Jie Pan

Jie Pan, Seungwon Lee, Cheligeer Cheligeer et al.

Objective: Electronic health records (EHR) are widely available to complement administrative data-based disease surveillance and healthcare performance evaluation. Defining conditions from EHR is labour-intensive and requires extensive manual labelling of disease outcomes. This study developed an efficient strategy based on advanced large language models to identify multiple conditions from EHR clinical notes. Methods: We linked a cardiac registry cohort in 2015 with an EHR system in Alberta, Canada. We developed a pipeline that leveraged a generative large language model (LLM) to analyze, understand, and interpret EHR notes by prompts based on specific diagnosis, treatment management, and clinical guidelines. The pipeline was applied to detect acute myocardial infarction (AMI), diabetes, and hypertension. The performance was compared against clinician-validated diagnoses as the reference standard and widely adopted International Classification of Diseases (ICD) codes-based methods. Results: The study cohort accounted for 3,088 patients and 551,095 clinical notes. The prevalence was 55.4%, 27.7%, 65.9% and for AMI, diabetes, and hypertension, respectively. The performance of the LLM-based pipeline for detecting conditions varied: AMI had 88% sensitivity, 63% specificity, and 77% positive predictive value (PPV); diabetes had 91% sensitivity, 86% specificity, and 71% PPV; and hypertension had 94% sensitivity, 32% specificity, and 72% PPV. Compared with ICD codes, the LLM-based method demonstrated improved sensitivity and negative predictive value across all conditions. The monthly percentage trends from the detected cases by LLM and reference standard showed consistent patterns.

Jie Pan, Tianyi Wang, Christian Claudel et al.

Intelligent transportation systems require connected and automated vehicles (CAVs) to conduct safe and efficient cooperation with human-driven vehicles (HVs) in complex real-world traffic environments. However, the inherent unpredictability of human behaviour, especially at bottlenecks such as highway on-ramp merging areas, often disrupts traffic flow and compromises system performance. To address the challenge of cooperative on-ramp merging in heterogeneous traffic environments, this study proposes a trust-based multi-agent reinforcement learning (Trust-MARL) framework. At the macro level, Trust-MARL enhances global traffic efficiency by leveraging inter-agent trust to improve bottleneck throughput and mitigate traffic shockwave through emergent group-level coordination. At the micro level, a dynamic trust mechanism is designed to enable CAVs to adjust their cooperative strategies in response to real-time behaviors and historical interactions with both HVs and other CAVs. Furthermore, a trust-triggered game-theoretic decision-making module is integrated to guide each CAV in adapting its cooperation factor and executing context-aware lane-changing decisions under safety, comfort, and efficiency constraints. An extensive set of ablation studies and comparative experiments validates the effectiveness of the proposed Trust-MARL approach, demonstrating significant improvements in safety, efficiency, comfort, and adaptability across varying CAV penetration rates and traffic densities.