Xinyu Zou

Hongjian Zhou, Fenglin Liu, Boyang Gu et al.

Large language models (LLMs), such as ChatGPT, have received substantial attention due to their capabilities for understanding and generating human language. While there has been a burgeoning trend in research focusing on the employment of LLMs in supporting different medical tasks (e.g., enhancing clinical diagnostics and providing medical education), a review of these efforts, particularly their development, practical applications, and outcomes in medicine, remains scarce. Therefore, this review aims to provide a detailed overview of the development and deployment of LLMs in medicine, including the challenges and opportunities they face. In terms of development, we provide a detailed introduction to the principles of existing medical LLMs, including their basic model structures, number of parameters, and sources and scales of data used for model development. It serves as a guide for practitioners in developing medical LLMs tailored to their specific needs. In terms of deployment, we offer a comparison of the performance of different LLMs across various medical tasks, and further compare them with state-of-the-art lightweight models, aiming to provide an understanding of the advantages and limitations of LLMs in medicine. Overall, in this review, we address the following questions: 1) What are the practices for developing medical LLMs 2) How to measure the medical task performance of LLMs in a medical setting? 3) How have medical LLMs been employed in real-world practice? 4) What challenges arise from the use of medical LLMs? and 5) How to more effectively develop and deploy medical LLMs? By answering these questions, this review aims to provide insights into the opportunities for LLMs in medicine and serve as a practical resource. We also maintain a regularly updated list of practical guides on medical LLMs at https://github.com/AI-in-Health/MedLLMsPracticalGuide

Xinyu Zou, Zhi Hu, Yiming Zhao et al.

Multi-scenario learning (MSL) enables a service provider to cater for users' fine-grained demands by separating services for different user sectors, e.g., by user's geographical region. Under each scenario there is a need to optimize multiple task-specific targets e.g., click through rate and conversion rate, known as multi-task learning (MTL). Recent solutions for MSL and MTL are mostly based on the multi-gate mixture-of-experts (MMoE) architecture. MMoE structure is typically static and its design requires domain-specific knowledge, making it less effective in handling both MSL and MTL. In this paper, we propose a novel Automatic Expert Selection framework for Multi-scenario and Multi-task search, named AESM^{2}. AESM^{2} integrates both MSL and MTL into a unified framework with an automatic structure learning. Specifically, AESM^{2} stacks multi-task layers over multi-scenario layers. This hierarchical design enables us to flexibly establish intrinsic connections between different scenarios, and at the same time also supports high-level feature extraction for different tasks. At each multi-scenario/multi-task layer, a novel expert selection algorithm is proposed to automatically identify scenario-/task-specific and shared experts for each input. Experiments over two real-world large-scale datasets demonstrate the effectiveness of AESM^{2} over a battery of strong baselines. Online A/B test also shows substantial performance gain on multiple metrics. Currently, AESM^{2} has been deployed online for serving major traffic.

Xiang Bai, Hanchen Wang, Liya Ma et al.

Artificial intelligence (AI) provides a promising substitution for streamlining COVID-19 diagnoses. However, concerns surrounding security and trustworthiness impede the collection of large-scale representative medical data, posing a considerable challenge for training a well-generalised model in clinical practices. To address this, we launch the Unified CT-COVID AI Diagnostic Initiative (UCADI), where the AI model can be distributedly trained and independently executed at each host institution under a federated learning framework (FL) without data sharing. Here we show that our FL model outperformed all the local models by a large yield (test sensitivity /specificity in China: 0.973/0.951, in the UK: 0.730/0.942), achieving comparable performance with a panel of professional radiologists. We further evaluated the model on the hold-out (collected from another two hospitals leaving out the FL) and heterogeneous (acquired with contrast materials) data, provided visual explanations for decisions made by the model, and analysed the trade-offs between the model performance and the communication costs in the federated training process. Our study is based on 9,573 chest computed tomography scans (CTs) from 3,336 patients collected from 23 hospitals located in China and the UK. Collectively, our work advanced the prospects of utilising federated learning for privacy-preserving AI in digital health.