Ruichen Rong

Jingwei Huang, Kuroush Nezafati, Zhikai Chi et al. · gatech

Extracting structured information from clinical notes requires navigating a dense web of interdependent variables where the value of one attribute logically constrains others. Existing Large Language Model (LLM)-based extraction pipelines often struggle to capture these dependencies, leading to clinically inconsistent outputs. We propose deep reflective reasoning, a large language model agent framework that iteratively self-critiques and revises structured outputs by checking consistency among variables, the input text, and retrieved domain knowledge, stopping when outputs converge. We extensively evaluate the proposed method in three diverse oncology applications: (1) On colorectal cancer synoptic reporting from gross descriptions (n=217), reflective reasoning improved average F1 across eight categorical synoptic variables from 0.828 to 0.911 and increased mean correct rate across four numeric variables from 0.806 to 0.895; (2) On Ewing sarcoma CD99 immunostaining pattern identification (n=200), the accuracy improved from 0.870 to 0.927; (3) On lung cancer tumor staging (n=100), tumor stage accuracy improved from 0.680 to 0.833 (pT: 0.842 -> 0.884; pN: 0.885 -> 0.948). The results demonstrate that deep reflective reasoning can systematically improve the reliability of LLM-based structured data extraction under interdependence constraints, enabling more consistent machine-operable clinical datasets and facilitating knowledge discovery with machine learning and data science towards digital health.

Jingwei Huang, Kuroush Nezafati, Ismael Villanueva-Miranda et al.

This study introduces a LLMs powered multiagent ensemble method to address challenges in hallucination and data labeling, particularly in large-scale EHR datasets. Manual labeling of such datasets requires domain expertise and is labor-intensive, time-consuming, expensive, and error-prone. To overcome this bottleneck, we developed an ensemble LLMs method and demonstrated its effectiveness in two real-world tasks: (1) labeling a large-scale unlabeled ECG dataset in MIMIC-IV; (2) identifying social determinants of health (SDOH) from the clinical notes of EHR. Trading off benefits and cost, we selected a pool of diverse open source LLMs with satisfactory performance. We treat each LLM's prediction as a vote and apply a mechanism of majority voting with minimal winning threshold for ensemble. We implemented an ensemble LLMs application for EHR data labeling tasks. By using the ensemble LLMs and natural language processing, we labeled MIMIC-IV ECG dataset of 623,566 ECG reports with an estimated accuracy of 98.2%. We applied the ensemble LLMs method to identify SDOH from social history sections of 1,405 EHR clinical notes, also achieving competitive performance. Our experiments show that the ensemble LLMs can outperform individual LLM even the best commercial one, and the method reduces hallucination errors. From the research, we found that (1) the ensemble LLMs method significantly reduces the time and effort required for labeling large-scale EHR data, automating the process with high accuracy and quality; (2) the method generalizes well to other text data labeling tasks, as shown by its application to SDOH identification; (3) the ensemble of a group of diverse LLMs can outperform or match the performance of the best individual LLM; and (4) the ensemble method substantially reduces hallucination errors. This approach provides a scalable and efficient solution to data-labeling challenges.

Peiran Quan, Zifan Gu, Zhuo Zhao et al.

Foundation models (FMs) have transformed computational pathology by providing powerful, general-purpose feature extractors. However, adapting and benchmarking individual FMs for specific diagnostic tasks is often time-consuming and resource-intensive, especially given their scale and diversity. To address this challenge, we introduce Group-Aggregative Selection Multi-Instance Learning (GAS-MIL), a flexible ensemble framework that seamlessly integrates features from multiple FMs, preserving their complementary strengths without requiring manual feature selection or extensive task-specific fine-tuning. Across classification tasks in three cancer datasets-prostate (PANDA), ovarian (UBC-OCEAN), and breast (TCGA-BrCa)-GAS-MIL consistently achieves superior or on-par performance relative to individual FMs and established MIL methods, demonstrating its robustness and generalizability. By enabling efficient integration of heterogeneous FMs, GAS-MIL streamlines model deployment for pathology and provides a scalable foundation for future multimodal and precision oncology applications.