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Mar 11

Automated Coding of Under-Studied Medical Concept Domains: Linking Physical Activity Reports to the International Classification of Functioning, Disability, and Health

Linking clinical narratives to standardized vocabularies and coding systems is a key component of unlocking the information in medical text for analysis. However, many domains of medical concepts lack well-developed terminologies that can support effective coding of medical text. We present a framework for developing natural language processing (NLP) technologies for automated coding of under-studied types of medical information, and demonstrate its applicability via a case study on physical mobility function. Mobility is a component of many health measures, from post-acute care and surgical outcomes to chronic frailty and disability, and is coded in the International Classification of Functioning, Disability, and Health (ICF). However, mobility and other types of functional activity remain under-studied in medical informatics, and neither the ICF nor commonly-used medical terminologies capture functional status terminology in practice. We investigated two data-driven paradigms, classification and candidate selection, to link narrative observations of mobility to standardized ICF codes, using a dataset of clinical narratives from physical therapy encounters. Recent advances in language modeling and word embedding were used as features for established machine learning models and a novel deep learning approach, achieving a macro F-1 score of 84% on linking mobility activity reports to ICF codes. Both classification and candidate selection approaches present distinct strengths for automated coding in under-studied domains, and we highlight that the combination of (i) a small annotated data set; (ii) expert definitions of codes of interest; and (iii) a representative text corpus is sufficient to produce high-performing automated coding systems. This study has implications for the ongoing growth of NLP tools for a variety of specialized applications in clinical care and research.

Coordinate Transformer: Achieving Single-stage Multi-person Mesh Recovery from Videos

Multi-person 3D mesh recovery from videos is a critical first step towards automatic perception of group behavior in virtual reality, physical therapy and beyond. However, existing approaches rely on multi-stage paradigms, where the person detection and tracking stages are performed in a multi-person setting, while temporal dynamics are only modeled for one person at a time. Consequently, their performance is severely limited by the lack of inter-person interactions in the spatial-temporal mesh recovery, as well as by detection and tracking defects. To address these challenges, we propose the Coordinate transFormer (CoordFormer) that directly models multi-person spatial-temporal relations and simultaneously performs multi-mesh recovery in an end-to-end manner. Instead of partitioning the feature map into coarse-scale patch-wise tokens, CoordFormer leverages a novel Coordinate-Aware Attention to preserve pixel-level spatial-temporal coordinate information. Additionally, we propose a simple, yet effective Body Center Attention mechanism to fuse position information. Extensive experiments on the 3DPW dataset demonstrate that CoordFormer significantly improves the state-of-the-art, outperforming the previously best results by 4.2%, 8.8% and 4.7% according to the MPJPE, PAMPJPE, and PVE metrics, respectively, while being 40% faster than recent video-based approaches. The released code can be found at https://github.com/Li-Hao-yuan/CoordFormer.

Therapy as an NLP Task: Psychologists' Comparison of LLMs and Human Peers in CBT

Wider access to therapeutic care is one of the biggest challenges in mental health treatment. Due to institutional barriers, some people seeking mental health support have turned to large language models (LLMs) for personalized therapy, even though these models are largely unsanctioned and untested. We investigate the potential and limitations of using LLMs as providers of evidence-based therapy by using mixed methods clinical metrics. Using HELPERT, a prompt run on a large language model using the same process and training as a comparative group of peer counselors, we replicated publicly accessible mental health conversations rooted in Cognitive Behavioral Therapy (CBT) to compare session dynamics and counselor's CBT-based behaviors between original peer support sessions and their reconstructed HELPERT sessions. Two licensed, CBT-trained clinical psychologists evaluated the sessions using the Cognitive Therapy Rating Scale and provided qualitative feedback. Our findings show that the peer sessions are characterized by empathy, small talk, therapeutic alliance, and shared experiences but often exhibit therapist drift. Conversely, HELPERT reconstructed sessions exhibit minimal therapist drift and higher adherence to CBT methods but display a lack of collaboration, empathy, and cultural understanding. Through CTRS ratings and psychologists' feedback, we highlight the importance of human-AI collaboration for scalable mental health. Our work outlines the ethical implication of imparting human-like subjective qualities to LLMs in therapeutic settings, particularly the risk of deceptive empathy, which may lead to unrealistic patient expectations and potential harm.

High-density Electromyography for Effective Gesture-based Control of Physically Assistive Mobile Manipulators

Injury to the cervical spinal cord can cause quadriplegia, impairing muscle function in all four limbs. People with impaired hand function and mobility encounter significant difficulties in carrying out essential self-care and household tasks. Despite the impairment of their neural drive, their volitional myoelectric activity is often partially preserved. High-density electromyography (HDEMG) can detect this myoelectric activity, which can serve as control inputs to assistive devices. Previous HDEMG-controlled robotic interfaces have primarily been limited to controlling table-mounted robot arms. These have constrained reach capabilities. Instead, the ability to control mobile manipulators, which have no such workspace constraints, could allow individuals with quadriplegia to perform a greater variety of assistive tasks, thus restoring independence and reducing caregiver workload. In this study, we introduce a non-invasive wearable HDEMG interface with real-time myoelectric hand gesture recognition, enabling both coarse and fine control over the intricate mobility and manipulation functionalities of an 8 degree-of-freedom mobile manipulator. Our evaluation, involving 13 participants engaging in challenging self-care and household activities, demonstrates the potential of our wearable HDEMG system to profoundly enhance user independence by enabling non-invasive control of a mobile manipulator.