arXiv subjects

Fenglin Liu

Publications and source records attributed to Fenglin Liu.

At least 37 records · Page 2Linked to original sources

arXiv2025

Large Language Models in Mental Health Care: a Scoping Review

Objectieve:This review aims to deliver a comprehensive analysis of Large Language Models (LLMs) utilization in mental health care, evaluating their effectiveness, identifying challenges, and exploring their potential for future application. Materials and Methods: A systematic search was performed across multiple databases including PubMed, Web of Science, Google Scholar, arXiv, medRxiv, and PsyArXiv in November 2023. The review includes all types of original research, regardless of peer-review status, published or disseminated between October 1, 2019, and December 2, 2023. Studies were included without language restrictions if they employed LLMs developed after T5 and directly investigated research questions within mental health care settings. Results: Out of an initial 313 articles, 34 were selected based on their relevance to LLMs applications in mental health care and the rigor of their reported outcomes. The review identified various LLMs applications in mental health care, including diagnostics, therapy, and enhancing patient engagement. Key challenges highlighted were related to data availability and reliability, the nuanced handling of mental states, and effective evaluation methods. While LLMs showed promise in improving accuracy and accessibility, significant gaps in clinical applicability and ethical considerations were noted. Conclusion: LLMs hold substantial promise for enhancing mental health care. For their full potential to be realized, emphasis must be placed on developing robust datasets, development and evaluation frameworks, ethical guidelines, and interdisciplinary collaborations to address current limitations.

cs.CL↗

arXiv2025

Sensing Cardiac Health Across Scenarios and Devices: A Multi-Modal Foundation Model Pretrained on Heterogeneous Data from 1.7 Million Individuals

Cardiac biosignals, such as electrocardiograms (ECG) and photoplethysmograms (PPG), are of paramount importance for the diagnosis, prevention, and management of cardiovascular diseases, and have been extensively used in a variety of clinical tasks. Conventional deep learning approaches for analyzing these signals typically rely on homogeneous datasets and static bespoke models, limiting their robustness and generalizability across diverse clinical settings and acquisition protocols. In this study, we present a cardiac sensing foundation model (CSFM) that leverages advanced transformer architectures and a generative, masked pretraining strategy to learn unified representations from vast, heterogeneous health records. Our model is pretrained on an innovative multi-modal integration of data from multiple large-scale datasets (including MIMIC-III-WDB, MIMIC-IV-ECG, and CODE), comprising cardiac signals and the corresponding clinical or machine-generated text reports from approximately 1.7 million individuals. We demonstrate that the embeddings derived from our CSFM not only serve as effective feature extractors across diverse cardiac sensing scenarios, but also enable seamless transfer learning across varying input configurations and sensor modalities. Extensive evaluations across diagnostic tasks, demographic information recognition, vital sign measurement, clinical outcome prediction, and ECG question answering reveal that CSFM consistently outperforms traditional one-modal-one-task approaches. Notably, CSFM exhibits robust performance across multiple ECG lead configurations from standard 12-lead systems to single-lead setups, and in scenarios where only ECG, only PPG, or a combination thereof is available. These findings highlight the potential of CSFM as a versatile and scalable solution, for comprehensive cardiac monitoring.

cs.LG↗

arXiv2025

MedVLM-R1: Incentivizing Medical Reasoning Capability of Vision-Language Models (VLMs) via Reinforcement Learning

Reasoning is a critical frontier for advancing medical image analysis, where transparency and trustworthiness play a central role in both clinician trust and regulatory approval. Although Medical Visual Language Models (VLMs) show promise for radiological tasks, most existing VLMs merely produce final answers without revealing the underlying reasoning. To address this gap, we introduce MedVLM-R1, a medical VLM that explicitly generates natural language reasoning to enhance transparency and trustworthiness. Instead of relying on supervised fine-tuning (SFT), which often suffers from overfitting to training distributions and fails to foster genuine reasoning, MedVLM-R1 employs a reinforcement learning framework that incentivizes the model to discover human-interpretable reasoning paths without using any reasoning references. Despite limited training data (600 visual question answering samples) and model parameters (2B), MedVLM-R1 boosts accuracy from 55.11% to 78.22% across MRI, CT, and X-ray benchmarks, outperforming larger models trained on over a million samples. It also demonstrates robust domain generalization under out-of-distribution tasks. By unifying medical image analysis with explicit reasoning, MedVLM-R1 marks a pivotal step toward trustworthy and interpretable AI in clinical practice. Inference model is available at: https://huggingface.co/JZPeterPan/MedVLM-R1.

cs.CV↗

arXiv2024

Large Language Models in the Clinic: A Comprehensive Benchmark

The adoption of large language models (LLMs) to assist clinicians has attracted remarkable attention. Existing works mainly adopt the close-ended question-answering (QA) task with answer options for evaluation. However, many clinical decisions involve answering open-ended questions without pre-set options. To better understand LLMs in the clinic, we construct a benchmark ClinicBench. We first collect eleven existing datasets covering diverse clinical language generation, understanding, and reasoning tasks. Furthermore, we construct six novel datasets and clinical tasks that are complex but common in real-world practice, e.g., open-ended decision-making, long document processing, and emerging drug analysis. We conduct an extensive evaluation of twenty-two LLMs under both zero-shot and few-shot settings. Finally, we invite medical experts to evaluate the clinical usefulness of LLMs. The benchmark data is available at https://github.com/AI-in-Health/ClinicBench.

cs.CL↗

arXiv2024

Mine yOur owN Anatomy: Revisiting Medical Image Segmentation with Extremely Limited Labels

Recent studies on contrastive learning have achieved remarkable performance solely by leveraging few labels in the context of medical image segmentation. Existing methods mainly focus on instance discrimination and invariant mapping. However, they face three common pitfalls: (1) tailness: medical image data usually follows an implicit long-tail class distribution. Blindly leveraging all pixels in training hence can lead to the data imbalance issues, and cause deteriorated performance; (2) consistency: it remains unclear whether a segmentation model has learned meaningful and yet consistent anatomical features due to the intra-class variations between different anatomical features; and (3) diversity: the intra-slice correlations within the entire dataset have received significantly less attention. This motivates us to seek a principled approach for strategically making use of the dataset itself to discover similar yet distinct samples from different anatomical views. In this paper, we introduce a novel semi-supervised 2D medical image segmentation framework termed Mine yOur owN Anatomy (MONA), and make three contributions. First, prior work argues that every pixel equally matters to the model training; we observe empirically that this alone is unlikely to define meaningful anatomical features, mainly due to lacking the supervision signal. We show two simple solutions towards learning invariances - through the use of stronger data augmentations and nearest neighbors. Second, we construct a set of objectives that encourage the model to be capable of decomposing medical images into a collection of anatomical features in an unsupervised manner. Lastly, we both empirically and theoretically, demonstrate the efficacy of our MONA on three benchmark datasets with different labeled settings, achieving new state-of-the-art under different labeled semi-supervised settings.

eess.IV↗

arXiv2024

SLaVA-CXR: Small Language and Vision Assistant for Chest X-ray Report Automation

Inspired by the success of large language models (LLMs), there is growing research interest in developing LLMs in the medical domain to assist clinicians. However, for hospitals, using closed-source commercial LLMs involves privacy issues, and developing open-source public LLMs requires large-scale computational resources, which are usually limited, especially in resource-efficient regions and low-income countries. We propose an open-source Small Language and Vision Assistant (SLaVA-CXR) that can be used for Chest X-Ray report automation. To efficiently train a small assistant, we first propose the Re$^3$Training method, which simulates the cognitive development of radiologists and optimizes the model in the Recognition, Reasoning, and Reporting training manner. Then, we introduce a data synthesis method, RADEX, which can generate a high-quality and diverse training corpus with privacy regulation compliance. The extensive experiments show that our SLaVA-CXR built on a 2.7B backbone not only outperforms but also achieves 6 times faster inference efficiency than previous state-of-the-art larger models.

cs.LG↗

arXiv2024

Applying and Evaluating Large Language Models in Mental Health Care: A Scoping Review of Human-Assessed Generative Tasks

Large language models (LLMs) are emerging as promising tools for mental health care, offering scalable support through their ability to generate human-like responses. However, the effectiveness of these models in clinical settings remains unclear. This scoping review aimed to assess the current generative applications of LLMs in mental health care, focusing on studies where these models were tested with human participants in real-world scenarios. A systematic search across APA PsycNet, Scopus, PubMed, and Web of Science identified 726 unique articles, of which 17 met the inclusion criteria. These studies encompassed applications such as clinical assistance, counseling, therapy, and emotional support. However, the evaluation methods were often non-standardized, with most studies relying on ad hoc scales that limit comparability and robustness. Privacy, safety, and fairness were also frequently underexplored. Moreover, reliance on proprietary models, such as OpenAI's GPT series, raises concerns about transparency and reproducibility. While LLMs show potential in expanding mental health care access, especially in underserved areas, the current evidence does not fully support their use as standalone interventions. More rigorous, standardized evaluations and ethical oversight are needed to ensure these tools can be safely and effectively integrated into clinical practice.

cs.AI↗

arXiv2024

A Survey of Large Language Models in Medicine: Progress, Application, and Challenge

Large language models (LLMs), such as ChatGPT, have received substantial attention due to their capabilities for understanding and generating human language. While there has been a burgeoning trend in research focusing on the employment of LLMs in supporting different medical tasks (e.g., enhancing clinical diagnostics and providing medical education), a review of these efforts, particularly their development, practical applications, and outcomes in medicine, remains scarce. Therefore, this review aims to provide a detailed overview of the development and deployment of LLMs in medicine, including the challenges and opportunities they face. In terms of development, we provide a detailed introduction to the principles of existing medical LLMs, including their basic model structures, number of parameters, and sources and scales of data used for model development. It serves as a guide for practitioners in developing medical LLMs tailored to their specific needs. In terms of deployment, we offer a comparison of the performance of different LLMs across various medical tasks, and further compare them with state-of-the-art lightweight models, aiming to provide an understanding of the advantages and limitations of LLMs in medicine. Overall, in this review, we address the following questions: 1) What are the practices for developing medical LLMs 2) How to measure the medical task performance of LLMs in a medical setting? 3) How have medical LLMs been employed in real-world practice? 4) What challenges arise from the use of medical LLMs? and 5) How to more effectively develop and deploy medical LLMs? By answering these questions, this review aims to provide insights into the opportunities for LLMs in medicine and serve as a practical resource. We also maintain a regularly updated list of practical guides on medical LLMs at https://github.com/AI-in-Health/MedLLMsPracticalGuide

cs.CL↗

arXiv2024

Retrieval-Augmented and Knowledge-Grounded Language Models for Faithful Clinical Medicine

Language models (LMs), including large language models (such as ChatGPT), have the potential to assist clinicians in generating various clinical notes. However, LMs are prone to produce ``hallucinations'', i.e., generated content that is not aligned with facts and knowledge. In this paper, we propose the Re$^3$Writer method with retrieval-augmented generation and knowledge-grounded reasoning to enable LMs to generate faithful clinical texts. We demonstrate the effectiveness of our method in generating patient discharge instructions. It requires the LMs not to only understand the patients' long clinical documents, i.e., the health records during hospitalization, but also to generate critical instructional information provided both to carers and to the patient at the time of discharge. The proposed Re$^3$Writer imitates the working patterns of physicians to first \textbf{re}trieve related working experience from historical instructions written by physicians, then \textbf{re}ason related medical knowledge. Finally, it \textbf{re}fines the retrieved working experience and reasoned medical knowledge to extract useful information, which is used to generate the discharge instructions for previously-unseen patients. Our experiments show that, using our method, the performance of five representative LMs can be substantially boosted across all metrics. Meanwhile, we show results from human evaluations to measure the effectiveness in terms of fluency, faithfulness, and comprehensiveness.

cs.CL↗

arXiv2024

MedVH: Towards Systematic Evaluation of Hallucination for Large Vision Language Models in the Medical Context

Large Vision Language Models (LVLMs) have recently achieved superior performance in various tasks on natural image and text data, which inspires a large amount of studies for LVLMs fine-tuning and training. Despite their advancements, there has been scant research on the robustness of these models against hallucination when fine-tuned on smaller datasets. In this study, we introduce a new benchmark dataset, the Medical Visual Hallucination Test (MedVH), to evaluate the hallucination of domain-specific LVLMs. MedVH comprises five tasks to evaluate hallucinations in LVLMs within the medical context, which includes tasks for comprehensive understanding of textual and visual input, as well as long textual response generation. Our extensive experiments with both general and medical LVLMs reveal that, although medical LVLMs demonstrate promising performance on standard medical tasks, they are particularly susceptible to hallucinations, often more so than the general models, raising significant concerns about the reliability of these domain-specific models. For medical LVLMs to be truly valuable in real-world applications, they must not only accurately integrate medical knowledge but also maintain robust reasoning abilities to prevent hallucination. Our work paves the way for future evaluations of these studies.

cs.CV↗

arXiv2024

ZeroNLG: Aligning and Autoencoding Domains for Zero-Shot Multimodal and Multilingual Natural Language Generation

Natural Language Generation (NLG) accepts input data in the form of images, videos, or text and generates corresponding natural language text as output. Existing NLG methods mainly adopt a supervised approach and rely heavily on coupled data-to-text pairs. However, for many targeted scenarios and for non-English languages, sufficient quantities of labeled data are often not available. To relax the dependency on labeled data of downstream tasks, we propose an intuitive and effective zero-shot learning framework, ZeroNLG, which can deal with multiple NLG tasks, including image-to-text (image captioning), video-to-text (video captioning), and text-to-text (neural machine translation), across English, Chinese, German, and French within a unified framework. ZeroNLG does not require any labeled downstream pairs for training. During training, ZeroNLG (i) projects different domains (across modalities and languages) to corresponding coordinates in a shared common latent space; (ii) bridges different domains by aligning their corresponding coordinates in this space; and (iii) builds an unsupervised multilingual auto-encoder to learn to generate text by reconstructing the input text given its coordinate in shared latent space. Consequently, during inference, based on the data-to-text pipeline, ZeroNLG can generate target sentences across different languages given the coordinate of input data in the common space. Within this unified framework, given visual (imaging or video) data as input, ZeroNLG can perform zero-shot visual captioning; given textual sentences as input, ZeroNLG can perform zero-shot machine translation. We present the results of extensive experiments on twelve NLG tasks, showing that, without using any labeled downstream pairs for training, ZeroNLG generates high-quality and believable outputs and significantly outperforms existing zero-shot methods.

cs.CL↗

arXiv2024

DTR-Bench: An in silico Environment and Benchmark Platform for Reinforcement Learning Based Dynamic Treatment Regime

Reinforcement learning (RL) has garnered increasing recognition for its potential to optimise dynamic treatment regimes (DTRs) in personalised medicine, particularly for drug dosage prescriptions and medication recommendations. However, a significant challenge persists: the absence of a unified framework for simulating diverse healthcare scenarios and a comprehensive analysis to benchmark the effectiveness of RL algorithms within these contexts. To address this gap, we introduce \textit{DTR-Bench}, a benchmarking platform comprising four distinct simulation environments tailored to common DTR applications, including cancer chemotherapy, radiotherapy, glucose management in diabetes, and sepsis treatment. We evaluate various state-of-the-art RL algorithms across these settings, particularly highlighting their performance amidst real-world challenges such as pharmacokinetic/pharmacodynamic (PK/PD) variability, noise, and missing data. Our experiments reveal varying degrees of performance degradation among RL algorithms in the presence of noise and patient variability, with some algorithms failing to converge. Additionally, we observe that using temporal observation representations does not consistently lead to improved performance in DTR settings. Our findings underscore the necessity of developing robust, adaptive RL algorithms capable of effectively managing these complexities to enhance patient-specific healthcare. We have open-sourced our benchmark and code at https://github.com/GilesLuo/DTR-Bench.

cs.LG↗

arXiv2024

Inquire, Interact, and Integrate: A Proactive Agent Collaborative Framework for Zero-Shot Multimodal Medical Reasoning

The adoption of large language models (LLMs) in healthcare has attracted significant research interest. However, their performance in healthcare remains under-investigated and potentially limited, due to i) they lack rich domain-specific knowledge and medical reasoning skills; and ii) most state-of-the-art LLMs are unimodal, text-only models that cannot directly process multimodal inputs. To this end, we propose a multimodal medical collaborative reasoning framework \textbf{MultiMedRes}, which incorporates a learner agent to proactively gain essential information from domain-specific expert models, to solve medical multimodal reasoning problems. Our method includes three steps: i) \textbf{Inquire}: The learner agent first decomposes given complex medical reasoning problems into multiple domain-specific sub-problems; ii) \textbf{Interact}: The agent then interacts with domain-specific expert models by repeating the ``ask-answer'' process to progressively obtain different domain-specific knowledge; iii) \textbf{Integrate}: The agent finally integrates all the acquired domain-specific knowledge to accurately address the medical reasoning problem. We validate the effectiveness of our method on the task of difference visual question answering for X-ray images. The experiments demonstrate that our zero-shot prediction achieves state-of-the-art performance, and even outperforms the fully supervised methods. Besides, our approach can be incorporated into various LLMs and multimodal LLMs to significantly boost their performance.

cs.AI↗

arXiv2024

Qilin-Med: Multi-stage Knowledge Injection Advanced Medical Large Language Model

Integrating large language models (LLMs) into healthcare holds great potential but faces challenges. Pre-training LLMs from scratch for domains like medicine is resource-heavy and often unfeasible. On the other hand, sole reliance on Supervised Fine-tuning (SFT) can result in overconfident predictions and may not tap into domain-specific insights. In response, we present a multi-stage training method combining Domain-specific Continued Pre-training (DCPT), SFT, and Direct Preference Optimization (DPO). In addition, we publish a 3Gb Chinese Medicine (ChiMed) dataset, encompassing medical question answering, plain texts, knowledge graphs, and dialogues, segmented into three training stages. The medical LLM trained with our pipeline, Qilin-Med, shows substantial performance improvement. In the CPT and SFT phases, Qilin-Med achieved 38.4% and 40.0% accuracy on the CMExam test set, respectively. It outperformed the basemodel Baichuan-7B (accuracy: 33.5%), by 7.5%. In the DPO phase, it scored 16.66 in BLEU-1 and 27.44 in ROUGE-1 on the Huatuo-26M test set, bringing further improvement to the SFT phase (12.69 in BLEU-1 and 24.21 in ROUGE-1). Additionally, we have further enhanced the model's performance through the Retrieval Augmented Generation (RAG) approach. Experiments demonstrate that Qilin-Med-RAG achieves an accuracy rate of 42.8% on CMExam. These results highlight the contribution of our novel training approach in building LLMs for medical applications.

cs.CL↗

arXiv2023

Rethinking Semi-Supervised Medical Image Segmentation: A Variance-Reduction Perspective

For medical image segmentation, contrastive learning is the dominant practice to improve the quality of visual representations by contrasting semantically similar and dissimilar pairs of samples. This is enabled by the observation that without accessing ground truth labels, negative examples with truly dissimilar anatomical features, if sampled, can significantly improve the performance. In reality, however, these samples may come from similar anatomical regions and the models may struggle to distinguish the minority tail-class samples, making the tail classes more prone to misclassification, both of which typically lead to model collapse. In this paper, we propose ARCO, a semi-supervised contrastive learning (CL) framework with stratified group theory for medical image segmentation. In particular, we first propose building ARCO through the concept of variance-reduced estimation and show that certain variance-reduction techniques are particularly beneficial in pixel/voxel-level segmentation tasks with extremely limited labels. Furthermore, we theoretically prove these sampling techniques are universal in variance reduction. Finally, we experimentally validate our approaches on eight benchmarks, i.e., five 2D/3D medical and three semantic segmentation datasets, with different label settings, and our methods consistently outperform state-of-the-art semi-supervised methods. Additionally, we augment the CL frameworks with these sampling techniques and demonstrate significant gains over previous methods. We believe our work is an important step towards semi-supervised medical image segmentation by quantifying the limitation of current self-supervision objectives for accomplishing such challenging safety-critical tasks.

cs.CV↗

arXiv2023

BPF Algorithms for Multiple Source-Translation Computed Tomography Reconstruction

Micro-computed tomography (micro-CT) is a widely used state-of-the-art instrument employed to study the morphological structures of objects in various fields. However, its small field-of-view (FOV) cannot meet the pressing demand for imaging relatively large objects at high spatial resolutions. Recently, we devised a novel scanning mode called multiple source translation CT (mSTCT) that effectively enlarges the FOV of the micro-CT and correspondingly developed a virtual projection-based filtered backprojection (V-FBP) algorithm for reconstruction. Although V-FBP skillfully solves the truncation problem in mSTCT, it requires densely sampled projections to arrive at high-resolution reconstruction, which reduces imaging efficiency. In this paper, we developed two backprojection-filtration (BPF)-based algorithms for mSTCT, i.e., S-BPF (derivatives along source) and D-BPF (derivatives along detector). D-BPF can achieve high-resolution reconstruction with fewer projections than V-FBP and S-BPF. Through simulated and real experiments conducted in this paper, we demonstrate that D-BPF can reduce source sampling by 75% compared with V-FBP at the same spatial resolution, which makes mSTCT more feasible in practice. Meanwhile, S-BPF can yield more stable results than D-BPF, which is similar to V-FBP.

cs.CV↗

arXiv2023

OSNet & MNetO: Two Types of General Reconstruction Architectures for Linear Computed Tomography in Multi-Scenarios

Recently, linear computed tomography (LCT) systems have actively attracted attention. To weaken projection truncation and image the region of interest (ROI) for LCT, the backprojection filtration (BPF) algorithm is an effective solution. However, in BPF for LCT, it is difficult to achieve stable interior reconstruction, and for differentiated backprojection (DBP) images of LCT, multiple rotation-finite inversion of Hilbert transform (Hilbert filtering)-inverse rotation operations will blur the image. To satisfy multiple reconstruction scenarios for LCT, including interior ROI, complete object, and exterior region beyond field-of-view (FOV), and avoid the rotation operations of Hilbert filtering, we propose two types of reconstruction architectures. The first overlays multiple DBP images to obtain a complete DBP image, then uses a network to learn the overlying Hilbert filtering function, referred to as the Overlay-Single Network (OSNet). The second uses multiple networks to train different directional Hilbert filtering models for DBP images of multiple linear scannings, respectively, and then overlays the reconstructed results, i.e., Multiple Networks Overlaying (MNetO). In two architectures, we introduce a Swin Transformer (ST) block to the generator of pix2pixGAN to extract both local and global features from DBP images at the same time. We investigate two architectures from different networks, FOV sizes, pixel sizes, number of projections, geometric magnification, and processing time. Experimental results show that two architectures can both recover images. OSNet outperforms BPF in various scenarios. For the different networks, ST-pix2pixGAN is superior to pix2pixGAN and CycleGAN. MNetO exhibits a few artifacts due to the differences among the multiple models, but any one of its models is suitable for imaging the exterior edge in a certain direction.

cs.CV↗

arXiv2023

MultiCapCLIP: Auto-Encoding Prompts for Zero-Shot Multilingual Visual Captioning

Supervised visual captioning models typically require a large scale of images or videos paired with descriptions in a specific language (i.e., the vision-caption pairs) for training. However, collecting and labeling large-scale datasets is time-consuming and expensive for many scenarios and languages. Therefore, sufficient labeled pairs are usually not available. To deal with the label shortage problem, we present a simple yet effective zero-shot approach MultiCapCLIP that can generate visual captions for different scenarios and languages without any labeled vision-caption pairs of downstream datasets. In the training stage, MultiCapCLIP only requires text data for input. Then it conducts two main steps: 1) retrieving concept prompts that preserve the corresponding domain knowledge of new scenarios; 2) auto-encoding the prompts to learn writing styles to output captions in a desired language. In the testing stage, MultiCapCLIP instead takes visual data as input directly to retrieve the concept prompts to generate the final visual descriptions. The extensive experiments on image and video captioning across four benchmarks and four languages (i.e., English, Chinese, German, and French) confirm the effectiveness of our approach. Compared with state-of-the-art zero-shot and weakly-supervised methods, our method achieves 4.8% and 21.5% absolute improvements in terms of BLEU@4 and CIDEr metrics. Our code is available at https://github.com/yangbang18/MultiCapCLIP.

cs.CV↗