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Daniella Meeker

Daniella Meeker contributes to research discovery and scholarly infrastructure.

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Artificial Intelligence Computation and Language eess.AS Sound

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preprint2026arXiv

Conditional Attribute Estimation with Autoregressive Sequence Models

Generative models are often trained with a next-token prediction objective, yet many downstream applications require the ability to estimate or control sequence-level properties. Next-token prediction can lead to overfitting of local patterns during training, underfitting of global structure, and requires significant downstream modifications or expensive sampling to guide or predict the global attributes of generated samples at inference time. Here, we introduce Conditional Attribute Transformers, a novel method for jointly estimating the next-token probability and the value of an attribute conditional on each potential next token selection. This framework enables three critical capabilities within a single forward pass, without modification of the input sequence: (1) per-token credit assignment across an entire sequence, by identifying how each token in a sequence is associated with an attribute's value; (2) counterfactual analysis, by quantifying attribute differences conditional on alternative next token choices; (3) steerable generation, by decoding sequences based on a combination of next-token and attribute likelihoods. Our approach achieves state of the art performance on sparse reward tasks, improves next-token prediction at sufficient model sizes, estimates attribute probabilities orders of magnitude faster than sampling, and can guide decoding of autoregressive sequence models on a range of language tasks.

preprint2026arXiv

Foundation Models to Unlock Real-World Evidence from Nationwide Medical Claims

Evidence derived from large-scale real-world data (RWD) is increasingly informing regulatory evaluation and healthcare decision-making. Administrative claims provide population-scale, longitudinal records of healthcare utilization, expenditure, and detailed coding of diagnoses, procedures, and medications, yet their potential as a substrate for healthcare foundation models remains largely unexplored. Here we present ReClaim, a generative transformer trained from scratch on 43.8 billion medical events from more than 200 million enrollees in the MarketScan claims data spanning 2008-2022. ReClaim models longitudinal trajectories across diagnoses, procedures, medications, and expenditure, and was scaled to 140 million, 700 million, and 1.7 billion parameters. Across over 1,000 disease-onset prediction tasks, ReClaim achieved a mean AUC of 75.6%, substantially outperforming disease-specific LightGBM (66.3%) and the transformer-based Delphi model (69.4%), with the largest gains for rare diseases. These advantages held across retrospective and prospective evaluations and in external validation on two independent datasets. Performance improved monotonically with scale, and post-training added 13.8 percentage points over pre-training alone. Beyond disease prediction, ReClaim captured financial outcomes and improved real-world evidence (RWE) analyses: for healthcare expenditure forecasting it increased explained variance from 0.28 to 0.37 relative to LightGBM, and in a target trial emulation it reduced systematic bias by 72% on average relative to Delphi. Together, these results establish administrative claims as a scalable substrate for healthcare foundation models and show that learned representations generalize across time periods and data sources, supporting disease surveillance, expenditure forecasting, and RWE generation.

preprint2020arXiv

Automated Empathy Detection for Oncology Encounters

Empathy involves understanding other people's situation, perspective, and feelings. In clinical interactions, it helps clinicians establish rapport with a patient and support patient-centered care and decision making. Understanding physician communication through observation of audio-recorded encounters is largely carried out with manual annotation and analysis. However, manual annotation has a prohibitively high cost. In this paper, a multimodal system is proposed for the first time to automatically detect empathic interactions in recordings of real-world face-to-face oncology encounters that might accelerate manual processes. An automatic speech and language processing pipeline is employed to segment and diarize the audio as well as for transcription of speech into text. Lexical and acoustic features are derived to help detect both empathic opportunities offered by the patient, and the expressed empathy by the oncologist. We make the empathy predictions using Support Vector Machines (SVMs) and evaluate the performance on different combinations of features in terms of average precision (AP).

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