RULE: Reliable Multimodal RAG for Factuality in Medical Vision Language Models

The recent emergence of Medical Large Vision Language Models (Med-LVLMs) has enhanced medical diagnosis. However, current Med-LVLMs frequently encounter factual issues, often generating responses that do not align with established medical facts. Retrieval-Augmented Generation (RAG), which utilizes external knowledge, can improve the factual accuracy of these models but introduces two major challenges. First, limited retrieved contexts might not cover all necessary information, while excessive retrieval can introduce irrelevant and inaccurate references, interfering with the model's generation. Second, in cases where the model originally responds correctly, applying RAG can lead to an over-reliance on retrieved contexts, resulting in incorrect answers. To address these issues, we propose RULE, which consists of two components. First, we introduce a provably effective strategy for controlling factuality risk through the calibrated selection of the number of retrieved contexts. Second, based on samples where over-reliance on retrieved contexts led to errors, we curate a preference dataset to fine-tune the model, balancing its dependence on inherent knowledge and retrieved contexts for generation. We demonstrate the effectiveness of RULE on three medical VQA datasets, achieving an average improvement of 20.8% in factual accuracy. We publicly release our benchmark and code in https://github.com/richard-peng-xia/RULE.

CARES: A Comprehensive Benchmark of Trustworthiness in Medical Vision Language Models

Artificial intelligence has significantly impacted medical applications, particularly with the advent of Medical Large Vision Language Models (Med-LVLMs), sparking optimism for the future of automated and personalized healthcare. However, the trustworthiness of Med-LVLMs remains unverified, posing significant risks for future model deployment. In this paper, we introduce CARES and aim to comprehensively evaluate the Trustworthiness of Med-LVLMs across the medical domain. We assess the trustworthiness of Med-LVLMs across five dimensions, including trustfulness, fairness, safety, privacy, and robustness. CARES comprises about 41K question-answer pairs in both closed and open-ended formats, covering 16 medical image modalities and 27 anatomical regions. Our analysis reveals that the models consistently exhibit concerns regarding trustworthiness, often displaying factual inaccuracies and failing to maintain fairness across different demographic groups. Furthermore, they are vulnerable to attacks and demonstrate a lack of privacy awareness. We publicly release our benchmark and code in https://github.com/richard-peng-xia/CARES.

Combining Experimental and Historical Data for Policy Evaluation

This paper studies policy evaluation with multiple data sources, especially in scenarios that involve one experimental dataset with two arms, complemented by a historical dataset generated under a single control arm. We propose novel data integration methods that linearly integrate base policy value estimators constructed based on the experimental and historical data, with weights optimized to minimize the mean square error (MSE) of the resulting combined estimator. We further apply the pessimistic principle to obtain more robust estimators, and extend these developments to sequential decision making. Theoretically, we establish non-asymptotic error bounds for the MSEs of our proposed estimators, and derive their oracle, efficiency and robustness properties across a broad spectrum of reward shift scenarios. Numerical experiments and real-data-based analyses from a ridesharing company demonstrate the superior performance of the proposed estimators.

UU-Mamba: Uncertainty-aware U-Mamba for Cardiac Image Segmentation

Biomedical image segmentation is critical for accurate identification and analysis of anatomical structures in medical imaging, particularly in cardiac MRI. However, manual segmentation is labor-intensive, time-consuming, and prone to variability, necessitating automated methods. Current machine learning approaches, while promising, face challenges such as overfitting, high computational demands, and the need for extensive annotated data. To address these issues, we propose a UU-Mamba model that integrates the U-Mamba model with the Sharpness-Aware Minimization optimizer and an uncertainty-aware loss function. SAM enhances generalization by finding flat minima in the loss landscape, mitigating overfitting. The uncertainty-aware loss combines region-based, distribution-based, and pixel-based losses, improving segmentation accuracy and robustness. Our method, evaluated on the ACDC cardiac dataset, outperforms state-of-the-art models (TransUNet, Swin-Unet, nnUNet, nnFormer), achieving superior Dice Similarity Coefficient and Mean Squared Error results, demonstrating the effectiveness of our approach in cardiac MRI segmentation.

An Analysis of Switchback Designs in Reinforcement Learning

This paper offers a detailed investigation of switchback designs in A/B testing, which alternate between baseline and new policies over time. Our aim is to thoroughly evaluate the effects of these designs on the accuracy of their resulting average treatment effect (ATE) estimators. We propose a novel "weak signal analysis" framework, which substantially simplifies the calculations of the mean squared errors (MSEs) of these ATEs in Markov decision process environments. Our findings suggest that (i) when the majority of reward errors are positively correlated, the switchback design is more efficient than the alternating-day design which switches policies in a daily basis. Additionally, increasing the frequency of policy switches tends to reduce the MSE of the ATE estimator. (ii) When the errors are uncorrelated, however, all these designs become asymptotically equivalent. (iii) In cases where the majority of errors are negative correlated, the alternating-day design becomes the optimal choice. These insights are crucial, offering guidelines for practitioners on designing experiments in A/B testing. Our analysis accommodates a variety of policy value estimators, including model-based estimators, least squares temporal difference learning estimators, and double reinforcement learning estimators, thereby offering a comprehensive understanding of optimal design strategies for policy evaluation in reinforcement learning.

Neural Radiance Fields in Medical Imaging: Challenges and Next Steps

Neural Radiance Fields (NeRF), as a pioneering technique in computer vision, offer great potential to revolutionize medical imaging by synthesizing three-dimensional representations from the projected two-dimensional image data. However, they face unique challenges when applied to medical applications. This paper presents a comprehensive examination of applications of NeRFs in medical imaging, highlighting four imminent challenges, including fundamental imaging principles, inner structure requirement, object boundary definition, and color density significance. We discuss current methods on different organs and discuss related limitations. We also review several datasets and evaluation metrics and propose several promising directions for future research.

Multimodal Clinical Trial Outcome Prediction with Large Language Models

The clinical trial is a pivotal and costly process, often spanning multiple years and requiring substantial financial resources. Therefore, the development of clinical trial outcome prediction models aims to exclude drugs likely to fail and holds the potential for significant cost savings. Recent data-driven attempts leverage deep learning methods to integrate multimodal data for predicting clinical trial outcomes. However, these approaches rely on manually designed modal-specific encoders, which limits both the extensibility to adapt new modalities and the ability to discern similar information patterns across different modalities. To address these issues, we propose a multimodal mixture-of-experts (LIFTED) approach for clinical trial outcome prediction. Specifically, LIFTED unifies different modality data by transforming them into natural language descriptions. Then, LIFTED constructs unified noise-resilient encoders to extract information from modal-specific language descriptions. Subsequently, a sparse Mixture-of-Experts framework is employed to further refine the representations, enabling LIFTED to identify similar information patterns across different modalities and extract more consistent representations from those patterns using the same expert model. Finally, a mixture-of-experts module is further employed to dynamically integrate different modality representations for prediction, which gives LIFTED the ability to automatically weigh different modalities and pay more attention to critical information. The experiments demonstrate that LIFTED significantly enhances performance in predicting clinical trial outcomes across all three phases compared to the best baseline, showcasing the effectiveness of our proposed key components.

Disentangled Latent Energy-Based Style Translation: An Image-Level Structural MRI Harmonization Framework

Brain magnetic resonance imaging (MRI) has been extensively employed across clinical and research fields, but often exhibits sensitivity to site effects arising from nonbiological variations such as differences in field strength and scanner vendors. Numerous retrospective MRI harmonization techniques have demonstrated encouraging outcomes in reducing the site effects at image level. However, existing methods generally suffer from high computational requirements and limited generalizability, restricting their applicability to unseen MRIs. In this paper, we design a novel disentangled latent energy-based style translation (DLEST) framework for unpaired image-level MRI harmonization, consisting of (1) site-invariant image generation (SIG), (2) site-specific style translation (SST), and (3) site-specific MRI synthesis (SMS). Specifically, the SIG employs a latent autoencoder to encode MRIs into a low-dimensional latent space and reconstruct MRIs from latent codes. The SST utilizes an energy-based model to comprehend the global latent distribution of a target domain and translate source latent codes toward the target domain, while SMS enables MRI synthesis with a target-specific style. By disentangling image generation and style translation in latent space, the DLEST can achieve efficient style translation. Our model was trained on T1-weighted MRIs from a public dataset (with 3,984 subjects across 58 acquisition sites/settings) and validated on an independent dataset (with 9 traveling subjects scanned in 11 sites/settings) in 4 tasks: (1) histogram and clustering comparison, (2) site classification, (3) brain tissue segmentation, and (4) site-specific MRI synthesis. Qualitative and quantitative results demonstrate the superiority of our method over several state-of-the-arts.

Artificial Intelligence in Image-based Cardiovascular Disease Analysis: A Comprehensive Survey and Future Outlook

Recent advancements in Artificial Intelligence (AI) have significantly influenced the field of Cardiovascular Disease (CVD) analysis, particularly in image-based diagnostics. Our paper presents an extensive review of AI applications in image-based CVD analysis, offering insights into its current state and future potential. We systematically categorize the literature based on the primary anatomical structures related to CVD, dividing them into non-vessel structures (such as ventricles and atria) and vessel structures (including the aorta and coronary arteries). This categorization provides a structured approach to explore various imaging modalities like Magnetic Resonance Imaging (MRI), which are commonly used in CVD research. Our review encompasses these modalities, giving a broad perspective on the diverse imaging techniques integrated with AI for CVD analysis. Additionally, we compile a list of publicly accessible cardiac image datasets and code repositories, intending to support research reproducibility and facilitate data and algorithm sharing within the community. We conclude with an examination of the challenges and limitations inherent in current AI-based CVD analysis methods and suggest directions for future research to overcome these hurdles.

Evaluating the Potential of Leading Large Language Models in Reasoning Biology Questions

Recent advances in Large Language Models (LLMs) have presented new opportunities for integrating Artificial General Intelligence (AGI) into biological research and education. This study evaluated the capabilities of leading LLMs, including GPT-4, GPT-3.5, PaLM2, Claude2, and SenseNova, in answering conceptual biology questions. The models were tested on a 108-question multiple-choice exam covering biology topics in molecular biology, biological techniques, metabolic engineering, and synthetic biology. Among the models, GPT-4 achieved the highest average score of 90 and demonstrated the greatest consistency across trials with different prompts. The results indicated GPT-4's proficiency in logical reasoning and its potential to aid biology research through capabilities like data analysis, hypothesis generation, and knowledge integration. However, further development and validation are still required before the promise of LLMs in accelerating biological discovery can be realized.