Yitong Qiao
Publications
EHR-Complex: Benchmarking Medical Agents for Complex Clinical Reasoning
Clinical agents promise to democratize access to electronic health records (EHRs), yet existing benchmarks fail to reflect the complexity of practical EHR analysis, e.g., often operating on idealized, clean EHRs via static SQL generation rather than interactive execution. In this work, we introduce EHR-Complex, a large-scale benchmark designed for interactive clinical database reasoning. Built on the large MIMIC-IV substrate (365K patients, 31 tables, 500M+ records), EHR-Complex comprises about 52K tasks spanning six clinical intents, supporting both patient-level and population-level queries, where each task requires an agent to interact with a sandboxed environment by executing SQL queries or Python code. Notably, EHR-Complex considers the real-world SQL task complexity for longitudinal multi-table aggregation and compositional reasoning, resulting in 31.93 SQL structural components per query on average. Evaluation results on EHR-Complex reveal the clinical difficulty of these EHR reasoning scenarios, with the top-performing model achieving only 62.3% exact-match accuracy. Pass^k consistency drops below 50% for nearly all evaluated models at k=4, exposing broad stochastic fragility. A fine-grained analysis of more than 3,800 failed trajectories for representative LLMs reveals three dominant failure modes: SQL logic errors, medical-code lookup failures, and semantic misunderstandings. EHR-Complex provides a rigorous testbed for clinical agents and highlights remaining gaps in robust reasoning for large-scale EHR analysis.
Do LLMs Build World Models From Text? A Multilingual Diagnostic of Spatial Reasoning
Whether large language models (LLMs) construct internal spatial world models from pure-text descriptions remains contested, and whether such capabilities transfer across languages has not been systematically studied. We introduce MentalMap, a multilingual diagnostic benchmark with a six-level capability hierarchy (L0-L5) spanning atomic spatial facts to generative world-graph construction, together with four diagnostic axes probing frame of reference, reading-direction bias, reasoning-effort allocation, and hallucination. MentalMap is built from 100 ProcTHOR household scenes, covers eight typologically diverse languages plus a structured-text control, and contains 39 task families across 1,950 evaluation cells. Evaluating thirteen LLMs across scales and model families, we identify a universal L3 reasoning cliff: no model retains even half of its L0 performance on viewpoint reasoning once baseline atomic accuracy exceeds 40%. The cliff persists across languages, scales, and prompting strategies, while structured-output failures and reasoning patterns vary substantially across models. Human evaluation under the identical pure-text protocol reproduces the same failure pattern, suggesting that the bottleneck arises from text-only working memory constraints rather than being specific to current LLM architectures. Our findings reframe pure-text spatial reasoning as a multi-axis world-modeling problem and motivate multimodal and scratchpad-augmented reasoning as future directions.