Can AI Relate: Testing Large Language Model Response for Mental Health Support

Large language models (LLMs) are already being piloted for clinical use in hospital systems like NYU Langone, Dana-Farber and the NHS. A proposed deployment use case is psychotherapy, where a LLM-powered chatbot can treat a patient undergoing a mental health crisis. Deployment of LLMs for mental health response could hypothetically broaden access to psychotherapy and provide new possibilities for personalizing care. However, recent high-profile failures, like damaging dieting advice offered by the Tessa chatbot to patients with eating disorders, have led to doubt about their reliability in high-stakes and safety-critical settings. In this work, we develop an evaluation framework for determining whether LLM response is a viable and ethical path forward for the automation of mental health treatment. Using human evaluation with trained clinicians and automatic quality-of-care metrics grounded in psychology research, we compare the responses provided by peer-to-peer responders to those provided by a state-of-the-art LLM. We show that LLMs like GPT-4 use implicit and explicit cues to infer patient demographics like race. We then show that there are statistically significant discrepancies between patient subgroups: Responses to Black posters consistently have lower empathy than for any other demographic group (2%-13% lower than the control group). Promisingly, we do find that the manner in which responses are generated significantly impacts the quality of the response. We conclude by proposing safety guidelines for the potential deployment of LLMs for mental health response.

G-VOILA: Gaze-Facilitated Information Querying in Daily Scenarios

Modern information querying systems are progressively incorporating multimodal inputs like vision and audio. However, the integration of gaze -- a modality deeply linked to user intent and increasingly accessible via gaze-tracking wearables -- remains underexplored. This paper introduces a novel gaze-facilitated information querying paradigm, named G-VOILA, which synergizes users' gaze, visual field, and voice-based natural language queries to facilitate a more intuitive querying process. In a user-enactment study involving 21 participants in 3 daily scenarios (p = 21, scene = 3), we revealed the ambiguity in users' query language and a gaze-voice coordination pattern in users' natural query behaviors with G-VOILA. Based on the quantitative and qualitative findings, we developed a design framework for the G-VOILA paradigm, which effectively integrates the gaze data with the in-situ querying context. Then we implemented a G-VOILA proof-of-concept using cutting-edge deep learning techniques. A follow-up user study (p = 16, scene = 2) demonstrates its effectiveness by achieving both higher objective score and subjective score, compared to a baseline without gaze data. We further conducted interviews and provided insights for future gaze-facilitated information querying systems.

Adaptive Collaboration Strategy for LLMs in Medical Decision Making

Foundation models have become invaluable in advancing the medical field. Despite their promise, the strategic deployment of LLMs for effective utility in complex medical tasks remains an open question. Our novel framework, Medical Decision-making Agents (MDAgents) aims to address this gap by automatically assigning the effective collaboration structure for LLMs. Assigned solo or group collaboration structure is tailored to the complexity of the medical task at hand, emulating real-world medical decision making processes. We evaluate our framework and baseline methods with state-of-the-art LLMs across a suite of challenging medical benchmarks: MedQA, MedMCQA, PubMedQA, DDXPlus, PMC-VQA, Path-VQA, and MedVidQA, achieving the best performance in 5 out of 7 benchmarks that require an understanding of multi-modal medical reasoning. Ablation studies reveal that MDAgents excels in adapting the number of collaborating agents to optimize efficiency and accuracy, showcasing its robustness in diverse scenarios. We also explore the dynamics of group consensus, offering insights into how collaborative agents could behave in complex clinical team dynamics. Our code can be found at https://github.com/mitmedialab/MDAgents.

Simultaneous Gesture Classification and Localization with an Automatic Gesture Annotation Model

Training a real-time gesture recognition model heavily relies on annotated data. However, manual data annotation is costly and demands substantial human effort. In order to address this challenge, we propose a novel annotation model that can automatically annotate gesture classes and identify their temporal ranges. Our ablation study demonstrates that our annotation model design surpasses the baseline in terms of both gesture classification accuracy (3-4\% improvement) and localization accuracy (71-75\% improvement). We believe that this annotation model has immense potential to improve the training of downstream gesture recognition models using unlabeled datasets.

Health-LLM: Large Language Models for Health Prediction via Wearable Sensor Data

Large language models (LLMs) are capable of many natural language tasks, yet they are far from perfect. In health applications, grounding and interpreting domain-specific and non-linguistic data is important. This paper investigates the capacity of LLMs to deliver multi-modal health predictions based on contextual information (e.g. user demographics, health knowledge) and physiological data (e.g. resting heart rate, sleep minutes). We present a comprehensive evaluation of eight state-of-the-art LLMs with diverse prompting and fine-tuning techniques on six public health datasets (PM-Data, LifeSnaps, GLOBEM, AW_FB, MIT-BIH & MIMIC-III). Our experiments cover thirteen consumer health prediction tasks in mental health, activity, metabolic, sleep, and cardiac assessment. Our fine-tuned model, Health-Alpaca exhibits comparable performance to larger models (GPT-3.5 and GPT-4), achieving the best performance in 5 out of 13 tasks. Ablation studies highlight the effectiveness of context enhancement strategies, and generalization capability of the fine-tuned models across training datasets and the size of training samples. Notably, we observe that our context enhancement can yield up to 23.8% improvement in performance. While constructing contextually rich prompts (combining user context, health knowledge and temporal information) exhibits synergistic improvement, the inclusion of health knowledge context in prompts significantly enhances overall performance.

MindShift: Leveraging Large Language Models for Mental-States-Based Problematic Smartphone Use Intervention

Problematic smartphone use negatively affects physical and mental health. Despite the wide range of prior research, existing persuasive techniques are not flexible enough to provide dynamic persuasion content based on users' physical contexts and mental states. We first conduct a Wizard-of-Oz study (N=12) and an interview study (N=10) to summarize the mental states behind problematic smartphone use: boredom, stress, and inertia. This informs our design of four persuasion strategies: understanding, comforting, evoking, and scaffolding habits. We leverage large language models (LLMs) to enable the automatic and dynamic generation of effective persuasion content. We develop MindShift, a novel LLM-powered problematic smartphone use intervention technique. MindShift takes users' in-the-moment physical contexts, mental states, app usage behaviors, users' goals & habits as input, and generates high-quality and flexible persuasive content with appropriate persuasion strategies. We conduct a 5-week field experiment (N=25) to compare MindShift with baseline techniques. The results show that MindShift significantly improves intervention acceptance rates by 17.8-22.5% and reduces smartphone use frequency by 12.1-14.4%. Moreover, users have a significant drop in smartphone addiction scale scores and a rise in self-efficacy. Our study sheds light on the potential of leveraging LLMs for context-aware persuasion in other behavior change domains.

Talk2Care: Facilitating Asynchronous Patient-Provider Communication with Large-Language-Model

Despite the plethora of telehealth applications to assist home-based older adults and healthcare providers, basic messaging and phone calls are still the most common communication methods, which suffer from limited availability, information loss, and process inefficiencies. One promising solution to facilitate patient-provider communication is to leverage large language models (LLMs) with their powerful natural conversation and summarization capability. However, there is a limited understanding of LLMs' role during the communication. We first conducted two interview studies with both older adults (N=10) and healthcare providers (N=9) to understand their needs and opportunities for LLMs in patient-provider asynchronous communication. Based on the insights, we built an LLM-powered communication system, Talk2Care, and designed interactive components for both groups: (1) For older adults, we leveraged the convenience and accessibility of voice assistants (VAs) and built an LLM-powered VA interface for effective information collection. (2) For health providers, we built an LLM-based dashboard to summarize and present important health information based on older adults' conversations with the VA. We further conducted two user studies with older adults and providers to evaluate the usability of the system. The results showed that Talk2Care could facilitate the communication process, enrich the health information collected from older adults, and considerably save providers' efforts and time. We envision our work as an initial exploration of LLMs' capability in the intersection of healthcare and interpersonal communication.

Rethinking Human-AI Collaboration in Complex Medical Decision Making: A Case Study in Sepsis Diagnosis

Today's AI systems for medical decision support often succeed on benchmark datasets in research papers but fail in real-world deployment. This work focuses on the decision making of sepsis, an acute life-threatening systematic infection that requires an early diagnosis with high uncertainty from the clinician. Our aim is to explore the design requirements for AI systems that can support clinical experts in making better decisions for the early diagnosis of sepsis. The study begins with a formative study investigating why clinical experts abandon an existing AI-powered Sepsis predictive module in their electrical health record (EHR) system. We argue that a human-centered AI system needs to support human experts in the intermediate stages of a medical decision-making process (e.g., generating hypotheses or gathering data), instead of focusing only on the final decision. Therefore, we build SepsisLab based on a state-of-the-art AI algorithm and extend it to predict the future projection of sepsis development, visualize the prediction uncertainty, and propose actionable suggestions (i.e., which additional laboratory tests can be collected) to reduce such uncertainty. Through heuristic evaluation with six clinicians using our prototype system, we demonstrate that SepsisLab enables a promising human-AI collaboration paradigm for the future of AI-assisted sepsis diagnosis and other high-stakes medical decision making.

Mental-LLM: Leveraging Large Language Models for Mental Health Prediction via Online Text Data

Advances in large language models (LLMs) have empowered a variety of applications. However, there is still a significant gap in research when it comes to understanding and enhancing the capabilities of LLMs in the field of mental health. In this work, we present the first comprehensive evaluation of multiple LLMs, including Alpaca, Alpaca-LoRA, FLAN-T5, GPT-3.5, and GPT-4, on various mental health prediction tasks via online text data. We conduct a broad range of experiments, covering zero-shot prompting, few-shot prompting, and instruction fine-tuning. The results indicate a promising yet limited performance of LLMs with zero-shot and few-shot prompt designs for the mental health tasks. More importantly, our experiments show that instruction finetuning can significantly boost the performance of LLMs for all tasks simultaneously. Our best-finetuned models, Mental-Alpaca and Mental-FLAN-T5, outperform the best prompt design of GPT-3.5 (25 and 15 times bigger) by 10.9% on balanced accuracy and the best of GPT-4 (250 and 150 times bigger) by 4.8%. They further perform on par with the state-of-the-art task-specific language model. We also conduct an exploratory case study on LLMs' capability on the mental health reasoning tasks, illustrating the promising capability of certain models such as GPT-4. We summarize our findings into a set of action guidelines for potential methods to enhance LLMs' capability for mental health tasks. Meanwhile, we also emphasize the important limitations before achieving deployability in real-world mental health settings, such as known racial and gender bias. We highlight the important ethical risks accompanying this line of research.

XAIR: A Framework of Explainable AI in Augmented Reality

Explainable AI (XAI) has established itself as an important component of AI-driven interactive systems. With Augmented Reality (AR) becoming more integrated in daily lives, the role of XAI also becomes essential in AR because end-users will frequently interact with intelligent services. However, it is unclear how to design effective XAI experiences for AR. We propose XAIR, a design framework that addresses "when", "what", and "how" to provide explanations of AI output in AR. The framework was based on a multi-disciplinary literature review of XAI and HCI research, a large-scale survey probing 500+ end-users' preferences for AR-based explanations, and three workshops with 12 experts collecting their insights about XAI design in AR. XAIR's utility and effectiveness was verified via a study with 10 designers and another study with 12 end-users. XAIR can provide guidelines for designers, inspiring them to identify new design opportunities and achieve effective XAI designs in AR.