Nicholas Marshall

Alireza Aghasi, Nicholas Marshall, Saeid Pourmand et al.

We propose a novel randomized algorithm for constructing binary neural networks with tunable accuracy. This approach is motivated by hyperdimensional computing (HDC), which is a brain-inspired paradigm that leverages high-dimensional vector representations, offering efficient hardware implementation and robustness to model corruptions. Unlike traditional low-precision methods that use quantization, we consider binary embeddings of data as points in the hypercube equipped with the Hamming distance. We propose a novel family of floating-point neural networks, G-Nets, which are general enough to mimic standard network layers. Each floating-point G-Net has a randomized binary embedding, an embedded hyperdimensional (EHD) G-Net, that retains the accuracy of its floating-point counterparts, with theoretical guarantees, due to the concentration of measure. Empirically, our binary models match convolutional neural network accuracies and outperform prior HDC models by large margins, for example, we achieve almost 30\% higher accuracy on CIFAR-10 compared to prior HDC models. G-Nets are a theoretically justified bridge between neural networks and randomized binary neural networks, opening a new direction for constructing robust binary/quantized deep learning models. Our implementation is available at https://github.com/GNet2025/GNet.

Fatemeh Amrollahi, Nicholas Marshall, Fateme Nateghi Haredasht et al.

Blood cultures are often over ordered without clear justification, straining healthcare resources and contributing to inappropriate antibiotic use pressures worsened by the global shortage. In study of 135483 emergency department (ED) blood culture orders, we developed machine learning (ML) models to predict the risk of bacteremia using structured electronic health record (EHR) data and provider notes via a large language model (LLM). The structured models AUC improved from 0.76 to 0.79 with note embeddings and reached 0.81 with added diagnosis codes. Compared to an expert recommendation framework applied by human reviewers and an LLM-based pipeline, our ML approach offered higher specificity without compromising sensitivity. The recommendation framework achieved sensitivity 86%, specificity 57%, while the LLM maintained high sensitivity (96%) but over classified negatives, reducing specificity (16%). These findings demonstrate that ML models integrating structured and unstructured data can outperform consensus recommendations, enhancing diagnostic stewardship beyond existing standards of care.

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.

Fateme Nateghi Haredasht, Fatemeh Amrollahi, Manoj Maddali et al.

The Antibiotic Resistance Microbiology Dataset (ARMD) is a de-identified resource derived from electronic health records (EHR) that facilitates research in antimicrobial resistance (AMR). ARMD encompasses big data from adult patients collected from over 15 years at two academic-affiliated hospitals, focusing on microbiological cultures, antibiotic susceptibilities, and associated clinical and demographic features. Key attributes include organism identification, susceptibility patterns for 55 antibiotics, implied susceptibility rules, and de-identified patient information. This dataset supports studies on antimicrobial stewardship, causal inference, and clinical decision-making. ARMD is designed to be reusable and interoperable, promoting collaboration and innovation in combating AMR. This paper describes the dataset's acquisition, structure, and utility while detailing its de-identification process.