Daily Papers

Understanding how diverse individuals and communities respond to persuasive messaging holds significant potential for advancing personalized and socially aware machine learning. While Large Vision and Language Models (VLMs) offer promise, their ability to emulate nuanced, heterogeneous human responses, particularly in high stakes domains like public health, remains underexplored due in part to the lack of comprehensive, multimodal dataset. We introduce PHORECAST (Public Health Outreach REceptivity and CAmpaign Signal Tracking), a multimodal dataset curated to enable fine-grained prediction of both individuallevel behavioral responses and community-wide engagement patterns to health messaging. This dataset supports tasks in multimodal understanding, response prediction, personalization, and social forecasting, allowing rigorous evaluation of how well modern AI systems can emulate, interpret, and anticipate heterogeneous public sentiment and behavior. By providing a new dataset to enable AI advances for public health, PHORECAST aims to catalyze the development of models that are not only more socially aware but also aligned with the goals of adaptive and inclusive health communication

Current mental-health conversational systems are usually based on fixed, generic dialogue patterns. This paper proposes an adaptive framework based on large language models that aims to personalize therapeutic interaction according to a user's psychological state, quantified with the Acceptance of Illness Scale (AIS). The framework defines three specialized agents, L, M, and H, each linked to a different level of illness acceptance, and adjusts conversational behavior over time using continuous feedback signals. The AIS-stratified architecture is treated as a diegetic prototype placed in a plausible near-future setting and examined through the method of design fiction. By embedding the architecture in narrative scenarios, the study explores how such agents might influence access to care and therapeutic relationship. The goal is to show how clinically informed personalization, technical feasibility, and speculative scenario analysis can together inform the responsible design of LLM-based companions for mental-health support.

Health misinformation spreading online poses a significant threat to public health. Researchers have explored methods for automatically generating counterspeech to health misinformation as a mitigation strategy. Existing approaches often produce uniform responses, ignoring that the health literacy level of the audience could affect the accessibility and effectiveness of counterspeech. We propose a Controlled-Literacy framework using retrieval-augmented generation (RAG) with reinforcement learning (RL) to generate tailored counterspeech adapted to different health literacy levels. In particular, we retrieve knowledge aligned with specific health literacy levels, enabling accessible and factual information to support generation. We design a reward function incorporating subjective user preferences and objective readability-based rewards to optimize counterspeech to the target health literacy level. Experiment results show that Controlled-Literacy outperforms baselines by generating more accessible and user-preferred counterspeech. This research contributes to more equitable and impactful public health communication by improving the accessibility and comprehension of counterspeech to health misinformation

Addressing the imminent shortfall of 10 million health workers by 2030, predominantly in Low- and Middle-Income Countries (LMICs), this paper introduces an innovative approach that harnesses the power of Large Language Models (LLMs) integrated with machine translation models. This solution is engineered to meet the unique needs of Community Health Workers (CHWs), overcoming language barriers, cultural sensitivities, and the limited availability of medical dialog datasets. I have crafted a model that not only boasts superior translation capabilities but also undergoes rigorous fine-tuning on open-source datasets to ensure medical accuracy and is equipped with comprehensive safety features to counteract the risks of misinformation. Featuring a modular design, this approach is specifically structured for swift adaptation across various linguistic and cultural contexts, utilizing open-source components to significantly reduce healthcare operational costs. This strategic innovation markedly improves the accessibility and quality of healthcare services by providing CHWs with contextually appropriate medical knowledge and diagnostic tools. This paper highlights the transformative impact of this context-aware LLM, underscoring its crucial role in addressing the global healthcare workforce deficit and propelling forward healthcare outcomes in LMICs.

We explore the potential of ChatGPT (3.5-turbo and 4) to generate conversations focused on self-care strategies for African-American heart failure patients -- a domain with limited specialized datasets. To simulate patient-health educator dialogues, we employed four prompting strategies: domain, African American Vernacular English (AAVE), Social Determinants of Health (SDOH), and SDOH-informed reasoning. Conversations were generated across key self-care domains of food, exercise, and fluid intake, with varying turn lengths (5, 10, 15) and incorporated patient-specific SDOH attributes such as age, gender, neighborhood, and socioeconomic status. Our findings show that effective prompt design is essential. While incorporating SDOH and reasoning improves dialogue quality, ChatGPT still lacks the empathy and engagement needed for meaningful healthcare communication.

Rare diseases present unique challenges in healthcare, often suffering from delayed diagnosis and fragmented information landscapes. The scarcity of reliable knowledge in these conditions poses a distinct challenge for Large Language Models (LLMs) in supporting clinical management and delivering precise patient information underscoring the need for focused training on these 'zebra' cases. We present Zebra-Llama, a specialized context-aware language model with high precision Retrieval Augmented Generation (RAG) capability, focusing on Ehlers-Danlos Syndrome (EDS) as our case study. EDS, affecting 1 in 5,000 individuals, exemplifies the complexities of rare diseases with its diverse symptoms, multiple subtypes, and evolving diagnostic criteria. By implementing a novel context-aware fine-tuning methodology trained on questions derived from medical literature, patient experiences, and clinical resources, along with expertly curated responses, Zebra-Llama demonstrates unprecedented capabilities in handling EDS-related queries. On a test set of real-world questions collected from EDS patients and clinicians, medical experts evaluated the responses generated by both models, revealing Zebra-Llama's substantial improvements over base model (Llama 3.1-8B-Instruct) in thoroughness (77.5% vs. 70.1%), accuracy (83.0% vs. 78.8%), clarity (74.7% vs. 72.0%) and citation reliability (70.6% vs. 52.3%). Released as an open-source resource, Zebra-Llama not only provides more accessible and reliable EDS information but also establishes a framework for developing specialized AI solutions for other rare conditions. This work represents a crucial step towards democratizing expert-level knowledge in rare disease management, potentially transforming how healthcare providers and patients navigate the complex landscape of rare diseases.

Patient-generated text such as secure messages, surveys, and interviews contains rich expressions of the patient voice (PV), reflecting communicative behaviors and social determinants of health (SDoH). Traditional qualitative coding frameworks are labor intensive and do not scale to large volumes of patient-authored messages across health systems. Existing machine learning (ML) and natural language processing (NLP) approaches provide partial solutions but often treat patient-centered communication (PCC) and SDoH as separate tasks or rely on models not well suited to patient-facing language. We introduce PVminer, a domain-adapted NLP framework for structuring patient voice in secure patient-provider communication. PVminer formulates PV detection as a multi-label, multi-class prediction task integrating patient-specific BERT encoders (PV-BERT-base and PV-BERT-large), unsupervised topic modeling for thematic augmentation (PV-Topic-BERT), and fine-tuned classifiers for Code, Subcode, and Combo-level labels. Topic representations are incorporated during fine-tuning and inference to enrich semantic inputs. PVminer achieves strong performance across hierarchical tasks and outperforms biomedical and clinical pre-trained baselines, achieving F1 scores of 82.25% (Code), 80.14% (Subcode), and up to 77.87% (Combo). An ablation study further shows that author identity and topic-based augmentation each contribute meaningful gains. Pre-trained models, source code, and documentation will be publicly released, with annotated datasets available upon request for research use.

Limited access to mental healthcare, extended wait times, and increasing capabilities of Large Language Models (LLMs) has led individuals to turn to LLMs for fulfilling their mental health needs. However, examining the multi-turn mental health conversation capabilities of LLMs remains under-explored. Existing evaluation frameworks typically focus on diagnostic accuracy and win-rates and often overlook alignment with patient-specific goals, values, and personalities required for meaningful conversations. To address this, we introduce MedAgent, a novel framework for synthetically generating realistic, multi-turn mental health sensemaking conversations and use it to create the Mental Health Sensemaking Dialogue (MHSD) dataset, comprising over 2,200 patient-LLM conversations. Additionally, we present MultiSenseEval, a holistic framework to evaluate the multi-turn conversation abilities of LLMs in healthcare settings using human-centric criteria. Our findings reveal that frontier reasoning models yield below-par performance for patient-centric communication and struggle at advanced diagnostic capabilities with average score of 31%. Additionally, we observed variation in model performance based on patient's persona and performance drop with increasing turns in the conversation. Our work provides a comprehensive synthetic data generation framework, a dataset and evaluation framework for assessing LLMs in multi-turn mental health conversations.

People are increasingly seeking healthcare information from large language models (LLMs) via interactive chatbots, yet the nature and inherent risks of these conversations remain largely unexplored. In this paper, we filter large-scale conversational AI datasets to achieve HealthChat-11K, a curated dataset of 11K real-world conversations composed of 25K user messages. We use HealthChat-11K and a clinician-driven taxonomy for how users interact with LLMs when seeking healthcare information in order to systematically study user interactions across 21 distinct health specialties. Our analysis reveals insights into the nature of how and why users seek health information, such as common interactions, instances of incomplete context, affective behaviors, and interactions (e.g., leading questions) that can induce sycophancy, underscoring the need for improvements in the healthcare support capabilities of LLMs deployed as conversational AI. Code and artifacts to retrieve our analyses and combine them into a curated dataset can be found here: https://github.com/yahskapar/HealthChat

A user-generated text on social media enables health workers to keep track of information, identify possible outbreaks, forecast disease trends, monitor emergency cases, and ascertain disease awareness and response to official health correspondence. This exchange of health information on social media has been regarded as an attempt to enhance public health surveillance (PHS). Despite its potential, the technology is still in its early stages and is not ready for widespread application. Advancements in pretrained language models (PLMs) have facilitated the development of several domain-specific PLMs and a variety of downstream applications. However, there are no PLMs for social media tasks involving PHS. We present and release PHS-BERT, a transformer-based PLM, to identify tasks related to public health surveillance on social media. We compared and benchmarked the performance of PHS-BERT on 25 datasets from different social medial platforms related to 7 different PHS tasks. Compared with existing PLMs that are mainly evaluated on limited tasks, PHS-BERT achieved state-of-the-art performance on all 25 tested datasets, showing that our PLM is robust and generalizable in the common PHS tasks. By making PHS-BERT available, we aim to facilitate the community to reduce the computational cost and introduce new baselines for future works across various PHS-related tasks.

Large language models (LLMs) hold immense promise to serve complex health information needs but also have the potential to introduce harm and exacerbate health disparities. Reliably evaluating equity-related model failures is a critical step toward developing systems that promote health equity. In this work, we present resources and methodologies for surfacing biases with potential to precipitate equity-related harms in long-form, LLM-generated answers to medical questions and then conduct an empirical case study with Med-PaLM 2, resulting in the largest human evaluation study in this area to date. Our contributions include a multifactorial framework for human assessment of LLM-generated answers for biases, and EquityMedQA, a collection of seven newly-released datasets comprising both manually-curated and LLM-generated questions enriched for adversarial queries. Both our human assessment framework and dataset design process are grounded in an iterative participatory approach and review of possible biases in Med-PaLM 2 answers to adversarial queries. Through our empirical study, we find that the use of a collection of datasets curated through a variety of methodologies, coupled with a thorough evaluation protocol that leverages multiple assessment rubric designs and diverse rater groups, surfaces biases that may be missed via narrower evaluation approaches. Our experience underscores the importance of using diverse assessment methodologies and involving raters of varying backgrounds and expertise. We emphasize that while our framework can identify specific forms of bias, it is not sufficient to holistically assess whether the deployment of an AI system promotes equitable health outcomes. We hope the broader community leverages and builds on these tools and methods towards realizing a shared goal of LLMs that promote accessible and equitable healthcare for all.

Objective: The reading level of health educational materials significantly influences the understandability and accessibility of the information, particularly for minoritized populations. Many patient educational resources surpass the reading level and complexity of widely accepted standards. There is a critical need for high-performing text simplification models in health information to enhance dissemination and literacy. This need is particularly acute in cancer education, where effective prevention and screening education can substantially reduce morbidity and mortality. Methods: We introduce Simplified Digestive Cancer (SimpleDC), a parallel corpus of cancer education materials tailored for health text simplification research, comprising educational content from the American Cancer Society, Centers for Disease Control and Prevention, and National Cancer Institute. Utilizing SimpleDC alongside the existing Med-EASi corpus, we explore Large Language Model (LLM)-based simplification methods, including fine-tuning, reinforcement learning (RL), reinforcement learning with human feedback (RLHF), domain adaptation, and prompt-based approaches. Our experimentation encompasses Llama 2 and GPT-4. A novel RLHF reward function is introduced, featuring a lightweight model adept at distinguishing between original and simplified texts, thereby enhancing the model's effectiveness with unlabeled data. Results: Fine-tuned Llama 2 models demonstrated high performance across various metrics. Our innovative RLHF reward function surpassed existing RL text simplification reward functions in effectiveness. The results underscore that RL/RLHF can augment fine-tuning, facilitating model training on unlabeled text and improving performance.

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.

There has been an increasing research interest in developing specialized dialogue systems that can offer mental health support. However, gathering large-scale and real-life multi-turn conversations for mental health support poses challenges due to the sensitivity of personal information, as well as the time and cost involved. To address these issues, we introduce the SMILE approach, an inclusive language expansion technique that employs ChatGPT to extend public single-turn dialogues into multi-turn ones. Our research first presents a preliminary exploratory study that validates the effectiveness of the SMILE approach. Furthermore, we conduct a comprehensive and systematic contrastive analysis of datasets generated with and without the SMILE approach, demonstrating that the SMILE method results in a large-scale, diverse, and close-to-real-life multi-turn mental health support conversation corpus, including dialog topics, lexical and semantic features. Finally, we use the collected corpus (SMILECHAT) to develop a more effective dialogue system that offers emotional support and constructive suggestions in multi-turn conversations for mental health support.

Wildfires have become increasingly frequent, irregular, and severe in recent years. Understanding how affected populations perceive and respond during wildfire crises is critical for timely and empathetic disaster response. Social media platforms offer a crowd-sourced channel to capture evolving public discourse, providing hyperlocal information and insight into public sentiment. This study analyzes Reddit discourse during the 2025 Los Angeles wildfires, spanning from the onset of the disaster to full containment. We collect 385 posts and 114,879 comments related to the Palisades and Eaton fires. We adopt topic modeling methods to identify the latent topics, enhanced by large language models (LLMs) and human-in-the-loop (HITL) refinement. Furthermore, we develop a hierarchical framework to categorize latent topics, consisting of two main categories, Situational Awareness (SA) and Crisis Narratives (CN). The volume of SA category closely aligns with real-world fire progressions, peaking within the first 2-5 days as the fires reach the maximum extent. The most frequent co-occurring category set of public health and safety, loss and damage, and emergency resources expands on a wide range of health-related latent topics, including environmental health, occupational health, and one health. Grief signals and mental health risks consistently accounted for 60 percentage and 40 percentage of CN instances, respectively, with the highest total volume occurring at night. This study contributes the first annotated social media dataset on the 2025 LA fires, and introduces a scalable multi-layer framework that leverages topic modeling for crisis discourse analysis. By identifying persistent public health concerns, our results can inform more empathetic and adaptive strategies for disaster response, public health communication, and future research in comparable climate-related disaster events.

Large Language Models (LLMs) in mental healthcare risk propagating biases that reinforce stigma and harm marginalized groups. While previous research identified concerning trends, systematic methods for detecting intersectional biases remain limited. This work introduces a multi-hop question answering (MHQA) framework to explore LLM response biases in mental health discourse. We analyze content from the Interpretable Mental Health Instruction (IMHI) dataset across symptom presentation, coping mechanisms, and treatment approaches. Using systematic tagging across age, race, gender, and socioeconomic status, we investigate bias patterns at demographic intersections. We evaluate four LLMs: Claude 3.5 Sonnet, Jamba 1.6, Gemma 3, and Llama 4, revealing systematic disparities across sentiment, demographics, and mental health conditions. Our MHQA approach demonstrates superior detection compared to conventional methods, identifying amplification points where biases magnify through sequential reasoning. We implement two debiasing techniques: Roleplay Simulation and Explicit Bias Reduction, achieving 66-94% bias reductions through few-shot prompting with BBQ dataset examples. These findings highlight critical areas where LLMs reproduce mental healthcare biases, providing actionable insights for equitable AI development.

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.

Seeking dietary guidance often requires navigating complex professional knowledge while accommodating individual health conditions. Knowledge Graphs (KGs) offer structured and interpretable nutritional information, whereas Large Language Models (LLMs) naturally facilitate conversational recommendation delivery. In this paper, we present HealthGenie, an interactive system that combines the strengths of LLMs and KGs to provide personalized dietary recommendations along with hierarchical information visualization for a quick and intuitive overview. Upon receiving a user query, HealthGenie performs query refinement and retrieves relevant information from a pre-built KG. The system then visualizes and highlights pertinent information, organized by defined categories, while offering detailed, explainable recommendation rationales. Users can further tailor these recommendations by adjusting preferences interactively. Our evaluation, comprising a within-subject comparative experiment and an open-ended discussion, demonstrates that HealthGenie effectively supports users in obtaining personalized dietary guidance based on their health conditions while reducing interaction effort and cognitive load. These findings highlight the potential of LLM-KG integration in supporting decision-making through explainable and visualized information. We examine the system's usefulness and effectiveness with an N=12 within-subject study and provide design considerations for future systems that integrate conversational LLM and KG.

Large Language Model (LLM) chatbots like ChatGPT have emerged as cognitive scaffolding for autistic users, yet the tension between their utility and risk remains under-articulated. Through an inductive thematic analysis of 3,984 social media posts by self-identified autistic users, we apply the Technology Affordance framework to examine this duality. We found that while users leveraged ChatGPT to offload executive dysfunction, regulate emotions, translate neurotypical communication, and validate their autistic identity, these affordances coexist with significant risks: reinforcing delusional thinking, erasing authentic identity through automated masking, and triggering conflicts with the autistic sense of justice. This poster identifies these trade-offs in autistic users' interactions with ChatGPT and concludes by outlining our future work on developing neuro-inclusive technologies that address these tensions through beneficial friction and bidirectional translation.

Large language models (LLMs) chatbots like ChatGPT are increasingly used for mental health support. They offer accessible, therapeutic support but also raise concerns about misinformation, over-reliance, and risks in high-stakes contexts of mental health. We crowdsource large-scale users' posts from six major social media platforms to examine how people discuss their interactions with LLM chatbots across different mental health conditions. Through an LLM-assisted pipeline grounded in Value-Sensitive Design (VSD), we mapped the relationships across user-reported sentiments, mental health conditions, perspectives, and values. Our results reveal that the use of LLM chatbots is condition-specific. Users with neurodivergent conditions (e.g., ADHD, ASD) report strong positive sentiments and instrumental or appraisal support, whereas higher-risk disorders (e.g., schizophrenia, bipolar disorder) show more negative sentiments. We further uncover how user perspectives co-occur with underlying values, such as identity, autonomy, and privacy. Finally, we discuss shifting from "one-size-fits-all" chatbot design toward condition-specific, value-sensitive LLM design.

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.

Large language models (LLMs) are transforming the ways the general public accesses and consumes information. Their influence is particularly pronounced in pivotal sectors like healthcare, where lay individuals are increasingly appropriating LLMs as conversational agents for everyday queries. While LLMs demonstrate impressive language understanding and generation proficiencies, concerns regarding their safety remain paramount in these high-stake domains. Moreover, the development of LLMs is disproportionately focused on English. It remains unclear how these LLMs perform in the context of non-English languages, a gap that is critical for ensuring equity in the real-world use of these systems.This paper provides a framework to investigate the effectiveness of LLMs as multi-lingual dialogue systems for healthcare queries. Our empirically-derived framework XlingEval focuses on three fundamental criteria for evaluating LLM responses to naturalistic human-authored health-related questions: correctness, consistency, and verifiability. Through extensive experiments on four major global languages, including English, Spanish, Chinese, and Hindi, spanning three expert-annotated large health Q&A datasets, and through an amalgamation of algorithmic and human-evaluation strategies, we found a pronounced disparity in LLM responses across these languages, indicating a need for enhanced cross-lingual capabilities. We further propose XlingHealth, a cross-lingual benchmark for examining the multilingual capabilities of LLMs in the healthcare context. Our findings underscore the pressing need to bolster the cross-lingual capacities of these models, and to provide an equitable information ecosystem accessible to all.

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.

Student mental health is a sensitive issue that necessitates special attention. A primary concern is the student-to-counselor ratio, which surpasses the recommended standard of 250:1 in most universities. This imbalance results in extended waiting periods for in-person consultations, which cause suboptimal treatment. Significant efforts have been directed toward developing mental health dialogue systems utilizing the existing open-source mental health-related datasets. However, currently available datasets either discuss general topics or various strategies that may not be viable for direct application due to numerous ethical constraints inherent in this research domain. To address this issue, this paper introduces a specialized mental health dataset that emphasizes the active listening strategy employed in conversation for counseling, also named as ConvCounsel. This dataset comprises both speech and text data, which can facilitate the development of a reliable pipeline for mental health dialogue systems. To demonstrate the utility of the proposed dataset, this paper also presents the NYCUKA, a spoken mental health dialogue system that is designed by using the ConvCounsel dataset. The results show the merit of using this dataset.

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.

Personalized nutrition intervention for patients with multimorbidity is critical for improving health outcomes, yet remains challenging because it requires the simultaneous integration of heterogeneous clinical conditions, medications, and dietary guidelines. Single-agent large language models (LLMs) often suffer from context overload and attention dilution when processing such high-dimensional patient profiles. We introduce NutriOrion, a hierarchical multi-agent framework with a parallel-then-sequential reasoning topology. NutriOrion decomposes nutrition planning into specialized domain agents with isolated contexts to mitigate anchoring bias, followed by a conditional refinement stage. The framework includes a multi-objective prioritization algorithm to resolve conflicting dietary requirements and a safety constraint mechanism that injects pharmacological contraindications as hard negative constraints during synthesis, ensuring clinical validity by construction rather than post-hoc filtering. For clinical interoperability, NutriOrion maps synthesized insights into the ADIME standard and FHIR R4 resources. Evaluated on 330 stroke patients with multimorbidity, NutriOrion outperforms multiple baselines, including GPT-4.1 and alternative multi-agent architectures. It achieves a 12.1 percent drug-food interaction violation rate, demonstrates strong personalization with negative correlations (-0.26 to -0.35) between patient biomarkers and recommended risk nutrients, and yields clinically meaningful dietary improvements, including a 167 percent increase in fiber and a 27 percent increase in potassium, alongside reductions in sodium (9 percent) and sugars (12 percent).

Large language models (LLMs) incorporated with Retrieval-Augmented Generation (RAG) have demonstrated powerful capabilities in generating counterspeech against misinformation. However, current studies rely on limited evidence and offer less control over final outputs. To address these challenges, we propose a Multi-agent Retrieval-Augmented Framework to generate counterspeech against health misinformation, incorporating multiple LLMs to optimize knowledge retrieval, evidence enhancement, and response refinement. Our approach integrates both static and dynamic evidence, ensuring that the generated counterspeech is relevant, well-grounded, and up-to-date. Our method outperforms baseline approaches in politeness, relevance, informativeness, and factual accuracy, demonstrating its effectiveness in generating high-quality counterspeech. To further validate our approach, we conduct ablation studies to verify the necessity of each component in our framework. Furthermore, cross evaluations show that our system generalizes well across diverse health misinformation topics and datasets. And human evaluations reveal that refinement significantly enhances counterspeech quality and obtains human preference.

As mental health issues globally escalate, there is a tremendous need for advanced digital support systems. We introduce MentalAgora, a novel framework employing large language models enhanced by interaction between multiple agents for tailored mental health support. This framework operates through three stages: strategic debating, tailored counselor creation, and response generation, enabling the dynamic customization of responses based on individual user preferences and therapeutic needs. We conduct experiments utilizing a high-quality evaluation dataset TherapyTalk crafted with mental health professionals, shwoing that MentalAgora generates expert-aligned and user preference-enhanced responses. Our evaluations, including experiments and user studies, demonstrate that MentalAgora aligns with professional standards and effectively meets user preferences, setting a new benchmark for digital mental health interventions.

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.

Artificial Intelligence (AI) is revolutionizing assistive technologies. It offers innovative solutions to enhance the quality of life for individuals with visual impairments. This review examines the development, applications, and impact of AI-powered tools in key domains, such as computer vision, natural language processing (NLP), and wearable devices. Specific advancements include object recognition for identifying everyday items, scene description for understanding surroundings, and NLP-driven text-to-speech systems for accessing digital information. Assistive technologies like smart glasses, smartphone applications, and AI-enabled navigation aids are discussed, demonstrating their ability to support independent travel, facilitate social interaction, and increase access to education and employment opportunities. The integration of deep learning models, multimodal interfaces, and real-time data processing has transformed the functionality and usability of these tools, fostering inclusivity and empowerment. This article also addresses critical challenges, including ethical considerations, affordability, and adaptability in diverse environments. Future directions highlight the need for interdisciplinary collaboration to refine these technologies, ensuring equitable access and sustainable innovation. By providing a comprehensive overview, this review underscores AI's transformative potential in promoting independence, enhancing accessibility, and fostering social inclusion for visually impaired individuals.

Large language models (LLMs) have shown impressive capabilities in natural language processing tasks, including dialogue generation. This research aims to conduct a novel comparative analysis of two prominent techniques, fine-tuning with LoRA (Low-Rank Adaptation) and the Retrieval-Augmented Generation (RAG) framework, in the context of doctor-patient chat conversations with multiple datasets of mixed medical domains. The analysis involves three state-of-the-art models: Llama-2, GPT, and the LSTM model. Employing real-world doctor-patient dialogues, we comprehensively evaluate the performance of models, assessing key metrics such as language quality (perplexity, BLEU score), factual accuracy (fact-checking against medical knowledge bases), adherence to medical guidelines, and overall human judgments (coherence, empathy, safety). The findings provide insights into the strengths and limitations of each approach, shedding light on their suitability for healthcare applications. Furthermore, the research investigates the robustness of the models in handling diverse patient queries, ranging from general health inquiries to specific medical conditions. The impact of domain-specific knowledge integration is also explored, highlighting the potential for enhancing LLM performance through targeted data augmentation and retrieval strategies.

Despite the prevalence of sleep-tracking devices, many individuals struggle to translate data into actionable improvements in sleep health. Current methods often provide data-driven suggestions but may not be feasible and adaptive to real-life constraints and individual contexts. We present HealthGuru, a novel large language model-powered chatbot to enhance sleep health through data-driven, theory-guided, and adaptive recommendations with conversational behavior change support. HealthGuru's multi-agent framework integrates wearable device data, contextual information, and a contextual multi-armed bandit model to suggest tailored sleep-enhancing activities. The system facilitates natural conversations while incorporating data-driven insights and theoretical behavior change techniques. Our eight-week in-the-wild deployment study with 16 participants compared HealthGuru to a baseline chatbot. Results show improved metrics like sleep duration and activity scores, higher quality responses, and increased user motivation for behavior change with HealthGuru. We also identify challenges and design considerations for personalization and user engagement in health chatbots.

Health is a fundamental pillar of human wellness, and the rapid advancements in large language models (LLMs) have driven the development of a new generation of health agents. However, the application of health agents to fulfill the diverse needs of individuals in daily non-clinical settings is underexplored. In this work, we aim to build a comprehensive personal health agent that is able to reason about multimodal data from everyday consumer wellness devices and common personal health records, and provide personalized health recommendations. To understand end-users' needs when interacting with such an assistant, we conducted an in-depth analysis of web search and health forum queries, alongside qualitative insights from users and health experts gathered through a user-centered design process. Based on these findings, we identified three major categories of consumer health needs, each of which is supported by a specialist sub-agent: (1) a data science agent that analyzes personal time-series wearable and health record data, (2) a health domain expert agent that integrates users' health and contextual data to generate accurate, personalized insights, and (3) a health coach agent that synthesizes data insights, guiding users using a specified psychological strategy and tracking users' progress. Furthermore, we propose and develop the Personal Health Agent (PHA), a multi-agent framework that enables dynamic, personalized interactions to address individual health needs. To evaluate each sub-agent and the multi-agent system, we conducted automated and human evaluations across 10 benchmark tasks, involving more than 7,000 annotations and 1,100 hours of effort from health experts and end-users. Our work represents the most comprehensive evaluation of a health agent to date and establishes a strong foundation towards the futuristic vision of a personal health agent accessible to everyone.

Mental health care-seeking among marginalized young adults has received limited attention in CSCW research. Through in-depth interviews and visual elicitation methods with 18 diverse U.S. participants, our study reveals how marginalized identities shape mental health care-seeking journeys, often characterized by low aspirations and passive care-seeking influenced by lived experiences of marginalization. However, we found the transformative function of "care encounters" - serendipitous interactions with mental health resources that occur when individuals are not actively seeking support. These encounters serve as critical turning points, catalyzing shifts in aspiration and enabling more proactive care-seeking behaviors. Our analysis identifies both the infrastructural conditions that enable transformative care encounters and the aspiration breakdowns that impede care-seeking processes. This work makes conceptual contributions by supplementing traditional motivation-based care-seeking models with a reconceptualization of "care encounters" that accounts for the infrastructural and serendipitous nature of mental health access. We advance understanding of how marginalized identity uniquely influences care-seeking behaviors while providing actionable design implications for embedding technology-mediated "care encounters" into socio-technical interventions that can better support mental health care access for vulnerable populations.

Machine learning (ML) approaches have demonstrated promising results in a wide range of healthcare applications. Data plays a crucial role in developing ML-based healthcare systems that directly affect people's lives. Many of the ethical issues surrounding the use of ML in healthcare stem from structural inequalities underlying the way we collect, use, and handle data. Developing guidelines to improve documentation practices regarding the creation, use, and maintenance of ML healthcare datasets is therefore of critical importance. In this work, we introduce Healthsheet, a contextualized adaptation of the original datasheet questionnaire ~gebru2018datasheets for health-specific applications. Through a series of semi-structured interviews, we adapt the datasheets for healthcare data documentation. As part of the Healthsheet development process and to understand the obstacles researchers face in creating datasheets, we worked with three publicly-available healthcare datasets as our case studies, each with different types of structured data: Electronic health Records (EHR), clinical trial study data, and smartphone-based performance outcome measures. Our findings from the interviewee study and case studies show 1) that datasheets should be contextualized for healthcare, 2) that despite incentives to adopt accountability practices such as datasheets, there is a lack of consistency in the broader use of these practices 3) how the ML for health community views datasheets and particularly Healthsheets as diagnostic tool to surface the limitations and strength of datasets and 4) the relative importance of different fields in the datasheet to healthcare concerns.

Hospitals struggle to predict critical outcomes. Traditional early warning systems, like NEWS and MEWS, rely on static variables and fixed thresholds, limiting their adaptability, accuracy, and personalization. We previously developed the Enhanced Transformer for Health Outcome Simulation (ETHOS), an AI model that tokenizes patient health timelines (PHTs) from EHRs and uses transformer-based architectures to predict future PHTs. ETHOS is a versatile framework for developing a wide range of applications. In this work, we develop the Adaptive Risk Estimation System (ARES) that leverages ETHOS to compute dynamic, personalized risk probabilities for clinician-defined critical events. ARES also features a personalized explainability module that highlights key clinical factors influencing risk estimates. We evaluated ARES using the MIMIC-IV v2.2 dataset together with its Emergency Department (ED) extension and benchmarked performance against both classical early warning systems and contemporary machine learning models. The entire dataset was tokenized resulting in 285,622 PHTs, comprising over 360 million tokens. ETHOS outperformed benchmark models in predicting hospital admissions, ICU admissions, and prolonged stays, achieving superior AUC scores. Its risk estimates were robust across demographic subgroups, with calibration curves confirming model reliability. The explainability module provided valuable insights into patient-specific risk factors. ARES, powered by ETHOS, advances predictive healthcare AI by delivering dynamic, real-time, personalized risk estimation with patient-specific explainability. Although our results are promising, the clinical impact remains uncertain. Demonstrating ARES's true utility in real-world settings will be the focus of our future work. We release the source code to facilitate future research.

One way to personalize chatbot interactions is by establishing common ground with the intended reader. A domain where establishing mutual understanding could be particularly impactful is vaccine concerns and misinformation. Vaccine interventions are forms of messaging which aim to answer concerns expressed about vaccination. Tailoring responses in this domain is difficult, since opinions often have seemingly little ideological overlap. We define the task of tailoring vaccine interventions to a Common-Ground Opinion (CGO). Tailoring responses to a CGO involves meaningfully improving the answer by relating it to an opinion or belief the reader holds. In this paper we introduce TAILOR-CGO, a dataset for evaluating how well responses are tailored to provided CGOs. We benchmark several major LLMs on this task; finding GPT-4-Turbo performs significantly better than others. We also build automatic evaluation metrics, including an efficient and accurate BERT model that outperforms finetuned LLMs, investigate how to successfully tailor vaccine messaging to CGOs, and provide actionable recommendations from this investigation. Code and model weights: https://github.com/rickardstureborg/tailor-cgo Dataset: https://huggingface.co/datasets/DukeNLP/tailor-cgo

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.

Advances in large language models (LLMs) have empowered a variety of applications. However, there is still a significant gap in research when it comes to understanding and enhancing the capabilities of LLMs in the field of mental health. In this work, we present the first comprehensive evaluation of multiple LLMs, including Alpaca, Alpaca-LoRA, FLAN-T5, GPT-3.5, and GPT-4, on various mental health prediction tasks via online text data. We conduct a broad range of experiments, covering zero-shot prompting, few-shot prompting, and instruction fine-tuning. The results indicate a promising yet limited performance of LLMs with zero-shot and few-shot prompt designs for the mental health tasks. More importantly, our experiments show that instruction finetuning can significantly boost the performance of LLMs for all tasks simultaneously. Our best-finetuned models, Mental-Alpaca and Mental-FLAN-T5, outperform the best prompt design of GPT-3.5 (25 and 15 times bigger) by 10.9% on balanced accuracy and the best of GPT-4 (250 and 150 times bigger) by 4.8%. They further perform on par with the state-of-the-art task-specific language model. We also conduct an exploratory case study on LLMs' capability on the mental health reasoning tasks, illustrating the promising capability of certain models such as GPT-4. We summarize our findings into a set of action guidelines for potential methods to enhance LLMs' capability for mental health tasks. Meanwhile, we also emphasize the important limitations before achieving deployability in real-world mental health settings, such as known racial and gender bias. We highlight the important ethical risks accompanying this line of research.

Qualitative insights from user experiences are critical for informing product and policy decisions, but collecting such data at scale is constrained by the time and availability of experts to conduct semi-structured interviews. Recent work has explored using large language models (LLMs) to automate interviewing, yet existing systems lack a principled mechanism for balancing systematic coverage of predefined topics with adaptive exploration, or the ability to pursue follow-ups, deep dives, and emergent themes that arise organically during conversation. In this work, we formulate adaptive semi-structured interviewing as an optimization problem over the interviewer's behavior. We define interview utility as a trade-off between coverage of a predefined interview topic guide, discovery of relevant emergent themes, and interview cost measured by length. Based on this formulation, we introduce SparkMe, a multi-agent LLM interviewer that performs deliberative planning via simulated conversation rollouts to select questions with high expected utility. We evaluate SparkMe through controlled experiments with LLM-based interviewees, showing that it achieves higher interview utility, improving topic guide coverage (+4.7% over the best baseline) and eliciting richer emergent insights while using fewer conversational turns than prior LLM interviewing approaches. We further validate SparkMe in a user study with 70 participants across 7 professions on the impact of AI on their workflows. Domain experts rate SparkMe as producing high-quality adaptive interviews that surface helpful profession-specific insights not captured by prior approaches. The code, datasets, and evaluation protocols for SparkMe are available as open-source at https://github.com/SALT-NLP/SparkMe.

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.

Infodemics and health misinformation have significant negative impact on individuals and society, exacerbating confusion and increasing hesitancy in adopting recommended health measures. Recent advancements in generative AI, capable of producing realistic, human like text and images, have significantly accelerated the spread and expanded the reach of health misinformation, resulting in an alarming surge in its dissemination. To combat the infodemics, most existing work has focused on developing misinformation datasets from social media and fact checking platforms, but has faced limitations in topical coverage, inclusion of AI generation, and accessibility of raw content. To address these issues, we present MM Health, a large scale multimodal misinformation dataset in the health domain consisting of 34,746 news article encompassing both textual and visual information. MM Health includes human-generated multimodal information (5,776 articles) and AI generated multimodal information (28,880 articles) from various SOTA generative AI models. Additionally, We benchmarked our dataset against three tasks (reliability checks, originality checks, and fine-grained AI detection) demonstrating that existing SOTA models struggle to accurately distinguish the reliability and origin of information. Our dataset aims to support the development of misinformation detection across various health scenarios, facilitating the detection of human and machine generated content at multimodal levels.

Urban assessments often compress diverse needs into single scores, which can obscure minority perspectives. We present a community-centered study in Montreal (n=35; wheelchair users, seniors, LGBTQIA2+ residents, and immigrants). Participants rated 20 streets (accessibility, inclusivity, aesthetics, practicality) and ranked 7 images on 12 interview-elicited criteria. Disagreement patterns were systematic in our sample: wheelchair users diverged most on accessibility and practicality; LGBTQIA2+ participants emphasized inclusion and liveliness; seniors prioritized security. Group discussion reduced information gaps but not value conflicts; ratings conveyed intensity, while rankings forced trade-offs. We then formalize negotiative alignment, a transparent, budget-aware bargaining procedure, and pilot it with role-played stakeholder agents plus a neutral mediator. Relative to the best base design under the same public rubric, the negotiated package increased total utility (21.10 to 24.55), raised the worst-group utility (3.20 to 3.90), improved twentieth percentile satisfaction (0.86 to 1.00; min-max normalized within the scenario), and reduced inequality (Gini 0.036 to 0.025). Treating disagreement as signal and reporting worst-group outcomes alongside totals may help planners and AI practitioners surface trade-offs and preserve minority priorities while maintaining efficiency.

Research in emergency triage is restricted to structured electronic health records (EHR) due to regulatory constraints on nurse-patient interactions. We introduce TriageSim, a simulation framework for generating persona-conditioned triage conversations from structured records. TriageSim enables multi-turn nurse-patient interactions with explicit control over disfluency and decision behaviour, producing a corpus of ~800 synthetic transcripts and corresponding audio. We use a combination of automated analysis for linguistic, behavioural and acoustic fidelity alongside manual evaluation for medical fidelity using a random subset of 50 conversations. The utility of the generated corpus is examined via conversational triage classification. We observe modest agreement for acuity levels across three modalities: generated synthetic text, ASR transcripts, and direct audio inputs. The code, persona schemata and triage policy prompts for TriageSim will be available upon acceptance.

Summaries generated from medical conversations can improve recall and understanding of care plans for patients and reduce documentation burden for doctors. Recent advancements in automatic speech recognition (ASR) and natural language understanding (NLU) offer potential solutions to generate these summaries automatically, but rigorous quantitative baselines for benchmarking research in this domain are lacking. In this paper, we bridge this gap for two tasks: classifying utterances from medical conversations according to (i) the SOAP section and (ii) the speaker role. Both are fundamental building blocks along the path towards an end-to-end, automated SOAP note for medical conversations. We provide details on a dataset that contains human and ASR transcriptions of medical conversations and corresponding machine learning optimized SOAP notes. We then present a systematic analysis in which we adapt an existing deep learning architecture to the two aforementioned tasks. The results suggest that modelling context in a hierarchical manner, which captures both word and utterance level context, yields substantial improvements on both classification tasks. Additionally, we develop and analyze a modular method for adapting our model to ASR output.

Large language models (LLMs) are increasingly under scrutiny for perpetuating identity-based discrimination in high-stakes domains such as hiring, particularly against people with disabilities (PwD). However, existing research remains largely Western-centric, overlooking how intersecting forms of marginalization--such as gender and caste--shape experiences of PwD in the Global South. We conduct a comprehensive audit of six LLMs across 2,820 hiring scenarios spanning diverse disability, gender, nationality, and caste profiles. To capture subtle intersectional harms and biases, we introduce ABLEIST (Ableism, Inspiration, Superhumanization, and Tokenism), a set of five ableism-specific and three intersectional harm metrics grounded in disability studies literature. Our results reveal significant increases in ABLEIST harms towards disabled candidates--harms that many state-of-the-art models failed to detect. These harms were further amplified by sharp increases in intersectional harms (e.g., Tokenism) for gender and caste-marginalized disabled candidates, highlighting critical blind spots in current safety tools and the need for intersectional safety evaluations of frontier models in high-stakes domains like hiring.

Considerable effort has been dedicated to mitigating toxicity, but existing methods often require drastic modifications to model parameters or the use of computationally intensive auxiliary models. Furthermore, previous approaches have often neglected the crucial factor of language's evolving nature over time. In this work, we present a comprehensive perspective on toxicity mitigation that takes into account its changing nature. We introduce Goodtriever, a flexible methodology that matches the current state-of-the-art toxicity mitigation while achieving 43% relative latency reduction during inference and being more computationally efficient. By incorporating a retrieval-based approach at decoding time, Goodtriever enables toxicity-controlled text generation. Our research advocates for an increased focus on adaptable mitigation techniques, which better reflect the data drift models face when deployed in the wild. Code and data are available at https://github.com/for-ai/goodtriever.

Large language models (LLMs) have received much attention and shown their potential in digital health, while their application in mental health is subject to ongoing debate. This systematic review aims to summarize and characterize the use of LLMs in mental health by investigating the strengths and limitations of the latest work in LLMs and discusses the challenges and opportunities for early screening, digital interventions, and other clinical applications in mental health. Following PRISMA guidelines, we examined English articles from PubMed, DBLP Computer Science Bibliography, and IEEE Xplore, published between 1 January 2017, and 1 September 2023, focusing on mental health and LLMs. The review analyzed 32 articles, including mental health analysis using social media datasets (n=13), mental health chatbots (n=10), and other mental health applications (n=9). Findings reveal LLMs' effectiveness in mental health issue detection and the enhancement of telepsychological services through personalised healthcare. Nonetheless, risks like text inconsistencies, hallucinatory content, and the lack of an ethical framework raise concerns about their clinical use. Despite these challenges, the advancement of LLMs underscores their potential as innovative clinical tools, necessitating further research and development. The review emphasizes that LLMs should complement, not replace, professional mental health services.

Over the past decade, wearable computing devices (``smart glasses'') have undergone remarkable advancements in sensor technology, design, and processing power, ushering in a new era of opportunity for high-density human behavior data. Equipped with wearable cameras, these glasses offer a unique opportunity to analyze non-verbal behavior in natural settings as individuals interact. Our focus lies in predicting engagement in dyadic interactions by scrutinizing verbal and non-verbal cues, aiming to detect signs of disinterest or confusion. Leveraging such analyses may revolutionize our understanding of human communication, foster more effective collaboration in professional environments, provide better mental health support through empathetic virtual interactions, and enhance accessibility for those with communication barriers. In this work, we collect a dataset featuring 34 participants engaged in casual dyadic conversations, each providing self-reported engagement ratings at the end of each conversation. We introduce a novel fusion strategy using Large Language Models (LLMs) to integrate multiple behavior modalities into a ``multimodal transcript'' that can be processed by an LLM for behavioral reasoning tasks. Remarkably, this method achieves performance comparable to established fusion techniques even in its preliminary implementation, indicating strong potential for further research and optimization. This fusion method is one of the first to approach ``reasoning'' about real-world human behavior through a language model. Smart glasses provide us the ability to unobtrusively gather high-density multimodal data on human behavior, paving the way for new approaches to understanding and improving human communication with the potential for important societal benefits. The features and data collected during the studies will be made publicly available to promote further research.

Objectives: While Large Language Models (LLMs) have been widely used to assist clinicians and support patients, no existing work has explored dialogue systems for standard diagnostic interviews and assessments. This study aims to bridge the gap in mental healthcare accessibility by developing an LLM-powered dialogue system that replicates clinician behavior. Materials and Methods: We introduce TRUST, a framework of cooperative LLM modules capable of conducting formal diagnostic interviews and assessments for Post-Traumatic Stress Disorder (PTSD). To guide the generation of appropriate clinical responses, we propose a Dialogue Acts schema specifically designed for clinical interviews. Additionally, we develop a patient simulation approach based on real-life interview transcripts to replace time-consuming and costly manual testing by clinicians. Results: A comprehensive set of evaluation metrics is designed to assess the dialogue system from both the agent and patient simulation perspectives. Expert evaluations by conversation and clinical specialists show that TRUST performs comparably to real-life clinical interviews. Discussion: Our system performs at the level of average clinicians, with room for future enhancements in communication styles and response appropriateness. Conclusions: Our TRUST framework shows its potential to facilitate mental healthcare availability.

Generative AI powers a growing wave of companion chatbots, yet principles for fostering genuine connection remain unsettled. We test two routes: visible user authorship versus covert language-style mimicry. In a preregistered 3x2 experiment (N = 162), we manipulated user-controlled avatar generation (none, premade, user-generated) and Language Style Matching (LSM) (static vs. adaptive). Generating an avatar boosted rapport (omega^2 = .040, p = .013), whereas adaptive LSM underperformed static style on personalization and satisfaction (d = 0.35, p = .009) and was paradoxically judged less adaptive (t = 3.07, p = .003, d = 0.48). We term this an Adaptation Paradox: synchrony erodes connection when perceived as incoherent, destabilizing persona. To explain, we propose a stability-and-legibility account: visible authorship fosters natural interaction, while covert mimicry risks incoherence. Our findings suggest designers should prioritize legible, user-driven personalization and limit stylistic shifts rather than rely on opaque mimicry.

Recent advances in inference time scaling with extended long chain-of thought have significantly improved the reasoning capabilities of both general and medical large language models (LLMs). However, these models tend to engage in lengthy reasoning processes regardless of the difficulty of the input question, leading to increased inference costs in real-world applications. Therefore, enabling adaptive thinking where models think less for simpler questions and think more for complex ones is critical for the effective use of medical LLMs in practice. Despite its importance, there is a lack of end-to-end approaches designed to enhance the adaptive thinking capabilities of medical LLMs while providing a comprehensive examination of the trade-off between performance and computational cost. To bridge this gap, we propose AdaThink-Med, the first end-to-end framework designed to enhance adaptive thinking ability in medical reasoning models with uncertainty-guided length calibration. AdaThink-Med first generates multiple candidate outputs for each question, evaluates the correctness and uncertainty of each candidate, and then estimates problem difficulty via an uncertainty-guided length calibration module. For outputs with low difficulty and correct answers, the framework penalizes longer reasoning paths; whereas for those with high difficulty and incorrect answers, it encourages extending the chain of thought to explore alternative solutions. On six public medical QA benchmarks, AdaThink-Med achieves up to 6.4x length reduction on average while retaining performance with only minimal degradation. Intriguingly, we observe that AdaThink-Med spontaneously develops two distinct reasoning modes, which we characterize as "non-thinking" and "thinking", demonstrating the model's ability to suppress redundant reasoning processes dynamically.

Community health workers (CHWs) provide last-mile healthcare services but face challenges due to limited medical knowledge and training. This paper describes the design, deployment, and evaluation of ASHABot, an LLM-powered, experts-in-the-loop, WhatsApp-based chatbot to address the information needs of CHWs in India. Through interviews with CHWs and their supervisors and log analysis, we examine factors affecting their engagement with ASHABot, and ASHABot's role in addressing CHWs' informational needs. We found that ASHABot provided a private channel for CHWs to ask rudimentary and sensitive questions they hesitated to ask supervisors. CHWs trusted the information they received on ASHABot and treated it as an authoritative resource. CHWs' supervisors expanded their knowledge by contributing answers to questions ASHABot failed to answer, but were concerned about demands on their workload and increased accountability. We emphasize positioning LLMs as supplemental fallible resources within the community healthcare ecosystem, instead of as replacements for supervisor support.

Multilingual automatic speech recognition (ASR) in the medical domain serves as a foundational task for various downstream applications such as speech translation, spoken language understanding, and voice-activated assistants. This technology enhances patient care by enabling efficient communication across language barriers, alleviating specialized workforce shortages, and facilitating improved diagnosis and treatment, particularly during pandemics. In this work, we introduce MultiMed, a collection of small-to-large end-to-end ASR models for the medical domain, spanning five languages: Vietnamese, English, German, French, and Mandarin Chinese, together with the corresponding real-world ASR dataset. To our best knowledge, MultiMed stands as the largest and the first multilingual medical ASR dataset, in terms of total duration, number of speakers, diversity of diseases, recording conditions, speaker roles, unique medical terms, accents, and ICD-10 codes. Secondly, we establish the empirical baselines, present the first reproducible study of multilinguality in medical ASR, conduct a layer-wise ablation study for end-to-end ASR training, and provide the first linguistic analysis for multilingual medical ASR. All code, data, and models are available online https://github.com/leduckhai/MultiMed/tree/master/MultiMed

Persuasion plays a pivotal role in a wide range of applications from health intervention to the promotion of social good. Persuasive chatbots can accelerate the positive effects of persuasion in such applications. Existing methods rely on fine-tuning persuasive chatbots with task-specific training data which is costly, if not infeasible, to collect. To address this issue, we propose a method to leverage the generalizability and inherent persuasive abilities of large language models (LLMs) in creating effective and truthful persuasive chatbot for any given domain in a zero-shot manner. Unlike previous studies which used pre-defined persuasion strategies, our method first uses an LLM to generate responses, then extracts the strategies used on the fly, and replaces any unsubstantiated claims in the response with retrieved facts supporting the strategies. We applied our chatbot, PersuaBot, to three significantly different domains needing persuasion skills: donation solicitation, recommendations, and health intervention. Our experiments on simulated and human conversations show that our zero-shot approach is more persuasive than prior work, while achieving factual accuracy surpassing state-of-the-art knowledge-oriented chatbots. Our study demonstrated that when persuasive chatbots are employed responsibly for social good, it is an enabler of positive individual and social change.

In today's interconnected globe, moving abroad is more and more prevalent, whether it's for employment, refugee resettlement, or other causes. Language difficulties between natives and immigrants present a common issue on a daily basis, especially in medical domain. This can make it difficult for patients and doctors to communicate during anamnesis or in the emergency room, which compromises patient care. The goal of the HYKIST Project is to develop a speech translation system to support patient-doctor communication with ASR and MT. ASR systems have recently displayed astounding performance on particular tasks for which enough quantities of training data are available, such as LibriSpeech. Building a good model is still difficult due to a variety of speaking styles, acoustic and recording settings, and a lack of in-domain training data. In this thesis, we describe our efforts to construct ASR systems for a conversational telephone speech recognition task in the medical domain for Vietnamese language to assist emergency room contact between doctors and patients across linguistic barriers. In order to enhance the system's performance, we investigate various training schedules and data combining strategies. We also examine how best to make use of the little data that is available. The use of publicly accessible models like XLSR-53 is compared to the use of customized pre-trained models, and both supervised and unsupervised approaches are utilized using wav2vec 2.0 as architecture.

Indonesia ranks fourth globally in the number of deaf cases. Individuals with hearing impairments often find communication challenging, necessitating the use of sign language. However, there are limited public services that offer such inclusivity. On the other hand, advancements in artificial intelligence (AI) present promising solutions to overcome communication barriers faced by the deaf. This study aims to explore the application of AI in developing models for a simplified sign language translation app and dictionary, designed for integration into public service facilities, to facilitate communication for individuals with hearing impairments, thereby enhancing inclusivity in public services. The researchers compared the performance of LSTM and 1D CNN + Transformer (1DCNNTrans) models for sign language recognition. Through rigorous testing and validation, it was found that the LSTM model achieved an accuracy of 94.67%, while the 1DCNNTrans model achieved an accuracy of 96.12%. Model performance evaluation indicated that although the LSTM exhibited lower inference latency, it showed weaknesses in classifying classes with similar keypoints. In contrast, the 1DCNNTrans model demonstrated greater stability and higher F1 scores for classes with varying levels of complexity compared to the LSTM model. Both models showed excellent performance, exceeding 90% validation accuracy and demonstrating rapid classification of 50 sign language gestures.

Global rates of mental health concerns are rising and there is increasing realization that existing models of mental healthcare will not adequately expand to meet the demand. With the emergence of large language models (LLMs) has come great optimism regarding their promise to create novel, large-scale solutions to support mental health. Despite their nascence, LLMs have already been applied to mental health-related tasks. In this review, we summarize the extant literature on efforts to use LLMs to provide mental health education, assessment, and intervention and highlight key opportunities for positive impact in each area. We then highlight risks associated with LLMs application to mental health and encourage adoption of strategies to mitigate these risks. The urgent need for mental health support must be balanced with responsible development, testing, and deployment of mental health LLMs. Especially critical is ensuring that mental health LLMs are fine-tuned for mental health, enhance mental health equity, adhere to ethical standards, and that people, including those with lived experience with mental health concerns, are involved in all stages from development through deployment. Prioritizing these efforts will minimize potential harms to mental health and maximize the likelihood that LLMs will positively impact mental health globally.

Social and behavioral determinants of health (SDOH) play a significant role in shaping health outcomes, and extracting these determinants from clinical notes is a first step to help healthcare providers systematically identify opportunities to provide appropriate care and address disparities. Progress on using NLP methods for this task has been hindered by the lack of high-quality publicly available labeled data, largely due to the privacy and regulatory constraints on the use of real patients' information. This paper introduces a new dataset, SDOH-NLI, that is based on publicly available notes and which we release publicly. We formulate SDOH extraction as a natural language inference (NLI) task, and provide binary textual entailment labels obtained from human raters for a cross product of a set of social history snippets as premises and SDOH factors as hypotheses. Our dataset differs from standard NLI benchmarks in that our premises and hypotheses are obtained independently. We evaluate both "off-the-shelf" entailment models as well as models fine-tuned on our data, and highlight the ways in which our dataset appears more challenging than commonly used NLI datasets.

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.

The pervasive influence of misinformation has far-reaching and detrimental effects on both individuals and society. The COVID-19 pandemic has witnessed an alarming surge in the dissemination of medical misinformation. However, existing datasets pertaining to misinformation predominantly focus on textual information, neglecting the inclusion of visual elements, and tend to center solely on COVID-19-related misinformation, overlooking misinformation surrounding other diseases. Furthermore, the potential of Large Language Models (LLMs), such as the ChatGPT developed in late 2022, in generating misinformation has been overlooked in previous works. To overcome these limitations, we present Med-MMHL, a novel multi-modal misinformation detection dataset in a general medical domain encompassing multiple diseases. Med-MMHL not only incorporates human-generated misinformation but also includes misinformation generated by LLMs like ChatGPT. Our dataset aims to facilitate comprehensive research and development of methodologies for detecting misinformation across diverse diseases and various scenarios, including human and LLM-generated misinformation detection at the sentence, document, and multi-modal levels. To access our dataset and code, visit our GitHub repository: https://github.com/styxsys0927/Med-MMHL.

Large language models (LLMs) have performed well in providing general and extensive health suggestions in single-turn conversations, exemplified by systems such as ChatGPT, ChatGLM, ChatDoctor, DoctorGLM, and etc. However, the limited information provided by users during single turn results in inadequate personalization and targeting of the generated suggestions, which requires users to independently select the useful part. It is mainly caused by the missing ability to engage in multi-turn questioning. In real-world medical consultations, doctors usually employ a series of iterative inquiries to comprehend the patient's condition thoroughly, enabling them to provide effective and personalized suggestions subsequently, which can be defined as chain of questioning (CoQ) for LLMs. To improve the CoQ of LLMs, we propose BianQue, a ChatGLM-based LLM finetuned with the self-constructed health conversation dataset BianQueCorpus that is consist of multiple turns of questioning and health suggestions polished by ChatGPT. Experimental results demonstrate that the proposed BianQue can simultaneously balance the capabilities of both questioning and health suggestions, which will help promote the research and application of LLMs in the field of proactive health.

The COVID-19 pandemic has accentuated socioeconomic disparities across various racial and ethnic groups in the United States. While previous studies have utilized traditional survey methods like the Household Pulse Survey (HPS) to elucidate these disparities, this paper explores the role of social media platforms in both highlighting and addressing these challenges. Drawing from real-time data sourced from Twitter, we analyzed language patterns related to four major types of adverse experiences: loss of employment income (LI), food scarcity (FS), housing insecurity (HI), and unmet needs for mental health services (UM). We first formulate a sparsity optimization problem that extracts low-level language features from social media data sources. Second, we propose novel constraints on feature similarity exploiting prior knowledge about the similarity of the language patterns among the adverse experiences. The proposed problem is challenging to solve due to the non-convexity objective and non-smoothness penalties. We develop an algorithm based on the alternating direction method of multipliers (ADMM) framework to solve the proposed formulation. Extensive experiments and comparisons to other models on real-world social media and the detection of adverse experiences justify the efficacy of our model.

Integrating language models (LMs) in healthcare systems holds great promise for improving medical workflows and decision-making. However, a critical barrier to their real-world adoption is the lack of reliable evaluation of their trustworthiness, especially in multilingual healthcare settings. Existing LMs are predominantly trained in high-resource languages, making them ill-equipped to handle the complexity and diversity of healthcare queries in mid- and low-resource languages, posing significant challenges for deploying them in global healthcare contexts where linguistic diversity is key. In this work, we present CLINIC, a Comprehensive Multilingual Benchmark to evaluate the trustworthiness of language models in healthcare. CLINIC systematically benchmarks LMs across five key dimensions of trustworthiness: truthfulness, fairness, safety, robustness, and privacy, operationalized through 18 diverse tasks, spanning 15 languages (covering all the major continents), and encompassing a wide array of critical healthcare topics like disease conditions, preventive actions, diagnostic tests, treatments, surgeries, and medications. Our extensive evaluation reveals that LMs struggle with factual correctness, demonstrate bias across demographic and linguistic groups, and are susceptible to privacy breaches and adversarial attacks. By highlighting these shortcomings, CLINIC lays the foundation for enhancing the global reach and safety of LMs in healthcare across diverse languages.

Over the recent years, the emergence of large language models (LLMs) has given rise to a proliferation of domain-specific models that are intended to reflect the particularities of linguistic context and content as a correlate of the originating domain. This paper details the conception, design, training and evaluation of DAEDRA, a LLM designed to detect regulatory-relevant outcomes (mortality, ER attendance and hospitalisation) in adverse event reports elicited through passive reporting (PR). While PR is a highly cost-efficient way of eliciting information from a wide and diverse audience -- typically including not only physicians and healthcare providers but also patients, family members and other lay stakeholders --, this diversity makes PR corpora difficult to analyse. Generic language models may not capture the complex clinical dimensions while specific clinical or biomedical models may not perform well on lay reports. To evaluate the utility of a subdomain-specific language model, an adaptive training approach was adapted, wherein base language model candidates were evaluated on a subset of the corpus, and the best performer was trained on the entire corpus. This yielded a small but significant improvement in F_1 (+1%), precision (+2.5%) and recall (+3.8%), at a relatively low training cost and a single-day training time. Subdomain-specific LLMs continue to be viable options for better results when analysing highly specialised corpora.

Mental health is a significant and growing public health concern. As language usage can be leveraged to obtain crucial insights into mental health conditions, there is a need for large-scale, labeled, mental health-related datasets of users who have been diagnosed with one or more of such conditions. In this paper, we investigate the creation of high-precision patterns to identify self-reported diagnoses of nine different mental health conditions, and obtain high-quality labeled data without the need for manual labelling. We introduce the SMHD (Self-reported Mental Health Diagnoses) dataset and make it available. SMHD is a novel large dataset of social media posts from users with one or multiple mental health conditions along with matched control users. We examine distinctions in users' language, as measured by linguistic and psychological variables. We further explore text classification methods to identify individuals with mental conditions through their language.

Automatic toxic language detection is critical for creating safe, inclusive online spaces. However, it is a highly subjective task, with perceptions of toxic language shaped by community norms and lived experience. Existing toxicity detection models are typically trained on annotations that collapse diverse annotator perspectives into a single ground truth, erasing important context-specific notions of toxicity such as reclaimed language. To address this, we introduce MODELCITIZENS, a dataset of 6.8K social media posts and 40K toxicity annotations across diverse identity groups. To capture the role of conversational context on toxicity, typical of social media posts, we augment MODELCITIZENS posts with LLM-generated conversational scenarios. State-of-the-art toxicity detection tools (e.g. OpenAI Moderation API, GPT-o4-mini) underperform on MODELCITIZENS, with further degradation on context-augmented posts. Finally, we release LLAMACITIZEN-8B and GEMMACITIZEN-12B, LLaMA- and Gemma-based models finetuned on MODELCITIZENS, which outperform GPT-o4-mini by 5.5% on in-distribution evaluations. Our findings highlight the importance of community-informed annotation and modeling for inclusive content moderation. The data, models and code are available at https://github.com/asuvarna31/modelcitizens.

Parameter-efficient fine-tuning (PEFT) for personalizing automatic speech recognition (ASR) has recently shown promise for adapting general population models to atypical speech. However, these approaches assume a priori knowledge of the atypical speech disorder being adapted for -- the diagnosis of which requires expert knowledge that is not always available. Even given this knowledge, data scarcity and high inter/intra-speaker variability further limit the effectiveness of traditional fine-tuning. To circumvent these challenges, we first identify the minimal set of model parameters required for ASR adaptation. Our analysis of each individual parameter's effect on adaptation performance allows us to reduce Word Error Rate (WER) by half while adapting 0.03% of all weights. Alleviating the need for cohort-specific models, we next propose the novel use of a meta-learned hypernetwork to generate highly individualized, utterance-level adaptations on-the-fly for a diverse set of atypical speech characteristics. Evaluating adaptation at the global, cohort and individual-level, we show that hypernetworks generalize better to out-of-distribution speakers, while maintaining an overall relative WER reduction of 75.2% using 0.1% of the full parameter budget.

Large language models (LLMs) show promise in drafting responses to patient portal messages, yet their integration into clinical workflows raises various concerns, including whether they would actually save clinicians time and effort in their portal workload. We investigate LLM alignment with individual clinicians through a comprehensive evaluation of the patient message response drafting task. We develop a novel taxonomy of thematic elements in clinician responses and propose a novel evaluation framework for assessing clinician editing load of LLM-drafted responses at both content and theme levels. We release an expert-annotated dataset and conduct large-scale evaluations of local and commercial LLMs using various adaptation techniques including thematic prompting, retrieval-augmented generation, supervised fine-tuning, and direct preference optimization. Our results reveal substantial epistemic uncertainty in aligning LLM drafts with clinician responses. While LLMs demonstrate capability in drafting certain thematic elements, they struggle with clinician-aligned generation in other themes, particularly question asking to elicit further information from patients. Theme-driven adaptation strategies yield improvements across most themes. Our findings underscore the necessity of adapting LLMs to individual clinician preferences to enable reliable and responsible use in patient-clinician communication workflows.

Online Mental Health Communities (OMHCs) provide crucial peer and expert support, yet many posts remain unanswered due to missing support attributes that signal the need for help. We present a novel framework that identifies these gaps and prompts users to enrich their posts, thereby improving engagement. To support this, we introduce REDDME, a new dataset of 4,760 posts from mental health subreddits annotated for the span and intensity of three key support attributes: event what happened?, effect what did the user experience?, and requirement what support they need?. Next, we devise a hierarchical taxonomy, CueTaxo, of support attributes for controlled question generation. Further, we propose MH-COPILOT, a reinforcement learning-based system that integrates (a) contextual attribute-span identification, (b) support attribute intensity classification, (c) controlled question generation via a hierarchical taxonomy, and (d) a verifier for reward modeling. Our model dynamically assesses posts for the presence/absence of support attributes, and generates targeted prompts to elicit missing information. Empirical results across four notable language models demonstrate significant improvements in attribute elicitation and user engagement. A human evaluation further validates the model's effectiveness in real-world OMHC settings.

Humans have the ability to adapt the type of information they use, the procedure they employ, and the amount of time they spend when solving problems. However, most standard neural networks have a fixed function type and computation budget regardless of the sample's nature or difficulty. Adaptivity is a powerful paradigm as it not only imbues practitioners with flexibility pertaining to the downstream usage of these models but can also serve as a powerful inductive bias for solving certain challenging classes of problems. In this work, we introduce a new approach called AdaTape, which allows for dynamic computation in neural networks through adaptive tape tokens. AdaTape utilizes an elastic input sequence by equipping an architecture with a dynamic read-and-write tape. Specifically, we adaptively generate input sequences using tape tokens obtained from a tape bank which can be either trainable or derived from input data. We examine the challenges and requirements to obtain dynamic sequence content and length, and propose the Adaptive Tape Reading (ATR) algorithm to achieve both goals. Through extensive experiments on image recognition tasks, we show that AdaTape can achieve better performance while maintaining the computational cost. To facilitate further research, we have released code at https://github.com/google-research/scenic.

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.

Ensuring accessibility for individuals with cognitive impairments is essential for autonomy, self-determination, and full citizenship. However, manual Easy-to-Read (ETR) text adaptations are slow, costly, and difficult to scale, limiting access to crucial information in healthcare, education, and civic life. AI-driven ETR generation offers a scalable solution but faces key challenges, including dataset scarcity, domain adaptation, and balancing lightweight learning of Large Language Models (LLMs). In this paper, we introduce ETR-fr, the first dataset for ETR text generation fully compliant with European ETR guidelines. We implement parameter-efficient fine-tuning on PLMs and LLMs to establish generative baselines. To ensure high-quality and accessible outputs, we introduce an evaluation framework based on automatic metrics supplemented by human assessments. The latter is conducted using a 36-question evaluation form that is aligned with the guidelines. Overall results show that PLMs perform comparably to LLMs and adapt effectively to out-of-domain texts.

Large language models (LLMs) are increasingly applied in mental health support systems, where reliable recognition of high-risk states such as suicidal ideation and self-harm is safety-critical. However, existing evaluations primarily rely on aggregate performance metrics, which often obscure risk-specific failure modes and provide limited insight into model behavior in realistic, multi-turn interactions. We present MHDash, an open-source platform designed to support the development, evaluation, and auditing of AI systems for mental health applications. MHDash integrates data collection, structured annotation, multi-turn dialogue generation, and baseline evaluation into a unified pipeline. The platform supports annotations across multiple dimensions, including Concern Type, Risk Level, and Dialogue Intent, enabling fine-grained and risk-aware analysis. Our results reveal several key findings: (i) simple baselines and advanced LLM APIs exhibit comparable overall accuracy yet diverge significantly on high-risk cases; (ii) some LLMs maintain consistent ordinal severity ranking while failing absolute risk classification, whereas others achieve reasonable aggregate scores but suffer from high false negative rates on severe categories; and (iii) performance gaps are amplified in multi-turn dialogues, where risk signals emerge gradually. These observations demonstrate that conventional benchmarks are insufficient for safety-critical mental health settings. By releasing MHDash as an open platform, we aim to promote reproducible research, transparent evaluation, and safety-aligned development of AI systems for mental health support.

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.

Effective mental health support is crucial for alleviating psychological distress. While large language model (LLM)-based assistants have shown promise in mental health interventions, existing research often defines "effective" support primarily in terms of empathetic acknowledgments, overlooking other essential dimensions such as informational guidance, community validation, and tangible coping strategies. To address this limitation and better understand what constitutes effective support, we introduce RedditESS, a novel real-world dataset derived from Reddit posts, including supportive comments and original posters' follow-up responses. Grounded in established social science theories, we develop an ensemble labeling mechanism to annotate supportive comments as effective or not and perform qualitative assessments to ensure the reliability of the annotations. Additionally, we demonstrate the practical utility of RedditESS by using it to guide LLM alignment toward generating more context-sensitive and genuinely helpful supportive responses. By broadening the understanding of effective support, our study paves the way for advanced AI-driven mental health interventions.

Medical dialogue systems (MDSs) aim to assist doctors and patients with a range of professional medical services, i.e., diagnosis, treatment and consultation. The development of MDSs is hindered because of a lack of resources. In particular. (1) there is no dataset with large-scale medical dialogues that covers multiple medical services and contains fine-grained medical labels (i.e., intents, actions, slots, values), and (2) there is no set of established benchmarks for MDSs for multi-domain, multi-service medical dialogues. In this paper, we present ReMeDi, a set of resource for medical dialogues. ReMeDi consists of two parts, the ReMeDi dataset and the ReMeDi benchmarks. The ReMeDi dataset contains 96,965 conversations between doctors and patients, including 1,557 conversations with fine-gained labels. It covers 843 types of diseases, 5,228 medical entities, and 3 specialties of medical services across 40 domains. To the best of our knowledge, the ReMeDi dataset is the only medical dialogue dataset that covers multiple domains and services, and has fine-grained medical labels. The second part of the ReMeDi resources consists of a set of state-of-the-art models for (medical) dialogue generation. The ReMeDi benchmark has the following methods: (1) pretrained models (i.e., BERT-WWM, BERT-MED, GPT2, and MT5) trained, validated, and tested on the ReMeDi dataset, and (2) a self-supervised contrastive learning(SCL) method to expand the ReMeDi dataset and enhance the training of the state-of-the-art pretrained models. We describe the creation of the ReMeDi dataset, the ReMeDi benchmarking methods, and establish experimental results using the ReMeDi benchmarking methods on the ReMeDi dataset for future research to compare against. With this paper, we share the dataset, implementations of the benchmarks, and evaluation scripts.

Large Language Models (LLMs), with their flexible generation abilities, can be powerful data sources in domains with few or no available corpora. However, problems like hallucinations and biases limit such applications. In this case study, we pick nutrition counselling, a domain lacking any public resource, and show that high-quality datasets can be gathered by combining LLMs, crowd-workers and nutrition experts. We first crowd-source and cluster a novel dataset of diet-related issues, then work with experts to prompt ChatGPT into producing related supportive text. Finally, we let the experts evaluate the safety of the generated text. We release HAI-coaching, the first expert-annotated nutrition counselling dataset containing ~2.4K dietary struggles from crowd workers, and ~97K related supportive texts generated by ChatGPT. Extensive analysis shows that ChatGPT while producing highly fluent and human-like text, also manifests harmful behaviours, especially in sensitive topics like mental health, making it unsuitable for unsupervised use.

Conversational artificial intelligence has the potential to assist users in preliminary medical consultations, particularly in settings where access to healthcare professionals is limited. However, many existing medical dialogue systems operate in a single-turn question--answering paradigm or rely on template-based datasets, limiting conversational realism and multilingual applicability. In this work, we introduce MedAidDialog, a multilingual multi-turn medical dialogue dataset designed to simulate realistic physician--patient consultations. The dataset extends the MDDial corpus by generating synthetic consultations using large language models and further expands them into a parallel multilingual corpus covering seven languages: English, Hindi, Telugu, Tamil, Bengali, Marathi, and Arabic. Building on this dataset, we develop MedAidLM, a conversational medical model trained using parameter-efficient fine-tuning on quantized small language models, enabling deployment without high-end computational infrastructure. Our framework additionally incorporates optional patient pre-context information (e.g., age, gender, allergies) to personalize the consultation process. Experimental results demonstrate that the proposed system can effectively perform symptom elicitation through multi-turn dialogue and generate diagnostic recommendations. We further conduct medical expert evaluation to assess the plausibility and coherence of the generated consultations.

Remarkable advancements in modern generative foundation models have enabled the development of sophisticated and highly capable autonomous agents that can observe their environment, invoke tools, and communicate with other agents to solve problems. Although such agents can communicate with users through natural language, their complexity and wide-ranging failure modes present novel challenges for human-AI interaction. Building on prior research and informed by a communication grounding perspective, we contribute to the study of human-agent communication by identifying and analyzing twelve key communication challenges that these systems pose. These include challenges in conveying information from the agent to the user, challenges in enabling the user to convey information to the agent, and overarching challenges that need to be considered across all human-agent communication. We illustrate each challenge through concrete examples and identify open directions of research. Our findings provide insights into critical gaps in human-agent communication research and serve as an urgent call for new design patterns, principles, and guidelines to support transparency and control in these systems.

This paper presents OnCoCo 1.0, a new public dataset for fine-grained message classification in online counseling. It is based on a new, integrative system of categories, designed to improve the automated analysis of psychosocial online counseling conversations. Existing category systems, predominantly based on Motivational Interviewing (MI), are limited by their narrow focus and dependence on datasets derived mainly from face-to-face counseling. This limits the detailed examination of textual counseling conversations. In response, we developed a comprehensive new coding scheme that differentiates between 38 types of counselor and 28 types of client utterances, and created a labeled dataset consisting of about 2.800 messages from counseling conversations. We fine-tuned several models on our dataset to demonstrate its applicability. The data and models are publicly available to researchers and practitioners. Thus, our work contributes a new type of fine-grained conversational resource to the language resources community, extending existing datasets for social and mental-health dialogue analysis.

As Large Language Models (LLMs) are increasingly integrated into healthcare to address complex inquiries, ensuring their reliability remains a critical challenge. Recent studies have highlighted that generic LLMs often struggle in clinical contexts, occasionally producing misleading guidance. To mitigate these risks, this research focuses on the domain-specific adaptation of Llama-2-7B using the Low-Rank Adaptation (LoRA) technique. By injecting trainable low-rank matrices into the Transformer layers, we efficiently adapted the model using authentic patient-physician transcripts while preserving the foundational knowledge of the base model. Our objective was to enhance precision and contextual relevance in responding to medical queries by capturing the specialized nuances of clinical discourse. Due to the resource-intensive nature of large-scale human validation, the model's performance was evaluated through a dual-track framework: Track A utilized traditional lexical similarity metrics (e.g., BLEU, ROUGE), while Track B employed an "LLM-as-a-Judge" paradigm using GPT-4 for semantic assessment. Our results demonstrate that while the LoRA-enhanced model achieved significant improvements across all quantitative lexical dimensions, a profound disagreement surfaced in the GPT-4 evaluation, which marginally favored the baseline model's conversational flow. This metric divergence underscores a pivotal finding: traditional automated scores may not fully reflect clinical utility. Consequently, we propose that while automated metrics and LLM judges serve as valuable developmental proxies, rigorous validation by human medical experts remains an indispensable requirement for the safe deployment of LLMs in healthcare settings.

Introduction: Electronic health records (EHR) are a critical medium through which patient stigmatization is perpetuated among healthcare teams. Methods: We identified linguistic features of doubt markers and stigmatizing labels in MIMIC-III EHR via expanded lexicon matching and supervised learning classifiers. Predictors of rates of linguistic features were assessed using Poisson regression models. Results: We found higher rates of stigmatizing labels per chart among patients who were Black or African American (RR: 1.16), patients with Medicare/Medicaid or government-run insurance (RR: 2.46), self-pay (RR: 2.12), and patients with a variety of stigmatizing disease and mental health conditions. Patterns among doubt markers were similar, though male patients had higher rates of doubt markers (RR: 1.25). We found increased stigmatizing labels used by nurses (RR: 1.40), and social workers (RR: 2.25), with similar patterns of doubt markers. Discussion: Stigmatizing language occurred at higher rates among historically stigmatized patients, perpetuated by multiple provider types.

In recent years, automatic text summarization has witnessed significant advancement, particularly with the development of transformer-based models. However, the challenge of controlling the readability level of generated summaries remains an under-explored area, especially for languages with complex linguistic features like Turkish. This gap has the effect of impeding effective communication and also limits the accessibility of information. Controlling readability of textual data is an important element for creating summaries for different audiences with varying literacy and education levels, such as students ranging from primary school to graduate level, as well as individuals with diverse educational backgrounds. Summaries that align with the needs of specific reader groups can improve comprehension and engagement, ensuring that the intended message is effectively communicated. Furthermore, readability adjustment is essential to expand the usability of summarization models in educational and professional domains. Current summarization models often don't have the mechanisms to adjust the complexity of their outputs, resulting in summaries that may be too simplistic or overly complex for certain types of reader groups. Developing adaptive models that can tailor content to specific readability levels is therefore crucial. To address this problem, we create our own custom dataset and train a model with our custom architecture. Our method ensures that readability levels are effectively controlled while maintaining accuracy and coherence. We rigorously compare our model to a supervised fine-tuned baseline, demonstrating its superiority in generating readability-aware summaries.

Climate change poses critical challenges globally, disproportionately affecting low-income countries that often lack resources and linguistic representation on the international stage. Despite Bangladesh's status as one of the most vulnerable nations to climate impacts, research gaps persist in Bengali-language studies related to climate change and NLP. To address this disparity, we introduce Dhoroni, a novel Bengali (Bangla) climate change and environmental news dataset, comprising a 2300 annotated Bangla news articles, offering multiple perspectives such as political influence, scientific/statistical data, authenticity, stance detection, and stakeholder involvement. Furthermore, we present an in-depth exploratory analysis of Dhoroni and introduce BanglaBERT-Dhoroni family, a novel baseline model family for climate and environmental opinion detection in Bangla, fine-tuned on our dataset. This research contributes significantly to enhancing accessibility and analysis of climate discourse in Bengali (Bangla), addressing crucial communication and research gaps in climate-impacted regions like Bangladesh with 180 million people.

Effective conversational agents must be able to personalize their behavior to suit a user's preferences, personality, and attributes, whether they are assisting with writing tasks or operating in domains like education or healthcare. Current training methods like Reinforcement Learning from Human Feedback (RLHF) prioritize helpfulness and safety but fall short in fostering truly empathetic, adaptive, and personalized interactions. Traditional approaches to personalization often rely on extensive user history, limiting their effectiveness for new or context-limited users. To overcome these limitations, we propose to incorporate an intrinsic motivation to improve the conversational agents's model of the user as an additional reward alongside multi-turn RLHF. This reward mechanism encourages the agent to actively elicit user traits by optimizing conversations to increase the accuracy of its user model. Consequently, the policy agent can deliver more personalized interactions through obtaining more information about the user. We applied our method both education and fitness settings, where LLMs teach concepts or recommend personalized strategies based on users' hidden learning style or lifestyle attributes. Using LLM-simulated users, our approach outperformed a multi-turn RLHF baseline in revealing information about the users' preferences, and adapting to them.

Large Language Models (LLMs) have great potential in the field of health care, yet they face great challenges in adapting to rapidly evolving medical knowledge. This can lead to outdated or contradictory treatment suggestions. This study investigated how LLMs respond to evolving clinical guidelines, focusing on concept drift and internal inconsistencies. We developed the DriftMedQA benchmark to simulate guideline evolution and assessed the temporal reliability of various LLMs. Our evaluation of seven state-of-the-art models across 4,290 scenarios demonstrated difficulties in rejecting outdated recommendations and frequently endorsing conflicting guidance. Additionally, we explored two mitigation strategies: Retrieval-Augmented Generation and preference fine-tuning via Direct Preference Optimization. While each method improved model performance, their combination led to the most consistent and reliable results. These findings underscore the need to improve LLM robustness to temporal shifts to ensure more dependable applications in clinical practice.

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.

Conversational agents are increasingly used to address emotional needs on top of information needs. One use case of increasing interest are counselling-style mental health and behaviour change interventions, with large language model (LLM)-based approaches becoming more popular. Research in this context so far has been largely system-focused, foregoing the aspect of user behaviour and the impact this can have on LLM-generated texts. To address this issue, we share a dataset containing text-based user interactions related to behaviour change with two GPT-4-based conversational agents collected in a preregistered user study. This dataset includes conversation data, user language analysis, perception measures, and user feedback for LLM-generated turns, and can offer valuable insights to inform the design of such systems based on real interactions.

The increasing prevalence of mental health disorders globally highlights the urgent need for effective digital screening methods that can be used in multilingual contexts. Most existing studies, however, focus on English data, overlooking critical mental health signals that may be present in non-English texts. To address this important gap, we present the first survey on the detection of mental health disorders using multilingual social media data. We investigate the cultural nuances that influence online language patterns and self-disclosure behaviors, and how these factors can impact the performance of NLP tools. Additionally, we provide a comprehensive list of multilingual data collections that can be used for developing NLP models for mental health screening. Our findings can inform the design of effective multilingual mental health screening tools that can meet the needs of diverse populations, ultimately improving mental health outcomes on a global scale.

In this paper, we introduce InMD-X, a collection of multiple large language models specifically designed to cater to the unique characteristics and demands of Internal Medicine Doctors (IMD). InMD-X represents a groundbreaking development in natural language processing, offering a suite of language models fine-tuned for various aspects of the internal medicine field. These models encompass a wide range of medical sub-specialties, enabling IMDs to perform more efficient and accurate research, diagnosis, and documentation. InMD-X's versatility and adaptability make it a valuable tool for improving the healthcare industry, enhancing communication between healthcare professionals, and advancing medical research. Each model within InMD-X is meticulously tailored to address specific challenges faced by IMDs, ensuring the highest level of precision and comprehensiveness in clinical text analysis and decision support. This paper provides an overview of the design, development, and evaluation of InMD-X, showcasing its potential to revolutionize the way internal medicine practitioners interact with medical data and information. We present results from extensive testing, demonstrating the effectiveness and practical utility of InMD-X in real-world medical scenarios.

This paper investigates the challenges of developing large language models (LLMs) proficient in both multilingual understanding and medical knowledge. We demonstrate that simply translating medical data does not guarantee strong performance on clinical tasks in the target language. Our experiments reveal that the optimal language mix in training data varies significantly across different medical tasks. We find that larger models with carefully calibrated language ratios achieve superior performance on native-language clinical tasks. Furthermore, our results suggest that relying solely on fine-tuning may not be the most effective approach for incorporating new language knowledge into LLMs. Instead, data and computationally intensive pretraining methods may still be necessary to achieve optimal performance in multilingual medical settings. These findings provide valuable guidance for building effective and inclusive medical AI systems for diverse linguistic communities.

We study the problem of adaptively identifying patient subpopulations that benefit from a given treatment during a confirmatory clinical trial. This type of adaptive clinical trial has been thoroughly studied in biostatistics, but has been allowed only limited adaptivity so far. Here, we aim to relax classical restrictions on such designs and investigate how to incorporate ideas from the recent machine learning literature on adaptive and online experimentation to make trials more flexible and efficient. We find that the unique characteristics of the subpopulation selection problem -- most importantly that (i) one is usually interested in finding subpopulations with any treatment benefit (and not necessarily the single subgroup with largest effect) given a limited budget and that (ii) effectiveness only has to be demonstrated across the subpopulation on average -- give rise to interesting challenges and new desiderata when designing algorithmic solutions. Building on these findings, we propose AdaGGI and AdaGCPI, two meta-algorithms for subpopulation construction. We empirically investigate their performance across a range of simulation scenarios and derive insights into their (dis)advantages across different settings.

This paper presents a hybrid framework for literature reviews that augments traditional bibliometric methods with large language models (LLMs). By fine-tuning open-source LLMs, our approach enables scalable extraction of qualitative insights from large volumes of research content, enhancing both the breadth and depth of knowledge synthesis. To improve annotation efficiency and consistency, we introduce an error-focused validation process in which LLMs generate initial labels and human reviewers correct misclassifications. Applying this framework to over 20000 scientific articles about human migration, we demonstrate that a domain-adapted LLM can serve as a "specialist" model - capable of accurately selecting relevant studies, detecting emerging trends, and identifying critical research gaps. Notably, the LLM-assisted review reveals a growing scholarly interest in climate-induced migration. However, existing literature disproportionately centers on a narrow set of environmental hazards (e.g., floods, droughts, sea-level rise, and land degradation), while overlooking others that more directly affect human health and well-being, such as air and water pollution or infectious diseases. This imbalance highlights the need for more comprehensive research that goes beyond physical environmental changes to examine their ecological and societal consequences, particularly in shaping migration as an adaptive response. Overall, our proposed framework demonstrates the potential of fine-tuned LLMs to conduct more efficient, consistent, and insightful literature reviews across disciplines, ultimately accelerating knowledge synthesis and scientific discovery.

Users of social platforms often perceive these sites as supportive spaces to post about their mental health issues. Those conversations contain important traces about individuals' health risks. Recently, researchers have exploited this online information to construct mental health detection models, which aim to identify users at risk on platforms like Twitter, Reddit or Facebook. Most of these models are centred on achieving good classification results, ignoring the explainability and interpretability of the decisions. Recent research has pointed out the importance of using clinical markers, such as the use of symptoms, to improve trust in the computational models by health professionals. In this paper, we propose using transformer-based architectures to detect and explain the appearance of depressive symptom markers in the users' writings. We present two approaches: i) train a model to classify, and another one to explain the classifier's decision separately and ii) unify the two tasks simultaneously using a single model. Additionally, for this latter manner, we also investigated the performance of recent conversational LLMs when using in-context learning. Our natural language explanations enable clinicians to interpret the models' decisions based on validated symptoms, enhancing trust in the automated process. We evaluate our approach using recent symptom-based datasets, employing both offline and expert-in-the-loop metrics to assess the quality of the explanations generated by our models. The experimental results show that it is possible to achieve good classification results while generating interpretable symptom-based explanations.

This paper presents the development of a prototype Automatic Speech Recognition (ASR) system specifically designed for Bengali biomedical data. Recent advancements in Bengali ASR are encouraging, but a lack of domain-specific data limits the creation of practical healthcare ASR models. This project bridges this gap by developing an ASR system tailored for Bengali medical terms like symptoms, severity levels, and diseases, encompassing two major dialects: Bengali and Sylheti. We train and evaluate two popular ASR frameworks on a comprehensive 46-hour Bengali medical corpus. Our core objective is to create deployable health-domain ASR systems for digital health applications, ultimately increasing accessibility for non-technical users in the healthcare sector.

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.

VR simulation in Health Professions (HP) education demonstrates huge potential, but fixed learning content with little customization limits its application beyond lab environments. To address these limitations in the context of VR for patient communication training, we conducted a user-centered study involving semi-structured interviews with advanced HP students to understand their challenges in clinical communication training and perceptions of VR-based solutions. From this, we derived design insights emphasizing the importance of realistic scenarios, simple interactions, and unpredictable dialogues. Building on these insights, we developed the Virtual AI Patient Simulator (VAPS), a novel VR system powered by Large Language Models (LLMs) and Embodied Conversational Agents (ECAs), supporting dynamic and customizable patient interactions for immersive learning. We also provided an example of how clinical professors could use user-friendly design forms to create personalized scenarios that align with course objectives in VAPS and discuss future implications of integrating AI-driven technologies into VR education.

Large Language Model (LLM) agents deployed for real-world tasks face a fundamental dilemma: user requests are underspecified, yet agents must decide whether to act on incomplete information or interrupt users for clarification. Existing approaches either rely on brittle confidence thresholds that require task-specific tuning, or fail to account for the varying stakes of different decisions. We introduce a decision-theoretic framework that resolves this trade-off through the Value of Information (VoI), enabling agents to dynamically weigh the expected utility gain from asking questions against the cognitive cost imposed on users. Our inference-time method requires no hyperparameter tuning and adapts seamlessly across contexts-from casual games to medical diagnosis. Experiments across four diverse domains (20 Questions, medical diagnosis, flight booking, and e-commerce) show that VoI consistently matches or exceeds the best manually-tuned baselines, achieving up to 1.36 utility points higher in high-cost settings. This work provides a parameter-free framework for adaptive agent communication that explicitly balances task risk, query ambiguity, and user effort.

People rely on social skills like conflict resolution to communicate effectively and to thrive in both work and personal life. However, practice environments for social skills are typically out of reach for most people. How can we make social skill training more available, accessible, and inviting? Drawing upon interdisciplinary research from communication and psychology, this perspective paper identifies social skill barriers to enter specialized fields. Then we present a solution that leverages large language models for social skill training via a generic framework. Our AI Partner, AI Mentor framework merges experiential learning with realistic practice and tailored feedback. This work ultimately calls for cross-disciplinary innovation to address the broader implications for workforce development and social equality.

Cognitive Restructuring (CR) is a psychotherapeutic process aimed at identifying and restructuring an individual's negative thoughts, arising from mental health challenges, into more helpful and positive ones via multi-turn dialogues. Clinician shortage and stigma urge the development of human-LLM interactive psychotherapy for CR. Yet, existing efforts implement CR via simple text rewriting, fixed-pattern dialogues, or a one-shot CR workflow, failing to align with the psychotherapeutic process for effective CR. To address this gap, we propose CRDial, a novel framework for CR, which creates multi-turn dialogues with specifically designed identification and restructuring stages of negative thoughts, integrates sentence-level supportive conversation strategies, and adopts a multi-channel loop mechanism to enable iterative CR. With CRDial, we distill Crisp, a large-scale and high-quality bilingual dialogue dataset, from LLM. We then train Crispers, Crisp-based conversational LLMs for CR, at 7B and 14B scales. Extensive human studies show the superiority of Crispers in pointwise, pairwise, and intervention evaluations.

Social interactions are fundamental to well-being, yet automatically detecting them in daily life-particularly using wearables-remains underexplored. Most existing systems are evaluated in controlled settings, focus primarily on in-person interactions, or rely on restrictive assumptions (e.g., requiring multiple speakers within fixed temporal windows), limiting generalizability to real-world use. We present an on-watch interaction detection system designed to capture diverse interactions in naturalistic settings. A core component is a foreground speech detector trained on a public dataset. Evaluated on over 100,000 labeled foreground speech and background sound instances, the detector achieves a balanced accuracy of 85.51%, outperforming prior work by 5.11%. We evaluated the system in a real-world deployment (N=38), with over 900 hours of total smartwatch wear time. The system detected 1,691 interactions, 77.28% were confirmed via participant self-report, with durations ranging from under one minute to over one hour. Among correct detections, 81.45% were in-person, 15.7% virtual, and 1.85% hybrid. Leveraging participant-labeled data, we further developed a multimodal model achieving a balanced accuracy of 90.36% and a sensitivity of 91.17% on 33,698 labeled 15-second windows. These results demonstrate the feasibility of real-world interaction sensing and open the door to adaptive, context-aware systems responding to users' dynamic social environments.

Recently, the demand for psychological counseling has significantly increased as more individuals express concerns about their mental health. This surge has accelerated efforts to improve the accessibility of counseling by using large language models (LLMs) as counselors. To ensure client privacy, training open-source LLMs faces a key challenge: the absence of realistic counseling datasets. To address this, we introduce Cactus, a multi-turn dialogue dataset that emulates real-life interactions using the goal-oriented and structured approach of Cognitive Behavioral Therapy (CBT). We create a diverse and realistic dataset by designing clients with varied, specific personas, and having counselors systematically apply CBT techniques in their interactions. To assess the quality of our data, we benchmark against established psychological criteria used to evaluate real counseling sessions, ensuring alignment with expert evaluations. Experimental results demonstrate that Camel, a model trained with Cactus, outperforms other models in counseling skills, highlighting its effectiveness and potential as a counseling agent. We make our data, model, and code publicly available.

The rapid rise of Large Language Models (LLMs) has created new disruptive possibilities for persuasive communication, by enabling fully-automated personalized and interactive content generation at an unprecedented scale. In this paper, we survey the research field of LLM-based persuasion that has emerged as a result. We begin by exploring the different modes in which LLM Systems are used to influence human attitudes and behaviors. In areas such as politics, marketing, public health, e-commerce, and charitable giving, such LLM Systems have already achieved human-level or even super-human persuasiveness. We identify key factors influencing their effectiveness, such as the manner of personalization and whether the content is labelled as AI-generated. We also summarize the experimental designs that have been used to evaluate progress. Our survey suggests that the current and future potential of LLM-based persuasion poses profound ethical and societal risks, including the spread of misinformation, the magnification of biases, and the invasion of privacy. These risks underscore the urgent need for ethical guidelines and updated regulatory frameworks to avoid the widespread deployment of irresponsible and harmful LLM Systems.

Drawing on contemporary pragmatist philosophy and linguistic theories on cognition, meaning, and communication, this paper presents a dynamic, metasemantic-metapragmatic taxonomy for grounding and conceptualizing human-like multimodal communicative alignment. The framework is rooted in contemporary developments of the three basic communicative capacities initially identified by American logician and pragmatist philosopher Charles Sanders Peirce: iconic (sensory and perceptual qualities), indexical (contextual and sociocultural associations), and rule-like (symbolic and intuitive reasoning). Expanding on these developments, I introduce the concept of indexical contextualization and propose the principle of "contextualization directionality" for characterizing the crucial metapragmatic capacity for maintaining, navigating, or transitioning between semantic and pragmatic modes of multimodal communication. I contend that current cognitive-social computational and engineering methodologies disproportionately emphasize the semantic/metasemantic domain, overlooking the pivotal role of metapragmatic indexicality in traversing the semantic-pragmatic spectrum of communication. The framework's broader implications for intentionality, identity, affect, and ethics in within-modal and cross-modal human-machine alignment are also discussed.

While NLP research has made strides in conversational tasks, many approaches focus on single-turn responses with well-defined objectives or evaluation criteria. In contrast, coaching presents unique challenges with initially undefined goals that evolve through multi-turn interactions, subjective evaluation criteria, mixed-initiative dialogue. In this work, we describe and implement five multi-turn coaching agents that exhibit distinct conversational styles, and evaluate them through a user study, collecting first-person feedback on 155 conversations. We find that users highly value core functionality, and that stylistic components in absence of core components are viewed negatively. By comparing user feedback with third-person evaluations from health experts and an LM, we reveal significant misalignment across evaluation approaches. Our findings provide insights into design and evaluation of conversational coaching agents and contribute toward improving human-centered NLP applications.

Accessibility remains a critical concern in today's society, as many technologies are not developed to support the full range of user needs. Existing multi-agent systems (MAS) often cannot provide comprehensive assistance for users in need due to the lack of customization stemming from closed-source designs. Consequently, individuals with disabilities frequently encounter significant barriers when attempting to interact with digital environments. We introduce MATE, a multimodal accessibility MAS, which performs the modality conversions based on the user's needs. The system is useful for assisting people with disabilities by ensuring that data will be converted to an understandable format. For instance, if the user cannot see well and receives an image, the system converts this image to its audio description. MATE can be applied to a wide range of domains, industries, and areas, such as healthcare, and can become a useful assistant for various groups of users. The system supports multiple types of models, ranging from LLM API calling to using custom machine learning (ML) classifiers. This flexibility ensures that the system can be adapted to various needs and is compatible with a wide variety of hardware. Since the system is expected to run locally, it ensures the privacy and security of sensitive information. In addition, the framework can be effectively integrated with institutional technologies (e.g., digital healthcare service) for real-time user assistance. Furthermore, we introduce ModCon-Task-Identifier, a model that is capable of extracting the precise modality conversion task from the user input. Numerous experiments show that ModCon-Task-Identifier consistently outperforms other LLMs and statistical models on our custom data. Our code and data are publicly available at https://github.com/AlgazinovAleksandr/Multi-Agent-MATE.

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.

This paper describes the challenges that deaf and hard of hearing people face with creating accessible multimedia content, such as portfolios, instructional videos and video presentations. Unlike content consumption, the process of content creation itself remains highly inaccessible, creating barriers to employment in all stages of recruiting, hiring, and carrying out assigned job duties. Overcoming these barriers incurs a "deaf content creation tax" that translates into requiring significant additional time and resources to produce content equivalent to what a non-disabled person would produce. We highlight this process and associated challenges through real-world examples experienced by the authors, and provide guidance and recommendations for addressing them.

In recent years, the intersection of Natural Language Processing (NLP) and public health has opened innovative pathways for investigating various domains, including chronic pain in textual datasets. Despite the promise of NLP in chronic pain, the literature is dispersed across various disciplines, and there is a need to consolidate existing knowledge, identify knowledge gaps in the literature, and inform future research directions in this emerging field. This review aims to investigate the state of the research on NLP-based interventions designed for chronic pain research. A search strategy was formulated and executed across PubMed, Web of Science, IEEE Xplore, Scopus, and ACL Anthology to find studies published in English between 2014 and 2024. After screening 132 papers, 26 studies were included in the final review. Key findings from this review underscore the significant potential of NLP techniques to address pressing challenges in chronic pain research. The past 10 years in this field have showcased the utilization of advanced methods (transformers like RoBERTa and BERT) achieving high-performance metrics (e.g., F1>0.8) in classification tasks, while unsupervised approaches like Latent Dirichlet Allocation (LDA) and k-means clustering have proven effective for exploratory analyses. Results also reveal persistent challenges such as limited dataset diversity, inadequate sample sizes, and insufficient representation of underrepresented populations. Future research studies should explore multimodal data validation systems, context-aware mechanistic modeling, and the development of standardized evaluation metrics to enhance reproducibility and equity in chronic pain research.

Large Language Models (LLMs) have shown proficiency in generating persuasive dialogue, yet concerns about the fluency and sophistication of their outputs persist. This paper presents a multi-LLM communication framework designed to enhance the generation of persuasive data automatically. This framework facilitates the efficient production of high-quality, diverse linguistic content with minimal human oversight. Through extensive evaluations, we demonstrate that the generated data excels in naturalness, linguistic diversity, and the strategic use of persuasion, even in complex scenarios involving social taboos. The framework also proves adept at generalizing across novel contexts. Our results highlight the framework's potential to significantly advance research in both computational and social science domains concerning persuasive communication.

Diet plays a critical role in human health, yet tailoring dietary reasoning to individual health conditions remains a major challenge. Nutrition Question Answering (QA) has emerged as a popular method for addressing this problem. However, current research faces two critical limitations. On one hand, the absence of datasets involving user-specific medical information severely limits personalization. This challenge is further compounded by the wide variability in individual health needs. On the other hand, while large language models (LLMs), a popular solution for this task, demonstrate strong reasoning abilities, they struggle with the domain-specific complexities of personalized healthy dietary reasoning, and existing benchmarks fail to capture these challenges. To address these gaps, we introduce the Nutritional Graph Question Answering (NGQA) benchmark, the first graph question answering dataset designed for personalized nutritional health reasoning. NGQA leverages data from the National Health and Nutrition Examination Survey (NHANES) and the Food and Nutrient Database for Dietary Studies (FNDDS) to evaluate whether a food is healthy for a specific user, supported by explanations of the key contributing nutrients. The benchmark incorporates three question complexity settings and evaluates reasoning across three downstream tasks. Extensive experiments with LLM backbones and baseline models demonstrate that the NGQA benchmark effectively challenges existing models. In sum, NGQA addresses a critical real-world problem while advancing GraphQA research with a novel domain-specific benchmark.

Language Models (LMs) are being proposed for mental health applications where the heightened risk of adverse outcomes means predictive performance may not be a sufficient litmus test of a model's utility in clinical practice. A model that can be trusted for practice should have a correspondence between explanation and clinical determination, yet no prior research has examined the attention fidelity of these models and their effect on ground truth explanations. We introduce an evaluation design that focuses on the robustness and explainability of LMs in identifying Wellness Dimensions (WDs). We focus on two existing mental health and well-being datasets: (a) Multi-label Classification-based MultiWD, and (b) WellXplain for evaluating attention mechanism veracity against expert-labeled explanations. The labels are based on Halbert Dunn's theory of wellness, which gives grounding to our evaluation. We reveal four surprising results about LMs/LLMs: (1) Despite their human-like capabilities, GPT-3.5/4 lag behind RoBERTa, and MedAlpaca, a fine-tuned LLM on WellXplain fails to deliver any remarkable improvements in performance or explanations. (2) Re-examining LMs' predictions based on a confidence-oriented loss function reveals a significant performance drop. (3) Across all LMs/LLMs, the alignment between attention and explanations remains low, with LLMs scoring a dismal 0.0. (4) Most mental health-specific LMs/LLMs overlook domain-specific knowledge and undervalue explanations, causing these discrepancies. This study highlights the need for further research into their consistency and explanations in mental health and well-being.

As generative artificial intelligence (GAI) enters the mental health landscape, questions arise about how individuals weigh AI tools against human therapists. Drawing on the Health Belief Model (HBM), this study examined belief-based predictors of intention to use GAI and therapists across two populations: a university sample (N = 1,155) and a nationally representative adult sample (N = 651). Using repeated-measures ANOVA and LASSO regression, we found that therapists were consistently valued for emotional, relational, and personalization benefits, while GAI was favored for accessibility and affordability. Yet structural advantages alone did not predict adoption; emotional benefit and personalization emerged as decisive factors. Adoption patterns diverged across groups: students treated GAI as a complement, whereas national adults approached it as a substitute. Concerns about privacy and reliability constrained GAI use in both groups. These findings extend HBM to multi-modality contexts and highlight design implications for trustworthy, emotionally resonant digital mental health tools.

Large Language Model (LLM)-based systems increasingly rely on function calling to enable structured and controllable interaction with external data sources, yet existing datasets do not address mental health-oriented access to wearable sensor data. This paper presents a synthetic function-calling dataset designed for mental health assistance grounded in wearable health signals such as sleep, physical activity, cardiovascular measures, stress indicators, and metabolic data. The dataset maps diverse natural language queries to standardized API calls derived from a widely adopted health data schema. Each sample includes a user query, a query category, an explicit reasoning step, a normalized temporal parameter, and a target function. The dataset covers explicit, implicit, behavioral, symptom-based, and metaphorical expressions, which reflect realistic mental health-related user interactions. This resource supports research on intent grounding, temporal reasoning, and reliable function invocation in LLM-based mental health agents and is publicly released to promote reproducibility and future work.

Despite the high-quality results of text-to-image generation, stereotypical biases have been spotted in their generated contents, compromising the fairness of generative models. In this work, we propose to learn adaptive inclusive tokens to shift the attribute distribution of the final generative outputs. Unlike existing de-biasing approaches, our method requires neither explicit attribute specification nor prior knowledge of the bias distribution. Specifically, the core of our method is a lightweight adaptive mapping network, which can customize the inclusive tokens for the concepts to be de-biased, making the tokens generalizable to unseen concepts regardless of their original bias distributions. This is achieved by tuning the adaptive mapping network with a handful of balanced and inclusive samples using an anchor loss. Experimental results demonstrate that our method outperforms previous bias mitigation methods without attribute specification while preserving the alignment between generative results and text descriptions. Moreover, our method achieves comparable performance to models that require specific attributes or editing directions for generation. Extensive experiments showcase the effectiveness of our adaptive inclusive tokens in mitigating stereotypical bias in text-to-image generation. The code will be available at https://github.com/itsmag11/AITTI.

Large language models (LLMs) are increasingly applied to outpatient referral tasks across healthcare systems. However, there is a lack of standardized evaluation criteria to assess their effectiveness, particularly in dynamic, interactive scenarios. In this study, we systematically examine the capabilities and limitations of LLMs in managing tasks within Intelligent Outpatient Referral (IOR) systems and propose a comprehensive evaluation framework specifically designed for such systems. This framework comprises two core tasks: static evaluation, which focuses on evaluating the ability of predefined outpatient referrals, and dynamic evaluation, which evaluates capabilities of refining outpatient referral recommendations through iterative dialogues. Our findings suggest that LLMs offer limited advantages over BERT-like models, but show promise in asking effective questions during interactive dialogues.

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.

Ensuring equitable Artificial Intelligence (AI) in healthcare demands systems that make unbiased decisions across all demographic groups, bridging technical innovation with ethical principles. Foundation Models (FMs), trained on vast datasets through self-supervised learning, enable efficient adaptation across medical imaging tasks while reducing dependency on labeled data. These models demonstrate potential for enhancing fairness, though significant challenges remain in achieving consistent performance across demographic groups. Our review indicates that effective bias mitigation in FMs requires systematic interventions throughout all stages of development. While previous approaches focused primarily on model-level bias mitigation, our analysis reveals that fairness in FMs requires integrated interventions throughout the development pipeline, from data documentation to deployment protocols. This comprehensive framework advances current knowledge by demonstrating how systematic bias mitigation, combined with policy engagement, can effectively address both technical and institutional barriers to equitable AI in healthcare. The development of equitable FMs represents a critical step toward democratizing advanced healthcare technologies, particularly for underserved populations and regions with limited medical infrastructure and computational resources.

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.