George Pu
Publications
CliniCARE-Bench: Clinical Calibrated Audit of Medical Reasoning in EHR
Large language models perform strongly on medical knowledge benchmarks, but reliable clinical deployment requires agents to conduct defensible investigations over heterogeneous, longitudinal records: determining what evidence is needed, retrieving and reconciling structured and free-text data, grounding conclusions in verifiable evidence, and deferring cases that cannot be resolved reliably. We introduce CliniCARE-Bench (Clinical Calibrated Audit of Medical Reasoning in EHR), a benchmark for retrospective clinical audit: 25 clinician-validated scenarios instantiated as 750 patient-specific cases over real-patient-derived MIMIC-IV data. Systems investigate each case through a governed, logged tool environment for record retrieval, computation, and policy access, and return one of four verdicts---Yes, No, Indeterminate: Lack of Data, or Indeterminate: Medically Ambiguous---the last two separating missing evidence from residual medical ambiguity. Beyond verdict accuracy, we score patient-evidence and policy grounding, process adherence, calibrated abstention, reliability, and efficiency against case-level reference verdicts produced by independent multi-model adjudication and calibrated against Clinical Board review. Every retrieval, computation, and report is replayable, so the investigation trace is inspectable and scorable. To our knowledge, CliniCARE-Bench is the first deployment-oriented clinical-agent benchmark to jointly evaluate real longitudinal EHR investigation, claim-level evidence grounding, governing-policy use, process adherence, and calibrated abstention within a common patient-level adjudication framework. Across 16 agentic systems, four-way accuracy spans 65.3-76.1%, but raw accuracy overstates investigation quality. Defect-free accuracy, which credits a verdict only when correct and free of prohibited shortcuts, is 4.8-14.8 points lower and reorders the leaderboard.
LHAW: Controllable Underspecification for Long-Horizon Tasks
Long-horizon workflow agents that operate effectively over extended periods are essential for truly autonomous systems. Their reliable execution critically depends on the ability to reason through ambiguous situations in which clarification seeking is necessary to ensure correct task execution. However, progress is limited by the lack of scalable, task-agnostic frameworks for systematically curating and measuring the impact of ambiguity across custom workflows. We address this gap by introducing LHAW (Long-Horizon Augmented Workflows), a modular, dataset-agnostic synthetic pipeline that transforms any well-specified task into controllable underspecified variants by systematically removing information across four dimensions - Goals, Constraints, Inputs, and Context - at configurable severity levels. Unlike approaches that rely on LLM predictions of ambiguity, LHAW validates variants through empirical agent trials, classifying them as outcome-critical, divergent, or benign based on observed terminal state divergence. We release 285 task variants from TheAgentCompany, SWE-Bench Pro and MCP-Atlas according to our taxonomy alongside formal analysis measuring how current agents detect, reason about, and resolve underspecification across ambiguous settings. LHAW provides the first systematic framework for cost-sensitive evaluation of agent clarification behavior in long-horizon settings, enabling development of reliable autonomous systems.