3.3AIOct 20, 2025
OG-Rank: Learning to Rank Fast and Slow with Uncertainty and Reward-Trend Guided Adaptive ExplorationPraphul Singh, Corey Barrett, Sumana Srivasta et al.
Clinicians need ranking systems that work in real time and still justify their choices. Motivated by the need for a low-latency, decoder-based reranker, we present OG-Rank, a single-decoder approach that pairs a pooled first-token scoring signal with an uncertainty-gated explanation step. The model scores all candidates in one pass and generates a brief, structured rationale only when the list is genuinely ambiguous, keeping latency predictable. Trained with a curriculum that concentrates effort on hard cases, OG-Rank delivers strong effectiveness on encounter-scoped order selection (fast path: Recall@1~0.45, nDCG@20~0.625) and improves further when the gate activates (Recall@1~0.56, nDCG@20~0.699 at a 45\% gate rate), while compact backbones show similar gains under the same policy. Encoder baselines trail in both effectiveness and flexibility. The result is a practical recipe: rank fast by default and explain when it helps, a pattern that applies broadly to decision tasks where selective generation buys accuracy at acceptable cost. The single-policy design simplifies deployment and budget planning, and the curriculum principle (spend more on the hard cases, less on the easy ones) readily transfers beyond clinical order selection.
11.1AIMay 23, 2025
RedactOR: An LLM-Powered Framework for Automatic Clinical Data De-IdentificationPraphul Singh, Charlotte Dzialo, Jangwon Kim et al.
Ensuring clinical data privacy while preserving utility is critical for AI-driven healthcare and data analytics. Existing de-identification (De-ID) methods, including rule-based techniques, deep learning models, and large language models (LLMs), often suffer from recall errors, limited generalization, and inefficiencies, limiting their real-world applicability. We propose a fully automated, multi-modal framework, RedactOR for de-identifying structured and unstructured electronic health records, including clinical audio records. Our framework employs cost-efficient De-ID strategies, including intelligent routing, hybrid rule and LLM based approaches, and a two-step audio redaction approach. We present a retrieval-based entity relexicalization approach to ensure consistent substitutions of protected entities, thereby enhancing data coherence for downstream applications. We discuss key design desiderata, de-identification and relexicalization methodology, and modular architecture of RedactOR and its integration with the Oracle Health Clinical AI system. Evaluated on the i2b2 2014 De-ID dataset using standard metrics with strict recall, our approach achieves competitive performance while optimizing token usage to reduce LLM costs. Finally, we discuss key lessons and insights from deployment in real-world AI- driven healthcare data pipelines.