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SubscribeICU-Sepsis: A Benchmark MDP Built from Real Medical Data
We present ICU-Sepsis, an environment that can be used in benchmarks for evaluating reinforcement learning (RL) algorithms. Sepsis management is a complex task that has been an important topic in applied RL research in recent years. Therefore, MDPs that model sepsis management can serve as part of a benchmark to evaluate RL algorithms on a challenging real-world problem. However, creating usable MDPs that simulate sepsis care in the ICU remains a challenge due to the complexities involved in acquiring and processing patient data. ICU-Sepsis is a lightweight environment that models personalized care of sepsis patients in the ICU. The environment is a tabular MDP that is widely compatible and is challenging even for state-of-the-art RL algorithms, making it a valuable tool for benchmarking their performance. However, we emphasize that while ICU-Sepsis provides a standardized environment for evaluating RL algorithms, it should not be used to draw conclusions that guide medical practice.
Learning the progression and clinical subtypes of Alzheimer's disease from longitudinal clinical data
Alzheimer's disease (AD) is a degenerative brain disease impairing a person's ability to perform day to day activities. The clinical manifestations of Alzheimer's disease are characterized by heterogeneity in age, disease span, progression rate, impairment of memory and cognitive abilities. Due to these variabilities, personalized care and treatment planning, as well as patient counseling about their individual progression is limited. Recent developments in machine learning to detect hidden patterns in complex, multi-dimensional datasets provides significant opportunities to address this critical need. In this work, we use unsupervised and supervised machine learning approaches for subtype identification and prediction. We apply machine learning methods to the extensive clinical observations available at the Alzheimer's Disease Neuroimaging Initiative (ADNI) data set to identify patient subtypes and to predict disease progression. Our analysis depicts the progression space for the Alzheimer's disease into low, moderate and high disease progression zones. The proposed work will enable early detection and characterization of distinct disease subtypes based on clinical heterogeneity. We anticipate that our models will enable patient counseling, clinical trial design, and ultimately individualized clinical care.
Neural Control System for Continuous Glucose Monitoring and Maintenance
Precise glucose level monitoring is critical for people with diabetes to avoid serious complications. While there are several methods for continuous glucose level monitoring, research on maintenance devices is limited. To mitigate the gap, we provide a novel neural control system for continuous glucose monitoring and management that uses differential predictive control. Our approach, led by a sophisticated neural policy and differentiable modeling, constantly adjusts insulin supply in real-time, thereby improving glucose level optimization in the body. This end-to-end method maximizes efficiency, providing personalized care and improved health outcomes, as confirmed by empirical evidence.
MentalArena: Self-play Training of Language Models for Diagnosis and Treatment of Mental Health Disorders
Mental health disorders are one of the most serious diseases in the world. Most people with such a disease lack access to adequate care, which highlights the importance of training models for the diagnosis and treatment of mental health disorders. However, in the mental health domain, privacy concerns limit the accessibility of personalized treatment data, making it challenging to build powerful models. In this paper, we introduce MentalArena, a self-play framework to train language models by generating domain-specific personalized data, where we obtain a better model capable of making a personalized diagnosis and treatment (as a therapist) and providing information (as a patient). To accurately model human-like mental health patients, we devise Symptom Encoder, which simulates a real patient from both cognition and behavior perspectives. To address intent bias during patient-therapist interactions, we propose Symptom Decoder to compare diagnosed symptoms with encoded symptoms, and dynamically manage the dialogue between patient and therapist according to the identified deviations. We evaluated MentalArena against 6 benchmarks, including biomedicalQA and mental health tasks, compared to 6 advanced models. Our models, fine-tuned on both GPT-3.5 and Llama-3-8b, significantly outperform their counterparts, including GPT-4o. We hope that our work can inspire future research on personalized care. Code is available in https://github.com/Scarelette/MentalArena/tree/main
Building Flexible, Scalable, and Machine Learning-ready Multimodal Oncology Datasets
The advancements in data acquisition, storage, and processing techniques have resulted in the rapid growth of heterogeneous medical data. Integrating radiological scans, histopathology images, and molecular information with clinical data is essential for developing a holistic understanding of the disease and optimizing treatment. The need for integrating data from multiple sources is further pronounced in complex diseases such as cancer for enabling precision medicine and personalized treatments. This work proposes Multimodal Integration of Oncology Data System (MINDS) - a flexible, scalable, and cost-effective metadata framework for efficiently fusing disparate data from public sources such as the Cancer Research Data Commons (CRDC) into an interconnected, patient-centric framework. MINDS offers an interface for exploring relationships across data types and building cohorts for developing large-scale multimodal machine learning models. By harmonizing multimodal data, MINDS aims to potentially empower researchers with greater analytical ability to uncover diagnostic and prognostic insights and enable evidence-based personalized care. MINDS tracks granular end-to-end data provenance, ensuring reproducibility and transparency. The cloud-native architecture of MINDS can handle exponential data growth in a secure, cost-optimized manner while ensuring substantial storage optimization, replication avoidance, and dynamic access capabilities. Auto-scaling, access controls, and other mechanisms guarantee pipelines' scalability and security. MINDS overcomes the limitations of existing biomedical data silos via an interoperable metadata-driven approach that represents a pivotal step toward the future of oncology data integration.
Navigating the Unknown: A Chat-Based Collaborative Interface for Personalized Exploratory Tasks
The rise of large language models (LLMs) has revolutionized user interactions with knowledge-based systems, enabling chatbots to synthesize vast amounts of information and assist with complex, exploratory tasks. However, LLM-based chatbots often struggle to provide personalized support, particularly when users start with vague queries or lack sufficient contextual information. This paper introduces the Collaborative Assistant for Personalized Exploration (CARE), a system designed to enhance personalization in exploratory tasks by combining a multi-agent LLM framework with a structured user interface. CARE's interface consists of a Chat Panel, Solution Panel, and Needs Panel, enabling iterative query refinement and dynamic solution generation. The multi-agent framework collaborates to identify both explicit and implicit user needs, delivering tailored, actionable solutions. In a within-subject user study with 22 participants, CARE was consistently preferred over a baseline LLM chatbot, with users praising its ability to reduce cognitive load, inspire creativity, and provide more tailored solutions. Our findings highlight CARE's potential to transform LLM-based systems from passive information retrievers to proactive partners in personalized problem-solving and exploration.
Clinical Text Summarization: Adapting Large Language Models Can Outperform Human Experts
Sifting through vast textual data and summarizing key information imposes a substantial burden on how clinicians allocate their time. Although large language models (LLMs) have shown immense promise in natural language processing (NLP) tasks, their efficacy across diverse clinical summarization tasks has not yet been rigorously examined. In this work, we employ domain adaptation methods on eight LLMs, spanning six datasets and four distinct summarization tasks: radiology reports, patient questions, progress notes, and doctor-patient dialogue. Our thorough quantitative assessment reveals trade-offs between models and adaptation methods in addition to instances where recent advances in LLMs may not lead to improved results. Further, in a clinical reader study with six physicians, we depict that summaries from the best adapted LLM are preferable to human summaries in terms of completeness and correctness. Our ensuing qualitative analysis delineates mutual challenges faced by both LLMs and human experts. Lastly, we correlate traditional quantitative NLP metrics with reader study scores to enhance our understanding of how these metrics align with physician preferences. Our research marks the first evidence of LLMs outperforming human experts in clinical text summarization across multiple tasks. This implies that integrating LLMs into clinical workflows could alleviate documentation burden, empowering clinicians to focus more on personalized patient care and other irreplaceable human aspects of medicine.
Enhancing Nursing and Elderly Care with Large Language Models: An AI-Driven Framework
This paper explores the application of large language models (LLMs) in nursing and elderly care, focusing on AI-driven patient monitoring and interaction. We introduce a novel Chinese nursing dataset and implement incremental pre-training (IPT) and supervised fine-tuning (SFT) techniques to enhance LLM performance in specialized tasks. Using LangChain, we develop a dynamic nursing assistant capable of real-time care and personalized interventions. Experimental results demonstrate significant improvements, paving the way for AI-driven solutions to meet the growing demands of healthcare in aging populations.
SemEval-2023 Task 7: Multi-Evidence Natural Language Inference for Clinical Trial Data
This paper describes the results of SemEval 2023 task 7 -- Multi-Evidence Natural Language Inference for Clinical Trial Data (NLI4CT) -- consisting of 2 tasks, a Natural Language Inference (NLI) task, and an evidence selection task on clinical trial data. The proposed challenges require multi-hop biomedical and numerical reasoning, which are of significant importance to the development of systems capable of large-scale interpretation and retrieval of medical evidence, to provide personalized evidence-based care. Task 1, the entailment task, received 643 submissions from 40 participants, and Task 2, the evidence selection task, received 364 submissions from 23 participants. The tasks are challenging, with the majority of submitted systems failing to significantly outperform the majority class baseline on the entailment task, and we observe significantly better performance on the evidence selection task than on the entailment task. Increasing the number of model parameters leads to a direct increase in performance, far more significant than the effect of biomedical pre-training. Future works could explore the limitations of large models for generalization and numerical inference, and investigate methods to augment clinical datasets to allow for more rigorous testing and to facilitate fine-tuning. We envisage that the dataset, models, and results of this task will be useful to the biomedical NLI and evidence retrieval communities. The dataset, competition leaderboard, and website are publicly available.
MC-LLaVA: Multi-Concept Personalized Vision-Language Model
Current vision-language models (VLMs) show exceptional abilities across diverse tasks including visual question answering. To enhance user experience in practical applications, recent studies investigate VLM personalization to understand user-provided concepts. However, existing studies mainly focus on single-concept personalization, neglecting the existence and interplay of multiple concepts, which limits the real-world applicability of personalized VLMs. In this paper, we propose the first multi-concept personalization method named MC-LLaVA along with a high-quality multi-concept personalization dataset. Specifically, MC-LLaVA uses a joint training strategy incorporating multiple concepts in a single training step, allowing VLMs to perform accurately in multi-concept personalization. To reduce the cost of joint training, MC-LLaVA leverages visual token information for concept token initialization, yielding improved concept representation and accelerating joint training. To advance multi-concept personalization research, we further contribute a high-quality dataset. We carefully collect images from various movies that contain multiple characters and manually generate the multi-concept question-answer samples. Our dataset features diverse movie types and question-answer types. We conduct comprehensive qualitative and quantitative experiments to demonstrate that MC-LLaVA can achieve impressive multi-concept personalized responses, paving the way for VLMs to become better user-specific assistants. The code and dataset will be publicly available at https://github.com/arctanxarc/MC-LLaVA.
Panza: A Personalized Text Writing Assistant via Data Playback and Local Fine-Tuning
The availability of powerful open-source large language models (LLMs) opens exciting use-cases, such as automated personal assistants that adapt to the user's unique data and demands. Two key desiderata for such assistants are personalization-in the sense that the assistant should reflect the user's own style-and privacy-in the sense that users may prefer to always store their personal data locally, on their own computing device. We present a new design for such an automated assistant, for the specific use case of personal assistant for email generation, which we call Panza. Specifically, Panza can be both trained and inferenced locally on commodity hardware, and is personalized to the user's writing style. Panza's personalization features are based on a new technique called data playback, which allows us to fine-tune an LLM to better reflect a user's writing style using limited data. We show that, by combining efficient fine-tuning and inference methods, Panza can be executed entirely locally using limited resources-specifically, it can be executed within the same resources as a free Google Colab instance. Finally, our key methodological contribution is a careful study of evaluation metrics, and of how different choices of system components (e.g. the use of Retrieval-Augmented Generation or different fine-tuning approaches) impact the system's performance.
Digital Twins for Patient Care via Knowledge Graphs and Closed-Form Continuous-Time Liquid Neural Networks
Digital twin technology has is anticipated to transform healthcare, enabling personalized medicines and support, earlier diagnoses, simulated treatment outcomes, and optimized surgical plans. Digital twins are readily gaining traction in industries like manufacturing, supply chain logistics, and civil infrastructure. Not in patient care, however. The challenge of modeling complex diseases with multimodal patient data and the computational complexities of analyzing it have stifled digital twin adoption in the biomedical vertical. Yet, these major obstacles can potentially be handled by approaching these models in a different way. This paper proposes a novel framework for addressing the barriers to clinical twin modeling created by computational costs and modeling complexities. We propose structuring patient health data as a knowledge graph and using closed-form continuous-time liquid neural networks, for real-time analytics. By synthesizing multimodal patient data and leveraging the flexibility and efficiency of closed form continuous time networks and knowledge graph ontologies, our approach enables real time insights, personalized medicine, early diagnosis and intervention, and optimal surgical planning. This novel approach provides a comprehensive and adaptable view of patient health along with real-time analytics, paving the way for digital twin simulations and other anticipated benefits in healthcare.
A Personalized Dialogue Generator with Implicit User Persona Detection
Current works in the generation of personalized dialogue primarily contribute to the agent presenting a consistent personality and driving a more informative response. However, we found that the generated responses from most previous models tend to be self-centered, with little care for the user in the dialogue. Moreover, we consider that human-like conversation is essentially built based on inferring information about the persona of the other party. Motivated by this, we propose a novel personalized dialogue generator by detecting an implicit user persona. Because it is hard to collect a large number of detailed personas for each user, we attempted to model the user's potential persona and its representation from dialogue history, with no external knowledge. The perception and fader variables were conceived using conditional variational inference. The two latent variables simulate the process of people being aware of each other's persona and producing a corresponding expression in conversation. Finally, posterior-discriminated regularization was presented to enhance the training procedure. Empirical studies demonstrate that, compared to state-of-the-art methods, our approach is more concerned with the user's persona and achieves a considerable boost across the evaluations.
CARES: A Comprehensive Benchmark of Trustworthiness in Medical Vision Language Models
Artificial intelligence has significantly impacted medical applications, particularly with the advent of Medical Large Vision Language Models (Med-LVLMs), sparking optimism for the future of automated and personalized healthcare. However, the trustworthiness of Med-LVLMs remains unverified, posing significant risks for future model deployment. In this paper, we introduce CARES and aim to comprehensively evaluate the Trustworthiness of Med-LVLMs across the medical domain. We assess the trustworthiness of Med-LVLMs across five dimensions, including trustfulness, fairness, safety, privacy, and robustness. CARES comprises about 41K question-answer pairs in both closed and open-ended formats, covering 16 medical image modalities and 27 anatomical regions. Our analysis reveals that the models consistently exhibit concerns regarding trustworthiness, often displaying factual inaccuracies and failing to maintain fairness across different demographic groups. Furthermore, they are vulnerable to attacks and demonstrate a lack of privacy awareness. We publicly release our benchmark and code in https://github.com/richard-peng-xia/CARES.
UniMS-RAG: A Unified Multi-source Retrieval-Augmented Generation for Personalized Dialogue Systems
Large Language Models (LLMs) has shown exceptional capabilities in many natual language understanding and generation tasks. However, the personalization issue still remains a much-coveted property, especially when it comes to the multiple sources involved in the dialogue system. To better plan and incorporate the use of multiple sources in generating personalized response, we firstly decompose it into three sub-tasks: Knowledge Source Selection, Knowledge Retrieval, and Response Generation. We then propose a novel Unified Multi-Source Retrieval-Augmented Generation system (UniMS-RAG) Specifically, we unify these three sub-tasks with different formulations into the same sequence-to-sequence paradigm during the training, to adaptively retrieve evidences and evaluate the relevance on-demand using special tokens, called acting tokens and evaluation tokens. Enabling language models to generate acting tokens facilitates interaction with various knowledge sources, allowing them to adapt their behavior to diverse task requirements. Meanwhile, evaluation tokens gauge the relevance score between the dialogue context and the retrieved evidence. In addition, we carefully design a self-refinement mechanism to iteratively refine the generated response considering 1) the consistency scores between the generated response and retrieved evidence; and 2) the relevance scores. Experiments on two personalized datasets (DuLeMon and KBP) show that UniMS-RAG achieves state-of-the-art performance on the knowledge source selection and response generation task with itself as a retriever in a unified manner. Extensive analyses and discussions are provided for shedding some new perspectives for personalized dialogue systems.
Knowledge-Augmented Large Language Models for Personalized Contextual Query Suggestion
Large Language Models (LLMs) excel at tackling various natural language tasks. However, due to the significant costs involved in re-training or fine-tuning them, they remain largely static and difficult to personalize. Nevertheless, a variety of applications could benefit from generations that are tailored to users' preferences, goals, and knowledge. Among them is web search, where knowing what a user is trying to accomplish, what they care about, and what they know can lead to improved search experiences. In this work, we propose a novel and general approach that augments an LLM with relevant context from users' interaction histories with a search engine in order to personalize its outputs. Specifically, we construct an entity-centric knowledge store for each user based on their search and browsing activities on the web, which is then leveraged to provide contextually relevant LLM prompt augmentations. This knowledge store is light-weight, since it only produces user-specific aggregate projections of interests and knowledge onto public knowledge graphs, and leverages existing search log infrastructure, thereby mitigating the privacy, compliance, and scalability concerns associated with building deep user profiles for personalization. We then validate our approach on the task of contextual query suggestion, which requires understanding not only the user's current search context but also what they historically know and care about. Through a number of experiments based on human evaluation, we show that our approach is significantly better than several other LLM-powered baselines, generating query suggestions that are contextually more relevant, personalized, and useful.
Deep Learning for Personalized Electrocardiogram Diagnosis: A Review
The electrocardiogram (ECG) remains a fundamental tool in cardiac diagnostics, yet its interpretation traditionally reliant on the expertise of cardiologists. The emergence of deep learning has heralded a revolutionary era in medical data analysis, particularly in the domain of ECG diagnostics. However, inter-patient variability prohibit the generalibility of ECG-AI model trained on a population dataset, hence degrade the performance of ECG-AI on specific patient or patient group. Many studies have address this challenge using different deep learning technologies. This comprehensive review systematically synthesizes research from a wide range of studies to provide an in-depth examination of cutting-edge deep-learning techniques in personalized ECG diagnosis. The review outlines a rigorous methodology for the selection of pertinent scholarly articles and offers a comprehensive overview of deep learning approaches applied to personalized ECG diagnostics. Moreover, the challenges these methods encounter are investigated, along with future research directions, culminating in insights into how the integration of deep learning can transform personalized ECG diagnosis and enhance cardiac care. By emphasizing both the strengths and limitations of current methodologies, this review underscores the immense potential of deep learning to refine and redefine ECG analysis in clinical practice, paving the way for more accurate, efficient, and personalized cardiac diagnostics.
An adapted large language model facilitates multiple medical tasks in diabetes care
Diabetes is a chronic disease that poses a significant global health burden, and optimizing diabetes management requires multi-stakeholder collaboration. Large language models (LLMs) have shown promise in various healthcare scenarios, but their effectiveness across a diverse range of diabetes tasks remains unproven. In this study, we introduced a framework to train and validate diabetes-specific LLMs. We first developed a comprehensive data processing pipeline that includes data collection, filtering, augmentation and refinement. This approach contributes to creating a high-quality, diabetes-specific dataset, and several evaluation benchmarks entirely from scratch. Utilizing the collected training dataset, we fine-tuned a diabetes-specific LLM family that demonstrated state-of-the-art proficiency in understanding and processing various diabetes tasks compared to other LLMs. Furthermore, clinical studies showed the potential applications of our models in diabetes care, including providing personalized healthcare, assisting medical education, and streamlining clinical tasks. In conclusion, our study introduced a framework to develop and evaluate a diabetes-specific LLM family, and highlighted its potential to enhance clinical practice and provide personalized, data-driven support for diabetes support when facing different end users. The code is provided via GitHub at https://github.com/waltonfuture/Diabetica.
ResumeFlow: An LLM-facilitated Pipeline for Personalized Resume Generation and Refinement
Crafting the ideal, job-specific resume is a challenging task for many job applicants, especially for early-career applicants. While it is highly recommended that applicants tailor their resume to the specific role they are applying for, manually tailoring resumes to job descriptions and role-specific requirements is often (1) extremely time-consuming, and (2) prone to human errors. Furthermore, performing such a tailoring step at scale while applying to several roles may result in a lack of quality of the edited resumes. To tackle this problem, in this demo paper, we propose ResumeFlow: a Large Language Model (LLM) aided tool that enables an end user to simply provide their detailed resume and the desired job posting, and obtain a personalized resume specifically tailored to that specific job posting in the matter of a few seconds. Our proposed pipeline leverages the language understanding and information extraction capabilities of state-of-the-art LLMs such as OpenAI's GPT-4 and Google's Gemini, in order to (1) extract details from a job description, (2) extract role-specific details from the user-provided resume, and then (3) use these to refine and generate a role-specific resume for the user. Our easy-to-use tool leverages the user-chosen LLM in a completely off-the-shelf manner, thus requiring no fine-tuning. We demonstrate the effectiveness of our tool via a video demo and propose novel task-specific evaluation metrics to control for alignment and hallucination. Our tool is available at https://job-aligned-resume.streamlit.app.
Bold but Cautious: Unlocking the Potential of Personalized Federated Learning through Cautiously Aggressive Collaboration
Personalized federated learning (PFL) reduces the impact of non-independent and identically distributed (non-IID) data among clients by allowing each client to train a personalized model when collaborating with others. A key question in PFL is to decide which parameters of a client should be localized or shared with others. In current mainstream approaches, all layers that are sensitive to non-IID data (such as classifier layers) are generally personalized. The reasoning behind this approach is understandable, as localizing parameters that are easily influenced by non-IID data can prevent the potential negative effect of collaboration. However, we believe that this approach is too conservative for collaboration. For example, for a certain client, even if its parameters are easily influenced by non-IID data, it can still benefit by sharing these parameters with clients having similar data distribution. This observation emphasizes the importance of considering not only the sensitivity to non-IID data but also the similarity of data distribution when determining which parameters should be localized in PFL. This paper introduces a novel guideline for client collaboration in PFL. Unlike existing approaches that prohibit all collaboration of sensitive parameters, our guideline allows clients to share more parameters with others, leading to improved model performance. Additionally, we propose a new PFL method named FedCAC, which employs a quantitative metric to evaluate each parameter's sensitivity to non-IID data and carefully selects collaborators based on this evaluation. Experimental results demonstrate that FedCAC enables clients to share more parameters with others, resulting in superior performance compared to state-of-the-art methods, particularly in scenarios where clients have diverse distributions.
HyperLoRA: Parameter-Efficient Adaptive Generation for Portrait Synthesis
Personalized portrait synthesis, essential in domains like social entertainment, has recently made significant progress. Person-wise fine-tuning based methods, such as LoRA and DreamBooth, can produce photorealistic outputs but need training on individual samples, consuming time and resources and posing an unstable risk. Adapter based techniques such as IP-Adapter freeze the foundational model parameters and employ a plug-in architecture to enable zero-shot inference, but they often exhibit a lack of naturalness and authenticity, which are not to be overlooked in portrait synthesis tasks. In this paper, we introduce a parameter-efficient adaptive generation method, namely HyperLoRA, that uses an adaptive plug-in network to generate LoRA weights, merging the superior performance of LoRA with the zero-shot capability of adapter scheme. Through our carefully designed network structure and training strategy, we achieve zero-shot personalized portrait generation (supporting both single and multiple image inputs) with high photorealism, fidelity, and editability.
Teaching VLMs to Localize Specific Objects from In-context Examples
Vision-Language Models (VLMs) have shown remarkable capabilities across diverse visual tasks, including image recognition, video understanding, and Visual Question Answering (VQA) when explicitly trained for these tasks. Despite these advances, we find that current VLMs lack a fundamental cognitive ability: learning to localize objects in a scene by taking into account the context. In this work, we focus on the task of few-shot personalized localization, where a model is given a small set of annotated images (in-context examples) -- each with a category label and bounding box -- and is tasked with localizing the same object type in a query image. To provoke personalized localization abilities in models, we present a data-centric solution that fine-tunes them using carefully curated data from video object tracking datasets. By leveraging sequences of frames tracking the same object across multiple shots, we simulate instruction-tuning dialogues that promote context awareness. To reinforce this, we introduce a novel regularization technique that replaces object labels with pseudo-names, ensuring the model relies on visual context rather than prior knowledge. Our method significantly enhances few-shot localization performance without sacrificing generalization, as demonstrated on several benchmarks tailored to personalized localization. This work is the first to explore and benchmark personalized few-shot localization for VLMs, laying a foundation for future research in context-driven vision-language applications. The code for our project is available at https://github.com/SivanDoveh/IPLoc
LLM Agents for Psychology: A Study on Gamified Assessments
Psychological measurement is essential for mental health, self-understanding, and personal development. Traditional methods, such as self-report scales and psychologist interviews, often face challenges with engagement and accessibility. While game-based and LLM-based tools have been explored to improve user interest and automate assessment, they struggle to balance engagement with generalizability. In this work, we propose PsychoGAT (Psychological Game AgenTs) to achieve a generic gamification of psychological assessment. The main insight is that powerful LLMs can function both as adept psychologists and innovative game designers. By incorporating LLM agents into designated roles and carefully managing their interactions, PsychoGAT can transform any standardized scales into personalized and engaging interactive fiction games. To validate the proposed method, we conduct psychometric evaluations to assess its effectiveness and employ human evaluators to examine the generated content across various psychological constructs, including depression, cognitive distortions, and personality traits. Results demonstrate that PsychoGAT serves as an effective assessment tool, achieving statistically significant excellence in psychometric metrics such as reliability, convergent validity, and discriminant validity. Moreover, human evaluations confirm PsychoGAT's enhancements in content coherence, interactivity, interest, immersion, and satisfaction.
CLIPSyntel: CLIP and LLM Synergy for Multimodal Question Summarization in Healthcare
In the era of modern healthcare, swiftly generating medical question summaries is crucial for informed and timely patient care. Despite the increasing complexity and volume of medical data, existing studies have focused solely on text-based summarization, neglecting the integration of visual information. Recognizing the untapped potential of combining textual queries with visual representations of medical conditions, we introduce the Multimodal Medical Question Summarization (MMQS) Dataset. This dataset, a major contribution to our work, pairs medical queries with visual aids, facilitating a richer and more nuanced understanding of patient needs. We also propose a framework, utilizing the power of Contrastive Language Image Pretraining(CLIP) and Large Language Models(LLMs), consisting of four modules that identify medical disorders, generate relevant context, filter medical concepts, and craft visually aware summaries. Our comprehensive framework harnesses the power of CLIP, a multimodal foundation model, and various general-purpose LLMs, comprising four main modules: the medical disorder identification module, the relevant context generation module, the context filtration module for distilling relevant medical concepts and knowledge, and finally, a general-purpose LLM to generate visually aware medical question summaries. Leveraging our MMQS dataset, we showcase how visual cues from images enhance the generation of medically nuanced summaries. This multimodal approach not only enhances the decision-making process in healthcare but also fosters a more nuanced understanding of patient queries, laying the groundwork for future research in personalized and responsive medical care
FSPO: Few-Shot Preference Optimization of Synthetic Preference Data in LLMs Elicits Effective Personalization to Real Users
Effective personalization of LLMs is critical for a broad range of user-interfacing applications such as virtual assistants and content curation. Inspired by the strong in-context learning capabilities of LLMs, we propose Few-Shot Preference Optimization (FSPO), which reframes reward modeling as a meta-learning problem. Under this framework, an LLM learns to quickly adapt to a user via a few labeled preferences from that user, constructing a personalized reward function for them. Additionally, since real-world preference data is scarce and challenging to collect at scale, we propose careful design choices to construct synthetic preference datasets for personalization, generating over 1M synthetic personalized preferences using publicly available LLMs. In particular, to successfully transfer from synthetic data to real users, we find it crucial for the data to exhibit both high diversity and coherent, self-consistent structure. We evaluate FSPO on personalized open-ended generation for up to 1,500 synthetic users across across three domains: movie reviews, pedagogical adaptation based on educational background, and general question answering, along with a controlled human study. Overall, FSPO achieves an 87% Alpaca Eval winrate on average in generating responses that are personalized to synthetic users and a 72% winrate with real human users in open-ended question answering.
MedSumm: A Multimodal Approach to Summarizing Code-Mixed Hindi-English Clinical Queries
In the healthcare domain, summarizing medical questions posed by patients is critical for improving doctor-patient interactions and medical decision-making. Although medical data has grown in complexity and quantity, the current body of research in this domain has primarily concentrated on text-based methods, overlooking the integration of visual cues. Also prior works in the area of medical question summarisation have been limited to the English language. This work introduces the task of multimodal medical question summarization for codemixed input in a low-resource setting. To address this gap, we introduce the Multimodal Medical Codemixed Question Summarization MMCQS dataset, which combines Hindi-English codemixed medical queries with visual aids. This integration enriches the representation of a patient's medical condition, providing a more comprehensive perspective. We also propose a framework named MedSumm that leverages the power of LLMs and VLMs for this task. By utilizing our MMCQS dataset, we demonstrate the value of integrating visual information from images to improve the creation of medically detailed summaries. This multimodal strategy not only improves healthcare decision-making but also promotes a deeper comprehension of patient queries, paving the way for future exploration in personalized and responsive medical care. Our dataset, code, and pre-trained models will be made publicly available.
Interpretable graph-based models on multimodal biomedical data integration: A technical review and benchmarking
Integrating heterogeneous biomedical data including imaging, omics, and clinical records supports accurate diagnosis and personalised care. Graph-based models fuse such non-Euclidean data by capturing spatial and relational structure, yet clinical uptake requires regulator-ready interpretability. We present the first technical survey of interpretable graph based models for multimodal biomedical data, covering 26 studies published between Jan 2019 and Sep 2024. Most target disease classification, notably cancer and rely on static graphs from simple similarity measures, while graph-native explainers are rare; post-hoc methods adapted from non-graph domains such as gradient saliency, and SHAP predominate. We group existing approaches into four interpretability families, outline trends such as graph-in-graph hierarchies, knowledge-graph edges, and dynamic topology learning, and perform a practical benchmark. Using an Alzheimer disease cohort, we compare Sensitivity Analysis, Gradient Saliency, SHAP and Graph Masking. SHAP and Sensitivity Analysis recover the broadest set of known AD pathways and Gene-Ontology terms, whereas Gradient Saliency and Graph Masking surface complementary metabolic and transport signatures. Permutation tests show all four beat random gene sets, but with distinct trade-offs: SHAP and Graph Masking offer deeper biology at higher compute cost, while Gradient Saliency and Sensitivity Analysis are quicker though coarser. We also provide a step-by-step flowchart covering graph construction, explainer choice and resource budgeting to help researchers balance transparency and performance. This review synthesises the state of interpretable graph learning for multimodal medicine, benchmarks leading techniques, and charts future directions, from advanced XAI tools to under-studied diseases, serving as a concise reference for method developers and translational scientists.
Control of Medical Digital Twins with Artificial Neural Networks
The objective of personalized medicine is to tailor interventions to an individual patient's unique characteristics. A key technology for this purpose involves medical digital twins, computational models of human biology that can be personalized and dynamically updated to incorporate patient-specific data collected over time. Certain aspects of human biology, such as the immune system, are not easily captured with physics-based models, such as differential equations. Instead, they are often multi-scale, stochastic, and hybrid. This poses a challenge to existing model-based control and optimization approaches that cannot be readily applied to such models. Recent advances in automatic differentiation and neural-network control methods hold promise in addressing complex control problems. However, the application of these approaches to biomedical systems is still in its early stages. This work introduces dynamics-informed neural-network controllers as an alternative approach to control of medical digital twins. As a first use case for this method, the focus is on agent-based models, a versatile and increasingly common modeling platform in biomedicine. The effectiveness of the proposed neural-network control method is illustrated and benchmarked against other methods with two widely-used agent-based model types. The relevance of the method introduced here extends beyond medical digital twins to other complex dynamical systems.
GraphCare: Enhancing Healthcare Predictions with Personalized Knowledge Graphs
Clinical predictive models often rely on patients' electronic health records (EHR), but integrating medical knowledge to enhance predictions and decision-making is challenging. This is because personalized predictions require personalized knowledge graphs (KGs), which are difficult to generate from patient EHR data. To address this, we propose GraphCare, an open-world framework that uses external KGs to improve EHR-based predictions. Our method extracts knowledge from large language models (LLMs) and external biomedical KGs to build patient-specific KGs, which are then used to train our proposed Bi-attention AugmenTed (BAT) graph neural network (GNN) for healthcare predictions. On two public datasets, MIMIC-III and MIMIC-IV, GraphCare surpasses baselines in four vital healthcare prediction tasks: mortality, readmission, length of stay (LOS), and drug recommendation. On MIMIC-III, it boosts AUROC by 17.6\% and 6.6\% for mortality and readmission, and F1-score by 7.9\% and 10.8\% for LOS and drug recommendation, respectively. Notably, GraphCare demonstrates a substantial edge in scenarios with limited data availability. Our findings highlight the potential of using external KGs in healthcare prediction tasks and demonstrate the promise of GraphCare in generating personalized KGs for promoting personalized medicine.
AI in Pharma for Personalized Sequential Decision-Making: Methods, Applications and Opportunities
In the pharmaceutical industry, the use of artificial intelligence (AI) has seen consistent growth over the past decade. This rise is attributed to major advancements in statistical machine learning methodologies, computational capabilities and the increased availability of large datasets. AI techniques are applied throughout different stages of drug development, ranging from drug discovery to post-marketing benefit-risk assessment. Kolluri et al. provided a review of several case studies that span these stages, featuring key applications such as protein structure prediction, success probability estimation, subgroup identification, and AI-assisted clinical trial monitoring. From a regulatory standpoint, there was a notable uptick in submissions incorporating AI components in 2021. The most prevalent therapeutic areas leveraging AI were oncology (27%), psychiatry (15%), gastroenterology (12%), and neurology (11%). The paradigm of personalized or precision medicine has gained significant traction in recent research, partly due to advancements in AI techniques hamburg2010path. This shift has had a transformative impact on the pharmaceutical industry. Departing from the traditional "one-size-fits-all" model, personalized medicine incorporates various individual factors, such as environmental conditions, lifestyle choices, and health histories, to formulate customized treatment plans. By utilizing sophisticated machine learning algorithms, clinicians and researchers are better equipped to make informed decisions in areas such as disease prevention, diagnosis, and treatment selection, thereby optimizing health outcomes for each individual.
Zero-shot causal learning
Predicting how different interventions will causally affect a specific individual is important in a variety of domains such as personalized medicine, public policy, and online marketing. There are a large number of methods to predict the effect of an existing intervention based on historical data from individuals who received it. However, in many settings it is important to predict the effects of novel interventions (e.g., a newly invented drug), which these methods do not address. Here, we consider zero-shot causal learning: predicting the personalized effects of a novel intervention. We propose CaML, a causal meta-learning framework which formulates the personalized prediction of each intervention's effect as a task. CaML trains a single meta-model across thousands of tasks, each constructed by sampling an intervention, along with its recipients and nonrecipients. By leveraging both intervention information (e.g., a drug's attributes) and individual features~(e.g., a patient's history), CaML is able to predict the personalized effects of novel interventions that do not exist at the time of training. Experimental results on real world datasets in large-scale medical claims and cell-line perturbations demonstrate the effectiveness of our approach. Most strikingly, CaML's zero-shot predictions outperform even strong baselines trained directly on data from the test interventions.
Large Language Models Illuminate a Progressive Pathway to Artificial Healthcare Assistant: A Review
With the rapid development of artificial intelligence, large language models (LLMs) have shown promising capabilities in mimicking human-level language comprehension and reasoning. This has sparked significant interest in applying LLMs to enhance various aspects of healthcare, ranging from medical education to clinical decision support. However, medicine involves multifaceted data modalities and nuanced reasoning skills, presenting challenges for integrating LLMs. This paper provides a comprehensive review on the applications and implications of LLMs in medicine. It begins by examining the fundamental applications of general-purpose and specialized LLMs, demonstrating their utilities in knowledge retrieval, research support, clinical workflow automation, and diagnostic assistance. Recognizing the inherent multimodality of medicine, the review then focuses on multimodal LLMs, investigating their ability to process diverse data types like medical imaging and EHRs to augment diagnostic accuracy. To address LLMs' limitations regarding personalization and complex clinical reasoning, the paper explores the emerging development of LLM-powered autonomous agents for healthcare. Furthermore, it summarizes the evaluation methodologies for assessing LLMs' reliability and safety in medical contexts. Overall, this review offers an extensive analysis on the transformative potential of LLMs in modern medicine. It also highlights the pivotal need for continuous optimizations and ethical oversight before these models can be effectively integrated into clinical practice. Visit https://github.com/mingze-yuan/Awesome-LLM-Healthcare for an accompanying GitHub repository containing latest papers.
Analyzing Wearables Dataset to Predict ADLs and Falls: A Pilot Study
Healthcare is an important aspect of human life. Use of technologies in healthcare has increased manifolds after the pandemic. Internet of Things based systems and devices proposed in literature can help elders, children and adults facing/experiencing health problems. This paper exhaustively reviews thirty-nine wearable based datasets which can be used for evaluating the system to recognize Activities of Daily Living and Falls. A comparative analysis on the SisFall dataset using five machine learning methods i.e., Logistic Regression, Linear Discriminant Analysis, K-Nearest Neighbor, Decision Tree and Naive Bayes is performed in python. The dataset is modified in two ways, in first all the attributes present in dataset are used as it is and labelled in binary form. In second, magnitude of three axes(x,y,z) for three sensors value are computed and then used in experiment with label attribute. The experiments are performed on one subject, ten subjects and all the subjects and compared in terms of accuracy, precision and recall. The results obtained from this study proves that KNN outperforms other machine learning methods in terms of accuracy, precision and recall. It is also concluded that personalization of data improves accuracy.
DTR Bandit: Learning to Make Response-Adaptive Decisions With Low Regret
Dynamic treatment regimes (DTRs) are personalized, adaptive, multi-stage treatment plans that adapt treatment decisions both to an individual's initial features and to intermediate outcomes and features at each subsequent stage, which are affected by decisions in prior stages. Examples include personalized first- and second-line treatments of chronic conditions like diabetes, cancer, and depression, which adapt to patient response to first-line treatment, disease progression, and individual characteristics. While existing literature mostly focuses on estimating the optimal DTR from offline data such as from sequentially randomized trials, we study the problem of developing the optimal DTR in an online manner, where the interaction with each individual affect both our cumulative reward and our data collection for future learning. We term this the DTR bandit problem. We propose a novel algorithm that, by carefully balancing exploration and exploitation, is guaranteed to achieve rate-optimal regret when the transition and reward models are linear. We demonstrate our algorithm and its benefits both in synthetic experiments and in a case study of adaptive treatment of major depressive disorder using real-world data.
CARE: A QLoRA-Fine Tuned Multi-Domain Chatbot With Fast Learning On Minimal Hardware
Large Language models have demonstrated excellent domain-specific question-answering capabilities when finetuned with a particular dataset of that specific domain. However, fine-tuning the models requires a significant amount of training time and a considerable amount of hardware. In this work, we propose CARE (Customer Assistance and Response Engine), a lightweight model made by fine-tuning Phi3.5-mini on very minimal hardware and data, designed to handle queries primarily across three domains: telecommunications support, medical support, and banking support. For telecommunications and banking, the chatbot addresses issues and problems faced by customers regularly in the above-mentioned domains. In the medical domain, CARE provides preliminary support by offering basic diagnoses and medical suggestions that a user might take before consulting a healthcare professional. Since CARE is built on Phi3.5-mini, it can be used even on mobile devices, increasing its usability. Our research also shows that CARE performs relatively well on various medical benchmarks, indicating that it can be used to make basic medical suggestions.
Enhancing Personalized Multi-Turn Dialogue with Curiosity Reward
Effective conversational agents must be able to personalize their behavior to suit a user's preferences, personality, and attributes, whether they are assisting with writing tasks or operating in domains like education or healthcare. Current training methods like Reinforcement Learning from Human Feedback (RLHF) prioritize helpfulness and safety but fall short in fostering truly empathetic, adaptive, and personalized interactions. Traditional approaches to personalization often rely on extensive user history, limiting their effectiveness for new or context-limited users. To overcome these limitations, we propose to incorporate an intrinsic motivation to improve the conversational agents's model of the user as an additional reward alongside multi-turn RLHF. This reward mechanism encourages the agent to actively elicit user traits by optimizing conversations to increase the accuracy of its user model. Consequently, the policy agent can deliver more personalized interactions through obtaining more information about the user. We applied our method both education and fitness settings, where LLMs teach concepts or recommend personalized strategies based on users' hidden learning style or lifestyle attributes. Using LLM-simulated users, our approach outperformed a multi-turn RLHF baseline in revealing information about the users' preferences, and adapting to them.
NutriGen: Personalized Meal Plan Generator Leveraging Large Language Models to Enhance Dietary and Nutritional Adherence
Maintaining a balanced diet is essential for overall health, yet many individuals struggle with meal planning due to nutritional complexity, time constraints, and lack of dietary knowledge. Personalized food recommendations can help address these challenges by tailoring meal plans to individual preferences, habits, and dietary restrictions. However, existing dietary recommendation systems often lack adaptability, fail to consider real-world constraints such as food ingredient availability, and require extensive user input, making them impractical for sustainable and scalable daily use. To address these limitations, we introduce NutriGen, a framework based on large language models (LLM) designed to generate personalized meal plans that align with user-defined dietary preferences and constraints. By building a personalized nutrition database and leveraging prompt engineering, our approach enables LLMs to incorporate reliable nutritional references like the USDA nutrition database while maintaining flexibility and ease-of-use. We demonstrate that LLMs have strong potential in generating accurate and user-friendly food recommendations, addressing key limitations in existing dietary recommendation systems by providing structured, practical, and scalable meal plans. Our evaluation shows that Llama 3.1 8B and GPT-3.5 Turbo achieve the lowest percentage errors of 1.55\% and 3.68\%, respectively, producing meal plans that closely align with user-defined caloric targets while minimizing deviation and improving precision. Additionally, we compared the performance of DeepSeek V3 against several established models to evaluate its potential in personalized nutrition planning.
Automatic Personalized Impression Generation for PET Reports Using Large Language Models
In this study, we aimed to determine if fine-tuned large language models (LLMs) can generate accurate, personalized impressions for whole-body PET reports. Twelve language models were trained on a corpus of PET reports using the teacher-forcing algorithm, with the report findings as input and the clinical impressions as reference. An extra input token encodes the reading physician's identity, allowing models to learn physician-specific reporting styles. Our corpus comprised 37,370 retrospective PET reports collected from our institution between 2010 and 2022. To identify the best LLM, 30 evaluation metrics were benchmarked against quality scores from two nuclear medicine (NM) physicians, with the most aligned metrics selecting the model for expert evaluation. In a subset of data, model-generated impressions and original clinical impressions were assessed by three NM physicians according to 6 quality dimensions (3-point scale) and an overall utility score (5-point scale). Each physician reviewed 12 of their own reports and 12 reports from other physicians. Bootstrap resampling was used for statistical analysis. Of all evaluation metrics, domain-adapted BARTScore and PEGASUSScore showed the highest Spearman's rank correlations (0.568 and 0.563) with physician preferences. Based on these metrics, the fine-tuned PEGASUS model was selected as the top LLM. When physicians reviewed PEGASUS-generated impressions in their own style, 89% were considered clinically acceptable, with a mean utility score of 4.08 out of 5. Physicians rated these personalized impressions as comparable in overall utility to the impressions dictated by other physicians (4.03, P=0.41). In conclusion, personalized impressions generated by PEGASUS were clinically useful, highlighting its potential to expedite PET reporting.
Participatory Personalization in Classification
Machine learning models are often personalized with information that is protected, sensitive, self-reported, or costly to acquire. These models use information about people but do not facilitate nor inform their consent. Individuals cannot opt out of reporting personal information to a model, nor tell if they benefit from personalization in the first place. We introduce a family of classification models, called participatory systems, that let individuals opt into personalization at prediction time. We present a model-agnostic algorithm to learn participatory systems for personalization with categorical group attributes. We conduct a comprehensive empirical study of participatory systems in clinical prediction tasks, benchmarking them with common approaches for personalization and imputation. Our results demonstrate that participatory systems can facilitate and inform consent while improving performance and data use across all groups who report personal data.
SleepCoT: A Lightweight Personalized Sleep Health Model via Chain-of-Thought Distillation
We present a novel approach to personalized sleep health management using few-shot Chain-of-Thought (CoT) distillation, enabling small-scale language models (> 2B parameters) to rival the performance of large language models (LLMs) in specialized health domains. Our method simultaneously distills problem-solving strategies, long-tail expert knowledge, and personalized recommendation capabilities from larger models into more efficient, compact models. Unlike existing systems, our approach offers three key functionalities: generating personalized sleep health recommendations, supporting user-specific follow-up inquiries, and providing responses to domain-specific knowledge questions. We focus on sleep health due to its measurability via wearable devices and its impact on overall well-being. Our experimental setup, involving GPT-4o for data synthesis, Qwen-max for instruction set creation, and Qwen2.5 1.5B for model distillation, demonstrates significant improvements over baseline small-scale models in penalization, reasoning, and knowledge application. Experiments using 100 simulated sleep reports and 1,000 domain-specific questions shows our model achieves comparable performance to larger models while maintaining efficiency for real-world deployment. This research not only advances AI-driven health management but also provides a novel approach to leveraging LLM capabilities in resource-constrained environments, potentially enhancing the accessibility of personalized healthcare solutions.
Synthetic Patients: Simulating Difficult Conversations with Multimodal Generative AI for Medical Education
Problem: Effective patient-centered communication is a core competency for physicians. However, both seasoned providers and medical trainees report decreased confidence in leading conversations on sensitive topics such as goals of care or end-of-life discussions. The significant administrative burden and the resources required to provide dedicated training in leading difficult conversations has been a long-standing problem in medical education. Approach: In this work, we present a novel educational tool designed to facilitate interactive, real-time simulations of difficult conversations in a video-based format through the use of multimodal generative artificial intelligence (AI). Leveraging recent advances in language modeling, computer vision, and generative audio, this tool creates realistic, interactive scenarios with avatars, or "synthetic patients." These synthetic patients interact with users throughout various stages of medical care using a custom-built video chat application, offering learners the chance to practice conversations with patients from diverse belief systems, personalities, and ethnic backgrounds. Outcomes: While the development of this platform demanded substantial upfront investment in labor, it offers a highly-realistic simulation experience with minimal financial investment. For medical trainees, this educational tool can be implemented within programs to simulate patient-provider conversations and can be incorporated into existing palliative care curriculum to provide a scalable, high-fidelity simulation environment for mastering difficult conversations. Next Steps: Future developments will explore enhancing the authenticity of these encounters by working with patients to incorporate their histories and personalities, as well as employing the use of AI-generated evaluations to offer immediate, constructive feedback to learners post-simulation.
Towards Unified Multi-Modal Personalization: Large Vision-Language Models for Generative Recommendation and Beyond
Developing a universal model that can effectively harness heterogeneous resources and respond to a wide range of personalized needs has been a longstanding community aspiration. Our daily choices, especially in domains like fashion and retail, are substantially shaped by multi-modal data, such as pictures and textual descriptions. These modalities not only offer intuitive guidance but also cater to personalized user preferences. However, the predominant personalization approaches mainly focus on the ID or text-based recommendation problem, failing to comprehend the information spanning various tasks or modalities. In this paper, our goal is to establish a Unified paradigm for Multi-modal Personalization systems (UniMP), which effectively leverages multi-modal data while eliminating the complexities associated with task- and modality-specific customization. We argue that the advancements in foundational generative modeling have provided the flexibility and effectiveness necessary to achieve the objective. In light of this, we develop a generic and extensible personalization generative framework, that can handle a wide range of personalized needs including item recommendation, product search, preference prediction, explanation generation, and further user-guided image generation. Our methodology enhances the capabilities of foundational language models for personalized tasks by seamlessly ingesting interleaved cross-modal user history information, ensuring a more precise and customized experience for users. To train and evaluate the proposed multi-modal personalized tasks, we also introduce a novel and comprehensive benchmark covering a variety of user requirements. Our experiments on the real-world benchmark showcase the model's potential, outperforming competitive methods specialized for each task.
Automatic Differential Diagnosis using Transformer-Based Multi-Label Sequence Classification
As the field of artificial intelligence progresses, assistive technologies are becoming more widely used across all industries. The healthcare industry is no different, with numerous studies being done to develop assistive tools for healthcare professionals. Automatic diagnostic systems are one such beneficial tool that can assist with a variety of tasks, including collecting patient information, analyzing test results, and diagnosing patients. However, the idea of developing systems that can provide a differential diagnosis has been largely overlooked in most of these research studies. In this study, we propose a transformer-based approach for providing differential diagnoses based on a patient's age, sex, medical history, and symptoms. We use the DDXPlus dataset, which provides differential diagnosis information for patients based on 49 disease types. Firstly, we propose a method to process the tabular patient data from the dataset and engineer them into patient reports to make them suitable for our research. In addition, we introduce two data modification modules to diversify the training data and consequently improve the robustness of the models. We approach the task as a multi-label classification problem and conduct extensive experiments using four transformer models. All the models displayed promising results by achieving over 97% F1 score on the held-out test set. Moreover, we design additional behavioral tests to get a broader understanding of the models. In particular, for one of our test cases, we prepared a custom test set of 100 samples with the assistance of a doctor. The results on the custom set showed that our proposed data modification modules improved the model's generalization capabilities. We hope our findings will provide future researchers with valuable insights and inspire them to develop reliable systems for automatic differential diagnosis.
Chasing Your Long Tails: Differentially Private Prediction in Health Care Settings
Machine learning models in health care are often deployed in settings where it is important to protect patient privacy. In such settings, methods for differentially private (DP) learning provide a general-purpose approach to learn models with privacy guarantees. Modern methods for DP learning ensure privacy through mechanisms that censor information judged as too unique. The resulting privacy-preserving models, therefore, neglect information from the tails of a data distribution, resulting in a loss of accuracy that can disproportionately affect small groups. In this paper, we study the effects of DP learning in health care. We use state-of-the-art methods for DP learning to train privacy-preserving models in clinical prediction tasks, including x-ray classification of images and mortality prediction in time series data. We use these models to perform a comprehensive empirical investigation of the tradeoffs between privacy, utility, robustness to dataset shift, and fairness. Our results highlight lesser-known limitations of methods for DP learning in health care, models that exhibit steep tradeoffs between privacy and utility, and models whose predictions are disproportionately influenced by large demographic groups in the training data. We discuss the costs and benefits of differentially private learning in health care.
The Ethics of ChatGPT in Medicine and Healthcare: A Systematic Review on Large Language Models (LLMs)
With the introduction of ChatGPT, Large Language Models (LLMs) have received enormous attention in healthcare. Despite their potential benefits, researchers have underscored various ethical implications. While individual instances have drawn much attention, the debate lacks a systematic overview of practical applications currently researched and ethical issues connected to them. Against this background, this work aims to map the ethical landscape surrounding the current stage of deployment of LLMs in medicine and healthcare. Electronic databases and preprint servers were queried using a comprehensive search strategy. Studies were screened and extracted following a modified rapid review approach. Methodological quality was assessed using a hybrid approach. For 53 records, a meta-aggregative synthesis was performed. Four fields of applications emerged and testify to a vivid exploration phase. Advantages of using LLMs are attributed to their capacity in data analysis, personalized information provisioning, support in decision-making, mitigating information loss and enhancing information accessibility. However, we also identifies recurrent ethical concerns connected to fairness, bias, non-maleficence, transparency, and privacy. A distinctive concern is the tendency to produce harmful misinformation or convincingly but inaccurate content. A recurrent plea for ethical guidance and human oversight is evident. Given the variety of use cases, it is suggested that the ethical guidance debate be reframed to focus on defining what constitutes acceptable human oversight across the spectrum of applications. This involves considering diverse settings, varying potentials for harm, and different acceptable thresholds for performance and certainty in healthcare. In addition, a critical inquiry is necessary to determine the extent to which the current experimental use of LLMs is necessary and justified.
A Survey on Medical Large Language Models: Technology, Application, Trustworthiness, and Future Directions
With the advent of Large Language Models (LLMs), medical artificial intelligence (AI) has experienced substantial technological progress and paradigm shifts, highlighting the potential of LLMs to streamline healthcare delivery and improve patient outcomes. Considering this rapid technical progress, in this survey, we trace the recent advances of Medical Large Language Models (Med-LLMs), including the background, key findings, and mainstream techniques, especially for the evolution from general-purpose models to medical-specialized applications. Firstly, we delve into the foundational technology of Med-LLMs, indicating how general models can be progressively adapted and refined for the complicated medical tasks. Secondly, the wide-ranging applications of Med-LLMs are investigated across various healthcare domains, as well as an up-to-date review of existing Med-LLMs. The transformative impact of these models on daily medical practice is evident through their ability to assist clinicians, educators, and patients. Recognizing the importance of responsible innovation, we discuss the challenges associated with ensuring fairness, accountability, privacy, and robustness. Ethical considerations, rigorous evaluation methodologies, and the establishment of regulatory frameworks are crucial for building trustworthiness in the real-world system. We emphasize the need for ongoing scrutiny and development to maintain high standards of safety and reliability. Finally, we anticipate possible future trajectories for Med-LLMs, identifying key avenues for prudent expansion. By consolidating these insights, our review aims to provide professionals and researchers with a thorough understanding of the strengths and limitations of Med-LLMs, fostering a balanced and ethical approach to their integration into the healthcare ecosystem.
Big-data-driven and AI-based framework to enable personalization in wireless networks
Current communication networks use design methodologies that prevent the realization of maximum network efficiency. In the first place, while users' perception of satisfactory service diverges widely, current networks are designed to be a "universal fit," where they are generally over-engineered to deliver services appealing to all types of users. Also, current networks lack user-level data cognitive intelligence that would enable fast personalized network decisions and actions through automation. Thus, in this article, we propose the utilization of AI, big data analytics, and real-time non-intrusive user feedback in order to enable the personalization of wireless networks. Based on each user's actual QoS requirements and context, a multi-objective formulation enables the network to micro-manage and optimize the provided QoS and user satisfaction levels simultaneously. Moreover, in order to enable user feedback tracking and measurement, we propose a user satisfaction model based on the zone of tolerance concept. Furthermore, we propose a big-data-driven and AI-based personalization framework to integrate personalization into wireless networks. Finally, we implement a personalized network prototype to demonstrate the proposed personalization concept and its potential benefits through a case study. The case study shows how personalization can be realized to enable the efficient optimization of network resources such that certain requirement levels of user satisfaction and revenue in the form of saved resources are achieved.
Characterizing LLM-Empowered Personalized Story-Reading and Interaction for Children: Insights from Multi-Stakeholder Perspectives
Personalized interaction is highly valued by parents in their story-reading activities with children. While AI-empowered story-reading tools have been increasingly used, their abilities to support personalized interaction with children are still limited. Recent advances in large language models (LLMs) show promise in facilitating personalized interactions, but little is known about how to effectively and appropriately use LLMs to enhance children's personalized story-reading experiences. This work explores this question through a design-based study. Drawing on a formative study, we designed and developed StoryMate, an LLM-empowered personalized interactive story-reading tool for children, following an empirical study with children, parents, and education experts. Our participants valued the personalized features in StoryMate, and also highlighted the need to support personalized content, guiding mechanisms, reading context variations, and interactive interfaces. Based on these findings, we propose a series of design recommendations for better using LLMs to empower children's personalized story reading and interaction.
Self-Aware Personalized Federated Learning
In the context of personalized federated learning (FL), the critical challenge is to balance local model improvement and global model tuning when the personal and global objectives may not be exactly aligned. Inspired by Bayesian hierarchical models, we develop a self-aware personalized FL method where each client can automatically balance the training of its local personal model and the global model that implicitly contributes to other clients' training. Such a balance is derived from the inter-client and intra-client uncertainty quantification. A larger inter-client variation implies more personalization is needed. Correspondingly, our method uses uncertainty-driven local training steps and aggregation rule instead of conventional local fine-tuning and sample size-based aggregation. With experimental studies on synthetic data, Amazon Alexa audio data, and public datasets such as MNIST, FEMNIST, CIFAR10, and Sent140, we show that our proposed method can achieve significantly improved personalization performance compared with the existing counterparts.
When Large Language Models Meet Personalization: Perspectives of Challenges and Opportunities
The advent of large language models marks a revolutionary breakthrough in artificial intelligence. With the unprecedented scale of training and model parameters, the capability of large language models has been dramatically improved, leading to human-like performances in understanding, language synthesizing, and common-sense reasoning, etc. Such a major leap-forward in general AI capacity will change the pattern of how personalization is conducted. For one thing, it will reform the way of interaction between humans and personalization systems. Instead of being a passive medium of information filtering, large language models present the foundation for active user engagement. On top of such a new foundation, user requests can be proactively explored, and user's required information can be delivered in a natural and explainable way. For another thing, it will also considerably expand the scope of personalization, making it grow from the sole function of collecting personalized information to the compound function of providing personalized services. By leveraging large language models as general-purpose interface, the personalization systems may compile user requests into plans, calls the functions of external tools to execute the plans, and integrate the tools' outputs to complete the end-to-end personalization tasks. Today, large language models are still being developed, whereas the application in personalization is largely unexplored. Therefore, we consider it to be the right time to review the challenges in personalization and the opportunities to address them with LLMs. In particular, we dedicate this perspective paper to the discussion of the following aspects: the development and challenges for the existing personalization system, the newly emerged capabilities of large language models, and the potential ways of making use of large language models for personalization.
Fidelity and Privacy of Synthetic Medical Data
The digitization of medical records ushered in a new era of big data to clinical science, and with it the possibility that data could be shared, to multiply insights beyond what investigators could abstract from paper records. The need to share individual-level medical data to accelerate innovation in precision medicine continues to grow, and has never been more urgent, as scientists grapple with the COVID-19 pandemic. However, enthusiasm for the use of big data has been tempered by a fully appropriate concern for patient autonomy and privacy. That is, the ability to extract private or confidential information about an individual, in practice, renders it difficult to share data, since significant infrastructure and data governance must be established before data can be shared. Although HIPAA provided de-identification as an approved mechanism for data sharing, linkage attacks were identified as a major vulnerability. A variety of mechanisms have been established to avoid leaking private information, such as field suppression or abstraction, strictly limiting the amount of information that can be shared, or employing mathematical techniques such as differential privacy. Another approach, which we focus on here, is creating synthetic data that mimics the underlying data. For synthetic data to be a useful mechanism in support of medical innovation and a proxy for real-world evidence, one must demonstrate two properties of the synthetic dataset: (1) any analysis on the real data must be matched by analysis of the synthetic data (statistical fidelity) and (2) the synthetic data must preserve privacy, with minimal risk of re-identification (privacy guarantee). In this paper we propose a framework for quantifying the statistical fidelity and privacy preservation properties of synthetic datasets and demonstrate these metrics for synthetic data generated by Syntegra technology.
Large Language Model Distilling Medication Recommendation Model
The recommendation of medication is a vital aspect of intelligent healthcare systems, as it involves prescribing the most suitable drugs based on a patient's specific health needs. Unfortunately, many sophisticated models currently in use tend to overlook the nuanced semantics of medical data, while only relying heavily on identities. Furthermore, these models face significant challenges in handling cases involving patients who are visiting the hospital for the first time, as they lack prior prescription histories to draw upon. To tackle these issues, we harness the powerful semantic comprehension and input-agnostic characteristics of Large Language Models (LLMs). Our research aims to transform existing medication recommendation methodologies using LLMs. In this paper, we introduce a novel approach called Large Language Model Distilling Medication Recommendation (LEADER). We begin by creating appropriate prompt templates that enable LLMs to suggest medications effectively. However, the straightforward integration of LLMs into recommender systems leads to an out-of-corpus issue specific to drugs. We handle it by adapting the LLMs with a novel output layer and a refined tuning loss function. Although LLM-based models exhibit remarkable capabilities, they are plagued by high computational costs during inference, which is impractical for the healthcare sector. To mitigate this, we have developed a feature-level knowledge distillation technique, which transfers the LLM's proficiency to a more compact model. Extensive experiments conducted on two real-world datasets, MIMIC-III and MIMIC-IV, demonstrate that our proposed model not only delivers effective results but also is efficient. To ease the reproducibility of our experiments, we release the implementation code online.
PatientSim: A Persona-Driven Simulator for Realistic Doctor-Patient Interactions
Doctor-patient consultations require multi-turn, context-aware communication tailored to diverse patient personas. Training or evaluating doctor LLMs in such settings requires realistic patient interaction systems. However, existing simulators often fail to reflect the full range of personas seen in clinical practice. To address this, we introduce PatientSim, a patient simulator that generates realistic and diverse patient personas for clinical scenarios, grounded in medical expertise. PatientSim operates using: 1) clinical profiles, including symptoms and medical history, derived from real-world data in the MIMIC-ED and MIMIC-IV datasets, and 2) personas defined by four axes: personality, language proficiency, medical history recall level, and cognitive confusion level, resulting in 37 unique combinations. We evaluated eight LLMs for factual accuracy and persona consistency. The top-performing open-source model, Llama 3.3, was validated by four clinicians to confirm the robustness of our framework. As an open-source, customizable platform, PatientSim provides a reproducible and scalable solution that can be customized for specific training needs. Offering a privacy-compliant environment, it serves as a robust testbed for evaluating medical dialogue systems across diverse patient presentations and shows promise as an educational tool for healthcare.
Data Minimization at Inference Time
In domains with high stakes such as law, recruitment, and healthcare, learning models frequently rely on sensitive user data for inference, necessitating the complete set of features. This not only poses significant privacy risks for individuals but also demands substantial human effort from organizations to verify information accuracy. This paper asks whether it is necessary to use all input features for accurate predictions at inference time. The paper demonstrates that, in a personalized setting, individuals may only need to disclose a small subset of their features without compromising decision-making accuracy. The paper also provides an efficient sequential algorithm to determine the appropriate attributes for each individual to provide. Evaluations across various learning tasks show that individuals can potentially report as little as 10\% of their information while maintaining the same accuracy level as a model that employs the full set of user information.
ChatDoctor: A Medical Chat Model Fine-tuned on LLaMA Model using Medical Domain Knowledge
Recent large language models (LLMs) in the general domain, such as ChatGPT, have shown remarkable success in following instructions and producing human-like responses. However, such language models have not been learned individually and carefully for the medical domain, resulting in poor diagnostic accuracy and inability to give correct recommendations for medical diagnosis, medications, etc. To address this issue, we collected more than 700 diseases and their corresponding symptoms, recommended medications, and required medical tests, and then generated 5K doctor-patient conversations. By fine-tuning models of doctor-patient conversations, these models emerge with great potential to understand patients' needs, provide informed advice, and offer valuable assistance in a variety of medical-related fields. The integration of these advanced language models into healthcare can revolutionize the way healthcare professionals and patients communicate, ultimately improving the overall quality of care and patient outcomes. In addition, we will open all source code, datasets and model weights to advance the further development of dialogue models in the medical field. In addition, the training data, code, and weights of this project are available at: https://github.com/Kent0n-Li/ChatDoctor.
Efficient and Personalized Mobile Health Event Prediction via Small Language Models
Healthcare monitoring is crucial for early detection, timely intervention, and the ongoing management of health conditions, ultimately improving individuals' quality of life. Recent research shows that Large Language Models (LLMs) have demonstrated impressive performance in supporting healthcare tasks. However, existing LLM-based healthcare solutions typically rely on cloud-based systems, which raise privacy concerns and increase the risk of personal information leakage. As a result, there is growing interest in running these models locally on devices like mobile phones and wearables to protect users' privacy. Small Language Models (SLMs) are potential candidates to solve privacy and computational issues, as they are more efficient and better suited for local deployment. However, the performance of SLMs in healthcare domains has not yet been investigated. This paper examines the capability of SLMs to accurately analyze health data, such as steps, calories, sleep minutes, and other vital statistics, to assess an individual's health status. Our results show that, TinyLlama, which has 1.1 billion parameters, utilizes 4.31 GB memory, and has 0.48s latency, showing the best performance compared other four state-of-the-art (SOTA) SLMs on various healthcare applications. Our results indicate that SLMs could potentially be deployed on wearable or mobile devices for real-time health monitoring, providing a practical solution for efficient and privacy-preserving healthcare.
LLMs-Healthcare : Current Applications and Challenges of Large Language Models in various Medical Specialties
We aim to present a comprehensive overview of the latest advancements in utilizing Large Language Models (LLMs) within the healthcare sector, emphasizing their transformative impact across various medical domains. LLMs have become pivotal in supporting healthcare, including physicians, healthcare providers, and patients. Our review provides insight into the applications of Large Language Models (LLMs) in healthcare, specifically focusing on diagnostic and treatment-related functionalities. We shed light on how LLMs are applied in cancer care, dermatology, dental care, neurodegenerative disorders, and mental health, highlighting their innovative contributions to medical diagnostics and patient care. Throughout our analysis, we explore the challenges and opportunities associated with integrating LLMs in healthcare, recognizing their potential across various medical specialties despite existing limitations. Additionally, we offer an overview of handling diverse data types within the medical field.
Decoding User Concerns in AI Health Chatbots: An Exploration of Security and Privacy in App Reviews
AI powered health chatbot applications are increasingly utilized for personalized healthcare services, yet they pose significant challenges related to user data security and privacy. This study evaluates the effectiveness of automated methods, specifically BART and Gemini GenAI, in identifying security privacy related (SPR) concerns within these applications' user reviews, benchmarking their performance against manual qualitative analysis. Our results indicate that while Gemini's performance in SPR classification is comparable to manual labeling, both automated methods have limitations, including the misclassification of unrelated issues. Qualitative analysis revealed critical user concerns, such as data collection practices, data misuse, and insufficient transparency and consent mechanisms. This research enhances the understanding of the relationship between user trust, privacy, and emerging mobile AI health chatbot technologies, offering actionable insights for improving security and privacy practices in AI driven health chatbots. Although exploratory, our findings highlight the necessity for rigorous audits and transparent communication strategies, providing valuable guidance for app developers and vendors in addressing user security and privacy concerns.
A Corpus for Detecting High-Context Medical Conditions in Intensive Care Patient Notes Focusing on Frequently Readmitted Patients
A crucial step within secondary analysis of electronic health records (EHRs) is to identify the patient cohort under investigation. While EHRs contain medical billing codes that aim to represent the conditions and treatments patients may have, much of the information is only present in the patient notes. Therefore, it is critical to develop robust algorithms to infer patients' conditions and treatments from their written notes. In this paper, we introduce a dataset for patient phenotyping, a task that is defined as the identification of whether a patient has a given medical condition (also referred to as clinical indication or phenotype) based on their patient note. Nursing Progress Notes and Discharge Summaries from the Intensive Care Unit of a large tertiary care hospital were manually annotated for the presence of several high-context phenotypes relevant to treatment and risk of re-hospitalization. This dataset contains 1102 Discharge Summaries and 1000 Nursing Progress Notes. Each Discharge Summary and Progress Note has been annotated by at least two expert human annotators (one clinical researcher and one resident physician). Annotated phenotypes include treatment non-adherence, chronic pain, advanced/metastatic cancer, as well as 10 other phenotypes. This dataset can be utilized for academic and industrial research in medicine and computer science, particularly within the field of medical natural language processing.
Personalized Image Generation with Deep Generative Models: A Decade Survey
Recent advancements in generative models have significantly facilitated the development of personalized content creation. Given a small set of images with user-specific concept, personalized image generation allows to create images that incorporate the specified concept and adhere to provided text descriptions. Due to its wide applications in content creation, significant effort has been devoted to this field in recent years. Nonetheless, the technologies used for personalization have evolved alongside the development of generative models, with their distinct and interrelated components. In this survey, we present a comprehensive review of generalized personalized image generation across various generative models, including traditional GANs, contemporary text-to-image diffusion models, and emerging multi-model autoregressive models. We first define a unified framework that standardizes the personalization process across different generative models, encompassing three key components, i.e., inversion spaces, inversion methods, and personalization schemes. This unified framework offers a structured approach to dissecting and comparing personalization techniques across different generative architectures. Building upon this unified framework, we further provide an in-depth analysis of personalization techniques within each generative model, highlighting their unique contributions and innovations. Through comparative analysis, this survey elucidates the current landscape of personalized image generation, identifying commonalities and distinguishing features among existing methods. Finally, we discuss the open challenges in the field and propose potential directions for future research. We keep tracing related works at https://github.com/csyxwei/Awesome-Personalized-Image-Generation.
Generalization in Healthcare AI: Evaluation of a Clinical Large Language Model
Advances in large language models (LLMs) provide new opportunities in healthcare for improved patient care, clinical decision-making, and enhancement of physician and administrator workflows. However, the potential of these models importantly depends on their ability to generalize effectively across clinical environments and populations, a challenge often underestimated in early development. To better understand reasons for these challenges and inform mitigation approaches, we evaluated ClinicLLM, an LLM trained on [HOSPITAL]'s clinical notes, analyzing its performance on 30-day all-cause readmission prediction focusing on variability across hospitals and patient characteristics. We found poorer generalization particularly in hospitals with fewer samples, among patients with government and unspecified insurance, the elderly, and those with high comorbidities. To understand reasons for lack of generalization, we investigated sample sizes for fine-tuning, note content (number of words per note), patient characteristics (comorbidity level, age, insurance type, borough), and health system aspects (hospital, all-cause 30-day readmission, and mortality rates). We used descriptive statistics and supervised classification to identify features. We found that, along with sample size, patient age, number of comorbidities, and the number of words in notes are all important factors related to generalization. Finally, we compared local fine-tuning (hospital specific), instance-based augmented fine-tuning and cluster-based fine-tuning for improving generalization. Among these, local fine-tuning proved most effective, increasing AUC by 0.25% to 11.74% (most helpful in settings with limited data). Overall, this study provides new insights for enhancing the deployment of large language models in the societally important domain of healthcare, and improving their performance for broader populations.
Multi Agent based Medical Assistant for Edge Devices
Large Action Models (LAMs) have revolutionized intelligent automation, but their application in healthcare faces challenges due to privacy concerns, latency, and dependency on internet access. This report introduces an ondevice, multi-agent healthcare assistant that overcomes these limitations. The system utilizes smaller, task-specific agents to optimize resources, ensure scalability and high performance. Our proposed system acts as a one-stop solution for health care needs with features like appointment booking, health monitoring, medication reminders, and daily health reporting. Powered by the Qwen Code Instruct 2.5 7B model, the Planner and Caller Agents achieve an average RougeL score of 85.5 for planning and 96.5 for calling for our tasks while being lightweight for on-device deployment. This innovative approach combines the benefits of ondevice systems with multi-agent architectures, paving the way for user-centric healthcare solutions.
SANSformers: Self-Supervised Forecasting in Electronic Health Records with Attention-Free Models
Despite the proven effectiveness of Transformer neural networks across multiple domains, their performance with Electronic Health Records (EHR) can be nuanced. The unique, multidimensional sequential nature of EHR data can sometimes make even simple linear models with carefully engineered features more competitive. Thus, the advantages of Transformers, such as efficient transfer learning and improved scalability are not always fully exploited in EHR applications. Addressing these challenges, we introduce SANSformer, an attention-free sequential model designed with specific inductive biases to cater for the unique characteristics of EHR data. In this work, we aim to forecast the demand for healthcare services, by predicting the number of patient visits to healthcare facilities. The challenge amplifies when dealing with divergent patient subgroups, like those with rare diseases, which are characterized by unique health trajectories and are typically smaller in size. To address this, we employ a self-supervised pretraining strategy, Generative Summary Pretraining (GSP), which predicts future summary statistics based on past health records of a patient. Our models are pretrained on a health registry of nearly one million patients, then fine-tuned for specific subgroup prediction tasks, showcasing the potential to handle the multifaceted nature of EHR data. In evaluation, SANSformer consistently surpasses robust EHR baselines, with our GSP pretraining method notably amplifying model performance, particularly within smaller patient subgroups. Our results illuminate the promising potential of tailored attention-free models and self-supervised pretraining in refining healthcare utilization predictions across various patient demographics.
A General-purpose AI Avatar in Healthcare
Recent advancements in machine learning and natural language processing have led to the rapid development of artificial intelligence (AI) as a valuable tool in the healthcare industry. Using large language models (LLMs) as conversational agents or chatbots has the potential to assist doctors in diagnosing patients, detecting early symptoms of diseases, and providing health advice to patients. This paper focuses on the role of chatbots in healthcare and explores the use of avatars to make AI interactions more appealing to patients. A framework of a general-purpose AI avatar application is demonstrated by using a three-category prompt dictionary and prompt improvement mechanism. A two-phase approach is suggested to fine-tune a general-purpose AI language model and create different AI avatars to discuss medical issues with users. Prompt engineering enhances the chatbot's conversational abilities and personality traits, fostering a more human-like interaction with patients. Ultimately, the injection of personality into the chatbot could potentially increase patient engagement. Future directions for research include investigating ways to improve chatbots' understanding of context and ensuring the accuracy of their outputs through fine-tuning with specialized medical data sets.
Ophthalmic Biomarker Detection: Highlights from the IEEE Video and Image Processing Cup 2023 Student Competition
The VIP Cup offers a unique experience to undergraduates, allowing students to work together to solve challenging, real-world problems with video and image processing techniques. In this iteration of the VIP Cup, we challenged students to balance personalization and generalization when performing biomarker detection in 3D optical coherence tomography (OCT) images. Balancing personalization and generalization is an important challenge to tackle, as the variation within OCT scans of patients between visits can be minimal while the difference in manifestation of the same disease across different patients may be substantial. The domain difference between OCT scans can arise due to pathology manifestation across patients, clinical labels, and the visit along the treatment process when the scan is taken. Hence, we provided a multimodal OCT dataset to allow teams to effectively target this challenge. Overall, this competition gave undergraduates an opportunity to learn about how artificial intelligence can be a powerful tool for the medical field, as well as the unique challenges one faces when applying machine learning to biomedical data.
In-Context Learning for Preserving Patient Privacy: A Framework for Synthesizing Realistic Patient Portal Messages
Since the COVID-19 pandemic, clinicians have seen a large and sustained influx in patient portal messages, significantly contributing to clinician burnout. To the best of our knowledge, there are no large-scale public patient portal messages corpora researchers can use to build tools to optimize clinician portal workflows. Informed by our ongoing work with a regional hospital, this study introduces an LLM-powered framework for configurable and realistic patient portal message generation. Our approach leverages few-shot grounded text generation, requiring only a small number of de-identified patient portal messages to help LLMs better match the true style and tone of real data. Clinical experts in our team deem this framework as HIPAA-friendly, unlike existing privacy-preserving approaches to synthetic text generation which cannot guarantee all sensitive attributes will be protected. Through extensive quantitative and human evaluation, we show that our framework produces data of higher quality than comparable generation methods as well as all related datasets. We believe this work provides a path forward for (i) the release of large-scale synthetic patient message datasets that are stylistically similar to ground-truth samples and (ii) HIPAA-friendly data generation which requires minimal human de-identification efforts.
EHRFL: Federated Learning Framework for Heterogeneous EHRs and Precision-guided Selection of Participating Clients
In this study, we provide solutions to two practical yet overlooked scenarios in federated learning for electronic health records (EHRs): firstly, we introduce EHRFL, a framework that facilitates federated learning across healthcare institutions with distinct medical coding systems and database schemas using text-based linearization of EHRs. Secondly, we focus on a scenario where a single healthcare institution initiates federated learning to build a model tailored for itself, in which the number of clients must be optimized in order to reduce expenses incurred by the host. For selecting participating clients, we present a novel precision-based method, leveraging data latents to identify suitable participants for the institution. Our empirical results show that EHRFL effectively enables federated learning across hospitals with different EHR systems. Furthermore, our results demonstrate the efficacy of our precision-based method in selecting reduced number of participating clients without compromising model performance, resulting in lower operational costs when constructing institution-specific models. We believe this work lays a foundation for the broader adoption of federated learning on EHRs.
FedJETs: Efficient Just-In-Time Personalization with Federated Mixture of Experts
One of the goals in Federated Learning (FL) is to create personalized models that can adapt to the context of each participating client, while utilizing knowledge from a shared global model. Yet, often, personalization requires a fine-tuning step using clients' labeled data in order to achieve good performance. This may not be feasible in scenarios where incoming clients are fresh and/or have privacy concerns. It, then, remains open how one can achieve just-in-time personalization in these scenarios. We propose FedJETs, a novel solution by using a Mixture-of-Experts (MoE) framework within a FL setup. Our method leverages the diversity of the clients to train specialized experts on different subsets of classes, and a gating function to route the input to the most relevant expert(s). Our gating function harnesses the knowledge of a pretrained model common expert to enhance its routing decisions on-the-fly. As a highlight, our approach can improve accuracy up to 18\% in state of the art FL settings, while maintaining competitive zero-shot performance. In practice, our method can handle non-homogeneous data distributions, scale more efficiently, and improve the state-of-the-art performance on common FL benchmarks.
README: Bridging Medical Jargon and Lay Understanding for Patient Education through Data-Centric NLP
The advancement in healthcare has shifted focus toward patient-centric approaches, particularly in self-care and patient education, facilitated by access to Electronic Health Records (EHR). However, medical jargon in EHRs poses significant challenges in patient comprehension. To address this, we introduce a new task of automatically generating lay definitions, aiming to simplify complex medical terms into patient-friendly lay language. We first created the README dataset, an extensive collection of over 50,000 unique (medical term, lay definition) pairs and 300,000 mentions, each offering context-aware lay definitions manually annotated by domain experts. We have also engineered a data-centric Human-AI pipeline that synergizes data filtering, augmentation, and selection to improve data quality. We then used README as the training data for models and leveraged a Retrieval-Augmented Generation method to reduce hallucinations and improve the quality of model outputs. Our extensive automatic and human evaluations demonstrate that open-source mobile-friendly models, when fine-tuned with high-quality data, are capable of matching or even surpassing the performance of state-of-the-art closed-source large language models like ChatGPT. This research represents a significant stride in closing the knowledge gap in patient education and advancing patient-centric healthcare solutions.
TxAgent: An AI Agent for Therapeutic Reasoning Across a Universe of Tools
Precision therapeutics require multimodal adaptive models that generate personalized treatment recommendations. We introduce TxAgent, an AI agent that leverages multi-step reasoning and real-time biomedical knowledge retrieval across a toolbox of 211 tools to analyze drug interactions, contraindications, and patient-specific treatment strategies. TxAgent evaluates how drugs interact at molecular, pharmacokinetic, and clinical levels, identifies contraindications based on patient comorbidities and concurrent medications, and tailors treatment strategies to individual patient characteristics. It retrieves and synthesizes evidence from multiple biomedical sources, assesses interactions between drugs and patient conditions, and refines treatment recommendations through iterative reasoning. It selects tools based on task objectives and executes structured function calls to solve therapeutic tasks that require clinical reasoning and cross-source validation. The ToolUniverse consolidates 211 tools from trusted sources, including all US FDA-approved drugs since 1939 and validated clinical insights from Open Targets. TxAgent outperforms leading LLMs, tool-use models, and reasoning agents across five new benchmarks: DrugPC, BrandPC, GenericPC, TreatmentPC, and DescriptionPC, covering 3,168 drug reasoning tasks and 456 personalized treatment scenarios. It achieves 92.1% accuracy in open-ended drug reasoning tasks, surpassing GPT-4o and outperforming DeepSeek-R1 (671B) in structured multi-step reasoning. TxAgent generalizes across drug name variants and descriptions. By integrating multi-step inference, real-time knowledge grounding, and tool-assisted decision-making, TxAgent ensures that treatment recommendations align with established clinical guidelines and real-world evidence, reducing the risk of adverse events and improving therapeutic decision-making.
AIMI: Leveraging Future Knowledge and Personalization in Sparse Event Forecasting for Treatment Adherence
Adherence to prescribed treatments is crucial for individuals with chronic conditions to avoid costly or adverse health outcomes. For certain patient groups, intensive lifestyle interventions are vital for enhancing medication adherence. Accurate forecasting of treatment adherence can open pathways to developing an on-demand intervention tool, enabling timely and personalized support. With the increasing popularity of smartphones and wearables, it is now easier than ever to develop and deploy smart activity monitoring systems. However, effective forecasting systems for treatment adherence based on wearable sensors are still not widely available. We close this gap by proposing Adherence Forecasting and Intervention with Machine Intelligence (AIMI). AIMI is a knowledge-guided adherence forecasting system that leverages smartphone sensors and previous medication history to estimate the likelihood of forgetting to take a prescribed medication. A user study was conducted with 27 participants who took daily medications to manage their cardiovascular diseases. We designed and developed CNN and LSTM-based forecasting models with various combinations of input features and found that LSTM models can forecast medication adherence with an accuracy of 0.932 and an F-1 score of 0.936. Moreover, through a series of ablation studies involving convolutional and recurrent neural network architectures, we demonstrate that leveraging known knowledge about future and personalized training enhances the accuracy of medication adherence forecasting. Code available: https://github.com/ab9mamun/AIMI.
Using Sequences of Life-events to Predict Human Lives
Over the past decade, machine learning has revolutionized computers' ability to analyze text through flexible computational models. Due to their structural similarity to written language, transformer-based architectures have also shown promise as tools to make sense of a range of multi-variate sequences from protein-structures, music, electronic health records to weather-forecasts. We can also represent human lives in a way that shares this structural similarity to language. From one perspective, lives are simply sequences of events: People are born, visit the pediatrician, start school, move to a new location, get married, and so on. Here, we exploit this similarity to adapt innovations from natural language processing to examine the evolution and predictability of human lives based on detailed event sequences. We do this by drawing on arguably the most comprehensive registry data in existence, available for an entire nation of more than six million individuals across decades. Our data include information about life-events related to health, education, occupation, income, address, and working hours, recorded with day-to-day resolution. We create embeddings of life-events in a single vector space showing that this embedding space is robust and highly structured. Our models allow us to predict diverse outcomes ranging from early mortality to personality nuances, outperforming state-of-the-art models by a wide margin. Using methods for interpreting deep learning models, we probe the algorithm to understand the factors that enable our predictions. Our framework allows researchers to identify new potential mechanisms that impact life outcomes and associated possibilities for personalized interventions.
Polaris: A Safety-focused LLM Constellation Architecture for Healthcare
We develop Polaris, the first safety-focused LLM constellation for real-time patient-AI healthcare conversations. Unlike prior LLM works in healthcare focusing on tasks like question answering, our work specifically focuses on long multi-turn voice conversations. Our one-trillion parameter constellation system is composed of several multibillion parameter LLMs as co-operative agents: a stateful primary agent that focuses on driving an engaging conversation and several specialist support agents focused on healthcare tasks performed by nurses to increase safety and reduce hallucinations. We develop a sophisticated training protocol for iterative co-training of the agents that optimize for diverse objectives. We train our models on proprietary data, clinical care plans, healthcare regulatory documents, medical manuals, and other medical reasoning documents. We align our models to speak like medical professionals, using organic healthcare conversations and simulated ones between patient actors and experienced nurses. This allows our system to express unique capabilities such as rapport building, trust building, empathy and bedside manner. Finally, we present the first comprehensive clinician evaluation of an LLM system for healthcare. We recruited over 1100 U.S. licensed nurses and over 130 U.S. licensed physicians to perform end-to-end conversational evaluations of our system by posing as patients and rating the system on several measures. We demonstrate Polaris performs on par with human nurses on aggregate across dimensions such as medical safety, clinical readiness, conversational quality, and bedside manner. Additionally, we conduct a challenging task-based evaluation of the individual specialist support agents, where we demonstrate our LLM agents significantly outperform a much larger general-purpose LLM (GPT-4) as well as from its own medium-size class (LLaMA-2 70B).
PersonaLens: A Benchmark for Personalization Evaluation in Conversational AI Assistants
Large language models (LLMs) have advanced conversational AI assistants. However, systematically evaluating how well these assistants apply personalization--adapting to individual user preferences while completing tasks--remains challenging. Existing personalization benchmarks focus on chit-chat, non-conversational tasks, or narrow domains, failing to capture the complexities of personalized task-oriented assistance. To address this, we introduce PersonaLens, a comprehensive benchmark for evaluating personalization in task-oriented AI assistants. Our benchmark features diverse user profiles equipped with rich preferences and interaction histories, along with two specialized LLM-based agents: a user agent that engages in realistic task-oriented dialogues with AI assistants, and a judge agent that employs the LLM-as-a-Judge paradigm to assess personalization, response quality, and task success. Through extensive experiments with current LLM assistants across diverse tasks, we reveal significant variability in their personalization capabilities, providing crucial insights for advancing conversational AI systems.
Preserving Privacy, Increasing Accessibility, and Reducing Cost: An On-Device Artificial Intelligence Model for Medical Transcription and Note Generation
Background: Clinical documentation represents a significant burden for healthcare providers, with physicians spending up to 2 hours daily on administrative tasks. Recent advances in large language models (LLMs) offer promising solutions, but privacy concerns and computational requirements limit their adoption in healthcare settings. Objective: To develop and evaluate a privacy-preserving, on-device medical transcription system using a fine-tuned Llama 3.2 1B model capable of generating structured medical notes from medical transcriptions while maintaining complete data sovereignty entirely in the browser. Methods: We fine-tuned a Llama 3.2 1B model using Parameter-Efficient Fine-Tuning (PEFT) with LoRA on 1,500 synthetic medical transcription-to-structured note pairs. The model was evaluated against the base Llama 3.2 1B on two datasets: 100 endocrinology transcripts and 140 modified ACI benchmark cases. Evaluation employed both statistical metrics (ROUGE, BERTScore, BLEURT) and LLM-as-judge assessments across multiple clinical quality dimensions. Results: The fine-tuned OnDevice model demonstrated substantial improvements over the base model. On the ACI benchmark, ROUGE-1 scores increased from 0.346 to 0.496, while BERTScore F1 improved from 0.832 to 0.866. Clinical quality assessments showed marked reduction in major hallucinations (from 85 to 35 cases) and enhanced factual correctness (2.81 to 3.54 on 5-point scale). Similar improvements were observed on the internal evaluation dataset, with composite scores increasing from 3.13 to 4.43 (+41.5%). Conclusions: Fine-tuning compact LLMs for medical transcription yields clinically meaningful improvements while enabling complete on-device browser deployment. This approach addresses key barriers to AI adoption in healthcare: privacy preservation, cost reduction, and accessibility for resource-constrained environments.
Artificial Intelligence in Mental Health and Well-Being: Evolution, Current Applications, Future Challenges, and Emerging Evidence
Artificial Intelligence (AI) is a broad field that is upturning mental health care in many ways, from addressing anxiety, depression, and stress to increasing access, personalization of treatment, and real-time monitoring that enhances patient outcomes. The current paper discusses the evolution, present application, and future challenges in the field of AI for mental health and well-being. From the early chatbot models, such as ELIZA, to modern machine learning systems, the integration of AI in mental health has grown rapidly to augment traditional treatment and open innovative solutions. AI-driven tools provide continuous support, offering personalized interventions and addressing issues such as treatment access and patient stigma. AI also enables early diagnosis through the analysis of complex datasets, including speech patterns and social media behavior, to detect early signs of conditions like depression and Post-Traumatic Stress Disorder (PTSD). Ethical challenges persist, however, most notably around privacy, data security, and algorithmic bias. With AI at the core of mental health care, there is a dire need to develop strong ethical frameworks that ensure patient rights are protected, access is equitable, and transparency is maintained in AI applications. Going forward, the role of AI in mental health will continue to evolve, and continued research and policy development will be needed to meet the diverse needs of patients while mitigating associated risks.
GenHPF: General Healthcare Predictive Framework with Multi-task Multi-source Learning
Despite the remarkable progress in the development of predictive models for healthcare, applying these algorithms on a large scale has been challenging. Algorithms trained on a particular task, based on specific data formats available in a set of medical records, tend to not generalize well to other tasks or databases in which the data fields may differ. To address this challenge, we propose General Healthcare Predictive Framework (GenHPF), which is applicable to any EHR with minimal preprocessing for multiple prediction tasks. GenHPF resolves heterogeneity in medical codes and schemas by converting EHRs into a hierarchical textual representation while incorporating as many features as possible. To evaluate the efficacy of GenHPF, we conduct multi-task learning experiments with single-source and multi-source settings, on three publicly available EHR datasets with different schemas for 12 clinically meaningful prediction tasks. Our framework significantly outperforms baseline models that utilize domain knowledge in multi-source learning, improving average AUROC by 1.2%P in pooled learning and 2.6%P in transfer learning while also showing comparable results when trained on a single EHR dataset. Furthermore, we demonstrate that self-supervised pretraining using multi-source datasets is effective when combined with GenHPF, resulting in a 0.6%P AUROC improvement compared to models without pretraining. By eliminating the need for preprocessing and feature engineering, we believe that this work offers a solid framework for multi-task and multi-source learning that can be leveraged to speed up the scaling and usage of predictive algorithms in healthcare.
HealthGenie: Empowering Users with Healthy Dietary Guidance through Knowledge Graph and Large Language Models
Seeking dietary guidance often requires navigating complex professional knowledge while accommodating individual health conditions. Knowledge Graphs (KGs) offer structured and interpretable nutritional information, whereas Large Language Models (LLMs) naturally facilitate conversational recommendation delivery. In this paper, we present HealthGenie, an interactive system that combines the strengths of LLMs and KGs to provide personalized dietary recommendations along with hierarchical information visualization for a quick and intuitive overview. Upon receiving a user query, HealthGenie performs query refinement and retrieves relevant information from a pre-built KG. The system then visualizes and highlights pertinent information, organized by defined categories, while offering detailed, explainable recommendation rationales. Users can further tailor these recommendations by adjusting preferences interactively. Our evaluation, comprising a within-subject comparative experiment and an open-ended discussion, demonstrates that HealthGenie effectively supports users in obtaining personalized dietary guidance based on their health conditions while reducing interaction effort and cognitive load. These findings highlight the potential of LLM-KG integration in supporting decision-making through explainable and visualized information. We examine the system's usefulness and effectiveness with an N=12 within-subject study and provide design considerations for future systems that integrate conversational LLM and KG.
Exploring Personalized Health Support through Data-Driven, Theory-Guided LLMs: A Case Study in Sleep Health
Despite the prevalence of sleep-tracking devices, many individuals struggle to translate data into actionable improvements in sleep health. Current methods often provide data-driven suggestions but may not be feasible and adaptive to real-life constraints and individual contexts. We present HealthGuru, a novel large language model-powered chatbot to enhance sleep health through data-driven, theory-guided, and adaptive recommendations with conversational behavior change support. HealthGuru's multi-agent framework integrates wearable device data, contextual information, and a contextual multi-armed bandit model to suggest tailored sleep-enhancing activities. The system facilitates natural conversations while incorporating data-driven insights and theoretical behavior change techniques. Our eight-week in-the-wild deployment study with 16 participants compared HealthGuru to a baseline chatbot. Results show improved metrics like sleep duration and activity scores, higher quality responses, and increased user motivation for behavior change with HealthGuru. We also identify challenges and design considerations for personalization and user engagement in health chatbots.
Personalized Federated Learning under Mixture of Distributions
The recent trend towards Personalized Federated Learning (PFL) has garnered significant attention as it allows for the training of models that are tailored to each client while maintaining data privacy. However, current PFL techniques primarily focus on modeling the conditional distribution heterogeneity (i.e. concept shift), which can result in suboptimal performance when the distribution of input data across clients diverges (i.e. covariate shift). Additionally, these techniques often lack the ability to adapt to unseen data, further limiting their effectiveness in real-world scenarios. To address these limitations, we propose a novel approach, FedGMM, which utilizes Gaussian mixture models (GMM) to effectively fit the input data distributions across diverse clients. The model parameters are estimated by maximum likelihood estimation utilizing a federated Expectation-Maximization algorithm, which is solved in closed form and does not assume gradient similarity. Furthermore, FedGMM possesses an additional advantage of adapting to new clients with minimal overhead, and it also enables uncertainty quantification. Empirical evaluations on synthetic and benchmark datasets demonstrate the superior performance of our method in both PFL classification and novel sample detection.
Adaptive Personlization in Federated Learning for Highly Non-i.i.d. Data
Federated learning (FL) is a distributed learning method that offers medical institutes the prospect of collaboration in a global model while preserving the privacy of their patients. Although most medical centers conduct similar medical imaging tasks, their differences, such as specializations, number of patients, and devices, lead to distinctive data distributions. Data heterogeneity poses a challenge for FL and the personalization of the local models. In this work, we investigate an adaptive hierarchical clustering method for FL to produce intermediate semi-global models, so clients with similar data distribution have the chance of forming a more specialized model. Our method forms several clusters consisting of clients with the most similar data distributions; then, each cluster continues to train separately. Inside the cluster, we use meta-learning to improve the personalization of the participants' models. We compare the clustering approach with classical FedAvg and centralized training by evaluating our proposed methods on the HAM10k dataset for skin lesion classification with extreme heterogeneous data distribution. Our experiments demonstrate significant performance gain in heterogeneous distribution compared to standard FL methods in classification accuracy. Moreover, we show that the models converge faster if applied in clusters and outperform centralized training while using only a small subset of data.
PersonaBench: Evaluating AI Models on Understanding Personal Information through Accessing (Synthetic) Private User Data
Personalization is critical in AI assistants, particularly in the context of private AI models that work with individual users. A key scenario in this domain involves enabling AI models to access and interpret a user's private data (e.g., conversation history, user-AI interactions, app usage) to understand personal details such as biographical information, preferences, and social connections. However, due to the sensitive nature of such data, there are no publicly available datasets that allow us to assess an AI model's ability to understand users through direct access to personal information. To address this gap, we introduce a synthetic data generation pipeline that creates diverse, realistic user profiles and private documents simulating human activities. Leveraging this synthetic data, we present PersonaBench, a benchmark designed to evaluate AI models' performance in understanding personal information derived from simulated private user data. We evaluate Retrieval-Augmented Generation (RAG) pipelines using questions directly related to a user's personal information, supported by the relevant private documents provided to the models. Our results reveal that current retrieval-augmented AI models struggle to answer private questions by extracting personal information from user documents, highlighting the need for improved methodologies to enhance personalization capabilities in AI.
Group Personalized Federated Learning
Federated learning (FL) can help promote data privacy by training a shared model in a de-centralized manner on the physical devices of clients. In the presence of highly heterogeneous distributions of local data, personalized FL strategy seeks to mitigate the potential client drift. In this paper, we present the group personalization approach for applications of FL in which there exist inherent partitions among clients that are significantly distinct. In our method, the global FL model is fine-tuned through another FL training process over each homogeneous group of clients, after which each group-specific FL model is further adapted and personalized for any client. The proposed method can be well interpreted from a Bayesian hierarchical modeling perspective. With experiments on two real-world datasets, we demonstrate this approach can achieve superior personalization performance than other FL counterparts.
Personalized Resource Allocation in Wireless Networks: An AI-Enabled and Big Data-Driven Multi-Objective Optimization
The design and optimization of wireless networks have mostly been based on strong mathematical and theoretical modeling. Nonetheless, as novel applications emerge in the era of 5G and beyond, unprecedented levels of complexity will be encountered in the design and optimization of the network. As a result, the use of Artificial Intelligence (AI) is envisioned for wireless network design and optimization due to the flexibility and adaptability it offers in solving extremely complex problems in real-time. One of the main future applications of AI is enabling user-level personalization for numerous use cases. AI will revolutionize the way we interact with computers in which computers will be able to sense commands and emotions from humans in a non-intrusive manner, making the entire process transparent to users. By leveraging this capability, and accelerated by the advances in computing technologies, wireless networks can be redesigned to enable the personalization of network services to the user level in real-time. While current wireless networks are being optimized to achieve a predefined set of quality requirements, the personalization technology advocated in this article is supported by an intelligent big data-driven layer designed to micro-manage the scarce network resources. This layer provides the intelligence required to decide the necessary service quality that achieves the target satisfaction level for each user. Due to its dynamic and flexible design, personalized networks are expected to achieve unprecedented improvements in optimizing two contradicting objectives in wireless networks: saving resources and improving user satisfaction levels.
Foresight -- Generative Pretrained Transformer (GPT) for Modelling of Patient Timelines using EHRs
Background: Electronic Health Records hold detailed longitudinal information about each patient's health status and general clinical history, a large portion of which is stored within the unstructured text. Existing approaches focus mostly on structured data and a subset of single-domain outcomes. We explore how temporal modelling of patients from free text and structured data, using deep generative transformers can be used to forecast a wide range of future disorders, substances, procedures or findings. Methods: We present Foresight, a novel transformer-based pipeline that uses named entity recognition and linking tools to convert document text into structured, coded concepts, followed by providing probabilistic forecasts for future medical events such as disorders, substances, procedures and findings. We processed the entire free-text portion from three different hospital datasets totalling 811336 patients covering both physical and mental health. Findings: On tests in two UK hospitals (King's College Hospital, South London and Maudsley) and the US MIMIC-III dataset precision@10 0.68, 0.76 and 0.88 was achieved for forecasting the next disorder in a patient timeline, while precision@10 of 0.80, 0.81 and 0.91 was achieved for forecasting the next biomedical concept. Foresight was also validated on 34 synthetic patient timelines by five clinicians and achieved relevancy of 97% for the top forecasted candidate disorder. As a generative model, it can forecast follow-on biomedical concepts for as many steps as required. Interpretation: Foresight is a general-purpose model for biomedical concept modelling that can be used for real-world risk forecasting, virtual trials and clinical research to study the progression of disorders, simulate interventions and counterfactuals, and educational purposes.
Data-Centric Foundation Models in Computational Healthcare: A Survey
The advent of foundation models (FMs) as an emerging suite of AI techniques has struck a wave of opportunities in computational healthcare. The interactive nature of these models, guided by pre-training data and human instructions, has ignited a data-centric AI paradigm that emphasizes better data characterization, quality, and scale. In healthcare AI, obtaining and processing high-quality clinical data records has been a longstanding challenge, ranging from data quantity, annotation, patient privacy, and ethics. In this survey, we investigate a wide range of data-centric approaches in the FM era (from model pre-training to inference) towards improving the healthcare workflow. We discuss key perspectives in AI security, assessment, and alignment with human values. Finally, we offer a promising outlook of FM-based analytics to enhance the performance of patient outcome and clinical workflow in the evolving landscape of healthcare and medicine. We provide an up-to-date list of healthcare-related foundation models and datasets at https://github.com/Yunkun-Zhang/Data-Centric-FM-Healthcare .
A Survey of Large Language Models for Healthcare: from Data, Technology, and Applications to Accountability and Ethics
The utilization of large language models (LLMs) in the Healthcare domain has generated both excitement and concern due to their ability to effectively respond to freetext queries with certain professional knowledge. This survey outlines the capabilities of the currently developed LLMs for Healthcare and explicates their development process, with the aim of providing an overview of the development roadmap from traditional Pretrained Language Models (PLMs) to LLMs. Specifically, we first explore the potential of LLMs to enhance the efficiency and effectiveness of various Healthcare applications highlighting both the strengths and limitations. Secondly, we conduct a comparison between the previous PLMs and the latest LLMs, as well as comparing various LLMs with each other. Then we summarize related Healthcare training data, training methods, optimization strategies, and usage. Finally, the unique concerns associated with deploying LLMs in Healthcare settings are investigated, particularly regarding fairness, accountability, transparency and ethics. Our survey provide a comprehensive investigation from perspectives of both computer science and Healthcare specialty. Besides the discussion about Healthcare concerns, we supports the computer science community by compiling a collection of open source resources, such as accessible datasets, the latest methodologies, code implementations, and evaluation benchmarks in the Github. Summarily, we contend that a significant paradigm shift is underway, transitioning from PLMs to LLMs. This shift encompasses a move from discriminative AI approaches to generative AI approaches, as well as a shift from model-centered methodologies to datacentered methodologies.
Unveiling Bias in Fairness Evaluations of Large Language Models: A Critical Literature Review of Music and Movie Recommendation Systems
The rise of generative artificial intelligence, particularly Large Language Models (LLMs), has intensified the imperative to scrutinize fairness alongside accuracy. Recent studies have begun to investigate fairness evaluations for LLMs within domains such as recommendations. Given that personalization is an intrinsic aspect of recommendation systems, its incorporation into fairness assessments is paramount. Yet, the degree to which current fairness evaluation frameworks account for personalization remains unclear. Our comprehensive literature review aims to fill this gap by examining how existing frameworks handle fairness evaluations of LLMs, with a focus on the integration of personalization factors. Despite an exhaustive collection and analysis of relevant works, we discovered that most evaluations overlook personalization, a critical facet of recommendation systems, thereby inadvertently perpetuating unfair practices. Our findings shed light on this oversight and underscore the urgent need for more nuanced fairness evaluations that acknowledge personalization. Such improvements are vital for fostering equitable development within the AI community.
When Personalization Harms: Reconsidering the Use of Group Attributes in Prediction
Machine learning models are often personalized with categorical attributes that are protected, sensitive, self-reported, or costly to acquire. In this work, we show models that are personalized with group attributes can reduce performance at a group level. We propose formal conditions to ensure the "fair use" of group attributes in prediction tasks by training one additional model -- i.e., collective preference guarantees to ensure that each group who provides personal data will receive a tailored gain in performance in return. We present sufficient conditions to ensure fair use in empirical risk minimization and characterize failure modes that lead to fair use violations due to standard practices in model development and deployment. We present a comprehensive empirical study of fair use in clinical prediction tasks. Our results demonstrate the prevalence of fair use violations in practice and illustrate simple interventions to mitigate their harm.
Applications of Large Models in Medicine
This paper explores the advancements and applications of large-scale models in the medical field, with a particular focus on Medical Large Models (MedLMs). These models, encompassing Large Language Models (LLMs), Vision Models, 3D Large Models, and Multimodal Models, are revolutionizing healthcare by enhancing disease prediction, diagnostic assistance, personalized treatment planning, and drug discovery. The integration of graph neural networks in medical knowledge graphs and drug discovery highlights the potential of Large Graph Models (LGMs) in understanding complex biomedical relationships. The study also emphasizes the transformative role of Vision-Language Models (VLMs) and 3D Large Models in medical image analysis, anatomical modeling, and prosthetic design. Despite the challenges, these technologies are setting new benchmarks in medical innovation, improving diagnostic accuracy, and paving the way for personalized healthcare solutions. This paper aims to provide a comprehensive overview of the current state and future directions of large models in medicine, underscoring their significance in advancing global health.
Radiology-GPT: A Large Language Model for Radiology
We introduce Radiology-GPT, a large language model for radiology. Using an instruction tuning approach on an extensive dataset of radiology domain knowledge, Radiology-GPT demonstrates superior performance compared to general language models such as StableLM, Dolly and LLaMA. It exhibits significant versatility in radiological diagnosis, research, and communication. This work serves as a catalyst for future developments in clinical NLP. The successful implementation of Radiology-GPT is indicative of the potential of localizing generative large language models, specifically tailored for distinctive medical specialties, while ensuring adherence to privacy standards such as HIPAA. The prospect of developing individualized, large-scale language models that cater to specific needs of various hospitals presents a promising direction. The fusion of conversational competence and domain-specific knowledge in these models is set to foster future development in healthcare AI. A demo of Radiology-GPT is available at https://huggingface.co/spaces/allen-eric/radiology-gpt.
Clinical knowledge in LLMs does not translate to human interactions
Global healthcare providers are exploring use of large language models (LLMs) to provide medical advice to the public. LLMs now achieve nearly perfect scores on medical licensing exams, but this does not necessarily translate to accurate performance in real-world settings. We tested if LLMs can assist members of the public in identifying underlying conditions and choosing a course of action (disposition) in ten medical scenarios in a controlled study with 1,298 participants. Participants were randomly assigned to receive assistance from an LLM (GPT-4o, Llama 3, Command R+) or a source of their choice (control). Tested alone, LLMs complete the scenarios accurately, correctly identifying conditions in 94.9% of cases and disposition in 56.3% on average. However, participants using the same LLMs identified relevant conditions in less than 34.5% of cases and disposition in less than 44.2%, both no better than the control group. We identify user interactions as a challenge to the deployment of LLMs for medical advice. Standard benchmarks for medical knowledge and simulated patient interactions do not predict the failures we find with human participants. Moving forward, we recommend systematic human user testing to evaluate interactive capabilities prior to public deployments in healthcare.
Leveraging Generative AI Models for Synthetic Data Generation in Healthcare: Balancing Research and Privacy
The widespread adoption of electronic health records and digital healthcare data has created a demand for data-driven insights to enhance patient outcomes, diagnostics, and treatments. However, using real patient data presents privacy and regulatory challenges, including compliance with HIPAA and GDPR. Synthetic data generation, using generative AI models like GANs and VAEs offers a promising solution to balance valuable data access and patient privacy protection. In this paper, we examine generative AI models for creating realistic, anonymized patient data for research and training, explore synthetic data applications in healthcare, and discuss its benefits, challenges, and future research directions. Synthetic data has the potential to revolutionize healthcare by providing anonymized patient data while preserving privacy and enabling versatile applications.
Towards conversational assistants for health applications: using ChatGPT to generate conversations about heart failure
We explore the potential of ChatGPT (3.5-turbo and 4) to generate conversations focused on self-care strategies for African-American heart failure patients -- a domain with limited specialized datasets. To simulate patient-health educator dialogues, we employed four prompting strategies: domain, African American Vernacular English (AAVE), Social Determinants of Health (SDOH), and SDOH-informed reasoning. Conversations were generated across key self-care domains of food, exercise, and fluid intake, with varying turn lengths (5, 10, 15) and incorporated patient-specific SDOH attributes such as age, gender, neighborhood, and socioeconomic status. Our findings show that effective prompt design is essential. While incorporating SDOH and reasoning improves dialogue quality, ChatGPT still lacks the empathy and engagement needed for meaningful healthcare communication.
On the Conversational Persuasiveness of Large Language Models: A Randomized Controlled Trial
The development and popularization of large language models (LLMs) have raised concerns that they will be used to create tailor-made, convincing arguments to push false or misleading narratives online. Early work has found that language models can generate content perceived as at least on par and often more persuasive than human-written messages. However, there is still limited knowledge about LLMs' persuasive capabilities in direct conversations with human counterparts and how personalization can improve their performance. In this pre-registered study, we analyze the effect of AI-driven persuasion in a controlled, harmless setting. We create a web-based platform where participants engage in short, multiple-round debates with a live opponent. Each participant is randomly assigned to one of four treatment conditions, corresponding to a two-by-two factorial design: (1) Games are either played between two humans or between a human and an LLM; (2) Personalization might or might not be enabled, granting one of the two players access to basic sociodemographic information about their opponent. We found that participants who debated GPT-4 with access to their personal information had 81.7% (p < 0.01; N=820 unique participants) higher odds of increased agreement with their opponents compared to participants who debated humans. Without personalization, GPT-4 still outperforms humans, but the effect is lower and statistically non-significant (p=0.31). Overall, our results suggest that concerns around personalization are meaningful and have important implications for the governance of social media and the design of new online environments.
PhysioLLM: Supporting Personalized Health Insights with Wearables and Large Language Models
We present PhysioLLM, an interactive system that leverages large language models (LLMs) to provide personalized health understanding and exploration by integrating physiological data from wearables with contextual information. Unlike commercial health apps for wearables, our system offers a comprehensive statistical analysis component that discovers correlations and trends in user data, allowing users to ask questions in natural language and receive generated personalized insights, and guides them to develop actionable goals. As a case study, we focus on improving sleep quality, given its measurability through physiological data and its importance to general well-being. Through a user study with 24 Fitbit watch users, we demonstrate that PhysioLLM outperforms both the Fitbit App alone and a generic LLM chatbot in facilitating a deeper, personalized understanding of health data and supporting actionable steps toward personal health goals.
The impact of using an AI chatbot to respond to patient messages
Documentation burden is a major contributor to clinician burnout, which is rising nationally and is an urgent threat to our ability to care for patients. Artificial intelligence (AI) chatbots, such as ChatGPT, could reduce clinician burden by assisting with documentation. Although many hospitals are actively integrating such systems into electronic medical record systems, AI chatbots utility and impact on clinical decision-making have not been studied for this intended use. We are the first to examine the utility of large language models in assisting clinicians draft responses to patient questions. In our two-stage cross-sectional study, 6 oncologists responded to 100 realistic synthetic cancer patient scenarios and portal messages developed to reflect common medical situations, first manually, then with AI assistance. We find AI-assisted responses were longer, less readable, but provided acceptable drafts without edits 58% of time. AI assistance improved efficiency 77% of time, with low harm risk (82% safe). However, 7.7% unedited AI responses could severely harm. In 31% cases, physicians thought AI drafts were human-written. AI assistance led to more patient education recommendations, fewer clinical actions than manual responses. Results show promise for AI to improve clinician efficiency and patient care through assisting documentation, if used judiciously. Monitoring model outputs and human-AI interaction remains crucial for safe implementation.
Implicit Personalization in Language Models: A Systematic Study
Implicit Personalization (IP) is a phenomenon of language models inferring a user's background from the implicit cues in the input prompts and tailoring the response based on this inference. While previous work has touched upon various instances of this problem, there lacks a unified framework to study this behavior. This work systematically studies IP through a rigorous mathematical formulation, a multi-perspective moral reasoning framework, and a set of case studies. Our theoretical foundation for IP relies on a structural causal model and introduces a novel method, indirect intervention, to estimate the causal effect of a mediator variable that cannot be directly intervened upon. Beyond the technical approach, we also introduce a set of moral reasoning principles based on three schools of moral philosophy to study when IP may or may not be ethically appropriate. Equipped with both mathematical and ethical insights, we present three diverse case studies illustrating the varied nature of the IP problem and offer recommendations for future research. Our code and data are at https://github.com/jiarui-liu/IP.
Large Language Model for Mental Health: A Systematic Review
Large language models (LLMs) have received much attention and shown their potential in digital health, while their application in mental health is subject to ongoing debate. This systematic review aims to summarize and characterize the use of LLMs in mental health by investigating the strengths and limitations of the latest work in LLMs and discusses the challenges and opportunities for early screening, digital interventions, and other clinical applications in mental health. Following PRISMA guidelines, we examined English articles from PubMed, DBLP Computer Science Bibliography, and IEEE Xplore, published between 1 January 2017, and 1 September 2023, focusing on mental health and LLMs. The review analyzed 32 articles, including mental health analysis using social media datasets (n=13), mental health chatbots (n=10), and other mental health applications (n=9). Findings reveal LLMs' effectiveness in mental health issue detection and the enhancement of telepsychological services through personalised healthcare. Nonetheless, risks like text inconsistencies, hallucinatory content, and the lack of an ethical framework raise concerns about their clinical use. Despite these challenges, the advancement of LLMs underscores their potential as innovative clinical tools, necessitating further research and development. The review emphasizes that LLMs should complement, not replace, professional mental health services.
Eir: Thai Medical Large Language Models
We present Eir Thai Medical LLM, a large language model with 8 billion parameters, specifically designed to enhance the accuracy of handling medical tasks in the Thai language. This model focuses on providing clear and easy-to-understand answers for both healthcare professionals and patients, thereby improving the efficiency of diagnosis and treatment processes. Human evaluation was conducted to ensure that the model adheres to care standards and provides unbiased answers. To prioritize data security, the model is deployed within the hospital's internal network, ensuring both high security and faster processing speeds. The internal API connection is secured with encryption and strict authentication measures to prevent data leaks and unauthorized access. We evaluated several open-source large language models with 8 billion parameters on four medical benchmarks: MedQA, MedMCQA, PubMedQA, and the medical subset of MMLU. The best-performing baselines were used to develop Eir Thai Medical LLM. Our evaluation employed multiple questioning strategies, including zero-shot, few-shot, chain-of-thought reasoning, and ensemble/self-consistency voting methods. Our model outperformed commercially available Thai-language large language models by more than 10%. In addition, we developed enhanced model testing tailored for clinical use in Thai across 18 clinical tasks, where our model exceeded GPT-4o performance by more than 11%
Demystifying Large Language Models for Medicine: A Primer
Large language models (LLMs) represent a transformative class of AI tools capable of revolutionizing various aspects of healthcare by generating human-like responses across diverse contexts and adapting to novel tasks following human instructions. Their potential application spans a broad range of medical tasks, such as clinical documentation, matching patients to clinical trials, and answering medical questions. In this primer paper, we propose an actionable guideline to help healthcare professionals more efficiently utilize LLMs in their work, along with a set of best practices. This approach consists of several main phases, including formulating the task, choosing LLMs, prompt engineering, fine-tuning, and deployment. We start with the discussion of critical considerations in identifying healthcare tasks that align with the core capabilities of LLMs and selecting models based on the selected task and data, performance requirements, and model interface. We then review the strategies, such as prompt engineering and fine-tuning, to adapt standard LLMs to specialized medical tasks. Deployment considerations, including regulatory compliance, ethical guidelines, and continuous monitoring for fairness and bias, are also discussed. By providing a structured step-by-step methodology, this tutorial aims to equip healthcare professionals with the tools necessary to effectively integrate LLMs into clinical practice, ensuring that these powerful technologies are applied in a safe, reliable, and impactful manner.