Dongshen Peng

Yuli Wang, Hyewon Jung, Dongshen Peng et al.

Vision Transformer (ViT) models, utilizing self-attention mechanisms, have demonstrated robust generalization capabilities across various vision tasks, including image classification. However, these models, typically pretrained on general public datasets, often lack the specialized domain knowledge necessary for medical imaging applications. In this study, we investigate the adaptation of ViT models, specifically for cardiac magnetic resonance (MR) images, using an in-house dataset. We found that pretrained ViT features do not effectively transfer to the cardiac MR domain. To overcome this limitation, we introduce an adaptation strategy that utilizes image-based self-supervised contrastive learning, demonstrating superior performance compared to traditional supervised training approaches. Moreover, our adapted ViT model exhibits strong generalization to external MR datasets such as BraTS and ADNI. Through ablation studies, we further investigate the impact of batch size and dataset scale on performance. Ultimately, our adapted model achieves classification AUC exceeding 0.75 across the four most common cardiac MR sequences.

Dongshen Peng, Yi Wang, Austin Schoeffler et al.

Large language models (LLMs) show promise in clinical decision support yet risk acquiescing to patient pressure for inappropriate care. We introduce SycoEval-EM, a multi-agent simulation framework evaluating LLM robustness through adversarial patient persuasion in emergency medicine. Across 20 LLMs and 1,875 encounters spanning three Choosing Wisely scenarios, acquiescence rates ranged from 0-100\%. Models showed higher vulnerability to imaging requests (38.8\%) than opioid prescriptions (25.0\%), with model capability poorly predicting robustness. All persuasion tactics proved equally effective (30.0-36.0\%), indicating general susceptibility rather than tactic-specific weakness. Our findings demonstrate that static benchmarks inadequately predict safety under social pressure, necessitating multi-turn adversarial testing for clinical AI certification.

Wenhao Zheng, Liaoyaqi Wang, Dongshen Peng et al.

The clinical trial is a pivotal and costly process, often spanning multiple years and requiring substantial financial resources. Therefore, the development of clinical trial outcome prediction models aims to exclude drugs likely to fail and holds the potential for significant cost savings. Recent data-driven attempts leverage deep learning methods to integrate multimodal data for predicting clinical trial outcomes. However, these approaches rely on manually designed modal-specific encoders, which limits both the extensibility to adapt new modalities and the ability to discern similar information patterns across different modalities. To address these issues, we propose a multimodal mixture-of-experts (LIFTED) approach for clinical trial outcome prediction. Specifically, LIFTED unifies different modality data by transforming them into natural language descriptions. Then, LIFTED constructs unified noise-resilient encoders to extract information from modal-specific language descriptions. Subsequently, a sparse Mixture-of-Experts framework is employed to further refine the representations, enabling LIFTED to identify similar information patterns across different modalities and extract more consistent representations from those patterns using the same expert model. Finally, a mixture-of-experts module is further employed to dynamically integrate different modality representations for prediction, which gives LIFTED the ability to automatically weigh different modalities and pay more attention to critical information. The experiments demonstrate that LIFTED significantly enhances performance in predicting clinical trial outcomes across all three phases compared to the best baseline, showcasing the effectiveness of our proposed key components.