Shreya Johri

Sraavya Sambara, Sung Eun Kim, Xiaoman Zhang et al.

Current Vision-Language Models (VLMs) struggle to ground anatomical regions in 3D medical images and reason about them in a step-by-step manner, a key requirement of real-world diagnostic assessment. This ability is essential for aligning model outputs with the diagnostic workflows clinicians use in practice, enabling trustworthy clinician-AI collaboration. Existing 3D datasets provide localization labels, but none support this "grounded reasoning" ability. To address this gap, we introduce 3DReasonKnee, the first 3D grounded reasoning dataset for medical images, which provides 494k high-quality quintuples derived from 7,970 3D knee MRI volumes. Each quintuple includes: (1) the 3D MRI volume, (2) a diagnostic question targeting a specific anatomical region (3) a 3D bounding box localizing the relevant anatomical structures, (4) clinician-generated diagnostic reasoning steps that explicitly detail the 3D reasoning process, and (5) structured severity assessments for the relevant anatomical region. The creation and validation of 3DReasonKnee, involving over 450 hours of expert clinician time for manually segmenting MRIs and generating reasoning chains, ensures its superior quality and clinical relevance. We establish ReasonKnee-Bench to evaluate localization and diagnostic accuracy, providing insight into VLM ability to perform grounding and severity assessment across anatomical regions and diagnostic inquiries. We benchmark five state-of-the-art VLMs, providing baseline performance for ReasonKnee-Bench. By providing this unique resource of expert-annotated 3D reasoning pathways, 3DReasonKnee serves as a repository of orthopedic surgeons' diagnostic expertise and offers a vital testbed for advancing multimodal medical AI systems towards 3D, clinically aligned, localized decision-making capabilities. The dataset can be found in: https://huggingface.co/datasets/rajpurkarlab/3DReasonKnee

Julian Acosta, Scott Adams, Julius Kernbach et al.

We developed a voice-driven artificial intelligence (AI) system that guides anyone - from paramedics to family members - through expert-level stroke evaluations using natural conversation, while also enabling smartphone video capture of key examination components for documentation and potential expert review. This addresses a critical gap in emergency care: current stroke recognition by first responders is inconsistent and often inaccurate, with sensitivity for stroke detection as low as 58%, causing life-threatening delays in treatment. Three non-medical volunteers used our AI system to assess ten simulated stroke patients, including cases with likely large vessel occlusion (LVO) strokes and stroke-like conditions, while we measured diagnostic accuracy, completion times, user confidence, and expert physician review of the AI-generated reports. The AI system correctly identified 84% of individual stroke signs and detected 75% of likely LVOs, completing evaluations in just over 6 minutes. Users reported high confidence (median 4.5/5) and ease of use (mean 4.67/5). The system successfully identified 86% of actual strokes but also incorrectly flagged 2 of 3 non-stroke cases as strokes. When an expert physician reviewed the AI reports with videos, they identified the correct diagnosis in 100% of cases, but felt confident enough to make preliminary treatment decisions in only 40% of cases due to observed AI errors including incorrect scoring and false information. While the current system's limitations necessitate human oversight, ongoing rapid advancements in speech-to-speech AI models suggest that future versions are poised to enable highly accurate assessments. Achieving human-level voice interaction could transform emergency medical care, putting expert-informed assessment capabilities in everyone's hands.

Yukti Makhija, Samarth Bhatia, Shalendra Singh et al.

Many countries are now experiencing the third wave of the COVID-19 pandemic straining the healthcare resources with an acute shortage of hospital beds and ventilators for the critically ill patients. This situation is especially worse in India with the second largest load of COVID-19 cases and a relatively resource-scarce medical infrastructure. Therefore, it becomes essential to triage the patients based on the severity of their disease and devote resources towards critically ill patients. Yan et al. 1 have published a very pertinent research that uses Machine learning (ML) methods to predict the outcome of COVID-19 patients based on their clinical parameters at the day of admission. They used the XGBoost algorithm, a type of ensemble model, to build the mortality prediction model. The final classifier is built through the sequential addition of multiple weak classifiers. The clinically operable decision rule was obtained from a 'single-tree XGBoost' and used lactic dehydrogenase (LDH), lymphocyte and high-sensitivity C-reactive protein (hs-CRP) values. This decision tree achieved a 100% survival prediction and 81% mortality prediction. However, these models have several technical challenges and do not provide an out of the box solution that can be deployed for other populations as has been reported in the "Matters Arising" section of Yan et al. Here, we show the limitations of this model by deploying it on one of the largest datasets of COVID-19 patients containing detailed clinical parameters collected from India.