Jingxuan Fan
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.
Circuit Mechanisms for Spatial Relation Generation in Diffusion Transformers
Diffusion Transformers (DiTs) have greatly advanced text-to-image generation, but models still struggle to generate the correct spatial relations between objects as specified in the text prompt. In this study, we adopt a mechanistic interpretability approach to investigate how a DiT can generate correct spatial relations between objects. We train, from scratch, DiTs of different sizes with different text encoders to learn to generate images containing two objects whose attributes and spatial relations are specified in the text prompt. We find that, although all the models can learn this task to near-perfect accuracy, the underlying mechanisms differ drastically depending on the choice of text encoder. When using random text embeddings, we find that the spatial-relation information is passed to image tokens through a two-stage circuit, involving two cross-attention heads that separately read the spatial relation and single-object attributes in the text prompt. When using a pretrained text encoder (T5), we find that the DiT uses a different circuit that leverages information fusion in the text tokens, reading spatial-relation and single-object information together from a single text token. We further show that, although the in-domain performance is similar for the two settings, their robustness to out-of-domain perturbations differs, potentially suggesting the difficulty of generating correct relations in real-world scenarios.