Huixue Zhou

Pengshan Cai, Zonghai Yao, Fei Liu et al.

Patient portal allows discharged patients to access their personalized discharge instructions in electronic health records (EHRs). However, many patients have difficulty understanding or memorizing their discharge instructions. In this paper, we present PaniniQA, a patient-centric interactive question answering system designed to help patients understand their discharge instructions. PaniniQA first identifies important clinical content from patients' discharge instructions and then formulates patient-specific educational questions. In addition, PaniniQA is also equipped with answer verification functionality to provide timely feedback to correct patients' misunderstandings. Our comprehensive automatic and human evaluation results demonstrate our PaniniQA is capable of improving patients' mastery of their medical instructions through effective interactions

Junda Wang, Zonghai Yao, Zhichao Yang et al.

We introduce NoteChat, a novel cooperative multi-agent framework leveraging Large Language Models (LLMs) to generate patient-physician dialogues. NoteChat embodies the principle that an ensemble of role-specific LLMs, through structured role-play and strategic prompting, can perform their assigned roles more effectively. The synergy among these role-playing LLMs results in a cohesive and efficient dialogue generation. Evaluation on MTS-dialogue, a benchmark dataset for patient-physician dialogues-note pairs, shows that models trained with the augmented synthetic patient-physician dialogues by NoteChat outperforms other state-of-the-art models for generating clinical notes. Our comprehensive automatic and human evaluation demonstrates that NoteChat substantially surpasses state-of-the-art models like ChatGPT and GPT-4 up to 22.78% by domain experts in generating superior synthetic patient-physician dialogues based on clinical notes. NoteChat has the potential to engage patients directly and help clinical documentation, a leading cause of physician burnout.

Zihao Zhang, Zonghai Yao, Huixue Zhou et al.

Large language models have shown success as a tutor in education in various fields. Educating patients about their clinical visits plays a pivotal role in patients' adherence to their treatment plans post-discharge. This paper presents EHRTutor, an innovative multi-component framework leveraging the Large Language Model (LLM) for patient education through conversational question-answering. EHRTutor first formulates questions pertaining to the electronic health record discharge instructions. It then educates the patient through conversation by administering each question as a test. Finally, it generates a summary at the end of the conversation. Evaluation results using LLMs and domain experts have shown a clear preference for EHRTutor over the baseline. Moreover, EHRTutor also offers a framework for generating synthetic patient education dialogues that can be used for future in-house system training.

Mingchen Li, Huixue Zhou, Rui Zhang

Biomedical triple extraction systems aim to automatically extract biomedical entities and relations between entities. The exploration of applying large language models (LLM) to triple extraction is still relatively unexplored. In this work, we mainly focus on sentence-level biomedical triple extraction. Furthermore, the absence of a high-quality biomedical triple extraction dataset impedes the progress in developing robust triple extraction systems. To address these challenges, initially, we compare the performance of various large language models. Additionally, we present GIT, an expert-annotated biomedical triple extraction dataset that covers a wider range of relation types.

Shuang Zhou, Kai Yu, Song Wang et al.

Heart diseases remain a leading cause of morbidity and mortality worldwide, necessitating accurate and trustworthy differential diagnosis. However, existing artificial intelligence-based diagnostic methods are often limited by insufficient cardiology knowledge, inadequate support for complex reasoning, and poor interpretability. Here we present HeartAgent, a cardiology-specific agent system designed to support a reliable and explainable differential diagnosis. HeartAgent integrates customized tools and curated data resources and orchestrates multiple specialized sub-agents to perform complex reasoning while generating transparent reasoning trajectories and verifiable supporting references. Evaluated on the MIMIC dataset and a private electronic health records cohort, HeartAgent achieved over 36% and 20% improvements over established comparative methods, in top-3 diagnostic accuracy, respectively. Additionally, clinicians assisted by HeartAgent demonstrated gains of 26.9% in diagnostic accuracy and 22.7% in explanatory quality compared with unaided experts. These results demonstrate that HeartAgent provides reliable, explainable, and clinically actionable decision support for cardiovascular care.

Ying Liu, Haozhu Wang, Huixue Zhou et al.

Reinforcement learning (RL) has emerged as a powerful approach for tackling complex medical decision-making problems such as treatment planning, personalized medicine, and optimizing the scheduling of surgeries and appointments. It has gained significant attention in the field of Natural Language Processing (NLP) due to its ability to learn optimal strategies for tasks such as dialogue systems, machine translation, and question-answering. This paper presents a review of the RL techniques in NLP, highlighting key advancements, challenges, and applications in healthcare. The review begins by visualizing a roadmap of machine learning and its applications in healthcare. And then it explores the integration of RL with NLP tasks. We examined dialogue systems where RL enables the learning of conversational strategies, RL-based machine translation models, question-answering systems, text summarization, and information extraction. Additionally, ethical considerations and biases in RL-NLP systems are addressed.

Shuang Zhou, Kai Yu, Zaifu Zhan et al.

Epilepsy and psychogenic non-epileptic seizures often present with similar seizure-like manifestations but require fundamentally different management strategies. Misdiagnosis is common and can lead to prolonged diagnostic delays, unnecessary treatments, and substantial patient morbidity. Although prolonged video-electroencephalography is the diagnostic gold standard, its high cost and limited accessibility hinder timely diagnosis. Here, we developed a low-cost, effective approach, EpiScreen, for early epilepsy detection by utilizing routinely collected clinical notes from electronic health records. Through fine-tuning large language models on labeled notes, EpiScreen achieved an AUC of up to 0.875 on the MIMIC-IV dataset and 0.980 on a private cohort of the University of Minnesota. In a clinician-AI collaboration setting, EpiScreen-assisted neurologists outperformed unaided experts by up to 10.9%. Overall, this study demonstrates that EpiScreen supports early epilepsy detection, facilitating timely and cost-effective screening that may reduce diagnostic delays and avoid unnecessary interventions, particularly in resource-limited regions.

Zonghai Yao, Aditya Parashar, Huixue Zhou et al.

Automatic question generation (QG) is essential for AI and NLP, particularly in intelligent tutoring, dialogue systems, and fact verification. Generating multiple-choice questions (MCQG) for professional exams, like the United States Medical Licensing Examination (USMLE), is particularly challenging, requiring domain expertise and complex multi-hop reasoning for high-quality questions. However, current large language models (LLMs) like GPT-4 struggle with professional MCQG due to outdated knowledge, hallucination issues, and prompt sensitivity, resulting in unsatisfactory quality and difficulty. To address these challenges, we propose MCQG-SRefine, an LLM self-refine-based (Critique and Correction) framework for converting medical cases into high-quality USMLE-style questions. By integrating expert-driven prompt engineering with iterative self-critique and self-correction feedback, MCQG-SRefine significantly enhances human expert satisfaction regarding both the quality and difficulty of the questions. Furthermore, we introduce an LLM-as-Judge-based automatic metric to replace the complex and costly expert evaluation process, ensuring reliable and expert-aligned assessments.

Tiejin Chen, Longchao Da, Huixue Zhou et al.

The privacy concerns associated with the use of Large Language Models (LLMs) have grown recently with the development of LLMs such as ChatGPT. Differential Privacy (DP) techniques are explored in existing work to mitigate their privacy risks at the cost of generalization degradation. Our paper reveals that the flatness of DP-trained models' loss landscape plays an essential role in the trade-off between their privacy and generalization. We further propose a holistic framework to enforce appropriate weight flatness, which substantially improves model generalization with competitive privacy preservation. It innovates from three coarse-to-grained levels, including perturbation-aware min-max optimization on model weights within a layer, flatness-guided sparse prefix-tuning on weights across layers, and weight knowledge distillation between DP \& non-DP weights copies. Comprehensive experiments of both black-box and white-box scenarios are conducted to demonstrate the effectiveness of our proposal in enhancing generalization and maintaining DP characteristics. For instance, on text classification dataset QNLI, DP-Flat achieves similar performance with non-private full fine-tuning but with DP guarantee under privacy budget $ε=3$, and even better performance given higher privacy budgets. Codes are provided in the supplement.

Zaifu Zhan, Shuang Zhou, Huixue Zhou et al.

The advancement of Large Language Models (LLMs) has significantly impacted biomedical Natural Language Processing (NLP), enhancing tasks such as named entity recognition, relation extraction, event extraction, and text classification. In this context, the DeepSeek series of models have shown promising potential in general NLP tasks, yet their capabilities in the biomedical domain remain underexplored. This study evaluates multiple DeepSeek models (Distilled-DeepSeek-R1 series and Deepseek-LLMs) across four key biomedical NLP tasks using 12 datasets, benchmarking them against state-of-the-art alternatives (Llama3-8B, Qwen2.5-7B, Mistral-7B, Phi-4-14B, Gemma-2-9B). Our results reveal that while DeepSeek models perform competitively in named entity recognition and text classification, challenges persist in event and relation extraction due to precision-recall trade-offs. We provide task-specific model recommendations and highlight future research directions. This evaluation underscores the strengths and limitations of DeepSeek models in biomedical NLP, guiding their future deployment and optimization.

Huixue Zhou, Hengrui Gu, Xi Liu et al.

The deployment of Large Language Models (LLMs) in recommender systems for predicting Click-Through Rates (CTR) necessitates a delicate balance between computational efficiency and predictive accuracy. This paper presents an optimization framework that combines Retrieval-Augmented Generation (RAG) with an innovative multi-head early exit architecture to concurrently enhance both aspects. By integrating Graph Convolutional Networks (GCNs) as efficient retrieval mechanisms, we are able to significantly reduce data retrieval times while maintaining high model performance. The early exit strategy employed allows for dynamic termination of model inference, utilizing real-time predictive confidence assessments across multiple heads. This not only quickens the responsiveness of LLMs but also upholds or improves their accuracy, making it ideal for real-time application scenarios. Our experiments demonstrate how this architecture effectively decreases computation time without sacrificing the accuracy needed for reliable recommendation delivery, establishing a new standard for efficient, real-time LLM deployment in commercial systems.

Zaifu Zhan, Shuang Zhou, Huixue Zhou et al.

Foundation models, including language models, e.g., GPT, and vision models, e.g., CLIP, have significantly advanced numerous biomedical tasks. Despite these advancements, the high inference latency and the "overthinking" issues in model inference impair the efficiency and effectiveness of foundation models, thus limiting their application in real-time clinical settings. To address these challenges, we proposed EPEE (Entropy- and Patience-based Early Exiting), a novel hybrid strategy designed to improve the inference efficiency of foundation models. The core idea was to leverage the strengths of entropy-based and patience-based early exiting methods to overcome their respective weaknesses. To evaluate EPEE, we conducted experiments on three core biomedical tasks-classification, relation extraction, and event extraction-using four foundation models (BERT, ALBERT, GPT-2, and ViT) across twelve datasets, including clinical notes and medical images. The results showed that EPEE significantly reduced inference time while maintaining or improving accuracy, demonstrating its adaptability to diverse datasets and tasks. EPEE addressed critical barriers to deploying foundation models in healthcare by balancing efficiency and effectiveness. It potentially provided a practical solution for real-time clinical decision-making with foundation models, supporting reliable and efficient workflows.

Xuchen Li, Hengrui Gu, Mohan Zhang et al.

Text-prompted foundation models for medical image segmentation offer an intuitive way to delineate anatomical structures from natural language queries, but their predictions often lack spatial precision and degrade under domain shift. In contrast, visual-prompted models achieve strong segmentation performance across diverse modalities by leveraging spatial cues of precise bounding-box (bbox) prompts to guide the segmentation of target lesions. However, it is costly and challenging to obtain the precise visual prompts in clinical practice. We propose PPBoost (Progressive Prompt-Boosting), a framework that bridges these limitations by transforming weak text-derived signals into strong, spatially grounded visual prompts, operating under a strict zero-shot regime with no image- or pixel-level segmentation labels. PPBoost first uses a vision-language model to produce initial pseudo-bboxes conditioned on the textual object descriptions and applies an uncertainty-aware criterion to filter unreliable predictions. The retained image-bboxes pairs are then leveraged to train a pseudo-labeled detector, producing the high-quality bboxes for the query images. During inference, PPBoost further refines the generated bboxes by appropriately expanding them to tightly cover the target anatomical structures. The enhanced spatially-grounding bbox prompts guide existing segmentation models to generate final dense masks, effectively amplifying weak text cues into strong spatial guidance. Across three datasets spanning diverse modalities and anatomies, PPBoost consistently improves Dice and Normalized Surface Distance over text- and visual-prompted baselines and, notably, surpasses few-shot segmentation models without using labeled data. PPBoost can generalize to multiple typical visual segmentation model backbones.

Yongkang Xiao, Sinian Zhang, Yi Dai et al.

Knowledge graph completion (KGC) aims to predict missing triples in knowledge graphs (KGs) by leveraging existing triples and textual information. Recently, generative large language models (LLMs) have been increasingly employed for graph tasks. However, current approaches typically encode graph context in textual form, which fails to fully exploit the potential of LLMs for perceiving and reasoning about graph structures. To address this limitation, we propose DrKGC (Dynamic Subgraph Retrieval-Augmented LLMs for Knowledge Graph Completion). DrKGC employs a flexible lightweight model training strategy to learn structural embeddings and logical rules within the KG. It then leverages a novel bottom-up graph retrieval method to extract a subgraph for each query guided by the learned rules. Finally, a graph convolutional network (GCN) adapter uses the retrieved subgraph to enhance the structural embeddings, which are then integrated into the prompt for effective LLM fine-tuning. Experimental results on two general domain benchmark datasets and two biomedical datasets demonstrate the superior performance of DrKGC. Furthermore, a realistic case study in the biomedical domain highlights its interpretability and practical utility.

Mingchen Li, Yang Ye, Jeremy Yeung et al.

Contrastive learning has become a popular solution for few-shot Name Entity Recognization (NER). The conventional configuration strives to reduce the distance between tokens with the same labels and increase the distance between tokens with different labels. The effect of this setup may, however, in the medical domain, there are a lot of entities annotated as OUTSIDE (O), and they are undesirably pushed apart to other entities that are not labeled as OUTSIDE (O) by the current contrastive learning method end up with a noisy prototype for the semantic representation of the label, though there are many OUTSIDE (O) labeled entities are relevant to the labeled entities. To address this challenge, we propose a novel method named Weighted Prototypical Contrastive Learning for Medical Few Shot Named Entity Recognization (W-PROCER). Our approach primarily revolves around constructing the prototype-based contractive loss and weighting network. These components play a crucial role in assisting the model in differentiating the negative samples from OUTSIDE (O) tokens and enhancing the discrimination ability of contrastive learning. Experimental results show that our proposed W-PROCER framework significantly outperforms the strong baselines on the three medical benchmark datasets.

Huixue Zhou, Robin Austin, Sheng-Chieh Lu et al.

Objective: Our study aimed to construct an exhaustive Complementary and Integrative Health (CIH) Lexicon (CIHLex) to better represent the often underrepresented physical and psychological CIH approaches in standard terminologies. We also intended to apply advanced Natural Language Processing (NLP) models such as Bidirectional Encoder Representations from Transformers (BERT) and GPT-3.5 Turbo for CIH named entity recognition, evaluating their performance against established models like MetaMap and CLAMP. Materials and Methods: We constructed the CIHLex by integrating various resources, compiling and integrating data from biomedical literature and relevant knowledge bases. The Lexicon encompasses 198 unique concepts with 1090 corresponding unique terms. We matched these concepts to the Unified Medical Language System (UMLS). Additionally, we developed and utilized BERT models and compared their efficiency in CIH named entity recognition to that of other models such as MetaMap, CLAMP, and GPT3.5-turbo. Results: From the 198 unique concepts in CIHLex, 62.1% could be matched to at least one term in the UMLS. Moreover, 75.7% of the mapped UMLS Concept Unique Identifiers (CUIs) were categorized as "Therapeutic or Preventive Procedure." Among the models applied to CIH named entity recognition, BLUEBERT delivered the highest macro average F1-score of 0.90, surpassing other models. Conclusion: Our CIHLex significantly augments representation of CIH approaches in biomedical literature. Demonstrating the utility of advanced NLP models, BERT notably excelled in CIH entity recognition. These results highlight promising strategies for enhancing standardization and recognition of CIH terminology in biomedical contexts.