Devora Berlowitz

Meet Shah, Jason Gusdorf, Anil Palepu et al.

The practice of medicine relies not only upon skillful dialogue but also on the nuanced exchange and interpretation of rich auditory and visual cues between doctors and patients. Building on the low-latency voice and video processing capabilities of Gemini, we introduce AI co-clinician, a first-of-its-kind conversational AI system utilizing continuous streams of audio-visual data from live patient conversations to inform real-time clinical decisions. Its dual-agent architecture balances deep clinical reasoning with the low latency required for natural dialogue. To assess this system, we implemented a video-based interface emulating telemedicine consultations. We crafted 20 standardized outpatient scenarios requiring proactive real-time auditory and visual reasoning and designed "TelePACES" evaluation criteria alongside case-specific rubrics. In a randomized, interface-blinded, crossover simulation study (n = 120 encounters) with 10 internal medicine residents as patient actors, we compared AI co-clinician with primary care physicians (PCPs), GPT-Realtime, and a baseline agent. AI co-clinician approached PCPs in key TelePACES dimensions, including management plans and differential diagnosis, while significantly outperforming GPT-Realtime across all general criteria. While our agent demonstrated parity with PCPs in case-specific triage measures, physicians maintained superior overall performance in case-specific assessments. Although AI co-clinician marks a significant advance in real-time telemedical AI, gaps remain in physical examination and disease-specific reasoning. Our work shows that text-only approaches fail to capture the true challenges of medical consultation and suggests that high-stakes real-time diagnostic AI is most safely advanced in collaborative, triadic models where AI can be a supportive co-clinician for doctors and patients.

Lin Ning, Luyang Liu, Jiaxing Wu et al.

Large language models (LLMs) have achieved remarkable success across various domains, but effectively incorporating complex and potentially noisy user timeline data into LLMs remains a challenge. Current approaches often involve translating user timelines into text descriptions before feeding them to LLMs, which can be inefficient and may not fully capture the nuances of user behavior. Inspired by how LLMs are effectively integrated with images through direct embeddings, we propose User-LLM, a novel framework that leverages user embeddings to directly contextualize LLMs with user history interactions. These embeddings, generated by a user encoder pretrained using self-supervised learning on diverse user interactions, capture latent user behaviors and interests as well as their evolution over time. We integrate these user embeddings with LLMs through cross-attention, enabling LLMs to dynamically adapt their responses based on the context of a user's past actions and preferences. Our approach achieves significant efficiency gains by representing user timelines directly as embeddings, leading to substantial inference speedups of up to 78.1X. Comprehensive experiments on MovieLens, Amazon Review, and Google Local Review datasets demonstrate that User-LLM outperforms text-prompt-based contextualization on tasks requiring deep user understanding, with improvements of up to 16.33%, particularly excelling on long sequences that capture subtle shifts in user behavior. Furthermore, the incorporation of Perceiver layers streamlines the integration between user encoders and LLMs, yielding additional computational savings.

Yuhan Liu, Lin Ning, Neo Wu et al.

User sequence modeling is crucial for modern large-scale recommendation systems, as it enables the extraction of informative representations of users and items from their historical interactions. These user representations are widely used for a variety of downstream tasks to enhance users' online experience. A key challenge for learning these representations is the lack of labeled training data. While self-supervised learning (SSL) methods have emerged as a promising solution for learning representations from unlabeled data, many existing approaches rely on extensive negative sampling, which can be computationally expensive and may not always be feasible in real-world scenario. In this work, we propose an adaptation of Barlow Twins, a state-of-the-art SSL methods, to user sequence modeling by incorporating suitable augmentation methods. Our approach aims to mitigate the need for large negative sample batches, enabling effective representation learning with smaller batch sizes and limited labeled data. We evaluate our method on the MovieLens-1M, MovieLens-20M, and Yelp datasets, demonstrating that our method consistently outperforms the widely-used dual encoder model across three downstream tasks, achieving an 8%-20% improvement in accuracy. Our findings underscore the effectiveness of our approach in extracting valuable sequence-level information for user modeling, particularly in scenarios where labeled data is scarce and negative examples are limited.