Jingxian He

Huizi Yu, Jiayan Zhou, Lingyao Li et al. · harvard

Background: Simulated patient systems are important in medical education and research, providing safe, integrative training environments and supporting clinical decision making. Advances in artificial intelligence (AI), especially large language models (LLMs), can enhance simulated patients by replicating medical conditions and doctor patient interactions with high fidelity and at low cost, but effectiveness and trustworthiness remain open challenges. Methods: We developed AIPatient, a simulated patient system powered by LLM based AI agents. The system uses a retrieval augmented generation (RAG) framework with six task specific agents for complex reasoning. To improve realism, it is linked to the AIPatient knowledge graph built from de identified real patient data in the MIMIC III intensive care database. Results: We evaluated electronic health record (EHR) based medical question answering (QA), readability, robustness, stability, and user experience. AIPatient reached 94.15 percent QA accuracy when all six agents were enabled, outperforming versions with partial or no agent integration. The knowledge base achieved an F1 score of 0.89. Readability scores showed a median Flesch Reading Ease of 68.77 and a median Flesch Kincaid Grade of 6.4, indicating accessibility for most medical trainees and clinicians. Robustness and stability were supported by non significant variance in repeated trials (analysis of variance F value 0.61, p greater than 0.1; F value 0.78, p greater than 0.1). A user study with medical students showed that AIPatient provides high fidelity, usability, and educational value, comparable to or better than human simulated patients for history taking. Conclusions: LLM based simulated patient systems can deliver accurate, readable, and reliable medical encounters and show strong potential to transform medical education.

Junjie Wang, Xianyang Gan, Dan Liu et al.

The widespread adoption of generative artificial intelligence conversational agents (AICAs) among university students constitutes a novel cognitive social environment whose impact on the maturing brain remains elusive. Combining surveys with high resolution structural MRI, we examined patterns of general, functional, and socio emotional AICA use, academic performance, mental health, and brain structural signatures in a comparatively large sample of 222 young individuals. Across computational anatomy, meta analytic network level, and behavioral decoding analyses, we observed use specific associations. Higher general and functional AICA use frequencies were linked to better academic outcomes (GPA), larger dorsolateral prefrontal and calcarine gray matter volume, and enhanced hippocampal network clustering and local efficiency. In contrast, more frequent socio emotional AICA use was associated with poorer mental health (depression, social anxiety) and lower volume of superior temporal and amygdalar regions central to social and affective processing. These findings indicate that the same class of AI tools exerts distinct effects depending on usage patterns and motivations, engaging prefrontal hippocampal systems that support cognition versus socio emotional systems that may track distress linked usage. These heterogeneities are crucial for designing environments that harness the educational benefits of AI while mitigating mental health risks.