Recent advancements in multimodal foundation models have showcased impressive capabilities in understanding and reasoning with visual and textual information. Adapting these foundation models trained for general usage to specialized domains like biomedicine requires large-scale domain-specific instruction datasets. While existing works have explored curating such datasets automatically, the resultant datasets are not explicitly aligned with domain expertise. In this work, we propose a data-centric framework, Biomedical Visual Instruction Tuning with Clinician Preference Alignment (BioMed-VITAL), that incorporates clinician preferences into both stages of generating and selecting instruction data for tuning biomedical multimodal foundation models. First, during the generation stage, we prompt the GPT-4V generator with a diverse set of clinician-selected demonstrations for preference-aligned data candidate generation. Then, during the selection phase, we train a separate selection model, which explicitly distills clinician and policy-guided model preferences into a rating function to select high-quality data for medical instruction tuning. Results show that the model tuned with the instruction-following data from our method demonstrates a significant improvement in open visual chat (18.5% relatively) and medical VQA (win rate up to 81.73%). Our instruction-following data and models are available at BioMed-VITAL.github.io.

Deep clustering, which learns representation and semantic clustering without labels information, poses a great challenge for deep learning-based approaches. Despite significant progress in recent years, most existing methods focus on uniformly distributed datasets, significantly limiting the practical applicability of their methods. In this paper, we propose a more practical problem setting named deep imbalanced clustering, where the underlying classes exhibit an imbalance distribution. To address this challenge, we introduce a novel optimal transport-based pseudo-label learning framework. Our framework formulates pseudo-label generation as a Semantic-regularized Progressive Partial Optimal Transport (SP$^2$OT) problem, which progressively transports each sample to imbalanced clusters under several prior distribution and semantic relation constraints, thus generating high-quality and imbalance-aware pseudo-labels. To solve SP$^2$OT, we develop a Majorization-Minimization-based optimization algorithm. To be more precise, we employ the strategy of majorization to reformulate the SP$^2$OT problem into a Progressive Partial Optimal Transport problem, which can be transformed into an unbalanced optimal transport problem with augmented constraints and can be solved efficiently by a fast matrix scaling algorithm. Experiments on various datasets, including a human-curated long-tailed CIFAR100, challenging ImageNet-R, and large-scale subsets of fine-grained iNaturalist2018 datasets, demonstrate the superiority of our method.

Data scarcity and privacy concerns limit the availability of high-quality medical images for public use, which can be mitigated through medical image synthesis. However, current medical image synthesis methods often struggle to accurately capture the complexity of detailed anatomical structures and pathological conditions. To address these challenges, we propose a novel medical image synthesis model that leverages fine-grained image-text alignment and anatomy-pathology prompts to generate highly detailed and accurate synthetic medical images. Our method integrates advanced natural language processing techniques with image generative modeling, enabling precise alignment between descriptive text prompts and the synthesized images' anatomical and pathological details. The proposed approach consists of two key components: an anatomy-pathology prompting module and a fine-grained alignment-based synthesis module. The anatomy-pathology prompting module automatically generates descriptive prompts for high-quality medical images. To further synthesize high-quality medical images from the generated prompts, the fine-grained alignment-based synthesis module pre-defines a visual codebook for the radiology dataset and performs fine-grained alignment between the codebook and generated prompts to obtain key patches as visual clues, facilitating accurate image synthesis. We validate the superiority of our method through experiments on public chest X-ray datasets and demonstrate that our synthetic images preserve accurate semantic information, making them valuable for various medical applications.

Conventional task- and modality-specific artificial intelligence (AI) models are inflexible in real-world deployment and maintenance for biomedicine. At the same time, the growing availability of biomedical data, coupled with the advancements in modern multi-modal multi-task AI techniques, has paved the way for the emergence of generalist biomedical AI solutions. These solutions hold the potential to interpret different medical modalities and produce expressive outputs such as free-text reports or disease diagnosis. Here, we propose BiomedGPT, the first open-source and generalist visual language AI for diverse biomedical tasks. BiomedGPT achieved 16 state-of-the-art results across five clinically significant tasks on 26 datasets. Notably, it outperformed OpenAI's GPT-4 with vision (GPT-4V) in radiology human evaluation and surpassed Google's Med-PaLM M (12B) in breast cancer diagnosis and medical visual question answering. Moreover, BiomedGPT facilitates zero-shot transfer learning, greatly enhancing its utility as a biomedical assistant, similar to ChatGPT. Our method demonstrates effective training with diverse datasets can lead to more practical biomedical AI.

Participant recruitment based on unstructured medical texts such as clinical notes and radiology reports has been a challenging yet important task for the cohort establishment in clinical research. Recently, Large Language Models (LLMs) such as ChatGPT have achieved tremendous success in various downstream tasks thanks to their promising performance in language understanding, inference, and generation. It is then natural to test their feasibility in solving the cohort recruitment task, which involves the classification of a given paragraph of medical text into disease label(s). However, when applied to knowledge-intensive problem settings such as medical text classification, where the LLMs are expected to understand the decision made by human experts and accurately identify the implied disease labels, the LLMs show a mediocre performance. A possible explanation is that, by only using the medical text, the LLMs neglect to use the rich context of additional information that languages afford. To this end, we propose to use a knowledge graph as auxiliary information to guide the LLMs in making predictions. Moreover, to further boost the LLMs adapt to the problem setting, we apply a chain-of-thought (CoT) sample selection strategy enhanced by reinforcement learning, which selects a set of CoT samples given each individual medical report. Experimental results and various ablation studies show that our few-shot learning method achieves satisfactory performance compared with fine-tuning strategies and gains superb advantages when the available data is limited. The code and sample dataset of the proposed CohortGPT model is available at: https://anonymous.4open.science/r/CohortGPT-4872/

Alzheimer's disease (AD) is a common form of dementia that severely impacts patient health. As AD impairs the patient's language understanding and expression ability, the speech of AD patients can serve as an indicator of this disease. This study investigates various methods for detecting AD using patients' speech and transcripts data from the DementiaBank Pitt database. The proposed approach involves pre-trained language models and Graph Neural Network (GNN) that constructs a graph from the speech transcript, and extracts features using GNN for AD detection. Data augmentation techniques, including synonym replacement, GPT-based augmenter, and so on, were used to address the small dataset size. Audio data was also introduced, and WavLM model was used to extract audio features. These features were then fused with text features using various methods. Finally, a contrastive learning approach was attempted by converting speech transcripts back to audio and using it for contrastive learning with the original audio. We conducted intensive experiments and analysis on the above methods. Our findings shed light on the challenges and potential solutions in AD detection using speech and audio data.

Modern supervised learning neural network models require a large amount of manually labeled data, which makes the construction of domain-specific knowledge graphs time-consuming and labor-intensive. In parallel, although there has been much research on named entity recognition and relation extraction based on distantly supervised learning, constructing a domain-specific knowledge graph from large collections of textual data without manual annotations is still an urgent problem to be solved. In response, we propose an integrated framework for adapting and re-learning knowledge graphs from one coarse domain (biomedical) to a finer-define domain (oncology). In this framework, we apply distant-supervision on cross-domain knowledge graph adaptation. Consequently, no manual data annotation is required to train the model. We introduce a novel iterative training strategy to facilitate the discovery of domain-specific named entities and triples. Experimental results indicate that the proposed framework can perform domain adaptation and construction of knowledge graph efficiently.

COVID-19 patient triaging with predictive outcome of the patients upon first present to emergency department (ED) is crucial for improving patient prognosis, as well as better hospital resources management and cross-infection control. We trained a deep feature fusion model to predict patient outcomes, where the model inputs were EHR data including demographic information, co-morbidities, vital signs and laboratory measurements, plus patient's CXR images. The model output was patient outcomes defined as the most insensitive oxygen therapy required. For patients without CXR images, we employed Random Forest method for the prediction. Predictive risk scores for COVID-19 severe outcomes ("CO-RISK" score) were derived from model output and evaluated on the testing dataset, as well as compared to human performance. The study's dataset (the "MGB COVID Cohort") was constructed from all patients presenting to the Mass General Brigham (MGB) healthcare system from March 1st to June 1st, 2020. ED visits with incomplete or erroneous data were excluded. Patients with no test order for COVID or confirmed negative test results were excluded. Patients under the age of 15 were also excluded. Finally, electronic health record (EHR) data from a total of 11060 COVID-19 confirmed or suspected patients were used in this study. Chest X-ray (CXR) images were also collected from each patient if available. Results show that CO-RISK score achieved area under the Curve (AUC) of predicting MV/death (i.e. severe outcomes) in 24 hours of 0.95, and 0.92 in 72 hours on the testing dataset. The model shows superior performance to the commonly used risk scores in ED (CURB-65 and MEWS). Comparing with physician's decisions, CO-RISK score has demonstrated superior performance to human in making ICU/floor decisions.