Sunyang Fu

Ziyi Chen, Ren Yang, Sunyang Fu et al.

Depression is a widespread mental health issue, affecting an estimated 3.8% of the global population. It is also one of the main contributors to disability worldwide. Recently it is becoming popular for individuals to use social media platforms (e.g., Reddit) to express their difficulties and health issues (e.g., depression) and seek support from other users in online communities. It opens great opportunities to automatically identify social media users with depression by parsing millions of posts for potential interventions. Deep learning methods have begun to dominate in the field of machine learning and natural language processing (NLP) because of their ease of use, efficient processing, and state-of-the-art results on many NLP tasks. In this work, we propose a hybrid deep learning model which combines a pretrained sentence BERT (SBERT) and convolutional neural network (CNN) to detect individuals with depression with their Reddit posts. The sentence BERT is used to learn the meaningful representation of semantic information in each post. CNN enables the further transformation of those embeddings and the temporal identification of behavioral patterns of users. We trained and evaluated the model performance to identify Reddit users with depression by utilizing the Self-reported Mental Health Diagnoses (SMHD) data. The hybrid deep learning model achieved an accuracy of 0.86 and an F1 score of 0.86 and outperformed the state-of-the-art documented result (F1 score of 0.79) by other machine learning models in the literature. The results show the feasibility of the hybrid model to identify individuals with depression. Although the hybrid model is validated to detect depression with Reddit posts, it can be easily tuned and applied to other text classification tasks and different clinical applications.

Thomas Yu Chow Tam, Sonish Sivarajkumar, Sumit Kapoor et al.

With generative artificial intelligence (AI), particularly large language models (LLMs), continuing to make inroads in healthcare, it is critical to supplement traditional automated evaluations with human evaluations. Understanding and evaluating the output of LLMs is essential to assuring safety, reliability, and effectiveness. However, human evaluation's cumbersome, time-consuming, and non-standardized nature presents significant obstacles to comprehensive evaluation and widespread adoption of LLMs in practice. This study reviews existing literature on human evaluation methodologies for LLMs in healthcare. We highlight a notable need for a standardized and consistent human evaluation approach. Our extensive literature search, adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, includes publications from January 2018 to February 2024. The review examines the human evaluation of LLMs across various medical specialties, addressing factors such as evaluation dimensions, sample types and sizes, selection, and recruitment of evaluators, frameworks and metrics, evaluation process, and statistical analysis type. Drawing on the diverse evaluation strategies employed in these studies, we propose a comprehensive and practical framework for human evaluation of LLMs: QUEST: Quality of Information, Understanding and Reasoning, Expression Style and Persona, Safety and Harm, and Trust and Confidence. This framework aims to improve the reliability, generalizability, and applicability of human evaluation of LLMs in different healthcare applications by defining clear evaluation dimensions and offering detailed guidelines.

Kai Zhang, Rong Zhou, Eashan Adhikarla et al.

Traditional biomedical artificial intelligence (AI) models, designed for specific tasks or modalities, often exhibit limited flexibility in real-world deployment and struggle to utilize holistic information. Generalist AI holds the potential to address these limitations due to its versatility in interpreting different data types and generating tailored outputs for diverse needs. However, existing biomedical generalist AI solutions are typically heavyweight and closed source to researchers, practitioners, and patients. Here, we propose BiomedGPT, the first open-source and lightweight vision-language foundation model, designed as a generalist capable of performing various biomedical tasks. BiomedGPT achieved state-of-the-art results in 16 out of 25 experiments while maintaining a computing-friendly model scale. We also conducted human evaluations to assess the capabilities of BiomedGPT in radiology visual question answering, report generation, and summarization. BiomedGPT exhibits robust prediction ability with a low error rate of 3.8% in question answering, satisfactory performance with an error rate of 8.3% in writing complex radiology reports, and competitive summarization ability with a nearly equivalent preference score to human experts. Our method demonstrates that effective training with diverse data can lead to more practical biomedical AI for improving diagnosis and workflow efficiency.

Rong Zhou, Dongping Chen, Zihan Jia et al.

Digital twins, as precise digital representations of physical systems, have evolved from passive simulation tools into intelligent and autonomous entities through the integration of artificial intelligence technologies. This paper presents a unified four-stage framework that systematically characterizes AI integration across the digital twin lifecycle, spanning modeling, mirroring, intervention, and autonomous management. By synthesizing existing technologies and practices, we distill a unified four-stage framework that systematically characterizes how AI methodologies are embedded across the digital twin lifecycle: (1) modeling the physical twin through physics-based and physics-informed AI approaches, (2) mirroring the physical system into a digital twin with real-time synchronization, (3) intervening in the physical twin through predictive modeling, anomaly detection, and optimization strategies, and (4) achieving autonomous management through large language models, foundation models, and intelligent agents. We analyze the synergy between physics-based modeling and data-driven learning, highlighting the shift from traditional numerical solvers to physics-informed and foundation models for physical systems. Furthermore, we examine how generative AI technologies, including large language models and generative world models, transform digital twins into proactive and self-improving cognitive systems capable of reasoning, communication, and creative scenario generation. Through a cross-domain review spanning eleven application domains, including healthcare, aerospace, smart manufacturing, robotics, and smart cities, we identify common challenges related to scalability, explainability, and trustworthiness, and outline directions for responsible AI-driven digital twin systems.

Jaerong Ahn, Andrew Wen, Nan Wang et al.

The Observational Medical Outcomes Partnership (OMOP) common data model (CDM) provides a standardized representation of heterogeneous health data to support large-scale, multi-institutional research. One critical step in data standardization using OMOP CDM is the mapping of source medical terms to OMOP standard concepts, a procedure that is resource-intensive and error-prone. While large language models (LLMs) have the potential to facilitate this process, their tendency toward hallucination makes them unsuitable for clinical deployment without training and expert validation. Here, we developed a zero-training, hallucination-preventive mapping system based on the Model Context Protocol (MCP), a standardized and secure framework allowing LLMs to interact with external resources and tools. The system enables explainable mapping and significantly improves efficiency and accuracy with minimal effort. It provides real-time vocabulary lookups and structured reasoning outputs suitable for immediate use in both exploratory and production environments.

Sijia Liu, Andrew Wen, Liwei Wang et al.

While we pay attention to the latest advances in clinical natural language processing (NLP), we can notice some resistance in the clinical and translational research community to adopt NLP models due to limited transparency, interpretability, and usability. In this study, we proposed an open natural language processing development framework. We evaluated it through the implementation of NLP algorithms for the National COVID Cohort Collaborative (N3C). Based on the interests in information extraction from COVID-19 related clinical notes, our work includes 1) an open data annotation process using COVID-19 signs and symptoms as the use case, 2) a community-driven ruleset composing platform, and 3) a synthetic text data generation workflow to generate texts for information extraction tasks without involving human subjects. The corpora were derived from texts from three different institutions (Mayo Clinic, University of Kentucky, University of Minnesota). The gold standard annotations were tested with a single institution's (Mayo) ruleset. This resulted in performances of 0.876, 0.706, and 0.694 in F-scores for Mayo, Minnesota, and Kentucky test datasets, respectively. The study as a consortium effort of the N3C NLP subgroup demonstrates the feasibility of creating a federated NLP algorithm development and benchmarking platform to enhance multi-institution clinical NLP study and adoption. Although we use COVID-19 as a use case in this effort, our framework is general enough to be applied to other domains of interest in clinical NLP.

Bhavani Singh Agnikula Kshatriya, Nicolas A Nunez, Manuel Gardea- Resendez et al.

Major depressive disorder (MDD) is a prevalent psychiatric disorder that is associated with significant healthcare burden worldwide. Phenotyping of MDD can help early diagnosis and consequently may have significant advantages in patient management. In prior research MDD phenotypes have been extracted from structured Electronic Health Records (EHR) or using Electroencephalographic (EEG) data with traditional machine learning models to predict MDD phenotypes. However, MDD phenotypic information is also documented in free-text EHR data, such as clinical notes. While clinical notes may provide more accurate phenotyping information, natural language processing (NLP) algorithms must be developed to abstract such information. Recent advancements in NLP resulted in state-of-the-art neural language models, such as Bidirectional Encoder Representations for Transformers (BERT) model, which is a transformer-based model that can be pre-trained from a corpus of unsupervised text data and then fine-tuned on specific tasks. However, such neural language models have been underutilized in clinical NLP tasks due to the lack of large training datasets. In the literature, researchers have utilized the distant supervision paradigm to train machine learning models on clinical text classification tasks to mitigate the issue of lacking annotated training data. It is still unknown whether the paradigm is effective for neural language models. In this paper, we propose to leverage the neural language models in a distant supervision paradigm to identify MDD phenotypes from clinical notes. The experimental results indicate that our proposed approach is effective in identifying MDD phenotypes and that the Bio- Clinical BERT, a specific BERT model for clinical data, achieved the best performance in comparison with conventional machine learning models.

Sunyang Fu, David Chen, Huan He et al.

Background Concept extraction, a subdomain of natural language processing (NLP) with a focus on extracting concepts of interest, has been adopted to computationally extract clinical information from text for a wide range of applications ranging from clinical decision support to care quality improvement. Objectives In this literature review, we provide a methodology review of clinical concept extraction, aiming to catalog development processes, available methods and tools, and specific considerations when developing clinical concept extraction applications. Methods Based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a literature search was conducted for retrieving EHR-based information extraction articles written in English and published from January 2009 through June 2019 from Ovid MEDLINE In-Process & Other Non-Indexed Citations, Ovid MEDLINE, Ovid EMBASE, Scopus, Web of Science, and the ACM Digital Library. Results A total of 6,686 publications were retrieved. After title and abstract screening, 228 publications were selected. The methods used for developing clinical concept extraction applications were discussed in this review.

Krishna B. Soundararajan, Sunyang Fu, Luke A. Carlson et al.

Alzheimer's Disease (AD) is the most common type of dementia, comprising 60-80% of cases. There were an estimated 5.8 million Americans living with Alzheimer's dementia in 2019, and this number will almost double every 20 years. The total lifetime cost of care for someone with dementia is estimated to be $350,174 in 2018, 70% of which is associated with family-provided care. Most family caregivers face emotional, financial and physical difficulties. As a medium to relieve this burden, online communities in social media websites such as Twitter, Reddit, and Yahoo! Answers provide potential venues for caregivers to search relevant questions and answers, or post questions and seek answers from other members. However, there are often a limited number of relevant questions and responses to search from, and posted questions are rarely answered immediately. Due to recent advancement in Artificial Intelligence (AI), particularly Natural Language Processing (NLP), we propose to utilize AI to automatically generate answers to AD-related consumer questions posted by caregivers and evaluate how good AI is at answering those questions. To the best of our knowledge, this is the first study in the literature applying and evaluating AI models designed to automatically answer consumer questions related to AD.

Yanshan Wang, Naveed Afzal, Sunyang Fu et al.

The wide adoption of electronic health records (EHRs) has enabled a wide range of applications leveraging EHR data. However, the meaningful use of EHR data largely depends on our ability to efficiently extract and consolidate information embedded in clinical text where natural language processing (NLP) techniques are essential. Semantic textual similarity (STS) that measures the semantic similarity between text snippets plays a significant role in many NLP applications. In the general NLP domain, STS shared tasks have made available a huge collection of text snippet pairs with manual annotations in various domains. In the clinical domain, STS can enable us to detect and eliminate redundant information that may lead to a reduction in cognitive burden and an improvement in the clinical decision-making process. This paper elaborates our efforts to assemble a resource for STS in the medical domain, MedSTS. It consists of a total of 174,629 sentence pairs gathered from a clinical corpus at Mayo Clinic. A subset of MedSTS (MedSTS_ann) containing 1,068 sentence pairs was annotated by two medical experts with semantic similarity scores of 0-5 (low to high similarity). We further analyzed the medical concepts in the MedSTS corpus, and tested four STS systems on the MedSTS_ann corpus. In the future, we will organize a shared task by releasing the MedSTS_ann corpus to motivate the community to tackle the real world clinical problems.