arXiv subjects

Steven Feiner

Publications and source records attributed to Steven Feiner.

2 recordsLinked to original sources

arXiv2026

Co-Annotator: Expert-Distilled ViT and VLM for Visual and Documentation Guidance in Age-Related Macular Degeneration

Clinical AI often optimizes predictive performance without engaging how clinicians decide where to look and what to write. We present Co-Annotator, which distills expert gaze and dictation into two guidance components: a gaze-aligned Vision Transformer producing fixation-aligned areas of interest (AOIs), and an ontology-bounded vision-language model (VLM) that pre-fills editable biomarker summaries for retinal optical coherence tomography (OCT). We first collect expert gaze and dictations (US1) to train the models, significantly improving diagnostic accuracy and biomarker generation. We then deploy the system with ophthalmology residents: a controlled resident study (US2) confirmed each modality is safe and independently beneficial, with AOI guidance producing lasting perceptual efficiency gains through post-guidance carryover and VLM guidance more than doubling biomarker documentation breadth. In a combined deployment across two academic institutions (US3), providing both modalities simultaneously produced efficiency gains that substantially exceeded either modality alone: correct diagnoses per minute increased by 40% and comment editing time fell by 67%, without compromising diagnostic accuracy. Notably, neither modality improved efficiency during guidance in US2, which makes the in-guidance efficiency gain under combined guidance in US3 the more striking result. Expert-distilled multimodal guidance can remove two distinct clinical workflow bottlenecks at once (visual search overhead and documentation burden) without compromising the diagnostic accuracy clinicians already achieve.

cs.AI↗

arXiv2026

Augmenting Human Performance with an XR Agent Learning from Online Behavior and BCI Evidence

We present OLIVE, a framework for adapting a foundation model to provide real-time assistance in temporally demanding, high-stakes, and dynamic tasks. We show that passive EEG, fused online with behavioral evidence, can meaningfully extend the number of targets users detect and engage beyond their unaided action bandwidth. OLIVE learns from both explicit behavioral signals (the targets the user shoots down in an XR first-person shooter game) and implicit physiological signals (fixation-locked EEG) to provide timely guidance, continuously adapting a frozen vision-language model's inference on which items are task-relevant by jointly estimating per-source reliability without manual labels or offline training. Through three user studies, including two live deployments of an assistive agent driven by OLIVE in XR, we show that OLIVE Pareto-dominates prior test-time adaptation frameworks, achieving the highest convergence rate at comparable convergence speed. Combining implicit physiological and explicit behavioral signals, the OLIVE agent produces the largest and most reliable within-session improvement to a user's ability to detect and engage targets, largely independent of the individual's skill. When the target switches silently, the agent that uses both behavioral and physiological signals reconverges significantly faster than the behavior-only agent (1.27 times faster on average, p = .008), restoring trustworthy guidance at the moment the task changes, precisely when reliable assistance matters most.

cs.AI↗