Enhancing LLMs' Clinical Reasoning with Real-World Data from a Nationwide Sepsis Registry

Although large language models (LLMs) have demonstrated impressive reasoning capabilities across general domains, their effectiveness in real-world clinical practice remains limited. This is likely due to their insufficient exposure to real-world clinical data during training, as such data is typically not included due to privacy concerns. To address this, we propose enhancing the clinical reasoning capabilities of LLMs by leveraging real-world clinical data. We constructed reasoning-intensive questions from a nationwide sepsis registry and fine-tuned Phi-4 on these questions using reinforcement learning, resulting in C-Reason. C-Reason exhibited strong clinical reasoning capabilities on the in-domain test set, as evidenced by both quantitative metrics and expert evaluations. Furthermore, its enhanced reasoning capabilities generalized to a sepsis dataset involving different tasks and patient cohorts, an open-ended consultations on antibiotics use task, and other diseases. Future research should focus on training LLMs with large-scale, multi-disease clinical datasets to develop more powerful, general-purpose clinical reasoning models.

PhenoFlow: A Human-LLM Driven Visual Analytics System for Exploring Large and Complex Stroke Datasets

Acute stroke demands prompt diagnosis and treatment to achieve optimal patient outcomes. However, the intricate and irregular nature of clinical data associated with acute stroke, particularly blood pressure (BP) measurements, presents substantial obstacles to effective visual analytics and decision-making. Through a year-long collaboration with experienced neurologists, we developed PhenoFlow, a visual analytics system that leverages the collaboration between human and Large Language Models (LLMs) to analyze the extensive and complex data of acute ischemic stroke patients. PhenoFlow pioneers an innovative workflow, where the LLM serves as a data wrangler while neurologists explore and supervise the output using visualizations and natural language interactions. This approach enables neurologists to focus more on decision-making with reduced cognitive load. To protect sensitive patient information, PhenoFlow only utilizes metadata to make inferences and synthesize executable codes, without accessing raw patient data. This ensures that the results are both reproducible and interpretable while maintaining patient privacy. The system incorporates a slice-and-wrap design that employs temporal folding to create an overlaid circular visualization. Combined with a linear bar graph, this design aids in exploring meaningful patterns within irregularly measured BP data. Through case studies, PhenoFlow has demonstrated its capability to support iterative analysis of extensive clinical datasets, reducing cognitive load and enabling neurologists to make well-informed decisions. Grounded in long-term collaboration with domain experts, our research demonstrates the potential of utilizing LLMs to tackle current challenges in data-driven clinical decision-making for acute ischemic stroke patients.