ColaCare: Enhancing Electronic Health Record Modeling through Large Language Model-Driven Multi-Agent Collaboration

We introduce ColaCare, a framework that enhances Electronic Health Record (EHR) modeling through multi-agent collaboration driven by Large Language Models (LLMs). Our approach seamlessly integrates domain-specific expert models with LLMs to bridge the gap between structured EHR data and text-based reasoning. Inspired by clinical consultations, ColaCare employs two types of agents: DoctorAgent and MetaAgent, which collaboratively analyze patient data. Expert models process and generate predictions from numerical EHR data, while LLM agents produce reasoning references and decision-making reports within the collaborative consultation framework. We additionally incorporate the Merck Manual of Diagnosis and Therapy (MSD) medical guideline within a retrieval-augmented generation (RAG) module for authoritative evidence support. Extensive experiments conducted on four distinct EHR datasets demonstrate ColaCare's superior performance in mortality prediction tasks, underscoring its potential to revolutionize clinical decision support systems and advance personalized precision medicine. The code, complete prompt templates, more case studies, etc. are publicly available at the anonymous link: https://colacare.netlify.app.

SuperGS: Super-Resolution 3D Gaussian Splatting via Latent Feature Field and Gradient-guided Splitting

Recently, 3D Gaussian Splatting (3DGS) has exceled in novel view synthesis with its real-time rendering capabilities and superior quality. However, it faces challenges for high-resolution novel view synthesis (HRNVS) due to the coarse nature of primitives derived from low-resolution input views. To address this issue, we propose Super-Resolution 3DGS (SuperGS), which is an expansion of 3DGS designed with a two-stage coarse-to-fine training framework, utilizing pretrained low-resolution scene representation as an initialization for super-resolution optimization. Moreover, we introduce Multi-resolution Feature Gaussian Splatting (MFGS) to incorporates a latent feature field for flexible feature sampling and Gradient-guided Selective Splitting (GSS) for effective Gaussian upsampling. By integrating these strategies within the coarse-to-fine framework ensure both high fidelity and memory efficiency. Extensive experiments demonstrate that SuperGS surpasses state-of-the-art HRNVS methods on challenging real-world datasets using only low-resolution inputs.

Is larger always better? Evaluating and prompting large language models for non-generative medical tasks

The use of Large Language Models (LLMs) in medicine is growing, but their ability to handle both structured Electronic Health Record (EHR) data and unstructured clinical notes is not well-studied. This study benchmarks various models, including GPT-based LLMs, BERT-based models, and traditional clinical predictive models, for non-generative medical tasks utilizing renowned datasets. We assessed 14 language models (9 GPT-based and 5 BERT-based) and 7 traditional predictive models using the MIMIC dataset (ICU patient records) and the TJH dataset (early COVID-19 EHR data), focusing on tasks such as mortality and readmission prediction, disease hierarchy reconstruction, and biomedical sentence matching, comparing both zero-shot and finetuned performance. Results indicated that LLMs exhibited robust zero-shot predictive capabilities on structured EHR data when using well-designed prompting strategies, frequently surpassing traditional models. However, for unstructured medical texts, LLMs did not outperform finetuned BERT models, which excelled in both supervised and unsupervised tasks. Consequently, while LLMs are effective for zero-shot learning on structured data, finetuned BERT models are more suitable for unstructured texts, underscoring the importance of selecting models based on specific task requirements and data characteristics to optimize the application of NLP technology in healthcare.

EMERGE: Integrating RAG for Improved Multimodal EHR Predictive Modeling

The integration of multimodal Electronic Health Records (EHR) data has notably advanced clinical predictive capabilities. However, current models that utilize clinical notes and multivariate time-series EHR data often lack the necessary medical context for precise clinical tasks. Previous methods using knowledge graphs (KGs) primarily focus on structured knowledge extraction. To address this, we propose EMERGE, a Retrieval-Augmented Generation (RAG) driven framework aimed at enhancing multimodal EHR predictive modeling. Our approach extracts entities from both time-series data and clinical notes by prompting Large Language Models (LLMs) and aligns them with professional PrimeKG to ensure consistency. Beyond triplet relationships, we include entities' definitions and descriptions to provide richer semantics. The extracted knowledge is then used to generate task-relevant summaries of patients' health statuses. These summaries are fused with other modalities utilizing an adaptive multimodal fusion network with cross-attention. Extensive experiments on the MIMIC-III and MIMIC-IV datasets for in-hospital mortality and 30-day readmission tasks demonstrate the superior performance of the EMERGE framework compared to baseline models. Comprehensive ablation studies and analyses underscore the efficacy of each designed module and the framework's robustness to data sparsity. EMERGE significantly enhances the use of multimodal EHR data in healthcare, bridging the gap with nuanced medical contexts crucial for informed clinical predictions.

Adaptive Activation Steering: A Tuning-Free LLM Truthfulness Improvement Method for Diverse Hallucinations Categories

Recent studies have indicated that Large Language Models (LLMs) harbor an inherent understanding of truthfulness, yet often fail to express fully and generate false statements. This gap between "knowing" and "telling" poses a challenge for ensuring the truthfulness of generated content. To address this, we introduce Adaptive Activation Steering (ACT), a tuning-free method that adaptively shift LLM's activations in "truthful" direction during inference. ACT addresses diverse categories of hallucinations by utilizing diverse steering vectors and adjusting the steering intensity adaptively. Applied as an add-on across various models, ACT significantly improves truthfulness in LLaMA ($\uparrow$ 142\%), LLaMA2 ($\uparrow$ 24\%), Alpaca ($\uparrow$ 36\%), Vicuna ($\uparrow$ 28\%), and LLaMA2-Chat ($\uparrow$ 19\%). Furthermore, we verify ACT's scalability across larger models (13B, 33B, 65B), underscoring the adaptability of ACT to large-scale language models.

Your Network May Need to Be Rewritten: Network Adversarial Based on High-Dimensional Function Graph Decomposition

In the past, research on a single low dimensional activation function in networks has led to internal covariate shift and gradient deviation problems. A relatively small research area is how to use function combinations to provide property completion for a single activation function application. We propose a network adversarial method to address the aforementioned challenges. This is the first method to use different activation functions in a network. Based on the existing activation functions in the current network, an adversarial function with opposite derivative image properties is constructed, and the two are alternately used as activation functions for different network layers. For complex situations, we propose a method of high-dimensional function graph decomposition(HD-FGD), which divides it into different parts and then passes through a linear layer. After integrating the inverse of the partial derivatives of each decomposed term, we obtain its adversarial function by referring to the computational rules of the decomposition process. The use of network adversarial methods or the use of HD-FGD alone can effectively replace the traditional MLP+activation function mode. Through the above methods, we have achieved a substantial improvement over standard activation functions regarding both training efficiency and predictive accuracy. The article addresses the adversarial issues associated with several prevalent activation functions, presenting alternatives that can be seamlessly integrated into existing models without any adverse effects. We will release the code as open source after the conference review process is completed.

AGFSync: Leveraging AI-Generated Feedback for Preference Optimization in Text-to-Image Generation

Text-to-Image (T2I) diffusion models have achieved remarkable success in image generation. Despite their progress, challenges remain in both prompt-following ability, image quality and lack of high-quality datasets, which are essential for refining these models. As acquiring labeled data is costly, we introduce AGFSync, a framework that enhances T2I diffusion models through Direct Preference Optimization (DPO) in a fully AI-driven approach. AGFSync utilizes Vision-Language Models (VLM) to assess image quality across style, coherence, and aesthetics, generating feedback data within an AI-driven loop. By applying AGFSync to leading T2I models such as SD v1.4, v1.5, and SDXL, our extensive experiments on the TIFA dataset demonstrate notable improvements in VQA scores, aesthetic evaluations, and performance on the HPSv2 benchmark, consistently outperforming the base models. AGFSync's method of refining T2I diffusion models paves the way for scalable alignment techniques.

LightM-UNet: Mamba Assists in Lightweight UNet for Medical Image Segmentation

UNet and its variants have been widely used in medical image segmentation. However, these models, especially those based on Transformer architectures, pose challenges due to their large number of parameters and computational loads, making them unsuitable for mobile health applications. Recently, State Space Models (SSMs), exemplified by Mamba, have emerged as competitive alternatives to CNN and Transformer architectures. Building upon this, we employ Mamba as a lightweight substitute for CNN and Transformer within UNet, aiming at tackling challenges stemming from computational resource limitations in real medical settings. To this end, we introduce the Lightweight Mamba UNet (LightM-UNet) that integrates Mamba and UNet in a lightweight framework. Specifically, LightM-UNet leverages the Residual Vision Mamba Layer in a pure Mamba fashion to extract deep semantic features and model long-range spatial dependencies, with linear computational complexity. Extensive experiments conducted on two real-world 2D/3D datasets demonstrate that LightM-UNet surpasses existing state-of-the-art literature. Notably, when compared to the renowned nnU-Net, LightM-UNet achieves superior segmentation performance while drastically reducing parameter and computation costs by 116x and 21x, respectively. This highlights the potential of Mamba in facilitating model lightweighting. Our code implementation is publicly available at https://github.com/MrBlankness/LightM-UNet.

REALM: RAG-Driven Enhancement of Multimodal Electronic Health Records Analysis via Large Language Models

The integration of multimodal Electronic Health Records (EHR) data has significantly improved clinical predictive capabilities. Leveraging clinical notes and multivariate time-series EHR, existing models often lack the medical context relevent to clinical tasks, prompting the incorporation of external knowledge, particularly from the knowledge graph (KG). Previous approaches with KG knowledge have primarily focused on structured knowledge extraction, neglecting unstructured data modalities and semantic high dimensional medical knowledge. In response, we propose REALM, a Retrieval-Augmented Generation (RAG) driven framework to enhance multimodal EHR representations that address these limitations. Firstly, we apply Large Language Model (LLM) to encode long context clinical notes and GRU model to encode time-series EHR data. Secondly, we prompt LLM to extract task-relevant medical entities and match entities in professionally labeled external knowledge graph (PrimeKG) with corresponding medical knowledge. By matching and aligning with clinical standards, our framework eliminates hallucinations and ensures consistency. Lastly, we propose an adaptive multimodal fusion network to integrate extracted knowledge with multimodal EHR data. Our extensive experiments on MIMIC-III mortality and readmission tasks showcase the superior performance of our REALM framework over baselines, emphasizing the effectiveness of each module. REALM framework contributes to refining the use of multimodal EHR data in healthcare and bridging the gap with nuanced medical context essential for informed clinical predictions.

Learnable Prompt as Pseudo-Imputation: Reassessing the Necessity of Traditional EHR Data Imputation in Downstream Clinical Prediction

Analyzing the health status of patients based on Electronic Health Records (EHR) is a fundamental research problem in medical informatics. The presence of extensive missing values in EHR makes it challenging for deep neural networks to directly model the patient's health status based on EHR. Existing deep learning training protocols require the use of statistical information or imputation models to reconstruct missing values; however, the protocols inject non-realistic data into downstream EHR analysis models, significantly limiting model performance. This paper introduces Learnable Prompt as Pseudo Imputation (PAI) as a new training protocol. PAI no longer introduces any imputed data but constructs a learnable prompt to model the implicit preferences of the downstream model for missing values, resulting in a significant performance improvement for all EHR analysis models. Additionally, our experiments show that PAI exhibits higher robustness in situations of data insufficiency and high missing rates. More importantly, in a real-world application involving cross-institutional data with zero-shot evaluation, PAI demonstrates stronger model generalization capabilities for non-overlapping features.