Priyank Jain

Peter G. Brodeur, Thomas A. Buckley, Zahir Kanjee et al.

A seminal paper published by Ledley and Lusted in 1959 introduced complex clinical diagnostic reasoning cases as the gold standard for the evaluation of expert medical computing systems, a standard that has held ever since. Here, we report the results of a physician evaluation of a large language model (LLM) on challenging clinical cases against a baseline of hundreds of physicians. We conduct five experiments to measure clinical reasoning across differential diagnosis generation, display of diagnostic reasoning, triage differential diagnosis, probabilistic reasoning, and management reasoning, all adjudicated by physician experts with validated psychometrics. We then report a real-world study comparing human expert and AI second opinions in randomly-selected patients in the emergency room of a major tertiary academic medical center in Boston, MA. We compared LLMs and board-certified physicians at three predefined diagnostic touchpoints: triage in the emergency room, initial evaluation by a physician, and admission to the hospital or intensive care unit. In all experiments--both vignettes and emergency room second opinions--the LLM displayed superhuman diagnostic and reasoning abilities, as well as continued improvement from prior generations of AI clinical decision support. Our study suggests that LLMs have achieved superhuman performance on general medical diagnostic and management reasoning, fulfilling the vision put forth by Ledley and Lusted, and motivating the urgent need for prospective trials.

Subrit Dikshit, Ritu Tiwari, Priyank Jain

Transfer Learning (TL) has accelerated the rapid development and availability of large language models (LLMs) for mainstream natural language processing (NLP) use cases. However, training and deploying such gigantic LLMs in resource-constrained, real-world healthcare situations remains challenging. This study addresses the limited support available to visually impaired users and speakers of low-resource languages such as Hindi who require medical assistance in rural environments. We propose PDFTEMRA (Performant Distilled Frequency Transformer Ensemble Model with Random Activations), a compact transformer-based architecture that integrates model distillation, frequency-domain modulation, ensemble learning, and randomized activation patterns to reduce computational cost while preserving language understanding performance. The model is trained and evaluated on medical question-answering and consultation datasets tailored to Hindi and accessibility scenarios, and its performance is compared against standard NLP state-of-the-art model baselines. Results demonstrate that PDFTEMRA achieves comparable performance with substantially lower computational requirements, indicating its suitability for accessible, inclusive, low-resource medical NLP applications.

David Wu, Fateme Nateghi Haredasht, Saloni Kumar Maharaj et al.

Large language models (LLMs) are routinely used by physicians and patients for medical advice, yet their clinical safety profiles remain poorly characterized. We present NOHARM (Numerous Options Harm Assessment for Risk in Medicine), a benchmark using 100 real primary-care-to-specialist consultation cases to measure harm frequency and severity from LLM-generated medical recommendations. NOHARM covers 10 specialties, with 12,747 expert annotations for 4,249 clinical management options. Across 31 LLMs, severe harm occurs in up to 22.2% (95% CI 21.6-22.8%) of cases, with harms of omission accounting for 76.6% (95% CI 76.4-76.8%) of errors. Safety performance is only moderately correlated (r = 0.61-0.64) with existing AI and medical knowledge benchmarks. The best models outperform generalist physicians on safety (mean difference 9.7%, 95% CI 7.0-12.5%), and a diverse multi-agent approach reduces harm compared to solo models (mean difference 8.0%, 95% CI 4.0-12.1%). Therefore, despite strong performance on existing evaluations, widely used AI models can produce severely harmful medical advice at nontrivial rates, underscoring clinical safety as a distinct performance dimension necessitating explicit measurement.

Subrit Dikshit, Ritu Tiwari, Priyank Jain

Cloud-based multilingual translation services like Google Translate and Microsoft Translator achieve state-of-the-art translation capabilities. These services inherently use large multilingual language models such as GRU, LSTM, BERT, GPT, T5, or similar encoder-decoder architectures with attention mechanisms as the backbone. Also, new age natural language systems, for instance ChatGPT and DeepSeek, have established huge potential in multiple tasks in natural language processing. At the same time, they also possess outstanding multilingual translation capabilities. However, these models use the classical computing realm as a backend. QEDACVC (Quantum Encoder Decoder Attention-based Convolutional Variational Circuits) is an alternate solution that explores the quantum computing realm instead of the classical computing realm to study and demonstrate multilingual machine translation. QEDACVC introduces the quantum encoder-decoder architecture that simulates and runs on quantum computing hardware via quantum convolution, quantum pooling, quantum variational circuit, and quantum attention as software alterations. QEDACVC achieves an Accuracy of 82% when trained on the OPUS dataset for English, French, German, and Hindi corpora for multilingual translations.