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Ashley Alexander

Publications and source records attributed to Ashley Alexander.

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HealthBench Professional: Evaluating Large Language Models on Real Clinician Chats

Millions of clinicians use ChatGPT to support clinical care, but evaluations of the most common use cases in model-clinician conversations are limited. We introduce HealthBench Professional, an open benchmark for evaluating large language models on real tasks that clinicians bring to ChatGPT in the course of their work. The benchmark is organized around three common use cases central to clinical practice: care consult, writing and documentation, and medical research. Each example includes a physician-authored conversation with ChatGPT for Clinicians and is scored via rubrics written and iteratively adjudicated by three or more physicians across three phases. HealthBench Professional examples were carefully selected for quality, representativeness, and difficulty for OpenAI's current frontier models, to enable continued measurement of progress. Difficult examples for recent OpenAI models were enriched by roughly 3.5 times relative to the candidate pool of 15,079 examples. Additionally, about one-third of examples involve physicians conducting deliberate adversarial testing of models. As a strong baseline, we also collected human physician responses for all tasks (unbounded time, specialist-matched, web access). The best scoring system, GPT-5.4 in ChatGPT for Clinicians, outperforms base GPT-5.4, all other models, and human physicians. We hope HealthBench Professional provides the healthcare AI community a measure to track frontier model progress in real-world clinical tasks and build systems that clinicians can trust to improve care.

cs.CL

Developing Performance-Guaranteed Biomarker Combination Rules with Integrated External Information under Practical Constraint

In clinical practice, there is significant interest in integrating novel biomarkers with existing clinical data to construct interpretable and robust decision rules. Motivated by the need to improve decision-making for early disease detection, we propose a framework for developing an optimal biomarker-based clinical decision rule that is both clinically meaningful and practically feasible. Specifically, our procedure constructs a linear decision rule designed to achieve optimal performance among class of linear rules by maximizing the true positive rate while adhering to a pre-specified positive predictive value constraint. Additionally, our method can adaptively incorporate individual risk information from external source to enhance performance when such information is beneficial. We establish the asymptotic properties of our proposed estimator and compare to the standard approach used in practice through extensive simulation studies. Results indicate that our approach offers strong finite-sample performance. We also apply the proposed methods to develop biomarker-based screening rules for pancreatic ductal adenocarcinoma (PDAC) among new-onset diabetes (NOD) patients.

stat.ME