Wencheng Li

Nigam H. Shah, Nerissa Ambers, Abby Pandya et al.

While large language models (LLMs) can support clinical documentation needs, standalone tools struggle with "workflow friction" from manual data entry. We developed ChatEHR, a system that enables the use of LLMs with the entire patient timeline spanning several years. ChatEHR enables automations - which are static combinations of prompts and data that perform a fixed task - and interactive use in the electronic health record (EHR) via a user interface (UI). The resulting ability to sift through patient medical records for diverse use-cases such as pre-visit chart review, screening for transfer eligibility, monitoring for surgical site infections, and chart abstraction, redefines LLM use as an institutional capability. This system, accessible after user-training, enables continuous monitoring and evaluation of LLM use. In 1.5 years, we built 7 automations and 1075 users have trained to become routine users of the UI, engaging in 23,000 sessions in the first 3 months of launch. For automations, being model-agnostic and accessing multiple types of data was essential for matching specific clinical or administrative tasks with the most appropriate LLM. Benchmark-based evaluations proved insufficient for monitoring and evaluation of the UI, requiring new methods to monitor performance. Generation of summaries was the most frequent task in the UI, with an estimated 0.73 hallucinations and 1.60 inaccuracies per generation. The resulting mix of cost savings, time savings, and revenue growth required a value assessment framework to prioritize work as well as quantify the impact of using LLMs. Initial estimates are $6M savings in the first year of use, without quantifying the benefit of the better care offered. Such a "build-from-within" strategy provides an opportunity for health systems to maintain agency via a vendor-agnostic, internally governed LLM platform.

Wencheng Li, Zhenhua Tan, Jingyu Ning et al.

Speaker recognition using i-vector has been replaced by speaker recognition using deep learning. Speaker recognition based on Convolutional Neural Networks (CNNs) has been widely used in recent years, which learn low-level speech representations from raw waveforms. On this basis, a CNN architecture called SincNet proposes a kind of unique convolutional layer, which has achieved band-pass filters. Compared with standard CNNs, SincNet learns the low and high cut-off frequencies of each filter. This paper proposes an improved CNNs architecture called PF-Net, which encourages the first convolutional layer to implement more personalized filters than SincNet. PF-Net parameterizes the frequency domain shape and can realize band-pass filters by learning some deformation points in frequency domain. Compared with standard CNN, PF-Net can learn the characteristics of each filter. Compared with SincNet, PF-Net can learn more characteristic parameters, instead of only low and high cut-off frequencies. This provides a personalized filter bank for different tasks. As a result, our experiments show that the PF-Net converges faster than standard CNN and performs better than SincNet. Our code is available at github.com/TAN-OpenLab/PF-NET.

Dawei Fan, Yifan Gao, Jiaming Yu et al.

Deep learning models have shown promising performance for cell nucleus segmentation in the field of pathology image analysis. However, training a robust model from multiple domains remains a great challenge for cell nucleus segmentation. Additionally, the shortcomings of background noise, highly overlapping between cell nucleus, and blurred edges often lead to poor performance. To address these challenges, we propose a novel framework termed CausalCellSegmenter, which combines Causal Inference Module (CIM) with Diversified Aggregation Convolution (DAC) techniques. The DAC module is designed which incorporates diverse downsampling features through a simple, parameter-free attention module (SimAM), aiming to overcome the problems of false-positive identification and edge blurring. Furthermore, we introduce CIM to leverage sample weighting by directly removing the spurious correlations between features for every input sample and concentrating more on the correlation between features and labels. Extensive experiments on the MoNuSeg-2018 dataset achieves promising results, outperforming other state-of-the-art methods, where the mIoU and DSC scores growing by 3.6% and 2.65%.

Abdul Rehman Akbar, Usama Sajjad, Ziyu Su et al.

Despite surgical resection, ~70% of invasive lung adenocarcinoma (ILA) patients recur within five years, and current tools fail to identify those needing adjuvant therapy. To address this unmet clinical need, we introduce CellEcoNet, a novel spatially aware deep learning framework that models whole slide images (WSIs) through natural language analogy, defining a "language of pathology," where cells act as words, cellular neighborhoods become phrases, and tissue architecture forms sentences. CellEcoNet learns these context-dependent meanings automatically, capturing how subtle variations and spatial interactions derive recurrence risk. On a dataset of 456 H&E-stained WSIs, CellEcoNet achieved superior predictive performance (AUC:77.8% HR:9.54), outperforming IASLC grading system (AUC:71.4% HR:2.36), AJCC Stage (AUC:64.0% HR:1.17) and state-of-the-art computational methods (AUCs:62.2-67.4%). CellEcoNet demonstrated fairness and consistent performance across diverse demographic and clinical subgroups. Beyond prognosis, CellEcoNet marks a paradigm shift by decoding the tumor microenvironment's cellular "language" to reveal how subtle cell variations encode recurrence risk.

Somalee Datta, Jose Posada, Garrick Olson et al.

Stanford Medicine is building a new data platform for our academic research community to do better clinical data science. Hospitals have a large amount of patient data and researchers have demonstrated the ability to reuse that data and AI approaches to derive novel insights, support patient care, and improve care quality. However, the traditional data warehouse and Honest Broker approaches that are in current use, are not scalable. We are establishing a new secure Big Data platform that aims to reduce time to access and analyze data. In this platform, data is anonymized to preserve patient data privacy and made available preparatory to Institutional Review Board (IRB) submission. Furthermore, the data is standardized such that analysis done at Stanford can be replicated elsewhere using the same analytical code and clinical concepts. Finally, the analytics data warehouse integrates with a secure data science computational facility to support large scale data analytics. The ecosystem is designed to bring the modern data science community to highly sensitive clinical data in a secure and collaborative big data analytics environment with a goal to enable bigger, better and faster science.