Robert T Chang

Jasmine Chiat Ling Ong, Yilin Ning, Mingxuan Liu et al.

The integration of generative AI (GenAI) and large language models (LLMs) in healthcare presents both unprecedented opportunities and challenges, necessitating innovative regulatory approaches. GenAI and LLMs offer broad applications, from automating clinical workflows to personalizing diagnostics. However, the non-deterministic outputs, broad functionalities and complex integration of GenAI and LLMs challenge existing medical device regulatory frameworks, including the total product life cycle (TPLC) approach. Here we discuss the constraints of the TPLC approach to GenAI and LLM-based medical device regulation, and advocate for global collaboration in regulatory science research. This serves as the foundation for developing innovative approaches including adaptive policies and regulatory sandboxes, to test and refine governance in real-world settings. International harmonization, as seen with the International Medical Device Regulators Forum, is essential to manage implications of LLM on global health, including risks of widening health inequities driven by inherent model biases. By engaging multidisciplinary expertise, prioritizing iterative, data-driven approaches, and focusing on the needs of diverse populations, global regulatory science research enables the responsible and equitable advancement of LLM innovations in healthcare.

Chris Piech, Ali Malik, Laura M Scott et al.

Chart-based visual acuity measurements are used by billions of people to diagnose and guide treatment of vision impairment. However, the ubiquitous eye exam has no mechanism for reasoning about uncertainty and as such, suffers from a well-documented reproducibility problem. In this paper we make two core contributions. First, we uncover a new parametric probabilistic model of visual acuity response based on detailed measurements of patients with eye disease. Then, we present an adaptive, digital eye exam using modern artificial intelligence techniques which substantially reduces acuity exam error over existing approaches, while also introducing the novel ability to model its own uncertainty and incorporate prior beliefs. Using standard evaluation metrics, we estimate a 74% reduction in prediction error compared to the ubiquitous chart-based eye exam and up to 67% reduction compared to the previous best digital exam. For patients with eye disease, the novel ability to finely measure acuity from home could be a crucial part in early diagnosis. We provide a web implementation of our algorithm for anyone in the world to use. The insights in this paper also provide interesting implications for the field of psychometric Item Response Theory.