Huahui Yi
Publications
RareLens: Towards End-to-End Rare Disease Care via Aligning Divergent Large Language Model Reasoning
Rare diseases represent one of the most challenging settings for clinical decision-making, where heterogeneous presentations, sparse evidence and limited expertise create persistent uncertainty throughout the care pathway. Although artificial intelligence could help, existing systems largely address isolated tasks, particularly diagnosis, and usually rely on downstream investigations rather than information available at initial presentation. Here we show that clinical AI performance under uncertainty can be improved not by scaling a single model, but by exploiting the diversity of multiple imperfect reasoning systems. Across heterogeneous large language models, we identify divergent reasoning trajectories with complementary error patterns and develop RareLens, which learns to reconcile these perspectives into actionable decisions across four stages of rare disease care: risk screening, diagnosis, treatment planning and prognosis prediction. Built on RarelensBench, a real-world dataset of 157,525 cases spanning all 33 Orphanet categories and more than 7,000 conditions, RareLens outperformed every frontier model tested, including GPT-5, DeepSeek-R1, Claude-3.7-Sonnet and Gemini-2.5-Pro, across all stages. It achieved an area under the curve of 0.917 for screening and top-1 accuracies of 65.5% and 89.8% for diagnosis and treatment. In an external evaluation involving 1,287 cases and 23 physicians, autonomous RareLens and physicians assisted by RareLens both outperformed unaided physicians, while demonstrating that effective human-AI collaboration requires more than simply providing model outputs. These findings establish divergent model reasoning as an exploitable source of information and suggest a general strategy for building AI systems that operate reliably under high clinical uncertainty.
Large Vision-Language Models Get Lost in Attention
Despite the rapid evolution of training paradigms, the decoder backbone of large vision--language models (LVLMs) remains fundamentally rooted in the residual-connection Transformer architecture. Therefore, deciphering the distinct roles of internal modules is critical for understanding model mechanics and guiding architectural optimization. While prior statistical approaches have provided valuable attribution-based insights, they often lack a unified theoretical basis. To bridge this gap, we propose a unified framework grounded in information theory and geometry to quantify the geometric and entropic nature of residual updates. Applying this unified framework reveals a fundamental functional decoupling: Attention acts as a subspace-preserving operator focused on reconfiguration, whereas FFNs serve as subspace-expanding operators driving semantic innovation. Strikingly, further experiments demonstrate that replacing learned attention weights with predefined values (e.g., Gaussian noise) yields comparable or even superior performance across a majority of datasets relative to vanilla models. These results expose severe misallocation and redundancy in current mechanisms, suggesting that state-of-the-art LVLMs effectively ``get lost in attention'' rather than efficiently leveraging visual context.
ClueTracer: Question-to-Vision Clue Tracing for Training-Free Hallucination Suppression in Multimodal Reasoning
Large multimodal reasoning models solve challenging visual problems via explicit long-chain inference: they gather visual clues from images and decode clues into textual tokens. Yet this capability also increases hallucinations, where the model generates content that is not supported by the input image or the question. To understand this failure mode, we identify \emph{reasoning drift}: during clue gathering, the model over-focuses on question-irrelevant entities, diluting focus on task-relevant cues and gradually decoupling the reasoning trace from visual grounding. As a consequence, many inference-time localization or intervention methods developed for non-reasoning models fail to pinpoint the true clues in reasoning settings. Motivated by these insights, we introduce ClueRecall, a metric for assessing visual clue retrieval, and present ClueTracer, a training-free, parameter-free, and architecture-agnostic plugin for hallucination suppression. ClueTracer starts from the question and traces how key clues propagate along the model's reasoning pathway (question $\rightarrow$ outputs $\rightarrow$ visual tokens), thereby localizing task-relevant patches while suppressing spurious attention to irrelevant regions. Remarkably, \textbf{without any additional training}, ClueTracer improves all \textbf{reasoning} architectures (including \texttt{R1-OneVision}, \texttt{Ocean-R1}, \texttt{MM-Eureka}, \emph{etc}.) by $\mathbf{1.21\times}$ on reasoning benchmarks. When transferred to \textbf{non-reasoning} settings, it yields a $\mathbf{1.14\times}$ gain.
RareAlert: Aligning heterogeneous large language model reasoning for early rare disease risk screening
Missed and delayed diagnosis remains a major challenge in rare disease care. At the initial clinical encounters, physicians assess rare disease risk using only limited information under high uncertainty. When high-risk patients are not recognised at this stage, targeted diagnostic testing is often not initiated, resulting in missed diagnosis. Existing primary care triage processes are structurally insufficient to reliably identify patients with rare diseases at initial clinical presentation and universal screening is needed to reduce diagnostic delay. Here we present RareAlert, an early screening system which predict patient-level rare disease risk from routinely available primary-visit information. RareAlert integrates reasoning generated by ten LLMs, calibrates and weights these signals using machine learning, and distils the aligned reasoning into a single locally deployable model. To develop and evaluate RareAlert, we curated RareBench, a real-world dataset of 158,666 cases covering 33 Orphanet disease categories and more than 7,000 rare conditions, including both rare and non-rare presentations. The results showed that rare disease identification can be reconceptualised as a universal uncertainty resolution process applied to the general patient population. On an independent test set, RareAlert, a Qwen3-4B based model trained with calibrated reasoning signals, achieved an AUC of 0.917, outperforming the best machine learning ensemble and all evaluated LLMs, including GPT-5, DeepSeek-R1, Claude-3.7-Sonnet, o3-mini, Gemini-2.5-Pro, and Qwen3-235B. These findings demonstrate the diversity in LLM medical reasoning and the effectiveness of aligning such reasoning in highly uncertain clinical tasks. By incorporating calibrated reasoning into a single model, RareAlert enables accurate, privacy-preserving, and scalable rare disease risk screening suitable for large-scale local deployment.