The Evolving Landscape of Generative Large Language Models and Traditional Natural Language Processing in Medicine

Natural language processing (NLP) has been traditionally applied to medicine, and generative large language models (LLMs) have become prominent recently. However, the differences between them across different medical tasks remain underexplored. We analyzed 19,123 studies, finding that generative LLMs demonstrate advantages in open-ended tasks, while traditional NLP dominates in information extraction and analysis tasks. As these technologies advance, ethical use of them is essential to ensure their potential in medical applications.

Toward Fair Federated Learning under Demographic Disparities and Data Imbalance

Ensuring fairness is critical when applying artificial intelligence to high-stakes domains such as healthcare, where predictive models trained on imbalanced and demographically skewed data risk exacerbating existing disparities. Federated learning (FL) enables privacy-preserving collaboration across institutions, but remains vulnerable to both algorithmic bias and subgroup imbalance - particularly when multiple sensitive attributes intersect. We propose FedIDA (Fed erated Learning for Imbalance and D isparity A wareness), a framework-agnostic method that combines fairness-aware regularization with group-conditional oversampling. FedIDA supports multiple sensitive attributes and heterogeneous data distributions without altering the convergence behavior of the underlying FL algorithm. We provide theoretical analysis establishing fairness improvement bounds using Lipschitz continuity and concentration inequalities, and show that FedIDA reduces the variance of fairness metrics across test sets. Empirical results on both benchmark and real-world clinical datasets confirm that FedIDA consistently improves fairness while maintaining competitive predictive performance, demonstrating its effectiveness for equitable and privacy-preserving modeling in healthcare. The source code is available on GitHub.

SIM-Shapley: A Stable and Computationally Efficient Approach to Shapley Value Approximation

Explainable artificial intelligence (XAI) is essential for trustworthy machine learning (ML), particularly in high-stakes domains such as healthcare and finance. Shapley value (SV) methods provide a principled framework for feature attribution in complex models but incur high computational costs, limiting their scalability in high-dimensional settings. We propose Stochastic Iterative Momentum for Shapley Value Approximation (SIM-Shapley), a stable and efficient SV approximation method inspired by stochastic optimization. We analyze variance theoretically, prove linear $Q$-convergence, and demonstrate improved empirical stability and low bias in practice on real-world datasets. In our numerical experiments, SIM-Shapley reduces computation time by up to 85% relative to state-of-the-art baselines while maintaining comparable feature attribution quality. Beyond feature attribution, our stochastic mini-batch iterative framework extends naturally to a broader class of sample average approximation problems, offering a new avenue for improving computational efficiency with stability guarantees. Code is publicly available at https://github.com/nliulab/SIM-Shapley.

seeBias: A Comprehensive Tool for Assessing and Visualizing AI Fairness

Fairness in artificial intelligence (AI) prediction models is increasingly emphasized to support responsible adoption in high-stakes domains such as health care and criminal justice. Guidelines and implementation frameworks highlight the importance of both predictive accuracy and equitable outcomes. However, current fairness toolkits often evaluate classification performance disparities in isolation, with limited attention to other critical aspects such as calibration. To address these gaps, we present seeBias, an R package for comprehensive evaluation of model fairness and predictive performance. seeBias offers an integrated evaluation across classification, calibration, and other performance domains, providing a more complete view of model behavior. It includes customizable visualizations to support transparent reporting and responsible AI implementation. Using public datasets from criminal justice and healthcare, we demonstrate how seeBias supports fairness evaluations, and uncovers disparities that conventional fairness metrics may overlook. The R package is available on GitHub, and a Python version is under development.

Enabling Inclusive Systematic Reviews: Incorporating Preprint Articles with Large Language Model-Driven Evaluations

Background. Systematic reviews in comparative effectiveness research require timely evidence synthesis. Preprints accelerate knowledge dissemination but vary in quality, posing challenges for systematic reviews. Methods. We propose AutoConfidence (automated confidence assessment), an advanced framework for predicting preprint publication, which reduces reliance on manual curation and expands the range of predictors, including three key advancements: (1) automated data extraction using natural language processing techniques, (2) semantic embeddings of titles and abstracts, and (3) large language model (LLM)-driven evaluation scores. Additionally, we employed two prediction models: a random forest classifier for binary outcome and a survival cure model that predicts both binary outcome and publication risk over time. Results. The random forest classifier achieved AUROC 0.692 with LLM-driven scores, improving to 0.733 with semantic embeddings and 0.747 with article usage metrics. The survival cure model reached AUROC 0.716 with LLM-driven scores, improving to 0.731 with semantic embeddings. For publication risk prediction, it achieved a concordance index of 0.658, increasing to 0.667 with semantic embeddings. Conclusion. Our study advances the framework for preprint publication prediction through automated data extraction and multiple feature integration. By combining semantic embeddings with LLM-driven evaluations, AutoConfidence enhances predictive performance while reducing manual annotation burden. The framework has the potential to facilitate systematic incorporation of preprint articles in evidence-based medicine, supporting researchers in more effective evaluation and utilization of preprint resources.

MMLU-ProX: A Multilingual Benchmark for Advanced Large Language Model Evaluation

Traditional benchmarks struggle to evaluate increasingly sophisticated language models in multilingual and culturally diverse contexts. To address this gap, we introduce MMLU-ProX, a comprehensive multilingual benchmark covering 13 typologically diverse languages with approximately 11,829 questions per language. Building on the challenging reasoning-focused design of MMLU-Pro, our framework employs a semi-automatic translation process: translations generated by state-of-the-art large language models (LLMs) are rigorously evaluated by expert annotators to ensure conceptual accuracy, terminological consistency, and cultural relevance. We comprehensively evaluate 25 state-of-the-art LLMs using 5-shot chain-of-thought (CoT) and zero-shot prompting strategies, analyzing their performance across linguistic and cultural boundaries. Our experiments reveal consistent performance degradation from high-resource languages to lower-resource ones, with the best models achieving over 70% accuracy on English but dropping to around 40% for languages like Swahili, highlighting persistent gaps in multilingual capabilities despite recent advances. MMLU-ProX is an ongoing project; we are expanding our benchmark by incorporating additional languages and evaluating more language models to provide a more comprehensive assessment of multilingual capabilities.

Real-world Deployment and Evaluation of PErioperative AI CHatbot (PEACH) -- a Large Language Model Chatbot for Perioperative Medicine

Large Language Models (LLMs) are emerging as powerful tools in healthcare, particularly for complex, domain-specific tasks. This study describes the development and evaluation of the PErioperative AI CHatbot (PEACH), a secure LLM-based system integrated with local perioperative guidelines to support preoperative clinical decision-making. PEACH was embedded with 35 institutional perioperative protocols in the secure Claude 3.5 Sonet LLM framework within Pair Chat (developed by Singapore Government) and tested in a silent deployment with real-world data. Accuracy, safety, and usability were assessed. Deviations and hallucinations were categorized based on potential harm, and user feedback was evaluated using the Technology Acceptance Model (TAM). Updates were made after the initial silent deployment to amend one protocol. In 240 real-world clinical iterations, PEACH achieved a first-generation accuracy of 97.5% (78/80) and an overall accuracy of 96.7% (232/240) across three iterations. The updated PEACH demonstrated improved accuracy of 97.9% (235/240), with a statistically significant difference from the null hypothesis of 95% accuracy (p = 0.018, 95% CI: 0.952-0.991). Minimal hallucinations and deviations were observed (both 1/240 and 2/240, respectively). Clinicians reported that PEACH expedited decisions in 95% of cases, and inter-rater reliability ranged from kappa 0.772-0.893 within PEACH and 0.610-0.784 among attendings. PEACH is an accurate, adaptable tool that enhances consistency and efficiency in perioperative decision-making. Future research should explore its scalability across specialties and its impact on clinical outcomes.

Fashion-VDM: Video Diffusion Model for Virtual Try-On

We present Fashion-VDM, a video diffusion model (VDM) for generating virtual try-on videos. Given an input garment image and person video, our method aims to generate a high-quality try-on video of the person wearing the given garment, while preserving the person's identity and motion. Image-based virtual try-on has shown impressive results; however, existing video virtual try-on (VVT) methods are still lacking garment details and temporal consistency. To address these issues, we propose a diffusion-based architecture for video virtual try-on, split classifier-free guidance for increased control over the conditioning inputs, and a progressive temporal training strategy for single-pass 64-frame, 512px video generation. We also demonstrate the effectiveness of joint image-video training for video try-on, especially when video data is limited. Our qualitative and quantitative experiments show that our approach sets the new state-of-the-art for video virtual try-on. For additional results, visit our project page: https://johannakarras.github.io/Fashion-VDM.

oRetrieval Augmented Generation for 10 Large Language Models and its Generalizability in Assessing Medical Fitness

Large Language Models (LLMs) show potential for medical applications but often lack specialized clinical knowledge. Retrieval Augmented Generation (RAG) allows customization with domain-specific information, making it suitable for healthcare. This study evaluates the accuracy, consistency, and safety of RAG models in determining fitness for surgery and providing preoperative instructions. We developed LLM-RAG models using 35 local and 23 international preoperative guidelines and tested them against human-generated responses. A total of 3,682 responses were evaluated. Clinical documents were processed using Llamaindex, and 10 LLMs, including GPT3.5, GPT4, and Claude-3, were assessed. Fourteen clinical scenarios were analyzed, focusing on seven aspects of preoperative instructions. Established guidelines and expert judgment were used to determine correct responses, with human-generated answers serving as comparisons. The LLM-RAG models generated responses within 20 seconds, significantly faster than clinicians (10 minutes). The GPT4 LLM-RAG model achieved the highest accuracy (96.4% vs. 86.6%, p=0.016), with no hallucinations and producing correct instructions comparable to clinicians. Results were consistent across both local and international guidelines. This study demonstrates the potential of LLM-RAG models for preoperative healthcare tasks, highlighting their efficiency, scalability, and reliability.

Estimation and Inference for Causal Functions with Multiway Clustered Data

This paper proposes methods of estimation and uniform inference for a general class of causal functions, such as the conditional average treatment effects and the continuous treatment effects, under multiway clustering. The causal function is identified as a conditional expectation of an adjusted (Neyman-orthogonal) signal that depends on high-dimensional nuisance parameters. We propose a two-step procedure where the first step uses machine learning to estimate the high-dimensional nuisance parameters. The second step projects the estimated Neyman-orthogonal signal onto a dictionary of basis functions whose dimension grows with the sample size. For this two-step procedure, we propose both the full-sample and the multiway cross-fitting estimation approaches. A functional limit theory is derived for these estimators. To construct the uniform confidence bands, we develop a novel resampling procedure, called the multiway cluster-robust sieve score bootstrap, that extends the sieve score bootstrap (Chen and Christensen, 2018) to the novel setting with multiway clustering. Extensive numerical simulations showcase that our methods achieve desirable finite-sample behaviors. We apply the proposed methods to analyze the causal relationship between mistrust levels in Africa and the historical slave trade. Our analysis rejects the null hypothesis of uniformly zero effects and reveals heterogeneous treatment effects, with significant impacts at higher levels of trade volumes.