIE uses a novel self-play based simulated environment with automated feedback mechanisms for scaling learning across diverse disease conditions, specialties, and contexts. We designed a framework for evaluating clinically-meaningful axes of performance including history-taking, diagnostic accuracy, management reasoning, communication skills, and empathy. We compared AMIE's performance to that of primary care physicians (PCPs) in a randomized, double-blind crossover study of text-based consultations with validated patient actors in the style of an Objective Structured Clinical Examination (OSCE). The study included 149 case scenarios from clinical providers in Canada, the UK, and India, 20 PCPs for comparison with AMIE, and evaluations by specialist physicians and patient actors. AMIE demonstrated greater diagnostic accuracy and superior performance on 28 of 32 axes according to specialist physicians and 24 of 26 axes according to patient actors. Our research has several limitations and should be interpreted with appropriate caution. Clinicians were limited to unfamiliar synchronous text-chat which permits large-scale LLM-patient interactions but is not representative of usual clinical practice. While further research is required before AMIE could be translated to real-world settings, the results represent a milestone towards conversational diagnostic AI.

Large language models (LLMs) are increasingly envisioned as decision-support tools in clinical practice, yet safe clinical reasoning demands integrating heterogeneous knowledge bases -- trials, primary studies, regulatory documents, and cost data -- under strict accuracy constraints. Existing evaluations often rely on synthetic prompts, reduce the task to single-hop factoid queries, or conflate reasoning with open-ended generation, leaving their real-world utility unclear. To close this gap, we present MedBrowseComp, the first benchmark that systematically tests an agent's ability to reliably retrieve and synthesize multi-hop medical facts from live, domain-specific knowledge bases. MedBrowseComp contains more than 1,000 human-curated questions that mirror clinical scenarios where practitioners must reconcile fragmented or conflicting information to reach an up-to-date conclusion. Applying MedBrowseComp to frontier agentic systems reveals performance shortfalls as low as ten percent, exposing a critical gap between current LLM capabilities and the rigor demanded in clinical settings. MedBrowseComp therefore offers a clear testbed for reliable medical information seeking and sets concrete goals for future model and toolchain upgrades. You can visit our project page at: https://moreirap12.github.io/mbc-browse-app/

In recent years, Large Language Models have garnered significant attention for their strong performance in various natural language tasks, such as machine translation and question answering. These models demonstrate an impressive ability to generalize across diverse tasks. However, their effectiveness in tackling domain-specific tasks, such as financial sentiment analysis and monetary policy understanding, remains a topic of debate, as these tasks often require specialized knowledge and precise reasoning. To address such challenges, researchers design various prompts to unlock the models' abilities. By carefully crafting input prompts, researchers can guide these models to produce more accurate responses. Consequently, prompt engineering has become a key focus of study. Despite the advancements in both models and prompt engineering, the relationship between the two-specifically, how prompt design impacts models' ability to perform domain-specific tasks-remains underexplored. This paper aims to bridge this research gap.

LLMs have gained immense popularity among researchers and the general public for its impressive capabilities on a variety of tasks. Notably, the efficacy of LLMs remains significantly dependent on the quality and structure of the input prompts, making prompt design a critical factor for their performance. Recent advancements in automated prompt optimization have introduced diverse techniques that automatically enhance prompts to better align model outputs with user expectations. However, these methods often suffer from the lack of standardization and compatibility across different techniques, limited flexibility in customization, inconsistent performance across model scales, and they often exclusively rely on expensive proprietary LLM APIs. To fill in this gap, we introduce GREATERPROMPT, a novel framework that democratizes prompt optimization by unifying diverse methods under a unified, customizable API while delivering highly effective prompts for different tasks. Our framework flexibly accommodates various model scales by leveraging both text feedback-based optimization for larger LLMs and internal gradient-based optimization for smaller models to achieve powerful and precise prompt improvements. Moreover, we provide a user-friendly Web UI that ensures accessibility for non-expert users, enabling broader adoption and enhanced performance across various user groups and application scenarios. GREATERPROMPT is available at https://github.com/psunlpgroup/GreaterPrompt via GitHub, PyPI, and web user interfaces.

The recommendation of medication is a vital aspect of intelligent healthcare systems, as it involves prescribing the most suitable drugs based on a patient's specific health needs. Unfortunately, many sophisticated models currently in use tend to overlook the nuanced semantics of medical data, while only relying heavily on identities. Furthermore, these models face significant challenges in handling cases involving patients who are visiting the hospital for the first time, as they lack prior prescription histories to draw upon. To tackle these issues, we harness the powerful semantic comprehension and input-agnostic characteristics of Large Language Models (LLMs). Our research aims to transform existing medication recommendation methodologies using LLMs. In this paper, we introduce a novel approach called Large Language Model Distilling Medication Recommendation (LEADER). We begin by creating appropriate prompt templates that enable LLMs to suggest medications effectively. However, the straightforward integration of LLMs into recommender systems leads to an out-of-corpus issue specific to drugs. We handle it by adapting the LLMs with a novel output layer and a refined tuning loss function. Although LLM-based models exhibit remarkable capabilities, they are plagued by high computational costs during inference, which is impractical for the healthcare sector. To mitigate this, we have developed a feature-level knowledge distillation technique, which transfers the LLM's proficiency to a more compact model. Extensive experiments conducted on two real-world datasets, MIMIC-III and MIMIC-IV, demonstrate that our proposed model not only delivers effective results but also is efficient. To ease the reproducibility of our experiments, we release the implementation code online.

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

In this paper, we conduct a comprehensive SWOT analysis of prompt engineering techniques within the realm of Large Language Models (LLMs). Emphasizing linguistic principles, we examine various techniques to identify their strengths, weaknesses, opportunities, and threats. Our findings provide insights into enhancing AI interactions and improving language model comprehension of human prompts. The analysis covers techniques including template-based approaches and fine-tuning, addressing the problems and challenges associated with each. The conclusion offers future research directions aimed at advancing the effectiveness of prompt engineering in optimizing human-machine communication.

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

Clinical dialogue represents a complex duality requiring both the empathetic fluency of natural conversation and the rigorous precision of evidence-based medicine. While Large Language Models possess unprecedented linguistic capabilities, their architectural reliance on reactive and stateless processing often favors probabilistic plausibility over factual veracity. This structural limitation has catalyzed a paradigm shift in medical AI from generative text prediction to agentic autonomy, where the model functions as a central reasoning engine capable of deliberate planning and persistent memory. Moving beyond existing reviews that primarily catalog downstream applications, this survey provides a first-principles analysis of the cognitive architecture underpinning this shift. We introduce a novel taxonomy structured along the orthogonal axes of knowledge source and agency objective to delineate the provenance of clinical knowledge against the system's operational scope. This framework facilitates a systematic analysis of the intrinsic trade-offs between creativity and reliability by categorizing methods into four archetypes: Latent Space Clinicians, Emergent Planners, Grounded Synthesizers, and Verifiable Workflow Automators. For each paradigm, we deconstruct the technical realization across the entire cognitive pipeline, encompassing strategic planning, memory management, action execution, collaboration, and evolution to reveal how distinct architectural choices balance the tension between autonomy and safety.

Large Language Models (LLMs) exhibit remarkable proficiency in addressing a diverse array of tasks within the Natural Language Processing (NLP) domain, with various prompt design strategies significantly augmenting their capabilities. However, these prompts, while beneficial, each possess inherent limitations. The primary prompt design methodologies are twofold: The first, exemplified by the Chain of Thought (CoT), involves manually crafting prompts specific to individual datasets, hence termed Expert-Designed Prompts (EDPs). Once these prompts are established, they are unalterable, and their effectiveness is capped by the expertise of the human designers. When applied to LLMs, the static nature of EDPs results in a uniform approach to both simple and complex problems within the same dataset, leading to the inefficient use of tokens for straightforward issues. The second method involves prompts autonomously generated by the LLM, known as LLM-Derived Prompts (LDPs), which provide tailored solutions to specific problems, mitigating the limitations of EDPs. However, LDPs may encounter a decline in performance when tackling complex problems due to the potential for error accumulation during the solution planning process. To address these challenges, we have conceived a novel Prompt Recursive Search (PRS) framework that leverages the LLM to generate solutions specific to the problem, thereby conserving tokens. The framework incorporates an assessment of problem complexity and an adjustable structure, ensuring a reduction in the likelihood of errors. We have substantiated the efficacy of PRS framework through extensive experiments using LLMs with different numbers of parameters across a spectrum of datasets in various domains. Compared to the CoT method, the PRS method has increased the accuracy on the BBH dataset by 8% using Llama3-7B model, achieving a 22% improvement.

Despite many advances in knowledge engineering (KE), challenges remain in areas such as engineering knowledge graphs (KGs) at scale, keeping up with evolving domain knowledge, multilingualism, and multimodality. Recently, KE has used LLMs to support semi-automatic tasks, but the most effective use of LLMs to support knowledge engineers across the KE activites is still in its infancy. To explore the vision of LLM copilots for KE and change existing KE practices, we conducted a multimethod study during a KE hackathon. We investigated participants' views on the use of LLMs, the challenges they face, the skills they may need to integrate LLMs into their practices, and how they use LLMs responsibly. We found participants felt LLMs could contribute to improving efficiency when engineering KGs, but presented increased challenges around the already complex issues of evaluating the KE tasks. We discovered prompting to be a useful but undervalued skill for knowledge engineers working with LLMs, and note that natural language processing skills may become more relevant across more roles in KG construction. Integrating LLMs into KE tasks needs to be mindful of potential risks and harms related to responsible AI. Given the limited ethical training, most knowledge engineers receive solutions such as our suggested `KG cards' based on data cards could be a useful guide for KG construction. Our findings can support designers of KE AI copilots, KE researchers, and practitioners using advanced AI to develop trustworthy applications, propose new methodologies for KE and operate new technologies responsibly.

In recent years, the rise of Large Language Models (LLMs) has spurred a growing demand for plug-and-play AI systems. Among the various AI techniques, prompt engineering stands out as particularly significant. However, users often face challenges in writing prompts due to the steep learning curve and significant time investment, and existing automatic prompt engineering (APE) models can be difficult to use. To address this issue, we propose PAS, an LLM-based plug-and-play APE system. PAS utilizes LLMs trained on high-quality, automatically generated prompt complementary datasets, resulting in exceptional performance. In comprehensive benchmarks, PAS achieves state-of-the-art (SoTA) results compared to previous APE models, with an average improvement of 6.09 points. Moreover, PAS is highly efficient, achieving SoTA performance with only 9000 data points. Additionally, PAS can autonomously generate prompt augmentation data without requiring additional human labor. Its flexibility also allows it to be compatible with all existing LLMs and applicable to a wide range of tasks. PAS excels in human evaluations, underscoring its suitability as a plug-in for users. This combination of high performance, efficiency, and flexibility makes PAS a valuable system for enhancing the usability and effectiveness of LLMs through improved prompt engineering.

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.

LLMs have become increasingly capable at accomplishing a range of specialized-tasks and can be utilized to expand equitable access to medical knowledge. Most medical LLMs have involved extensive fine-tuning, leveraging specialized medical data and significant, thus costly, amounts of computational power. Many of the top performing LLMs are proprietary and their access is limited to very few research groups. However, open-source (OS) models represent a key area of growth for medical LLMs due to significant improvements in performance and an inherent ability to provide the transparency and compliance required in healthcare. We present OpenMedLM, a prompting platform which delivers state-of-the-art (SOTA) performance for OS LLMs on medical benchmarks. We evaluated a range of OS foundation LLMs (7B-70B) on four medical benchmarks (MedQA, MedMCQA, PubMedQA, MMLU medical-subset). We employed a series of prompting strategies, including zero-shot, few-shot, chain-of-thought (random selection and kNN selection), and ensemble/self-consistency voting. We found that OpenMedLM delivers OS SOTA results on three common medical LLM benchmarks, surpassing the previous best performing OS models that leveraged computationally costly extensive fine-tuning. The model delivers a 72.6% accuracy on the MedQA benchmark, outperforming the previous SOTA by 2.4%, and achieves 81.7% accuracy on the MMLU medical-subset, establishing itself as the first OS LLM to surpass 80% accuracy on this benchmark. Our results highlight medical-specific emergent properties in OS LLMs which have not yet been documented to date elsewhere, and showcase the benefits of further leveraging prompt engineering to improve the performance of accessible LLMs for medical applications.

Unstructured clinical notes contain essential patient information but are challenging for physicians to search and interpret efficiently. Although large language models (LLMs) have shown promise in question answering (QA), most existing systems lack transparency, usability, and alignment with clinical workflows. This work introduces an interactive QA system that enables physicians to query clinical notes via text or voice and receive extractive answers highlighted directly in the note for traceability. The system was built using OpenAI models with zero-shot prompting and evaluated across multiple metrics, including exact string match, word overlap, SentenceTransformer similarity, and BERTScore. Results show that while exact match scores ranged from 47 to 62 percent, semantic similarity scores exceeded 87 percent, indicating strong contextual alignment even when wording varied. To assess usability, the system was also evaluated using simulated clinical personas. Seven diverse physician and nurse personas interacted with the system across scenario-based tasks and provided structured feedback. The evaluations highlighted strengths in intuitive design and answer accessibility, alongside opportunities for enhancing explanation clarity.

Prompt engineering is critical for the development of LLM-based applications. However, it is usually done manually in a "trial and error" fashion. This manual procedure can be time consuming, ineffective, and the generated prompts are, in a lot of cases, sub-optimal. Even for the prompts which seemingly work well, there is always a lingering question: can the prompts be made better with further modifications? To address these questions, in this paper, we investigate prompt engineering automation. We consider a specific use case scenario in which developers/users have drafted initial prompts, but lack the time/expertise to optimize them. We propose PRewrite, an automated tool to rewrite these drafts and to generate highly effective new prompts. PRewrite is based on the Reinforcement Learning (RL) framework which allows for end-to-end optimization and our design allows the RL search to happen in a large action space. The automated tool leverages manually crafted prompts as starting points which makes the rewriting procedure more guided and efficient. The generated prompts are human readable, and self-explanatory, unlike some of those in previous works. We conducted extensive experiments on diverse datasets and found that the prompts generated with this new method not only outperform professionally crafted prompts, but also prompts generated with other previously proposed methods.

Recent advances in large language models (LLMs) have led to their popularity across multiple use-cases. However, prompt engineering, the process for optimally utilizing such models, remains approximation-driven and subjective. Most of the current research on prompt engineering focuses on task-specific optimization, while neglecting the behavior of the LLM under consideration during prompt development. This paper introduces MODP -- Multi Objective Directional Prompting, a framework based on two key concepts: 1) multi-objectivity: the importance of considering an LLM's intrinsic behavior as an additional objective in prompt development, and 2) directional prompting: a metrics-driven method for prompt engineering to ensure development of robust and high-precision prompts. We demonstrate the effectiveness of our proposed ideas on a summarization task, using a synthetically created dataset, achieving a 26% performance gain over initial prompts. Finally, we apply MODP to develop prompts for Dell's Next Best Action support tool, which is now in production and is used by more than 10,000 internal support agents and serving millions of customers worldwide.

Generative Artificial Intelligence (GenAI) systems are being increasingly deployed across all parts of industry and research settings. Developers and end users interact with these systems through the use of prompting or prompt engineering. While prompting is a widespread and highly researched concept, there exists conflicting terminology and a poor ontological understanding of what constitutes a prompt due to the area's nascency. This paper establishes a structured understanding of prompts, by assembling a taxonomy of prompting techniques and analyzing their use. We present a comprehensive vocabulary of 33 vocabulary terms, a taxonomy of 58 text-only prompting techniques, and 40 techniques for other modalities. We further present a meta-analysis of the entire literature on natural language prefix-prompting.

With the advancement of telemedicine, both researchers and medical practitioners are working hand-in-hand to develop various techniques to automate various medical operations, such as diagnosis report generation. In this paper, we first present a multi-modal clinical conversation summary generation task that takes a clinician-patient interaction (both textual and visual information) and generates a succinct synopsis of the conversation. We propose a knowledge-infused, multi-modal, multi-tasking medical domain identification and clinical conversation summary generation (MM-CliConSummation) framework. It leverages an adapter to infuse knowledge and visual features and unify the fused feature vector using a gated mechanism. Furthermore, we developed a multi-modal, multi-intent clinical conversation summarization corpus annotated with intent, symptom, and summary. The extensive set of experiments, both quantitatively and qualitatively, led to the following findings: (a) critical significance of visuals, (b) more precise and medical entity preserving summary with additional knowledge infusion, and (c) a correlation between medical department identification and clinical synopsis generation. Furthermore, the dataset and source code are available at https://github.com/NLP-RL/MM-CliConSummation.

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

The effectiveness of large language models (LLMs) is closely tied to the design of prompts, making prompt optimization essential for enhancing their performance across a wide range of tasks. Many existing approaches to automating prompt engineering rely exclusively on textual feedback, refining prompts based solely on inference errors identified by large, computationally expensive LLMs. Unfortunately, smaller models struggle to generate high-quality feedback, resulting in complete dependence on large LLM judgment. Moreover, these methods fail to leverage more direct and finer-grained information, such as gradients, due to operating purely in text space. To this end, we introduce GReaTer, a novel prompt optimization technique that directly incorporates gradient information over task-specific reasoning. By utilizing task loss gradients, GReaTer enables self-optimization of prompts for open-source, lightweight language models without the need for costly closed-source LLMs. This allows high-performance prompt optimization without dependence on massive LLMs, closing the gap between smaller models and the sophisticated reasoning often needed for prompt refinement. Extensive evaluations across diverse reasoning tasks including BBH, GSM8k, and FOLIO demonstrate that GReaTer consistently outperforms previous state-of-the-art prompt optimization methods, even those reliant on powerful LLMs. Additionally, GReaTer-optimized prompts frequently exhibit better transferability and, in some cases, boost task performance to levels comparable to or surpassing those achieved by larger language models, highlighting the effectiveness of prompt optimization guided by gradients over reasoning. Code of GReaTer is available at https://github.com/psunlpgroup/GreaTer.

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

VR simulation in Health Professions (HP) education demonstrates huge potential, but fixed learning content with little customization limits its application beyond lab environments. To address these limitations in the context of VR for patient communication training, we conducted a user-centered study involving semi-structured interviews with advanced HP students to understand their challenges in clinical communication training and perceptions of VR-based solutions. From this, we derived design insights emphasizing the importance of realistic scenarios, simple interactions, and unpredictable dialogues. Building on these insights, we developed the Virtual AI Patient Simulator (VAPS), a novel VR system powered by Large Language Models (LLMs) and Embodied Conversational Agents (ECAs), supporting dynamic and customizable patient interactions for immersive learning. We also provided an example of how clinical professors could use user-friendly design forms to create personalized scenarios that align with course objectives in VAPS and discuss future implications of integrating AI-driven technologies into VR education.

Recent advancements in large language models (LLMs) have enabled a wide range of natural language processing (NLP) tasks to be performed through simple prompt-based interactions. Consequently, several approaches have been proposed to engineer prompts that most effectively enable LLMs to perform a given task (e.g., chain-of-thought prompting). In settings with a well-defined metric to optimize model performance, automatic prompt optimization (APO) methods have been developed to refine a seed prompt. Advancing this line of research, we propose APIO, a simple but effective prompt induction and optimization approach for the tasks of Grammatical Error Correction (GEC) and Text Simplification, without relying on manually specified seed prompts. APIO achieves a new state-of-the-art performance for purely LLM-based prompting methods on these tasks. We make our data, code, prompts, and outputs publicly available.

Large Language Models (LLMs) and multi-agent systems have shown impressive capabilities in natural language tasks but face challenges in clinical trial applications, primarily due to limited access to external knowledge. Recognizing the potential of advanced clinical trial tools that aggregate and predict based on the latest medical data, we propose an integrated solution to enhance their accessibility and utility. We introduce Clinical Agent System (ClinicalAgent), a clinical multi-agent system designed for clinical trial tasks, leveraging GPT-4, multi-agent architectures, LEAST-TO-MOST, and ReAct reasoning technology. This integration not only boosts LLM performance in clinical contexts but also introduces novel functionalities. The proposed method achieves competitive predictive performance in clinical trial outcome prediction (0.7908 PR-AUC), obtaining a 0.3326 improvement over the standard prompt Method. Publicly available code can be found at https://anonymous.4open.science/r/ClinicalAgent-6671.

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

Extracting patient information from unstructured text is a critical task in health decision-support and clinical research. Large language models (LLMs) have shown the potential to accelerate clinical curation via few-shot in-context learning, in contrast to supervised learning which requires much more costly human annotations. However, despite drastic advances in modern LLMs such as GPT-4, they still struggle with issues regarding accuracy and interpretability, especially in mission-critical domains such as health. Here, we explore a general mitigation framework using self-verification, which leverages the LLM to provide provenance for its own extraction and check its own outputs. This is made possible by the asymmetry between verification and generation, where the latter is often much easier than the former. Experimental results show that our method consistently improves accuracy for various LLMs in standard clinical information extraction tasks. Additionally, self-verification yields interpretations in the form of a short text span corresponding to each output, which makes it very efficient for human experts to audit the results, paving the way towards trustworthy extraction of clinical information in resource-constrained scenarios. To facilitate future research in this direction, we release our code and prompts.

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.

Automatic medical report generation (MRG) is of great research value as it has the potential to relieve radiologists from the heavy burden of report writing. Despite recent advancements, accurate MRG remains challenging due to the need for precise clinical understanding and the identification of clinical findings. Moreover, the imbalanced distribution of diseases makes the challenge even more pronounced, as rare diseases are underrepresented in training data, making their diagnostic performance unreliable. To address these challenges, we propose diagnosis-driven prompts for medical report generation (PromptMRG), a novel framework that aims to improve the diagnostic accuracy of MRG with the guidance of diagnosis-aware prompts. Specifically, PromptMRG is based on encoder-decoder architecture with an extra disease classification branch. When generating reports, the diagnostic results from the classification branch are converted into token prompts to explicitly guide the generation process. To further improve the diagnostic accuracy, we design cross-modal feature enhancement, which retrieves similar reports from the database to assist the diagnosis of a query image by leveraging the knowledge from a pre-trained CLIP. Moreover, the disease imbalanced issue is addressed by applying an adaptive logit-adjusted loss to the classification branch based on the individual learning status of each disease, which overcomes the barrier of text decoder's inability to manipulate disease distributions. Experiments on two MRG benchmarks show the effectiveness of the proposed method, where it obtains state-of-the-art clinical efficacy performance on both datasets.

Background: Large language models (LLMs) are trained to follow directions, but this introduces a vulnerability to blindly comply with user requests even if they generate wrong information. In medicine, this could accelerate the generation of misinformation that impacts human well-being. Objectives/Methods: We analyzed compliance to requests to generate misleading content about medications in settings where models know the request is illogical. We investigated whether in-context directions and instruction-tuning of LLMs to prioritize logical reasoning over compliance reduced misinformation risk. Results: While all frontier LLMs complied with misinformation requests, both prompt-based and parameter-based approaches can improve the detection of logic flaws in requests and prevent the dissemination of medical misinformation. Conclusion: Shifting LLMs to prioritize logic over compliance could reduce risks of exploitation for medical misinformation.

In autoregressive (AR) image generation, models based on the 'next-token prediction' paradigm of LLMs have shown comparable performance to diffusion models by reducing inductive biases. However, directly applying LLMs to complex image generation can struggle with reconstructing the image's structure and details, impacting the generation's accuracy and stability. Additionally, the 'next-token prediction' paradigm in the AR model does not align with the contextual scanning and logical reasoning processes involved in human visual perception, limiting effective image generation. Prompt engineering, as a key technique for guiding LLMs, leverages specifically designed prompts to improve model performance on complex natural language processing (NLP) tasks, enhancing accuracy and stability of generation while maintaining contextual coherence and logical consistency, similar to human reasoning. Inspired by prompt engineering from the field of NLP, we propose Vision Full-view prompt (VF prompt) to enhance autoregressive image generation. Specifically, we design specialized image-related VF prompts for AR image generation to simulate the process of human image creation. This enhances contextual logic ability by allowing the model to first perceive overall distribution information before generating the image, and improve generation stability by increasing the inference steps. Compared to the AR method without VF prompts, our method shows outstanding performance and achieves an approximate improvement of 20%.

In this paper, we present a localized and culturally adapted Estonian translation of the test set from the widely used commonsense reasoning benchmark, WinoGrande. We detail the translation and adaptation process carried out by translation specialists and evaluate the performance of both proprietary and open source models on the human translated benchmark. Additionally, we explore the feasibility of achieving high-quality machine translation by incorporating insights from the manual translation process into the design of a detailed prompt. This prompt is specifically tailored to address both the linguistic characteristics of Estonian and the unique translation challenges posed by the WinoGrande dataset. Our findings show that model performance on the human translated Estonian dataset is slightly lower than on the original English test set, while performance on machine-translated data is notably worse. Additionally, our experiments indicate that prompt engineering offers limited improvement in translation quality or model accuracy, and highlight the importance of involving language specialists in dataset translation and adaptation to ensure reliable and interpretable evaluations of language competency and reasoning in large language models.

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

Despite impressive recent advances in text-to-image diffusion models, obtaining high-quality images often requires prompt engineering by humans who have developed expertise in using them. In this work, we present NeuroPrompts, an adaptive framework that automatically enhances a user's prompt to improve the quality of generations produced by text-to-image models. Our framework utilizes constrained text decoding with a pre-trained language model that has been adapted to generate prompts similar to those produced by human prompt engineers. This approach enables higher-quality text-to-image generations and provides user control over stylistic features via constraint set specification. We demonstrate the utility of our framework by creating an interactive application for prompt enhancement and image generation using Stable Diffusion. Additionally, we conduct experiments utilizing a large dataset of human-engineered prompts for text-to-image generation and show that our approach automatically produces enhanced prompts that result in superior image quality. We make our code, a screencast video demo and a live demo instance of NeuroPrompts publicly available.

The field of natural language processing (NLP) has witnessed significant progress in recent years, with a notable focus on improving large language models' (LLM) performance through innovative prompting techniques. Among these, prompt engineering coupled with structures has emerged as a promising paradigm, with designs such as Chain-of-Thought, Tree of Thoughts, or Graph of Thoughts, in which the overall LLM reasoning is guided by a structure such as a graph. As illustrated with numerous examples, this paradigm significantly enhances the LLM's capability to solve numerous tasks, ranging from logical or mathematical reasoning to planning or creative writing. To facilitate the understanding of this growing field and pave the way for future developments, we devise a general blueprint for effective and efficient LLM reasoning schemes. For this, we conduct an in-depth analysis of the prompt execution pipeline, clarifying and clearly defining different concepts. We then build the first taxonomy of structure-enhanced LLM reasoning schemes. We focus on identifying fundamental classes of harnessed structures, and we analyze the representations of these structures, algorithms executed with these structures, and many others. We refer to these structures as reasoning topologies, because their representation becomes to a degree spatial, as they are contained within the LLM context. Our study compares existing prompting schemes using the proposed taxonomy, discussing how certain design choices lead to different patterns in performance and cost. We also outline theoretical underpinnings, relationships between prompting and others parts of the LLM ecosystem such as knowledge bases, and the associated research challenges. Our work will help to advance future prompt engineering techniques.

Critical peer review of scientific manuscripts presents a significant challenge for Large Language Models (LLMs), partly due to data limitations and the complexity of expert reasoning. This report introduces Persistent Workflow Prompting (PWP), a potentially broadly applicable prompt engineering methodology designed to bridge this gap using standard LLM chat interfaces (zero-code, no APIs). We present a proof-of-concept PWP prompt for the critical analysis of experimental chemistry manuscripts, featuring a hierarchical, modular architecture (structured via Markdown) that defines detailed analysis workflows. We develop this PWP prompt through iterative application of meta-prompting techniques and meta-reasoning aimed at systematically codifying expert review workflows, including tacit knowledge. Submitted once at the start of a session, this PWP prompt equips the LLM with persistent workflows triggered by subsequent queries, guiding modern reasoning LLMs through systematic, multimodal evaluations. Demonstrations show the PWP-guided LLM identifying major methodological flaws in a test case while mitigating LLM input bias and performing complex tasks, including distinguishing claims from evidence, integrating text/photo/figure analysis to infer parameters, executing quantitative feasibility checks, comparing estimates against claims, and assessing a priori plausibility. To ensure transparency and facilitate replication, we provide full prompts, detailed demonstration analyses, and logs of interactive chats as supplementary resources. Beyond the specific application, this work offers insights into the meta-development process itself, highlighting the potential of PWP, informed by detailed workflow formalization, to enable sophisticated analysis using readily available LLMs for complex scientific tasks.

Prompt engineering can significantly improve the performance of large language models (LLMs), with automated prompt optimization (APO) gaining significant attention due to the time-consuming and laborious nature of manual prompt design. However, much of the existing work in APO overlooks task-specific characteristics, resulting in prompts that lack domain specificity and are not well-suited for task-specific optimization. In this paper, we introduce TAPO, a multitask-aware prompt optimization framework composed of three key modules. First, a task-aware metric selection module is proposed to enhance task-specific prompt generation capabilities. Second, we present a multi-metrics evaluation module to jointly evaluate prompts from multiple perspectives. Third, an evolution-based optimization framework is introduced for automatic prompt refinement, which improves adaptability across various tasks. Extensive experiments on six datasets demonstrate the effectiveness of our approach, and our code is publicly available.

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

This study investigates GPT-4's assessment of its performance in healthcare applications. A simple prompting technique was used to prompt the LLM with questions taken from the United States Medical Licensing Examination (USMLE) questionnaire and it was tasked to evaluate its confidence score before posing the question and after asking the question. The questionnaire was categorized into two groups-questions with feedback (WF) and questions with no feedback(NF) post-question. The model was asked to provide absolute and relative confidence scores before and after each question. The experimental findings were analyzed using statistical tools to study the variability of confidence in WF and NF groups. Additionally, a sequential analysis was conducted to observe the performance variation for the WF and NF groups. Results indicate that feedback influences relative confidence but doesn't consistently increase or decrease it. Understanding the performance of LLM is paramount in exploring its utility in sensitive areas like healthcare. This study contributes to the ongoing discourse on the reliability of AI, particularly of LLMs like GPT-4, within healthcare, offering insights into how feedback mechanisms might be optimized to enhance AI-assisted medical education and decision support.

Prompt engineering is a new paradigm for enhancing the performance of trained neural network models. For optimizing text-style prompts, existing methods usually individually operate small portions of a text step by step, which either breaks the fluency or could not globally adjust a prompt. Since large language models (LLMs) have powerful ability of generating coherent texts token by token, can we utilize LLMs for improving prompts? Based on this motivation, in this paper, considering a trained LLM as a text generator, we attempt to design a black-box evolution algorithm for automatically optimizing texts, namely SPELL (Semantic Prompt Evolution based on a LLM). The proposed method is evaluated with different LLMs and evolution parameters in different text tasks. Experimental results show that SPELL could rapidly improve the prompts indeed. We further explore the evolution process and discuss on the limitations, potential possibilities and future work.

The rapid advancement of large language models (LLMs) has significantly impacted various domains, including healthcare and biomedicine. However, the phenomenon of hallucination, where LLMs generate outputs that deviate from factual accuracy or context, poses a critical challenge, especially in high-stakes domains. This paper conducts a scoping study of existing techniques for mitigating hallucinations in knowledge-based task in general and especially for medical domains. Key methods covered in the paper include Retrieval-Augmented Generation (RAG)-based techniques, iterative feedback loops, supervised fine-tuning, and prompt engineering. These techniques, while promising in general contexts, require further adaptation and optimization for the medical domain due to its unique demands for up-to-date, specialized knowledge and strict adherence to medical guidelines. Addressing these challenges is crucial for developing trustworthy AI systems that enhance clinical decision-making and patient safety as well as accuracy of biomedical scientific research.

Prompt engineering has emerged as a powerful technique for optimizing large language models (LLMs) for specific applications, enabling faster prototyping and improved performance, and giving rise to the interest of the community in protecting proprietary system prompts. In this work, we explore a novel perspective on prompt privacy through the lens of membership inference. We develop Prompt Detective, a statistical method to reliably determine whether a given system prompt was used by a third-party language model. Our approach relies on a statistical test comparing the distributions of two groups of model outputs corresponding to different system prompts. Through extensive experiments with a variety of language models, we demonstrate the effectiveness of Prompt Detective for prompt membership inference. Our work reveals that even minor changes in system prompts manifest in distinct response distributions, enabling us to verify prompt usage with statistical significance.

Pre-trained large vision-language models (VLMs) like CLIP have revolutionized visual representation learning using natural language as supervisions, and demonstrated promising generalization ability. In this work, we propose ViP, a novel visual symptom-guided prompt learning framework for medical image analysis, which facilitates general knowledge transfer from CLIP. ViP consists of two key components: a visual symptom generator (VSG) and a dual-prompt network. Specifically, VSG aims to extract explicable visual symptoms from pre-trained large language models, while the dual-prompt network utilizes these visual symptoms to guide the training on two learnable prompt modules, i.e., context prompt and merge prompt, which effectively adapts our framework to medical image analysis via large VLMs. Extensive experimental results demonstrate that ViP can outperform state-of-the-art methods on two challenging datasets.

The latest large language models (LLMs) such as ChatGPT, exhibit strong capabilities in automated mental health analysis. However, existing relevant studies bear several limitations, including inadequate evaluations, lack of prompting strategies, and ignorance of exploring LLMs for explainability. To bridge these gaps, we comprehensively evaluate the mental health analysis and emotional reasoning ability of LLMs on 11 datasets across 5 tasks. We explore the effects of different prompting strategies with unsupervised and distantly supervised emotional information. Based on these prompts, we explore LLMs for interpretable mental health analysis by instructing them to generate explanations for each of their decisions. We convey strict human evaluations to assess the quality of the generated explanations, leading to a novel dataset with 163 human-assessed explanations. We benchmark existing automatic evaluation metrics on this dataset to guide future related works. According to the results, ChatGPT shows strong in-context learning ability but still has a significant gap with advanced task-specific methods. Careful prompt engineering with emotional cues and expert-written few-shot examples can also effectively improve performance on mental health analysis. In addition, ChatGPT generates explanations that approach human performance, showing its great potential in explainable mental health analysis.

The first generation of Large Language Models - what might be called "Act I" of generative AI (2020-2023) - achieved remarkable success through massive parameter and data scaling, yet exhibited fundamental limitations in knowledge latency, shallow reasoning, and constrained cognitive processes. During this era, prompt engineering emerged as our primary interface with AI, enabling dialogue-level communication through natural language. We now witness the emergence of "Act II" (2024-present), where models are transitioning from knowledge-retrieval systems (in latent space) to thought-construction engines through test-time scaling techniques. This new paradigm establishes a mind-level connection with AI through language-based thoughts. In this paper, we clarify the conceptual foundations of cognition engineering and explain why this moment is critical for its development. We systematically break down these advanced approaches through comprehensive tutorials and optimized implementations, democratizing access to cognition engineering and enabling every practitioner to participate in AI's second act. We provide a regularly updated collection of papers on test-time scaling in the GitHub Repository: https://github.com/GAIR-NLP/cognition-engineering

Recently, prompt-tuning has achieved promising results for specific few-shot classification tasks. The core idea of prompt-tuning is to insert text pieces (i.e., templates) into the input and transform a classification task into a masked language modeling problem. However, for relation extraction, determining an appropriate prompt template requires domain expertise, and it is cumbersome and time-consuming to obtain a suitable label word. Furthermore, there exists abundant semantic and prior knowledge among the relation labels that cannot be ignored. To this end, we focus on incorporating knowledge among relation labels into prompt-tuning for relation extraction and propose a Knowledge-aware Prompt-tuning approach with synergistic optimization (KnowPrompt). Specifically, we inject latent knowledge contained in relation labels into prompt construction with learnable virtual type words and answer words. Then, we synergistically optimize their representation with structured constraints. Extensive experimental results on five datasets with standard and low-resource settings demonstrate the effectiveness of our approach. Our code and datasets are available in https://github.com/zjunlp/KnowPrompt for reproducibility.

Specialized clinical AI assistants are rapidly entering medical practice, often framed as safer or more reliable than general-purpose large language models (LLMs). Yet, unlike frontier models, these clinical tools are rarely subjected to independent, quantitative evaluation, creating a critical evidence gap despite their growing influence on diagnosis, triage, and guideline interpretation. We assessed two widely deployed clinical AI systems (OpenEvidence and UpToDate Expert AI) against three state-of-the-art generalist LLMs (GPT-5, Gemini 3 Pro, and Claude Sonnet 4.5) using a 1,000-item mini-benchmark combining MedQA (medical knowledge) and HealthBench (clinician-alignment) tasks. Generalist models consistently outperformed clinical tools, with GPT-5 achieving the highest scores, while OpenEvidence and UpToDate demonstrated deficits in completeness, communication quality, context awareness, and systems-based safety reasoning. These findings reveal that tools marketed for clinical decision support may often lag behind frontier LLMs, underscoring the urgent need for transparent, independent evaluation before deployment in patient-facing workflows.

Large language models (LLMs) have the potential to transform medicine, but real-world clinical scenarios contain extraneous information that can hinder performance. The rise of assistive technologies like ambient dictation, which automatically generates draft notes from live patient encounters, has the potential to introduce additional noise making it crucial to assess the ability of LLM's to filter relevant data. To investigate this, we developed MedDistractQA, a benchmark using USMLE-style questions embedded with simulated real-world distractions. Our findings show that distracting statements (polysemous words with clinical meanings used in a non-clinical context or references to unrelated health conditions) can reduce LLM accuracy by up to 17.9%. Commonly proposed solutions to improve model performance such as retrieval-augmented generation (RAG) and medical fine-tuning did not change this effect and in some cases introduced their own confounders and further degraded performance. Our findings suggest that LLMs natively lack the logical mechanisms necessary to distinguish relevant from irrelevant clinical information, posing challenges for real-world applications. MedDistractQA and our results highlights the need for robust mitigation strategies to enhance LLM resilience to extraneous information.

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

In this paper, we propose a novel text promptable surgical instrument segmentation approach to overcome challenges associated with diversity and differentiation of surgical instruments in minimally invasive surgeries. We redefine the task as text promptable, thereby enabling a more nuanced comprehension of surgical instruments and adaptability to new instrument types. Inspired by recent advancements in vision-language models, we leverage pretrained image and text encoders as our model backbone and design a text promptable mask decoder consisting of attention- and convolution-based prompting schemes for surgical instrument segmentation prediction. Our model leverages multiple text prompts for each surgical instrument through a new mixture of prompts mechanism, resulting in enhanced segmentation performance. Additionally, we introduce a hard instrument area reinforcement module to improve image feature comprehension and segmentation precision. Extensive experiments on EndoVis2017 and EndoVis2018 datasets demonstrate our model's superior performance and promising generalization capability. To our knowledge, this is the first implementation of a promptable approach to surgical instrument segmentation, offering significant potential for practical application in the field of robotic-assisted surgery.

Current Large Language Models (LLMs) exhibit significant limitations, notably in structured, interpretable, and verifiable medical reasoning, alongside practical deployment challenges related to computational resources and data privacy. This report focused on the development of WiNGPT-3.0, the 32-billion parameter LLMs, engineered with the objective of enhancing its capacity for medical reasoning and exploring its potential for effective integration within healthcare IT infrastructures. The broader aim is to advance towards clinically applicable models. The approach involved a multi-stage training pipeline tailored for general, medical, and clinical reasoning. This pipeline incorporated supervised fine-tuning (SFT) and reinforcement learning (RL), leveraging curated Long Chain-of-Thought (CoT) datasets, auxiliary reward models, and an evidence-based diagnostic chain simulation. WiNGPT-3.0 demonstrated strong performance: specific model variants achieved scores of 66.6 on MedCalc and 87.1 on MedQA-USMLE. Furthermore, targeted training improved performance on a clinical reasoning task from a baseline score of 58.1 to 62.5. These findings suggest that reinforcement learning, even when applied with a limited dataset of only a few thousand examples, can enhance medical reasoning accuracy. Crucially, this demonstration of RL's efficacy with limited data and computation paves the way for more trustworthy and practically deployable LLMs within clinical workflows and health information infrastructures.

Objectives: While Large Language Models (LLMs) have been widely used to assist clinicians and support patients, no existing work has explored dialogue systems for standard diagnostic interviews and assessments. This study aims to bridge the gap in mental healthcare accessibility by developing an LLM-powered dialogue system that replicates clinician behavior. Materials and Methods: We introduce TRUST, a framework of cooperative LLM modules capable of conducting formal diagnostic interviews and assessments for Post-Traumatic Stress Disorder (PTSD). To guide the generation of appropriate clinical responses, we propose a Dialogue Acts schema specifically designed for clinical interviews. Additionally, we develop a patient simulation approach based on real-life interview transcripts to replace time-consuming and costly manual testing by clinicians. Results: A comprehensive set of evaluation metrics is designed to assess the dialogue system from both the agent and patient simulation perspectives. Expert evaluations by conversation and clinical specialists show that TRUST performs comparably to real-life clinical interviews. Discussion: Our system performs at the level of average clinicians, with room for future enhancements in communication styles and response appropriateness. Conclusions: Our TRUST framework shows its potential to facilitate mental healthcare availability.

Pre-trained vision-language models, e.g., CLIP, working with manually designed prompts have demonstrated great capacity of transfer learning. Recently, learnable prompts achieve state-of-the-art performance, which however are prone to overfit to seen classes, failing to generalize to unseen classes. In this paper, we propose a Knowledge-Aware Prompt Tuning (KAPT) framework for vision-language models. Our approach takes inspiration from human intelligence in which external knowledge is usually incorporated into recognizing novel categories of objects. Specifically, we design two complementary types of knowledge-aware prompts for the text encoder to leverage the distinctive characteristics of category-related external knowledge. The discrete prompt extracts the key information from descriptions of an object category, and the learned continuous prompt captures overall contexts. We further design an adaptation head for the visual encoder to aggregate salient attentive visual cues, which establishes discriminative and task-aware visual representations. We conduct extensive experiments on 11 widely-used benchmark datasets and the results verify the effectiveness in few-shot image classification, especially in generalizing to unseen categories. Compared with the state-of-the-art CoCoOp method, KAPT exhibits favorable performance and achieves an absolute gain of 3.22% on new classes and 2.57% in terms of harmonic mean.

By conditioning on natural language instructions, large language models (LLMs) have displayed impressive capabilities as general-purpose computers. However, task performance depends significantly on the quality of the prompt used to steer the model, and most effective prompts have been handcrafted by humans. Inspired by classical program synthesis and the human approach to prompt engineering, we propose Automatic Prompt Engineer (APE) for automatic instruction generation and selection. In our method, we treat the instruction as the "program," optimized by searching over a pool of instruction candidates proposed by an LLM in order to maximize a chosen score function. To evaluate the quality of the selected instruction, we evaluate the zero-shot performance of another LLM following the selected instruction. Experiments on 24 NLP tasks show that our automatically generated instructions outperform the prior LLM baseline by a large margin and achieve better or comparable performance to the instructions generated by human annotators on 19/24 tasks. We conduct extensive qualitative and quantitative analyses to explore the performance of APE. We show that APE-engineered prompts can be applied to steer models toward truthfulness and/or informativeness, as well as to improve few-shot learning performance by simply prepending them to standard in-context learning prompts. Please check out our webpage at https://sites.google.com/view/automatic-prompt-engineer.

Clinical evidence, derived from rigorous research and data analysis, provides healthcare professionals with reliable scientific foundations for informed decision-making. Integrating clinical evidence into real-time practice is challenging due to the enormous workload, complex professional processes, and time constraints. This highlights the need for tools that automate evidence synthesis to support more efficient and accurate decision making in clinical settings. This study introduces Quicker, an evidence-based clinical decision support system powered by large language models (LLMs), designed to automate evidence synthesis and generate clinical recommendations modeled after standard clinical guideline development processes. Quicker implements a fully automated chain that covers all phases, from questions to clinical recommendations, and further enables customized decision-making through integrated tools and interactive user interfaces. To evaluate Quicker's capabilities, we developed the Q2CRBench-3 benchmark dataset, based on clinical guideline development records for three different diseases. Experimental results highlighted Quicker's strong performance, with fine-grained question decomposition tailored to user preferences, retrieval sensitivities comparable to human experts, and literature screening performance approaching comprehensive inclusion of relevant studies. In addition, Quicker-assisted evidence assessment effectively supported human reviewers, while Quicker's recommendations were more comprehensive and logically coherent than those of clinicians. In system-level testing, collaboration between a single reviewer and Quicker reduced the time required for recommendation development to 20-40 minutes. In general, our findings affirm the potential of Quicker to help physicians make quicker and more reliable evidence-based clinical decisions.

Although large language models (LLMs) have demonstrated impressive reasoning capabilities across general domains, their effectiveness in real-world clinical practice remains limited. This is likely due to their insufficient exposure to real-world clinical data during training, as such data is typically not included due to privacy concerns. To address this, we propose enhancing the clinical reasoning capabilities of LLMs by leveraging real-world clinical data. We constructed reasoning-intensive questions from a nationwide sepsis registry and fine-tuned Phi-4 on these questions using reinforcement learning, resulting in C-Reason. C-Reason exhibited strong clinical reasoning capabilities on the in-domain test set, as evidenced by both quantitative metrics and expert evaluations. Furthermore, its enhanced reasoning capabilities generalized to a sepsis dataset involving different tasks and patient cohorts, an open-ended consultations on antibiotics use task, and other diseases. Future research should focus on training LLMs with large-scale, multi-disease clinical datasets to develop more powerful, general-purpose clinical reasoning models.

Recent advancements in large language models (LLMs) have raised concerns about inference costs, increasing the need for research into model compression. While knowledge distillation (KD) is a prominent method for this, research on KD for generative language models like LLMs is relatively sparse, and the approach of distilling student-friendly knowledge, which has shown promising performance in KD for classification models, remains unexplored in generative language models. To explore this approach, we propose PromptKD, a simple yet effective method that utilizes prompt tuning - for the first time in KD - to enable generative language models to transfer student-friendly knowledge. Unlike previous works in classification that require fine-tuning the entire teacher model for extracting student-friendly knowledge, PromptKD achieves similar effects by adding a small number of prompt tokens and tuning only the prompt with student guidance. Extensive experiments on instruction-following datasets using the GPT-2 model family show that PromptKD achieves state-of-the-art performance while adding only 0.0007% of the teacher's parameters as prompts. Further analysis suggests that distilling student-friendly knowledge alleviates exposure bias effectively throughout the entire training process, leading to performance enhancements.

Electrocardiography (ECG) offers critical cardiovascular insights, such as identifying arrhythmias and myocardial ischemia, but enabling automated systems to answer complex clinical questions directly from ECG signals (ECG-QA) remains a significant challenge. Current approaches often lack robust multimodal reasoning capabilities or rely on generic architectures ill-suited for the nuances of physiological signals. We introduce Q-Heart, a novel multimodal framework designed to bridge this gap. Q-Heart leverages a powerful, adapted ECG encoder and integrates its representations with textual information via a specialized ECG-aware transformer-based mapping layer. Furthermore, Q-Heart leverages dynamic prompting and retrieval of relevant historical clinical reports to guide tuning the language model toward knowledge-aware ECG reasoning. Extensive evaluations on the benchmark ECG-QA dataset show Q-Heart achieves state-of-the-art performance, outperforming existing methods by a 4% improvement in exact match accuracy. Our work demonstrates the effectiveness of combining domain-specific architectural adaptations with knowledge-augmented LLM instruction tuning for complex physiological ECG analysis, paving the way for more capable and potentially interpretable clinical patient care systems.

Large language models (LLMs) require well-crafted prompts for effective use. Prompt engineering, the process of designing prompts, is challenging, particularly for non-experts who are less familiar with AI technologies. While researchers have proposed techniques and tools to assist LLM users in prompt design, these works primarily target AI application developers rather than non-experts. To address this research gap, we propose social prompt engineering, a novel paradigm that leverages social computing techniques to facilitate collaborative prompt design. To investigate social prompt engineering, we introduce Wordflow, an open-source and social text editor that enables everyday users to easily create, run, share, and discover LLM prompts. Additionally, by leveraging modern web technologies, Wordflow allows users to run LLMs locally and privately in their browsers. Two usage scenarios highlight how social prompt engineering and our tool can enhance laypeople's interaction with LLMs. Wordflow is publicly accessible at https://poloclub.github.io/wordflow.

Large language models have shown promise in clinical decision making, but current approaches struggle to localize and correct errors at specific steps of the reasoning process. This limitation is critical in medicine, where identifying and addressing reasoning errors is essential for accurate diagnosis and effective patient care. We introduce Med-PRM, a process reward modeling framework that leverages retrieval-augmented generation to verify each reasoning step against established medical knowledge bases. By verifying intermediate reasoning steps with evidence retrieved from clinical guidelines and literature, our model can precisely assess the reasoning quality in a fine-grained manner. Evaluations on five medical QA benchmarks and two open-ended diagnostic tasks demonstrate that Med-PRM achieves state-of-the-art performance, with improving the performance of base models by up to 13.50% using Med-PRM. Moreover, we demonstrate the generality of Med-PRM by integrating it in a plug-and-play fashion with strong policy models such as Meerkat, achieving over 80\% accuracy on MedQA for the first time using small-scale models of 8 billion parameters. Our code and data are available at: https://med-prm.github.io/

LLMs have demonstrated commendable performance across diverse domains. Nevertheless, formulating high-quality prompts to instruct LLMs proficiently poses a challenge for non-AI experts. Existing research in prompt engineering suggests somewhat scattered optimization principles and designs empirically dependent prompt optimizers. Unfortunately, these endeavors lack a structured design template, incurring high learning costs and resulting in low reusability. In addition, it is not conducive to the iterative updating of prompts. Inspired by structured reusable programming languages, we propose LangGPT, a dual-layer prompt design framework as the programming language for LLMs. LangGPT has an easy-to-learn normative structure and provides an extended structure for migration and reuse. Experiments illustrate that LangGPT significantly enhances the performance of LLMs. Moreover, the case study shows that LangGPT leads LLMs to generate higher-quality responses. Furthermore, we analyzed the ease of use and reusability of LangGPT through a user survey in our online community.

Large Language Models (LLMs) demonstrate remarkable versatility in various NLP tasks but encounter distinct challenges in biomedical due to the complexities of language and data scarcity. This paper investigates LLMs application in the biomedical domain by exploring strategies to enhance their performance for the NER task. Our study reveals the importance of meticulously designed prompts in the biomedical. Strategic selection of in-context examples yields a marked improvement, offering ~15-20\% increase in F1 score across all benchmark datasets for biomedical few-shot NER. Additionally, our results indicate that integrating external biomedical knowledge via prompting strategies can enhance the proficiency of general-purpose LLMs to meet the specialized needs of biomedical NER. Leveraging a medical knowledge base, our proposed method, DiRAG, inspired by Retrieval-Augmented Generation (RAG), can boost the zero-shot F1 score of LLMs for biomedical NER. Code is released at https://github.com/masoud-monajati/LLM_Bio_NER

We explore the automatic generation of interactive, scenario-based lessons designed to train novice human tutors who teach middle school mathematics online. Employing prompt engineering through a Retrieval-Augmented Generation approach with GPT-4o, we developed a system capable of creating structured tutor training lessons. Our study generated lessons in English for three key topics: Encouraging Students' Independence, Encouraging Help-Seeking Behavior, and Turning on Cameras, using a task decomposition prompting strategy that breaks lesson generation into sub-tasks. The generated lessons were evaluated by two human evaluators, who provided both quantitative and qualitative evaluations using a comprehensive rubric informed by lesson design research. Results demonstrate that the task decomposition strategy led to higher-rated lessons compared to single-step generation. Human evaluators identified several strengths in the LLM-generated lessons, including well-structured content and time-saving potential, while also noting limitations such as generic feedback and a lack of clarity in some instructional sections. These findings underscore the potential of hybrid human-AI approaches for generating effective lessons in tutor training.

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

This case study investigates the task of job classification in a real-world setting, where the goal is to determine whether an English-language job posting is appropriate for a graduate or entry-level position. We explore multiple approaches to text classification, including supervised approaches such as traditional models like Support Vector Machines (SVMs) and state-of-the-art deep learning methods such as DeBERTa. We compare them with Large Language Models (LLMs) used in both few-shot and zero-shot classification settings. To accomplish this task, we employ prompt engineering, a technique that involves designing prompts to guide the LLMs towards the desired output. Specifically, we evaluate the performance of two commercially available state-of-the-art GPT-3.5-based language models, text-davinci-003 and gpt-3.5-turbo. We also conduct a detailed analysis of the impact of different aspects of prompt engineering on the model's performance. Our results show that, with a well-designed prompt, a zero-shot gpt-3.5-turbo classifier outperforms all other models, achieving a 6% increase in Precision@95% Recall compared to the best supervised approach. Furthermore, we observe that the wording of the prompt is a critical factor in eliciting the appropriate "reasoning" in the model, and that seemingly minor aspects of the prompt significantly affect the model's performance.

Recently, large pre-trained vision-language models have shown remarkable performance in zero-shot anomaly detection (ZSAD). With fine-tuning on a single auxiliary dataset, the model enables cross-category anomaly detection on diverse datasets covering industrial defects and medical lesions. Compared to manually designed prompts, prompt learning eliminates the need for expert knowledge and trial-and-error. However, it still faces the following challenges: (i) static learnable tokens struggle to capture the continuous and diverse patterns of normal and anomalous states, limiting generalization to unseen categories; (ii) fixed textual labels provide overly sparse category information, making the model prone to overfitting to a specific semantic subspace. To address these issues, we propose Conditional Prompt Synthesis (CoPS), a novel framework that synthesizes dynamic prompts conditioned on visual features to enhance ZSAD performance. Specifically, we extract representative normal and anomaly prototypes from fine-grained patch features and explicitly inject them into prompts, enabling adaptive state modeling. Given the sparsity of class labels, we leverage a variational autoencoder to model semantic image features and implicitly fuse varied class tokens into prompts. Additionally, integrated with our spatially-aware alignment mechanism, extensive experiments demonstrate that CoPS surpasses state-of-the-art methods by 2.5% AUROC in both classification and segmentation across 13 industrial and medical datasets. Code will be available at https://github.com/cqylunlun/CoPS.

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

Test-time compute has led to remarkable success in the large language model (LLM) community, particularly for complex tasks, where longer chains of thought (CoTs) are generated to enhance reasoning capabilities. However, growing evidence reveals that such reasoning models often produce CoTs plagued by excessive redundancy, including unnecessary verification steps and repetitive reasoning shifts. The root cause lies in post-training of them that overly rely on outcome reward paradigms, as the data of process reward paradigms, which regulate intermediate reasoning steps, is difficult to construct at scale. To address this, we propose PI, a novel framework for Test-time Prompt Intervention. PI provides an interface to dynamically guide and regulate reasoning paths during inference through timely (When module) and proper (How module) interventions and post-intervention sampling (Which module). This allows human problem-solving expertise and cognitive science principles to be seamlessly integrated into LLMs' reasoning processes, enhancing controllability and interpretability. Extensive experiments across multiple models and datasets demonstrate that PI significantly shortens CoTs while reducing hallucination, yielding more concise and reliable reasoning.

Test-time scaling has emerged as a powerful technique for enhancing the reasoning capabilities of large language models. However, its effectiveness in medical reasoning remains uncertain, as the medical domain fundamentally differs from mathematical tasks in terms of knowledge representation and decision-making processes. In this paper, we provide the first comprehensive investigation of test-time scaling for medical reasoning and present m1, a simple yet effective approach that increases a model's medical reasoning capability at inference. Our evaluation across diverse medical tasks demonstrates that test-time scaling consistently enhances medical reasoning, enabling lightweight fine-tuned models under 10B parameters to establish new state-of-the-art performance, while our 32B model rivals previous 70B-scale medical LLMs. However, we identify an optimal reasoning token budget of approximately 4K, beyond which performance may degrade due to overthinking. Budget forcing, which extends test-time computation through iterative prompts, helps models double-check answers but does not necessarily improve the overall medical QA performance and, in some cases, even introduces errors into previously correct responses. Our case-by-case analysis identifies insufficient medical knowledge as a key bottleneck that prevents further performance gains through test-time scaling. We find that increasing data scale, improving data quality, and expanding model capacity consistently enhance medical knowledge grounding, enabling continued performance improvements, particularly on challenging medical benchmarks where smaller models reach saturation. These findings underscore fundamental differences between medical and mathematical reasoning in LLMs, highlighting that enriched medical knowledge, other than increased reasoning depth alone, is essential for realizing the benefits of test-time scaling.

Prompt engineering enables Large Language Models (LLMs) to perform a variety of tasks. However, lengthy prompts significantly increase computational complexity and economic costs. To address this issue, we study six prompt compression methods for LLMs, aiming to reduce prompt length while maintaining LLM response quality. In this paper, we present a comprehensive analysis covering aspects such as generation performance, model hallucinations, efficacy in multimodal tasks, word omission analysis, and more. We evaluate these methods across 13 datasets, including news, scientific articles, commonsense QA, math QA, long-context QA, and VQA datasets. Our experiments reveal that prompt compression has a greater impact on LLM performance in long contexts compared to short ones. In the Longbench evaluation, moderate compression even enhances LLM performance. Our code and data is available at https://github.com/3DAgentWorld/Toolkit-for-Prompt-Compression.

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

A growing variety of prompt engineering techniques has been proposed for Large Language Models (LLMs), yet systematic evaluation of each technique on individual software engineering (SE) tasks remains underexplored. In this study, we present a systematic evaluation of 14 established prompt techniques across 10 SE tasks using four LLM models. As identified in the prior literature, the selected prompting techniques span six core dimensions (Zero-Shot, Few-Shot, Thought Generation, Ensembling, Self-Criticism, and Decomposition). They are evaluated on tasks such as code generation, bug fixing, and code-oriented question answering, to name a few. Our results show which prompting techniques are most effective for SE tasks requiring complex logic and intensive reasoning versus those that rely more on contextual understanding and example-driven scenarios. We also analyze correlations between the linguistic characteristics of prompts and the factors that contribute to the effectiveness of prompting techniques in enhancing performance on SE tasks. Additionally, we report the time and token consumption for each prompting technique when applied to a specific task and model, offering guidance for practitioners in selecting the optimal prompting technique for their use cases.

Medical open-domain question answering demands substantial access to specialized knowledge. Recent efforts have sought to decouple knowledge from model parameters, counteracting architectural scaling and allowing for training on common low-resource hardware. The retrieve-then-read paradigm has become ubiquitous, with model predictions grounded on relevant knowledge pieces from external repositories such as PubMed, textbooks, and UMLS. An alternative path, still under-explored but made possible by the advent of domain-specific large language models, entails constructing artificial contexts through prompting. As a result, "to generate or to retrieve" is the modern equivalent of Hamlet's dilemma. This paper presents MedGENIE, the first generate-then-read framework for multiple-choice question answering in medicine. We conduct extensive experiments on MedQA-USMLE, MedMCQA, and MMLU, incorporating a practical perspective by assuming a maximum of 24GB VRAM. MedGENIE sets a new state-of-the-art (SOTA) in the open-book setting of each testbed, even allowing a small-scale reader to outcompete zero-shot closed-book 175B baselines while using up to 706times fewer parameters. Overall, our findings reveal that generated passages are more effective than retrieved counterparts in attaining higher accuracy.

Contrastively trained text-image models have the remarkable ability to perform zero-shot classification, that is, classifying previously unseen images into categories that the model has never been explicitly trained to identify. However, these zero-shot classifiers need prompt engineering to achieve high accuracy. Prompt engineering typically requires hand-crafting a set of prompts for individual downstream tasks. In this work, we aim to automate this prompt engineering and improve zero-shot accuracy through prompt ensembling. In particular, we ask "Given a large pool of prompts, can we automatically score the prompts and ensemble those that are most suitable for a particular downstream dataset, without needing access to labeled validation data?". We demonstrate that this is possible. In doing so, we identify several pathologies in a naive prompt scoring method where the score can be easily overconfident due to biases in pre-training and test data, and we propose a novel prompt scoring method that corrects for the biases. Using our proposed scoring method to create a weighted average prompt ensemble, our method outperforms equal average ensemble, as well as hand-crafted prompts, on ImageNet, 4 of its variants, and 11 fine-grained classification benchmarks, all while being fully automatic, optimization-free, and not requiring access to labeled validation data.

Large language models (LLMs) have revolutionised many fields, with LLM-as-a-service (LLMSaaS) offering accessible, general-purpose solutions without costly task-specific training. In contrast to the widely studied prompt engineering for directly solving tasks (in vivo), this paper explores LLMs' potential for in-vitro applications: using LLM-generated labels to improve supervised training of mainstream models. We examine two strategies - (1) noisy label correction and (2) training data augmentation - in empathy computing, an emerging task to predict psychology-based questionnaire outcomes from inputs like textual narratives. Crowdsourced datasets in this domain often suffer from noisy labels that misrepresent underlying empathy. We show that replacing or supplementing these crowdsourced labels with LLM-generated labels, developed using psychology-based scale-aware prompts, achieves statistically significant accuracy improvements. Notably, the RoBERTa pre-trained language model (PLM) trained with noise-reduced labels yields a state-of-the-art Pearson correlation coefficient of 0.648 on the public NewsEmp benchmarks. This paper further analyses evaluation metric selection and demographic biases to help guide the future development of more equitable empathy computing models. Code and LLM-generated labels are available at https://github.com/hasan-rakibul/LLMPathy.

Clinical diagnosis is a highly specialized discipline requiring both domain expertise and strict adherence to rigorous guidelines. While current AI-driven medical research predominantly focuses on knowledge graphs or natural text pretraining paradigms to incorporate medical knowledge, these approaches primarily rely on implicitly encoded knowledge within model parameters, neglecting task-specific knowledge required by diverse downstream tasks. To address this limitation, we propose Retrieval-Augmented Diagnosis (RAD), a novel framework that explicitly injects external knowledge into multimodal models directly on downstream tasks. Specifically, RAD operates through three key mechanisms: retrieval and refinement of disease-centered knowledge from multiple medical sources, a guideline-enhanced contrastive loss that constrains the latent distance between multi-modal features and guideline knowledge, and the dual transformer decoder that employs guidelines as queries to steer cross-modal fusion, aligning the models with clinical diagnostic workflows from guideline acquisition to feature extraction and decision-making. Moreover, recognizing the lack of quantitative evaluation of interpretability for multimodal diagnostic models, we introduce a set of criteria to assess the interpretability from both image and text perspectives. Extensive evaluations across four datasets with different anatomies demonstrate RAD's generalizability, achieving state-of-the-art performance. Furthermore, RAD enables the model to concentrate more precisely on abnormal regions and critical indicators, ensuring evidence-based, trustworthy diagnosis. Our code is available at https://github.com/tdlhl/RAD.

Prompt engineering is very important to enhance the performance of large language models (LLMs). When dealing with complex issues, prompt engineers tend to distill multiple patterns from examples and inject relevant solutions to optimize the prompts, achieving satisfying results. However, existing automatic prompt optimization techniques are only limited to producing single flow instructions, struggling with handling diverse patterns. In this paper, we present AMPO, an automatic prompt optimization method that can iteratively develop a multi-branched prompt using failure cases as feedback. Our goal is to explore a novel way of structuring prompts with multi-branches to better handle multiple patterns in complex tasks, for which we introduce three modules: Pattern Recognition, Branch Adjustment, and Branch Pruning. In experiments across five tasks, AMPO consistently achieves the best results. Additionally, our approach demonstrates significant optimization efficiency due to our adoption of a minimal search strategy.

Generalist Large Language Models (LLMs), such as GPT-4, have shown considerable promise in various domains, including medical diagnosis. Rare diseases, affecting approximately 300 million people worldwide, often have unsatisfactory clinical diagnosis rates primarily due to a lack of experienced physicians and the complexity of differentiating among many rare diseases. In this context, recent news such as "ChatGPT correctly diagnosed a 4-year-old's rare disease after 17 doctors failed" underscore LLMs' potential, yet underexplored, role in clinically diagnosing rare diseases. To bridge this research gap, we introduce RareBench, a pioneering benchmark designed to systematically evaluate the capabilities of LLMs on 4 critical dimensions within the realm of rare diseases. Meanwhile, we have compiled the largest open-source dataset on rare disease patients, establishing a benchmark for future studies in this domain. To facilitate differential diagnosis of rare diseases, we develop a dynamic few-shot prompt methodology, leveraging a comprehensive rare disease knowledge graph synthesized from multiple knowledge bases, significantly enhancing LLMs' diagnostic performance. Moreover, we present an exhaustive comparative study of GPT-4's diagnostic capabilities against those of specialist physicians. Our experimental findings underscore the promising potential of integrating LLMs into the clinical diagnostic process for rare diseases. This paves the way for exciting possibilities in future advancements in this field.

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

Contrastive pretrained large Vision-Language Models (VLMs) like CLIP have revolutionized visual representation learning by providing good performance on downstream datasets. VLMs are 0-shot adapted to a downstream dataset by designing prompts that are relevant to the dataset. Such prompt engineering makes use of domain expertise and a validation dataset. Meanwhile, recent developments in generative pretrained models like GPT-4 mean they can be used as advanced internet search tools. They can also be manipulated to provide visual information in any structure. In this work, we show that GPT-4 can be used to generate text that is visually descriptive and how this can be used to adapt CLIP to downstream tasks. We show considerable improvements in 0-shot transfer accuracy on specialized fine-grained datasets like EuroSAT (~7%), DTD (~7%), SUN397 (~4.6%), and CUB (~3.3%) when compared to CLIP's default prompt. We also design a simple few-shot adapter that learns to choose the best possible sentences to construct generalizable classifiers that outperform the recently proposed CoCoOP by ~2% on average and by over 4% on 4 specialized fine-grained datasets. We will release the code, prompts, and auxiliary text dataset upon acceptance.

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

Ensuring that Software Requirements Specifications (SRS) align with higher-level organizational or national requirements is vital, particularly in regulated environments such as finance and aerospace. In these domains, maintaining consistency, adhering to regulatory frameworks, minimizing errors, and meeting critical expectations are essential for the reliable functioning of systems. The widespread adoption of large language models (LLMs) highlights their immense potential, yet there remains considerable scope for improvement in retrieving relevant information and enhancing reasoning capabilities. This study demonstrates that integrating a robust Graph-RAG framework with advanced prompt engineering techniques, such as Chain of Thought and Tree of Thought, can significantly enhance performance. Compared to baseline RAG methods and simple prompting strategies, this approach delivers more accurate and context-aware results. While this method demonstrates significant improvements in performance, it comes with challenges. It is both costly and more complex to implement across diverse contexts, requiring careful adaptation to specific scenarios. Additionally, its effectiveness heavily relies on having complete and accurate input data, which may not always be readily available, posing further limitations to its scalability and practicality.