Kun-Hsing Yu

Dianbo Liu, Karmel W. Choi, Paulo Lizano et al.

Importance: The prevalence of severe mental illnesses (SMIs) in the United States is approximately 3% of the whole population. The ability to conduct risk screening of SMIs at large scale could inform early prevention and treatment. Objective: A scalable machine learning based tool was developed to conduct population-level risk screening for SMIs, including schizophrenia, schizoaffective disorders, psychosis, and bipolar disorders,using 1) healthcare insurance claims and 2) electronic health records (EHRs). Design, setting and participants: Data from beneficiaries from a nationwide commercial healthcare insurer with 77.4 million members and data from patients from EHRs from eight academic hospitals based in the U.S. were used. First, the predictive models were constructed and tested using data in case-control cohorts from insurance claims or EHR data. Second, performance of the predictive models across data sources were analyzed. Third, as an illustrative application, the models were further trained to predict risks of SMIs among 18-year old young adults and individuals with substance associated conditions. Main outcomes and measures: Machine learning-based predictive models for SMIs in the general population were built based on insurance claims and EHR.

Qian Da, Yijiang Chen, Min Ju et al.

Recent breakthroughs in artificial intelligence through foundation models and agents have accelerated the evolution of computational pathology. Demonstrated performance gains reported across academia in benchmarking datasets in predictive tasks such as diagnosis, prognosis, and treatment response have ignited substantial enthusiasm for clinical application. Despite this development momentum, real world adoption has lagged, as implementation faces economic, technical, and administrative challenges. Beyond existing discussions of technical architectures and comparative performance, this review considers how these emerging AI systems can be responsibly integrated into medical practice by connecting deployable clinical relevance with downstream analytical capabilities and their technical maturity, operational readiness, and economic and regulatory context. Drawing on perspectives from an international group, we provide a practical assessment of current capabilities and barriers to adoption in patient care settings.

Xiaoye Wang, Nicole Xi Zhang, Hongyu He et al.

Recent advancements in artificial intelligence (AI), particularly in large language models (LLMs), have unlocked significant potential to enhance the quality and efficiency of medical care. By introducing a novel way to interact with AI and data through natural language, LLMs offer new opportunities for medical practitioners, patients, and researchers. However, as AI and LLMs become more powerful and especially achieve superhuman performance in some medical tasks, public concerns over their safety have intensified. These concerns about AI safety have emerged as the most significant obstacles to the adoption of AI in medicine. In response, this review examines emerging risks in AI utilization during the LLM era. First, we explore LLM-specific safety challenges from functional and communication perspectives, addressing issues across data collection, model training, and real-world application. We then consider inherent safety problems shared by all AI systems, along with additional complications introduced by LLMs. Last, we discussed how safety issues of using AI in clinical practice and healthcare system operation would undermine trust among patient, clinicians and the public, and how to build confidence in these systems. By emphasizing the development of safe AI, we believe these technologies can be more rapidly and reliably integrated into everyday medical practice to benefit both patients and clinicians.

Hongyu He, Shaowen Xiang, Ye Zhang et al.

Generative artificial intelligence (AI) is rapidly populating medical records with synthetic content, creating a feedback loop where future models are increasingly at risk of training on uncurated AI-generated data. However, the clinical consequences of this AI-generated data contamination remain unexplored. Here, we show that in the absence of mandatory human verification, this self-referential cycle drives a rapid erosion of pathological variability and diagnostic reliability. By analysing more than 800,000 synthetic data points across clinical text generation, vision-language reporting, and medical image synthesis, we find that models progressively converge toward generic phenotypes regardless of the model architecture. Specifically, rare but critical findings, including pneumothorax and effusions, vanish from the synthetic content generated by AI models, while demographic representations skew heavily toward middle-aged male phenotypes. Crucially, this degradation is masked by false diagnostic confidence; models continue to issue reassuring reports while failing to detect life-threatening pathology, with false reassurance rates tripling to 40%. Blinded physician evaluation confirms that this decoupling of confidence and accuracy renders AI-generated documentation clinically useless after just two generations. We systematically evaluate three mitigation strategies, finding that while synthetic volume scaling fails to prevent collapse, mixing real data with quality-aware filtering effectively preserves diversity. Ultimately, our results suggest that without policy-mandated human oversight, the deployment of generative AI threatens to degrade the very healthcare data ecosystems it relies upon.

Mohammed Baharoon, Siavash Raissi, John S. Jun et al.

We introduce RadGame, an AI-powered gamified platform for radiology education that targets two core skills: localizing findings and generating reports. Traditional radiology training is based on passive exposure to cases or active practice with real-time input from supervising radiologists, limiting opportunities for immediate and scalable feedback. RadGame addresses this gap by combining gamification with large-scale public datasets and automated, AI-driven feedback that provides clear, structured guidance to human learners. In RadGame Localize, players draw bounding boxes around abnormalities, which are automatically compared to radiologist-drawn annotations from public datasets, and visual explanations are generated by vision-language models for user missed findings. In RadGame Report, players compose findings given a chest X-ray, patient age and indication, and receive structured AI feedback based on radiology report generation metrics, highlighting errors and omissions compared to a radiologist's written ground truth report from public datasets, producing a final performance and style score. In a prospective evaluation, participants using RadGame achieved a 68% improvement in localization accuracy compared to 17% with traditional passive methods and a 31% improvement in report-writing accuracy compared to 4% with traditional methods after seeing the same cases. RadGame highlights the potential of AI-driven gamification to deliver scalable, feedback-rich radiology training and reimagines the application of medical AI resources in education.

Yousef Yeganeh, Maximilian Frantzen, Michael Lee et al.

While Whole Slide Imaging (WSI) scanners remain the gold standard for digitizing pathology samples, their high cost limits accessibility in many healthcare settings. Other low-cost solutions also face critical limitations: automated microscopes struggle with consistent focus across varying tissue morphology, traditional auto-focus methods require time-consuming focal stacks, and existing deep-learning approaches either need multiple input images or lack generalization capability across tissue types and staining protocols. We introduce a novel automated microscopic system powered by DeepAf, a novel auto-focus framework that uniquely combines spatial and spectral features through a hybrid architecture for single-shot focus prediction. The proposed network automatically regresses the distance to the optimal focal point using the extracted spatiospectral features and adjusts the control parameters for optimal image outcomes. Our system transforms conventional microscopes into efficient slide scanners, reducing focusing time by 80% compared to stack-based methods while achieving focus accuracy of 0.18 μm on the same-lab samples, matching the performance of dual-image methods (0.19 μm) with half the input requirements. DeepAf demonstrates robust cross-lab generalization with only 0.72% false focus predictions and 90% of predictions within the depth of field. Through an extensive clinical study of 536 brain tissue samples, our system achieves 0.90 AUC in cancer classification at 4x magnification, a significant achievement at lower magnification than typical 20x WSI scans. This results in a comprehensive hardware-software design enabling accessible, real-time digital pathology in resource-constrained settings while maintaining diagnostic accuracy.

Benjamin D. Lee, Anthony Gitter, Casey S. Greene et al.

Machine learning is a modern approach to problem-solving and task automation. In particular, machine learning is concerned with the development and applications of algorithms that can recognize patterns in data and use them for predictive modeling. Artificial neural networks are a particular class of machine learning algorithms and models that evolved into what is now described as deep learning. Given the computational advances made in the last decade, deep learning can now be applied to massive data sets and in innumerable contexts. Therefore, deep learning has become its own subfield of machine learning. In the context of biological research, it has been increasingly used to derive novel insights from high-dimensional biological data. To make the biological applications of deep learning more accessible to scientists who have some experience with machine learning, we solicited input from a community of researchers with varied biological and deep learning interests. These individuals collaboratively contributed to this manuscript's writing using the GitHub version control platform and the Manubot manuscript generation toolset. The goal was to articulate a practical, accessible, and concise set of guidelines and suggestions to follow when using deep learning. In the course of our discussions, several themes became clear: the importance of understanding and applying machine learning fundamentals as a baseline for utilizing deep learning, the necessity for extensive model comparisons with careful evaluation, and the need for critical thought in interpreting results generated by deep learning, among others.