Xiang Li

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.

Songting Shi, Xiang Li, Arkadiusz Sitek et al.

In this article, we derive a Bayesian model to learning the sparse and low rank PARAFAC decomposition for the observed tensor with missing values via the elastic net, with property to find the true rank and sparse factor matrix which is robust to the noise. We formulate efficient block coordinate descent algorithm and admax stochastic block coordinate descent algorithm to solve it, which can be used to solve the large scale problem. To choose the appropriate rank and sparsity in PARAFAC decomposition, we will give a solution path by gradually increasing the regularization to increase the sparsity and decrease the rank. When we find the sparse structure of the factor matrix, we can fixed the sparse structure, using a small to regularization to decreasing the recovery error, and one can choose the proper decomposition from the solution path with sufficient sparse factor matrix with low recovery error. We test the power of our algorithm on the simulation data and real data, which show it is powerful.