Daily Papers

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.

Certification for machine learning is proving that no adversarial sample can evade a model within a range under certain conditions, a necessity for safety-critical domains. Common certification methods for segmentation use a flat set of fine-grained classes, leading to high abstain rates due to model uncertainty across many classes. We propose a novel, more practical setting, which certifies pixels within a multi-level hierarchy, and adaptively relaxes the certification to a coarser level for unstable components classic methods would abstain from, effectively lowering the abstain rate whilst providing more certified semantically meaningful information. We mathematically formulate the problem setup, introduce an adaptive hierarchical certification algorithm and prove the correctness of its guarantees. Since certified accuracy does not take the loss of information into account for coarser classes, we introduce the Certified Information Gain (CIG) metric, which is proportional to the class granularity level. Our extensive experiments on the datasets Cityscapes, PASCAL-Context, ACDC and COCO-Stuff demonstrate that our adaptive algorithm achieves a higher CIG and lower abstain rate compared to the current state-of-the-art certification method. Our code can be found here: https://github.com/AlaaAnani/adaptive-certify.