Huizi Yu

Huizi Yu, Jiayan Zhou, Lingyao Li et al. · harvard

Background: Simulated patient systems are important in medical education and research, providing safe, integrative training environments and supporting clinical decision making. Advances in artificial intelligence (AI), especially large language models (LLMs), can enhance simulated patients by replicating medical conditions and doctor patient interactions with high fidelity and at low cost, but effectiveness and trustworthiness remain open challenges. Methods: We developed AIPatient, a simulated patient system powered by LLM based AI agents. The system uses a retrieval augmented generation (RAG) framework with six task specific agents for complex reasoning. To improve realism, it is linked to the AIPatient knowledge graph built from de identified real patient data in the MIMIC III intensive care database. Results: We evaluated electronic health record (EHR) based medical question answering (QA), readability, robustness, stability, and user experience. AIPatient reached 94.15 percent QA accuracy when all six agents were enabled, outperforming versions with partial or no agent integration. The knowledge base achieved an F1 score of 0.89. Readability scores showed a median Flesch Reading Ease of 68.77 and a median Flesch Kincaid Grade of 6.4, indicating accessibility for most medical trainees and clinicians. Robustness and stability were supported by non significant variance in repeated trials (analysis of variance F value 0.61, p greater than 0.1; F value 0.78, p greater than 0.1). A user study with medical students showed that AIPatient provides high fidelity, usability, and educational value, comparable to or better than human simulated patients for history taking. Conclusions: LLM based simulated patient systems can deliver accurate, readable, and reliable medical encounters and show strong potential to transform medical education.

Lizhou Fan, Lingyao Li, Zihui Ma et al.

Large language models (LLMs) are a class of language models that have demonstrated outstanding performance across a range of natural language processing (NLP) tasks and have become a highly sought-after research area, because of their ability to generate human-like language and their potential to revolutionize science and technology. In this study, we conduct bibliometric and discourse analyses of scholarly literature on LLMs. Synthesizing over 5,000 publications, this paper serves as a roadmap for researchers, practitioners, and policymakers to navigate the current landscape of LLMs research. We present the research trends from 2017 to early 2023, identifying patterns in research paradigms and collaborations. We start with analyzing the core algorithm developments and NLP tasks that are fundamental in LLMs research. We then investigate the applications of LLMs in various fields and domains including medicine, engineering, social science, and humanities. Our review also reveals the dynamic, fast-paced evolution of LLMs research. Overall, this paper offers valuable insights into the current state, impact, and potential of LLMs research and its applications.

Xinxin Lin, Guangxin Dai, Yi Zhong et al.

Large language models (LLMs) hold transformative potential for medical decision support yet their application in psychiatry remains constrained by hallucinations and superficial reasoning. This limitation is particularly acute in light-parameter LLMs which are essential for privacy-preserving and efficient clinical deployment. Existing training paradigms prioritize linguistic fluency over structured clinical logic and result in a fundamental misalignment with professional diagnostic cognition. Here we introduce ClinMPO, a reinforcement learning framework designed to align the internal reasoning of LLMs with professional psychiatric practice. The framework employs a specialized reward model trained independently on a dataset derived from 4,474 psychiatry journal articles and structured according to evidence-based medicine principles. We evaluated ClinMPO on a unseen subset of the benchmark designed to isolate reasoning capabilities from rote memorization. This test set comprises items where leading large-parameter LLMs consistently fail. We compared the ClinMPO-aligned light LLM performance against a cohort of 300 medical students. The ClinMPO-tuned Qwen3-8B model achieved a diagnostic accuracy of 31.4% and surpassed the human benchmark of 30.8% on these complex cases. These results demonstrate that medical evidence-guided optimization enables light-parameter LLMs to master complex reasoning tasks. Our findings suggest that explicit cognitive alignment offers a scalable pathway to reliable and safe psychiatric decision support.

Huizi Yu, Lizhou Fan, Lingyao Li et al.

Large Language Models (LLMs) have rapidly become important tools in Biomedical and Health Informatics (BHI), enabling new ways to analyze data, treat patients, and conduct research. This study aims to provide a comprehensive overview of LLM applications in BHI, highlighting their transformative potential and addressing the associated ethical and practical challenges. We reviewed 1,698 research articles from January 2022 to December 2023, categorizing them by research themes and diagnostic categories. Additionally, we conducted network analysis to map scholarly collaborations and research dynamics. Our findings reveal a substantial increase in the potential applications of LLMs to a variety of BHI tasks, including clinical decision support, patient interaction, and medical document analysis. Notably, LLMs are expected to be instrumental in enhancing the accuracy of diagnostic tools and patient care protocols. The network analysis highlights dense and dynamically evolving collaborations across institutions, underscoring the interdisciplinary nature of LLM research in BHI. A significant trend was the application of LLMs in managing specific disease categories such as mental health and neurological disorders, demonstrating their potential to influence personalized medicine and public health strategies. LLMs hold promising potential to further transform biomedical research and healthcare delivery. While promising, the ethical implications and challenges of model validation call for rigorous scrutiny to optimize their benefits in clinical settings. This survey serves as a resource for stakeholders in healthcare, including researchers, clinicians, and policymakers, to understand the current state and future potential of LLMs in BHI.

Xiang Li, Huizi Yu, Wenkong Wang et al.

Objective: Emergency medical dispatch (EMD) is a high-stakes process challenged by caller distress, ambiguity, and cognitive load. Large Language Models (LLMs) and Multi-Agent Systems (MAS) offer opportunities to augment dispatchers. This study aimed to develop and evaluate a taxonomy-grounded, LLM-powered multi-agent system for simulating realistic EMD scenarios. Methods: We constructed a clinical taxonomy (32 chief complaints, 6 caller identities from MIMIC-III) and a six-phase call protocol. Using this framework, we developed an AutoGen-based MAS with Caller and Dispatcher Agents. The system grounds interactions in a fact commons to ensure clinical plausibility and mitigate misinformation. We used a hybrid evaluation framework: four physicians assessed 100 simulated cases for "Guidance Efficacy" and "Dispatch Effectiveness," supplemented by automated linguistic analysis (sentiment, readability, politeness). Results: Human evaluation, with substantial inter-rater agreement (Gwe's AC1 > 0.70), confirmed the system's high performance. It demonstrated excellent Dispatch Effectiveness (e.g., 94 % contacting the correct potential other agents) and Guidance Efficacy (advice provided in 91 % of cases), both rated highly by physicians. Algorithmic metrics corroborated these findings, indicating a predominantly neutral affective profile (73.7 % neutral sentiment; 90.4 % neutral emotion), high readability (Flesch 80.9), and a consistently polite style (60.0 % polite; 0 % impolite). Conclusion: Our taxonomy-grounded MAS simulates diverse, clinically plausible dispatch scenarios with high fidelity. Findings support its use for dispatcher training, protocol evaluation, and as a foundation for real-time decision support. This work outlines a pathway for safely integrating advanced AI agents into emergency response workflows.

Boya Ouyang, Yuhai Li, Yu Song et al.

Despite enormous efforts over the last decades to establish the relationship between concrete proportioning and strength, a robust knowledge-based model for accurate concrete strength predictions is still lacking. As an alternative to physical or chemical-based models, data-driven machine learning (ML) methods offer a new solution to this problem. Although this approach is promising for handling the complex, non-linear, non-additive relationship between concrete mixture proportions and strength, a major limitation of ML lies in the fact that large datasets are needed for model training. This is a concern as reliable, consistent strength data is rather limited, especially for realistic industrial concretes. Here, based on the analysis of a large dataset (>10,000 observations) of measured compressive strengths from industrially-produced concretes, we compare the ability of select ML algorithms to "learn" how to reliably predict concrete strength as a function of the size of the dataset. Based on these results, we discuss the competition between how accurate a given model can eventually be (when trained on a large dataset) and how much data is actually required to train this model.