Real-Time Surrogate Modeling for Personalized Blood Flow Prediction and Hemodynamic Analysis

Cardiovascular modeling has rapidly advanced over the past few decades due to the rising needs for health tracking and early detection of cardiovascular diseases. While 1-D arterial models offer an attractive compromise between computational efficiency and solution fidelity, their application on large populations or for generating large \emph{in silico} cohorts remains challenging. Certain hemodynamic parameters like the terminal resistance/compliance, are difficult to clinically estimate and often yield non-physiological hemodynamics when sampled naively, resulting in large portions of simulated datasets to be discarded. In this work, we present a systematic framework for training machine learning (ML) models, capable of instantaneous hemodynamic prediction and parameter estimation. We initially start with generating a parametric virtual cohort of patients which is based on the multivariate correlations observed in the large Asklepios clinical dataset, ensuring that physiological parameter distributions are respected. We then train a deep neural surrogate model, able to predict patient-specific arterial pressure and cardiac output (CO), enabling rapid a~priori screening of input parameters. This allows for immediate rejection of non-physiological combinations and drastically reduces the cost of targeted synthetic dataset generation (e.g. hypertensive groups). The model also provides a principled means of sampling the terminal resistance to minimize the uncertainties of unmeasurable parameters. Moreover, by assessing the model's predictive performance we determine the theoretical information which suffices for solving the inverse problem of estimating the CO. Finally, we apply the surrogate on a clinical dataset for the estimation of central aortic hemodynamics i.e. the CO and aortic systolic blood pressure (cSBP).

Prompt Triage: Structured Optimization Enhances Vision-Language Model Performance on Medical Imaging Benchmarks

Vision-language foundation models (VLMs) show promise for diverse imaging tasks but often underperform on medical benchmarks. Prior efforts to improve performance include model finetuning, which requires large domain-specific datasets and significant compute, or manual prompt engineering, which is hard to generalize and often inaccessible to medical institutions seeking to deploy these tools. These challenges motivate interest in approaches that draw on a model's embedded knowledge while abstracting away dependence on human-designed prompts to enable scalable, weight-agnostic performance improvements. To explore this, we adapt the Declarative Self-improving Python (DSPy) framework for structured automated prompt optimization in medical vision-language systems through a comprehensive, formal evaluation. We implement prompting pipelines for five medical imaging tasks across radiology, gastroenterology, and dermatology, evaluating 10 open-source VLMs with four prompt optimization techniques. Optimized pipelines achieved a median relative improvement of 53% over zero-shot prompting baselines, with the largest gains ranging from 300% to 3,400% on tasks where zero-shot performance is low. These results highlight the substantial potential of applying automated prompt optimization to medical AI systems, demonstrating significant gains for vision-based applications requiring accurate clinical image interpretation. By reducing dependence on prompt design to elicit intended outputs, these techniques allow clinicians to focus on patient care and clinical decision-making. Furthermore, our experiments offer scalability and preserve data privacy, demonstrating performance improvement on open-source VLMs. We publicly release our evaluation pipelines to support reproducible research on specialized medical tasks, available at https://github.com/DaneshjouLab/prompt-triage-lab.