6.7CLNov 17, 2025
Generalist Foundation Models Are Not Clinical Enough for Hospital OperationsLavender Y. Jiang, Angelica Chen, Xu Han et al.
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.
2.4IVSep 16, 2021
Stereo Video Reconstruction Without Explicit Depth Maps for Endoscopic SurgeryAnnika Brundyn, Jesse Swanson, Kyunghyun Cho et al.
We introduce the task of stereo video reconstruction or, equivalently, 2D-to-3D video conversion for minimally invasive surgical video. We design and implement a series of end-to-end U-Net-based solutions for this task by varying the input (single frame vs. multiple consecutive frames), loss function (MSE, MAE, or perceptual losses), and network architecture. We evaluate these solutions by surveying ten experts - surgeons who routinely perform endoscopic surgery. We run two separate reader studies: one evaluating individual frames and the other evaluating fully reconstructed 3D video played on a VR headset. In the first reader study, a variant of the U-Net that takes as input multiple consecutive video frames and outputs the missing view performs best. We draw two conclusions from this outcome. First, motion information coming from multiple past frames is crucial in recreating stereo vision. Second, the proposed U-Net variant can indeed exploit such motion information for solving this task. The result from the second study further confirms the effectiveness of the proposed U-Net variant. The surgeons reported that they could successfully perceive depth from the reconstructed 3D video clips. They also expressed a clear preference for the reconstructed 3D video over the original 2D video. These two reader studies strongly support the usefulness of the proposed task of stereo reconstruction for minimally invasive surgical video and indicate that deep learning is a promising approach to this task. Finally, we identify two automatic metrics, LPIPS and DISTS, that are strongly correlated with expert judgement and that could serve as proxies for the latter in future studies.
SearchQA: A New Q&A Dataset Augmented with Context from a Search EngineMatthew Dunn, Levent Sagun, Mike Higgins et al.
We publicly release a new large-scale dataset, called SearchQA, for machine comprehension, or question-answering. Unlike recently released datasets, such as DeepMind CNN/DailyMail and SQuAD, the proposed SearchQA was constructed to reflect a full pipeline of general question-answering. That is, we start not from an existing article and generate a question-answer pair, but start from an existing question-answer pair, crawled from J! Archive, and augment it with text snippets retrieved by Google. Following this approach, we built SearchQA, which consists of more than 140k question-answer pairs with each pair having 49.6 snippets on average. Each question-answer-context tuple of the SearchQA comes with additional meta-data such as the snippet's URL, which we believe will be valuable resources for future research. We conduct human evaluation as well as test two baseline methods, one simple word selection and the other deep learning based, on the SearchQA. We show that there is a meaningful gap between the human and machine performances. This suggests that the proposed dataset could well serve as a benchmark for question-answering.