medical data engineers

Abstract: Surgical video generation holds substantial potential for surgical education, simulation, and data augmentation, yet generating surgical videos with realistic and clinically plausible motion remains challenging. Most existing methods rely on auxiliary conditions, such as masks, trajectories, depth, or reference videos, to achieve visually plausible synthesis. Yet, these auxiliary conditions typically require additional manual annotation or specialized acquisition, making it difficult to scale such methods beyond small, curated datasets. This motivates the need for a reference-free architecture capable of generating high-quality surgical video without requiring auxiliary visual conditions at inference time. We propose FLAIR, a Flow-guided LatentAction Injection framework for Reference-free surgical video generation. FLAIR learns action priors from optical flow of real surgical videos, dynamically predicts corresponding latent action representation from an input prompt, and injects it into a frozen base model to generate surgical videos with improved action consistency. We further construct SurgActionClip-30K, the first large-scale surgical vision dataset comprising action-centric segmented clips and structured caption labels, addressing the persistent lack of fine-grained, action-centric surgical datasets. Lastly, we introduce SurgMetrics, the first surgical domain-specific evaluation metrics for quantifying the quality of generated surgical videos, addressing the persistent absence of clinically grounded evaluation standards in this domain. Extensive experiments demonstrate that FLAIR enables generating high-quality surgical videos using text-only inference without auxiliary conditions, and validation in SurgMetrics demonstrates its strength in alignment with human perception compared to traditional metrics.

Abstract: We introduce ApexQuant, a calibration-free quantization method that recursively re-quantizes the residual error, serving as a refinement layer on top of existing quantizers. We establish that a fresh random rotation returns each residual to the uniform distribution on the hypersphere, which characterizes the rate of progressive error decay across successive passes. This result lets us determine, before any weight is read, how many passes a layer needs for a target weight-space error. Every prefix is itself a valid lower-rate model, so one artifact serves several precisions. We instantiate ApexQuant with three interchangeable stages, scalar, $E_8$ and trellis, and validate it on four open-weight LLMs and on Earth-observation and medical domains where in-distribution data is often unattainable as imagery arrives under restrictive licences or due to patient material under privacy constraints. Progressive re-isotropization comes within a few percent of full precision at four bits and gives the best two-bit arm we measure, in a completely data-free setting.

Abstract: We consider the fusion of lung ultrasound images with routinely-collected clinical and demographic data for the purpose of automated tuberculosis (TB) screening using deep-learning. Such deep-learning based screening tools for TB could meaningfully support the health care system in Africa, where the burden of disease is severe and resources are constrained. Beginning with an established ResNet baseline for classification of lung ultrasound images, which achieves an area under the receiver operating characteristic (AUROC) curve of 0.91 [0.86,0.96] (95% CI), we consider the incorporation of the clinical and demographic data using three fusion approaches. We find that a simple average-based fusion of the output scores of separately-trained image and clinical data classifiers consistently matches or outperforms a more complex approach where the data is fused earlier and a combined classifier is trained. Fusing the image and the clinical classifiers in this way leads to a classifier with an overall AUROC of 0.95 [0.91,0.99] (specificity of 0.76 at sensitivity 0.93) which is an improvement of 4% absolute over the image-only baseline. We also find that greedy feature selection can be used to reduce the number of clinical and demographic inputs without sacrificing classification performance. Finally, when we differentiate between clinical and demographic data that are self-reported, that require some basic measurement or calculation, and that require a point-of-care (POC) test, we find the inclusion of the POC tests included in this study to be of minimal benefit to classification performance. We conclude that the incorporation of routinely-collected clinical and demographic data is a promising way to improve the performance of lung ultrasound based automatic classification.

Abstract: Large language models (LLMs) are increasingly deployed in enterprise, scientific, and medical applications, where agents must incorporate domain-specific knowledge and adapt from experience. Context engineering offers a practical alternative to weight updates by improving model behavior through instructions, strategies, and evidence supplied at inference time. However, adapting context online typically requires a costly trial-and-error process, while queries are often processed independently, preventing useful experience from carrying forward. Memory systems address this limitation by retaining information across interactions, but approaches that continually append information to a shared context face increasing token costs, context-window limits, and performance degradation as the context expands. We introduce a unified formulation of context optimization and show that an agent memory system update can be interpreted as an optimization update procedure over the model's context. This perspective attempts to provide a principled framework for studying memory design and its efficiency. We then propose GraphMemory, a lightweight graph-based memory that accumulates, refines, organizes, and connects reusable strategies. For each query, GraphMemory retrieves only the relevant subgraph, enabling online context adaptation without exposing the model to the entire memory. Under bounded retrieval, the amount of retrieved memory remains constant as the number of processed examples grows. Experiments show that GraphMemory achieves competitive downstream performance while using approximately 81-85% fewer memory-construction tokens than our baselines.

Abstract: Retrieval-based factuality evaluation, where LLM-generated claims are verified against evidence from authoritative medical corpora, has become the dominant paradigm for scalable hallucination detection in high-stakes clinical settings. Despite the urgency of reliable and transparent medical fact verification, most systems measure performance with aggregate metrics like F1, which obscure where and why failures occur. Existing RAG diagnostics require gold answers or annotated gold evidence, neither of which exists in this regime. We introduce two comprehensive taxonomies, grounded in a case study on the open-ended MedExpert dataset and 3 closed-ended datasets, decomposing failures into retrieval-stage errors along five quality dimensions, and verifier-reasoning errors into six consecutive steps. We adapt an automatic pattern induction pipeline using LLM-as-Judge to label evidence quality and classify verifier reasoning errors at scale, and then stress-test our findings across 4 retrieval methods and 6 frontier verifier models. Our analysis reveals that scaling model size, adding reasoning effort, expanding to authoritative web sources, and applying medical fine-tuning do not resolve these failure modes, demonstrating that they represent fundamental limitations of the retrieve-then-verify paradigm in open-ended medical settings rather than artifacts of outdated systems. We release our code and data at https://anonymous.4open.science/r/Medical_RAG_eval-4AB5 for the full reproducibility of our results.

Abstract: Clinical decision making heavily relies on predicting the disease progression trajectory by seeking to understand patient's health status which is characterised by multimodal medical data. AI holds great potential for learning useful representations from multimodal medical data to predict disease progression and aid clinical decision making. However, development of predictive AI models is constrained by missing modalities and incomplete tabular data frequently occurring in medical datasets. In addition, disease labels alone may only provide limited supervisory signals for learning representations from high-dimensional multimodal data. Here, we present MMAP, a novel Multimodal Missing-aware Alignment Pretraining method for learning image-tabular representations from incomplete data. An image encoder is pretrained with efficient sigmoid contrastive learning combined with generative reconstruction. A tabular encoder is built upon a tabular foundation model. A missing token generator enables the two encoders to take incomplete data as input, enabling the model to be robust against missing modalities, either with missing images or missing tabular data. We evaluate the clinical usefulness of the learnt multimodal representations on two challenging longitudinal clinical tasks for Alzheimer's disease: predicting disease stage conversion and predicting amyloid status. The proposed method outperforms strong multimodal and unimodal baselines.