The g-formula can be used to estimate causal effects of sustained treatment strategies using observational data under the identifying assumptions of consistency, positivity, and exchangeability. The non-iterative conditional expectation (NICE) estimator of the g-formula also requires correct estimation of the conditional distribution of the time-varying treatment, confounders, and outcome. Parametric models, which have been traditionally used for this purpose, are subject to model misspecification, which may result in biased causal estimates. Here, we propose a unified deep learning framework for the NICE g-formula estimator that uses multitask recurrent neural networks for estimation of the joint conditional distributions. Using simulated data, we evaluated our model's bias and compared it with that of the parametric g-formula estimator. We found lower bias in the estimates of the causal effect of sustained treatment strategies on a survival outcome when using the deep learning estimator compared with the parametric NICE estimator in settings with simple and complex temporal dependencies between covariates. These findings suggest that our Deep Learning g-formula estimator may be less sensitive to model misspecification than the classical parametric NICE estimator when estimating the causal effect of sustained treatment strategies from complex observational data.

Objective: The growing use of large language models (LLMs) stimulates a need for a comprehensive review of their applications and outcomes in mental health care contexts. This scoping review aims to critically analyze the existing development and applications of LLMs in mental health care, highlighting their successes and identifying their challenges and limitations in these specialized fields. Materials and Methods: A broad literature search was conducted in November 2023 using six databases (PubMed, Web of Science, Google Scholar, arXiv, medRxiv, and PsyArXiv) following the 2020 version of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A total of 313 publications were initially identified, and after applying the study inclusion criteria, 34 publications were selected for the final review. Results: We identified diverse applications of LLMs in mental health care, including diagnosis, therapy, patient engagement enhancement, etc. Key challenges include data availability and reliability, nuanced handling of mental states, and effective evaluation methods. Despite successes in accuracy and accessibility improvement, gaps in clinical applicability and ethical considerations were evident, pointing to the need for robust data, standardized evaluations, and interdisciplinary collaboration. Conclusion: LLMs show promising potential in advancing mental health care, with applications in diagnostics, and patient support. Continued advancements depend on collaborative, multidisciplinary efforts focused on framework enhancement, rigorous dataset development, technological refinement, and ethical integration to ensure the effective and safe application of LLMs in mental health care.

Both models demonstrate mastery of the pre-training task but neither consistently outperform XGBoost on downstream supervised tasks. We encourage future work to focus on joint modeling of multiple EHR data categories and to include tree-based baselines in their evaluations. In recent years, self-supervised pre-training of masked language models (MLMs) (see Appendix A for background) has demonstrated remarkable success across a wide range of machine learning problems and has led to significant downstream improvements across diverse tasks in natural language processing (Liu et al., 2019; Devlin et al., 2019; Raffel et al., 2020). There is considerable excitement surrounding the potential of large pre-trained MLMs to achieve similar success in medical applications. For instance, existing applications of MLMs in medicine have already yielded promising results in tasks related to medical text understanding (Lee et al., 2020; Alsentzer et al., 2019; Huang et al., 2019; Yang et al., 2019; Beltagy et al., 2019). Laboratory data is abundant, routinely collected, less biased compared to other types of data in electronic health records (EHRs) like billing codes (Beam et al., 2021), and directly measure a patient's physiological state, offering a valuable opportunity for creating a medical foundation model. However, there is a large body of evidence showing that deep learning is consistently outperformed on so-called "tabular" data prediction tasks by traditional machine learning techniques like random forests, XGBoost, and even simple regression models (Bellamy et al., 2020; Finlayson et al., 2023; Sharma, 2013). The reasons for this are only partially understood, but previous work (Grinsztajn et al., 2022) has suggested that this phenomenon may be caused by a rotational invariance in deep learning models that is harmful for tabular data. More broadly, the success of deep learning is thought to be largely due to inductive biases that can be leveraged for images, text, and graphs. These inductive biases are absent or only weakly present in tabular data. Conversely, tree-based methods are scale invariant and robust to uninformative features. We evaluated both models on several downstream outcome prediction tasks and validated the success of pre-training with a set of intrinsic evaluations.

As large language models continue to be widely developed, robust uncertainty quantification techniques will become crucial for their safe deployment in high-stakes scenarios. In this work, we explore how conformal prediction can be used to provide uncertainty quantification in language models for the specific task of multiple-choice question-answering. We find that the uncertainty estimates from conformal prediction are tightly correlated with prediction accuracy. This observation can be useful for downstream applications such as selective classification and filtering out low-quality predictions. We also investigate the exchangeability assumption required by conformal prediction to out-of-subject questions, which may be a more realistic scenario for many practical applications. Our work contributes towards more trustworthy and reliable usage of large language models in safety-critical situations, where robust guarantees of error rate are required.

Self-supervised models trained with a contrastive loss such as CLIP have shown to be very powerful in zero-shot classification settings. However, to be used as a zero-shot classifier these models require the user to provide new captions over a fixed set of labels at test time. In many settings, it is hard or impossible to know if a new query caption is compatible with the source captions used to train the model. We address these limitations by framing the zero-shot classification task as an outlier detection problem and develop a conformal prediction procedure to assess when a given test caption may be reliably used. On a real-world medical example, we show that our proposed conformal procedure improves the reliability of CLIP-style models in the zero-shot classification setting, and we provide an empirical analysis of the factors that may affect its performance.