Daily Papers

Large language models (LLMs) have emerged as valuable tools for many natural language understanding tasks. In safety-critical applications such as healthcare, the utility of these models is governed by their ability to generate outputs that are factually accurate and complete. In this work, we present dialog-enabled resolving agents (DERA). DERA is a paradigm made possible by the increased conversational abilities of LLMs, namely GPT-4. It provides a simple, interpretable forum for models to communicate feedback and iteratively improve output. We frame our dialog as a discussion between two agent types - a Researcher, who processes information and identifies crucial problem components, and a Decider, who has the autonomy to integrate the Researcher's information and makes judgments on the final output. We test DERA against three clinically-focused tasks. For medical conversation summarization and care plan generation, DERA shows significant improvement over the base GPT-4 performance in both human expert preference evaluations and quantitative metrics. In a new finding, we also show that GPT-4's performance (70%) on an open-ended version of the MedQA question-answering (QA) dataset (Jin et al. 2021, USMLE) is well above the passing level (60%), with DERA showing similar performance. We release the open-ended MEDQA dataset at https://github.com/curai/curai-research/tree/main/DERA.

This paper explores the task of radiology report generation, which aims at generating free-text descriptions for a set of radiographs. One significant challenge of this task is how to correctly maintain the consistency between the images and the lengthy report. Previous research explored solving this issue through planning-based methods, which generate reports only based on high-level plans. However, these plans usually only contain the major observations from the radiographs (e.g., lung opacity), lacking much necessary information, such as the observation characteristics and preliminary clinical diagnoses. To address this problem, the system should also take the image information into account together with the textual plan and perform stronger reasoning during the generation process. In this paper, we propose an observation-guided radiology report generation framework (ORGAN). It first produces an observation plan and then feeds both the plan and radiographs for report generation, where an observation graph and a tree reasoning mechanism are adopted to precisely enrich the plan information by capturing the multi-formats of each observation. Experimental results demonstrate that our framework outperforms previous state-of-the-art methods regarding text quality and clinical efficacy

Objective: Using natural language processing (NLP) to find sentences that state treatment plans in a clinical note, would automate plan extraction and would further enable their use in tools that help providers and care managers. However, as in the most NLP tasks on clinical text, creating gold standard to train and test NLP models is tedious and expensive. Fortuitously, sometimes but not always clinical notes contain sections with a heading that identifies the section as a plan. Leveraging contents of such labeled sections as a noisy training data, we assessed accuracy of NLP models trained with the data. Methods: We used common variations of plan headings and rule-based heuristics to find plan sections with headings in clinical notes, and we extracted sentences from them and formed a noisy training data of plan sentences. We trained Support Vector Machine (SVM) and Convolutional Neural Network (CNN) models with the data. We measured accuracy of the trained models on the noisy dataset using ten-fold cross validation and separately on a set-aside manually annotated dataset. Results: About 13% of 117,730 clinical notes contained treatment plans sections with recognizable headings in the 1001 longitudinal patient records that were obtained from Cleveland Clinic under an IRB approval. We were able to extract and create a noisy training data of 13,492 plan sentences from the clinical notes. CNN achieved best F measures, 0.91 and 0.97 in the cross-validation and set-aside evaluation experiments respectively. SVM slightly underperformed with F measures of 0.89 and 0.96 in the same experiments. Conclusion: Our study showed that the training supervised learning models using noisy plan sentences was effective in identifying them in all clinical notes. More broadly, sections with informal headings in clinical notes can be a good source for generating effective training data.

Recent immense breakthroughs in generative models such as in GPT4 have precipitated re-imagined ubiquitous usage of these models in all applications. One area that can benefit by improvements in artificial intelligence (AI) is healthcare. The note generation task from doctor-patient encounters, and its associated electronic medical record documentation, is one of the most arduous time-consuming tasks for physicians. It is also a natural prime potential beneficiary to advances in generative models. However with such advances, benchmarking is more critical than ever. Whether studying model weaknesses or developing new evaluation metrics, shared open datasets are an imperative part of understanding the current state-of-the-art. Unfortunately as clinic encounter conversations are not routinely recorded and are difficult to ethically share due to patient confidentiality, there are no sufficiently large clinic dialogue-note datasets to benchmark this task. Here we present the Ambient Clinical Intelligence Benchmark (ACI-BENCH) corpus, the largest dataset to date tackling the problem of AI-assisted note generation from visit dialogue. We also present the benchmark performances of several common state-of-the-art approaches.

Recent advances in generative models, including large language models (LLMs), vision language models (VLMs), and diffusion models, have accelerated the field of natural language and image processing in medicine and marked a significant paradigm shift in how biomedical models can be developed and deployed. While these models are highly adaptable to new tasks, scaling and evaluating their usage presents new challenges not addressed in previous frameworks. In particular, the ability of these models to produce useful outputs with little to no specialized training data ("zero-" or "few-shot" approaches), as well as the open-ended nature of their outputs, necessitate the development of new guidelines for robust reporting of clinical generative model research. In response to gaps in standards and best practices for the development of clinical AI tools identified by US Executive Order 141103 and several emerging national networks for clinical AI evaluation, we begin to formalize some of these guidelines by building on the original MI-CLAIM checklist. The new checklist, MI-CLAIM-GEN (Table 1), aims to address differences in training, evaluation, interpretability, and reproducibility of new generative models compared to non-generative ("predictive") AI models. This MI-CLAIM-GEN checklist also seeks to clarify cohort selection reporting with unstructured clinical data and adds additional items on alignment with ethical standards for clinical AI research.

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.

Millions of users come to online peer counseling platforms to seek support on diverse topics ranging from relationship stress to anxiety. However, studies show that online peer support groups are not always as effective as expected largely due to users' negative experiences with unhelpful counselors. Peer counselors are key to the success of online peer counseling platforms, but most of them often do not have systematic ways to receive guidelines or supervision. In this work, we introduce CARE: an interactive AI-based tool to empower peer counselors through automatic suggestion generation. During the practical training stage, CARE helps diagnose which specific counseling strategies are most suitable in the given context and provides tailored example responses as suggestions. Counselors can choose to select, modify, or ignore any suggestion before replying to the support seeker. Building upon the Motivational Interviewing framework, CARE utilizes large-scale counseling conversation data together with advanced natural language generation techniques to achieve these functionalities. We demonstrate the efficacy of CARE by performing both quantitative evaluations and qualitative user studies through simulated chats and semi-structured interviews. We also find that CARE especially helps novice counselors respond better in challenging situations.

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.

The discharge summary is a one of critical documents in the patient journey, encompassing all events experienced during hospitalization, including multiple visits, medications, tests, surgery/procedures, and admissions/discharge. Providing a summary of the patient's progress is crucial, as it significantly influences future care and planning. Consequently, clinicians face the laborious and resource-intensive task of manually collecting, organizing, and combining all the necessary data for a discharge summary. Therefore, we propose "NOTE", which stands for "Notable generation Of patient Text summaries through an Efficient approach based on direct preference optimization". NOTE is based on Medical Information Mart for Intensive Care- III dataset and summarizes a single hospitalization of a patient. Patient events are sequentially combined and used to generate a discharge summary for each hospitalization. In the present circumstances, large language models' application programming interfaces (LLMs' APIs) are widely available, but importing and exporting medical data presents significant challenges due to privacy protection policies in healthcare institutions. Moreover, to ensure optimal performance, it is essential to implement a lightweight model for internal server or program within the hospital. Therefore, we utilized DPO and parameter efficient fine tuning (PEFT) techniques to apply a fine-tuning method that guarantees superior performance. To demonstrate the practical application of the developed NOTE, we provide a webpage-based demonstration software. In the future, we will aim to deploy the software available for actual use by clinicians in hospital. NOTE can be utilized to generate various summaries not only discharge summaries but also throughout a patient's journey, thereby alleviating the labor-intensive workload of clinicians and aiming for increased efficiency.

Automatically summarizing patients' main problems from daily progress notes using natural language processing methods helps to battle against information and cognitive overload in hospital settings and potentially assists providers with computerized diagnostic decision support. Problem list summarization requires a model to understand, abstract, and generate clinical documentation. In this work, we propose a new NLP task that aims to generate a list of problems in a patient's daily care plan using input from the provider's progress notes during hospitalization. We investigate the performance of T5 and BART, two state-of-the-art seq2seq transformer architectures, in solving this problem. We provide a corpus built on top of progress notes from publicly available electronic health record progress notes in the Medical Information Mart for Intensive Care (MIMIC)-III. T5 and BART are trained on general domain text, and we experiment with a data augmentation method and a domain adaptation pre-training method to increase exposure to medical vocabulary and knowledge. Evaluation methods include ROUGE, BERTScore, cosine similarity on sentence embedding, and F-score on medical concepts. Results show that T5 with domain adaptive pre-training achieves significant performance gains compared to a rule-based system and general domain pre-trained language models, indicating a promising direction for tackling the problem summarization task.

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.

Radiotherapy (RT) planning is complex, subjective, and time-intensive. Advances in artificial intelligence (AI) promise to improve its precision, efficiency, and consistency, but progress is often limited by the scarcity of large, standardized datasets. To address this, we introduce the Automated Iterative RT Planning (AIRTP) system, a scalable solution for generating high-quality treatment plans. This scalable solution is designed to generate substantial volumes of consistently high-quality treatment plans, overcoming a key obstacle in the advancement of AI-driven RT planning. Our AIRTP pipeline adheres to clinical guidelines and automates essential steps, including organ-at-risk (OAR) contouring, helper structure creation, beam setup, optimization, and plan quality improvement, using AI integrated with RT planning software like Eclipse of Varian. Furthermore, a novel approach for determining optimization parameters to reproduce 3D dose distributions, i.e. a method to convert dose predictions to deliverable treatment plans constrained by machine limitations. A comparative analysis of plan quality reveals that our automated pipeline produces treatment plans of quality comparable to those generated manually, which traditionally require several hours of labor per plan. Committed to public research, the first data release of our AIRTP pipeline includes nine cohorts covering head-and-neck and lung cancer sites to support an AAPM 2025 challenge. This data set features more than 10 times the number of plans compared to the largest existing well-curated public data set to our best knowledge. Repo:{https://github.com/RiqiangGao/GDP-HMM_AAPMChallenge}

Recent text-to-image generative models have demonstrated an unparalleled ability to generate diverse and creative imagery guided by a target text prompt. While revolutionary, current state-of-the-art diffusion models may still fail in generating images that fully convey the semantics in the given text prompt. We analyze the publicly available Stable Diffusion model and assess the existence of catastrophic neglect, where the model fails to generate one or more of the subjects from the input prompt. Moreover, we find that in some cases the model also fails to correctly bind attributes (e.g., colors) to their corresponding subjects. To help mitigate these failure cases, we introduce the concept of Generative Semantic Nursing (GSN), where we seek to intervene in the generative process on the fly during inference time to improve the faithfulness of the generated images. Using an attention-based formulation of GSN, dubbed Attend-and-Excite, we guide the model to refine the cross-attention units to attend to all subject tokens in the text prompt and strengthen - or excite - their activations, encouraging the model to generate all subjects described in the text prompt. We compare our approach to alternative approaches and demonstrate that it conveys the desired concepts more faithfully across a range of text prompts.

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.

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.

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.

Daily progress notes are common types in the electronic health record (EHR) where healthcare providers document the patient's daily progress and treatment plans. The EHR is designed to document all the care provided to patients, but it also enables note bloat with extraneous information that distracts from the diagnoses and treatment plans. Applications of natural language processing (NLP) in the EHR is a growing field with the majority of methods in information extraction. Few tasks use NLP methods for downstream diagnostic decision support. We introduced the 2022 National NLP Clinical Challenge (N2C2) Track 3: Progress Note Understanding - Assessment and Plan Reasoning as one step towards a new suite of tasks. The Assessment and Plan Reasoning task focuses on the most critical components of progress notes, Assessment and Plan subsections where health problems and diagnoses are contained. The goal of the task was to develop and evaluate NLP systems that automatically predict causal relations between the overall status of the patient contained in the Assessment section and its relation to each component of the Plan section which contains the diagnoses and treatment plans. The goal of the task was to identify and prioritize diagnoses as the first steps in diagnostic decision support to find the most relevant information in long documents like daily progress notes. We present the results of 2022 n2c2 Track 3 and provide a description of the data, evaluation, participation and system performance.

Plan-and-Write is a common hierarchical approach in long-form narrative text generation, which first creates a plan to guide the narrative writing. Following this approach, several studies rely on simply prompting large language models for planning, which often yields suboptimal results. In this paper, we propose a new framework called Evaluation-guided Iterative Plan Extraction for long-form narrative text generation (EIPE-text), which extracts plans from the corpus of narratives and utilizes the extracted plans to construct a better planner. EIPE-text has three stages: plan extraction, learning, and inference. In the plan extraction stage, it iteratively extracts and improves plans from the narrative corpus and constructs a plan corpus. We propose a question answer (QA) based evaluation mechanism to automatically evaluate the plans and generate detailed plan refinement instructions to guide the iterative improvement. In the learning stage, we build a better planner by fine-tuning with the plan corpus or in-context learning with examples in the plan corpus. Finally, we leverage a hierarchical approach to generate long-form narratives. We evaluate the effectiveness of EIPE-text in the domains of novels and storytelling. Both GPT-4-based evaluations and human evaluations demonstrate that our method can generate more coherent and relevant long-form narratives. Our code will be released in the future.

The meaningful use of electronic health records (EHR) continues to progress in the digital era with clinical decision support systems augmented by artificial intelligence. A priority in improving provider experience is to overcome information overload and reduce the cognitive burden so fewer medical errors and cognitive biases are introduced during patient care. One major type of medical error is diagnostic error due to systematic or predictable errors in judgment that rely on heuristics. The potential for clinical natural language processing (cNLP) to model diagnostic reasoning in humans with forward reasoning from data to diagnosis and potentially reduce the cognitive burden and medical error has not been investigated. Existing tasks to advance the science in cNLP have largely focused on information extraction and named entity recognition through classification tasks. We introduce a novel suite of tasks coined as Diagnostic Reasoning Benchmarks, DR.BENCH, as a new benchmark for developing and evaluating cNLP models with clinical diagnostic reasoning ability. The suite includes six tasks from ten publicly available datasets addressing clinical text understanding, medical knowledge reasoning, and diagnosis generation. DR.BENCH is the first clinical suite of tasks designed to be a natural language generation framework to evaluate pre-trained language models. Experiments with state-of-the-art pre-trained generative language models using large general domain models and models that were continually trained on a medical corpus demonstrate opportunities for improvement when evaluated in DR. BENCH. We share DR. BENCH as a publicly available GitLab repository with a systematic approach to load and evaluate models for the cNLP community.

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.

Large Language Model (LLM) based agents have garnered significant attention and are becoming increasingly popular. Furthermore, planning ability is a crucial component of an LLM-based agent, involving interaction with the environment and executing actions to complete a planning task, which generally entails achieving a desired goal from an initial state. This paper investigates enhancing the planning abilities of LLMs through instruction tuning, referred to as agent training. Recent studies have demonstrated that utilizing expert-level trajectory for instruction-tuning LLMs effectively enhances their planning capabilities. However, existing work primarily focuses on synthesizing trajectories from manually designed planning tasks and environments. The labor-intensive nature of creating these environments and tasks impedes the generation of sufficiently varied and extensive trajectories. To address this limitation, this paper explores the automated synthesis of diverse environments and a gradual range of planning tasks, from easy to difficult. We introduce a framework, AgentGen, that leverages LLMs first to generate environments and subsequently generate planning tasks conditioned on these environments. Specifically, to improve environmental diversity, we propose using an inspiration corpus composed of various domain-specific text segments as the context for synthesizing environments. Moreover, to increase the difficulty diversity of generated planning tasks, we propose a bidirectional evolution method, Bi-Evol, that evolves planning tasks from easier and harder directions to synthesize a task set with a smoother difficulty curve. The evaluation results derived from AgentBoard show that AgentGen greatly improves LLMs' planning ability, e.g., the AgentGen instruction-tuned Llama-3 8B surpasses GPT-3.5 in overall performance. Moreover, in certain tasks, it even outperforms GPT-4.

Achieving true human-like ability to conduct a conversation remains an elusive goal for open-ended dialogue systems. We posit this is because extant approaches towards natural language generation (NLG) are typically construed as end-to-end architectures that do not adequately model human generation processes. To investigate, we decouple generation into two separate phases: planning and realization. In the planning phase, we train two planners to generate plans for response utterances. The realization phase uses response plans to produce an appropriate response. Through rigorous evaluations, both automated and human, we demonstrate that decoupling the process into planning and realization performs better than an end-to-end approach.

Generative models hold promise for revolutionizing medical education, robot-assisted surgery, and data augmentation for medical AI development. Diffusion models can now generate realistic images from text prompts, while recent advancements have demonstrated their ability to create diverse, high-quality videos. However, these models often struggle with generating accurate representations of medical procedures and detailed anatomical structures. This paper introduces Bora, the first spatio-temporal diffusion probabilistic model designed for text-guided biomedical video generation. Bora leverages Transformer architecture and is pre-trained on general-purpose video generation tasks. It is fine-tuned through model alignment and instruction tuning using a newly established medical video corpus, which includes paired text-video data from various biomedical fields. To the best of our knowledge, this is the first attempt to establish such a comprehensive annotated biomedical video dataset. Bora is capable of generating high-quality video data across four distinct biomedical domains, adhering to medical expert standards and demonstrating consistency and diversity. This generalist video generative model holds significant potential for enhancing medical consultation and decision-making, particularly in resource-limited settings. Additionally, Bora could pave the way for immersive medical training and procedure planning. Extensive experiments on distinct medical modalities such as endoscopy, ultrasound, MRI, and cell tracking validate the effectiveness of our model in understanding biomedical instructions and its superior performance across subjects compared to state-of-the-art generation models.

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.

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.

Generating synthetic text addresses the challenge of data availability in privacy-sensitive domains such as healthcare. This study explores the applicability of synthetic data in real-world medical settings. We introduce MedSyn, a novel medical text generation framework that integrates large language models with a Medical Knowledge Graph (MKG). We use MKG to sample prior medical information for the prompt and generate synthetic clinical notes with GPT-4 and fine-tuned LLaMA models. We assess the benefit of synthetic data through application in the ICD code prediction task. Our research indicates that synthetic data can increase the classification accuracy of vital and challenging codes by up to 17.8% compared to settings without synthetic data. Furthermore, to provide new data for further research in the healthcare domain, we present the largest open-source synthetic dataset of clinical notes for the Russian language, comprising over 41k samples covering 219 ICD-10 codes.

Restless multi-armed bandits (RMAB) have demonstrated success in optimizing resource allocation for large beneficiary populations in public health settings. Unfortunately, RMAB models lack flexibility to adapt to evolving public health policy priorities. Concurrently, Large Language Models (LLMs) have emerged as adept automated planners across domains of robotic control and navigation. In this paper, we propose a Decision Language Model (DLM) for RMABs, enabling dynamic fine-tuning of RMAB policies in public health settings using human-language commands. We propose using LLMs as automated planners to (1) interpret human policy preference prompts, (2) propose reward functions as code for a multi-agent RMAB environment, and (3) iterate on the generated reward functions using feedback from grounded RMAB simulations. We illustrate the application of DLM in collaboration with ARMMAN, an India-based non-profit promoting preventative care for pregnant mothers, that currently relies on RMAB policies to optimally allocate health worker calls to low-resource populations. We conduct a technology demonstration in simulation using the Gemini Pro model, showing DLM can dynamically shape policy outcomes using only human prompts as input.

Despite the significant progress of large language models (LLMs) in various tasks, they often produce factual errors due to their limited internal knowledge. Retrieval-Augmented Generation (RAG), which enhances LLMs with external knowledge sources, offers a promising solution. However, these methods can be misled by irrelevant paragraphs in retrieved documents. Due to the inherent uncertainty in LLM generation, inputting the entire document may introduce off-topic information, causing the model to deviate from the central topic and affecting the relevance of the generated content. To address these issues, we propose the Retrieve-Plan-Generation (RPG) framework. RPG generates plan tokens to guide subsequent generation in the plan stage. In the answer stage, the model selects relevant fine-grained paragraphs based on the plan and uses them for further answer generation. This plan-answer process is repeated iteratively until completion, enhancing generation relevance by focusing on specific topics. To implement this framework efficiently, we utilize a simple but effective multi-task prompt-tuning method, enabling the existing LLMs to handle both planning and answering. We comprehensively compare RPG with baselines across 5 knowledge-intensive generation tasks, demonstrating the effectiveness of our approach.

Introduction. Generative Artificial Intelligence, particularly large language models (LLMs), offers transformative potential for Health Economics and Outcomes Research (HEOR). However, evaluating the quality, transparency, and rigor of LLM-assisted research lacks standardized guidance. This article introduces the ELEVATE AI LLMs framework and checklist, designed to support researchers and reviewers in assessing LLM use in HEOR. Methods. The ELEVATE AI LLMs framework was developed through a targeted review of existing guidelines and evaluation frameworks. The framework comprises ten evaluation domains, including model characteristics, accuracy, comprehensiveness, and fairness. The accompanying checklist operationalizes the framework. To validate the framework, we applied it to two published studies, demonstrating its usability across different HEOR tasks. Results. The ELEVATE AI LLMs framework provides a comprehensive structure for evaluating LLM-assisted research, while the checklist facilitates practical application. Validation of the framework and checklist on studies of systematic literature reviews and health economic modeling highlighted their ability to identify strengths and gaps in reporting. Limitations. While the ELEVATE AI LLMs framework provides robust guidance, its broader generalizability and applicability to diverse HEOR tasks require further empirical testing. Additionally, several metrics adapted from computer science need further validation in HEOR contexts. Conclusion. The ELEVATE AI LLMs framework and checklist fill a critical gap in HEOR by offering structured guidance for evaluating LLM-assisted research. By promoting transparency, accuracy, and reproducibility, they aim to standardize and improve the integration of LLMs into HEOR, ensuring their outputs meet the field's rigorous standards.

Text-to-image (T2I) generation has seen significant growth over the past few years. Despite this, there has been little work on generating diagrams with T2I models. A diagram is a symbolic/schematic representation that explains information using structurally rich and spatially complex visualizations (e.g., a dense combination of related objects, text labels, directional arrows, connection lines, etc.). Existing state-of-the-art T2I models often fail at diagram generation because they lack fine-grained object layout control when many objects are densely connected via complex relations such as arrows/lines and also often fail to render comprehensible text labels. To address this gap, we present DiagrammerGPT, a novel two-stage text-to-diagram generation framework that leverages the layout guidance capabilities of LLMs (e.g., GPT-4) to generate more accurate open-domain, open-platform diagrams. In the first stage, we use LLMs to generate and iteratively refine 'diagram plans' (in a planner-auditor feedback loop) which describe all the entities (objects and text labels), their relationships (arrows or lines), and their bounding box layouts. In the second stage, we use a diagram generator, DiagramGLIGEN, and a text label rendering module to generate diagrams following the diagram plans. To benchmark the text-to-diagram generation task, we introduce AI2D-Caption, a densely annotated diagram dataset built on top of the AI2D dataset. We show quantitatively and qualitatively that our DiagrammerGPT framework produces more accurate diagrams, outperforming existing T2I models. We also provide comprehensive analysis including open-domain diagram generation, vector graphic diagram generation in different platforms, human-in-the-loop diagram plan editing, and multimodal planner/auditor LLMs (e.g., GPT-4Vision). We hope our work can inspire further research on diagram generation via T2I models and LLMs.

Continuity of care is crucial to ensuring positive health outcomes for patients discharged from an inpatient hospital setting, and improved information sharing can help. To share information, caregivers write discharge notes containing action items to share with patients and their future caregivers, but these action items are easily lost due to the lengthiness of the documents. In this work, we describe our creation of a dataset of clinical action items annotated over MIMIC-III, the largest publicly available dataset of real clinical notes. This dataset, which we call CLIP, is annotated by physicians and covers 718 documents representing 100K sentences. We describe the task of extracting the action items from these documents as multi-aspect extractive summarization, with each aspect representing a type of action to be taken. We evaluate several machine learning models on this task, and show that the best models exploit in-domain language model pre-training on 59K unannotated documents, and incorporate context from neighboring sentences. We also propose an approach to pre-training data selection that allows us to explore the trade-off between size and domain-specificity of pre-training datasets for this task.

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.

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.

The detailed clinical records drafted by doctors after each patient's visit are crucial for medical practitioners and researchers. Automating the creation of these notes with language models can reduce the workload of doctors. However, training such models can be difficult due to the limited public availability of conversations between patients and doctors. In this paper, we introduce NoteChat, a cooperative multi-agent framework leveraging Large Language Models (LLMs) for generating synthetic doctor-patient conversations conditioned on clinical notes. NoteChat consists of Planning, Roleplay, and Polish modules. We provide a comprehensive automatic and human evaluation of NoteChat, comparing it with state-of-the-art models, including OpenAI's ChatGPT and GPT-4. Results demonstrate that NoteChat facilitates high-quality synthetic doctor-patient conversations, underscoring the untapped potential of LLMs in healthcare. This work represents the first instance of multiple LLMs cooperating to complete a doctor-patient conversation conditioned on clinical notes, offering promising avenues for the intersection of AI and healthcare

Artificial Intelligence (AI) advancement is heavily dependent on access to large-scale, high-quality training data. However, in specialized domains such as healthcare, data acquisition faces significant constraints due to privacy regulations, ethical considerations, and limited availability. While synthetic data generation offers a promising solution, conventional approaches typically require substantial real data for training generative models. The emergence of large-scale prompt-based models presents new opportunities for synthetic data generation without direct access to protected data. However, crafting effective prompts for domain-specific data generation remains challenging, and manual prompt engineering proves insufficient for achieving output with sufficient precision and authenticity. We review recent developments in automatic prompt optimization, following PRISMA guidelines. We analyze six peer-reviewed studies published between 2020 and 2024 that focus on automatic data-free prompt optimization methods. Our analysis reveals three approaches: feedback-driven, error-based, and control-theoretic. Although all approaches demonstrate promising capabilities in prompt refinement and adaptation, our findings suggest the need for an integrated framework that combines complementary optimization techniques to enhance synthetic data generation while minimizing manual intervention. We propose future research directions toward developing robust, iterative prompt optimization frameworks capable of improving the quality of synthetic data. This advancement can be particularly crucial for sensitive fields and in specialized domains where data access is restricted, potentially transforming how we approach synthetic data generation for AI development.

We introduce Planning-guided Retrieval Augmented Generation (PlantimesRAG), a novel framework that augments the retrieve-then-reason paradigm of existing RAG frameworks to plan-then-retrieve. PlantimesRAG formulates a reasoning plan as a directed acyclic graph (DAG), decomposing queries into interrelated atomic sub-queries. Answer generation follows the DAG structure, allowing significant gains in efficiency through parallelized retrieval and generation. While state-of-the-art RAG solutions require extensive data generation and fine-tuning of language models (LMs), PlantimesRAG incorporates frozen LMs as plug-and-play experts to generate high-quality answers. Compared to existing RAG solutions, PlantimesRAG demonstrates significant improvements in reducing hallucinations and bolstering attribution due to its structured sub-query decomposition. Overall, PlantimesRAG offers a new perspective on integrating external knowledge in LMs while ensuring attribution by design, contributing towards more reliable LM-based systems.

Medical language models (MLMs) have become pivotal in advancing medical natural language processing. However, prior models that rely on pre-training or supervised fine-tuning often exhibit low data efficiency and limited practicality in real-world clinical applications. While OpenAIs O1 highlights test-time scaling in mathematics, attempts to replicate this approach in medicine typically distill responses from GPT-series models to open-source models, focusing primarily on multiple-choice tasks. This strategy, though straightforward, neglects critical concerns like data privacy and realistic deployment in clinical settings. In this work, we present a deployable, small-scale medical language model, \mone, designed for long-chain reasoning in clinical tasks using a self-evolution paradigm. Starting with a seed dataset of around 8,000 instances spanning five domains and 16 datasets, we prompt a base policy model to perform Monte Carlo Tree Search (MCTS) to construct verifiable reasoning chains. Each reasoning step is assigned an evolution rollout value, allowing verified trajectories to train the policy model and the reward model. During inference, the policy model generates multiple responses, and the reward model selects the one with the highest reward score. Experiments on eleven evaluation datasets demonstrate that \mone outperforms prior open-source models by 2 points, with the addition of the reward model further boosting performance (sim13 points), surpassing GPT-4o-mini. Code and data are available at https://github.com/pixas/MedSSS.

Over the past several years, across the globe, there has been an increase in people seeking care in emergency departments (EDs). ED resources, including nurse staffing, are strained by such increases in patient volume. Accurate forecasting of incoming patient volume in emergency departments (ED) is crucial for efficient utilization and allocation of ED resources. Working with a suburban ED in the Pacific Northwest, we developed a tool powered by machine learning models, to forecast ED arrivals and ED patient volume to assist end-users, such as ED nurses, in resource allocation. In this paper, we discuss the results from our predictive models, the challenges, and the learnings from users' experiences with the tool in active clinical deployment in a real world setting.

Machine learning (ML) recourse techniques are increasingly used in high-stakes domains, providing end users with actions to alter ML predictions, but they assume ML developers understand what input variables can be changed. However, a recourse plan's actionability is subjective and unlikely to match developers' expectations completely. We present GAM Coach, a novel open-source system that adapts integer linear programming to generate customizable counterfactual explanations for Generalized Additive Models (GAMs), and leverages interactive visualizations to enable end users to iteratively generate recourse plans meeting their needs. A quantitative user study with 41 participants shows our tool is usable and useful, and users prefer personalized recourse plans over generic plans. Through a log analysis, we explore how users discover satisfactory recourse plans, and provide empirical evidence that transparency can lead to more opportunities for everyday users to discover counterintuitive patterns in ML models. GAM Coach is available at: https://poloclub.github.io/gam-coach/.

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).

Urgent care clinics and emergency departments around the world periodically suffer from extended wait times beyond patient expectations due to inadequate staffing levels. These delays have been linked with adverse clinical outcomes. Previous research into forecasting demand this domain has mostly used a collection of statistical techniques, with machine learning approaches only now beginning to emerge in recent literature. The forecasting problem for this domain is difficult and has also been complicated by the COVID-19 pandemic which has introduced an additional complexity to this estimation due to typical demand patterns being disrupted. This study explores the ability of machine learning methods to generate accurate patient presentations at two large urgent care clinics located in Auckland, New Zealand. A number of machine learning algorithms were explored in order to determine the most effective technique for this problem domain, with the task of making forecasts of daily patient demand three months in advance. The study also performed an in-depth analysis into the model behaviour in respect to the exploration of which features are most effective at predicting demand and which features are capable of adaptation to the volatility caused by the COVID-19 pandemic lockdowns. The results showed that ensemble-based methods delivered the most accurate and consistent solutions on average, generating improvements in the range of 23%-27% over the existing in-house methods for estimating the daily demand.

Although large language models have demonstrated impressive ability in code generation, they are still struggling to address the complicated intent provided by humans. It is widely acknowledged that humans typically employ planning to decompose complex problems and schedule the solution steps prior to implementation. Thus we introduce planning into code generation to help the model understand complex intent and reduce the difficulty of problem solving. This paper proposes a self-planning code generation method with large language model, which consists of two phases, namely planning phase and implementation phase. Specifically, in the planning phase, the language model plans out the solution steps from the intent combined with in-context learning. Then it enters the implementation phase, where the model generates code step by step, guided by the solution steps. The effectiveness of self-planning code generation has been rigorously evaluated on multiple code generation datasets and the results have demonstrated a marked superiority over naive direct generation approaches with language model. The improvement in performance is substantial, highlighting the significance of self-planning in code generation tasks.

Flowchart-grounded troubleshooting dialogue (FTD) systems, which follow the instructions of a flowchart to diagnose users' problems in specific domains (e.g., vehicle, laptop), have been gaining research interest in recent years. However, collecting sufficient dialogues that are naturally grounded on flowcharts is costly, thus FTD systems are impeded by scarce training data. To mitigate the data sparsity issue, we propose a plan-based synthetic data generation (PlanSDG) approach that generates diverse synthetic dialog data at scale by transforming concise flowchart into dialogues. Specifically, its generative model employs a variational-base framework with a hierarchical planning strategy that includes global and local latent planning variables. Experiments on the FloDial dataset show that synthetic dialogue produced by PlanSDG improves the performance of downstream tasks, including flowchart path retrieval and response generation, in particular on the Out-of-Flowchart settings. In addition, further analysis demonstrate the quality of synthetic data generated by PlanSDG in paths that are covered by current sample dialogues and paths that are not covered.

Medical Dialogue Generation serves a critical role in telemedicine by facilitating the dissemination of medical expertise to patients. Existing studies focus on incorporating textual representations, which have limited their ability to represent the semantics of text, such as ignoring important medical entities. To enhance the model's understanding of the textual semantics and the medical knowledge including entities and relations, we introduce the use of Abstract Meaning Representations (AMR) to construct graphical representations that delineate the roles of language constituents and medical entities within the dialogues. In this paper, We propose a novel framework that models dialogues between patients and healthcare professionals using AMR graphs, where the neural networks incorporate textual and graphical knowledge with a dual attention mechanism. Experimental results show that our framework outperforms strong baseline models in medical dialogue generation, demonstrating the effectiveness of AMR graphs in enhancing the representations of medical knowledge and logical relationships. Furthermore, to support future research in this domain, we provide the corresponding source code at https://github.com/Bernard-Yang/MedDiaAMR.

Generative modeling has experienced substantial progress in recent years, particularly in text-to-image and text-to-video synthesis. However, the medical field has not yet fully exploited the potential of large-scale foundational models for synthetic data generation. In this paper, we introduce GenerateCT, the first method for text-conditional computed tomography (CT) generation, addressing the limitations in 3D medical imaging research and making our entire framework open-source. GenerateCT consists of a pre-trained large language model, a transformer-based text-conditional 3D chest CT generation architecture, and a text-conditional spatial super-resolution diffusion model. We also propose CT-ViT, which efficiently compresses CT volumes while preserving auto-regressiveness in-depth, enabling the generation of 3D CT volumes with variable numbers of axial slices. Our experiments demonstrate that GenerateCT can produce realistic, high-resolution, and high-fidelity 3D chest CT volumes consistent with medical language text prompts. We further investigate the potential of GenerateCT by training a model using generated CT volumes for multi-abnormality classification of chest CT volumes. Our contributions provide a valuable foundation for future research in text-conditional 3D medical image generation and have the potential to accelerate advancements in medical imaging research. Our code, pre-trained models, and generated data are available at https://github.com/ibrahimethemhamamci/GenerateCT.

Large Language Models (LLMs) have demonstrated a powerful ability for text generation. However, achieving optimal results with a given prompt or instruction can be challenging, especially for billion-sized models. Additionally, undesired behaviors such as toxicity or hallucinations can manifest. While much larger models (e.g., ChatGPT) may demonstrate strength in mitigating these issues, there is still no guarantee of complete prevention. In this work, we propose formalizing text generation as a future-constrained generation problem to minimize undesirable behaviors and enforce faithfulness to instructions. The estimation of future constraint satisfaction, accomplished using LLMs, guides the text generation process. Our extensive experiments demonstrate the effectiveness of the proposed approach across three distinct text generation tasks: keyword-constrained generation (Lin et al., 2020), toxicity reduction (Gehman et al., 2020), and factual correctness in question-answering (Gao et al., 2023).

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.

Recent work has considered whether large language models (LLMs) can function as planners: given a task, generate a plan. We investigate whether LLMs can serve as generalized planners: given a domain and training tasks, generate a program that efficiently produces plans for other tasks in the domain. In particular, we consider PDDL domains and use GPT-4 to synthesize Python programs. We also consider (1) Chain-of-Thought (CoT) summarization, where the LLM is prompted to summarize the domain and propose a strategy in words before synthesizing the program; and (2) automated debugging, where the program is validated with respect to the training tasks, and in case of errors, the LLM is re-prompted with four types of feedback. We evaluate this approach in seven PDDL domains and compare it to four ablations and four baselines. Overall, we find that GPT-4 is a surprisingly powerful generalized planner. We also conclude that automated debugging is very important, that CoT summarization has non-uniform impact, that GPT-4 is far superior to GPT-3.5, and that just two training tasks are often sufficient for strong generalization.

Social determinants of health (SDoH) have an important impact on patient outcomes but are incompletely collected from the electronic health records (EHR). This study researched the ability of large language models to extract SDoH from free text in EHRs, where they are most commonly documented, and explored the role of synthetic clinical text for improving the extraction of these scarcely documented, yet extremely valuable, clinical data. 800 patient notes were annotated for SDoH categories, and several transformer-based models were evaluated. The study also experimented with synthetic data generation and assessed for algorithmic bias. Our best-performing models were fine-tuned Flan-T5 XL (macro-F1 0.71) for any SDoH, and Flan-T5 XXL (macro-F1 0.70). The benefit of augmenting fine-tuning with synthetic data varied across model architecture and size, with smaller Flan-T5 models (base and large) showing the greatest improvements in performance (delta F1 +0.12 to +0.23). Model performance was similar on the in-hospital system dataset but worse on the MIMIC-III dataset. Our best-performing fine-tuned models outperformed zero- and few-shot performance of ChatGPT-family models for both tasks. These fine-tuned models were less likely than ChatGPT to change their prediction when race/ethnicity and gender descriptors were added to the text, suggesting less algorithmic bias (p<0.05). At the patient-level, our models identified 93.8% of patients with adverse SDoH, while ICD-10 codes captured 2.0%. Our method can effectively extracted SDoH information from clinic notes, performing better compare to GPT zero- and few-shot settings. These models could enhance real-world evidence on SDoH and aid in identifying patients needing social support.

Large language models (LLMs) have shown remarkable progress in encoding clinical knowledge and responding to complex medical queries with appropriate clinical reasoning. However, their applicability in subspecialist or complex medical settings remains underexplored. In this work, we probe the performance of AMIE, a research conversational diagnostic AI system, in the subspecialist domain of breast oncology care without specific fine-tuning to this challenging domain. To perform this evaluation, we curated a set of 50 synthetic breast cancer vignettes representing a range of treatment-naive and treatment-refractory cases and mirroring the key information available to a multidisciplinary tumor board for decision-making (openly released with this work). We developed a detailed clinical rubric for evaluating management plans, including axes such as the quality of case summarization, safety of the proposed care plan, and recommendations for chemotherapy, radiotherapy, surgery and hormonal therapy. To improve performance, we enhanced AMIE with the inference-time ability to perform web search retrieval to gather relevant and up-to-date clinical knowledge and refine its responses with a multi-stage self-critique pipeline. We compare response quality of AMIE with internal medicine trainees, oncology fellows, and general oncology attendings under both automated and specialist clinician evaluations. In our evaluations, AMIE outperformed trainees and fellows demonstrating the potential of the system in this challenging and important domain. We further demonstrate through qualitative examples, how systems such as AMIE might facilitate conversational interactions to assist clinicians in their decision making. However, AMIE's performance was overall inferior to attending oncologists suggesting that further research is needed prior to consideration of prospective uses.

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.

This paper introduces Opus, a novel framework for generating and optimizing Workflows tailored to complex Business Process Outsourcing (BPO) use cases, focusing on cost reduction and quality enhancement while adhering to established industry processes and operational constraints. Our approach generates executable Workflows from Intention, defined as the alignment of Client Input, Client Output, and Process Context. These Workflows are represented as Directed Acyclic Graphs (DAGs), with nodes as Tasks consisting of sequences of executable Instructions, including tools and human expert reviews. We adopt a two-phase methodology: Workflow Generation and Workflow Optimization. In the Generation phase, Workflows are generated using a Large Work Model (LWM) informed by a Work Knowledge Graph (WKG) that encodes domain-specific procedural and operational knowledge. In the Optimization phase, Workflows are transformed into Workflow Graphs (WFGs), where optimal Workflows are determined through path optimization. Our experiments demonstrate that state-of-the-art Large Language Models (LLMs) face challenges in reliably retrieving detailed process data as well as generating industry-compliant workflows. The key contributions of this paper include: - The integration of a Work Knowledge Graph (WKG) into a Large Work Model (LWM), enabling the generation of context-aware, semantically aligned, structured and auditable Workflows. - A two-phase approach that combines Workflow Generation from Intention with graph-based Workflow Optimization. - Opus Alpha 1 Large and Opus Alpha 1 Small, models that outperform state-of-the-art LLMs by 38\% and 29\% respectively in Workflow Generation for a Medical Coding use case.

With the advent of Vision-Language Models (VLMs), medical artificial intelligence (AI) has experienced significant technological progress and paradigm shifts. This survey provides an extensive review of recent advancements in Medical Vision-Language Models (Med-VLMs), which integrate visual and textual data to enhance healthcare outcomes. We discuss the foundational technology behind Med-VLMs, illustrating how general models are adapted for complex medical tasks, and examine their applications in healthcare. The transformative impact of Med-VLMs on clinical practice, education, and patient care is highlighted, alongside challenges such as data scarcity, narrow task generalization, interpretability issues, and ethical concerns like fairness, accountability, and privacy. These limitations are exacerbated by uneven dataset distribution, computational demands, and regulatory hurdles. Rigorous evaluation methods and robust regulatory frameworks are essential for safe integration into healthcare workflows. Future directions include leveraging large-scale, diverse datasets, improving cross-modal generalization, and enhancing interpretability. Innovations like federated learning, lightweight architectures, and Electronic Health Record (EHR) integration are explored as pathways to democratize access and improve clinical relevance. This review aims to provide a comprehensive understanding of Med-VLMs' strengths and limitations, fostering their ethical and balanced adoption in healthcare.

AI technologies are moving rapidly from research to production. With the popularity of Foundation Models (FMs) that generate text, images, and video, AI-based systems are increasing their complexity. Compared to traditional AI-based software, systems employing FMs, or GenAI-based systems, are more difficult to design due to their scale and versatility. This makes it necessary to document best practices, known as design patterns in software engineering, that can be used across GenAI applications. Our first contribution is to formalize two techniques, Task Decomposition and Retrieval-Augmented Generation (RAG), as design patterns for GenAI-based systems. We discuss their trade-offs in terms of software quality attributes and comment on alternative approaches. We recommend to AI practitioners to consider these techniques not only from a scientific perspective but also from the standpoint of desired engineering properties such as flexibility, maintainability, safety, and security. As a second contribution, we describe our industry experience applying Task Decomposition and RAG to build a complex real-world GenAI application for enterprise users: Workflow Generation. The task of generating workflows entails generating a specific plan using data from the system environment, taking as input a user requirement. As these two patterns affect the entire AI development cycle, we explain how they impacted the dataset creation, model training, model evaluation, and deployment phases.

Today's classical planners are powerful, but modeling input tasks in formats such as PDDL is tedious and error-prone. In contrast, planning with Large Language Models (LLMs) allows for almost any input text, but offers no guarantees on plan quality or even soundness. In an attempt to merge the best of these two approaches, some work has begun to use LLMs to automate parts of the PDDL creation process. However, these methods still require various degrees of expert input. We present NL2Plan, the first domain-agnostic offline LLM-driven planning system. NL2Plan uses an LLM to incrementally extract the necessary information from a short text prompt before creating a complete PDDL description of both the domain and the problem, which is finally solved by a classical planner. We evaluate NL2Plan on four planning domains and find that it solves 10 out of 15 tasks - a clear improvement over a plain chain-of-thought reasoning LLM approach, which only solves 2 tasks. Moreover, in two out of the five failure cases, instead of returning an invalid plan, NL2Plan reports that it failed to solve the task. In addition to using NL2Plan in end-to-end mode, users can inspect and correct all of its intermediate results, such as the PDDL representation, increasing explainability and making it an assistive tool for PDDL creation.

Electronic Health Records (EHRs) hold immense potential for advancing healthcare, offering rich, longitudinal data that combines structured information with valuable insights from unstructured clinical notes. However, the unstructured nature of clinical text poses significant challenges for secondary applications. Traditional methods for structuring EHR free-text data, such as rule-based systems and multi-stage pipelines, are often limited by their time-consuming configurations and inability to adapt across clinical notes from diverse healthcare settings. Few systems provide a comprehensive attribute extraction for terminologies. While giant large language models (LLMs) like GPT-4 and LLaMA 405B excel at structuring tasks, they are slow, costly, and impractical for large-scale use. To overcome these limitations, we introduce GENIE, a Generative Note Information Extraction system that leverages LLMs to streamline the structuring of unstructured clinical text into usable data with standardized format. GENIE processes entire paragraphs in a single pass, extracting entities, assertion statuses, locations, modifiers, values, and purposes with high accuracy. Its unified, end-to-end approach simplifies workflows, reduces errors, and eliminates the need for extensive manual intervention. Using a robust data preparation pipeline and fine-tuned small scale LLMs, GENIE achieves competitive performance across multiple information extraction tasks, outperforming traditional tools like cTAKES and MetaMap and can handle extra attributes to be extracted. GENIE strongly enhances real-world applicability and scalability in healthcare systems. By open-sourcing the model and test data, we aim to encourage collaboration and drive further advancements in EHR structurization.

Many recent works have explored using language models for planning problems. One line of research focuses on translating natural language descriptions of planning tasks into structured planning languages, such as the planning domain definition language (PDDL). While this approach is promising, accurately measuring the quality of generated PDDL code continues to pose significant challenges. First, generated PDDL code is typically evaluated using planning validators that check whether the problem can be solved with a planner. This method is insufficient because a language model might generate valid PDDL code that does not align with the natural language description of the task. Second, existing evaluation sets often have natural language descriptions of the planning task that closely resemble the ground truth PDDL, reducing the challenge of the task. To bridge this gap, we introduce \benchmarkName, a benchmark designed to evaluate language models' ability to generate PDDL code from natural language descriptions of planning tasks. We begin by creating a PDDL equivalence algorithm that rigorously evaluates the correctness of PDDL code generated by language models by flexibly comparing it against a ground truth PDDL. Then, we present a dataset of 132,037 text-to-PDDL pairs across 13 different tasks, with varying levels of difficulty. Finally, we evaluate several API-access and open-weight language models that reveal this task's complexity. For example, 87.6% of the PDDL problem descriptions generated by GPT-4o are syntactically parseable, 82.2% are valid, solve-able problems, but only 35.1% are semantically correct, highlighting the need for a more rigorous benchmark for this problem.

The successes of foundation models such as ChatGPT and AlphaFold have spurred significant interest in building similar models for electronic medical records (EMRs) to improve patient care and hospital operations. However, recent hype has obscured critical gaps in our understanding of these models' capabilities. We review over 80 foundation models trained on non-imaging EMR data (i.e. clinical text and/or structured data) and create a taxonomy delineating their architectures, training data, and potential use cases. We find that most models are trained on small, narrowly-scoped clinical datasets (e.g. MIMIC-III) or broad, public biomedical corpora (e.g. PubMed) and are evaluated on tasks that do not provide meaningful insights on their usefulness to health systems. In light of these findings, we propose an improved evaluation framework for measuring the benefits of clinical foundation models that is more closely grounded to metrics that matter in healthcare.

Large language models (LLMs) have demonstrated remarkable zero-shot generalization abilities: state-of-the-art chatbots can provide plausible answers to many common questions that arise in daily life. However, so far, LLMs cannot reliably solve long-horizon planning problems. By contrast, classical planners, once a problem is given in a formatted way, can use efficient search algorithms to quickly identify correct, or even optimal, plans. In an effort to get the best of both worlds, this paper introduces LLM+P, the first framework that incorporates the strengths of classical planners into LLMs. LLM+P takes in a natural language description of a planning problem, then returns a correct (or optimal) plan for solving that problem in natural language. LLM+P does so by first converting the language description into a file written in the planning domain definition language (PDDL), then leveraging classical planners to quickly find a solution, and then translating the found solution back into natural language. Along with LLM+P, we define a diverse set of different benchmark problems taken from common planning scenarios. Via a comprehensive set of experiments on these benchmark problems, we find that LLM+P is able to provide optimal solutions for most problems, while LLMs fail to provide even feasible plans for most problems.\footnote{The code and results are publicly available at https://github.com/Cranial-XIX/llm-pddl.git.

After being collected for patient care, Observational Health Data (OHD) can further benefit patient well-being by sustaining the development of health informatics and medical research. Vast potential is unexploited because of the fiercely private nature of patient-related data and regulations to protect it. Generative Adversarial Networks (GANs) have recently emerged as a groundbreaking way to learn generative models that produce realistic synthetic data. They have revolutionized practices in multiple domains such as self-driving cars, fraud detection, digital twin simulations in industrial sectors, and medical imaging. The digital twin concept could readily apply to modelling and quantifying disease progression. In addition, GANs posses many capabilities relevant to common problems in healthcare: lack of data, class imbalance, rare diseases, and preserving privacy. Unlocking open access to privacy-preserving OHD could be transformative for scientific research. In the midst of COVID-19, the healthcare system is facing unprecedented challenges, many of which of are data related for the reasons stated above. Considering these facts, publications concerning GAN applied to OHD seemed to be severely lacking. To uncover the reasons for this slow adoption, we broadly reviewed the published literature on the subject. Our findings show that the properties of OHD were initially challenging for the existing GAN algorithms (unlike medical imaging, for which state-of-the-art model were directly transferable) and the evaluation synthetic data lacked clear metrics. We find more publications on the subject than expected, starting slowly in 2017, and since then at an increasing rate. The difficulties of OHD remain, and we discuss issues relating to evaluation, consistency, benchmarking, data modelling, and reproducibility.

Automated plot generation is the challenge of generating a sequence of events that will be perceived by readers as the plot of a coherent story. Traditional symbolic planners plan a story from a goal state and guarantee logical causal plot coherence but rely on a library of hand-crafted actions with their preconditions and effects. This closed world setting limits the length and diversity of what symbolic planners can generate. On the other hand, pre-trained neural language models can generate stories with great diversity, while being generally incapable of ending a story in a specified manner and can have trouble maintaining coherence. In this paper, we present an approach to story plot generation that unifies causal planning with neural language models. We propose to use commonsense knowledge extracted from large language models to recursively expand a story plot in a backward chaining fashion. Specifically, our system infers the preconditions for events in the story and then events that will cause those conditions to become true. We performed automatic evaluation to measure narrative coherence as indicated by the ability to answer questions about whether different events in the story are causally related to other events. Results indicate that our proposed method produces more coherent plotlines than several strong baselines.

Large Language Models have been shown to fail to create executable and verifiable plans in grounded environments. An emerging line of work shows success in using LLM as a formalizer to generate a formal representation (e.g., PDDL) of the planning domain, which can be deterministically solved to find a plan. We systematically evaluate this methodology while bridging some major gaps. While previous work only generates a partial PDDL representation given templated and thus unrealistic environment descriptions, we generate the complete representation given descriptions of various naturalness levels. Among an array of observations critical to improve LLMs' formal planning ability, we note that large enough models can effectively formalize descriptions as PDDL, outperforming those directly generating plans, while being robust to lexical perturbation. As the descriptions become more natural-sounding, we observe a decrease in performance and provide detailed error analysis.

The absence of transparency and explainability hinders the clinical adoption of Machine learning (ML) algorithms. Although various methods of explainable artificial intelligence (XAI) have been suggested, there is a lack of literature that delves into their practicality and assesses them based on criteria that could foster trust in clinical environments. To address this gap this study evaluates two popular XAI methods used for explaining predictive models in the healthcare context in terms of whether they (i) generate domain-appropriate representation, i.e. coherent with respect to the application task, (ii) impact clinical workflow and (iii) are consistent. To that end, explanations generated at the cohort and patient levels were analysed. The paper reports the first benchmarking of the XAI methods applied to risk prediction models obtained by evaluating the concordance between generated explanations and the trigger of a future clinical deterioration episode recorded by the data collection system. We carried out an analysis using two Electronic Medical Records (EMR) datasets sourced from Australian major hospitals. The findings underscore the limitations of state-of-the-art XAI methods in the clinical context and their potential benefits. We discuss these limitations and contribute to the theoretical development of trustworthy XAI solutions where clinical decision support guides the choice of intervention by suggesting the pattern or drivers for clinical deterioration in the future.

The advancement in generative AI could be boosted with more accessible mathematics. Beyond human-AI chat, large language models (LLMs) are emerging in programming, algorithm discovery, and theorem proving, yet their genomics application is limited. This project introduces Math Agents and mathematical embedding as fresh entries to the "Moore's Law of Mathematics", using a GPT-based workflow to convert equations from literature into LaTeX and Python formats. While many digital equation representations exist, there's a lack of automated large-scale evaluation tools. LLMs are pivotal as linguistic user interfaces, providing natural language access for human-AI chat and formal languages for large-scale AI-assisted computational infrastructure. Given the infinite formal possibility spaces, Math Agents, which interact with math, could potentially shift us from "big data" to "big math". Math, unlike the more flexible natural language, has properties subject to proof, enabling its use beyond traditional applications like high-validation math-certified icons for AI alignment aims. This project aims to use Math Agents and mathematical embeddings to address the ageing issue in information systems biology by applying multiscalar physics mathematics to disease models and genomic data. Generative AI with episodic memory could help analyse causal relations in longitudinal health records, using SIR Precision Health models. Genomic data is suggested for addressing the unsolved Alzheimer's disease problem.

Although recent text-to-video (T2V) generation methods have seen significant advancements, most of these works focus on producing short video clips of a single event with a single background (i.e., single-scene videos). Meanwhile, recent large language models (LLMs) have demonstrated their capability in generating layouts and programs to control downstream visual modules such as image generation models. This raises an important question: can we leverage the knowledge embedded in these LLMs for temporally consistent long video generation? In this paper, we propose VideoDirectorGPT, a novel framework for consistent multi-scene video generation that uses the knowledge of LLMs for video content planning and grounded video generation. Specifically, given a single text prompt, we first ask our video planner LLM (GPT-4) to expand it into a 'video plan', which involves generating the scene descriptions, the entities with their respective layouts, the background for each scene, and consistency groupings of the entities and backgrounds. Next, guided by this output from the video planner, our video generator, Layout2Vid, has explicit control over spatial layouts and can maintain temporal consistency of entities/backgrounds across scenes, while only trained with image-level annotations. Our experiments demonstrate that VideoDirectorGPT framework substantially improves layout and movement control in both single- and multi-scene video generation and can generate multi-scene videos with visual consistency across scenes, while achieving competitive performance with SOTAs in open-domain single-scene T2V generation. We also demonstrate that our framework can dynamically control the strength for layout guidance and can also generate videos with user-provided images. We hope our framework can inspire future work on better integrating the planning ability of LLMs into consistent long video generation.

The way people respond to messaging from public health organizations on social media can provide insight into public perceptions on critical health issues, especially during a global crisis such as COVID-19. It could be valuable for high-impact organizations such as the US Centers for Disease Control and Prevention (CDC) or the World Health Organization (WHO) to understand how these perceptions impact reception of messaging on health policy recommendations. We collect two datasets of public health messages and their responses from Twitter relating to COVID-19 and Vaccines, and introduce a predictive method which can be used to explore the potential reception of such messages. Specifically, we harness a generative model (GPT-2) to directly predict probable future responses and demonstrate how it can be used to optimize expected reception of important health guidance. Finally, we introduce a novel evaluation scheme with extensive statistical testing which allows us to conclude that our models capture the semantics and sentiment found in actual public health responses.

Generating clinical reports from raw recordings such as X-rays and electroencephalogram (EEG) is an essential and routine task for doctors. However, it is often time-consuming to write accurate and detailed reports. Most existing methods try to generate the whole reports from the raw input with limited success because 1) generated reports often contain errors that need manual review and correction, 2) it does not save time when doctors want to write additional information into the report, and 3) the generated reports are not customized based on individual doctors' preference. We propose {\it CL}inic{\it A}l {\it R}eport {\it A}uto-completion (CLARA), an interactive method that generates reports in a sentence by sentence fashion based on doctors' anchor words and partially completed sentences. CLARA searches for most relevant sentences from existing reports as the template for the current report. The retrieved sentences are sequentially modified by combining with the input feature representations to create the final report. In our experimental evaluation, CLARA achieved 0.393 CIDEr and 0.248 BLEU-4 on X-ray reports and 0.482 CIDEr and 0.491 BLEU-4 for EEG reports for sentence-level generation, which is up to 35% improvement over the best baseline. Also via our qualitative evaluation, CLARA is shown to produce reports which have a significantly higher level of approval by doctors in a user study (3.74 out of 5 for CLARA vs 2.52 out of 5 for the baseline).

The process of creating training data to teach models is currently driven by humans, who manually analyze model weaknesses and plan how to create data that improves a student model. Recent approaches using LLMs as annotators reduce human effort, but still require humans to interpret feedback from evaluations and control the LLM to produce data the student needs. Automating this labor-intensive process by creating autonomous data generation agents - or teachers - is desirable, but requires environments that can simulate the feedback-driven, iterative, closed loop of data creation. To enable rapid and scalable testing for such agents and their modules, we introduce DataEnvGym, a testbed of teacher environments for data generation agents. DataEnvGym frames data generation as a sequential decision-making task, involving an agent consisting of a data generation policy (which generates a plan for creating training data) and a data generation engine (which transforms the plan into data), inside an environment that provides student feedback. The agent's goal is to improve student performance. Students are iteratively trained and evaluated on generated data, with their feedback (in the form of errors or weak skills) being reported to the agent after each iteration. DataEnvGym includes multiple teacher environment instantiations across 3 levels of structure in the state representation and action space. More structured environments are based on inferred skills and offer more interpretability and curriculum control. We support 3 diverse tasks (math, code, and VQA) and test multiple students and teachers. Example agents in our teaching environments can iteratively improve students across tasks and settings. Moreover, we show that environments teach different skill levels and test variants of key modules, pointing to future work in improving data generation agents, engines, and feedback mechanisms.

Mental illness remains one of the most critical public health issues. Despite its importance, many mental health professionals highlight a disconnect between their training and actual real-world patient practice. To help bridge this gap, we propose PATIENT-{\Psi}, a novel patient simulation framework for cognitive behavior therapy (CBT) training. To build PATIENT-{\Psi}, we construct diverse patient cognitive models based on CBT principles and use large language models (LLMs) programmed with these cognitive models to act as a simulated therapy patient. We propose an interactive training scheme, PATIENT-{\Psi}-TRAINER, for mental health trainees to practice a key skill in CBT -- formulating the cognitive model of the patient -- through role-playing a therapy session with PATIENT-{\Psi}. To evaluate PATIENT-{\Psi}, we conducted a comprehensive user study of 13 mental health trainees and 20 experts. The results demonstrate that practice using PATIENT-{\Psi}-TRAINER enhances the perceived skill acquisition and confidence of the trainees beyond existing forms of training such as textbooks, videos, and role-play with non-patients. Based on the experts' perceptions, PATIENT-{\Psi} is perceived to be closer to real patient interactions than GPT-4, and PATIENT-{\Psi}-TRAINER holds strong promise to improve trainee competencies. Our code and data are released at https://github.com/ruiyiw/patient-psi.

Planning in textual environments have been shown to be a long-standing challenge even for current models. A recent, promising line of work uses LLMs to generate a formal representation of the environment that can be solved by a symbolic planner. However, existing methods rely on a fully-observed environment where all entity states are initially known, so a one-off representation can be constructed, leading to a complete plan. In contrast, we tackle partially-observed environments where there is initially no sufficient information to plan for the end-goal. We propose PDDLEGO that iteratively construct a planning representation that can lead to a partial plan for a given sub-goal. By accomplishing the sub-goal, more information is acquired to augment the representation, eventually achieving the end-goal. We show that plans produced by few-shot PDDLEGO are 43% more efficient than generating plans end-to-end on the Coin Collector simulation, with strong performance (98%) on the more complex Cooking World simulation where end-to-end LLMs fail to generate coherent plans (4%).

Medicine, by its nature, is a multifaceted domain that requires the synthesis of information across various modalities. Medical generative vision-language models (VLMs) make a first step in this direction and promise many exciting clinical applications. However, existing models typically have to be fine-tuned on sizeable down-stream datasets, which poses a significant limitation as in many medical applications data is scarce, necessitating models that are capable of learning from few examples in real-time. Here we propose Med-Flamingo, a multimodal few-shot learner adapted to the medical domain. Based on OpenFlamingo-9B, we continue pre-training on paired and interleaved medical image-text data from publications and textbooks. Med-Flamingo unlocks few-shot generative medical visual question answering (VQA) abilities, which we evaluate on several datasets including a novel challenging open-ended VQA dataset of visual USMLE-style problems. Furthermore, we conduct the first human evaluation for generative medical VQA where physicians review the problems and blinded generations in an interactive app. Med-Flamingo improves performance in generative medical VQA by up to 20\% in clinician's rating and firstly enables multimodal medical few-shot adaptations, such as rationale generation. We release our model, code, and evaluation app under https://github.com/snap-stanford/med-flamingo.

Code generation is to automatically generate source code conforming to a given programming specification, which has received extensive attention especially with the development of large language models (LLMs). Due to the inherent difficulty of code generation, the code generated by LLMs may be also not aligned with the specification. To improve the perfor mance of LLMs in code generation, some Chain of Thought (CoT) techniques have been proposed to guide LLMs for programming understanding before code generation. However, they are still hard to figure out complicated programming logic according to the (concise) specification, leadingto unsatisfactory code generation performance. In this work, we propose the first test-case-driven CoT technique, called TCoT, to further enhance the ability of LLMs in code generation. It understands the programming specification from the novel perspective of test cases, which is aligned with human practice by using examples to understand complicated problems. Due to the existence of the expected output specified in a test case, TCoT can instantly check the correctness of the programming understanding and then refine it to be as correct as possible before code generation. In this way, it is more likely to generate correct code. Our evaluation on 6 datasets and 14 baselines demonstrates the effectiveness of TCoT. For example, TCoT improves ChatGPT by 13.93%~69.44% in terms of Pass@1 (measuring the ratio of programming problems for which the generated code passes all test cases), and outperforms the existing CoT technique with the improvement of 12.14%~53.72% in terms of Pass@1.

Program synthesis or code generation aims to generate a program that satisfies a problem specification. Recent approaches using large-scale pretrained language models (LMs) have shown promising results, yet they have some critical limitations. In particular, they often follow a standard supervised fine-tuning procedure to train a code generation model only from the pairs of natural-language problem descriptions and ground-truth programs. Such paradigm largely ignores some important but potentially useful signals in the problem specification such as unit tests, which thus often results in poor performance when solving complex unseen coding tasks. To address the limitations, we propose "CodeRL", a new framework for program synthesis tasks through pretrained LMs and deep reinforcement learning (RL). Specifically, during training, we treat the code-generating LM as an actor network, and introduce a critic network that is trained to predict the functional correctness of generated programs and provide dense feedback signals to the actor. During inference, we introduce a new generation procedure with a critical sampling strategy that allows a model to automatically regenerate programs based on feedback from example unit tests and critic scores. For the model backbones, we extended the encoder-decoder architecture of CodeT5 with enhanced learning objectives, larger model sizes, and better pretraining data. Our method not only achieves new SOTA results on the challenging APPS benchmark, but also shows strong zero-shot transfer capability with new SOTA results on the simpler MBPP benchmark.

Code generation aims to produce code that fulfills requirements written in natural languages automatically. Large language Models (LLMs) like ChatGPT have demonstrated promising effectiveness in this area. Nonetheless, these LLMs often fail to ensure the syntactic and semantic correctness of the generated code. Recently, researchers proposed multi-agent frameworks that guide LLMs with different prompts to analyze programming tasks, generate code, perform testing in a sequential workflow. However, the performance of the workflow is not robust as the code generation depends on the performance of each agent. To address this challenge, we propose CodeCoR, a self-reflective multi-agent framework that evaluates the effectiveness of each agent and their collaborations. Specifically, for a given task description, four agents in CodeCoR generate prompts, code, test cases, and repair advice, respectively. Each agent generates more than one output and prunes away the low-quality ones. The generated code is tested in the local environment: the code that fails to pass the generated test cases is sent to the repair agent and the coding agent re-generates the code based on repair advice. Finally, the code that passes the most number of generated test cases is returned to users. Our experiments on four widely used datasets, HumanEval, HumanEval-ET, MBPP, and MBPP-ET, demonstrate that CodeCoR significantly outperforms existing baselines (e.g., CodeCoT and MapCoder), achieving an average Pass@1 score of 77.8%.

The integration of Large Language Models (LLMs) into healthcare promises to transform medical diagnostics, research, and patient care. Yet, the progression of medical LLMs faces obstacles such as complex training requirements, rigorous evaluation demands, and the dominance of proprietary models that restrict academic exploration. Transparent, comprehensive access to LLM resources is essential for advancing the field, fostering reproducibility, and encouraging innovation in healthcare AI. We present Hippocrates, an open-source LLM framework specifically developed for the medical domain. In stark contrast to previous efforts, it offers unrestricted access to its training datasets, codebase, checkpoints, and evaluation protocols. This open approach is designed to stimulate collaborative research, allowing the community to build upon, refine, and rigorously evaluate medical LLMs within a transparent ecosystem. Also, we introduce Hippo, a family of 7B models tailored for the medical domain, fine-tuned from Mistral and LLaMA2 through continual pre-training, instruction tuning, and reinforcement learning from human and AI feedback. Our models outperform existing open medical LLMs models by a large-margin, even surpassing models with 70B parameters. Through Hippocrates, we aspire to unlock the full potential of LLMs not just to advance medical knowledge and patient care but also to democratize the benefits of AI research in healthcare, making them available across the globe.

The increased capabilities of generative AI have dramatically expanded its possible use cases in medicine. We provide a comprehensive overview of generative AI use cases for clinicians, patients, clinical trial organizers, researchers, and trainees. We then discuss the many challenges -- including maintaining privacy and security, improving transparency and interpretability, upholding equity, and rigorously evaluating models -- which must be overcome to realize this potential, and the open research directions they give rise to.

Healthcare systems continuously generate vast amounts of electronic health records (EHRs), commonly stored in the Fast Healthcare Interoperability Resources (FHIR) standard. Despite the wealth of information in these records, their complexity and volume make it difficult for users to retrieve and interpret crucial health insights. Recent advances in Large Language Models (LLMs) offer a solution, enabling semantic question answering (QA) over medical data, allowing users to interact with their health records more effectively. However, ensuring privacy and compliance requires edge and private deployments of LLMs. This paper proposes a novel approach to semantic QA over EHRs by first identifying the most relevant FHIR resources for a user query (Task1) and subsequently answering the query based on these resources (Task2). We explore the performance of privately hosted, fine-tuned LLMs, evaluating them against benchmark models such as GPT-4 and GPT-4o. Our results demonstrate that fine-tuned LLMs, while 250x smaller in size, outperform GPT-4 family models by 0.55% in F1 score on Task1 and 42% on Meteor Task in Task2. Additionally, we examine advanced aspects of LLM usage, including sequential fine-tuning, model self-evaluation (narcissistic evaluation), and the impact of training data size on performance. The models and datasets are available here: https://huggingface.co/genloop

In this paper, we introduce a simulacrum of hospital called Agent Hospital that simulates the entire process of treating illness. All patients, nurses, and doctors are autonomous agents powered by large language models (LLMs). Our central goal is to enable a doctor agent to learn how to treat illness within the simulacrum. To do so, we propose a method called MedAgent-Zero. As the simulacrum can simulate disease onset and progression based on knowledge bases and LLMs, doctor agents can keep accumulating experience from both successful and unsuccessful cases. Simulation experiments show that the treatment performance of doctor agents consistently improves on various tasks. More interestingly, the knowledge the doctor agents have acquired in Agent Hospital is applicable to real-world medicare benchmarks. After treating around ten thousand patients (real-world doctors may take over two years), the evolved doctor agent achieves a state-of-the-art accuracy of 93.06% on a subset of the MedQA dataset that covers major respiratory diseases. This work paves the way for advancing the applications of LLM-powered agent techniques in medical scenarios.

Open-ended text generation tasks, such as dialogue generation and story completion, require models to generate a coherent continuation given limited preceding context. The open-ended nature of these tasks brings new challenges to the neural auto-regressive text generators nowadays. Despite these neural models are good at producing human-like text, it is difficult for them to arrange causalities and relations between given facts and possible ensuing events. To bridge this gap, we propose a novel two-stage method which explicitly arranges the ensuing events in open-ended text generation. Our approach can be understood as a specially-trained coarse-to-fine algorithm, where an event transition planner provides a "coarse" plot skeleton and a text generator in the second stage refines the skeleton. Experiments on two open-ended text generation tasks demonstrate that our proposed method effectively improves the quality of the generated text, especially in coherence and diversity. The code is available at: https://github.com/qtli/EventPlanforTextGen.

Large language models (LLMs) have demonstrated exceptional performance in planning the use of various functional tools, such as calculators and retrievers, particularly in question-answering tasks. In this paper, we expand the definition of these tools, centering on conceptual tools within the context of dialogue systems. A conceptual tool specifies a cognitive concept that aids systematic or investigative thought. These conceptual tools play important roles in practice, such as multiple psychological or tutoring strategies being dynamically applied in a single turn to compose helpful responses. To further enhance the reasoning and planning capability of LLMs with these conceptual tools, we introduce a multi-persona collaboration framework: Think-Plan-Execute (TPE). This framework decouples the response generation process into three distinct roles: Thinker, Planner, and Executor. Specifically, the Thinker analyzes the internal status exhibited in the dialogue context, such as user emotions and preferences, to formulate a global guideline. The Planner then generates executable plans to call different conceptual tools (e.g., sources or strategies), while the Executor compiles all intermediate results into a coherent response. This structured approach not only enhances the explainability and controllability of responses but also reduces token redundancy. We demonstrate the effectiveness of TPE across various dialogue response generation tasks, including multi-source (FoCus) and multi-strategy interactions (CIMA and PsyQA). This reveals its potential to handle real-world dialogue interactions that require more complicated tool learning beyond just functional tools. The full code and data will be released for reproduction.

Generating plans of action, and reasoning about change have long been considered a core competence of intelligent agents. It is thus no surprise that evaluating the planning and reasoning capabilities of large language models (LLMs) has become a hot topic of research. Most claims about LLM planning capabilities are however based on common sense tasks-where it becomes hard to tell whether LLMs are planning or merely retrieving from their vast world knowledge. There is a strong need for systematic and extensible planning benchmarks with sufficient diversity to evaluate whether LLMs have innate planning capabilities. Motivated by this, we propose PlanBench, an extensible benchmark suite based on the kinds of domains used in the automated planning community, especially in the International Planning Competition, to test the capabilities of LLMs in planning or reasoning about actions and change. PlanBench provides sufficient diversity in both the task domains and the specific planning capabilities. Our studies also show that on many critical capabilities-including plan generation-LLM performance falls quite short, even with the SOTA models. PlanBench can thus function as a useful marker of progress of LLMs in planning and reasoning.

Real-world multi-modal problems are rarely solved by a single machine learning model, and often require multi-step computational plans that involve stitching several models. Tool-augmented LLMs hold tremendous promise for automating the generation of such computational plans. However, the lack of standardized benchmarks for evaluating LLMs as planners for multi-step multi-modal tasks has prevented a systematic study of planner design decisions. Should LLMs generate a full plan in a single shot or step-by-step? Should they invoke tools directly with Python code or through structured data formats like JSON? Does feedback improve planning? To answer these questions and more, we introduce m&m's: a benchmark containing 4K+ multi-step multi-modal tasks involving 33 tools that include multi-modal models, (free) public APIs, and image processing modules. For each of these task queries, we provide automatically generated plans using this realistic toolset. We further provide a high-quality subset of 1,565 task plans that are human-verified and correctly executable. With m&m's, we evaluate 6 popular LLMs with 2 planning strategies (multi-step vs. step-by-step planning), 2 plan formats (JSON vs. code), and 3 types of feedback (parsing/verification/execution). Finally, we summarize takeaways from our extensive experiments. Our dataset and code are available on HuggingFace (https://huggingface.co/datasets/zixianma/mnms) and Github (https://github.com/RAIVNLab/mnms).

Developing domain models is one of the few remaining places that require manual human labor in AI planning. Thus, in order to make planning more accessible, it is desirable to automate the process of domain model generation. To this end, we investigate if large language models (LLMs) can be used to generate planning domain models from simple textual descriptions. Specifically, we introduce a framework for automated evaluation of LLM-generated domains by comparing the sets of plans for domain instances. Finally, we perform an empirical analysis of 7 large language models, including coding and chat models across 9 different planning domains, and under three classes of natural language domain descriptions. Our results indicate that LLMs, particularly those with high parameter counts, exhibit a moderate level of proficiency in generating correct planning domains from natural language descriptions. Our code is available at https://github.com/IBM/NL2PDDL.

Foundation model-enabled generative artificial intelligence facilitates the development and implementation of agents, which can leverage distinguished reasoning and language processing capabilities to takes a proactive, autonomous role to pursue users' goals. Nevertheless, there is a lack of systematic knowledge to guide practitioners in designing the agents considering challenges of goal-seeking (including generating instrumental goals and plans), such as hallucinations inherent in foundation models, explainability of reasoning process, complex accountability, etc. To address this issue, we have performed a systematic literature review to understand the state-of-the-art foundation model-based agents and the broader ecosystem. In this paper, we present a pattern catalogue consisting of 18 architectural patterns with analyses of the context, forces, and trade-offs as the outcomes from the previous literature review. We propose a decision model for selecting the patterns. The proposed catalogue can provide holistic guidance for the effective use of patterns, and support the architecture design of foundation model-based agents by facilitating goal-seeking and plan generation.

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

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.

In the era of digital healthcare, the huge volumes of textual information generated every day in hospitals constitute an essential but underused asset that could be exploited with task-specific, fine-tuned biomedical language representation models, improving patient care and management. For such specialized domains, previous research has shown that fine-tuning models stemming from broad-coverage checkpoints can largely benefit additional training rounds over large-scale in-domain resources. However, these resources are often unreachable for less-resourced languages like Italian, preventing local medical institutions to employ in-domain adaptation. In order to reduce this gap, our work investigates two accessible approaches to derive biomedical language models in languages other than English, taking Italian as a concrete use-case: one based on neural machine translation of English resources, favoring quantity over quality; the other based on a high-grade, narrow-scoped corpus natively written in Italian, thus preferring quality over quantity. Our study shows that data quantity is a harder constraint than data quality for biomedical adaptation, but the concatenation of high-quality data can improve model performance even when dealing with relatively size-limited corpora. The models published from our investigations have the potential to unlock important research opportunities for Italian hospitals and academia. Finally, the set of lessons learned from the study constitutes valuable insights towards a solution to build biomedical language models that are generalizable to other less-resourced languages and different domain settings.

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.

Medical open-domain question answering demands substantial access to specialized knowledge. Recent efforts have sought to decouple knowledge from model parameters, counteracting architectural scaling and allowing for training on common low-resource hardware. The retrieve-then-read paradigm has become ubiquitous, with model predictions grounded on relevant knowledge pieces from external repositories such as PubMed, textbooks, and UMLS. An alternative path, still under-explored but made possible by the advent of domain-specific large language models, entails constructing artificial contexts through prompting. As a result, "to generate or to retrieve" is the modern equivalent of Hamlet's dilemma. This paper presents MedGENIE, the first generate-then-read framework for multiple-choice question answering in medicine. We conduct extensive experiments on MedQA-USMLE, MedMCQA, and MMLU, incorporating a practical perspective by assuming a maximum of 24GB VRAM. MedGENIE sets a new state-of-the-art (SOTA) in the open-book setting of each testbed, even allowing a small-scale reader to outcompete zero-shot closed-book 175B baselines while using up to 706times fewer parameters. Overall, our findings reveal that generated passages are more effective than retrieved counterparts in attaining higher accuracy.

Under the pandemic of COVID-19, people experiencing COVID19-related symptoms or exposed to risk factors have a pressing need to consult doctors. Due to hospital closure, a lot of consulting services have been moved online. Because of the shortage of medical professionals, many people cannot receive online consultations timely. To address this problem, we aim to develop a medical dialogue system that can provide COVID19-related consultations. We collected two dialogue datasets -- CovidDialog -- (in English and Chinese respectively) containing conversations between doctors and patients about COVID-19. On these two datasets, we train several dialogue generation models based on Transformer, GPT, and BERT-GPT. Since the two COVID-19 dialogue datasets are small in size, which bear high risk of overfitting, we leverage transfer learning to mitigate data deficiency. Specifically, we take the pretrained models of Transformer, GPT, and BERT-GPT on dialog datasets and other large-scale texts, then finetune them on our CovidDialog tasks. We perform both automatic and human evaluation of responses generated by these models. The results show that the generated responses are promising in being doctor-like, relevant to the conversation history, and clinically informative. The data and code are available at https://github.com/UCSD-AI4H/COVID-Dialogue.

Previous studies reveal that Electronic Health Records (EHR), which have been widely adopted in the U.S. to allow patients to access their personal medical information, do not have high readability to patients due to the prevalence of medical jargon. Tailoring medical notes to individual comprehension by identifying jargon that is difficult for each person will enhance the utility of generative models. We present the first quantitative analysis to measure the impact of role-playing in LLM in medical term extraction. By comparing the results of Mechanical Turk workers over 20 sentences, our study demonstrates that LLM role-playing improves F1 scores in 95% of cases across 14 different socio-demographic backgrounds. Furthermore, applying role-playing with in-context learning outperformed the previous state-of-the-art models. Our research showed that ChatGPT can improve traditional medical term extraction systems by utilizing role-play to deliver personalized patient education, a potential that previous models had not achieved.

Large Language Models (LLMs) are transforming artificial intelligence, enabling autonomous agents to perform diverse tasks across various domains. These agents, proficient in human-like text comprehension and generation, have the potential to revolutionize sectors from customer service to healthcare. However, they face challenges such as multimodality, human value alignment, hallucinations, and evaluation. Techniques like prompting, reasoning, tool utilization, and in-context learning are being explored to enhance their capabilities. Evaluation platforms like AgentBench, WebArena, and ToolLLM provide robust methods for assessing these agents in complex scenarios. These advancements are leading to the development of more resilient and capable autonomous agents, anticipated to become integral in our digital lives, assisting in tasks from email responses to disease diagnosis. The future of AI, with LLMs at the forefront, is promising.

Solving complex planning problems requires Large Language Models (LLMs) to explicitly model the state transition to avoid rule violations, comply with constraints, and ensure optimality-a task hindered by the inherent ambiguity of natural language. To overcome such ambiguity, Planning Domain Definition Language (PDDL) is leveraged as a planning abstraction that enables precise and formal state descriptions. With PDDL, we can generate a symbolic world model where classic searching algorithms, such as A*, can be seamlessly applied to find optimal plans. However, directly generating PDDL domains with current LLMs remains an open challenge due to the lack of PDDL training data. To address this challenge, we propose to scale up the test-time computation of LLMs to enhance their PDDL reasoning capabilities, thereby enabling the generation of high-quality PDDL domains. Specifically, we introduce a simple yet effective algorithm, which first employs a Best-of-N sampling approach to improve the quality of the initial solution and then refines the solution in a fine-grained manner with verbalized machine learning. Our method outperforms o1-mini by a considerable margin in the generation of PDDL domain, achieving over 50% success rate on two tasks (i.e., generating PDDL domains from natural language description or PDDL problems). This is done without requiring additional training. By taking advantage of PDDL as state abstraction, our method is able to outperform current state-of-the-art methods on almost all competition-level planning tasks.

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.

Large language models (LLMs) have demonstrated impressive capabilities in disease diagnosis. However, their effectiveness in identifying rarer diseases, which are inherently more challenging to diagnose, remains an open question. Rare disease performance is critical with the increasing use of LLMs in healthcare settings. This is especially true if a primary care physician needs to make a rarer prognosis from only a patient conversation so that they can take the appropriate next step. To that end, several clinical decision support systems are designed to support providers in rare disease identification. Yet their utility is limited due to their lack of knowledge of common disorders and difficulty of use. In this paper, we propose RareScale to combine the knowledge LLMs with expert systems. We use jointly use an expert system and LLM to simulate rare disease chats. This data is used to train a rare disease candidate predictor model. Candidates from this smaller model are then used as additional inputs to black-box LLM to make the final differential diagnosis. Thus, RareScale allows for a balance between rare and common diagnoses. We present results on over 575 rare diseases, beginning with Abdominal Actinomycosis and ending with Wilson's Disease. Our approach significantly improves the baseline performance of black-box LLMs by over 17% in Top-5 accuracy. We also find that our candidate generation performance is high (e.g. 88.8% on gpt-4o generated chats).

Storytelling is the lifeline of the entertainment industry -- movies, TV shows, and stand-up comedies, all need stories. A good and gripping script is the lifeline of storytelling and demands creativity and resource investment. Good scriptwriters are rare to find and often work under severe time pressure. Consequently, entertainment media are actively looking for automation. In this paper, we present an AI-based script-writing workbench called KUROSAWA which addresses the tasks of plot generation and script generation. Plot generation aims to generate a coherent and creative plot (600-800 words) given a prompt (15-40 words). Script generation, on the other hand, generates a scene (200-500 words) in a screenplay format from a brief description (15-40 words). Kurosawa needs data to train. We use a 4-act structure of storytelling to annotate the plot dataset manually. We create a dataset of 1000 manually annotated plots and their corresponding prompts/storylines and a gold-standard dataset of 1000 scenes with four main elements -- scene headings, action lines, dialogues, and character names -- tagged individually. We fine-tune GPT-3 with the above datasets to generate plots and scenes. These plots and scenes are first evaluated and then used by the scriptwriters of a large and famous media platform ErosNow. We release the annotated datasets and the models trained on these datasets as a working benchmark for automatic movie plot and script generation.

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.

This paper introduces Personalized Path Recourse, a novel method that generates recourse paths for an agent. The objective is to achieve desired goals (e.g., better outcomes compared to the agent's original paths of action), while ensuring a high similarity to the agent's original paths and being personalized to the agent. Personalization refers to the extent to which the new path is tailored to the agent's observed behavior patterns from their policy function. We train a personalized recourse agent to generate such personalized paths, which are obtained using reward functions that consider the goal, similarity, and personalization. The proposed method is applicable to both reinforcement learning and supervised learning settings for correcting or improving sequences of actions or sequences of data to achieve a pre-determined goal. The method is evaluated in various settings and demonstrates promising results.

The rapid advancement of large-scale vision-language models has showcased remarkable capabilities across various tasks. However, the lack of extensive and high-quality image-text data in medicine has greatly hindered the development of large-scale medical vision-language models. In this work, we present a diagnosis-guided bootstrapping strategy that exploits both image and label information to construct vision-language datasets. Based on the constructed dataset, we developed MedDr, a generalist foundation model for healthcare capable of handling diverse medical data modalities, including radiology, pathology, dermatology, retinography, and endoscopy. Moreover, during inference, we propose a simple but effective retrieval-augmented medical diagnosis strategy, which enhances the model's generalization ability. Extensive experiments on visual question answering, medical report generation, and medical image diagnosis demonstrate the superiority of our method.

Generating low-level robot task plans from high-level natural language instructions remains a challenging problem. Although large language models have shown promising results in generating plans, the accuracy of the output remains unverified. Furthermore, the lack of domain-specific language data poses a limitation on the applicability of these models. In this paper, we propose CLAIRIFY, a novel approach that combines automatic iterative prompting with program verification to ensure programs written in data-scarce domain-specific language are syntactically valid and incorporate environment constraints. Our approach provides effective guidance to the language model on generating structured-like task plans by incorporating any errors as feedback, while the verifier ensures the syntactic accuracy of the generated plans. We demonstrate the effectiveness of CLAIRIFY in planning chemistry experiments by achieving state-of-the-art results. We also show that the generated plans can be executed on a real robot by integrating them with a task and motion planner.

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.

Recent large language models (LLMs) offer the potential to support public health monitoring by facilitating health disclosure through open-ended conversations but rarely preserve the knowledge gained about individuals across repeated interactions. Augmenting LLMs with long-term memory (LTM) presents an opportunity to improve engagement and self-disclosure, but we lack an understanding of how LTM impacts people's interaction with LLM-driven chatbots in public health interventions. We examine the case of CareCall -- an LLM-driven voice chatbot with LTM -- through the analysis of 1,252 call logs and interviews with nine users. We found that LTM enhanced health disclosure and fostered positive perceptions of the chatbot by offering familiarity. However, we also observed challenges in promoting self-disclosure through LTM, particularly around addressing chronic health conditions and privacy concerns. We discuss considerations for LTM integration in LLM-driven chatbots for public health monitoring, including carefully deciding what topics need to be remembered in light of public health goals.

Introduction: Recently, the effectiveness of Large Language Models (LLMs) has increased rapidly, allowing them to be used in a great number of applications. However, the risks posed by the generation of false information through LLMs significantly limit their applications in sensitive areas such as healthcare, highlighting the necessity for rigorous validations to determine their utility and reliability. To date, no study has extensively compared the performance of LLMs on Polish medical examinations across a broad spectrum of specialties on a very large dataset. Objectives: This study evaluated the performance of three Generative Pretrained Transformer (GPT) models on the Polish Board Certification Exam (Pa\'nstwowy Egzamin Specjalizacyjny, PES) dataset, which consists of 297 tests. Methods: We developed a software program to download and process PES exams and tested the performance of GPT models using OpenAI Application Programming Interface. Results: Our findings reveal that GPT-3.5 did not pass any of the analyzed exams. In contrast, the GPT-4 models demonstrated the capability to pass the majority of the exams evaluated, with the most recent model, gpt-4-0125, successfully passing 222 (75%) of them. The performance of the GPT models varied significantly, displaying excellence in exams related to certain specialties while completely failing others. Conclusions: The significant progress and impressive performance of LLM models hold great promise for the increased application of AI in the field of medicine in Poland. For instance, this advancement could lead to the development of AI-based medical assistants for healthcare professionals, enhancing the efficiency and accuracy of medical services.

Hospital information systems (HIS) have become an essential part of healthcare institutions and now incorporate prescribing support software. Prescription support software allows for structured information capture, which improves the safety, appropriateness and efficiency of prescriptions and reduces the number of adverse drug events (ADEs). However, such a system increases the amount of time physicians spend at a computer entering information instead of providing medical care. In addition, any new visiting clinician must learn to manage complex interfaces since each HIS has its own interfaces. In this paper, we present a natural language interface for e-prescribing software in the form of a spoken dialogue system accessible on a smartphone. This system allows prescribers to record their prescriptions verbally, a form of interaction closer to their usual practice. The system extracts the formal representation of the prescription ready to be checked by the prescribing software and uses the dialogue to request mandatory information, correct errors or warn of particular situations. Since, to the best of our knowledge, there is no existing voice-based prescription dialogue system, we present the system developed in a low-resource environment, focusing on dialogue modeling, semantic extraction and data augmentation. The system was evaluated in the wild with 55 participants. This evaluation showed that our system has an average prescription time of 66.15 seconds for physicians and 35.64 seconds for other experts, and a task success rate of 76\% for physicians and 72\% for other experts. All evaluation data were recorded and annotated to form PxCorpus, the first spoken drug prescription corpus that has been made fully available to the community (https://doi.org/10.5281/zenodo.6524162).

Recent researches of large language models(LLM), which is pre-trained on massive general-purpose corpora, have achieved breakthroughs in responding human queries. However, these methods face challenges including limited data insufficiency to support extensive pre-training and can not align responses with users' instructions. To address these issues, we introduce a medical instruction dataset, CMedINS, containing six medical instructions derived from actual medical tasks, which effectively fine-tunes LLM in conjunction with other data. Subsequently, We launch our medical model, IIMedGPT, employing an efficient preference alignment method, Direct preference Optimization(DPO). The results show that our final model outperforms existing medical models in medical dialogue.Datsets, Code and model checkpoints will be released upon acceptance.

We are interested in enabling visual planning for complex long-horizon tasks in the space of generated videos and language, leveraging recent advances in large generative models pretrained on Internet-scale data. To this end, we present video language planning (VLP), an algorithm that consists of a tree search procedure, where we train (i) vision-language models to serve as both policies and value functions, and (ii) text-to-video models as dynamics models. VLP takes as input a long-horizon task instruction and current image observation, and outputs a long video plan that provides detailed multimodal (video and language) specifications that describe how to complete the final task. VLP scales with increasing computation budget where more computation time results in improved video plans, and is able to synthesize long-horizon video plans across different robotics domains: from multi-object rearrangement, to multi-camera bi-arm dexterous manipulation. Generated video plans can be translated into real robot actions via goal-conditioned policies, conditioned on each intermediate frame of the generated video. Experiments show that VLP substantially improves long-horizon task success rates compared to prior methods on both simulated and real robots (across 3 hardware platforms).

Large language models have exhibited exceptional performance on various Natural Language Processing (NLP) tasks, leveraging techniques such as the pre-training, and instruction fine-tuning. Despite these advances, their effectiveness in medical applications is limited, due to challenges such as factual inaccuracies, reasoning abilities, and lack grounding in real-world experience. In this study, we present ClinicalGPT, a language model explicitly designed and optimized for clinical scenarios. By incorporating extensive and diverse real-world data, such as medical records, domain-specific knowledge, and multi-round dialogue consultations in the training process, ClinicalGPT is better prepared to handle multiple clinical task. Furthermore, we introduce a comprehensive evaluation framework that includes medical knowledge question-answering, medical exams, patient consultations, and diagnostic analysis of medical records. Our results demonstrate that ClinicalGPT significantly outperforms other models in these tasks, highlighting the effectiveness of our approach in adapting large language models to the critical domain of healthcare.

Intrigued by the claims of emergent reasoning capabilities in LLMs trained on general web corpora, in this paper, we set out to investigate their planning capabilities. We aim to evaluate (1) the effectiveness of LLMs in generating plans autonomously in commonsense planning tasks and (2) the potential of LLMs as a source of heuristic guidance for other agents (AI planners) in their planning tasks. We conduct a systematic study by generating a suite of instances on domains similar to the ones employed in the International Planning Competition and evaluate LLMs in two distinct modes: autonomous and heuristic. Our findings reveal that LLMs' ability to generate executable plans autonomously is rather limited, with the best model (GPT-4) having an average success rate of ~12% across the domains. However, the results in the heuristic mode show more promise. In the heuristic mode, we demonstrate that LLM-generated plans can improve the search process for underlying sound planners and additionally show that external verifiers can help provide feedback on the generated plans and back-prompt the LLM for better plan generation.

Clinicians spend a significant amount of time reviewing medical images and transcribing their findings regarding patient diagnosis, referral and treatment in text form. Vision-language models (VLMs), which automatically interpret images and summarize their findings as text, have enormous potential to alleviate clinical workloads and increase patient access to high-quality medical care. While foundational models have stirred considerable interest in the medical community, it is unclear whether their general capabilities translate to real-world clinical utility. In this work, we show that foundation VLMs markedly underperform compared to practicing ophthalmologists on specialist tasks crucial to the care of patients with age-related macular degeneration (AMD). To address this, we initially identified the essential capabilities required for image-based clinical decision-making, and then developed a curriculum to selectively train VLMs in these skills. The resulting model, RetinaVLM, can be instructed to write reports that significantly outperform those written by leading foundation medical VLMs in disease staging (F1 score of 0.63 vs. 0.11) and patient referral (0.67 vs. 0.39), and approaches the diagnostic performance of junior ophthalmologists (who achieve 0.77 and 0.78 on the respective tasks). Furthermore, in a reader study involving two senior ophthalmologists with up to 32 years of experience, RetinaVLM's reports were found to be similarly correct (78.6% vs. 82.1%) and complete (both 78.6%) as reports written by junior ophthalmologists with up to 10 years of experience. These results demonstrate that our curriculum-based approach provides a blueprint for specializing generalist foundation medical VLMs to handle real-world clinical tasks.

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%

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.

Online medical consultation (OMC) restricts doctors to gathering patient information solely through inquiries, making the already complex sequential decision-making process of diagnosis even more challenging. Recently, the rapid advancement of large language models has demonstrated a significant potential to transform OMC. However, most studies have primarily focused on improving diagnostic accuracy under conditions of relatively sufficient information, while paying limited attention to the "inquiry" phase of the consultation process. This lack of focus has left the relationship between "inquiry" and "diagnosis" insufficiently explored. In this paper, we first extract real patient interaction strategies from authentic doctor-patient conversations and use these strategies to guide the training of a patient simulator that closely mirrors real-world behavior. By inputting medical records into our patient simulator to simulate patient responses, we conduct extensive experiments to explore the relationship between "inquiry" and "diagnosis" in the consultation process. Experimental results demonstrate that inquiry and diagnosis adhere to the Liebig's law: poor inquiry quality limits the effectiveness of diagnosis, regardless of diagnostic capability, and vice versa. Furthermore, the experiments reveal significant differences in the inquiry performance of various models. To investigate this phenomenon, we categorize the inquiry process into four types: (1) chief complaint inquiry; (2) specification of known symptoms; (3) inquiry about accompanying symptoms; and (4) gathering family or medical history. We analyze the distribution of inquiries across the four types for different models to explore the reasons behind their significant performance differences. We plan to open-source the weights and related code of our patient simulator at https://github.com/LIO-H-ZEN/PatientSimulator.

In this review, we explore the potential applications of Artificial General Intelligence (AGI) models in healthcare, focusing on foundational Large Language Models (LLMs), Large Vision Models, and Large Multimodal Models. We emphasize the importance of integrating clinical expertise, domain knowledge, and multimodal capabilities into AGI models. In addition, we lay out key roadmaps that guide the development and deployment of healthcare AGI models. Throughout the review, we provide critical perspectives on the potential challenges and pitfalls associated with deploying large-scale AGI models in the medical field. This comprehensive review aims to offer insights into the future implications of AGI in medical imaging, healthcare and beyond.

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.

A code generation model generates code by taking a prompt from a code comment, existing code, or a combination of both. Although code generation models (e.g. GitHub Copilot) are increasingly being adopted in practice, it is unclear whether they can successfully be used for unit test generation without fine-tuning. We investigated how well three generative models (Codex, GPT-3.5-Turbo, and StarCoder) can generate test cases to fill this gap. We used two benchmarks (HumanEval and Evosuite SF110) to investigate the context generation's effect in the unit test generation process. We evaluated the models based on compilation rates, test correctness, coverage, and test smells. We found that the Codex model achieved above 80% coverage for the HumanEval dataset, but no model had more than 2% coverage for the EvoSuite SF110 benchmark. The generated tests also suffered from test smells, such as Duplicated Asserts and Empty Tests.

Large language models (LLMs) have demonstrated remarkable capabilities in natural language understanding and generation across various domains, including medicine. We present a comprehensive evaluation of GPT-4, a state-of-the-art LLM, on medical competency examinations and benchmark datasets. GPT-4 is a general-purpose model that is not specialized for medical problems through training or engineered to solve clinical tasks. Our analysis covers two sets of official practice materials for the USMLE, a three-step examination program used to assess clinical competency and grant licensure in the United States. We also evaluate performance on the MultiMedQA suite of benchmark datasets. Beyond measuring model performance, experiments were conducted to investigate the influence of test questions containing both text and images on model performance, probe for memorization of content during training, and study probability calibration, which is of critical importance in high-stakes applications like medicine. Our results show that GPT-4, without any specialized prompt crafting, exceeds the passing score on USMLE by over 20 points and outperforms earlier general-purpose models (GPT-3.5) as well as models specifically fine-tuned on medical knowledge (Med-PaLM, a prompt-tuned version of Flan-PaLM 540B). In addition, GPT-4 is significantly better calibrated than GPT-3.5, demonstrating a much-improved ability to predict the likelihood that its answers are correct. We also explore the behavior of the model qualitatively through a case study that shows the ability of GPT-4 to explain medical reasoning, personalize explanations to students, and interactively craft new counterfactual scenarios around a medical case. Implications of the findings are discussed for potential uses of GPT-4 in medical education, assessment, and clinical practice, with appropriate attention to challenges of accuracy and safety.

Large Language Models (LLMs) have demonstrated impressive planning abilities due to their vast "world knowledge". Yet, obtaining plans that are both feasible (grounded in affordances) and cost-effective (in plan length), remains a challenge, despite recent progress. This contrasts with heuristic planning methods that employ domain knowledge (formalized in action models such as PDDL) and heuristic search to generate feasible, optimal plans. Inspired by this, we propose to combine the power of LLMs and heuristic planning by leveraging the world knowledge of LLMs and the principles of heuristic search. Our approach, SayCanPay, employs LLMs to generate actions (Say) guided by learnable domain knowledge, that evaluates actions' feasibility (Can) and long-term reward/payoff (Pay), and heuristic search to select the best sequence of actions. Our contributions are (1) a novel framing of the LLM planning problem in the context of heuristic planning, (2) integrating grounding and cost-effective elements into the generated plans, and (3) using heuristic search over actions. Our extensive evaluations show that our model surpasses other LLM planning approaches.

Machine learning has successfully framed many sequential decision making problems as either supervised prediction, or optimal decision-making policy identification via reinforcement learning. In data-constrained offline settings, both approaches may fail as they assume fully optimal behavior or rely on exploring alternatives that may not exist. We introduce an inherently different approach that identifies possible "dead-ends" of a state space. We focus on the condition of patients in the intensive care unit, where a "medical dead-end" indicates that a patient will expire, regardless of all potential future treatment sequences. We postulate "treatment security" as avoiding treatments with probability proportional to their chance of leading to dead-ends, present a formal proof, and frame discovery as an RL problem. We then train three independent deep neural models for automated state construction, dead-end discovery and confirmation. Our empirical results discover that dead-ends exist in real clinical data among septic patients, and further reveal gaps between secure treatments and those that were administered.

Synthesizing clinical evidence largely relies on systematic reviews of clinical trials and retrospective analyses from medical literature. However, the rapid expansion of publications presents challenges in efficiently identifying, summarizing, and updating clinical evidence. Here, we introduce TrialMind, a generative artificial intelligence (AI) pipeline for facilitating human-AI collaboration in three crucial tasks for evidence synthesis: study search, screening, and data extraction. To assess its performance, we chose published systematic reviews to build the benchmark dataset, named TrialReviewBench, which contains 100 systematic reviews and the associated 2,220 clinical studies. Our results show that TrialMind excels across all three tasks. In study search, it generates diverse and comprehensive search queries to achieve high recall rates (Ours 0.711-0.834 v.s. Human baseline 0.138-0.232). For study screening, TrialMind surpasses traditional embedding-based methods by 30% to 160%. In data extraction, it outperforms a GPT-4 baseline by 29.6% to 61.5%. We further conducted user studies to confirm its practical utility. Compared to manual efforts, human-AI collaboration using TrialMind yielded a 71.4% recall lift and 44.2% time savings in study screening and a 23.5% accuracy lift and 63.4% time savings in data extraction. Additionally, when comparing synthesized clinical evidence presented in forest plots, medical experts favored TrialMind's outputs over GPT-4's outputs in 62.5% to 100% of cases. These findings show the promise of LLM-based approaches like TrialMind to accelerate clinical evidence synthesis via streamlining study search, screening, and data extraction from medical literature, with exceptional performance improvement when working with human experts.

Automating radiology report generation can significantly alleviate radiologists' workloads. Previous research has primarily focused on realizing highly concise observations while neglecting the precise attributes that determine the severity of diseases (e.g., small pleural effusion). Since incorrect attributes will lead to imprecise radiology reports, strengthening the generation process with precise attribute modeling becomes necessary. Additionally, the temporal information contained in the historical records, which is crucial in evaluating a patient's current condition (e.g., heart size is unchanged), has also been largely disregarded. To address these issues, we propose RECAP, which generates precise and accurate radiology reports via dynamic disease progression reasoning. Specifically, RECAP first predicts the observations and progressions (i.e., spatiotemporal information) given two consecutive radiographs. It then combines the historical records, spatiotemporal information, and radiographs for report generation, where a disease progression graph and dynamic progression reasoning mechanism are devised to accurately select the attributes of each observation and progression. Extensive experiments on two publicly available datasets demonstrate the effectiveness of our model.

A goal of artificial intelligence is to construct an agent that can solve a wide variety of tasks. Recent progress in text-guided image synthesis has yielded models with an impressive ability to generate complex novel images, exhibiting combinatorial generalization across domains. Motivated by this success, we investigate whether such tools can be used to construct more general-purpose agents. Specifically, we cast the sequential decision making problem as a text-conditioned video generation problem, where, given a text-encoded specification of a desired goal, a planner synthesizes a set of future frames depicting its planned actions in the future, after which control actions are extracted from the generated video. By leveraging text as the underlying goal specification, we are able to naturally and combinatorially generalize to novel goals. The proposed policy-as-video formulation can further represent environments with different state and action spaces in a unified space of images, which, for example, enables learning and generalization across a variety of robot manipulation tasks. Finally, by leveraging pretrained language embeddings and widely available videos from the internet, the approach enables knowledge transfer through predicting highly realistic video plans for real robots.

At the heart of medicine lies the physician-patient dialogue, where skillful history-taking paves the way for accurate diagnosis, effective management, and enduring trust. Artificial Intelligence (AI) systems capable of diagnostic dialogue could increase accessibility, consistency, and quality of care. However, approximating clinicians' expertise is an outstanding grand challenge. Here, we introduce AMIE (Articulate Medical Intelligence Explorer), a Large Language Model (LLM) based AI system optimized for diagnostic dialogue. AMIE uses a novel self-play based simulated environment with automated feedback mechanisms for scaling learning across diverse disease conditions, specialties, and contexts. We designed a framework for evaluating clinically-meaningful axes of performance including history-taking, diagnostic accuracy, management reasoning, communication skills, and empathy. We compared AMIE's performance to that of primary care physicians (PCPs) in a randomized, double-blind crossover study of text-based consultations with validated patient actors in the style of an Objective Structured Clinical Examination (OSCE). The study included 149 case scenarios from clinical providers in Canada, the UK, and India, 20 PCPs for comparison with AMIE, and evaluations by specialist physicians and patient actors. AMIE demonstrated greater diagnostic accuracy and superior performance on 28 of 32 axes according to specialist physicians and 24 of 26 axes according to patient actors. Our research has several limitations and should be interpreted with appropriate caution. Clinicians were limited to unfamiliar synchronous text-chat which permits large-scale LLM-patient interactions but is not representative of usual clinical practice. While further research is required before AMIE could be translated to real-world settings, the results represent a milestone towards conversational diagnostic AI.

Large Language Models (LLMs) have shown the potential to significantly contribute to patient care, diagnostics, and administrative processes. Emerging biomedical LLMs address healthcare-specific challenges, including privacy demands and computational constraints. However, evaluation of these models has primarily been limited to non-clinical tasks, which do not reflect the complexity of practical clinical applications. Additionally, there has been no thorough comparison between biomedical and general-domain LLMs for clinical tasks. To fill this gap, we present the Clinical Language Understanding Evaluation (CLUE), a benchmark tailored to evaluate LLMs on real-world clinical tasks. CLUE includes two novel datasets derived from MIMIC IV discharge letters and four existing tasks designed to test the practical applicability of LLMs in healthcare settings. Our evaluation covers several biomedical and general domain LLMs, providing insights into their clinical performance and applicability. CLUE represents a step towards a standardized approach to evaluating and developing LLMs in healthcare to align future model development with the real-world needs of clinical application. We publish our evaluation and data generation scripts: https://github.com/dadaamin/CLUE

In our pursuit of advancing multi-modal AI assistants capable of guiding users to achieve complex multi-step goals, we propose the task of "Visual Planning for Assistance (VPA)". Given a succinct natural language goal, e.g., "make a shelf", and a video of the user's progress so far, the aim of VPA is to devise a plan, i.e., a sequence of actions such as "sand shelf", "paint shelf", etc. to realize the specified goal. This requires assessing the user's progress from the (untrimmed) video, and relating it to the requirements of natural language goal, i.e., which actions to select and in what order? Consequently, this requires handling long video history and arbitrarily complex action dependencies. To address these challenges, we decompose VPA into video action segmentation and forecasting. Importantly, we experiment by formulating the forecasting step as a multi-modal sequence modeling problem, allowing us to leverage the strength of pre-trained LMs (as the sequence model). This novel approach, which we call Visual Language Model based Planner (VLaMP), outperforms baselines across a suite of metrics that gauge the quality of the generated plans. Furthermore, through comprehensive ablations, we also isolate the value of each component--language pre-training, visual observations, and goal information. We have open-sourced all the data, model checkpoints, and training code.

Recent advances in generative vision-language models (VLMs) have exciting potential implications for AI in radiology, yet VLMs are also known to produce hallucinations, nonsensical text, and other unwanted behaviors that can waste clinicians' time and cause patient harm. Drawing on recent work on direct preference optimization (DPO), we propose a simple method for modifying the behavior of pretrained VLMs performing radiology report generation by suppressing unwanted types of generations. We apply our method to the prevention of hallucinations of prior exams, addressing a long-established problem behavior in models performing chest X-ray report generation. Across our experiments, we find that DPO fine-tuning achieves a 3.2-4.8x reduction in lines hallucinating prior exams while maintaining model performance on clinical accuracy metrics. Our work is, to the best of our knowledge, the first work to apply DPO to medical VLMs, providing a data- and compute- efficient way to suppress problem behaviors while maintaining overall clinical accuracy.

Generative Foundation Models (GenFMs) have emerged as transformative tools. However, their widespread adoption raises critical concerns regarding trustworthiness across dimensions. This paper presents a comprehensive framework to address these challenges through three key contributions. First, we systematically review global AI governance laws and policies from governments and regulatory bodies, as well as industry practices and standards. Based on this analysis, we propose a set of guiding principles for GenFMs, developed through extensive multidisciplinary collaboration that integrates technical, ethical, legal, and societal perspectives. Second, we introduce TrustGen, the first dynamic benchmarking platform designed to evaluate trustworthiness across multiple dimensions and model types, including text-to-image, large language, and vision-language models. TrustGen leverages modular components--metadata curation, test case generation, and contextual variation--to enable adaptive and iterative assessments, overcoming the limitations of static evaluation methods. Using TrustGen, we reveal significant progress in trustworthiness while identifying persistent challenges. Finally, we provide an in-depth discussion of the challenges and future directions for trustworthy GenFMs, which reveals the complex, evolving nature of trustworthiness, highlighting the nuanced trade-offs between utility and trustworthiness, and consideration for various downstream applications, identifying persistent challenges and providing a strategic roadmap for future research. This work establishes a holistic framework for advancing trustworthiness in GenAI, paving the way for safer and more responsible integration of GenFMs into critical applications. To facilitate advancement in the community, we release the toolkit for dynamic evaluation.

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.

In response to the pressing need for advanced clinical problem-solving tools in healthcare, we introduce BooksMed, a novel framework based on a Large Language Model (LLM). BooksMed uniquely emulates human cognitive processes to deliver evidence-based and reliable responses, utilizing the GRADE (Grading of Recommendations, Assessment, Development, and Evaluations) framework to effectively quantify evidence strength. For clinical decision-making to be appropriately assessed, an evaluation metric that is clinically aligned and validated is required. As a solution, we present ExpertMedQA, a multispecialty clinical benchmark comprised of open-ended, expert-level clinical questions, and validated by a diverse group of medical professionals. By demanding an in-depth understanding and critical appraisal of up-to-date clinical literature, ExpertMedQA rigorously evaluates LLM performance. BooksMed outperforms existing state-of-the-art models Med-PaLM 2, Almanac, and ChatGPT in a variety of medical scenarios. Therefore, a framework that mimics human cognitive stages could be a useful tool for providing reliable and evidence-based responses to clinical inquiries.

We introduce the task of text-to-diagram generation, which focuses on creating structured visual representations directly from textual descriptions. Existing approaches in text-to-image and text-to-code generation lack the logical organization and flexibility needed to produce accurate, editable diagrams, often resulting in outputs that are either unstructured or difficult to modify. To address this gap, we introduce DiagramGenBenchmark, a comprehensive evaluation framework encompassing eight distinct diagram categories, including flowcharts, model architecture diagrams, and mind maps. Additionally, we present DiagramAgent, an innovative framework with four core modules-Plan Agent, Code Agent, Check Agent, and Diagram-to-Code Agent-designed to facilitate both the generation and refinement of complex diagrams. Our extensive experiments, which combine objective metrics with human evaluations, demonstrate that DiagramAgent significantly outperforms existing baseline models in terms of accuracy, structural coherence, and modifiability. This work not only establishes a foundational benchmark for the text-to-diagram generation task but also introduces a powerful toolset to advance research and applications in this emerging area.

Recent advancements in large language models (LLMs) have enabled LLM-based agents to successfully tackle interactive planning tasks. However, despite their successes, existing approaches often suffer from planning hallucinations and require retraining for each new agent. To address these challenges, we propose the Meta Plan Optimization (MPO) framework, which enhances agent planning capabilities by directly incorporating explicit guidance. Unlike previous methods that rely on complex knowledge, which either require significant human effort or lack quality assurance, MPO leverages high-level general guidance through meta plans to assist agent planning and enables continuous optimization of the meta plans based on feedback from the agent's task execution. Our experiments conducted on two representative tasks demonstrate that MPO significantly outperforms existing baselines. Moreover, our analysis indicates that MPO provides a plug-and-play solution that enhances both task completion efficiency and generalization capabilities in previous unseen scenarios.

Automated Planning and Scheduling is among the growing areas in Artificial Intelligence (AI) where mention of LLMs has gained popularity. Based on a comprehensive review of 126 papers, this paper investigates eight categories based on the unique applications of LLMs in addressing various aspects of planning problems: language translation, plan generation, model construction, multi-agent planning, interactive planning, heuristics optimization, tool integration, and brain-inspired planning. For each category, we articulate the issues considered and existing gaps. A critical insight resulting from our review is that the true potential of LLMs unfolds when they are integrated with traditional symbolic planners, pointing towards a promising neuro-symbolic approach. This approach effectively combines the generative aspects of LLMs with the precision of classical planning methods. By synthesizing insights from existing literature, we underline the potential of this integration to address complex planning challenges. Our goal is to encourage the ICAPS community to recognize the complementary strengths of LLMs and symbolic planners, advocating for a direction in automated planning that leverages these synergistic capabilities to develop more advanced and intelligent planning systems.

The recent advancements in artificial intelligence highlight the potential of language models in psychological health support. While models trained on data from mental health service platform have achieved preliminary success, challenges persist in areas such as data scarcity, quality, and ensuring a solid foundation in psychological techniques. To address these challenges, this study introduces a novel approach to enhance the precision and efficacy of psychological support through large language models. Specifically, we design a specific prompt derived from principles of Cognitive Behavioral Therapy (CBT) and have generated the CBT QA dataset, specifically for Chinese psychological health Q&A based on CBT structured intervention strategies. Unlike previous methods, our dataset emphasizes professional and structured response. Utilizing this dataset, we fine-tuned the large language model, giving birth to CBT-LLM, the large-scale language model specifically designed for Cognitive Behavioral Therapy techniques. Empirical evaluations demonstrate that CBT-LLM excels in generating structured, professional, and highly relevant responses in psychological health support tasks, showcasing its practicality and quality. The model is available on Hugging Face: https://huggingface.co/Hongbin37/CBT-LLM.

Large language models (LLMs) are increasingly essential in processing natural languages, yet their application is frequently compromised by biases and inaccuracies originating in their training data. In this study, we introduce Cross-Care, the first benchmark framework dedicated to assessing biases and real world knowledge in LLMs, specifically focusing on the representation of disease prevalence across diverse demographic groups. We systematically evaluate how demographic biases embedded in pre-training corpora like ThePile influence the outputs of LLMs. We expose and quantify discrepancies by juxtaposing these biases against actual disease prevalences in various U.S. demographic groups. Our results highlight substantial misalignment between LLM representation of disease prevalence and real disease prevalence rates across demographic subgroups, indicating a pronounced risk of bias propagation and a lack of real-world grounding for medical applications of LLMs. Furthermore, we observe that various alignment methods minimally resolve inconsistencies in the models' representation of disease prevalence across different languages. For further exploration and analysis, we make all data and a data visualization tool available at: www.crosscare.net.

Large-language models have recently demonstrated impressive zero-shot capabilities in a variety of natural language tasks such as summarization, dialogue generation, and question-answering. Despite many promising applications in clinical medicine, adoption of these models in real-world settings has been largely limited by their tendency to generate incorrect and sometimes even toxic statements. In this study, we develop Almanac, a large language model framework augmented with retrieval capabilities for medical guideline and treatment recommendations. Performance on a novel dataset of clinical scenarios (n = 130) evaluated by a panel of 5 board-certified and resident physicians demonstrates significant increases in factuality (mean of 18% at p-value < 0.05) across all specialties, with improvements in completeness and safety. Our results demonstrate the potential for large language models to be effective tools in the clinical decision-making process, while also emphasizing the importance of careful testing and deployment to mitigate their shortcomings.

Text-to-Image (T2I) generation is enabling new applications that support creators, designers, and general end users of productivity software by generating illustrative content with high photorealism starting from a given descriptive text as a prompt. Such models are however trained on massive amounts of web data, which surfaces the peril of potential harmful biases that may leak in the generation process itself. In this paper, we take a multi-dimensional approach to studying and quantifying common social biases as reflected in the generated images, by focusing on how occupations, personality traits, and everyday situations are depicted across representations of (perceived) gender, age, race, and geographical location. Through an extensive set of both automated and human evaluation experiments we present findings for two popular T2I models: DALLE-v2 and Stable Diffusion. Our results reveal that there exist severe occupational biases of neutral prompts majorly excluding groups of people from results for both models. Such biases can get mitigated by increasing the amount of specification in the prompt itself, although the prompting mitigation will not address discrepancies in image quality or other usages of the model or its representations in other scenarios. Further, we observe personality traits being associated with only a limited set of people at the intersection of race, gender, and age. Finally, an analysis of geographical location representations on everyday situations (e.g., park, food, weddings) shows that for most situations, images generated through default location-neutral prompts are closer and more similar to images generated for locations of United States and Germany.

There is a growing interest in applying pre-trained large language models (LLMs) to planning problems. However, methods that use LLMs directly as planners are currently impractical due to several factors, including limited correctness of plans, strong reliance on feedback from interactions with simulators or even the actual environment, and the inefficiency in utilizing human feedback. In this work, we introduce a novel alternative paradigm that constructs an explicit world (domain) model in planning domain definition language (PDDL) and then uses it to plan with sound domain-independent planners. To address the fact that LLMs may not generate a fully functional PDDL model initially, we employ LLMs as an interface between PDDL and sources of corrective feedback, such as PDDL validators and humans. For users who lack a background in PDDL, we show that LLMs can translate PDDL into natural language and effectively encode corrective feedback back to the underlying domain model. Our framework not only enjoys the correctness guarantee offered by the external planners but also reduces human involvement by allowing users to correct domain models at the beginning, rather than inspecting and correcting (through interactive prompting) every generated plan as in previous work. On two IPC domains and a Household domain that is more complicated than commonly used benchmarks such as ALFWorld, we demonstrate that GPT-4 can be leveraged to produce high-quality PDDL models for over 40 actions, and the corrected PDDL models are then used to successfully solve 48 challenging planning tasks. Resources including the source code will be released at: https://guansuns.github.io/pages/llm-dm.

Recent research on large language models (LLMs) has primarily focused on their adaptation and application in specialized domains. The application of LLMs in the medical field is mainly concentrated on tasks such as the automation of medical report generation, summarization, diagnostic reasoning, and question-and-answer interactions between doctors and patients. The challenge of becoming a good teacher is more formidable than that of becoming a good student, and this study pioneers the application of LLMs in the field of medical education. In this work, we investigate the extent to which LLMs can generate medical qualification exam questions and corresponding answers based on few-shot prompts. Utilizing a real-world Chinese dataset of elderly chronic diseases, we tasked the LLMs with generating open-ended questions and answers based on a subset of sampled admission reports across eight widely used LLMs, including ERNIE 4, ChatGLM 4, Doubao, Hunyuan, Spark 4, Qwen, Llama 3, and Mistral. Furthermore, we engaged medical experts to manually evaluate these open-ended questions and answers across multiple dimensions. The study found that LLMs, after using few-shot prompts, can effectively mimic real-world medical qualification exam questions, whereas there is room for improvement in the correctness, evidence-based statements, and professionalism of the generated answers. Moreover, LLMs also demonstrate a decent level of ability to correct and rectify reference answers. Given the immense potential of artificial intelligence in the medical field, the task of generating questions and answers for medical qualification exams aimed at medical students, interns and residents can be a significant focus of future research.

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.

Collecting large amounts of real-world interaction data to train general robotic policies is often prohibitively expensive, thus motivating the use of simulation data. However, existing methods for data generation have generally focused on scene-level diversity (e.g., object instances and poses) rather than task-level diversity, due to the human effort required to come up with and verify novel tasks. This has made it challenging for policies trained on simulation data to demonstrate significant task-level generalization. In this paper, we propose to automatically generate rich simulation environments and expert demonstrations by exploiting a large language models' (LLM) grounding and coding ability. Our approach, dubbed GenSim, has two modes: goal-directed generation, wherein a target task is given to the LLM and the LLM proposes a task curriculum to solve the target task, and exploratory generation, wherein the LLM bootstraps from previous tasks and iteratively proposes novel tasks that would be helpful in solving more complex tasks. We use GPT4 to expand the existing benchmark by ten times to over 100 tasks, on which we conduct supervised finetuning and evaluate several LLMs including finetuned GPTs and Code Llama on code generation for robotic simulation tasks. Furthermore, we observe that LLMs-generated simulation programs can enhance task-level generalization significantly when used for multitask policy training. We further find that with minimal sim-to-real adaptation, the multitask policies pretrained on GPT4-generated simulation tasks exhibit stronger transfer to unseen long-horizon tasks in the real world and outperform baselines by 25%. See the project website (https://liruiw.github.io/gensim) for code, demos, and videos.

Background: Rapid advancements in natural language processing have led to the development of large language models with the potential to revolutionize mental health care. These models have shown promise in assisting clinicians and providing support to individuals experiencing various psychological challenges. Objective: This study aims to compare the performance of two large language models, GPT-4 and Chat-GPT, in responding to a set of 18 psychological prompts, to assess their potential applicability in mental health care settings. Methods: A blind methodology was employed, with a clinical psychologist evaluating the models' responses without knowledge of their origins. The prompts encompassed a diverse range of mental health topics, including depression, anxiety, and trauma, to ensure a comprehensive assessment. Results: The results demonstrated a significant difference in performance between the two models (p > 0.05). GPT-4 achieved an average rating of 8.29 out of 10, while Chat-GPT received an average rating of 6.52. The clinical psychologist's evaluation suggested that GPT-4 was more effective at generating clinically relevant and empathetic responses, thereby providing better support and guidance to potential users. Conclusions: This study contributes to the growing body of literature on the applicability of large language models in mental health care settings. The findings underscore the importance of continued research and development in the field to optimize these models for clinical use. Further investigation is necessary to understand the specific factors underlying the performance differences between the two models and to explore their generalizability across various populations and mental health conditions.

The increasing use of tools and solutions based on Large Language Models (LLMs) for various tasks in the medical domain has become a prominent trend. Their use in this highly critical and sensitive domain has thus raised important questions about their robustness, especially in response to variations in input, and the reliability of the generated outputs. This study addresses these questions by constructing a textual dataset based on the ICD-10-CM code descriptions, widely used in US hospitals and containing many clinical terms, and their easily reproducible rephrasing. We then benchmarked existing embedding models, either generalist or specialized in the clinical domain, in a semantic search task where the goal was to correctly match the rephrased text to the original description. Our results showed that generalist models performed better than clinical models, suggesting that existing clinical specialized models are more sensitive to small changes in input that confuse them. The highlighted problem of specialized models may be due to the fact that they have not been trained on sufficient data, and in particular on datasets that are not diverse enough to have a reliable global language understanding, which is still necessary for accurate handling of medical documents.

Recently, large language model (LLM) based artificial intelligence (AI) systems have demonstrated remarkable capabilities in natural language understanding and generation. However, these models face a significant challenge when it comes to sensitive applications, such as reasoning over medical knowledge and answering medical questions in a physician-like manner. Prior studies attempted to overcome this challenge by increasing the model size (>100B) to learn more general medical knowledge, while there is still room for improvement in LLMs with smaller-scale model sizes (<100B). In this work, we start from a pre-trained general LLM model (AntGLM-10B) and fine-tune it from a medical beginner towards a medical expert (called AntGLM-Med-10B), which leverages a 3-stage optimization procedure, i.e., general medical knowledge injection, medical domain instruction tuning, and specific medical task adaptation. Our contributions are threefold: (1) We specifically investigate how to adapt a pre-trained general LLM in medical domain, especially for a specific medical task. (2) We collect and construct large-scale medical datasets for each stage of the optimization process. These datasets encompass various data types and tasks, such as question-answering, medical reasoning, multi-choice questions, and medical conversations. (3) Specifically for multi-choice questions in the medical domain, we propose a novel Verification-of-Choice approach for prompting engineering, which significantly enhances the reasoning ability of LLMs. Remarkably, by combining the above approaches, our AntGLM-Med-10B model can outperform the most of LLMs on PubMedQA, including both general and medical LLMs, even when these LLMs have larger model size.

Generative AI applications, such as ChatGPT or DALL-E, have shown the world their impressive capabilities in generating human-like text or image. Diving deeper, the science stakeholder for those AI applications are Deep Generative Models, a.k.a DGMs, which are designed to learn the underlying distribution of the data and generate new data points that are statistically similar to the original dataset. One critical question is raised: how can we leverage DGMs into morden retail supply chain realm? To address this question, this paper expects to provide a comprehensive review of DGMs and discuss their existing and potential usecases in retail supply chain, by (1) providing a taxonomy and overview of state-of-the-art DGMs and their variants, (2) reviewing existing DGM applications in retail supply chain from a end-to-end view of point, and (3) discussing insights and potential directions on how DGMs can be further utilized on solving retail supply chain problems.

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.

Generalist foundation models such as GPT-4 have displayed surprising capabilities in a wide variety of domains and tasks. Yet, there is a prevalent assumption that they cannot match specialist capabilities of fine-tuned models. For example, most explorations to date on medical competency benchmarks have leveraged domain-specific training, as exemplified by efforts on BioGPT and Med-PaLM. We build on a prior study of GPT-4's capabilities on medical challenge benchmarks in the absence of special training. Rather than using simple prompting to highlight the model's out-of-the-box capabilities, we perform a systematic exploration of prompt engineering. We find that prompting innovation can unlock deeper specialist capabilities and show that GPT-4 easily tops prior leading results for medical benchmarks. The prompting methods we explore are general purpose, and make no specific use of domain expertise, removing the need for expert-curated content. Our experimental design carefully controls for overfitting during the prompt engineering process. We introduce Medprompt, based on a composition of several prompting strategies. With Medprompt, GPT-4 achieves state-of-the-art results on all nine of the benchmark datasets in the MultiMedQA suite. The method outperforms leading specialist models such as Med-PaLM 2 by a significant margin with an order of magnitude fewer calls to the model. Steering GPT-4 with Medprompt achieves a 27% reduction in error rate on the MedQA dataset over the best methods to date achieved with specialist models and surpasses a score of 90% for the first time. Beyond medical problems, we show the power of Medprompt to generalize to other domains and provide evidence for the broad applicability of the approach via studies of the strategy on exams in electrical engineering, machine learning, philosophy, accounting, law, nursing, and clinical psychology.

Accurately forecasting patient arrivals at Urgent Care Clinics (UCCs) and Emergency Departments (EDs) is important for effective resourcing and patient care. However, correctly estimating patient flows is not straightforward since it depends on many drivers. The predictability of patient arrivals has recently been further complicated by the COVID-19 pandemic conditions and the resulting lockdowns. This study investigates how a suite of novel quasi-real-time variables like Google search terms, pedestrian traffic, the prevailing incidence levels of influenza, as well as the COVID-19 Alert Level indicators can both generally improve the forecasting models of patient flows and effectively adapt the models to the unfolding disruptions of pandemic conditions. This research also uniquely contributes to the body of work in this domain by employing tools from the eXplainable AI field to investigate more deeply the internal mechanics of the models than has previously been done. The Voting ensemble-based method combining machine learning and statistical techniques was the most reliable in our experiments. Our study showed that the prevailing COVID-19 Alert Level feature together with Google search terms and pedestrian traffic were effective at producing generalisable forecasts. The implications of this study are that proxy variables can effectively augment standard autoregressive features to ensure accurate forecasting of patient flows. The experiments showed that the proposed features are potentially effective model inputs for preserving forecast accuracies in the event of future pandemic outbreaks.

Reproducibility remains a significant challenge in machine learning (ML) for healthcare. In this field, datasets, model pipelines, and even task/cohort definitions are often private, leading to a significant barrier in sharing, iterating, and understanding ML results on electronic health record (EHR) datasets. In this paper, we address a significant part of this problem by introducing the Automatic Cohort Extraction System for Event-Stream Datasets (ACES). This tool is designed to simultaneously simplify the development of task/cohorts for ML in healthcare and enable the reproduction of these cohorts, both at an exact level for single datasets and at a conceptual level across datasets. To accomplish this, ACES provides (1) a highly intuitive and expressive configuration language for defining both dataset-specific concepts and dataset-agnostic inclusion/exclusion criteria, and (2) a pipeline to automatically extract patient records that meet these defined criteria from real-world data. ACES can be automatically applied to any dataset in either the Medical Event Data Standard (MEDS) or EventStreamGPT (ESGPT) formats, or to *any* dataset for which the necessary task-specific predicates can be extracted in an event-stream form. ACES has the potential to significantly lower the barrier to entry for defining ML tasks, redefine the way researchers interact with EHR datasets, and significantly improve the state of reproducibility for ML studies in this modality. ACES is available at https://github.com/justin13601/aces.

This paper studies close-loop task planning, which refers to the process of generating a sequence of skills (a plan) to accomplish a specific goal while adapting the plan based on real-time observations. Recently, prompting Large Language Models (LLMs) to generate actions iteratively has become a prevalent paradigm due to its superior performance and user-friendliness. However, this paradigm is plagued by two inefficiencies: high token consumption and redundant error correction, both of which hinder its scalability for large-scale testing and applications. To address these issues, we propose Tree-Planner, which reframes task planning with LLMs into three distinct phases: plan sampling, action tree construction, and grounded deciding. Tree-Planner starts by using an LLM to sample a set of potential plans before execution, followed by the aggregation of them to form an action tree. Finally, the LLM performs a top-down decision-making process on the tree, taking into account real-time environmental information. Experiments show that Tree-Planner achieves state-of-the-art performance while maintaining high efficiency. By decomposing LLM queries into a single plan-sampling call and multiple grounded-deciding calls, a considerable part of the prompt are less likely to be repeatedly consumed. As a result, token consumption is reduced by 92.2% compared to the previously best-performing model. Additionally, by enabling backtracking on the action tree as needed, the correction process becomes more flexible, leading to a 40.5% decrease in error corrections. Project page: https://tree-planner.github.io/

Synthetic data generation has the potential to impact applications and domains with scarce data. However, before such data is used for sensitive tasks such as mental health, we need an understanding of how different demographics are represented in it. In our paper, we analyze the potential of producing synthetic data using GPT-3 by exploring the various stressors it attributes to different race and gender combinations, to provide insight for future researchers looking into using LLMs for data generation. Using GPT-3, we develop HEADROOM, a synthetic dataset of 3,120 posts about depression-triggering stressors, by controlling for race, gender, and time frame (before and after COVID-19). Using this dataset, we conduct semantic and lexical analyses to (1) identify the predominant stressors for each demographic group; and (2) compare our synthetic data to a human-generated dataset. We present the procedures to generate queries to develop depression data using GPT-3, and conduct analyzes to uncover the types of stressors it assigns to demographic groups, which could be used to test the limitations of LLMs for synthetic data generation for depression data. Our findings show that synthetic data mimics some of the human-generated data distribution for the predominant depression stressors across diverse demographics.

This paper gives an overview of the latest applications of Large Language Models (LLMs) in the healthcare sector, highlighting their transformative role in enhancing medical care quality. By processing vast amounts of data from diverse medical domains, LLMs have become pivotal in assisting doctors, healthcare providers, and patients. We explore their utilization in various medical specialties, such as cancer diagnostics, dentistry, nephrology, dermatology, etc. The paper includes the LLM methodologies applied in various medical specialties, different data types in the medical domains and the relevant input formatting for LLMs, along with practical use-cases of LLMs in the healthcare domain.

Extracting patient information from unstructured text is a critical task in health decision-support and clinical research. Large language models (LLMs) have shown the potential to accelerate clinical curation via few-shot in-context learning, in contrast to supervised learning which requires much more costly human annotations. However, despite drastic advances in modern LLMs such as GPT-4, they still struggle with issues regarding accuracy and interpretability, especially in mission-critical domains such as health. Here, we explore a general mitigation framework using self-verification, which leverages the LLM to provide provenance for its own extraction and check its own outputs. This is made possible by the asymmetry between verification and generation, where the latter is often much easier than the former. Experimental results show that our method consistently improves accuracy for various LLMs in standard clinical information extraction tasks. Additionally, self-verification yields interpretations in the form of a short text span corresponding to each output, which makes it very efficient for human experts to audit the results, paving the way towards trustworthy extraction of clinical information in resource-constrained scenarios. To facilitate future research in this direction, we release our code and prompts.

How do we communicate with others to achieve our goals? We use our prior experience or advice from others, or construct a candidate utterance by predicting how it will be received. However, our experiences are limited and biased, and reasoning about potential outcomes can be difficult and cognitively challenging. In this paper, we explore how we can leverage Large Language Model (LLM) simulations to help us communicate better. We propose the Explore-Generate-Simulate (EGS) framework, which takes as input any scenario where an individual is communicating to an audience with a goal they want to achieve. EGS (1) explores the solution space by producing a diverse set of advice relevant to the scenario, (2) generates communication candidates conditioned on subsets of the advice, and (3) simulates the reactions from various audiences to determine both the best candidate and advice to use. We evaluate the framework on eight scenarios spanning the ten fundamental processes of interpersonal communication. For each scenario, we collect a dataset of human evaluations across candidates and baselines, and showcase that our framework's chosen candidate is preferred over popular generation mechanisms including Chain-of-Thought. We also find that audience simulations achieve reasonably high agreement with human raters across 5 of the 8 scenarios. Finally, we demonstrate the generality of our framework by applying it to real-world scenarios described by users on web forums. Through evaluations and demonstrations, we show that EGS enhances the effectiveness and outcomes of goal-oriented communication across a variety of situations, thus opening up new possibilities for the application of large language models in revolutionizing communication and decision-making processes.

As the capabilities of Large Language Models (LLMs) in healthcare and medicine continue to advance, there is a growing need for competitive open-source models that can safeguard public interest. With the increasing availability of highly competitive open base models, the impact of continued pre-training is increasingly uncertain. In this work, we explore the role of instruct tuning, model merging, alignment, red teaming and advanced inference schemes, as means to improve current open models. To that end, we introduce the Aloe family, a set of open medical LLMs highly competitive within its scale range. Aloe models are trained on the current best base models (Mistral, LLaMA 3), using a new custom dataset which combines public data sources improved with synthetic Chain of Thought (CoT). Aloe models undergo an alignment phase, becoming one of the first few policy-aligned open healthcare LLM using Direct Preference Optimization, setting a new standard for ethical performance in healthcare LLMs. Model evaluation expands to include various bias and toxicity datasets, a dedicated red teaming effort, and a much-needed risk assessment for healthcare LLMs. Finally, to explore the limits of current LLMs in inference, we study several advanced prompt engineering strategies to boost performance across benchmarks, yielding state-of-the-art results for open healthcare 7B LLMs, unprecedented at this scale.

Traditional applications of natural language processing (NLP) in healthcare have predominantly focused on patient-centered services, enhancing patient interactions and care delivery, such as through medical dialogue systems. However, the potential of NLP to benefit inexperienced doctors, particularly in areas such as communicative medical coaching, remains largely unexplored. We introduce ``ChatCoach,'' an integrated human-AI cooperative framework. Within this framework, both a patient agent and a coaching agent collaboratively support medical learners in practicing their medical communication skills during consultations. Unlike traditional dialogue systems, ChatCoach provides a simulated environment where a human doctor can engage in medical dialogue with a patient agent. Simultaneously, a coaching agent provides real-time feedback to the doctor. To construct the ChatCoach system, we developed a dataset and integrated Large Language Models such as ChatGPT and Llama2, aiming to assess their effectiveness in communicative medical coaching tasks. Our comparative analysis demonstrates that instruction-tuned Llama2 significantly outperforms ChatGPT's prompting-based approaches.

Diagnosing and managing a patient is a complex, sequential decision making process that requires physicians to obtain information -- such as which tests to perform -- and to act upon it. Recent advances in artificial intelligence (AI) and large language models (LLMs) promise to profoundly impact clinical care. However, current evaluation schemes overrely on static medical question-answering benchmarks, falling short on interactive decision-making that is required in real-life clinical work. Here, we present AgentClinic: a multimodal benchmark to evaluate LLMs in their ability to operate as agents in simulated clinical environments. In our benchmark, the doctor agent must uncover the patient's diagnosis through dialogue and active data collection. We present two open medical agent benchmarks: a multimodal image and dialogue environment, AgentClinic-NEJM, and a dialogue-only environment, AgentClinic-MedQA. We embed cognitive and implicit biases both in patient and doctor agents to emulate realistic interactions between biased agents. We find that introducing bias leads to large reductions in diagnostic accuracy of the doctor agents, as well as reduced compliance, confidence, and follow-up consultation willingness in patient agents. Evaluating a suite of state-of-the-art LLMs, we find that several models that excel in benchmarks like MedQA are performing poorly in AgentClinic-MedQA. We find that the LLM used in the patient agent is an important factor for performance in the AgentClinic benchmark. We show that both having limited interactions as well as too many interaction reduces diagnostic accuracy in doctor agents. The code and data for this work is publicly available at https://AgentClinic.github.io.

Systems that support users in the automatic creation of visualizations must address several subtasks - understand the semantics of data, enumerate relevant visualization goals and generate visualization specifications. In this work, we pose visualization generation as a multi-stage generation problem and argue that well-orchestrated pipelines based on large language models (LLMs) such as ChatGPT/GPT-4 and image generation models (IGMs) are suitable to addressing these tasks. We present LIDA, a novel tool for generating grammar-agnostic visualizations and infographics. LIDA comprises of 4 modules - A SUMMARIZER that converts data into a rich but compact natural language summary, a GOAL EXPLORER that enumerates visualization goals given the data, a VISGENERATOR that generates, refines, executes and filters visualization code and an INFOGRAPHER module that yields data-faithful stylized graphics using IGMs. LIDA provides a python api, and a hybrid user interface (direct manipulation and multilingual natural language) for interactive chart, infographics and data story generation. Learn more about the project here - https://microsoft.github.io/lida/

The ability of large language models (LLMs) to follow natural language instructions with human-level fluency suggests many opportunities in healthcare to reduce administrative burden and improve quality of care. However, evaluating LLMs on realistic text generation tasks for healthcare remains challenging. Existing question answering datasets for electronic health record (EHR) data fail to capture the complexity of information needs and documentation burdens experienced by clinicians. To address these challenges, we introduce MedAlign, a benchmark dataset of 983 natural language instructions for EHR data. MedAlign is curated by 15 clinicians (7 specialities), includes clinician-written reference responses for 303 instructions, and provides 276 longitudinal EHRs for grounding instruction-response pairs. We used MedAlign to evaluate 6 general domain LLMs, having clinicians rank the accuracy and quality of each LLM response. We found high error rates, ranging from 35% (GPT-4) to 68% (MPT-7B-Instruct), and an 8.3% drop in accuracy moving from 32k to 2k context lengths for GPT-4. Finally, we report correlations between clinician rankings and automated natural language generation metrics as a way to rank LLMs without human review. We make MedAlign available under a research data use agreement to enable LLM evaluations on tasks aligned with clinician needs and preferences.

Inference-time search algorithms such as Monte-Carlo Tree Search (MCTS) may seem unnecessary when generating natural language text based on state-of-the-art reinforcement learning such as Proximal Policy Optimization (PPO). In this paper, we demonstrate that it is possible to get extra mileage out of PPO by integrating MCTS on top. The key idea is not to throw out the value network, a byproduct of PPO training for evaluating partial output sequences, when decoding text out of the policy network. More concretely, we present a novel value-guided decoding algorithm called PPO-MCTS, which can integrate the value network from PPO to work closely with the policy network during inference-time generation. Compared to prior approaches based on MCTS for controlled text generation, the key strength of our approach is to reduce the fundamental mismatch of the scoring mechanisms of the partial outputs between training and test. Evaluation on four text generation tasks demonstrate that PPO-MCTS greatly improves the preferability of generated text compared to the standard practice of using only the PPO policy. Our results demonstrate the promise of search algorithms even on top of the aligned language models from PPO, and the under-explored benefit of the value network.

Procedural planning aims to implement complex high-level goals by decomposition into sequential simpler low-level steps. Although procedural planning is a basic skill set for humans in daily life, it remains a challenge for large language models (LLMs) that lack a deep understanding of the cause-effect relations in procedures. Previous methods require manual exemplars to acquire procedural planning knowledge from LLMs in the zero-shot setting. However, such elicited pre-trained knowledge in LLMs induces spurious correlations between goals and steps, which impair the model generalization to unseen tasks. In contrast, this paper proposes a neuro-symbolic procedural PLANner (PLAN) that elicits procedural planning knowledge from the LLMs with commonsense-infused prompting. To mitigate spurious goal-step correlations, we use symbolic program executors on the latent procedural representations to formalize prompts from commonsense knowledge bases as a causal intervention toward the Structural Causal Model. Both automatic and human evaluations on WikiHow and RobotHow show the superiority of PLAN on procedural planning without further training or manual exemplars.

In the field of urban planning, general-purpose large language models often struggle to meet the specific needs of planners. Tasks like generating urban planning texts, retrieving related information, and evaluating planning documents pose unique challenges. To enhance the efficiency of urban professionals and overcome these obstacles, we introduce PlanGPT, the first specialized Large Language Model tailored for urban and spatial planning. Developed through collaborative efforts with institutions like the Chinese Academy of Urban Planning, PlanGPT leverages a customized local database retrieval framework, domain-specific fine-tuning of base models, and advanced tooling capabilities. Empirical tests demonstrate that PlanGPT has achieved advanced performance, delivering responses of superior quality precisely tailored to the intricacies of urban planning.

Traditional POI recommendation systems often lack transparency, interpretability, and scrutability due to their reliance on dense vector-based user embeddings. Furthermore, the cold-start problem -- where systems have insufficient data for new users -- limits their ability to generate accurate recommendations. Existing methods often address this by leveraging similar trajectories from other users, but this approach can be computationally expensive and increases the context length for LLM-based methods, making them difficult to scale. To address these limitations, we propose a method that generates natural language (NL) user profiles from large-scale, location-based social network (LBSN) check-ins, utilizing robust personality assessments and behavioral theories. These NL profiles capture user preferences, routines, and behaviors, improving POI prediction accuracy while offering enhanced transparency. By incorporating NL profiles as system prompts to LLMs, our approach reduces reliance on extensive historical data, while remaining flexible, easily updated, and computationally efficient. Our method is not only competitive with other LLM-based and complex agentic frameworks but is also more scalable for real-world scenarios and on-device POI recommendations. Results demonstrate that our approach consistently outperforms baseline methods, offering a more interpretable and resource-efficient solution for POI recommendation systems. Our source code is available at: https://github.com/w11wo/GenUP.

Video generation has been used to generate visual plans for controlling robotic systems. Given an image observation and a language instruction, previous work has generated video plans which are then converted to robot controls to be executed. However, a major bottleneck in leveraging video generation for control lies in the quality of the generated videos, which often suffer from hallucinatory content and unrealistic physics, resulting in low task success when control actions are extracted from the generated videos. While scaling up dataset and model size provides a partial solution, integrating external feedback is both natural and essential for grounding video generation in the real world. With this observation, we propose VideoAgent for self-improving generated video plans based on external feedback. Instead of directly executing the generated video plan, VideoAgent first refines the generated video plans using a novel procedure which we call self-conditioning consistency, allowing inference-time compute to be turned into better generated video plans. As the refined video plan is being executed, VideoAgent can collect additional data from the environment to further improve video plan generation. Experiments in simulated robotic manipulation from MetaWorld and iTHOR show that VideoAgent drastically reduces hallucination, thereby boosting success rate of downstream manipulation tasks. We further illustrate that VideoAgent can effectively refine real-robot videos, providing an early indicator that robots can be an effective tool in grounding video generation in the physical world. Video demos and code can be found at https://video-as-agent.github.io.

The rapid development of Large Language Models (LLMs) for healthcare applications has spurred calls for holistic evaluation beyond frequently-cited benchmarks like USMLE, to better reflect real-world performance. While real-world assessments are valuable indicators of utility, they often lag behind the pace of LLM evolution, likely rendering findings obsolete upon deployment. This temporal disconnect necessitates a comprehensive upfront evaluation that can guide model selection for specific clinical applications. We introduce MEDIC, a framework assessing LLMs across five critical dimensions of clinical competence: medical reasoning, ethics and bias, data and language understanding, in-context learning, and clinical safety. MEDIC features a novel cross-examination framework quantifying LLM performance across areas like coverage and hallucination detection, without requiring reference outputs. We apply MEDIC to evaluate LLMs on medical question-answering, safety, summarization, note generation, and other tasks. Our results show performance disparities across model sizes, baseline vs medically finetuned models, and have implications on model selection for applications requiring specific model strengths, such as low hallucination or lower cost of inference. MEDIC's multifaceted evaluation reveals these performance trade-offs, bridging the gap between theoretical capabilities and practical implementation in healthcare settings, ensuring that the most promising models are identified and adapted for diverse healthcare applications.

Transformers have significantly advanced the modeling of Electronic Health Records (EHR), yet their deployment in real-world healthcare is limited by several key challenges. Firstly, the quadratic computational cost and insufficient context length of these models pose significant obstacles for hospitals in processing the extensive medical histories typical in EHR data. Additionally, existing models employ separate finetuning for each clinical task, complicating maintenance in healthcare environments. Moreover, these models focus exclusively on either clinical prediction or EHR forecasting, lacking the flexibility to perform well across both. To overcome these limitations, we introduce EHRMamba, a robust foundation model built on the Mamba architecture. EHRMamba can process sequences up to four times longer than previous models due to its linear computational cost. We also introduce a novel approach to Multitask Prompted Finetuning (MTF) for EHR data, which enables EHRMamba to simultaneously learn multiple clinical tasks in a single finetuning phase, significantly enhancing deployment and cross-task generalization. Furthermore, our model leverages the HL7 FHIR data standard to simplify integration into existing hospital systems. Alongside EHRMamba, we open-source Odyssey, a toolkit designed to support the development and deployment of EHR foundation models, with an emphasis on data standardization and interpretability. Our evaluations on the MIMIC-IV dataset demonstrate that EHRMamba advances state-of-the-art performance across 6 major clinical tasks and excels in EHR forecasting, marking a significant leap forward in the field.

In recent years, the machine learning research community has benefited tremendously from the availability of openly accessible benchmark datasets. Clinical data are usually not openly available due to their highly confidential nature. This has hampered the development of reproducible and generalisable machine learning applications in health care. Here we introduce the Health Gym - a growing collection of highly realistic synthetic medical datasets that can be freely accessed to prototype, evaluate, and compare machine learning algorithms, with a specific focus on reinforcement learning. The three synthetic datasets described in this paper present patient cohorts with acute hypotension and sepsis in the intensive care unit, and people with human immunodeficiency virus (HIV) receiving antiretroviral therapy in ambulatory care. The datasets were created using a novel generative adversarial network (GAN). The distributions of variables, and correlations between variables and trends over time in the synthetic datasets mirror those in the real datasets. Furthermore, the risk of sensitive information disclosure associated with the public distribution of the synthetic datasets is estimated to be very low.

Effective planning is essential for the success of any task, from organizing a vacation to routing autonomous vehicles and developing corporate strategies. It involves setting goals, formulating plans, and allocating resources to achieve them. LLMs are particularly well-suited for automated planning due to their strong capabilities in commonsense reasoning. They can deduce a sequence of actions needed to achieve a goal from a given state and identify an effective course of action. However, it is frequently observed that plans generated through direct prompting often fail upon execution. Our survey aims to highlight the existing challenges in planning with language models, focusing on key areas such as embodied environments, optimal scheduling, competitive and cooperative games, task decomposition, reasoning, and planning. Through this study, we explore how LLMs transform AI planning and provide unique insights into the future of LM-assisted planning.

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.

Large Language Models (LLMs) have been the subject of active research, significantly advancing the field of Natural Language Processing (NLP). From BERT to BLOOM, LLMs have surpassed state-of-the-art results in various natural language tasks such as question answering, summarization, and text generation. Many ongoing efforts focus on understanding LLMs' capabilities, including their knowledge of the world, syntax, and semantics. However, extending the textual prowess of LLMs to symbolic reasoning has been slow and predominantly focused on tackling problems related to the mathematical field. In this paper, we explore the use of LLMs for automated planning - a branch of AI concerned with the realization of action sequences (plans) to achieve a goal, typically executed by intelligent agents, autonomous robots, and unmanned vehicles. We introduce Plansformer; an LLM fine-tuned on planning problems and capable of generating plans with favorable behavior in terms of correctness and length with reduced knowledge-engineering efforts. We also demonstrate the adaptability of Plansformer in solving different planning domains with varying complexities, owing to the transfer learning abilities of LLMs. For one configuration of Plansformer, we achieve ~97% valid plans, out of which ~95% are optimal for Towers of Hanoi - a puzzle-solving domain.

In an era of model and data proliferation in machine learning/AI especially marked by the rapid advancement of open-sourced technologies, there arises a critical need for standardized consistent documentation. Our work addresses the information incompleteness in current human-generated model and data cards. We propose an automated generation approach using Large Language Models (LLMs). Our key contributions include the establishment of CardBench, a comprehensive dataset aggregated from over 4.8k model cards and 1.4k data cards, coupled with the development of the CardGen pipeline comprising a two-step retrieval process. Our approach exhibits enhanced completeness, objectivity, and faithfulness in generated model and data cards, a significant step in responsible AI documentation practices ensuring better accountability and traceability.

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.