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cs.AI updates on arXiv.org

Policy Split: Incentivizing Dual-Mode Exploration in LLM Reinforcement with Dual-Mode Entropy Regularization METER: Evaluating Multi-Level Contextual Causal Reasoning in Large Language Models Think Before you Write: QA-Guided Reasoning for Character Descriptions in Books METRO: Towards Strategy Induction from Expert Dialogue Transcripts for Non-collaborative Dialogues Retrieval as Generation: A Unified Framework with Self-Triggered Information Planning Do LLMs Know Tool Irrelevance? Demystifying Structural Alignment Bias in Tool Invocations Enhancing Multimodal Large Language Models for Ancient Chinese Character Evolution Analysis via Glyph-Driven Fine-Tuning Exploring Knowledge Conflicts for Faithful LLM Reasoning: Benchmark and Method CocoaBench: Evaluating Unified Digital Agents in the Wild MathAgent: Adversarial Evolution of Constraint Graphs for Mathematical Reasoning Data Synthesis Efficient Training for Cross-lingual Speech Language Models Shared Emotion Geometry Across Small Language Models: A Cross-Architecture Study of Representation, Behavior, and Methodological Confounds A Systematic Analysis of the Impact of Persona Steering on LLM Capabilities Uncertainty-Aware Web-Conditioned Scientific Fact-Checking When Valid Signals Fail: Regime Boundaries Between LLM Features and RL Trading Policies When Verification Fails: How Compositionally Infeasible Claims Escape Rejection Mem$^2$Evolve: Towards Self-Evolving Agents via Co-Evolutionary Capability Expansion and Experience Distillation AOP-Smart: A RAG-Enhanced Large Language Model Framework for Adverse Outcome Pathway Analysis Advancing Polish Language Modeling through Tokenizer Optimization in the Bielik v3 7B and 11B Series TInR: Exploring Tool-Internalized Reasoning in Large Language Models Do BERT Embeddings Encode Narrative Dimensions? A Token-Level Probing Analysis of Time, Space, Causality, and Character in Fiction Generating Multiple-Choice Knowledge Questions with Interpretable Difficulty Estimation using Knowledge Graphs and Large Language Models Deep-Reporter: Deep Research for Grounded Multimodal Long-Form Generation Too Nice to Tell the Truth: Quantifying Agreeableness-Driven Sycophancy in Role-Playing Language Models Learning and Enforcing Context-Sensitive Control for LLMs Efficient Process Reward Modeling via Contrastive Mutual Information Computational Lesions in Multilingual Language Models Separate Shared and Language-specific Brain Alignment Bridging Linguistic Gaps: Cross-Lingual Mapping in Pre-Training and Dataset for Enhanced Multilingual LLM Performance Early Decisions Matter: Proximity Bias and Initial Trajectory Shaping in Non-Autoregressive Diffusion Language Models LLMs Should Incorporate Explicit Mechanisms for Human Empathy
COPE: Chain-Of-Thought Prediction Engine for Open-Source ...
Yongkai Liu, Helena Feng, Bin Jiang, Yixin Wang, Max Wintermark, · 2025-12-02 · via cs.AI updates on arXiv.org

Predicting outcomes in acute ischemic stroke (AIS) guides clinical decision-making, patient counseling, and resource allocation. Clinical notes contain rich contextual information, but their unstructured nature limits their use in traditional predictive models. We developed and evaluated the Chain-of-Thought (CoT) Outcome Prediction Engine (COPE), a reasoning-enhanced large language model framework, for predicting 90-day functional outcomes after AIS from unstructured clinical notes. This study included 464 AIS patients with discharge summaries and 90-day modified Rankin Scale (mRS) scores. COPE uses a two-step CoT framework based on sequential open-source LLaMA-3-8B models: the first generates clinical reasoning, and the second outputs an mRS prediction. We compared COPE with GPT-4.1, ClinicalBERT, a structured variable-based machine learning model (Clinical ML), and a single-step LLM without CoT. Performance was evaluated using mean absolute error (MAE), accuracy within +/-1 mRS point, and exact accuracy. COPE achieved an MAE of 1.01 (95% CI 0.92-1.11), +/-1 accuracy of 74.4% (69.9, 78.8%), and exact accuracy of 32.8% (28.0, 37.6%), comparable to GPT-4.1 and superior to ClinicalBERT [MAE 1.24 (1.13-1.36)], Clinical ML [1.28 (1.18-1.39)], and the single-step LLM [1.20 (1.09-1.33)]. Subgroup analyses showed consistent performance across sex and age, with slightly higher error among older patients, those undergoing thrombectomy, and those with longer summaries. These findings demonstrate that COPE, a lightweight, interpretable, and privacy-preserving open-source framework, provides an accurate and practical solution for outcome prediction from unstructured clinical text.