arXiv:2602.13666v1 Announce Type: cross Abstract: In complex clinical decision-making, clinicians must often track a variety of competing metrics defined by aim (ideal) and limit (strict) thresholds. Sifting through these high-dimensional tradeoffs to infer the optimal patient-specific strategy is cognitively demanding and historically prone to variability. In this paper, we address this challenge within the context of High-Dose-Rate (HDR) brachytherapy for cervical cancer, where planning requires strictly managing radiation hot spots while balancing tumor coverage against organ sparing. We present ALMo (Aim-Limit-defined Multi-Objective system), an interactive decision support system designed to infer and operationalize clinician intent. ALMo employs a novel optimization framework that minimizes manual input through automated parameter setup and enables flexible control over toxicity risks. Crucially, the system allows clinicians to navigate the Pareto surface of dosimetric tradeoffs by directly manipulating intuitive aim and limit values. In a retrospective evaluation of 25 clinical cases, ALMo generated treatment plans that consistently met or exceeded manual planning quality, with 65% of cases demonstrating dosimetric improvements. Furthermore, the system significantly enhanced efficiency, reducing average planning time to approximately 17 minutes, compared to the conventional 30-60 minutes. While validated in brachytherapy, ALMo demonstrates a generalized framework for streamlining interaction in multi-criteria clinical decision-making.

arXiv:2602.15012v1 Announce Type: cross Abstract: Cold-start personalization requires inferring user preferences through interaction when no user-specific historical data is available. The core challenge is a routing problem: each task admits dozens of preference dimensions, yet individual users care about only a few, and which ones matter depends on who is asking. With a limited question budget, asking without structure will miss the dimensions that matter. Reinforcement learning is the natural formulation, but in multi-turn settings its terminal reward fails to exploit the factored, per-criterion structure of preference data, and in practice learned policies collapse to static question sequences that ignore user responses. We propose decomposing cold-start elicitation into offline structure learning and online Bayesian inference. Pep (Preference Elicitation with Priors) learns a structured world model of preference correlations offline from complete profiles, then performs training-free Bayesian inference online to select informative questions and predict complete preference profiles, including dimensions never asked about. The framework is modular across downstream solvers and requires only simple belief models. Across medical, mathematical, social, and commonsense reasoning, Pep achieves 80.8% alignment between generated responses and users' stated preferences versus 68.5% for RL, with 3-5x fewer interactions. When two users give different answers to the same question, Pep changes its follow-up 39-62% of the time versus 0-28% for RL. It does so with ~10K parameters versus 8B for RL, showing that the bottleneck in cold-start elicitation is the capability to exploit the factored structure of preference data.