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Apr 21

MedRAG: Enhancing Retrieval-augmented Generation with Knowledge Graph-Elicited Reasoning for Healthcare Copilot

Retrieval-augmented generation (RAG) is a well-suited technique for retrieving privacy-sensitive Electronic Health Records (EHR). It can serve as a key module of the healthcare copilot, helping reduce misdiagnosis for healthcare practitioners and patients. However, the diagnostic accuracy and specificity of existing heuristic-based RAG models used in the medical domain are inadequate, particularly for diseases with similar manifestations. This paper proposes MedRAG, a RAG model enhanced by knowledge graph (KG)-elicited reasoning for the medical domain that retrieves diagnosis and treatment recommendations based on manifestations. MedRAG systematically constructs a comprehensive four-tier hierarchical diagnostic KG encompassing critical diagnostic differences of various diseases. These differences are dynamically integrated with similar EHRs retrieved from an EHR database, and reasoned within a large language model. This process enables more accurate and specific decision support, while also proactively providing follow-up questions to enhance personalized medical decision-making. MedRAG is evaluated on both a public dataset DDXPlus and a private chronic pain diagnostic dataset (CPDD) collected from Tan Tock Seng Hospital, and its performance is compared against various existing RAG methods. Experimental results show that, leveraging the information integration and relational abilities of the KG, our MedRAG provides more specific diagnostic insights and outperforms state-of-the-art models in reducing misdiagnosis rates. Our code will be available at https://github.com/SNOWTEAM2023/MedRAG

  • 4 authors
·
Feb 6, 2025

EEG Emotion Copilot: Optimizing Lightweight LLMs for Emotional EEG Interpretation with Assisted Medical Record Generation

In the fields of affective computing (AC) and brain-machine interface (BMI), the analysis of physiological and behavioral signals to discern individual emotional states has emerged as a critical research frontier. While deep learning-based approaches have made notable strides in EEG emotion recognition, particularly in feature extraction and pattern recognition, significant challenges persist in achieving end-to-end emotion computation, including real-time processing, individual adaptation, and seamless user interaction. This paper presents the EEG Emotion Copilot, a system optimizing a lightweight large language model (LLM) with 0.5B parameters operating in a local setting, which first recognizes emotional states directly from EEG signals, subsequently generates personalized diagnostic and treatment suggestions, and finally supports the automation of assisted electronic medical records. Specifically, we demonstrate the critical techniques in the novel data structure of prompt, model pruning and fine-tuning training, and deployment strategies aiming at improving real-time performance and computational efficiency. Extensive experiments show that our optimized lightweight LLM-based copilot achieves an enhanced intuitive interface for participant interaction, superior accuracy of emotion recognition and assisted electronic medical records generation, in comparison to such models with similar scale parameters or large-scale parameters such as 1.5B, 1.8B, 3B and 7B. In summary, through these efforts, the proposed copilot is expected to advance the application of AC in the medical domain, offering innovative solution to mental health monitoring. The codes will be released at https://github.com/NZWANG/EEG_Emotion_Copilot.

  • 12 authors
·
Sep 30, 2024

GDC Cohort Copilot: An AI Copilot for Curating Cohorts from the Genomic Data Commons

Motivation: The Genomic Data Commons (GDC) provides access to high quality, harmonized cancer genomics data through a unified curation and analysis platform centered around patient cohorts. While GDC users can interactively create complex cohorts through the graphical Cohort Builder, users (especially new ones) may struggle to find specific cohort descriptors across hundreds of possible fields and properties. However, users may be better able to describe their desired cohort in free-text natural language. Results: We introduce GDC Cohort Copilot, an open-source copilot tool for curating cohorts from the GDC. GDC Cohort Copilot automatically generates the GDC cohort filter corresponding to a user-input natural language description of their desired cohort, before exporting the cohort back to the GDC for further analysis. An interactive user interface allows users to further refine the generated cohort. We develop and evaluate multiple large language models (LLMs) for GDC Cohort Copilot and demonstrate that our locally-served, open-source GDC Cohort LLM achieves better results than GPT-4o prompting in generating GDC cohorts. Availability and implementation: The standalone docker image for GDC Cohort Copilot is available at https://quay.io/repository/cdis/gdc-cohort-copilot. Source code is available at https://github.com/uc-cdis/gdc-cohort-copilot. GDC Cohort LLM weights are available at https://huggingface.co/uc-ctds.

  • 5 authors
·
Jul 2, 2025

Causal-Copilot: An Autonomous Causal Analysis Agent

Causal analysis plays a foundational role in scientific discovery and reliable decision-making, yet it remains largely inaccessible to domain experts due to its conceptual and algorithmic complexity. This disconnect between causal methodology and practical usability presents a dual challenge: domain experts are unable to leverage recent advances in causal learning, while causal researchers lack broad, real-world deployment to test and refine their methods. To address this, we introduce Causal-Copilot, an autonomous agent that operationalizes expert-level causal analysis within a large language model framework. Causal-Copilot automates the full pipeline of causal analysis for both tabular and time-series data -- including causal discovery, causal inference, algorithm selection, hyperparameter optimization, result interpretation, and generation of actionable insights. It supports interactive refinement through natural language, lowering the barrier for non-specialists while preserving methodological rigor. By integrating over 20 state-of-the-art causal analysis techniques, our system fosters a virtuous cycle -- expanding access to advanced causal methods for domain experts while generating rich, real-world applications that inform and advance causal theory. Empirical evaluations demonstrate that Causal-Copilot achieves superior performance compared to existing baselines, offering a reliable, scalable, and extensible solution that bridges the gap between theoretical sophistication and real-world applicability in causal analysis. A live interactive demo of Causal-Copilot is available at https://causalcopilot.com/.

  • 13 authors
·
Apr 17, 2025 2

Copilot Refinement: Addressing Code Smells in Copilot-Generated Python Code

As one of the most popular dynamic languages, Python experiences a decrease in readability and maintainability when code smells are present. Recent advancements in Large Language Models have sparked growing interest in AI-enabled tools for both code generation and refactoring. GitHub Copilot is one such tool that has gained widespread usage. Copilot Chat, released on September 2023, functions as an interactive tool aims at facilitating natural language-powered coding. However, limited attention has been given to understanding code smells in Copilot-generated Python code and Copilot's ability to fix the code smells it generates. To this end, we built a dataset comprising 102 code smells in Copilot-generated Python code. Our aim is to first explore the occurrence of code smells in Copilot-generated Python code and then evaluate the effectiveness of Copilot in fixing these code smells employing different prompts. The results show that 8 out of 10 types of Python smells can be detected in Copilot-generated Python code, among which Multiply-Nested Container is the most common one. For these code smells, Copilot Chat achieves a highest fixing rate of 87.1%, showing promise in fixing Python code smells generated by Copilot itself. Besides, the effectiveness of Copilot Chat in fixing these smells can be improved with the provision of more detailed prompts. However, using Copilot Chat to fix these smells might introduce new code smells.

  • 5 authors
·
Jan 25, 2024

CarePilot: A Multi-Agent Framework for Long-Horizon Computer Task Automation in Healthcare

Multimodal agentic pipelines are transforming human-computer interaction by enabling efficient and accessible automation of complex, real-world tasks. However, recent efforts have focused on short-horizon or general-purpose applications (e.g., mobile or desktop interfaces), leaving long-horizon automation for domain-specific systems, particularly in healthcare, largely unexplored. To address this, we introduce CareFlow, a high-quality human-annotated benchmark comprising complex, long-horizon software workflows across medical annotation tools, DICOM viewers, EHR systems, and laboratory information systems. On this benchmark, existing vision-language models (VLMs) perform poorly, struggling with long-horizon reasoning and multi-step interactions in medical contexts. To overcome this, we propose CarePilot, a multi-agent framework based on the actor-critic paradigm. The Actor integrates tool grounding with dual-memory mechanisms (long-term and short-term experience) to predict the next semantic action from the visual interface and system state. The Critic evaluates each action, updates memory based on observed effects, and either executes or provides corrective feedback to refine the workflow. Through iterative agentic simulation, the Actor learns to perform more robust and reasoning-aware predictions during inference. Our experiments show that CarePilot achieves state-of-the-art performance, outperforming strong closed-source and open-source multimodal baselines by approximately 15.26% and 3.38%, respectively, on our benchmark and out-of-distribution dataset.

T2I-Copilot: A Training-Free Multi-Agent Text-to-Image System for Enhanced Prompt Interpretation and Interactive Generation

Text-to-Image (T2I) generative models have revolutionized content creation but remain highly sensitive to prompt phrasing, often requiring users to repeatedly refine prompts multiple times without clear feedback. While techniques such as automatic prompt engineering, controlled text embeddings, denoising, and multi-turn generation mitigate these issues, they offer limited controllability, or often necessitate additional training, restricting the generalization abilities. Thus, we introduce T2I-Copilot, a training-free multi-agent system that leverages collaboration between (Multimodal) Large Language Models to automate prompt phrasing, model selection, and iterative refinement. This approach significantly simplifies prompt engineering while enhancing generation quality and text-image alignment compared to direct generation. Specifically, T2I-Copilot consists of three agents: (1) Input Interpreter, which parses the input prompt, resolves ambiguities, and generates a standardized report; (2) Generation Engine, which selects the appropriate model from different types of T2I models and organizes visual and textual prompts to initiate generation; and (3) Quality Evaluator, which assesses aesthetic quality and text-image alignment, providing scores and feedback for potential regeneration. T2I-Copilot can operate fully autonomously while also supporting human-in-the-loop intervention for fine-grained control. On GenAI-Bench, using open-source generation models, T2I-Copilot achieves a VQA score comparable to commercial models RecraftV3 and Imagen 3, surpasses FLUX1.1-pro by 6.17% at only 16.59% of its cost, and outperforms FLUX.1-dev and SD 3.5 Large by 9.11% and 6.36%. Code will be released at: https://github.com/SHI-Labs/T2I-Copilot.

  • 4 authors
·
Jul 28, 2025

Data-Copilot: Bridging Billions of Data and Humans with Autonomous Workflow

Various industries such as finance, meteorology, and energy generate vast amounts of heterogeneous data every day. There is a natural demand for humans to manage, process, and display data efficiently. However, it necessitates labor-intensive efforts and a high level of expertise for these data-related tasks. Considering that large language models (LLMs) have showcased promising capabilities in semantic understanding and reasoning, we advocate that the deployment of LLMs could autonomously manage and process massive amounts of data while displaying and interacting in a human-friendly manner. Based on this belief, we propose Data-Copilot, an LLM-based system that connects numerous data sources on one end and caters to diverse human demands on the other end. Acting like an experienced expert, Data-Copilot autonomously transforms raw data into visualization results that best match the user's intent. Specifically, Data-Copilot autonomously designs versatile interfaces (tools) for data management, processing, prediction, and visualization. In real-time response, it automatically deploys a concise workflow by invoking corresponding interfaces step by step for the user's request. The interface design and deployment processes are fully controlled by Data-Copilot itself, without human assistance. Besides, we create a Data-Copilot demo that links abundant data from different domains (stock, fund, company, economics, and live news) and accurately respond to diverse requests, serving as a reliable AI assistant.

  • 4 authors
·
Jun 12, 2023

CP-Env: Evaluating Large Language Models on Clinical Pathways in a Controllable Hospital Environment

Medical care follows complex clinical pathways that extend beyond isolated physician-patient encounters, emphasizing decision-making and transitions between different stages. Current benchmarks focusing on static exams or isolated dialogues inadequately evaluate large language models (LLMs) in dynamic clinical scenarios. We introduce CP-Env, a controllable agentic hospital environment designed to evaluate LLMs across end-to-end clinical pathways. CP-Env simulates a hospital ecosystem with patient and physician agents, constructing scenarios ranging from triage and specialist consultation to diagnostic testing and multidisciplinary team meetings for agent interaction. Following real hospital adaptive flow of healthcare, it enables branching, long-horizon task execution. We propose a three-tiered evaluation framework encompassing Clinical Efficacy, Process Competency, and Professional Ethics. Results reveal that most models struggle with pathway complexity, exhibiting hallucinations and losing critical diagnostic details. Interestingly, excessive reasoning steps can sometimes prove counterproductive, while top models tend to exhibit reduced tool dependency through internalized knowledge. CP-Env advances medical AI agents development through comprehensive end-to-end clinical evaluation. We provide the benchmark and evaluation tools for further research and development at https://github.com/SPIRAL-MED/CP_ENV.

  • 8 authors
·
Dec 10, 2025

Transformer Copilot: Learning from The Mistake Log in LLM Fine-tuning

Large language models are typically adapted to downstream tasks through supervised fine-tuning on domain-specific data. While standard fine-tuning focuses on minimizing generation loss to optimize model parameters, we take a deeper step by retaining and leveraging the model's own learning signals, analogous to how human learners reflect on past mistakes to improve future performance. We first introduce the concept of Mistake Log to systematically track the model's learning behavior and recurring errors throughout fine-tuning. Treating the original transformer-based model as the Pilot, we correspondingly design a Copilot model to refine the Pilot's inference performance via logits rectification. We name the overall Pilot-Copilot framework the Transformer Copilot, which introduces (i) a novel Copilot model design, (ii) a joint training paradigm where the Copilot continuously learns from the evolving Mistake Log alongside the Pilot, and (iii) a fused inference paradigm where the Copilot rectifies the Pilot's logits for enhanced generation. We provide both theoretical and empirical analyses on our new learning framework. Experiments on 12 benchmarks spanning commonsense, arithmetic, and recommendation tasks demonstrate that Transformer Copilot consistently improves performance by up to 34.5%, while introducing marginal computational overhead to Pilot models and exhibiting strong scalability and transferability.

  • 7 authors
·
May 22, 2025 2

Tutor CoPilot: A Human-AI Approach for Scaling Real-Time Expertise

Generative AI, particularly Language Models (LMs), has the potential to transform real-world domains with societal impact, particularly where access to experts is limited. For example, in education, training novice educators with expert guidance is important for effectiveness but expensive, creating significant barriers to improving education quality at scale. This challenge disproportionately harms students from under-served communities, who stand to gain the most from high-quality education. We introduce Tutor CoPilot, a novel Human-AI approach that leverages a model of expert thinking to provide expert-like guidance to tutors as they tutor. This study is the first randomized controlled trial of a Human-AI system in live tutoring, involving 900 tutors and 1,800 K-12 students from historically under-served communities. Following a preregistered analysis plan, we find that students working with tutors that have access to Tutor CoPilot are 4 percentage points (p.p.) more likely to master topics (p<0.01). Notably, students of lower-rated tutors experienced the greatest benefit, improving mastery by 9 p.p. We find that Tutor CoPilot costs only $20 per-tutor annually. We analyze 550,000+ messages using classifiers to identify pedagogical strategies, and find that tutors with access to Tutor CoPilot are more likely to use high-quality strategies to foster student understanding (e.g., asking guiding questions) and less likely to give away the answer to the student. Tutor interviews highlight how Tutor CoPilot's guidance helps tutors to respond to student needs, though they flag issues in Tutor CoPilot, such as generating suggestions that are not grade-level appropriate. Altogether, our study of Tutor CoPilot demonstrates how Human-AI systems can scale expertise in real-world domains, bridge gaps in skills and create a future where high-quality education is accessible to all students.

  • 5 authors
·
Oct 3, 2024 5

WiNGPT-3.0 Technical Report

Current Large Language Models (LLMs) exhibit significant limitations, notably in structured, interpretable, and verifiable medical reasoning, alongside practical deployment challenges related to computational resources and data privacy. This report focused on the development of WiNGPT-3.0, the 32-billion parameter LLMs, engineered with the objective of enhancing its capacity for medical reasoning and exploring its potential for effective integration within healthcare IT infrastructures. The broader aim is to advance towards clinically applicable models. The approach involved a multi-stage training pipeline tailored for general, medical, and clinical reasoning. This pipeline incorporated supervised fine-tuning (SFT) and reinforcement learning (RL), leveraging curated Long Chain-of-Thought (CoT) datasets, auxiliary reward models, and an evidence-based diagnostic chain simulation. WiNGPT-3.0 demonstrated strong performance: specific model variants achieved scores of 66.6 on MedCalc and 87.1 on MedQA-USMLE. Furthermore, targeted training improved performance on a clinical reasoning task from a baseline score of 58.1 to 62.5. These findings suggest that reinforcement learning, even when applied with a limited dataset of only a few thousand examples, can enhance medical reasoning accuracy. Crucially, this demonstration of RL's efficacy with limited data and computation paves the way for more trustworthy and practically deployable LLMs within clinical workflows and health information infrastructures.

  • 13 authors
·
May 22, 2025

GenHPF: General Healthcare Predictive Framework with Multi-task Multi-source Learning

Despite the remarkable progress in the development of predictive models for healthcare, applying these algorithms on a large scale has been challenging. Algorithms trained on a particular task, based on specific data formats available in a set of medical records, tend to not generalize well to other tasks or databases in which the data fields may differ. To address this challenge, we propose General Healthcare Predictive Framework (GenHPF), which is applicable to any EHR with minimal preprocessing for multiple prediction tasks. GenHPF resolves heterogeneity in medical codes and schemas by converting EHRs into a hierarchical textual representation while incorporating as many features as possible. To evaluate the efficacy of GenHPF, we conduct multi-task learning experiments with single-source and multi-source settings, on three publicly available EHR datasets with different schemas for 12 clinically meaningful prediction tasks. Our framework significantly outperforms baseline models that utilize domain knowledge in multi-source learning, improving average AUROC by 1.2%P in pooled learning and 2.6%P in transfer learning while also showing comparable results when trained on a single EHR dataset. Furthermore, we demonstrate that self-supervised pretraining using multi-source datasets is effective when combined with GenHPF, resulting in a 0.6%P AUROC improvement compared to models without pretraining. By eliminating the need for preprocessing and feature engineering, we believe that this work offers a solid framework for multi-task and multi-source learning that can be leveraged to speed up the scaling and usage of predictive algorithms in healthcare.

  • 10 authors
·
Jul 20, 2022

Vision Language Models in Medicine

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.

  • 3 authors
·
Feb 24, 2025

SurgRAW: Multi-Agent Workflow with Chain-of-Thought Reasoning for Surgical Intelligence

Integration of Vision-Language Models (VLMs) in surgical intelligence is hindered by hallucinations, domain knowledge gaps, and limited understanding of task interdependencies within surgical scenes, undermining clinical reliability. While recent VLMs demonstrate strong general reasoning and thinking capabilities, they still lack the domain expertise and task-awareness required for precise surgical scene interpretation. Although Chain-of-Thought (CoT) can structure reasoning more effectively, current approaches rely on self-generated CoT steps, which often exacerbate inherent domain gaps and hallucinations. To overcome this, we present SurgRAW, a CoT-driven multi-agent framework that delivers transparent, interpretable insights for most tasks in robotic-assisted surgery. By employing specialized CoT prompts across five tasks: instrument recognition, action recognition, action prediction, patient data extraction, and outcome assessment, SurgRAW mitigates hallucinations through structured, domain-aware reasoning. Retrieval-Augmented Generation (RAG) is also integrated to external medical knowledge to bridge domain gaps and improve response reliability. Most importantly, a hierarchical agentic system ensures that CoT-embedded VLM agents collaborate effectively while understanding task interdependencies, with a panel discussion mechanism promotes logical consistency. To evaluate our method, we introduce SurgCoTBench, the first reasoning-based dataset with structured frame-level annotations. With comprehensive experiments, we demonstrate the effectiveness of proposed SurgRAW with 29.32% accuracy improvement over baseline VLMs on 12 robotic procedures, achieving the state-of-the-art performance and advancing explainable, trustworthy, and autonomous surgical assistance.

  • 7 authors
·
Mar 13, 2025

EHRCon: Dataset for Checking Consistency between Unstructured Notes and Structured Tables in Electronic Health Records

Electronic Health Records (EHRs) are integral for storing comprehensive patient medical records, combining structured data (e.g., medications) with detailed clinical notes (e.g., physician notes). These elements are essential for straightforward data retrieval and provide deep, contextual insights into patient care. However, they often suffer from discrepancies due to unintuitive EHR system designs and human errors, posing serious risks to patient safety. To address this, we developed EHRCon, a new dataset and task specifically designed to ensure data consistency between structured tables and unstructured notes in EHRs. EHRCon was crafted in collaboration with healthcare professionals using the MIMIC-III EHR dataset, and includes manual annotations of 3,943 entities across 105 clinical notes checked against database entries for consistency. EHRCon has two versions, one using the original MIMIC-III schema, and another using the OMOP CDM schema, in order to increase its applicability and generalizability. Furthermore, leveraging the capabilities of large language models, we introduce CheckEHR, a novel framework for verifying the consistency between clinical notes and database tables. CheckEHR utilizes an eight-stage process and shows promising results in both few-shot and zero-shot settings. The code is available at https://github.com/dustn1259/EHRCon.

  • 9 authors
·
Jun 24, 2024 7

Benchmarking emergency department triage prediction models with machine learning and large public electronic health records

The demand for emergency department (ED) services is increasing across the globe, particularly during the current COVID-19 pandemic. Clinical triage and risk assessment have become increasingly challenging due to the shortage of medical resources and the strain on hospital infrastructure caused by the pandemic. As a result of the widespread use of electronic health records (EHRs), we now have access to a vast amount of clinical data, which allows us to develop predictive models and decision support systems to address these challenges. To date, however, there are no widely accepted benchmark ED triage prediction models based on large-scale public EHR data. An open-source benchmarking platform would streamline research workflows by eliminating cumbersome data preprocessing, and facilitate comparisons among different studies and methodologies. In this paper, based on the Medical Information Mart for Intensive Care IV Emergency Department (MIMIC-IV-ED) database, we developed a publicly available benchmark suite for ED triage predictive models and created a benchmark dataset that contains over 400,000 ED visits from 2011 to 2019. We introduced three ED-based outcomes (hospitalization, critical outcomes, and 72-hour ED reattendance) and implemented a variety of popular methodologies, ranging from machine learning methods to clinical scoring systems. We evaluated and compared the performance of these methods against benchmark tasks. Our codes are open-source, allowing anyone with MIMIC-IV-ED data access to perform the same steps in data processing, benchmark model building, and experiments. This study provides future researchers with insights, suggestions, and protocols for managing raw data and developing risk triaging tools for emergency care.

  • 13 authors
·
Nov 22, 2021

Hippocrates: An Open-Source Framework for Advancing Large Language Models in Healthcare

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

  • 7 authors
·
Apr 25, 2024

Generalist Foundation Models Are Not Clinical Enough for Hospital Operations

Hospitals and healthcare systems rely on operational decisions that determine patient flow, cost, and quality of care. Despite strong performance on medical knowledge and conversational benchmarks, foundation models trained on general text may lack the specialized knowledge required for these operational decisions. We introduce Lang1, a family of models (100M-7B parameters) pretrained on a specialized corpus blending 80B clinical tokens from NYU Langone Health's EHRs and 627B tokens from the internet. To rigorously evaluate Lang1 in real-world settings, we developed the REalistic Medical Evaluation (ReMedE), a benchmark derived from 668,331 EHR notes that evaluates five critical tasks: 30-day readmission prediction, 30-day mortality prediction, length of stay, comorbidity coding, and predicting insurance claims denial. In zero-shot settings, both general-purpose and specialized models underperform on four of five tasks (36.6%-71.7% AUROC), with mortality prediction being an exception. After finetuning, Lang1-1B outperforms finetuned generalist models up to 70x larger and zero-shot models up to 671x larger, improving AUROC by 3.64%-6.75% and 1.66%-23.66% respectively. We also observed cross-task scaling with joint finetuning on multiple tasks leading to improvement on other tasks. Lang1-1B effectively transfers to out-of-distribution settings, including other clinical tasks and an external health system. Our findings suggest that predictive capabilities for hospital operations require explicit supervised finetuning, and that this finetuning process is made more efficient by in-domain pretraining on EHR. Our findings support the emerging view that specialized LLMs can compete with generalist models in specialized tasks, and show that effective healthcare systems AI requires the combination of in-domain pretraining, supervised finetuning, and real-world evaluation beyond proxy benchmarks.

newyorkuniversity New York University
·
Nov 17, 2025 3

Demystifying Large Language Models for Medicine: A Primer

Large language models (LLMs) represent a transformative class of AI tools capable of revolutionizing various aspects of healthcare by generating human-like responses across diverse contexts and adapting to novel tasks following human instructions. Their potential application spans a broad range of medical tasks, such as clinical documentation, matching patients to clinical trials, and answering medical questions. In this primer paper, we propose an actionable guideline to help healthcare professionals more efficiently utilize LLMs in their work, along with a set of best practices. This approach consists of several main phases, including formulating the task, choosing LLMs, prompt engineering, fine-tuning, and deployment. We start with the discussion of critical considerations in identifying healthcare tasks that align with the core capabilities of LLMs and selecting models based on the selected task and data, performance requirements, and model interface. We then review the strategies, such as prompt engineering and fine-tuning, to adapt standard LLMs to specialized medical tasks. Deployment considerations, including regulatory compliance, ethical guidelines, and continuous monitoring for fairness and bias, are also discussed. By providing a structured step-by-step methodology, this tutorial aims to equip healthcare professionals with the tools necessary to effectively integrate LLMs into clinical practice, ensuring that these powerful technologies are applied in a safe, reliable, and impactful manner.

  • 23 authors
·
Oct 24, 2024

A Survey on Medical Large Language Models: Technology, Application, Trustworthiness, and Future Directions

With the advent of Large Language Models (LLMs), medical artificial intelligence (AI) has experienced substantial technological progress and paradigm shifts, highlighting the potential of LLMs to streamline healthcare delivery and improve patient outcomes. Considering this rapid technical progress, in this survey, we trace the recent advances of Medical Large Language Models (Med-LLMs), including the background, key findings, and mainstream techniques, especially for the evolution from general-purpose models to medical-specialized applications. Firstly, we delve into the foundational technology of Med-LLMs, indicating how general models can be progressively adapted and refined for the complicated medical tasks. Secondly, the wide-ranging applications of Med-LLMs are investigated across various healthcare domains, as well as an up-to-date review of existing Med-LLMs. The transformative impact of these models on daily medical practice is evident through their ability to assist clinicians, educators, and patients. Recognizing the importance of responsible innovation, we discuss the challenges associated with ensuring fairness, accountability, privacy, and robustness. Ethical considerations, rigorous evaluation methodologies, and the establishment of regulatory frameworks are crucial for building trustworthiness in the real-world system. We emphasize the need for ongoing scrutiny and development to maintain high standards of safety and reliability. Finally, we anticipate possible future trajectories for Med-LLMs, identifying key avenues for prudent expansion. By consolidating these insights, our review aims to provide professionals and researchers with a thorough understanding of the strengths and limitations of Med-LLMs, fostering a balanced and ethical approach to their integration into the healthcare ecosystem.

  • 9 authors
·
Jun 5, 2024

ACES: Automatic Cohort Extraction System for Event-Stream Datasets

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

  • 4 authors
·
Jun 28, 2024

PARHAF, a human-authored corpus of clinical reports for fictitious patients in French

The development of clinical natural language processing (NLP) systems is severely hampered by the sensitive nature of medical records, which restricts data sharing under stringent privacy regulations, particularly in France and the broader European Union. To address this gap, we introduce PARHAF, a large open-source corpus of clinical documents in French. PARHAF comprises expert-authored clinical reports describing realistic yet entirely fictitious patient cases, making it anonymous and freely shareable by design. The corpus was developed using a structured protocol that combined clinician expertise with epidemiological guidance from the French National Health Data System (SNDS), ensuring broad clinical coverage. A total of 104 medical residents across 18 specialties authored and peer-reviewed the reports following predefined clinical scenarios and document templates. The corpus contains 7394 clinical reports covering 5009 patient cases across a wide range of medical and surgical specialties. It includes a general-purpose component designed to approximate real-world hospitalization distributions, and four specialized subsets that support information-extraction use cases in oncology, infectious diseases, and diagnostic coding. Documents are released under a CC-BY open license, with a portion temporarily embargoed to enable future benchmarking under controlled conditions. PARHAF provides a valuable resource for training and evaluating French clinical language models in a fully privacy-preserving setting, and establishes a replicable methodology for building shareable synthetic clinical corpora in other languages and health systems.

  • 7 authors
·
Mar 20

Where Are Large Language Models for Code Generation on GitHub?

The increasing use of Large Language Models (LLMs) in software development has garnered significant attention from researchers assessing the quality of the code they generate. However, much of the research focuses on controlled datasets such as HumanEval, which fail to adequately represent how developers actually utilize LLMs' code generation capabilities or clarify the characteristics of LLM-generated code in real-world development scenarios. To bridge this gap, our study investigates the characteristics of LLM-generated code and its corresponding projects hosted on GitHub. Our findings reveal several key insights: (1) ChatGPT and Copilot are the most frequently utilized for generating code on GitHub. In contrast, there is very little code generated by other LLMs on GitHub. (2) Projects containing ChatGPT/Copilot-generated code are often small and less known, led by individuals or small teams. Despite this, most projects are continuously evolving and improving. (3) ChatGPT/Copilot is mainly utilized for generating Python, Java, and TypeScript scripts for data processing and transformation. C/C++ and JavaScript code generation focuses on algorithm and data structure implementation and user interface code. Most ChatGPT/Copilot-generated code snippets are relatively short and exhibit low complexity. (4) Compared to human-written code, ChatGPT/Copilot-generated code exists in a small proportion of projects and generally undergoes fewer modifications. Additionally, modifications due to bugs are even fewer, ranging from just 3% to 8% across different languages. (5) Most comments on ChatGPT/Copilot-generated code lack detailed information, often only stating the code's origin without mentioning prompts, human modifications, or testing status. Based on these findings, we discuss the implications for researchers and practitioners.

  • 6 authors
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Jun 27, 2024

Medical Hallucinations in Foundation Models and Their Impact on Healthcare

Foundation Models that are capable of processing and generating multi-modal data have transformed AI's role in medicine. However, a key limitation of their reliability is hallucination, where inaccurate or fabricated information can impact clinical decisions and patient safety. We define medical hallucination as any instance in which a model generates misleading medical content. This paper examines the unique characteristics, causes, and implications of medical hallucinations, with a particular focus on how these errors manifest themselves in real-world clinical scenarios. Our contributions include (1) a taxonomy for understanding and addressing medical hallucinations, (2) benchmarking models using medical hallucination dataset and physician-annotated LLM responses to real medical cases, providing direct insight into the clinical impact of hallucinations, and (3) a multi-national clinician survey on their experiences with medical hallucinations. Our results reveal that inference techniques such as Chain-of-Thought (CoT) and Search Augmented Generation can effectively reduce hallucination rates. However, despite these improvements, non-trivial levels of hallucination persist. These findings underscore the ethical and practical imperative for robust detection and mitigation strategies, establishing a foundation for regulatory policies that prioritize patient safety and maintain clinical integrity as AI becomes more integrated into healthcare. The feedback from clinicians highlights the urgent need for not only technical advances but also for clearer ethical and regulatory guidelines to ensure patient safety. A repository organizing the paper resources, summaries, and additional information is available at https://github.com/mitmedialab/medical hallucination.

  • 25 authors
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Feb 25, 2025

A Survey of Large Language Models for Healthcare: from Data, Technology, and Applications to Accountability and Ethics

The utilization of large language models (LLMs) in the Healthcare domain has generated both excitement and concern due to their ability to effectively respond to freetext queries with certain professional knowledge. This survey outlines the capabilities of the currently developed LLMs for Healthcare and explicates their development process, with the aim of providing an overview of the development roadmap from traditional Pretrained Language Models (PLMs) to LLMs. Specifically, we first explore the potential of LLMs to enhance the efficiency and effectiveness of various Healthcare applications highlighting both the strengths and limitations. Secondly, we conduct a comparison between the previous PLMs and the latest LLMs, as well as comparing various LLMs with each other. Then we summarize related Healthcare training data, training methods, optimization strategies, and usage. Finally, the unique concerns associated with deploying LLMs in Healthcare settings are investigated, particularly regarding fairness, accountability, transparency and ethics. Our survey provide a comprehensive investigation from perspectives of both computer science and Healthcare specialty. Besides the discussion about Healthcare concerns, we supports the computer science community by compiling a collection of open source resources, such as accessible datasets, the latest methodologies, code implementations, and evaluation benchmarks in the Github. Summarily, we contend that a significant paradigm shift is underway, transitioning from PLMs to LLMs. This shift encompasses a move from discriminative AI approaches to generative AI approaches, as well as a shift from model-centered methodologies to datacentered methodologies.

  • 7 authors
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Oct 9, 2023 1

Efficient and Personalized Mobile Health Event Prediction via Small Language Models

Healthcare monitoring is crucial for early detection, timely intervention, and the ongoing management of health conditions, ultimately improving individuals' quality of life. Recent research shows that Large Language Models (LLMs) have demonstrated impressive performance in supporting healthcare tasks. However, existing LLM-based healthcare solutions typically rely on cloud-based systems, which raise privacy concerns and increase the risk of personal information leakage. As a result, there is growing interest in running these models locally on devices like mobile phones and wearables to protect users' privacy. Small Language Models (SLMs) are potential candidates to solve privacy and computational issues, as they are more efficient and better suited for local deployment. However, the performance of SLMs in healthcare domains has not yet been investigated. This paper examines the capability of SLMs to accurately analyze health data, such as steps, calories, sleep minutes, and other vital statistics, to assess an individual's health status. Our results show that, TinyLlama, which has 1.1 billion parameters, utilizes 4.31 GB memory, and has 0.48s latency, showing the best performance compared other four state-of-the-art (SOTA) SLMs on various healthcare applications. Our results indicate that SLMs could potentially be deployed on wearable or mobile devices for real-time health monitoring, providing a practical solution for efficient and privacy-preserving healthcare.

  • 4 authors
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Sep 16, 2024

Healthsheet: Development of a Transparency Artifact for Health Datasets

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.

  • 10 authors
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Feb 25, 2022

What Makes a GitHub Issue Ready for Copilot?

AI-agents help developers in different coding tasks, such as developing new features, fixing bugs, and reviewing code. Developers can write a Github issue and assign it to an AI-agent like Copilot for implementation. Based on the issue and its related discussion, the AI-agent performs a plan for the implementation, and executes it. However, the performance of AI-agents and LLMs heavily depends on the input they receive. For instance, a GitHub issue that is unclear or not well scoped might not lead to a successful implementation that will eventually be merged. GitHub Copilot provides a set of best practice recommendations that are limited and high-level. In this paper, we build a set of 32 detailed criteria that we leverage to measure the quality of GitHub issues to make them suitable for AI-agents. We compare the GitHub issues that lead to a merged pull request versus closed pull request. Then, we build an interpretable machine learning model to predict the likelihood of a GitHub issue resulting in a merged pull request. We observe that pull requests that end up being merged are those originating from issues that are shorter, well scoped, with clear guidance and hints about the relevant artifacts for an issue, and with guidance on how to perform the implementation. Issues with external references including configuration, context setup, dependencies or external APIs are associated with lower merge rates. We built an interpretable machine learning model to help users identify how to improve a GitHub issue to increase the chances of the issue resulting in a merged pull request by Copilot. Our model has a median AUC of 72\%. Our results shed light on quality metrics relevant for writing GitHub issues and motivate future studies further investigate the writing of GitHub issues as a first-class software engineering activity in the era of AI-teammates.

  • 1 authors
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Dec 24, 2025

Harnessing the Potential of Gen-AI Coding Assistants in Public Sector Software Development

The study on GitHub Copilot by GovTech Singapore's Engineering Productivity Programme (EPP) reveals significant potential for AI Code Assistant tools to boost developer productivity and improve application quality in the public sector. Highlighting the substantial benefits for the public sector, the study observed an increased productivity (coding / tasks speed increased by 21-28%), which translates into accelerated development, and quicker go-to-market, with a notable consensus (95%) that the tool increases developer satisfaction. Particularly, junior developers experienced considerable efficiency gains and reduced coding times, illustrating Copilot's capability to enhance job satisfaction by easing routine tasks. This advancement allows for a sharper focus on complex projects, faster learning, and improved code quality. Recognising the strategic importance of these tools, the study recommends the development of an AI Framework to maximise such benefits while cautioning against potential over-reliance without solid foundational programming skills. It also advises public sector developers to classify their code as "Open" to use Gen-AI Coding Assistant tools on the Cloud like GitHub Copilot and to consider self-hosted tools like Codeium or Code Llama for confidential code to leverage technology efficiently within the public sector framework. With up to 8,000 developers, comprising both public officers and vendors developing applications for the public sector and its customers, there is significant potential to enhance productivity.

  • 4 authors
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Sep 25, 2024

Polaris: A Safety-focused LLM Constellation Architecture for Healthcare

We develop Polaris, the first safety-focused LLM constellation for real-time patient-AI healthcare conversations. Unlike prior LLM works in healthcare focusing on tasks like question answering, our work specifically focuses on long multi-turn voice conversations. Our one-trillion parameter constellation system is composed of several multibillion parameter LLMs as co-operative agents: a stateful primary agent that focuses on driving an engaging conversation and several specialist support agents focused on healthcare tasks performed by nurses to increase safety and reduce hallucinations. We develop a sophisticated training protocol for iterative co-training of the agents that optimize for diverse objectives. We train our models on proprietary data, clinical care plans, healthcare regulatory documents, medical manuals, and other medical reasoning documents. We align our models to speak like medical professionals, using organic healthcare conversations and simulated ones between patient actors and experienced nurses. This allows our system to express unique capabilities such as rapport building, trust building, empathy and bedside manner. Finally, we present the first comprehensive clinician evaluation of an LLM system for healthcare. We recruited over 1100 U.S. licensed nurses and over 130 U.S. licensed physicians to perform end-to-end conversational evaluations of our system by posing as patients and rating the system on several measures. We demonstrate Polaris performs on par with human nurses on aggregate across dimensions such as medical safety, clinical readiness, conversational quality, and bedside manner. Additionally, we conduct a challenging task-based evaluation of the individual specialist support agents, where we demonstrate our LLM agents significantly outperform a much larger general-purpose LLM (GPT-4) as well as from its own medium-size class (LLaMA-2 70B).

  • 26 authors
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Mar 20, 2024

Large Language Models Illuminate a Progressive Pathway to Artificial Healthcare Assistant: A Review

With the rapid development of artificial intelligence, large language models (LLMs) have shown promising capabilities in mimicking human-level language comprehension and reasoning. This has sparked significant interest in applying LLMs to enhance various aspects of healthcare, ranging from medical education to clinical decision support. However, medicine involves multifaceted data modalities and nuanced reasoning skills, presenting challenges for integrating LLMs. This paper provides a comprehensive review on the applications and implications of LLMs in medicine. It begins by examining the fundamental applications of general-purpose and specialized LLMs, demonstrating their utilities in knowledge retrieval, research support, clinical workflow automation, and diagnostic assistance. Recognizing the inherent multimodality of medicine, the review then focuses on multimodal LLMs, investigating their ability to process diverse data types like medical imaging and EHRs to augment diagnostic accuracy. To address LLMs' limitations regarding personalization and complex clinical reasoning, the paper explores the emerging development of LLM-powered autonomous agents for healthcare. Furthermore, it summarizes the evaluation methodologies for assessing LLMs' reliability and safety in medical contexts. Overall, this review offers an extensive analysis on the transformative potential of LLMs in modern medicine. It also highlights the pivotal need for continuous optimizations and ethical oversight before these models can be effectively integrated into clinical practice. Visit https://github.com/mingze-yuan/Awesome-LLM-Healthcare for an accompanying GitHub repository containing latest papers.

  • 11 authors
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Nov 3, 2023