United States

Large language models (LLMs) have been widely adopted in healthcare, yet they still encounter significant challenges in complex clinical decision-making scenarios. Existing benchmarks primarily assess LLM performance in single-course settings and lack systematic evaluation in multi-course scenarios, where a patient’s condition evolves over time. To address this gap, we propose ClinicalMC, a benchmark for multi-course clinical decision-making. It includes 1,275 Chinese and 5,804 English samples across four stages from admission to discharge. These stages cover triage, first-course examination/diagnosis/treatment, subsequent multi-course examination/assessment/treatment, and final diagnosis. In ClinicalMC, patients in the English dataset undergo an average of 5.11 clinical courses, whereas those in the Chinese dataset undergo 3.42. To assess LLM performance, we construct a multi-agent evaluation framework that includes patient, examiner, and doctor agents. Based on the benchmark and framework, we design two experimental settings—a single-turn static setting and a multi-turn dynamic setting—and assess three categories of LLMs: 1) closed-source LLMs like GPT-4o-mini; 2) open-source LLMs like DeepSeek-V3, and 3) medical LLMs like HuatuoGPT-o1. Through extensive evaluation, we aim to better understand LLM performance in the medical domain and support its effective deployment in healthcare.

ACL 2026

ClinicalMC: A Benchmark for Multi-Course Clinical Decision-Making with Large Language Models

poster

It is my great pleasure and honor to welcome you to the 64th Annual Meeting of the Association for Computational Linguistics (ACL 2026), held in San Diego, California, USA, July 2–7, 2026. ACL 2026 continues our fields tradition of excellence in scholarship, innovation, and inclusivity, and I am deeply grateful to the many volunteers who have worked tirelessly to bring this event to life.

It is exciting to see the many developments in the field reflected at our conference, such as the advancement of large language models (born out of our community) into many application directions. This is not without challenges, partly due to unsolved problems, and partly due to misuse of the technology. All this is reflected well at ACL 2026. The conference also reflects that the field is not only about advancing technology, but also the science of fundamentally understanding language and how it is use by many different speaker communities. <br>
[Full Message from General Chair Philipp Koehn](https://drive.google.com/file/d/1QiJFOmMjvDgsDo3i1XzlQnImxe3RU_Cy/view?usp=sharing) <br><br><br>
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The 64th Annual Meeting of the Association for Computational Linguistics (ACL 2026) will take place in San Diego, California, from July 2 - 7, 2026.

Selecting an appropriate LLM configuration for a given query is critical, yet existing routing frameworks operate within a single computational paradigm. To address this gap, we formalize the Cross-System Routing Problem, a hierarchical decision-making task that decomposes routing into intra-regime configuration selection and inter-regime system selection. Building on this, we propose BiCSRouter, a bi-level cross-system routing framework that integrates two orthogonal regimes: intensive reasoning via single-agent systems and extensive collaboration via multi-agent systems. BiCSRouter performs policy learning within each system and employs a lightweight inter-regime router that selects the optimal regime based on predicted performance and cost. Experiments on the MBPP and MATH benchmarks demonstrate that BiCSRouter outperforms 15 representative baselines across three types. On MBPP, compared to the performance ceiling of GPT-5, BiCSRouter achieves a 46\% reduction in cost with only a 2\% drop in accuracy. Finally, we show that BiCSRouter can extend to additional regimes, highlighting its generality as a cross-system routing framework.

BiCSRouter: Bi-Level Cross-System Routing for Utility-Aware LLM Inference

Tool calling requires Large Language Models (LLMs) to generate structured decisions including tool names and schema-constrained arguments, where small decoding mistakes can cause hard failures. Existing methods either rely on costly tool-use training data or only constrain syntax, leaving tool selection and argument value errors largely unsolved. We analyze tool calling failures through a Where–When lens: (Where) failures correlate with persistent uncertainty in late transformer layers, (When) uncertainty concentrates on content-bearing tokens (tool names and argument values) rather than schema tokens. Based on this, and motivated by evidence that transformer Feed Forward Networks (FFNs) act as key–value style memories that store and retrieve factual or associative mappings, we propose Memory Space Tool Retracing (MemTR), a weight-free decoding-time method that retrieves relevant tool evidence from the tool library and mixes it into the FFN-output at the uncertain layer, treating FFNs as key–value memories. Through extensive experiments on various model families (Qwen, Llama, and xLAM) and benchmarks (BFCL, ACEBench, APIBank), MemTR reduces tool calling failures by 2%–9% with only 1%–2% runtime overhead, without any fine-tuning or additional tool-use training data.

MemTR: Enhancing Tool-Calling Reliability via Uncertainty-Triggered FFN-Space Retracing

Autoregressive decoding in Large Language Models (LLMs) generates one token per step, causing high inference latency. Speculative decoding (SD) mitigates this through a guess-and-verify strategy, but existing training-free variants face trade-offs: retrieval-based drafts break when no exact match exists, while logits-based drafts lack structural guidance. We propose $\textbf{RACER}$ ($\textbf{R}$etrieval-$\textbf{A}$ugmented $\textbf{C}$ont$\textbf{e}$xtual $\textbf{R}$apid Speculative Decoding), a lightweight and training-free method that integrates retrieved exact patterns with logit-driven future cues. This unification supplies both reliable anchors and flexible extrapolation, yielding richer speculative drafts. Experiments on Spec-Bench, HumanEval, and MGSM-ZH demonstrate that RACER consistently accelerates inference, achieving more than $2\times$ speedup over autoregressive decoding, and outperforms prior training-free methods, offering a scalable, plug-and-play solution for efficient LLM decoding. Our source code is available at https://github.com/hkr04/RACER.

 RACER: Retrieval-Augmented Contextual Rapid Speculative Decoding

Self-Consistency improves reasoning reliability through multi-sample aggregation, but incurs substantial inference cost. Adaptive self-consistency methods mitigate this issue by adjusting the sampling budget; however, they rely on count-based stopping rules that treat all responses equally, often leading to unnecessary sampling. We propose \textbf{Re}liability-Aware \textbf{A}daptive \textbf{S}elf-\textbf{C}onsistency (\texttt{ReASC}), which addresses this limitation by reframing adaptive sampling from response counting to evidence sufficiency, leveraging response-level confidence for principled information aggregation. \texttt{ReASC} operates in two stages: a single-sample decision stage that resolves instances confidently answerable from a single response, and a reliability-aware accumulation stage that aggregates responses by jointly leveraging their frequency and confidence. Across five models and four datasets, \texttt{ReASC} consistently achieves the best accuracy-cost trade-off compared to existing baselines, yielding improved inference efficiency across model scales from 3B to 27B parameters. As a concrete example, \texttt{ReASC} reduces inference cost by up to 70% relative to self-consistency while preserving accuracy on GSM8K using Gemma-3-4B-it.

Reliability-Aware Adaptive Self-Consistency for Efficient Sampling in LLM Reasoning

Large Language Models (LLMs) typically come with a fixed architecture, despite growing evidence that not all layers contribute equally to every downstream task. We introduce TALE (Task-Aware Layer Elimination), an inference-time method that improves task performance by selectively removing layers that are irrelevant or detrimental for a given task. TALE optimizes task-specific performance, yielding a task-optimized architecture without retraining. Across 9 tasks and 5 model families, under both zero-shot and few-shot settings, TALE consistently matches or surpasses baseline performance while simultaneously reducing computational costs. TALE also synergizes with fine-tuning, leading to further performance improvements. Computing TALE for a new task requires modest resources, making it a practical and deployable solution for task-specialized LLM inference.

 TELL-TALE: Task Efficient LLMs with Task Aware Layer Elimination

Long-horizon agents face the challenge of growing context size during interaction with environment, which degrades the performance and stability. Existing methods typically introduce the external memory module and look up the relevant information from the stored memory, which prevents the model itself from proactively managing its memory content and aligning with the agent's overarching task objectives. To address these limitations, we propose the self-memory policy optimization algorithm (MemPO), which enables the agent (policy model) to autonomously summarize and manage their memory during interaction with environment. By improving the credit assignment mechanism based on memory effectiveness, the policy model can selectively retain crucial information, significantly reducing token consumption while preserving task performance. Extensive experiments and analyses confirm that MemPO achieves absolute F1 score gains of 25.98 over the base model and 7.1 over the previous SOTA baseline, while reducing token usage by 67.58% and 73.12%.

MemPO: Self-Memory Policy Optimization for Long-Horizon Agents

Recent advancements in the Generative Reward Model (GRM) have demonstrated its potential to enhance the reasoning abilities of LLMs through Chain-of-Thought (CoT) prompting. Despite these gains, existing implementations of GRM suffer from two critical limitations. First, CoT prompting is applied indiscriminately to all inputs regardless of their inherent complexity. This introduces unnecessary computational costs for tasks amenable to fast, direct inference. Second, existing approaches primarily rely on voting-based mechanisms to evaluate CoT outputs, which often lack granularity and precision in assessing reasoning quality. In this paper, we propose E-GRM, an efficient generative reward modeling framework grounded in model-internal uncertainty. E-GRM leverages the convergence behavior of parallel model generations to estimate uncertainty and selectively trigger CoT reasoning only when needed, without relying on handcrafted features or task-dependent signals. To improve reward fidelity, we introduce a lightweight discriminative scorer trained with a hybrid regression–ranking objective to provide fine-grained evaluation of reasoning paths. Experiments on multiple reasoning benchmarks show that E-GRM substantially reduces inference cost while consistently improving answer accuracy, demonstrating that model-internal uncertainty is an effective and general signal for efficient reasoning-aware reward modeling.

Reason Only When Needed: Efficient Generative Reward Modeling via Model-Internal Uncertainty

A fundamental challenge in creative writing lies in reconciling the inherent tension between maintaining global coherence in long-form narratives and preserving local expressiveness in short-form texts. While long-context generation necessitates explicit macroscopic planning, short-form creativity often demands spontaneous, constraint-free expression. Existing alignment paradigms, however, typically employ static reward signals and rely heavily on high-quality supervised data, which is costly and difficult to scale. To address this, we propose UniCreative, a unified reference-free reinforcement learning framework. We first introduce AC-GenRM, an adaptive constraint-aware reward model that dynamically synthesizes query-specific criteria to provide fine-grained preference judgments. Leveraging these signals, we propose ACPO, a policy optimization algorithm that aligns models with human preferences across both content quality and structural paradigms without supervised fine-tuning and ground-truth references. Empirical results demonstrate that AC-GenRM aligns closely with expert evaluations, while ACPO significantly enhances performance across diverse writing tasks. Crucially, our analysis reveals an emergent meta-cognitive ability: the model learns to autonomously differentiate between tasks requiring rigorous planning and those favoring direct generation, validating the effectiveness of our direct alignment approach.

UniCreative: Unifying Long-form Logic and Short-form Sparkle via Reference-Free Reinforcement Learning

Current research on large language models (LLMs) with retrieval-augmented code generation (RACG) has largely focused on single-language settings, leaving their cross-lingual effectiveness underexplored. Multilingual RACG systems are increasingly important for migrating and reusing code across programming languages (PLs), a common yet challenging task in modern software development. To systematically study cross-lingual code knowledge transfer in RACG, we construct a dataset covering 13 PLs with nearly 14K instances. Our experiments reveal three key insights: (1) Knowledge transfer in RACG across PLs is non-trivial even using direct injection. (2) RACG exhibits unequal cross-lingual knowledge transfer, and its efficacy depends on linguistic affinity of PL pair and diversity of LLM pretraining corpus. (3) RACG shows limited reliance on natural language information embedded in code when equipped with a code-specific retriever. These findings provide practical guidance for designing effective multilingual RACG systems. https://github.com/icip-cas/Cross-Lingual-RACG

Across Programming Language Silos: A Study on Cross-Lingual Retrieval-Augmented Code Generation

Character description generation is an important capability for narrative-focused applications such as summarization, story analysis, and character-driven simulations. However, generating accurate character descriptions from long-form narratives (e.g., novels) is challenging: models must track evolving attributes (e.g., relationships and events), integrate evidence scattered across the text, and infer implicit details. Despite the success of reasoning-enabled LLMs on many benchmarks, we find that for character description generation their performance improves when built-in reasoning is disabled (i.e., an empty reasoning trace). Motivated by this, we propose a training framework that decouples reasoning from generation. Our approach, which can be applied on top of long-context LLMs or chunk-based methods, consists of a reasoning model that produces a structured QA reasoning trace and a generation model that conditions on this trace to produce the final character description. Experiments on two datasets (BookWorm and CroSS) show that QA-guided reasoning improves faithfulness, informativeness, and grounding over strong long-context baselines.

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BiCSRouter: Bi-Level Cross-System Routing for Utility-Aware LLM Inference

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