Eliciting associations between clinical variables from LLMs via comparison questions across populations

The training data of large language models (LLMs) comprises a wide range of biomedical literature, reflecting data from many different patient populations. We investigate how it might be possible to recover information on correlation and causal links between patient characteristics, as a key building block for medical decision making. To avoid the pitfalls of direct elicitation, we propose an approach based on structured comparison questions, specifically patient comparison triplet questions. This is combined with a statistical model for the LLM representation that provides estimates of correlations without access to activations or model internals. Intuitively, we consider how similarity decisions of LLMs based on a first variable are affected by providing information on a second variable for one of the patients being assessed. We then induce prompt-level environment shifts to obtain correlation estimates for different subpopulations, which enables an invariant causal prediction (ICP) approach to obtain conservative candidate parent links. We demonstrate the method in two clinical domains, chronic obstructive pulmonary disease (COPD) and multiple sclerosis (MS). Across prompted environments, the elicited correlations are smooth, stable, and clinically interpretable, yet vary in a statistically significant way that supports downstream invariance testing, such that ICP provides a small set of candidate invariant parent links. These results show that indirect elicitation via triplet comparisons can recover meaningful association structure from LLMs and offer a cautious route from implicit correlations to causal statements that are congruent with LLM answering patterns.

GateNet: A novel Neural Network Architecture for Automated Flow Cytometry Gating

Flow cytometry is widely used to identify cell populations in patient-derived fluids such as peripheral blood (PB) or cerebrospinal fluid (CSF). While ubiquitous in research and clinical practice, flow cytometry requires gating, i.e. cell type identification which requires labor-intensive and error-prone manual adjustments. To facilitate this process, we designed GateNet, the first neural network architecture enabling full end-to-end automated gating without the need to correct for batch effects. We train GateNet with over 8,000,000 events based on N=127 PB and CSF samples which were manually labeled independently by four experts. We show that for novel, unseen samples, GateNet achieves human-level performance (F1 score ranging from 0.910 to 0.997). In addition we apply GateNet to a publicly available dataset confirming generalization with an F1 score of 0.936. As our implementation utilizes graphics processing units (GPU), gating only needs 15 microseconds per event. Importantly, we also show that GateNet only requires ~10 samples to reach human-level performance, rendering it widely applicable in all domains of flow cytometry.