LGMay 29
IRIS: time-structured manifold projectionsBrian Ondov, Chia-Hsuan Chang, Weipeng Zhou et al.
High-dimensional biomedical data, such as cell-by-gene matrices, are increasingly generated temporally. However, Manifold Learning algorithms, like t-SNE and UMAP, cannot incorporate time-ordering in their layouts, obfuscating the dynamics of cell types or other classes. As a solution, we present IRIS, a new Manifold Learning algorithm that structures layouts both chronologically and by manifold topology. IRIS can visualize a wide range of dynamic biomedical data, including scRNA-seq, comparative metagenomics, and literature.
CYAug 24, 2023Code
Considerations for health care institutions training large language models on electronic health recordsWeipeng Zhou, Danielle Bitterman, Majid Afshar et al.
Large language models (LLMs) like ChatGPT have excited scientists across fields; in medicine, one source of excitement is the potential applications of LLMs trained on electronic health record (EHR) data. But there are tough questions we must first answer if health care institutions are interested in having LLMs trained on their own data; should they train an LLM from scratch or fine-tune it from an open-source model? For healthcare institutions with a predefined budget, what are the biggest LLMs they can afford? In this study, we take steps towards answering these questions with an analysis on dataset sizes, model sizes, and costs for LLM training using EHR data. This analysis provides a framework for thinking about these questions in terms of data scale, compute scale, and training budgets.
CLApr 13, 2023
LeafAI: query generator for clinical cohort discovery rivaling a human programmerNicholas J Dobbins, Bin Han, Weipeng Zhou et al.
Objective: Identifying study-eligible patients within clinical databases is a critical step in clinical research. However, accurate query design typically requires extensive technical and biomedical expertise. We sought to create a system capable of generating data model-agnostic queries while also providing novel logical reasoning capabilities for complex clinical trial eligibility criteria. Materials and Methods: The task of query creation from eligibility criteria requires solving several text-processing problems, including named entity recognition and relation extraction, sequence-to-sequence transformation, normalization, and reasoning. We incorporated hybrid deep learning and rule-based modules for these, as well as a knowledge base of the Unified Medical Language System (UMLS) and linked ontologies. To enable data-model agnostic query creation, we introduce a novel method for tagging database schema elements using UMLS concepts. To evaluate our system, called LeafAI, we compared the capability of LeafAI to a human database programmer to identify patients who had been enrolled in 8 clinical trials conducted at our institution. We measured performance by the number of actual enrolled patients matched by generated queries. Results: LeafAI matched a mean 43% of enrolled patients with 27,225 eligible across 8 clinical trials, compared to 27% matched and 14,587 eligible in queries by a human database programmer. The human programmer spent 26 total hours crafting queries compared to several minutes by LeafAI. Conclusions: Our work contributes a state-of-the-art data model-agnostic query generation system capable of conditional reasoning using a knowledge base. We demonstrate that LeafAI can rival an experienced human programmer in finding patients eligible for clinical trials.
CLJan 29
A Federated and Parameter-Efficient Framework for Large Language Model Training in MedicineAnran Li, Yuanyuan Chen, Wenjun Long et al.
Large language models (LLMs) have demonstrated strong performance on medical benchmarks, including question answering and diagnosis. To enable their use in clinical settings, LLMs are typically further adapted through continued pretraining or post-training using clinical data. However, most medical LLMs are trained on data from a single institution, which faces limitations in generalizability and safety in heterogeneous systems. Federated learning (FL) is a promising solution for enabling collaborative model development across healthcare institutions. Yet applying FL to LLMs in medicine remains fundamentally limited. First, conventional FL requires transmitting the full model during each communication round, which becomes impractical for multi-billion-parameter LLMs given the limited computational resources. Second, many FL algorithms implicitly assume data homogeneity, whereas real-world clinical data are highly heterogeneous across patients, diseases, and institutional practices. We introduce the model-agnostic and parameter-efficient federated learning framework for adapting LLMs to medical applications. Fed-MedLoRA transmits only low-rank adapter parameters, reducing communication and computation overhead, while Fed-MedLoRA+ further incorporates adaptive, data-aware aggregation to improve convergence under cross-site heterogeneity. We apply the framework to clinical information extraction (IE), which transforms patient narratives into structured medical entities and relations. Accuracy was assessed across five patient cohorts through comparisons with BERT models, and LLaMA-3 and DeepSeek-R1, GPT-4o models. Evaluation settings included (1) in-domain training and testing, (2) external validation on independent cohorts, and (3) a low-resource new-site adaptation scenario using real-world clinical notes from the Yale New Haven Health System.
AIMay 4
Foundation Models to Unlock Real-World Evidence from Nationwide Medical ClaimsFan Ma, Yuntian Liu, Xiang Lan et al.
Evidence derived from large-scale real-world data (RWD) is increasingly informing regulatory evaluation and healthcare decision-making. Administrative claims provide population-scale, longitudinal records of healthcare utilization, expenditure, and detailed coding of diagnoses, procedures, and medications, yet their potential as a substrate for healthcare foundation models remains largely unexplored. Here we present ReClaim, a generative transformer trained from scratch on 43.8 billion medical events from more than 200 million enrollees in the MarketScan claims data spanning 2008-2022. ReClaim models longitudinal trajectories across diagnoses, procedures, medications, and expenditure, and was scaled to 140 million, 700 million, and 1.7 billion parameters. Across over 1,000 disease-onset prediction tasks, ReClaim achieved a mean AUC of 75.6%, substantially outperforming disease-specific LightGBM (66.3%) and the transformer-based Delphi model (69.4%), with the largest gains for rare diseases. These advantages held across retrospective and prospective evaluations and in external validation on two independent datasets. Performance improved monotonically with scale, and post-training added 13.8 percentage points over pre-training alone. Beyond disease prediction, ReClaim captured financial outcomes and improved real-world evidence (RWE) analyses: for healthcare expenditure forecasting it increased explained variance from 0.28 to 0.37 relative to LightGBM, and in a target trial emulation it reduced systematic bias by 72% on average relative to Delphi. Together, these results establish administrative claims as a scalable substrate for healthcare foundation models and show that learned representations generalize across time periods and data sources, supporting disease surveillance, expenditure forecasting, and RWE generation.
CLFeb 12, 2025
Fino1: On the Transferability of Reasoning-Enhanced LLMs and Reinforcement Learning to FinanceLingfei Qian, Weipeng Zhou, Yan Wang et al.
As the fundamental capability behind decision-making in finance, financial reasoning poses distinct challenges for LLMs. Although reinforcement learning (RL) have boosted generic reasoning, the progress in finance is hindered by the absence of empirical study of building effective financial chain-of-thought (CoT) corpus, a systematic comparison of different RL methods, and comprehensive benchmarks. To address these gaps, we introduce FinCoT, the first open high-fidelity CoT corpus for finance, distilled from seven QA datasets by a novel three-stage pipeline that incorporates domain supervision, iterative LLM refinement, and difficulty-aware filtering. Based on FinCoT, we develop Fin-o1, the first open financial reasoning models trained via supervised fine-tuning and GRPO-based RL. Our models outperform existing financial reasoning models and SOTA general models such as GPT-o1, DeepSeek-R1, and GPT-4.5. We also investigate the effectiveness of three different RL methods in improving domain-specific reasoning, offering the first such empirical study. We finally propose FinReason, the first financial reasoning benchmark covering multi-table analysis, long-context reasoning, and equation-based tasks, and evaluate 29 LLMs. Our extensive experiments reveal general reasoning models excel on standard benchmarks yet exhibit obvious performance degradation in financial contexts; even finance-tuned models like Dianjin-R1 and FinR1 degrade on lengthy documents. In contrast, our Fin-o1 models consistently outperform their backbones and larger GPT-o1 and DeepSeek-R1, confirming the effectiveness of our data building and model training strategy. Our study further shows that GRPO yields reliable gains whereas PPO and DPO do not, highlighting the need for targeted data and optimisation rather than scale alone.
LGNov 27, 2021
Forecasting Daily COVID-19 Related Calls in VA Health Care System: Predictive Model DevelopmentWeipeng Zhou, Ryan J. Laundry, Paul L. Hebert et al.
Background: COVID-19 has become a challenge worldwide and properly planning of medical resources is the key to combating COVID-19. In the US Veteran Affairs Health Care System (VA), many of the enrollees are susceptible to COVID-19. Predicting the COVID-19 to allocate medical resources promptly becomes a critical issue. When the VA enrollees have COVID-19 symptoms, it is recommended that their first step should be to call the VA Call Center. For confirmed COVID-19 patients, the median time from the first symptom to hospital admission was seven days. By predicting the number of COVID-19 related calls, we could predict imminent surges in healthcare use and plan medical resources ahead. Objective: The study aims to develop a method to forecast the daily number of COVID-19 related calls for each of the 110 VA medical centers. Methods: In the proposed method, we pre-trained a model using a cluster of medical centers and fine-tuned it for individual medical centers. At the cluster level, we performed feature selection to select significant features and automatic hyper-parameter search to select optimal hyper-parameter value combinations for the model. Conclusions: This study proposed an accurate method to forecast the daily number of COVID-19 related calls for VA medical centers. The proposed method was able to overcome modeling challenges by grouping similar medical centers into clusters to enlarge the dataset for training models, and using hyper-parameter search to automatically find optimal hyper-parameter value combinations for models. With the proposed method, surges in health care can be predicted ahead. This allows health care practitioners to better plan medical resources and combat COVID-19.