The Rise of Small Language Models in Healthcare: A Comprehensive Survey

Despite substantial progress in healthcare applications driven by large language models (LLMs), growing concerns around data privacy, and limited resources; the small language models (SLMs) offer a scalable and clinically viable solution for efficient performance in resource-constrained environments for next-generation healthcare informatics. Our comprehensive survey presents a taxonomic framework to identify and categorize them for healthcare professionals and informaticians. The timeline of healthcare SLM contributions establishes a foundational framework for analyzing models across three dimensions: NLP tasks, stakeholder roles, and the continuum of care. We present a taxonomic framework to identify the architectural foundations for building models from scratch; adapting SLMs to clinical precision through prompting, instruction fine-tuning, and reasoning; and accessibility and sustainability through compression techniques. Our primary objective is to offer a comprehensive survey for healthcare professionals, introducing recent innovations in model optimization and equipping them with curated resources to support future research and development in the field. Aiming to showcase the groundbreaking advancements in SLMs for healthcare, we present a comprehensive compilation of experimental results across widely studied NLP tasks in healthcare to highlight the transformative potential of SLMs in healthcare. The updated repository is available at Github

Optimizing Large Language Models: Metrics, Energy Efficiency, and Case Study Insights

The rapid adoption of large language models (LLMs) has led to significant energy consumption and carbon emissions, posing a critical challenge to the sustainability of generative AI technologies. This paper explores the integration of energy-efficient optimization techniques in the deployment of LLMs to address these environmental concerns. We present a case study and framework that demonstrate how strategic quantization and local inference techniques can substantially lower the carbon footprints of LLMs without compromising their operational effectiveness. Experimental results reveal that these methods can reduce energy consumption and carbon emissions by up to 45\% post quantization, making them particularly suitable for resource-constrained environments. The findings provide actionable insights for achieving sustainability in AI while maintaining high levels of accuracy and responsiveness.

FairSense-AI: Responsible AI Meets Sustainability

In this paper, we introduce FairSense-AI: a multimodal framework designed to detect and mitigate bias in both text and images. By leveraging Large Language Models (LLMs) and Vision-Language Models (VLMs), FairSense-AI uncovers subtle forms of prejudice or stereotyping that can appear in content, providing users with bias scores, explanatory highlights, and automated recommendations for fairness enhancements. In addition, FairSense-AI integrates an AI risk assessment component that aligns with frameworks like the MIT AI Risk Repository and NIST AI Risk Management Framework, enabling structured identification of ethical and safety concerns. The platform is optimized for energy efficiency via techniques such as model pruning and mixed-precision computation, thereby reducing its environmental footprint. Through a series of case studies and applications, we demonstrate how FairSense-AI promotes responsible AI use by addressing both the social dimension of fairness and the pressing need for sustainability in large-scale AI deployments. https://vectorinstitute.github.io/FairSense-AI, https://pypi.org/project/fair-sense-ai/ (Sustainability , Responsible AI , Large Language Models , Vision Language Models , Ethical AI , Green AI)

Comprehensive Analysis of Transparency and Accessibility of ChatGPT, DeepSeek, And other SoTA Large Language Models

Despite increasing discussions on open-source Artificial Intelligence (AI), existing research lacks a discussion on the transparency and accessibility of state-of-the-art (SoTA) Large Language Models (LLMs). The Open Source Initiative (OSI) has recently released its first formal definition of open-source software. This definition, when combined with standard dictionary definitions and the sparse published literature, provide an initial framework to support broader accessibility to AI models such as LLMs, but more work is essential to capture the unique dynamics of openness in AI. In addition, concerns about open-washing, where models claim openness but lack full transparency, has been raised, which limits the reproducibility, bias mitigation, and domain adaptation of these models. In this context, our study critically analyzes SoTA LLMs from the last five years, including ChatGPT, DeepSeek, LLaMA, and others, to assess their adherence to transparency standards and the implications of partial openness. Specifically, we examine transparency and accessibility from two perspectives: open-source vs. open-weight models. Our findings reveal that while some models are labeled as open-source, this does not necessarily mean they are fully open-sourced. Even in the best cases, open-source models often do not report model training data, and code as well as key metrics, such as weight accessibility, and carbon emissions. To the best of our knowledge, this is the first study that systematically examines the transparency and accessibility of over 100 different SoTA LLMs through the dual lens of open-source and open-weight models. The findings open avenues for further research and call for responsible and sustainable AI practices to ensure greater transparency, accountability, and ethical deployment of these models.(DeepSeek transparency, ChatGPT accessibility, open source, DeepSeek open source)

VLDBench: Vision Language Models Disinformation Detection Benchmark

The rapid rise of AI-generated content has made detecting disinformation increasingly challenging. In particular, multimodal disinformation, i.e., online posts-articles that contain images and texts with fabricated information are specially designed to deceive. While existing AI safety benchmarks primarily address bias and toxicity, multimodal disinformation detection remains largely underexplored. To address this challenge, we present the Vision-Language Disinformation Detection Benchmark VLDBench, the first comprehensive benchmark for detecting disinformation across both unimodal (text-only) and multimodal (text and image) content, comprising 31,000} news article-image pairs, spanning 13 distinct categories, for robust evaluation. VLDBench features a rigorous semi-automated data curation pipeline, with 22 domain experts dedicating 300 plus hours} to annotation, achieving a strong inter-annotator agreement (Cohen kappa = 0.78). We extensively evaluate state-of-the-art Large Language Models (LLMs) and Vision-Language Models (VLMs), demonstrating that integrating textual and visual cues in multimodal news posts improves disinformation detection accuracy by 5 - 35 % compared to unimodal models. Developed in alignment with AI governance frameworks such as the EU AI Act, NIST guidelines, and the MIT AI Risk Repository 2024, VLDBench is expected to become a benchmark for detecting disinformation in online multi-modal contents. Our code and data will be publicly available.

Perceived Confidence Scoring for Data Annotation with Zero-Shot LLMs

Zero-shot LLMs are now also used for textual classification tasks, e.g., sentiment/emotion detection of a given input as a sentence/article. However, their performance can be suboptimal in such data annotation tasks. We introduce a novel technique Perceived Confidence Scoring (PCS) that evaluates LLM's confidence for its classification of an input by leveraging Metamorphic Relations (MRs). The MRs generate semantically equivalent yet textually mutated versions of the input. Following the principles of Metamorphic Testing (MT), the mutated versions are expected to have annotation labels similar to the input. By analyzing the consistency of LLM responses across these variations, PCS computes a confidence score based on the frequency of predicted labels. PCS can be used both for single LLM and multiple LLM settings (e.g., majority voting). We introduce an algorithm Perceived Differential Evolution (PDE) that determines the optimal weights assigned to the MRs and the LLMs for a classification task. Empirical evaluation shows PCS significantly improves zero-shot accuracy for Llama-3-8B-Instruct (4.96%) and Mistral-7B-Instruct-v0.3 (10.52%), with Gemma-2-9b-it showing a 9.39% gain. When combining all three models, PCS significantly outperforms majority voting by 7.75%.

FairUDT: Fairness-aware Uplift Decision Trees

Training data used for developing machine learning classifiers can exhibit biases against specific protected attributes. Such biases typically originate from historical discrimination or certain underlying patterns that disproportionately under-represent minority groups, such as those identified by their gender, religion, or race. In this paper, we propose a novel approach, FairUDT, a fairness-aware Uplift-based Decision Tree for discrimination identification. FairUDT demonstrates how the integration of uplift modeling with decision trees can be adapted to include fair splitting criteria. Additionally, we introduce a modified leaf relabeling approach for removing discrimination. We divide our dataset into favored and deprived groups based on a binary sensitive attribute, with the favored dataset serving as the treatment group and the deprived dataset as the control group. By applying FairUDT and our leaf relabeling approach to preprocess three benchmark datasets, we achieve an acceptable accuracy-discrimination tradeoff. We also show that FairUDT is inherently interpretable and can be utilized in discrimination detection tasks. The code for this project is available https://github.com/ara-25/FairUDT

Image, Text, and Speech Data Augmentation using Multimodal LLMs for Deep Learning: A Survey

In the past five years, research has shifted from traditional Machine Learning (ML) and Deep Learning (DL) approaches to leveraging Large Language Models (LLMs) , including multimodality, for data augmentation to enhance generalization, and combat overfitting in training deep convolutional neural networks. However, while existing surveys predominantly focus on ML and DL techniques or limited modalities (text or images), a gap remains in addressing the latest advancements and multi-modal applications of LLM-based methods. This survey fills that gap by exploring recent literature utilizing multimodal LLMs to augment image, text, and audio data, offering a comprehensive understanding of these processes. We outlined various methods employed in the LLM-based image, text and speech augmentation, and discussed the limitations identified in current approaches. Additionally, we identified potential solutions to these limitations from the literature to enhance the efficacy of data augmentation practices using multimodal LLMs. This survey serves as a foundation for future research, aiming to refine and expand the use of multimodal LLMs in enhancing dataset quality and diversity for deep learning applications. (Surveyed Paper GitHub Repo: https://github.com/WSUAgRobotics/data-aug-multi-modal-llm. Keywords: LLM data augmentation, LLM text data augmentation, LLM image data augmentation, LLM speech data augmentation, audio augmentation, voice augmentation, chatGPT for data augmentation, DeepSeek R1 text data augmentation, DeepSeek R1 image augmentation, Image Augmentation using LLM, Text Augmentation using LLM, LLM data augmentation for deep learning applications)

EQUATOR: A Deterministic Framework for Evaluating LLM Reasoning with Open-Ended Questions. # v1.0.0-beta

Despite the remarkable coherence of Large Language Models (LLMs), existing evaluation methods often suffer from fluency bias and rely heavily on multiple-choice formats, making it difficult to assess factual accuracy and complex reasoning effectively. LLMs thus frequently generate factually inaccurate responses, especially in complex reasoning tasks, highlighting two prominent challenges: (1) the inadequacy of existing methods to evaluate reasoning and factual accuracy effectively, and (2) the reliance on human evaluators for nuanced judgment, as illustrated by Williams and Huckle (2024)[1], who found manual grading indispensable despite automated grading advancements. To address evaluation gaps in open-ended reasoning tasks, we introduce the EQUATOR Evaluator (Evaluation of Question Answering Thoroughness in Open-ended Reasoning). This framework combines deterministic scoring with a focus on factual accuracy and robust reasoning assessment. Using a vector database, EQUATOR pairs open-ended questions with human-evaluated answers, enabling more precise and scalable evaluations. In practice, EQUATOR significantly reduces reliance on human evaluators for scoring and improves scalability compared to Williams and Huckle's (2004)[1] methods. Our results demonstrate that this framework significantly outperforms traditional multiple-choice evaluations while maintaining high accuracy standards. Additionally, we introduce an automated evaluation process leveraging smaller, locally hosted LLMs. We used LLaMA 3.2B, running on the Ollama binaries to streamline our assessments. This work establishes a new paradigm for evaluating LLM performance, emphasizing factual accuracy and reasoning ability, and provides a robust methodological foundation for future research.

ViLBias: A Framework for Bias Detection using Linguistic and Visual Cues

The integration of Large Language Models (LLMs) and Vision-Language Models (VLMs) opens new avenues for addressing complex challenges in multimodal content analysis, particularly in biased news detection. This study introduces ViLBias, a framework that leverages state of the art LLMs and VLMs to detect linguistic and visual biases in news content, addressing the limitations of traditional text-only approaches. Our contributions include a novel dataset pairing textual content with accompanying visuals from diverse news sources and a hybrid annotation framework, combining LLM-based annotations with human review to enhance quality while reducing costs and improving scalability. We evaluate the efficacy of LLMs and VLMs in identifying biases, revealing their strengths in detecting subtle framing and text-visual inconsistencies. Empirical analysis demonstrates that incorporating visual cues alongside text enhances bias detection accuracy by 3 to 5 %, showcasing the complementary strengths of LLMs in generative reasoning and Small Language Models (SLMs) in classification. This study offers a comprehensive exploration of LLMs and VLMs as tools for detecting multimodal biases in news content, highlighting both their potential and limitations. Our research paves the way for more robust, scalable, and nuanced approaches to media bias detection, contributing to the broader field of natural language processing and multimodal analysis. (The data and code will be made available for research purposes).