arXiv subjects

Hersh Sagreiya

Publications and source records attributed to Hersh Sagreiya.

6 recordsLinked to original sources

arXiv2026

ETHOS: Towards a Modular Ethics Framework for Clinical Multi-Agent Systems

The rapid adoption of large language models has enabled the development of clinical multi-agent systems (MAS) capable of integrating multimodal patient data and supporting increasingly complex clinical decision-making. However, the deployment of these systems in real-world healthcare settings raises critical ethical concerns related to safety, fairness, accountability, transparency, and patient trust. While numerous organizations, including the World Health Organization, the National Academy of Medicine, and the FUTURE-AI consortium, have proposed ethical frameworks and governance principles for healthcare AI, these efforts remain largely conceptual. To address this challenge, we present ETHOS (Ethics and Trust through Hierarchical Oversight System), a modular ethics framework designed as a governance meta-agent that can be integrated with any existing multi-agent system without requiring changes to its underlying architecture. ETHOS translates stakeholder-informed ethical requirements into executable runtime oversight through a layered governance approach consisting of deterministic checks, contextual reviews, and a final ethics critic. These components continuously evaluate intermediate reasoning steps and final outputs, enabling the system to identify ethical risks, request revisions, or suppress responses that fail predefined safety and trustworthiness criteria. We demonstrate ETHOS within a hepatology clinical decision-support MAS. Results show that ETHOS improves decision reliability by detecting incomplete, inconsistent, or out-of-scope evidence and appropriately increasing abstention when safe recommendations cannot be supported. By embedding ethical governance directly into system operation, ETHOS provides a practical and auditable mechanism for transforming high-level AI ethics principles into deployable safeguards.

cs.MA↗

arXiv2024

Evidence Is All You Need: Ordering Imaging Studies via Language Model Alignment with the ACR Appropriateness Criteria

Diagnostic imaging studies are an increasingly important component of the workup and management of acutely presenting patients. However, ordering appropriate imaging studies according to evidence-based medical guidelines is a challenging task with a high degree of variability between healthcare providers. To address this issue, recent work has investigated if generative AI and large language models can be leveraged to help clinicians order relevant imaging studies for patients. However, it is challenging to ensure that these tools are correctly aligned with medical guidelines, such as the American College of Radiology's Appropriateness Criteria (ACR AC). In this study, we introduce a framework to intelligently leverage language models by recommending imaging studies for patient cases that are aligned with evidence-based guidelines. We make available a novel dataset of patient "one-liner" scenarios to power our experiments, and optimize state-of-the-art language models to achieve an accuracy on par with clinicians in image ordering. Finally, we demonstrate that our language model-based pipeline can be used as intelligent assistants by clinicians to support image ordering workflows and improve the accuracy of imaging study ordering according to the ACR AC. Our work demonstrates and validates a strategy to leverage AI-based software to improve trustworthy clinical decision making in alignment with expert evidence-based guidelines.

cs.LG↗

arXiv2024

Machine learning-based algorithms for at-home respiratory disease monitoring and respiratory assessment

Respiratory diseases impose a significant burden on global health, with current diagnostic and management practices primarily reliant on specialist clinical testing. This work aims to develop machine learning-based algorithms to facilitate at-home respiratory disease monitoring and assessment for patients undergoing continuous positive airway pressure (CPAP) therapy. Data were collected from 30 healthy adults, encompassing respiratory pressure, flow, and dynamic thoraco-abdominal circumferential measurements under three breathing conditions: normal, panting, and deep breathing. Various machine learning models, including the random forest classifier, logistic regression, and support vector machine (SVM), were trained to predict breathing types. The random forest classifier demonstrated the highest accuracy, particularly when incorporating breathing rate as a feature. These findings support the potential of AI-driven respiratory monitoring systems to transition respiratory assessments from clinical settings to home environments, enhancing accessibility and patient autonomy. Future work involves validating these models with larger, more diverse populations and exploring additional machine learning techniques.

cs.LG↗

arXiv2024

CopilotCAD: Empowering Radiologists with Report Completion Models and Quantitative Evidence from Medical Image Foundation Models

Computer-aided diagnosis systems hold great promise to aid radiologists and clinicians in radiological clinical practice and enhance diagnostic accuracy and efficiency. However, the conventional systems primarily focus on delivering diagnostic results through text report generation or medical image classification, positioning them as standalone decision-makers rather than helpers and ignoring radiologists' expertise. This study introduces an innovative paradigm to create an assistive co-pilot system for empowering radiologists by leveraging Large Language Models (LLMs) and medical image analysis tools. Specifically, we develop a collaborative framework to integrate LLMs and quantitative medical image analysis results generated by foundation models with radiologists in the loop, achieving efficient and safe generation of radiology reports and effective utilization of computational power of AI and the expertise of medical professionals. This approach empowers radiologists to generate more precise and detailed diagnostic reports, enhancing patient outcomes while reducing the burnout of clinicians. Our methodology underscores the potential of AI as a supportive tool in medical diagnostics, promoting a harmonious integration of technology and human expertise to advance the field of radiology.

cs.CV↗

arXiv2023

SynthA1c: Towards Clinically Interpretable Patient Representations for Diabetes Risk Stratification

Early diagnosis of Type 2 Diabetes Mellitus (T2DM) is crucial to enable timely therapeutic interventions and lifestyle modifications. As the time available for clinical office visits shortens and medical imaging data become more widely available, patient image data could be used to opportunistically identify patients for additional T2DM diagnostic workup by physicians. We investigated whether image-derived phenotypic data could be leveraged in tabular learning classifier models to predict T2DM risk in an automated fashion to flag high-risk patients without the need for additional blood laboratory measurements. In contrast to traditional binary classifiers, we leverage neural networks and decision tree models to represent patient data as 'SynthA1c' latent variables, which mimic blood hemoglobin A1c empirical lab measurements, that achieve sensitivities as high as 87.6%. To evaluate how SynthA1c models may generalize to other patient populations, we introduce a novel generalizable metric that uses vanilla data augmentation techniques to predict model performance on input out-of-domain covariates. We show that image-derived phenotypes and physical examination data together can accurately predict diabetes risk as a means of opportunistic risk stratification enabled by artificial intelligence and medical imaging. Our code is available at https://github.com/allisonjchae/DMT2RiskAssessment.

cs.LG↗

arXiv2019

Cross-Modal Data Programming Enables Rapid Medical Machine Learning

Labeling training datasets has become a key barrier to building medical machine learning models. One strategy is to generate training labels programmatically, for example by applying natural language processing pipelines to text reports associated with imaging studies. We propose cross-modal data programming, which generalizes this intuitive strategy in a theoretically-grounded way that enables simpler, clinician-driven input, reduces required labeling time, and improves with additional unlabeled data. In this approach, clinicians generate training labels for models defined over a target modality (e.g. images or time series) by writing rules over an auxiliary modality (e.g. text reports). The resulting technical challenge consists of estimating the accuracies and correlations of these rules; we extend a recent unsupervised generative modeling technique to handle this cross-modal setting in a provably consistent way. Across four applications in radiography, computed tomography, and electroencephalography, and using only several hours of clinician time, our approach matches or exceeds the efficacy of physician-months of hand-labeling with statistical significance, demonstrating a fundamentally faster and more flexible way of building machine learning models in medicine.

cs.LG↗