Juming Xiong
Publications
It's Not Always Sycophancy: Measuring LLM Conformity as a Function of Epistemic Uncertainty
Large language models (LLMs) are known to abandon their initial stance to conform to user pushback. While prior research largely attributes this behavior to sycophancy learned during reinforcement learning from human feedback, we hypothesize that conformity is also driven by a model's epistemic uncertainty at inference time. In this paper, we introduce MUSE, a two-stage evaluation framework to disentangle the mechanisms driving LLM conformity. Specifically, MUSE maps a model's epistemic uncertainty in responding to a query against its likelihood to yield to user pushback in a subsequent turn. We demonstrate that the mechanisms driving conformity extend beyond sycophancy alone. Specifically, we characterize two distinct factors that jointly drive conformity: sycophantic conformity, where a model aligns with user pushback even with absolute certainty in its initial response, and uncertainty-driven conformity, where a model's likelihood for conformity increases alongside its uncertainty. Furthermore, we conduct ablation studies to demonstrate that both sycophantic conformity and uncertainty-driven conformity grow with 1) the LLM's perceived expertise of the user and 2) the plausibility of the user's suggestions. More broadly, MUSE informs more targeted intervention strategies by distinguishing alignment-induced sycophancy and training-corpora-driven uncertainty.
Stop Listening to Me! How Multi-turn Conversations Can Degrade Diagnostic Reasoning
Patients and clinicians are increasingly using chatbots powered by large language models (LLMs) for healthcare inquiries. While state-of-the-art LLMs exhibit high performance on static diagnostic reasoning benchmarks, their efficacy across multi-turn conversations, which better reflect real-world usage, has been understudied. In this paper, we evaluate 17 LLMs across three clinical datasets to investigate how partitioning the decision-space into multiple simpler turns of conversation influences their diagnostic reasoning. Specifically, we develop a "stick-or-switch" evaluation framework to measure model conviction (i.e., defending a correct diagnosis or safe abstention against incorrect suggestions) and flexibility (i.e., recognizing a correct suggestion when it is introduced) across conversations. Our experiments reveal the conversation tax, where multi-turn interactions consistently degrade performance when compared to single-shot baselines. Notably, models frequently abandon initial correct diagnoses and safe abstentions to align with incorrect user suggestions. Additionally, several models exhibit blind switching, failing to distinguish between signal and incorrect suggestions.
AdaFuse: Adaptive Multimodal Fusion for Lung Cancer Risk Prediction via Reinforcement Learning
Multimodal fusion has emerged as a promising paradigm for disease diagnosis and prognosis, integrating complementary information from heterogeneous data sources such as medical images, clinical records, and radiology reports. However, existing fusion methods process all available modalities through the network, either treating them equally or learning to assign different contribution weights, leaving a fundamental question unaddressed: for a given patient, should certain modalities be used at all? We present AdaFuse, an adaptive multimodal fusion framework that leverages reinforcement learning (RL) to learn patient-specific modality selection and fusion strategies for lung cancer risk prediction. AdaFuse formulates multimodal fusion as a sequential decision process, where the policy network iteratively decides whether to incorporate an additional modality or proceed to prediction based on the information already acquired. This sequential formulation enables the model to condition each selection on previously observed modalities and terminate early when sufficient information is available, rather than committing to a fixed subset upfront. We evaluate AdaFuse on the National Lung Screening Trial (NLST) dataset. Experimental results demonstrate that AdaFuse achieves the highest AUC (0.762) compared to the best single-modality baseline (0.732), the best fixed fusion strategy (0.759), and adaptive baselines including DynMM (0.754) and MoE (0.742), while using fewer FLOPs than all triple-modality methods. Our work demonstrates the potential of reinforcement learning for personalized multimodal fusion in medical imaging, representing a shift from uniform fusion strategies toward adaptive diagnostic pipelines that learn when to consult additional modalities and when existing information suffices for accurate prediction.