Jiayan Zhou

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.

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.

Xiaoran Xu, Zhaoqian Xue, Chi Zhang et al.

Investigating the public experience of urgent care facilities is essential for promoting community healthcare development. Traditional survey methods often fall short due to limited scope, time, and spatial coverage. Crowdsourcing through online reviews or social media offers a valuable approach to gaining such insights. With recent advancements in large language models (LLMs), extracting nuanced perceptions from reviews has become feasible. This study collects Google Maps reviews across the DMV and Florida areas and conducts prompt engineering with the GPT model to analyze the aspect-based sentiment of urgent care. We first analyze the geospatial patterns of various aspects, including interpersonal factors, operational efficiency, technical quality, finances, and facilities. Next, we determine Census Block Group(CBG)-level characteristics underpinning differences in public perception, including population density, median income, GINI Index, rent-to-income ratio, household below poverty rate, no insurance rate, and unemployment rate. Our results show that interpersonal factors and operational efficiency emerge as the strongest determinants of patient satisfaction in urgent care, while technical quality, finances, and facilities show no significant independent effects when adjusted for in multivariate models. Among socioeconomic and demographic factors, only population density demonstrates a significant but modest association with patient ratings, while the remaining factors exhibit no significant correlations. Overall, this study highlights the potential of crowdsourcing to uncover the key factors that matter to residents and provide valuable insights for stakeholders to improve public satisfaction with urgent care.

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.

Zhijie Duan, Kai Wei, Zhaoqian Xue et al.

Social media is a rich source of real-world data that captures valuable patient experience information for pharmacovigilance. However, mining data from unstructured and noisy social media content remains a challenging task. We present a systematic framework that leverages large language models (LLMs) to extract medication side effects from social media and organize them into a knowledge graph (KG). We apply this framework to semaglutide for weight loss using data from Reddit. Using the constructed knowledge graph, we perform comprehensive analyses to investigate reported side effects across different semaglutide brands over time. These findings are further validated through comparison with adverse events reported in the FAERS database, providing important patient-centered insights into semaglutide's side effects that complement its safety profile and current knowledge base of semaglutide for both healthcare professionals and patients. Our work demonstrates the feasibility of using LLMs to transform social media data into structured KGs for pharmacovigilance.