Jimmy Nguyen

Yin Huang, Yifan Ethan Xu, Kai Sun et al.

Can Large Language Models (LLMs) be trained to avoid hallucinating factual statements, and can Retrieval-Augmented Generation (RAG) be triggered only when necessary to reduce retrieval and computation costs? In this work, we address both challenges simultaneously. We introduce ConfQA, a fine-tuning strategy that reduces hallucination rates from 20-40% to below 5% across multiple factuality benchmarks. The approach is simple: when the model answers correctly, it is trained to output the answer; otherwise, it is trained to respond with "I am unsure". Two design choices make this training effective: (1) a dampening prompt ("answer only if you are confident") that explicitly discourages overconfident hallucinations, and (2) training data drawn from atomic factual statements (e.g., knowledge graph attribute values), which calibrates model confidence and yields robust generalization across domains and question types. Building on ConfQA, we propose ConfRAG, a triggering strategy that invokes RAG only when the model responses with unsure. This framework achieves accuracy above 95% in ideal case while reducing unnecessary external retrievals by over 30%.

Gregory Rehm, Jimmy Nguyen, Chelsea Gilbeau et al.

Non-invasive estimation of respiratory physiology using computational algorithms promises to be a valuable technique for future clinicians to detect detrimental changes in patient pathophysiology. However, few clinical algorithms used to non-invasively analyze lung physiology have undergone rigorous validation in a clinical setting, and are often validated either using mechanical devices, or with small clinical validation datasets using 2-8 patients. This work aims to improve this situation by first, establishing an open, and clinically validated dataset comprising data from both mechanical lungs and nearly 40,000 breaths from 18 intubated patients. Next, we use this data to evaluate 15 different algorithms that use the "single chamber" model of estimating respiratory compliance. We evaluate these algorithms under varying clinical scenarios patients typically experience during hospitalization. In particular, we explore algorithm performance under four different types of patient ventilator asynchrony. We also analyze algorithms under varying ventilation modes to benchmark algorithm performance and to determine if ventilation mode has any impact on the algorithm. Our approach yields several advances by 1) showing which specific algorithms work best clinically under varying mode and asynchrony scenarios, 2) developing a simple mathematical method to reduce variance in algorithmic results, and 3) presenting additional insights about single-chamber model algorithms. We hope that our paper, approach, dataset, and software framework can thus be used by future researchers to improve their work and allow future integration of "single chamber" algorithms into clinical practice.

Gregory B. Rehm, Brooks T. Kuhn, Jimmy Nguyen et al.

Clinical decision support systems (CDSS) will play an in-creasing role in improving the quality of medical care for critically ill patients. However, due to limitations in current informatics infrastructure, CDSS do not always have com-plete information on state of supporting physiologic monitor-ing devices, which can limit the input data available to CDSS. This is especially true in the use case of mechanical ventilation (MV), where current CDSS have no knowledge of critical ventilation settings, such as ventilation mode. To enable MV CDSS to make accurate recommendations related to ventilator mode, we developed a highly performant ma-chine learning model that is able to perform per-breath clas-sification of 5 of the most widely used ventilation modes in the USA with an average F1-score of 97.52%. We also show how our approach makes methodologic improvements over previous work and that it is highly robust to missing data caused by software/sensor error.