arXiv subjects

Benjamin Glicksberg

Publications and source records attributed to Benjamin Glicksberg.

5 recordsLinked to original sources

arXiv2025

A global log for medical AI

Modern computer systems rely on syslog, a universal protocol that records critical events across heterogeneous infrastructure. Medicine's rapidly growing AI stack has no equivalent. As medicine deploys AI tools at scale, there is no standard way to record how, when, by whom, and for whom these models are used. Without such records, it is difficult to measure real-world performance and outcomes, detect adverse events, or identify bias and dataset drift. Here we introduce MedLog, a protocol for event-level logging of medical AI. Each time an AI model interacts with a human, another algorithm, or an automated workflow, MedLog creates a record. Each record contains nine core fields: header, model, user, target, inputs, artifacts, outputs, outcomes, and feedback. We apply MedLog across four deployments in the US, Switzerland, and Vietnam: ICU deterioration prediction, tetanus progression monitoring from wearable signals, automated sepsis quality reporting, and patient attendance prediction. MedLog records capture model behavior, workflow interactions, and downstream outcomes, including AI performance degradation during severe weather events in patient attendance prediction and increased laboratory testing after ICU deterioration alerts. MedLog limits the data footprint through risk-based sampling, lifecycle-aware retention policies, and write-behind caching, enabling deployment in low-resource settings. It also supports detailed traces for complex, agentic, or multi-stage workflows, creating a foundation for continuous monitoring, auditing, and improvement of medical AI.

cs.AI↗

arXiv2024

Natural Language Programming in Medicine: Administering Evidence Based Clinical Workflows with Autonomous Agents Powered by Generative Large Language Models

Generative Large Language Models (LLMs) hold significant promise in healthcare, demonstrating capabilities such as passing medical licensing exams and providing clinical knowledge. However, their current use as information retrieval tools is limited by challenges like data staleness, resource demands, and occasional generation of incorrect information. This study assessed the potential of LLMs to function as autonomous agents in a simulated tertiary care medical center, using real-world clinical cases across multiple specialties. Both proprietary and open-source LLMs were evaluated, with Retrieval Augmented Generation (RAG) enhancing contextual relevance. Proprietary models, particularly GPT-4, generally outperformed open-source models, showing improved guideline adherence and more accurate responses with RAG. The manual evaluation by expert clinicians was crucial in validating models' outputs, underscoring the importance of human oversight in LLM operation. Further, the study emphasizes Natural Language Programming (NLP) as the appropriate paradigm for modifying model behavior, allowing for precise adjustments through tailored prompts and real-world interactions. This approach highlights the potential of LLMs to significantly enhance and supplement clinical decision-making, while also emphasizing the value of continuous expert involvement and the flexibility of NLP to ensure their reliability and effectiveness in healthcare settings.

cs.AI↗

arXiv2022

HeartBEiT: Vision Transformer for Electrocardiogram Data Improves Diagnostic Performance at Low Sample Sizes

The electrocardiogram (ECG) is a ubiquitous diagnostic modality. Convolutional neural networks (CNNs) applied towards ECG analysis require large sample sizes, and transfer learning approaches result in suboptimal performance when pre-training is done on natural images. We leveraged masked image modeling to create the first vision-based transformer model, HeartBEiT, for electrocardiogram waveform analysis. We pre-trained this model on 8.5 million ECGs and then compared performance vs. standard CNN architectures for diagnosis of hypertrophic cardiomyopathy, low left ventricular ejection fraction and ST elevation myocardial infarction using differing training sample sizes and independent validation datasets. We show that HeartBEiT has significantly higher performance at lower sample sizes compared to other models. Finally, we also show that HeartBEiT improves explainability of diagnosis by highlighting biologically relevant regions of the EKG vs. standard CNNs. Thus, we present the first vision-based waveform transformer that can be used to develop specialized models for ECG analysis especially at low sample sizes.

eess.SP↗

arXiv2022

Knowledge-Augmented Contrastive Learning for Abnormality Classification and Localization in Chest X-rays with Radiomics using a Feedback Loop

Building a highly accurate predictive model for classification and localization of abnormalities in chest X-rays usually requires a large number of manually annotated labels and pixel regions (bounding boxes) of abnormalities. However, it is expensive to acquire such annotations, especially the bounding boxes. Recently, contrastive learning has shown strong promise in leveraging unlabeled natural images to produce highly generalizable and discriminative features. However, extending its power to the medical image domain is under-explored and highly non-trivial, since medical images are much less amendable to data augmentations. In contrast, their prior knowledge, as well as radiomic features, is often crucial. To bridge this gap, we propose an end-to-end semi-supervised knowledge-augmented contrastive learning framework, that simultaneously performs disease classification and localization tasks. The key knob of our framework is a unique positive sampling approach tailored for the medical images, by seamlessly integrating radiomic features as a knowledge augmentation. Specifically, we first apply an image encoder to classify the chest X-rays and to generate the image features. We next leverage Grad-CAM to highlight the crucial (abnormal) regions for chest X-rays (even when unannotated), from which we extract radiomic features. The radiomic features are then passed through another dedicated encoder to act as the positive sample for the image features generated from the same chest X-ray. In this way, our framework constitutes a feedback loop for image and radiomic modality features to mutually reinforce each other. Their contrasting yields knowledge-augmented representations that are both robust and interpretable. Extensive experiments on the NIH Chest X-ray dataset demonstrate that our approach outperforms existing baselines in both classification and localization tasks.

cs.CV↗

arXiv2018

Processing of Electronic Health Records using Deep Learning: A review

Availability of large amount of clinical data is opening up new research avenues in a number of fields. An exciting field in this respect is healthcare, where secondary use of healthcare data is beginning to revolutionize healthcare. Except for availability of Big Data, both medical data from healthcare institutions (such as EMR data) and data generated from health and wellbeing devices (such as personal trackers), a significant contribution to this trend is also being made by recent advances on machine learning, specifically deep learning algorithms.

cs.CY↗