Carlos Guestrin
Publications
ALMo: Interactive Aim-Limit-Defined, Multi-Objective System for Personalized High-Dose-Rate Brachytherapy Treatment Planning and Visualization for Cervical Cancer
In complex clinical decision-making, clinicians must often track a variety of competing metrics defined by aim (ideal) and limit (strict) thresholds. Sifting through these high-dimensional tradeoffs to infer the optimal patient-specific strategy is cognitively demanding and historically prone to variability. In this paper, we address this challenge within the context of High-Dose-Rate (HDR) brachytherapy for cervical cancer, where planning requires strictly managing radiation hot spots while balancing tumor coverage against organ sparing. We present ALMo (Aim-Limit-defined Multi-Objective system), an interactive decision support system designed to infer and operationalize clinician intent. ALMo employs a novel optimization framework that minimizes manual input through automated parameter setup and enables flexible control over toxicity risks. Crucially, the system allows clinicians to navigate the Pareto surface of dosimetric tradeoffs by directly manipulating intuitive aim and limit values. In a retrospective evaluation of 25 clinical cases, ALMo generated treatment plans that consistently met or exceeded manual planning quality, with 65% of cases demonstrating dosimetric improvements. Furthermore, the system significantly enhanced efficiency, reducing average planning time to approximately 17 minutes, compared to the conventional 30-60 minutes. While validated in brachytherapy, ALMo demonstrates a generalized framework for streamlining interaction in multi-criteria clinical decision-making.
PluRel: Synthetic Data unlocks Scaling Laws for Relational Foundation Models
Relational Foundation Models (RFMs) facilitate data-driven decision-making by learning from complex multi-table databases. However, the diverse relational databases needed to train such models are rarely public due to privacy constraints. While there are methods to generate synthetic tabular data of arbitrary size, incorporating schema structure and primary--foreign key connectivity for multi-table generation remains challenging. Here we introduce PluRel, a framework to synthesize multi-tabular relational databases from scratch. In a step-by-step fashion, PluRel models (1) schemas with directed graphs, (2) inter-table primary-foreign key connectivity with bipartite graphs, and, (3) feature distributions in tables via conditional causal mechanisms. The design space across these stages supports the synthesis of a wide range of diverse databases, while being computationally lightweight. Using PluRel, we observe for the first time that (1) RFM pretraining loss exhibits power-law scaling with the number of synthetic databases and total pretraining tokens, (2) scaling the number of synthetic databases improves generalization to real databases, and (3) synthetic pretraining yields strong base models for continued pretraining on real databases. Overall, our framework and results position synthetic data scaling as a promising paradigm for RFMs.
Reinforcement Learning via Self-Distillation
Large language models are increasingly post-trained with reinforcement learning in verifiable domains such as code and math. Yet, current methods for reinforcement learning with verifiable rewards (RLVR) learn only from a scalar outcome reward per attempt, creating a severe credit-assignment bottleneck. Many verifiable environments actually provide rich textual feedback, such as runtime errors or judge evaluations, that explain why an attempt failed. We formalize this setting as reinforcement learning with rich feedback and introduce Self-Distillation Policy Optimization (SDPO), which converts tokenized feedback into a dense learning signal without any external teacher or explicit reward model. SDPO treats the current model conditioned on feedback as a self-teacher and distills its feedback-informed next-token predictions back into the policy. In this way, SDPO leverages the model's ability to retrospectively identify its own mistakes in-context. Across scientific reasoning, tool use, and competitive programming on LiveCodeBench v6, SDPO improves sample efficiency and final accuracy over strong RLVR baselines. Notably, SDPO also outperforms baselines in standard RLVR environments that only return scalar feedback by using successful rollouts as implicit feedback for failed attempts. Finally, applying SDPO to individual questions at test time accelerates discovery on difficult binary-reward tasks, achieving the same discovery probability as best-of-k sampling or multi-turn conversations with 3x fewer attempts.
Learning to Discover at Test Time
How can we use AI to discover a new state of the art for a scientific problem? Prior work in test-time scaling, such as AlphaEvolve, performs search by prompting a frozen LLM. We perform reinforcement learning at test time, so the LLM can continue to train, but now with experience specific to the test problem. This form of continual learning is quite special, because its goal is to produce one great solution rather than many good ones on average, and to solve this very problem rather than generalize to other problems. Therefore, our learning objective and search subroutine are designed to prioritize the most promising solutions. We call this method Test-Time Training to Discover (TTT-Discover). Following prior work, we focus on problems with continuous rewards. We report results for every problem we attempted, across mathematics, GPU kernel engineering, algorithm design, and biology. TTT-Discover sets the new state of the art in almost all of them: (i) Erdős' minimum overlap problem and an autocorrelation inequality; (ii) a GPUMode kernel competition (up to $2\times$ faster than prior art); (iii) past AtCoder algorithm competitions; and (iv) denoising problem in single-cell analysis. Our solutions are reviewed by experts or the organizers. All our results are achieved with an open model, OpenAI gpt-oss-120b, and can be reproduced with our publicly available code, in contrast to previous best results that required closed frontier models. Our test-time training runs are performed using Tinker, an API by Thinking Machines, with a cost of only a few hundred dollars per problem.