A prospective clinical feasibility study of a conversational diagnostic AI in an ambulatory primary care clinic

Large language model (LLM)-based AI systems have shown promise for patient-facing diagnostic and management conversations in simulated settings. Translating these systems into clinical practice requires assessment in real-world workflows with rigorous safety oversight. We report a prospective, single-arm feasibility study of an LLM-based conversational AI, the Articulate Medical Intelligence Explorer (AMIE), conducting clinical history taking and presentation of potential diagnoses for patients to discuss with their provider at urgent care appointments at a leading academic medical center. 100 adult patients completed an AMIE text-chat interaction up to 5 days before their appointment. We sought to assess the conversational safety and quality, patient and clinician experience, and clinical reasoning capabilities compared to primary care providers (PCPs). Human safety supervisors monitored all patient-AMIE interactions in real time and did not need to intervene to stop any consultations based on pre-defined criteria. Patients reported high satisfaction and their attitudes towards AI improved after interacting with AMIE (p < 0.001). PCPs found AMIE's output useful with a positive impact on preparedness. AMIE's differential diagnosis (DDx) included the final diagnosis, per chart review 8 weeks post-encounter, in 90% of cases, with 75% top-3 accuracy. Blinded assessment of AMIE and PCP DDx and management (Mx) plans suggested similar overall DDx and Mx plan quality, without significant differences for DDx (p = 0.6) and appropriateness and safety of Mx (p = 0.1 and 1.0, respectively). PCPs outperformed AMIE in the practicality (p = 0.003) and cost effectiveness (p = 0.004) of Mx. While further research is needed, this study demonstrates the initial feasibility, safety, and user acceptance of conversational AI in a real-world setting, representing crucial steps towards clinical translation.

Robust Disaster Assessment from Aerial Imagery Using Text-to-Image Synthetic Data

We present a simple and efficient method to leverage emerging text-to-image generative models in creating large-scale synthetic supervision for the task of damage assessment from aerial images. While significant recent advances have resulted in improved techniques for damage assessment using aerial or satellite imagery, they still suffer from poor robustness to domains where manual labeled data is unavailable, directly impacting post-disaster humanitarian assistance in such under-resourced geographies. Our contribution towards improving domain robustness in this scenario is two-fold. Firstly, we leverage the text-guided mask-based image editing capabilities of generative models and build an efficient and easily scalable pipeline to generate thousands of post-disaster images from low-resource domains. Secondly, we propose a simple two-stage training approach to train robust models while using manual supervision from different source domains along with the generated synthetic target domain data. We validate the strength of our proposed framework under cross-geography domain transfer setting from xBD and SKAI images in both single-source and multi-source settings, achieving significant improvements over a source-only baseline in each case.