Pathologists' narrated slide reviews became supervision that beat Claude Code and Codex on diagnostic tasks by 17.9 and 24.1 points
AspireAI community · arXiv
PathCowork turns how pathologists examine slides - synchronized gaze, narration and navigation - into training supervision, not just the diagnoses they write down. Across 48 sessions with 16 pathologists the platform captured 1,028 minutes of slide review, and the authors trained PathCowork-1T for server deployment and PathCowork-27B for local use. On five organ-specific evaluations, agents combining that visual grounding with recorded diagnostic procedures averaged primary task scores 17.9 points above Claude Code and 24.1 points above Codex, with shorter processing times and lower inference cost, and the agent-proposed regions beat state-of-the-art multiple-instance-learning models on prostate grading even with limited slide labels. The comparison runs against those two coding agents on pathology cases, and the recordings come from 16 clinicians at a single institution, which is a narrow sample for the behavioural supervision.
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Two sparse-autoencoder analyses have resisted scaling: matching semantically similar features across layers, and compressing large feature circuits into interpretable supernodes. This paper argues both are the same underlying problem, estimating semantic distances between SAE features that sit on different activation manifolds. Its representation treats each feature not as a single decoder vector but as an activation-weighted distribution over the hidden states expressing it, projects those distributions into a shared reference space, and compares them with Wasserstein distance. The representation is proved invariant to activation rescaling and stable under perturbation, and recovers true matches under finite-sample margin conditions. Empirically it outperformed decoder-vector and LLM-based baselines and captured subtle functional distinctions between related features, and it compressed large feature circuits into interpretable supernodes automatically. The limitation is that this is interpretability tooling: the paper demonstrates better feature matching and circuit compression, not that downstream interpretability claims become more accurate.