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Healthcare
Clinical AI, diagnostic bias, patient safety and medical-device regulation — the healthcare front of AI ethics, daily.
SHIELD: A Diverse Clinical Note Dataset and Distilled Small Language Models for Enterprise-Scale De-identification
De-identification of clinical text is a prerequisite for the secondary use of electronic health records. Existing public benchmarks such as the i2b2 2006 and 2014 corpora are over a decade old and lack the semantic and demographic diversity of modern clinical narratives. Large Language Models (LLMs) reach state-of-the-art zero-shot extraction, but their use at enterprise scale is limited by computational cost and by hospital data governance that restricts sending Protected Health Information (PH
ADAPTS: Agentic Decomposition for Automated Protocol-agnostic Tracking of Symptoms
Modeling latent clinical constructs from unconstrained clinical interactions is a unique challenge in affective computing. We present ADAPTS (Agentic Decomposition for Automated Protocol-agnostic Tracking of Symptoms), a framework for automated rating of depression and anxiety severity using a mixture-of-agents LLM architecture. This approach decomposes long-form clinical interviews into symptom-specific reasoning tasks, producing auditable justifications while preserving temporal and speaker al
Making the Invisible Visible: Understanding the Mismatch Between Organizational Goals and Worker Experiences in AI Adoption
While AI is often introduced into organizations to drive innovation and efficiency, many adoption efforts fail as workers resist and struggle to integrate these systems. These failures point to a deeper issue: workers, the very people expected to collaborate with AI, are often invisible in decisions about how AI is designed and used. Drawing on interviews with professionals who interact with AI systems daily in healthcare, finance, and management, we examine the disconnect between organizational
Hidden Coalitions in Multi-Agent AI: A Spectral Diagnostic from Internal Representations
Collections of interacting AI agents can form coalitions, creating emergent group-level organization that is critical for AI safety and alignment. However, observing agent behavior alone is often insufficient to distinguish genuine informational coupling from spurious similarity, as consequential coalitions may form at the level of internal representations before any overt behavioral change is apparent. Here, we introduce a practical method for detecting coalition structure from the internal neu
Fine-Grained Graph Generation through Latent Mixture Scheduling
Structure aware graph generation aims to generate graphs that satisfy given topological properties. It has applications in domains such as drug discovery, social network modeling, and knowledge graph construction. Unlike existing methods that only provide coarse control over graph properties, we introduce a novel conditional variational autoencoder for fine-grained structural control in graph generation. The approach refines the decoder's latent space by dynamically aligning graph- and property-
Bolek: A Multimodal Language Model for Molecular Reasoning
Molecular property models increasingly support high-stakes drug-discovery decisions, but their outputs are often difficult to audit: classical predictors return scores without rationale, while language models can produce fluent explanations weakly grounded in the input molecule. We introduce Bolek, a compact multimodal language model that grounds natural-language reasoning in molecular structure by injecting a Morgan fingerprint embedding into an instruction-tuned text decoder. Bolek is fine-tun
An Empirical Study of Agent Skills for Healthcare: Practice, Gaps, and Governance
Healthcare automation is shaped by local procedures and organizational constraints, so agent capabilities rarely transfer unchanged across settings. Agent skills, self-contained directories that package reusable procedures for AI agents, are emerging as a procedural layer for adapting healthcare agents across diverse healthcare settings. We present the first empirical analysis of healthcare agent skills, drawing on 557 healthcare-related skills filtered from 58,159 public skills on ClawHub and a
SAIL: Structure-Aware Interpretable Learning for Anatomy-Aligned Post-hoc Explanations in OCT
Optical coherence tomography (OCT), a commonly used retinal imaging modality, plays a central role in retinal disease diagnosis by providing high-resolution visualization of retinal layers. While deep learning (DL) has achieved expert-level accuracy in OCT-based retinal disease detection, its "black box" nature poses challenges for clinical adoption, where explainability is essential for clinical trust and regulatory approval. Existing post-hoc explainable AI (XAI) methods often struggle to deli
An explainable hypothesis-driven approach to Drug-Induced Liver Injury with HADES
Drug-induced liver injury (DILI) remains a leading cause of late-stage clinical trial attrition. However, existing computational predictors primarily rely on binary classification, a framing that limits generalization and yields no mechanistic insight to guide translational decisions. We argue that DILI prediction is better posed as an explainable hypothesis-generation problem. To support this shift, we introduce the DILER Benchmark, a dataset that extends beyond binary labels by augmenting a cu
Reliability-Oriented Multilingual Orthopedic Diagnosis: A Domain-Adaptive Modeling and a Conceptual Validation Framework
Large Language Models (LLMs) are increasingly proposed for clinical decision support including multilingual diagnosis in low-resource settings. However, their reliability, calibration and safety characteristics remain insufficiently understood for structured, high-risk tasks. We present a system-level analysis of multilingual orthopedic diagnosis from free-text clinical notes in English, Hindi and Punjabi. We evaluate three modeling regimes: (i) task-aligned multilingual transformer encoders, (i
Manifold-Aligned Guided Integrated Gradients for Reliable Feature Attribution
Feature attribution is central to diagnosing and trusting deep neural networks, and Integrated Gradients (IG) is widely used due to its axiomatic properties. However, IG can yield unreliable explanations when the integration path between a baseline and the input passes through regions with noisy gradients. While Guided Integrated Gradients reduces this sensitivity by adaptively updating low-gradient-magnitude features, input-space guidance still produces intermediate inputs that deviate from the
Principles and Guidelines for Randomized Controlled Trials in AI Evaluation
This work establishes a foundational framework for standardizing AI evaluation RCTs (sometimes called human uplift studies). Drawing on established experimental practices from disciplines with established RCT traditions, including software engineering, economics, clinical and health sciences, and psychology, we adopt the (Shadish et al., 2002) four-validity framework and extend it with a fifth principle on transparency, repeatability, and verification adapted from the Transparency and Openness P
What's on Your Mind? Exploring Privacy of Mental Health Apps
Therapy and life-coaching apps have been rapidly growing in number, flavors, and popularity. However, their users routinely share highly sensitive and personal information, such as traumas, fantasies, desires, relationship difficulties, and other mental health concerns. This prompts the need for an empirical analysis of privacy practices in this ecosystem, and particularly the alignment between these apps' privacy policies and their actual behavior. In this paper, we present a comprehensive anal
From Awareness to Action: Understanding and Overcoming the Research-Practice Gap in Algorithmic Fairness for Public Health
Algorithmic fairness is essential for responsible ML-driven public health research, yet its practical implementation remains limited. To investigate this awareness-action gap, we conducted a sequential mixed-methods study comprising expert interviews, an online survey, and systematic mapping. The expert interviews informed the design of the survey, which in turn revealed fragmented definitions of fairness, limited training and guidance, reliance on external sources, and rare use of formal assess
MindMelody: A Closed-Loop EEG-Driven System for Personalized Music Intervention
Driven by the escalating global burden of mental health conditions, music-based interventions have attracted significant attention as a non-invasive, cost-effective modality for emotion regulation and psychological stress relief. However, current digital music services rely on static preferences and fail to adapt to users' instantaneous psychological states. Furthermore, directly mapping electroencephalography (EEG) to music generation remains challenging due to severe paired-data scarcity and a
NEURON: A Neuro-symbolic System for Grounded Clinical Explainability
Clinical AI adoption is hindered by the black-box/grey-box nature of high-performing models, which lack the ontological grounding and narrative transparency required for professional-level explainability. We present NEURON, a neuro-symbolic system designed to enhance both predictive reliability and clinical interpretability. NEURON integrates SNOMED CT ontology-informed structural representations with machine learning models to bridge the gap between raw data and medical nomenclature. To facilit
PERSA: Reinforcement Learning for Professor-Style Personalized Feedback with LLMs
Large language models (LLMs) can provide automated feedback in educational settings, but aligning an LLMs style with a specific instructors tone while maintaining diagnostic correctness remains challenging. We ask how can we update an LLM for automated feedback generation to align with a target instructors style without sacrificing core knowledge? We study how Reinforcement Learning from Human Feedback (RLHF) can adapt a transformer-based LLM to generate programming feedback that matches a profe
Virtual Speech Therapist: A Clinician-in-the-Loop AI Speech Therapy Agent for Personalized and Supervised Therapy
This paper develops Virtual Speech Therapist (VST), an intelligent agent-based platform that streamlines stuttering assessment and delivers customized therapy planning through automated and adaptive AI-driven workflows. VST integrates state-of-the-art deep learning-based stuttering classification, and multi-agent large language model (LLM) reasoning to support evidence-based clinical decision-making. The VST begins with the acquisition and feature extraction of patient speech samples, followed b
A Knowledge-Driven LLM-Based Decision-Support System for Explainable Defect Analysis and Mitigation Guidance in Laser Powder Bed Fusion
This work presents a knowledge-driven decision-support system that integrates structured defect knowledge with LLM-based reasoning to provide explainable defect diagnosis and mitigation guidance in manufacturing, using LPBF as a representative, safety-critical case study. The proposed ontology-integrated LLM-based decision support system for LPBF defect analysis and mitigation guidance is built on a knowledge base containing 27 known LPBF defect types organized into hierarchical categories and c
When RAG Chatbots Expose Their Backend: An Anonymized Case Study of Privacy and Security Risks in Patient-Facing Medical AI
Background: Patient-facing medical chatbots based on retrieval-augmented generation (RAG) are increasingly promoted to deliver accessible, grounded health information. AI-assisted development lowers the barrier to building them, but they still demand rigorous security, privacy, and governance controls. Objective: To report an anonymized, non-destructive security assessment of a publicly accessible patient-facing medical RAG chatbot and identify governance lessons for safe deployment of generativ
Recent Advances in Generative AI for Healthcare Applications
Learning from Disagreement: Clinician Overrides as Implicit Preference Signals for Clinical AI in Value-Based Care
We reframe clinician overrides of clinical AI recommendations as implicit preference data - the same signal structure exploited by reinforcement learning from human feedback (RLHF), but richer: the annotator is a domain expert, the alternatives carry real consequences, and downstream outcomes are observable. We present a formal framework extending standard preference learning with three contributions: a five-category override taxonomy mapping override types to distinct model update targets; a pr
Consumer Attitudes Towards AI in Digital Health: A Mixed-Methods Survey in Australia
AI applications are increasingly being introduced into digital health. While technical performance has advanced rapidly, successful deployment mainly depends on consumer attitudes, especially to patient-facing applications. However, most existing research examines consumer attitudes towards healthcare AI at an abstract level rather than in response to concrete artefacts. We report a mixed-methods survey study in Australia (N=275) examining consumer readiness, acceptance, trust, and risk percepti
Mapping how LLMs debate societal issues when shadowing human personality traits, sociodemographics and social media behavior
Large Language Models (LLMs) can strongly shape social discourse, yet datasets investigating how LLM outputs vary across controlled social and contextual prompting remain sparse. Cognitive Digital Shadows (CDS) is a 190,000-record synthetic corpus supporting analyses of LLM-generated discourse. Each CDS record is generated by one of 19 LLMs, prompted to shadow either a human persona or an AI-assistant role. CDS contains LLM responses on 4 controversial societal topics: vaccines/healthcare, socia
RIHA: Report-Image Hierarchical Alignment for Radiology Report Generation
Radiology report generation (RRG) has emerged as a promising approach to alleviate radiologists' workload and reduce human errors by automatically generating diagnostic reports from medical images. A key challenge in RRG is achieving fine-grained alignment between complex visual features and the hierarchical structure of long-form radiology reports. Although recent methods have improved image-text representation learning, they often treat reports as flat sequences, overlooking their structured s
Multi-element Persuasion in Social Media Health Communication: Synergistic and Trade-off Effects
Health messages on social media are typically constructed through combinations of source cues, appeals, frames, and evidence, which jointly shape communication and persuasive effects. However, prior research has largely focused on single elements or simple pairwise interactions, offering insufficient insight into how multiple elements operate together in real-world digital environments. To address this gap, this study adopts a systems perspective to examine multi-element message combinations. Us
End-to-End Evaluation and Governance of an EHR-Embedded AI Agent for Clinicians
Clinical AI systems require not just point-in-time evaluation but continuous governance: the ongoing practice of monitoring, evaluating, iterating, and re-evaluating performance throughout deployment. We present an end-to-end framework of governance that integrates rubric validation, live deployment feedback, technical performance monitoring, and cost tracking, with controlled experimentation gating system changes before deployment. Applied to Hyperscribe, an EHR-embedded agent that converts amb
Detecting Clinical Discrepancies in Health Coaching Agents: A Dual-Stream Memory and Reconciliation Architecture
As Large Language Model (LLM) agents transition from single-session tools to persistent systems managing longitudinal healthcare journeys, their memory architectures face a critical challenge: reconciling two imperfect sources of truth. The patient's evolving self-report is current but prone to recall bias, while the Electronic Health Record (EHR) is medically validated but frequently stale. General-purpose agent memory systems optimize for coherence by overwriting older facts with the user's la
A self-evolving agent for explainable diagnosis of DFT-experiment band-gap mismatch
Standard density functional theory (DFT) routinely misclassifies the electronic ground state of correlated and structurally complex compounds, predicting metallic behaviour for materials that experiments report as semiconductors. Each such mismatch encodes a specific non-ideality -- magnetic ordering, electron correlation, an alternative polymorph, or a defect -- that the calculation excluded, but extracting that signal at scale has remained a manual exercise. Here we introduce XDFT, a closed-lo
Benchmarking the Safety of Large Language Models for Robotic Health Attendant Control
Large language models (LLMs) are increasingly considered for deployment as the control component of robotic health attendants, yet their safety in this context remains poorly characterized. We introduce a dataset of 270 harmful instructions spanning nine prohibited behavior categories grounded in the American Medical Association Principles of Medical Ethics, and use it to evaluate 72 LLMs in a simulation environment based on the Robotic Health Attendant framework. The mean violation rate across
MedSynapse-V: Bridging Visual Perception and Clinical Intuition via Latent Memory Evolution
High-precision medical diagnosis relies not only on static imaging features but also on the implicit diagnostic memory experts instantly invoke during image interpretation. We pinpoint a fundamental cognitive misalignment in medical VLMs caused by discrete tokenization, leading to quantization loss, long-range information dissipation, and missing case-adaptive expertise. To bridge this gap, we propose ours, a framework for latent diagnostic memory evolution that simulates the experiential invoca
DepthPilot: From Controllability to Interpretability in Colonoscopy Video Generation
Controllable medical video generation has achieved remarkable progress, but it still lacks interpretability, which requires the alignment of generated contents with physical priors and faithful clinical manifestations. To push the boundaries from mere controllability to interpretability, we propose DepthPilot, the first interpretable framework for colonoscopy video generation. This work takes a step toward trustworthy generation through two synergistic paradigms. To achieve explicit geometric gr
Algorithmic Authority and the Clinical Standard of Care
The integration of artificial intelligence into clinical medicine creates a fundamental tension between algorithmic probabilistic reasoning and the experiential intuition of expert physicians; applying Lawrence Lessig's \enquote{Code is Law} framework, I argue that the architecture of clinical AI systems already functions as de facto medical regulation, reshaping liability and the standard of care. Reframing AI \enquote{hallucination} as structurally analogous to well-documented human cognitive
People-Centred Medical Image Analysis via Fairness-Aware Human-AI Cooperation
Machine learning models for medical image analysis often exhibit subgroup-dependent performance, which impacts how decisions should be allocated between automated systems and human experts under limited resources. Prior work on AI fairness and human-AI cooperation, including learning to defer (L2D) and learning to complement (L2C), typically addresses these problems in isolation. We propose People-Centred Medical Image Analysis (PecMan), a framework for fairness-aware human-AI co-operative class
PSI-Bench: Towards Clinically Grounded and Interpretable Evaluation of Depression Patient Simulators
Patient simulators are gaining traction in mental health training by providing scalable exposure to complex and sensitive patient interactions. Simulating depressed patients is particularly challenging, as safety constraints and high patient variability complicate simulations and underscore the need for simulators that capture diverse and realistic patient behaviors. However, existing evaluations heavily rely on LLM-judges with poorly specified prompts and do not assess behavioral diversity. We
Think Before You Act -- A Neurocognitive Governance Model for Autonomous AI Agents
The rapid deployment of autonomous AI agents across enterprise, healthcare, and safety-critical environments has created a fundamental governance gap. Existing approaches, runtime guardrails, training-time alignment, and post-hoc auditing treat governance as an external constraint rather than an internalized behavioral principle, leaving agents vulnerable to unsafe and irreversible actions. We address this gap by drawing on how humans self-govern naturally: before acting, humans engage deliberat
Health System Scale Semantic Search Across Unstructured Clinical Notes
Introduction: Semantic search, which retrieves documents based on conceptual similarity rather than keywords, offers advantages for retrieval of clinical information. However, deploying semantic search across health systems, comprising hundreds of millions of clinical notes, presents formidable engineering, cost, and governance challenges that have prevented institutional adoption. Methods: We deployed a semantic search system at a large children's hospital indexing 166 million clinical notes (4
Improving Hospital Process Management through Process Mining: A Case Study on COVID-19 Clinical Pathways
This study analyzes COVID-19 care pathways using the COVID Data for Shared Learning dataset. We build a transparent, reproducible pipeline that transforms heterogeneous clinical tables into a process-mining-ready event log and applies discovery, declarative conformance checking, and outcome analysis. The reconstructed pathways highlight the monitoring backbone of inpatient care, variability at the Emergency department-admission interface, and outcome differences driven by age and exposure to int
CoRE: Concept-Reasoning Expansion for Continual Brain Lesion Segmentation
Accurate brain lesion segmentation in MRI is vital for effective clinical diagnosis and treatment planning. Due to high annotation costs and strict data privacy regulations, universal models require employing Continual Learning (CL) to adapt to evolving clinical tasks without losing previously acquired knowledge. However, existing CL paradigms often suffer from capacity limits or redundant parameter growth, and even advanced dynamic methods rely mostly on image-perception strategies that struggl
The Structured Output Benchmark: A Multi-Source Benchmark for Evaluating Structured Output Quality in Large Language Models
Large Language Models are increasingly being deployed to extract structured data from unstructured and semi-structured sources: parsing invoices, medical records, and converting PDF documents to database entries. Yet existing benchmarks for structured output generation either focus on schema compliance alone, or evaluate value correctness within a single source domain. We introduce SOB (The Structured Output Benchmark), a multi-source benchmark spanning three source modalities: native text, imag