Dukyong Yoon

Changho Han, Songsoo Kim, Dong Won Kim et al.

Large language models (LLMs), trained on vast datasets, encode extensive real-world knowledge within their parameters, yet their black-box nature obscures the mechanisms and extent of this encoding. Surrogate modeling, which uses simplified models to approximate complex systems, can offer a path toward better interpretability of black-box models. We propose a surrogate modeling framework that quantitatively explains LLM-encoded knowledge. For a specific hypothesis derived from domain knowledge, this framework approximates the latent LLM knowledge space using observable elements (input-output pairs) through extensive prompting across a comprehensive range of simulated scenarios. Through proof-of-concept experiments in medical predictions, we demonstrate our framework's effectiveness in revealing the extent to which LLMs "perceive" each input variable in relation to the output. Particularly, given concerns that LLMs may perpetuate inaccuracies and societal biases embedded in their training data, our experiments using this framework quantitatively revealed both associations that contradict established medical knowledge and the persistence of scientifically refuted racial assumptions within LLM-encoded knowledge. By disclosing these issues, our framework can act as a red-flag indicator to support the safe and reliable application of these models.

Madeline Bittner, Dina Demner-Fushman, Yasmeen Shabazz et al.

Health literacy is a critical determinant of patient outcomes, yet current screening tools are not always feasible and differ considerably in the number of items, question format, and dimensions of health literacy they capture, making documentation in structured electronic health records difficult to achieve. Automated detection from unstructured clinical notes offers a promising alternative, as these notes often contain richer, more contextual health literacy information, but progress has been limited by the lack of annotated resources. We introduce HEALIX, the first publicly available annotated health literacy dataset derived from real clinical notes, curated through a combination of social worker note sampling, keyword-based filtering, and LLM-based active learning. HEALIX contains 589 notes across 9 note types, annotated with three health literacy labels: low, normal, and high. To demonstrate its utility, we benchmarked zero-shot and few-shot prompting strategies across four open source large language models (LLMs).

Songsoo Kim, Seungtae Lee, See Young Lee et al.

Background: The positive predictive value (PPV) of large language model (LLM)-based proofreading for radiology reports is limited due to the low error prevalence. Purpose: To assess whether a three-pass LLM framework enhances PPV and reduces operational costs compared with baseline approaches. Materials and Methods: A retrospective analysis was performed on 1,000 consecutive radiology reports (250 each: radiography, ultrasonography, CT, MRI) from the MIMIC-III database. Two external datasets (CheXpert and Open-i) were validation sets. Three LLM frameworks were tested: (1) single-prompt detector; (2) extractor plus detector; and (3) extractor, detector, and false-positive verifier. Precision was measured by PPV and absolute true positive rate (aTPR). Efficiency was calculated from model inference charges and reviewer remuneration. Statistical significance was tested using cluster bootstrap, exact McNemar tests, and Holm-Bonferroni correction. Results: Framework PPV increased from 0.063 (95% CI, 0.036-0.101, Framework 1) to 0.079 (0.049-0.118, Framework 2), and significantly to 0.159 (0.090-0.252, Framework 3; P<.001 vs. baselines). aTPR remained stable (0.012-0.014; P>=.84). Operational costs per 1,000 reports dropped to USD 5.58 (Framework 3) from USD 9.72 (Framework 1) and USD 6.85 (Framework 2), reflecting reductions of 42.6% and 18.5%, respectively. Human-reviewed reports decreased from 192 to 88. External validation supported Framework 3's superior PPV (CheXpert 0.133, Open-i 0.105) and stable aTPR (0.007). Conclusion: A three-pass LLM framework significantly enhanced PPV and reduced operational costs, maintaining detection performance, providing an effective strategy for AI-assisted radiology report quality assurance.