Michael J. Becich

David Oniani, Bambang Parmanto, Andi Saptono et al.

Rehabilitation research focuses on determining the components of a treatment intervention, the mechanism of how these components lead to recovery and rehabilitation, and ultimately the optimal intervention strategies to maximize patients' physical, psychologic, and social functioning. Traditional randomized clinical trials that study and establish new interventions face several challenges, such as high cost and time commitment. Observational studies that use existing clinical data to observe the effect of an intervention have shown several advantages over RCTs. Electronic Health Records (EHRs) have become an increasingly important resource for conducting observational studies. To support these studies, we developed a clinical research datamart, called ReDWINE (Rehabilitation Datamart With Informatics iNfrastructure for rEsearch), that transforms the rehabilitation-related EHR data collected from the UPMC health care system to the Observational Health Data Sciences and Informatics (OHDSI) Observational Medical Outcomes Partnership (OMOP) Common Data Model (CDM) to facilitate rehabilitation research. The standardized EHR data stored in ReDWINE will further reduce the time and effort required by investigators to pool, harmonize, clean, and analyze data from multiple sources, leading to more robust and comprehensive research findings. ReDWINE also includes deployment of data visualization and data analytics tools to facilitate cohort definition and clinical data analysis. These include among others the Open Health Natural Language Processing (OHNLP) toolkit, a high-throughput NLP pipeline, to provide text analytical capabilities at scale in ReDWINE. Using this comprehensive representation of patient data in ReDWINE for rehabilitation research will facilitate real-world evidence for health interventions and outcomes.

Chenyu Li, Zohaib Akhtar, Mingu Kwak et al.

As large language models (LLMs) increasingly generate and process clinical text, scalable evaluation has become critical. LLM-as-a-Judge (LaaJ), which uses LLMs to evaluate model outputs, offers a scalable alternative to costly expert review, but its healthcare adoption raises safety and bias concerns. We conducted a PRISMA-ScR scoping review of six databases (January 2020-January 2026), screening 11,727 studies and including 49. The landscape was dominated by evaluation and benchmarking applications (n=37, 75.5%), pointwise scoring (n=42, 85.7%), and GPT-family judges (n=36, 73.5%). Despite growing adoption, validation rigor was limited: among 36 studies with human involvement, the median number of expert validators was 3, while 13 (26.5%) used none. Risk of bias testing was absent in 36 studies (73.5%), only 1 (2.0%) examined demographic fairness, and none assessed temporal stability or patient context. Deployment remained limited, with 1 study (2.0%) reaching production and four (8.2%) prototype stage. Importantly, these gaps may interact: when judges and evaluated systems share training data or architectures, they may inherit similar blind spots, and agreement metrics may fail to distinguish true validity from shared errors. Minimal human oversight, limited bias assessment, and model monoculture together represent a governance gap where current validation may miss clinically significant errors. To address this, we propose MedJUDGE (Medical Judge Utility, De-biasing, Governance and Evaluation), a risk-stratified three-pillar framework organized around validity, safety, and accountability across clinical risk tiers, providing deployment-oriented evaluation guidance for healthcare LaaJ systems.