An Agentic AI System for Multi-Framework Communication Coding

Clinical communication is central to patient outcomes, yet large-scale human annotation of patient-provider conversation remains labor-intensive, inconsistent, and difficult to scale. Existing approaches based on large language models typically rely on single-task models that lack adaptability, interpretability, and reliability, especially when applied across various communication frameworks and clinical domains. In this study, we developed a Multi-framework Structured Agentic AI system for Clinical Communication (MOSAIC), built on a LangGraph-based architecture that orchestrates four core agents, including a Plan Agent for codebook selection and workflow planning, an Update Agent for maintaining up-to-date retrieval databases, a set of Annotation Agents that applies codebook-guided retrieval-augmented generation (RAG) with dynamic few-shot prompting, and a Verification Agent that provides consistency checks and feedback. To evaluate performance, we compared MOSAIC outputs against gold-standard annotations created by trained human coders. We developed and evaluated MOSAIC using 26 gold standard annotated transcripts for training and 50 transcripts for testing, spanning rheumatology and OB/GYN domains. On the test set, MOSAIC achieved an overall F1 score of 0.928. Performance was highest in the Rheumatology subset (F1 = 0.962) and strongest for Patient Behavior (e.g., patients asking questions, expressing preferences, or showing assertiveness). Ablations revealed that MOSAIC outperforms baseline benchmarking.

A Framework for Fairness: A Systematic Review of Existing Fair AI Solutions

In a world of daily emerging scientific inquisition and discovery, the prolific launch of machine learning across industries comes to little surprise for those familiar with the potential of ML. Neither so should the congruent expansion of ethics-focused research that emerged as a response to issues of bias and unfairness that stemmed from those very same applications. Fairness research, which focuses on techniques to combat algorithmic bias, is now more supported than ever before. A large portion of fairness research has gone to producing tools that machine learning practitioners can use to audit for bias while designing their algorithms. Nonetheless, there is a lack of application of these fairness solutions in practice. This systematic review provides an in-depth summary of the algorithmic bias issues that have been defined and the fairness solution space that has been proposed. Moreover, this review provides an in-depth breakdown of the caveats to the solution space that have arisen since their release and a taxonomy of needs that have been proposed by machine learning practitioners, fairness researchers, and institutional stakeholders. These needs have been organized and addressed to the parties most influential to their implementation, which includes fairness researchers, organizations that produce ML algorithms, and the machine learning practitioners themselves. These findings can be used in the future to bridge the gap between practitioners and fairness experts and inform the creation of usable fair ML toolkits.

Can Explainable AI Explain Unfairness? A Framework for Evaluating Explainable AI

Many ML models are opaque to humans, producing decisions too complex for humans to easily understand. In response, explainable artificial intelligence (XAI) tools that analyze the inner workings of a model have been created. Despite these tools' strength in translating model behavior, critiques have raised concerns about the impact of XAI tools as a tool for `fairwashing` by misleading users into trusting biased or incorrect models. In this paper, we created a framework for evaluating explainable AI tools with respect to their capabilities for detecting and addressing issues of bias and fairness as well as their capacity to communicate these results to their users clearly. We found that despite their capabilities in simplifying and explaining model behavior, many prominent XAI tools lack features that could be critical in detecting bias. Developers can use our framework to suggest modifications needed in their toolkits to reduce issues likes fairwashing.