Hasil untuk "Medical philosophy. Medical ethics"

Xiaokai Wang, Guiran Liu, Binrong Zhu et al.

This study proposes a medical entity extraction method based on Transformer to enhance the information extraction capability of medical literature. Considering the professionalism and complexity of medical texts, we compare the performance of different pre-trained language models (BERT, BioBERT, PubMedBERT, ClinicalBERT) in medical entity extraction tasks. Experimental results show that PubMedBERT achieves the best performance (F1-score = 88.8%), indicating that a language model pre-trained on biomedical literature is more effective in the medical domain. In addition, we analyze the impact of different entity extraction methods (CRF, Span-based, Seq2Seq) and find that the Span-based approach performs best in medical entity extraction tasks (F1-score = 88.6%). It demonstrates superior accuracy in identifying entity boundaries. In low-resource scenarios, we further explore the application of Few-shot Learning in medical entity extraction. Experimental results show that even with only 10-shot training samples, the model achieves an F1-score of 79.1%, verifying the effectiveness of Few-shot Learning under limited data conditions. This study confirms that the combination of pre-trained language models and Few-shot Learning can enhance the accuracy of medical entity extraction. Future research can integrate knowledge graphs and active learning strategies to improve the model's generalization and stability, providing a more effective solution for medical NLP research. Keywords- Natural Language Processing, medical named entity recognition, pre-trained language model, Few-shot Learning, information extraction, deep learning

Pittawat Taveekitworachai, Natpatchara Pongjirapat, Krittaphas Chaisutyakorn et al.

Medical reasoning models (MRMs) achieve superior performance on medical benchmarks compared to medical LLMs; however, high accuracy alone is insufficient for practical deployment. One of such requirements for real-world application is robustness to varying output constraints. Specifically, posing the same medical question while requesting different answer formats should not affect the underlying correctness of the response. We investigate this phenomenon in this paper, focusing on MRMs. To quantify this behavior, we propose the metric answer-format robustness: the ability to reliably generate correct outputs across varying specified formats. We examine three representative formats: multiple-choice, open-ended question-answering, and ranked lists. Across 15 proprietary and open-weight models, we observe substantial variation in format robustness (35-100%). Furthermore, we conduct controlled fine-tuning experiments on a shared backbone with matched training data to isolate the effects of the fine-tuning paradigm. We find that supervised fine-tuning yields more stable behavior across formats, whereas reinforcement fine-tuning often exhibits higher cross-format brittleness, with the degree of instability strongly dependent on reward design. Overall, answer-format robustness in MRMs is trainable yet brittle and requires careful evaluation for practical medical use.

Wisdom O. Ikezogwo, Kevin Zhang, Mehmet Saygin Seyfioglu et al.

Multi-modal models are data hungry. While datasets with natural images are abundant, medical image datasets can not afford the same luxury. To enable representation learning for medical images at scale, we turn to YouTube, a platform with a large reservoir of open-source medical pedagogical videos. We curate MedicalNarratives, a dataset 4.7M medical image-text pairs, with 1M samples containing dense annotations in the form of spatial traces (and bounding boxes), and 118K videos centered on the trace event (with aligned text), enabling spatiotemporal grounding beyond single frames. Similar to $\textit{think-aloud}$ studies where instructors speak while hovering their mouse cursor movements over relevant image regions, 1M images in MedicalNarratives contains localized mouse traces in image pixels, creating a spatial and temporal association between the text and pixels. To evaluate the utility of MedicalNarratives, we train GenMedClip with a CLIP-like objective using our dataset spanning 12 medical domains. GenMedClip outperforms previous state-of-the-art models on all 12 domains on a newly constructed medical imaging benchmark. $\href{https://huggingface.co/datasets/wisdomik/MedicalNarratives}{[Data]}$

Zeyu Liu, Zhitian Hou, Guanghao Zhu et al.

Multimodal Large Language Models (MLLMs) have achieved remarkable progress in domains such as visual understanding and mathematical reasoning. However, their application in the medical domain is constrained by two key challenges: (1) multimodal medical datasets are scarce and often contain sparse information, limiting reasoning depth; and (2) Reinforcement Learning with Verifiable Rewards (RLVR), though effective in general domains, cannot reliably improve model performance in the medical domain. To overcome these challenges, during the supervised fine-tuning (SFT) stage, we incorporate high-quality textual reasoning data and general multimodal data alongside multimodal medical data to efficiently enhance foundational medical capabilities and restore the base model's reasoning ability. Moreover, considering that there are some multimodal medical datasets with sparse information, we further synthesize reflective-pattern-injected chain-of-thought (CoT) in addition to general CoT samples, equipping the model with initial reflective reasoning capabilities that provide a structured foundation for subsequent RLVR training. Finally, we introduce our InfiMed-Series models, InfiMed-SFT-3B and InfiMed-RL-3B, both of which deliver state-of-the-art performance across seven multimodal medical benchmarks. Notably, InfiMed-RL-3B achieves an average accuracy of 59.2%, outperforming even larger models like InternVL3-8B, which achieves 57.3%. Specifically, during the SFT phase, we utilized 188K samples, while the RLVR phase incorporated 36K samples, demonstrating the efficacy of both training strategies in achieving superior performance. We also conducted a series of extensive experiments, which provide valuable insights that contribute to advancing the performance of MLLMs in medical scenarios.

Edwin D. de Jong, Eric Marcus, Jonas Teuwen

Pathology Foundation Models (FMs) hold great promise for healthcare. Before they can be used in clinical practice, it is essential to ensure they are robust to variations between medical centers. We measure whether pathology FMs focus on biological features like tissue and cancer type, or on the well known confounding medical center signatures introduced by staining procedure and other differences. We introduce the Robustness Index. This novel robustness metric reflects to what degree biological features dominate confounding features. Ten current publicly available pathology FMs are evaluated. We find that all current pathology foundation models evaluated represent the medical center to a strong degree. Significant differences in the robustness index are observed. Only one model so far has a robustness index greater than one, meaning biological features dominate confounding features, but only slightly. A quantitative approach to measure the influence of medical center differences on FM-based prediction performance is described. We analyze the impact of unrobustness on classification performance of downstream models, and find that cancer-type classification errors are not random, but specifically attributable to same-center confounders: images of other classes from the same medical center. We visualize FM embedding spaces, and find these are more strongly organized by medical centers than by biological factors. As a consequence, the medical center of origin is predicted more accurately than the tissue source and cancer type. The robustness index introduced here is provided with the aim of advancing progress towards clinical adoption of robust and reliable pathology FMs.

Anwai Archit, Luca Freckmann, Constantin Pape

Medical image segmentation is an important analysis task in clinical practice and research. Deep learning has massively advanced the field, but current approaches are mostly based on models trained for a specific task. Training such models or adapting them to a new condition is costly due to the need for (manually) labeled data. The emergence of vision foundation models, especially Segment Anything, offers a path to universal segmentation for medical images, overcoming these issues. Here, we study how to improve Segment Anything for medical images by comparing different finetuning strategies on a large and diverse dataset. We evaluate the finetuned models on a wide range of interactive and (automatic) semantic segmentation tasks. We find that the performance can be clearly improved for interactive segmentation. However, semantic segmentation does not benefit from pretraining on medical images. Our best model, MedicoSAM, is publicly available at https://github.com/computational-cell-analytics/medico-sam. We show that it is compatible with existing tools for data annotation and believe that it will be of great practical value.

Lei Li, Xiangxu Zhang, Xiao Zhou et al.

Medical information retrieval (MIR) is essential for retrieving relevant medical knowledge from diverse sources, including electronic health records, scientific literature, and medical databases. However, achieving effective zero-shot dense retrieval in the medical domain poses substantial challenges due to the lack of relevance-labeled data. In this paper, we introduce a novel approach called \textbf{S}elf-\textbf{L}earning \textbf{Hy}pothetical \textbf{D}ocument \textbf{E}mbeddings (\textbf{SL-HyDE}) to tackle this issue. SL-HyDE leverages large language models (LLMs) as generators to generate hypothetical documents based on a given query. These generated documents encapsulate key medical context, guiding a dense retriever in identifying the most relevant documents. The self-learning framework progressively refines both pseudo-document generation and retrieval, utilizing unlabeled medical corpora without requiring any relevance-labeled data. Additionally, we present the Chinese Medical Information Retrieval Benchmark (CMIRB), a comprehensive evaluation framework grounded in real-world medical scenarios, encompassing five tasks and ten datasets. By benchmarking ten models on CMIRB, we establish a rigorous standard for evaluating medical information retrieval systems. Experimental results demonstrate that SL-HyDE significantly surpasses HyDE in retrieval accuracy while showcasing strong generalization and scalability across various LLM and retriever configurations. Our code and data are publicly available at: https://github.com/ll0ruc/AutoMIR

Laura Wenderoth

This study explores the potential of using training dynamics as an automated alternative to human annotation for evaluating the quality of training data. The framework used is Data Maps, which classifies data points into categories such as easy-to-learn, hard-to-learn, and ambiguous (Swayamdipta et al., 2020). Swayamdipta et al. (2020) highlight that difficult-to-learn examples often contain errors, and ambiguous cases significantly impact model training. To confirm the reliability of these findings, we replicated the experiments using a challenging dataset, with a focus on medical question answering. In addition to text comprehension, this field requires the acquisition of detailed medical knowledge, which further complicates the task. A comprehensive evaluation was conducted to assess the feasibility and transferability of the Data Maps framework to the medical domain. The evaluation indicates that the framework is unsuitable for addressing datasets' unique challenges in answering medical questions.

Al Amin, Kamrul Hasan, Saleh Zein-Sabatto et al.

Healthcare industries face challenges when experiencing rare diseases due to limited samples. Artificial Intelligence (AI) communities overcome this situation to create synthetic data which is an ethical and privacy issue in the medical domain. This research introduces the CAT-U-Net framework as a new approach to overcome these limitations, which enhances feature extraction from medical images without the need for large datasets. The proposed framework adds an extra concatenation layer with downsampling parts, thereby improving its ability to learn from limited data while maintaining patient privacy. To validate, the proposed framework's robustness, different medical conditioning datasets were utilized including COVID-19, brain tumors, and wrist fractures. The framework achieved nearly 98% reconstruction accuracy, with a Dice coefficient close to 0.946. The proposed CAT-U-Net has the potential to make a big difference in medical image diagnostics in settings with limited data.

Wei-Chien Wang, Euijoon Ahn, Dagan Feng et al.

Over the last decade, supervised deep learning on manually annotated big data has been progressing significantly on computer vision tasks. But the application of deep learning in medical image analysis was limited by the scarcity of high-quality annotated medical imaging data. An emerging solution is self-supervised learning (SSL), among which contrastive SSL is the most successful approach to rivalling or outperforming supervised learning. This review investigates several state-of-the-art contrastive SSL algorithms originally on natural images as well as their adaptations for medical images, and concludes by discussing recent advances, current limitations, and future directions in applying contrastive SSL in the medical domain.

Zhongnuo Yan, Tong Han, Yuhao Huang et al.

Medical image segmentation aims to delineate the anatomical or pathological structures of interest, playing a crucial role in clinical diagnosis. A substantial amount of high-quality annotated data is crucial for constructing high-precision deep segmentation models. However, medical annotation is highly cumbersome and time-consuming, especially for medical videos or 3D volumes, due to the huge labeling space and poor inter-frame consistency. Recently, a fundamental task named Moving Object Segmentation (MOS) has made significant advancements in natural images. Its objective is to delineate moving objects from the background within image sequences, requiring only minimal annotations. In this paper, we propose the first foundation model, named iMOS, for MOS in medical images. Extensive experiments on a large multi-modal medical dataset validate the effectiveness of the proposed iMOS. Specifically, with the annotation of only a small number of images in the sequence, iMOS can achieve satisfactory tracking and segmentation performance of moving objects throughout the entire sequence in bi-directions. We hope that the proposed iMOS can help accelerate the annotation speed of experts, and boost the development of medical foundation models.

Iakes Goenaga, Aitziber Atutxa, Koldo Gojenola et al.

Developing the required technology to assist medical experts in their everyday activities is currently a hot topic in the Artificial Intelligence research field. Thus, a number of large language models (LLMs) and automated benchmarks have recently been proposed with the aim of facilitating information extraction in Evidence-Based Medicine (EBM) using natural language as a tool for mediating in human-AI interaction. The most representative benchmarks are limited to either multiple-choice or long-form answers and are available only in English. In order to address these shortcomings, in this paper we present a new dataset which, unlike previous work: (i) includes not only explanatory arguments for the correct answer, but also arguments to reason why the incorrect answers are not correct; (ii) the explanations are written originally by medical doctors to answer questions from the Spanish Residency Medical Exams. Furthermore, this new benchmark allows us to setup a novel extractive task which consists of identifying the explanation of the correct answer written by medical doctors. An additional benefit of our setting is that we can leverage the extractive QA paradigm to automatically evaluate performance of LLMs without resorting to costly manual evaluation by medical experts. Comprehensive experimentation with language models for Spanish shows that sometimes multilingual models fare better than monolingual ones, even outperforming models which have been adapted to the medical domain. Furthermore, results across the monolingual models are mixed, with supposedly smaller and inferior models performing competitively. In any case, the obtained results show that our novel dataset and approach can be an effective technique to help medical practitioners in identifying relevant evidence-based explanations for medical questions.

Athanasios Vlontzos, Daniel Rueckert, Bernhard Kainz

Medical image analysis is a vibrant research area that offers doctors and medical practitioners invaluable insight and the ability to accurately diagnose and monitor disease. Machine learning provides an additional boost for this area. However, machine learning for medical image analysis is particularly vulnerable to natural biases like domain shifts that affect algorithmic performance and robustness. In this paper we analyze machine learning for medical image analysis within the framework of Technology Readiness Levels and review how causal analysis methods can fill a gap when creating robust and adaptable medical image analysis algorithms. We review methods using causality in medical imaging AI/ML and find that causal analysis has the potential to mitigate critical problems for clinical translation but that uptake and clinical downstream research has been limited so far.

Sicen Liu, Xiaolong Wang, Yang Xiang et al.

Medical event prediction (MEP) is a fundamental task in the medical domain, which needs to predict medical events, including medications, diagnosis codes, laboratory tests, procedures, outcomes, and so on, according to historical medical records. The task is challenging as medical data is a type of complex time series data with heterogeneous and temporal irregular characteristics. Many machine learning methods that consider the two characteristics have been proposed for medical event prediction. However, most of them consider the two characteristics separately and ignore the correlations among different types of medical events, especially relations between historical medical events and target medical events. In this paper, we propose a novel neural network based on attention mechanism, called cross-event attention-based time-aware network (CATNet), for medical event prediction. It is a time-aware, event-aware and task-adaptive method with the following advantages: 1) modeling heterogeneous information and temporal information in a unified way and considering temporal irregular characteristics locally and globally respectively, 2) taking full advantage of correlations among different types of events via cross-event attention. Experiments on two public datasets (MIMIC-III and eICU) show CATNet can be adaptive with different MEP tasks and outperforms other state-of-the-art methods on various MEP tasks. The source code of CATNet will be released after this manuscript is accepted.

Mingjie Li, Fuyu Wang, Xiaojun Chang et al.

Beyond the common difficulties faced in the natural image captioning, medical report generation specifically requires the model to describe a medical image with a fine-grained and semantic-coherence paragraph that should satisfy both medical commonsense and logic. Previous works generally extract the global image features and attempt to generate a paragraph that is similar to referenced reports; however, this approach has two limitations. Firstly, the regions of primary interest to radiologists are usually located in a small area of the global image, meaning that the remainder parts of the image could be considered as irrelevant noise in the training procedure. Secondly, there are many similar sentences used in each medical report to describe the normal regions of the image, which causes serious data bias. This deviation is likely to teach models to generate these inessential sentences on a regular basis. To address these problems, we propose an Auxiliary Signal-Guided Knowledge Encoder-Decoder (ASGK) to mimic radiologists' working patterns. In more detail, ASGK integrates internal visual feature fusion and external medical linguistic information to guide medical knowledge transfer and learning. The core structure of ASGK consists of a medical graph encoder and a natural language decoder, inspired by advanced Generative Pre-Training (GPT). Experiments on the CX-CHR dataset and our COVID-19 CT Report dataset demonstrate that our proposed ASGK is able to generate a robust and accurate report, and moreover outperforms state-of-the-art methods on both medical terminology classification and paragraph generation metrics.

Bas Hulsken

The need for fast diagnostic image viewing in zero footprint web applications and the ever increasing image sizes for new modalities such as digital pathology have painfully brought to light that the currently available image compression methods fall short. JPEG2000 delivers the image quality required for medical grade viewing, but is supported on fewer than 10% of desktop web browsers installed today (caniuse.com) and even then it does not support the high bit depth images required by medical applications. JPEG2000's high computational complexity and inability to do fast compression and viewing of images undoubtedly contributed to its lack of adoption. The venerable JPEG standard is supported in all installed web browsers today, and allows for fast viewing and compression, but it cannot provide medical grade image quality, lossless compression, or high bit depths. To remedy the situation medical image web applications need to take full control of the image path by implementing the image decompression in the application itself, instead of relying on web browser implementations. This will give users and manufacturers the confidence that medical images will be displayed in their full intended fidelity! This paper introduces a simple, fast, yet efficient image compression method that can be implemented in zero footprint web applications to provide fast medical grade image viewing on today's web browser installed base, on the premise and in the cloud. Due to its efficiency it is very suitable for fast and affordable compression and viewing of very large images, and is used as such by Philips in the iSyntax file format in use in its digital pathology products today.

Christy Y. Li, Xiaodan Liang, Zhiting Hu et al.

Generating long and semantic-coherent reports to describe medical images poses great challenges towards bridging visual and linguistic modalities, incorporating medical domain knowledge, and generating realistic and accurate descriptions. We propose a novel Knowledge-driven Encode, Retrieve, Paraphrase (KERP) approach which reconciles traditional knowledge- and retrieval-based methods with modern learning-based methods for accurate and robust medical report generation. Specifically, KERP decomposes medical report generation into explicit medical abnormality graph learning and subsequent natural language modeling. KERP first employs an Encode module that transforms visual features into a structured abnormality graph by incorporating prior medical knowledge; then a Retrieve module that retrieves text templates based on the detected abnormalities; and lastly, a Paraphrase module that rewrites the templates according to specific cases. The core of KERP is a proposed generic implementation unit---Graph Transformer (GTR) that dynamically transforms high-level semantics between graph-structured data of multiple domains such as knowledge graphs, images and sequences. Experiments show that the proposed approach generates structured and robust reports supported with accurate abnormality description and explainable attentive regions, achieving the state-of-the-art results on two medical report benchmarks, with the best medical abnormality and disease classification accuracy and improved human evaluation performance.

Kaylen J. Pfisterer, Jennifer Boger, Alexander Wong

In computer vision research, especially when novel applications of tools are developed, ethical implications around user perceptions of trust in the underlying technology should be considered and supported. Here, we describe an example of the incorporation of such considerations within the long-term care sector for tracking resident food and fluid intake. We highlight our recent user study conducted to develop a Goldilocks quality horizontal prototype designed to support trust cues in which perceived trust in our horizontal prototype was higher than the existing system in place. We discuss the importance and need for user engagement as part of ongoing computer vision-driven technology development and describe several important factors related to trust that are relevant to developing decision-making tools.

Zhiqiang Wang, Pingchuan Ma, Xiaoxiang Zou et al.

Recent years have witnessed a boom of connected medical devices, which brings security issues in the meantime. Medical imaging devices, an essential part of medical cyber-physical systems, play a vital role in modern hospitals and are often life-critical. However, security and privacy issues in these medical cyber-physical systems are sometimes ignored. In this paper, we perform an empirical study on imaging devices to analyse the security of medical cyber-physical systems. To be precise, we design a threat model and propose prospective attack techniques for medical imaging devices. To tackle potential cyber threats, we introduce protection mechanisms, evaluate the effectiveness and efficiency of protection mechanisms as well as its interplay with attack techniques. To scoring security, we design a hierarchical system that provides actionable suggestions for imaging devices in different scenarios. We investigate 15 devices from 9 manufacturers to demonstrate empirical comprehension and real-world security issues.

Xueping Peng, Guodong Long, Tao Shen et al.

In longitudinal electronic health records (EHRs), the event records of a patient are distributed over a long period of time and the temporal relations between the events reflect sufficient domain knowledge to benefit prediction tasks such as the rate of inpatient mortality. Medical concept embedding as a feature extraction method that transforms a set of medical concepts with a specific time stamp into a vector, which will be fed into a supervised learning algorithm. The quality of the embedding significantly determines the learning performance over the medical data. In this paper, we propose a medical concept embedding method based on applying a self-attention mechanism to represent each medical concept. We propose a novel attention mechanism which captures the contextual information and temporal relationships between medical concepts. A light-weight neural net, "Temporal Self-Attention Network (TeSAN)", is then proposed to learn medical concept embedding based solely on the proposed attention mechanism. To test the effectiveness of our proposed methods, we have conducted clustering and prediction tasks on two public EHRs datasets comparing TeSAN against five state-of-the-art embedding methods. The experimental results demonstrate that the proposed TeSAN model is superior to all the compared methods. To the best of our knowledge, this work is the first to exploit temporal self-attentive relations between medical events.