Standardization of Neuromuscular Reflex Analysis -- Role of Fine-Tuned Vision-Language Model Consortium and OpenAI gpt-oss Reasoning LLM Enabled Decision Support System

Accurate assessment of neuromuscular reflexes, such as the H-reflex, plays a critical role in sports science, rehabilitation, and clinical neurology. Traditional analysis of H-reflex EMG waveforms is subject to variability and interpretation bias among clinicians and researchers, limiting reliability and standardization. To address these challenges, we propose a Fine-Tuned Vision-Language Model (VLM) Consortium and a reasoning Large-Language Model (LLM)-enabled Decision Support System for automated H-reflex waveform interpretation and diagnosis. Our approach leverages multiple VLMs, each fine-tuned on curated datasets of H-reflex EMG waveform images annotated with clinical observations, recovery timelines, and athlete metadata. These models are capable of extracting key electrophysiological features and predicting neuromuscular states, including fatigue, injury, and recovery, directly from EMG images and contextual metadata. Diagnostic outputs from the VLM consortium are aggregated using a consensus-based method and refined by a specialized reasoning LLM, which ensures robust, transparent, and explainable decision support for clinicians and sports scientists. The end-to-end platform orchestrates seamless communication between the VLM ensemble and the reasoning LLM, integrating prompt engineering strategies and automated reasoning workflows using LLM Agents. Experimental results demonstrate that this hybrid system delivers highly accurate, consistent, and interpretable H-reflex assessments, significantly advancing the automation and standardization of neuromuscular diagnostics. To our knowledge, this work represents the first integration of a fine-tuned VLM consortium with a reasoning LLM for image-based H-reflex analysis, laying the foundation for next-generation AI-assisted neuromuscular assessment and athlete monitoring platforms.

Proof-of-TBI -- Fine-Tuned Vision Language Model Consortium and OpenAI-o3 Reasoning LLM-Based Medical Diagnosis Support System for Mild Traumatic Brain Injury (TBI) Prediction

Mild Traumatic Brain Injury (TBI) detection presents significant challenges due to the subtle and often ambiguous presentation of symptoms in medical imaging, making accurate diagnosis a complex task. To address these challenges, we propose Proof-of-TBI, a medical diagnosis support system that integrates multiple fine-tuned vision-language models with the OpenAI-o3 reasoning large language model (LLM). Our approach fine-tunes multiple vision-language models using a labeled dataset of TBI MRI scans, training them to diagnose TBI symptoms effectively. The predictions from these models are aggregated through a consensus-based decision-making process. The system evaluates the predictions from all fine-tuned vision language models using the OpenAI-o3 reasoning LLM, a model that has demonstrated remarkable reasoning performance, to produce the most accurate final diagnosis. The LLM Agents orchestrates interactions between the vision-language models and the reasoning LLM, managing the final decision-making process with transparency, reliability, and automation. This end-to-end decision-making workflow combines the vision-language model consortium with the OpenAI-o3 reasoning LLM, enabled by custom prompt engineering by the LLM agents. The prototype for the proposed platform was developed in collaboration with the U.S. Army Medical Research team in Newport News, Virginia, incorporating five fine-tuned vision-language models. The results demonstrate the transformative potential of combining fine-tuned vision-language model inputs with the OpenAI-o3 reasoning LLM to create a robust, secure, and highly accurate diagnostic system for mild TBI prediction. To the best of our knowledge, this research represents the first application of fine-tuned vision-language models integrated with a reasoning LLM for TBI prediction tasks.