Irbaz Bin Riaz

Zeshan Hussain, Barbara D. Lam, Fernando A. Acosta-Perez et al.

As machine learning (ML)-based decision support tools proliferate in clinical practice, understanding how clinicians integrate personalized ML predictions alongside randomized controlled trial (RCT) evidence is critical. We designed a web-based clinical decision support system (CDSS) presenting survival and adverse event data from a simulated RCT and ML model across 12 synthetic multiple myeloma scenarios. In a within- subjects study with 32 physicians, we evaluated how clinicians synthesize competing evidence sources to make treatment decisions. When ML and RCT outputs were concordant, physicians reported greater confidence than with RCT data alone. When results were discordant, most physicians shifted toward the ML-supported treatment, often before reviewing any information about model training or validation, suggesting a tendency toward automation bias rather than algorithm avoidance. Despite reporting higher perceived reliability after viewing model quality disclosures, physicians were largely unable to describe the validation procedures they had reviewed. Taken together, these findings reveal that clinicians may over-rely on ML recommendations even when equipped with tools designed to support critical appraisal. We discuss implications for CDSS design, clinician training, and the institutional safeguards needed before ML-based systems are deployed in high-stakes oncology settings.

Ethan Cerami, Pavel Trukhanov, Morgan A. Paul et al.

Clinical trials drive improvements in cancer treatments and outcomes. However, most adults with cancer do not participate in trials, and trials often fail to enroll enough patients to answer their scientific questions. Artificial intelligence could accelerate matching of patients to appropriate clinical trials. Here, we describe the development and evaluation of the MatchMiner-AI pipeline for clinical trial searching and ranking. MatchMiner-AI focuses on matching patients to potential trials based on core criteria describing clinical "spaces," or disease contexts, targeted by a trial. It aims to accelerate the human work of identifying potential matches, not to fully automate trial screening. The pipeline includes modules for extraction of key information from a patient's longitudinal electronic health record; rapid ranking of candidate trial-patient matches based on embeddings in vector space; and classification of whether a candidate match represents a reasonable clinical consideration. Code and synthetic data are available at https://huggingface.co/ksg-dfci/MatchMiner-AI . Model weights based on synthetic data are available at https://huggingface.co/ksg-dfci/TrialSpace and https://huggingface.co/ksg-dfci/TrialChecker . A simple cancer clinical trial search engine to demonstrate pipeline components is available at https://huggingface.co/spaces/ksg-dfci/trial_search_alpha .

Niklas Mannhardt, Elizabeth Bondi-Kelly, Barbara Lam et al. · microsoft-research

Large language models (LLMs) have immense potential to make information more accessible, particularly in medicine, where complex medical jargon can hinder patient comprehension of clinical notes. We developed a patient-facing tool using LLMs to make clinical notes more readable by simplifying, extracting information from, and adding context to the notes. We piloted the tool with clinical notes donated by patients with a history of breast cancer and synthetic notes from a clinician. Participants (N=200, healthy, female-identifying patients) were randomly assigned three clinical notes in our tool with varying levels of augmentations and answered quantitative and qualitative questions evaluating their understanding of follow-up actions. Augmentations significantly increased their quantitative understanding scores. In-depth interviews were conducted with participants (N=7, patients with a history of breast cancer), revealing both positive sentiments about the augmentations and concerns about AI. We also performed a qualitative clinician-driven analysis of the model's error modes.

Adarsh Srinivasan, Jacob Dineen, Muhammad Umar Afzal et al.

Large language models in healthcare often miss critical emotional cues, delivering medically sound but emotionally flat advice. This is especially problematic in clinical contexts where patients are distressed and vulnerable, and require empathic communication to support safety, adherence, and trust. We present RECAP (Reflect-Extract-Calibrate-Align-Produce), an inference-time framework that adds structured emotional reasoning without retraining. By decomposing empathy into transparent appraisal-theoretic stages and exposing per-dimension Likert signals, RECAP produces nuanced, auditable responses. Across EmoBench, SECEU, and EQ-Bench, RECAP improves emotional reasoning by 22-28% on 8B models and 10-13% on larger models over zero-shot baselines. Clinician evaluations further confirm superior empathetic communication. RECAP shows that modular, theory-grounded prompting can systematically enhance emotional intelligence in medical AI while preserving the accountability required for deployment.

Xiao Ye, Jacob Dineen, Zhaonan Li et al.

Medical Large language models achieve strong scores on standard benchmarks; however, the transfer of those results to safe and reliable performance in clinical workflows remains a challenge. This survey reframes evaluation through a levels-of-autonomy lens (L0-L3), spanning informational tools, information transformation and aggregation, decision support, and supervised agents. We align existing benchmarks and metrics with the actions permitted at each level and their associated risks, making the evaluation targets explicit. This motivates a level-conditioned blueprint for selecting metrics, assembling evidence, and reporting claims, alongside directions that link evaluation to oversight. By centering autonomy, the survey moves the field beyond score-based claims toward credible, risk-aware evidence for real clinical use.