Henry Foote

Yun-Chung Liu, Rui Yang, Jonathan Chong Kai Liew et al.

Systematic reviews are a key component of evidence-based medicine, playing a critical role in synthesizing existing research evidence and guiding clinical decisions. However, with the rapid growth of research publications, conducting systematic reviews has become increasingly burdensome, with title and abstract screening being one of the most time-consuming and resource-intensive steps. To mitigate this issue, we designed a two-stage dynamic few-shot learning (DFSL) approach aimed at improving the efficiency and performance of large language models (LLMs) in the title and abstract screening task. Specifically, this approach first uses a low-cost LLM for initial screening, then re-evaluates low-confidence instances using a high-performance LLM, thereby enhancing screening performance while controlling computational costs. We evaluated this approach across 10 systematic reviews, and the results demonstrate its strong generalizability and cost-effectiveness, with potential to reduce manual screening burden and accelerate the systematic review process in practical applications.

Michael Gao, Suresh Balu, William Knechtle et al.

Clinical documentation and data retrieval within Electronic Health Records (EHRs) contribute substantially to clinician workload and burnout. To address this, we developed Scout, an LLM-based EHR search and synthesis platform that enables clinicians to query EHR data using natural language. Each response includes citations linking each claim to the original data source, facilitating easy verification of generated content. We conducted a prospective randomized, evaluator-blinded crossover trial across seven clinical specialties (20 participants, 200 structured cases). Participants completed realistic clinical tasks using either Scout or the EHR alone, with outcomes including time to completion, NASA Task Load Index workload scores, and blinded expert adjudication of accuracy, completeness, and relevance. Scout reduced task completion time by 37.6% and significantly decreased perceived workload, with the largest reductions in mental demand, effort, and temporal demand. Non-inferiority analyses showed that tasks completed with Scout maintained accuracy, completeness, and relevance relative to tasks completed with the EHR-only. A concurrent pilot deployment across over 200 users and more than 20 specialties generated over 6,600 interactions in three months, revealing diverse clinical and administrative use cases. Automated evaluation using an LLM-as-judge framework identified errors at low rates. Subsequent manual review of a subset of outputs revealed that most claims flagged by the automated judge as errors were in fact supported by the patient chart, demonstrating the importance of human validation. These findings provide early trial-based evidence that LLM-powered EHR tools can meaningfully reduce clinical and administrative workloads while maintaining output quality.