Hye Sun Yun

Hye Sun Yun, Mehdi Arjmand, Phillip Sherlock et al.

Standardized, validated questionnaires are vital tools in research and healthcare, offering dependable self-report data. Prior work has revealed that virtual agent-administered questionnaires are almost equivalent to self-administered ones in an electronic form. Despite being an engaging method, repeated use of virtual agent-administered questionnaires in longitudinal or pre-post studies can induce respondent fatigue, impacting data quality via response biases and decreased response rates. We propose using large language models (LLMs) to generate diverse questionnaire versions while retaining good psychometric properties. In a longitudinal study, participants interacted with our agent system and responded daily for two weeks to one of the following questionnaires: a standardized depression questionnaire, question variants generated by LLMs, or question variants accompanied by LLM-generated small talk. The responses were compared to a validated depression questionnaire. Psychometric testing revealed consistent covariation between the external criterion and focal measure administered across the three conditions, demonstrating the reliability and validity of the LLM-generated variants. Participants found that the variants were significantly less repetitive than repeated administrations of the same standardized questionnaire. Our findings highlight the potential of LLM-generated variants to invigorate agent-administered questionnaires and foster engagement and interest, without compromising their validity.

Hye Sun Yun, Geetika Kapoor, Michael Mackert et al.

Patients are increasingly turning to large language models (LLMs) with medical questions that are complex and difficult to articulate clearly. However, LLMs are sensitive to prompt phrasings and can be influenced by the way questions are worded. Ideally, LLMs should respond consistently regardless of phrasing, particularly when grounded in the same underlying evidence. We investigate this through a systematic evaluation in a controlled retrieval-augmented generation (RAG) setting for medical question answering (QA), where expert-selected documents are used rather than retrieved automatically. We examine two dimensions of patient query variation: question framing (positive vs. negative) and language style (technical vs. plain language). We construct a dataset of 6,614 query pairs grounded in clinical trial abstracts and evaluate response consistency across eight LLMs. Our findings show that positively- and negatively-framed pairs are significantly more likely to produce contradictory conclusions than same-framing pairs. This framing effect is further amplified in multi-turn conversations, where sustained persuasion increases inconsistency. We find no significant interaction between framing and language style. Our results demonstrate that LLM responses in medical QA can be systematically influenced through query phrasing alone, even when grounded in the same evidence, highlighting the importance of phrasing robustness as an evaluation criterion for RAG-based systems in high-stakes settings.

Hye Sun Yun, David Pogrebitskiy, Iain J. Marshall et al.

Meta-analyses statistically aggregate the findings of different randomized controlled trials (RCTs) to assess treatment effectiveness. Because this yields robust estimates of treatment effectiveness, results from meta-analyses are considered the strongest form of evidence. However, rigorous evidence syntheses are time-consuming and labor-intensive, requiring manual extraction of data from individual trials to be synthesized. Ideally, language technologies would permit fully automatic meta-analysis, on demand. This requires accurately extracting numerical results from individual trials, which has been beyond the capabilities of natural language processing (NLP) models to date. In this work, we evaluate whether modern large language models (LLMs) can reliably perform this task. We annotate (and release) a modest but granular evaluation dataset of clinical trial reports with numerical findings attached to interventions, comparators, and outcomes. Using this dataset, we evaluate the performance of seven LLMs applied zero-shot for the task of conditionally extracting numerical findings from trial reports. We find that massive LLMs that can accommodate lengthy inputs are tantalizingly close to realizing fully automatic meta-analysis, especially for dichotomous (binary) outcomes (e.g., mortality). However, LLMs -- including ones trained on biomedical texts -- perform poorly when the outcome measures are complex and tallying the results requires inference. This work charts a path toward fully automatic meta-analysis of RCTs via LLMs, while also highlighting the limitations of existing models for this aim.

Hye Sun Yun, Karen Y. C. Zhang, Ramez Kouzy et al.

Medical research faces well-documented challenges in translating novel treatments into clinical practice. Publishing incentives encourage researchers to present "positive" findings, even when empirical results are equivocal. Consequently, it is well-documented that authors often spin study results, especially in article abstracts. Such spin can influence clinician interpretation of evidence and may affect patient care decisions. In this study, we ask whether the interpretation of trial results offered by Large Language Models (LLMs) is similarly affected by spin. This is important since LLMs are increasingly being used to trawl through and synthesize published medical evidence. We evaluated 22 LLMs and found that they are across the board more susceptible to spin than humans. They might also propagate spin into their outputs: We find evidence, e.g., that LLMs implicitly incorporate spin into plain language summaries that they generate. We also find, however, that LLMs are generally capable of recognizing spin, and can be prompted in a way to mitigate spin's impact on LLM outputs.

Emily Alsentzer, Marie-Laure Charpignon, Bill Chen et al.

The 6th Annual Conference on Health, Inference, and Learning (CHIL 2025), hosted by the Association for Health Learning and Inference (AHLI), was held in person on June 25-27, 2025, at the University of California, Berkeley, in Berkeley, California, USA. As part of this year's program, we hosted Research Roundtables to catalyze collaborative, small-group dialogue around critical, timely topics at the intersection of machine learning and healthcare. Each roundtable was moderated by a team of senior and junior chairs who fostered open exchange, intellectual curiosity, and inclusive engagement. The sessions emphasized rigorous discussion of key challenges, exploration of emerging opportunities, and collective ideation toward actionable directions in the field. In total, eight roundtables were held by 19 roundtable chairs on topics of "Explainability, Interpretability, and Transparency," "Uncertainty, Bias, and Fairness," "Causality," "Domain Adaptation," "Foundation Models," "Learning from Small Medical Data," "Multimodal Methods," and "Scalable, Translational Healthcare Solutions."

Hye Sun Yun, Iain J. Marshall, Thomas A. Trikalinos et al.

Medical systematic reviews play a vital role in healthcare decision making and policy. However, their production is time-consuming, limiting the availability of high-quality and up-to-date evidence summaries. Recent advancements in large language models (LLMs) offer the potential to automatically generate literature reviews on demand, addressing this issue. However, LLMs sometimes generate inaccurate (and potentially misleading) texts by hallucination or omission. In healthcare, this can make LLMs unusable at best and dangerous at worst. We conducted 16 interviews with international systematic review experts to characterize the perceived utility and risks of LLMs in the specific context of medical evidence reviews. Experts indicated that LLMs can assist in the writing process by drafting summaries, generating templates, distilling information, and crosschecking information. They also raised concerns regarding confidently composed but inaccurate LLM outputs and other potential downstream harms, including decreased accountability and proliferation of low-quality reviews. Informed by this qualitative analysis, we identify criteria for rigorous evaluation of biomedical LLMs aligned with domain expert views.

Chang Min Hyun, Taigyntuya Bayaraa, Hye Sun Yun et al.

Low-dose dental cone beam computed tomography (CBCT) has been increasingly used for maxillofacial modeling. However, the presence of metallic inserts, such as implants, crowns, and dental filling, causes severe streaking and shading artifacts in a CBCT image and loss of the morphological structures of the teeth, which consequently prevents accurate segmentation of bones. A two-stage metal artifact reduction method is proposed for accurate 3D low-dose maxillofacial CBCT modeling, where a key idea is to utilize explicit tooth shape prior information from intra-oral scan data whose acquisition does not require any extra radiation exposure. In the first stage, an image-to-image deep learning network is employed to mitigate metal-related artifacts. To improve the learning ability, the proposed network is designed to take advantage of the intra-oral scan data as side-inputs and perform multi-task learning of auxiliary tooth segmentation. In the second stage, a 3D maxillofacial model is constructed by segmenting the bones from the dental CBCT image corrected in the first stage. For accurate bone segmentation, weighted thresholding is applied, wherein the weighting region is determined depending on the geometry of the intra-oral scan data. Because acquiring a paired training dataset of metal-artifact-free and metal artifact-affected dental CBCT images is challenging in clinical practice, an automatic method of generating a realistic dataset according to the CBCT physics model is introduced. Numerical simulations and clinical experiments show the feasibility of the proposed method, which takes advantage of tooth surface information from intra-oral scan data in 3D low dose maxillofacial CBCT modeling.

Tae Jun Jang, Hye Sun Yun, Chang Min Hyun et al.

We present a fully automated method of integrating intraoral scan (IOS) and dental cone-beam computerized tomography (CBCT) images into one image by complementing each image's weaknesses. Dental CBCT alone may not be able to delineate precise details of the tooth surface due to limited image resolution and various CBCT artifacts, including metal-induced artifacts. IOS is very accurate for the scanning of narrow areas, but it produces cumulative stitching errors during full-arch scanning. The proposed method is intended not only to compensate the low-quality of CBCT-derived tooth surfaces with IOS, but also to correct the cumulative stitching errors of IOS across the entire dental arch. Moreover, the integration provide both gingival structure of IOS and tooth roots of CBCT in one image. The proposed fully automated method consists of four parts; (i) individual tooth segmentation and identification module for IOS data (TSIM-IOS); (ii) individual tooth segmentation and identification module for CBCT data (TSIM-CBCT); (iii) global-to-local tooth registration between IOS and CBCT; and (iv) stitching error correction of full-arch IOS. The experimental results show that the proposed method achieved landmark and surface distance errors of 112.4 $μ$m and 301.7 $μ$m, respectively.

Hye Sun Yun, Chang Min Hyun, Seong Hyeon Baek et al.

Identification of 3D cephalometric landmarks that serve as proxy to the shape of human skull is the fundamental step in cephalometric analysis. Since manual landmarking from 3D computed tomography (CT) images is a cumbersome task even for the trained experts, automatic 3D landmark detection system is in a great need. Recently, automatic landmarking of 2D cephalograms using deep learning (DL) has achieved great success, but 3D landmarking for more than 80 landmarks has not yet reached a satisfactory level, because of the factors hindering machine learning such as the high dimensionality of the input data and limited amount of training data due to ethical restrictions on the use of medical data. This paper presents a semi-supervised DL method for 3D landmarking that takes advantage of anonymized landmark dataset with paired CT data being removed. The proposed method first detects a small number of easy-to-find reference landmarks, then uses them to provide a rough estimation of the entire landmarks by utilizing the low dimensional representation learned by variational autoencoder (VAE). Anonymized landmark dataset is used for training the VAE. Finally, coarse-to-fine detection is applied to the small bounding box provided by rough estimation, using separate strategies suitable for mandible and cranium. For mandibular landmarks, patch-based 3D CNN is applied to the segmented image of the mandible (separated from the maxilla), in order to capture 3D morphological features of mandible associated with the landmarks. We detect 6 landmarks around the condyle all at once, instead of one by one, because they are closely related to each other. For cranial landmarks, we again use VAE-based latent representation for more accurate annotation. In our experiment, the proposed method achieved an averaged 3D point-to-point error of 2.91 mm for 90 landmarks only with 15 paired training data.