Congkai Xie
Publications
Evaluating Counterfactual Sensitivity to Patient Information in Medication-Safety Reasoning
Applying a valid medication-safety rule when its patient-specific conditions are not met can produce an incorrect decision. Existing medical evaluations largely use isolated and fixed scenarios. A model may therefore answer correctly by recalling a drug-risk association without showing that it used patient information to decide whether the rule applies. To address this gap, we introduce MedPIC-Bench, a benchmark of source-verifiable recommendations and expert-validated questions for patient-specific medication-safety reasoning. It combines guideline-following questions with paired counterfactual questions in which a controlled change in patient information changes whether a rule applies. The benchmark contains 467 questions annotated along six clinical and reasoning dimensions. Across 28 medical-specific, general, and proprietary LLMs, every model performs worse on counterfactual questions, with mean accuracy falling from 63.6\% to 45.1\%. Models perform well when an explicit patient attribute directly signals a familiar contraindication, but struggle when patient information must narrow or withdraw a safety warning. Model rationales often acknowledge the changed patient information, yet the final answers retain the previous safety judgment. This vulnerability persists among medical-specific LLMs, whose average CF performance trails that of general LLMs. MedPIC-Bench therefore makes conditional rule application measurable and highlights the limitations of static medication-safety accuracy for assessing patient-specific reliability.
MergePipe: A Budget-Aware Parameter Management System for Scalable LLM Merging
Large language model (LLM) merging has become a key technique in modern LLM development pipelines, enabling the integration of multiple task- or domain-specific expert models without retraining. However, as the number of experts grows, existing merging implementations treat model parameters as unstructured files and execute merges in a stateless, one-shot manner, leading to excessive disk I/O, redundant parameter scans, and poor scalability. In this paper, we present \textbf{MergePipe}, a parameter management system for scalable LLM merging. MergePipe is the first system that treats LLM merging as a data management and execution problem, and introduces a catalog-driven abstraction over model parameters, merge plans, and execution lineage. At its core, MergePipe employs a cost-aware planner that explicitly models expert parameter I/O and enforces user-specified I/O budgets, followed by a streaming execution engine that materializes merged models under transactional guarantees. Our key insight is that while base model reads and output writes are unavoidable, expert parameter reads dominate merge cost and constitute the primary optimization target. By making expert access budget-aware throughout planning and execution, MergePipe mitigates the $O(K)$ I/O growth of naive pipelines and achieves predictable scaling behavior. Experiments show that MergePipe reduces total I/O by up to an order of magnitude and delivers up to $11\times$ end-to-end speedups (up to 90\% wall-time reduction) over state-of-the-art LLM merging pipelines.