Data privacy is a critical challenge in modern medical workflows as the adoption of electronic patient records has grown rapidly. Stringent data protection regulations limit access to clinical records for training and integrating machine learning models that have shown promise in improving diagnostic accuracy and personalized care outcomes. Synthetic data offers a promising alternative; however, current generative models either struggle with time-series data or lack formal privacy guaranties. In this paper, we enhance a state-of-the-art time-series generative model to better handle longitudinal clinical data while incorporating quantifiable privacy safeguards. Using real data from chronic kidney disease and ICU patients, we evaluate our method through statistical tests, a Train-on-Synthetic-Test-on-Real (TSTR) setup, and expert clinical review. Our non-private model (Augmented TimeGAN) outperforms transformer- and flow-based models on statistical metrics in several datasets, while our private model (DP-TimeGAN) maintains a mean authenticity of 0.778 on the CKD dataset, outperforming existing state-of-the-art models on the privacy-utility frontier. Both models achieve performance comparable to real data in clinician evaluations, providing robust input data necessary for developing models for complex chronic conditions without compromising data privacy.

With the rising global burden of chronic diseases and the multimodal and heterogeneous clinical data (medical imaging, free-text recordings, wearable sensor streams, etc.), there is an urgent need for a unified multimodal AI framework that can proactively predict individual health risks. We propose VL-RiskFormer, a hierarchical stacked visual-language multimodal Transformer with a large language model (LLM) inference head embedded in its top layer. The system builds on the dual-stream architecture of existing visual-linguistic models (e.g., PaLM-E, LLaVA) with four key innovations: (i) pre-training with cross-modal comparison and fine-grained alignment of radiological images, fundus maps, and wearable device photos with corresponding clinical narratives using momentum update encoders and debiased InfoNCE losses; (ii) a time fusion block that integrates irregular visit sequences into the causal Transformer decoder through adaptive time interval position coding; (iii) a disease ontology map adapter that injects ICD-10 codes into visual and textual channels in layers and infers comorbid patterns with the help of a graph attention mechanism. On the MIMIC-IV longitudinal cohort, VL-RiskFormer achieved an average AUROC of 0.90 with an expected calibration error of 2.7 percent.

The Trump administration is pushing an initiative for millions of Americans to upload personal health data and medical records on new apps and systems run by private tech companies, promising easier to access health records and wellness monitoring. Donald Trump is expected to deliver remarks on the initiative on Wednesday afternoon in the East Room. The event is expected to involve leaders from more than 60 companies, including major tech companies such as Google and Amazon, as well as prominent hospital systems like the Cleveland clinic. The new system will focus on diabetes and weight management, conversational artificial intelligence that helps patients, and digital tools such as QR codes and apps that register patients for check-ins or track medications. The initiative, spearheaded by an administration that has already freely shared highly personal data about Americans in ways that have tested legal bounds, could put patients' desires for more convenience at their doctor's office on a collision course with their expectations that their medical information be kept private.

Chronic diseases are long-term, manageable, yet typically incurable conditions, highlighting the need for effective preventive strategies. Machine learning has been widely used to assess individual risk for chronic diseases. However, many models rely on medical test data (e.g. blood results, glucose levels), which limits their utility for proactive self-assessment. Additionally, to gain public trust, machine learning models should be explainable and transparent. Although some research on self-assessment machine learning models includes explainability, their explanations are not validated against established medical literature, reducing confidence in their reliability. To address these issues, we develop deep learning models that predict the risk of developing 13 chronic diseases using only personal and lifestyle factors, enabling accessible, self-directed preventive care. Importantly, we use SHAP-based explainability to identify the most influential model features and validate them against established medical literature. Our results show a strong alignment between the models' most influential features and established medical literature, reinforcing the models' trustworthiness. Critically, we find that this observation holds across 13 distinct diseases, indicating that this machine learning approach can be broadly trusted for chronic disease prediction. This work lays the foundation for developing trustworthy machine learning tools for self-directed preventive care. Future research can explore other approaches for models' trustworthiness and discuss how the models can be used ethically and responsibly.

This study addresses a critical gap in the healthcare system by developing a clinically meaningful, practical, and explainable disease surveillance system for multiple chronic diseases, utilizing routine EHR data from multiple U.S. practices integrated with CureMD's EMR/EHR system. Unlike traditional systems--using AI models that rely on features from patients' labs--our approach focuses on routinely available data, such as medical history, vitals, diagnoses, and medications, to preemptively assess the risks of chronic diseases in the next year. We trained three distinct models for each chronic disease: prediction models that forecast the risk of a disease 3, 6, and 12 months before a potential diagnosis. We developed Random Forest models, which were internally validated using F1 scores and AUROC as performance metrics and further evaluated by a panel of expert physicians for clinical relevance based on inferences grounded in medical knowledge. Additionally, we discuss our implementation of integrating these models into a practical EMR system. Beyond using Shapley attributes and surrogate models for explainability, we also introduce a new rule-engineering framework to enhance the intrinsic explainability of Random Forests.

Recent research on large language models (LLMs) has primarily focused on their adaptation and application in specialized domains. The application of LLMs in the medical field is mainly concentrated on tasks such as the automation of medical report generation, summarization, diagnostic reasoning, and question-and-answer interactions between doctors and patients. The challenge of becoming a good teacher is more formidable than that of becoming a good student, and this study pioneers the application of LLMs in the field of medical education. In this work, we investigate the extent to which LLMs can generate medical qualification exam questions and corresponding answers based on few-shot prompts. Utilizing a real-world Chinese dataset of elderly chronic diseases, we tasked the LLMs with generating open-ended questions and answers based on a subset of sampled admission reports across eight widely used LLMs, including ERNIE 4, ChatGLM 4, Doubao, Hunyuan, Spark 4, Qwen, Llama 3, and Mistral. Furthermore, we engaged medical experts to manually evaluate these open-ended questions and answers across multiple dimensions. The study found that LLMs, after using few-shot prompts, can effectively mimic real-world medical qualification exam questions, whereas there is room for improvement in the correctness, evidence-based statements, and professionalism of the generated answers. Moreover, LLMs also demonstrate a decent level of ability to correct and rectify reference answers. Given the immense potential of artificial intelligence in the medical field, the task of generating questions and answers for medical qualification exams aimed at medical students, interns and residents can be a significant focus of future research.

Clinical data informs the personalization of health care with a potential for more effective disease management. In practice, this is achieved by subgrouping, whereby clusters with similar patient characteristics are identified and then receive customized treatment plans with the goal of targeting subgroup-specific disease dynamics. In this paper, we propose a novel mixture hidden Markov model for subgrouping patient trajectories from chronic diseases. Our model is probabilistic and carefully designed to capture different trajectory phases of chronic diseases (i.e., "severe", "moderate", and "mild") through tailored latent states. We demonstrate our subgrouping framework based on a longitudinal study across 847 patients with non-specific low back pain. Here, our subgrouping framework identifies 8 subgroups. Further, we show that our subgrouping framework outperforms common baselines in terms of cluster validity indices. Finally, we discuss the applicability of the model to other chronic and long-lasting diseases.

Chronic diseases such as diabetes are the leading causes of morbidity and mortality worldwide. Numerous research studies have been attempted with various deep learning models in diagnosis. However, most previous studies had certain limitations, including using publicly available datasets (e.g. MIMIC), and imbalanced data. In this study, we collected five-year electronic health records (EHRs) from the Taiwan hospital database, including 1,420,596 clinical notes, 387,392 laboratory test results, and more than 1,505 laboratory test items, focusing on research pre-training large language models. We proposed a novel Large Language Multimodal Models (LLMMs) framework incorporating multimodal data from clinical notes and laboratory test results for the prediction of chronic disease risk. Our method combined a text embedding encoder and multi-head attention layer to learn laboratory test values, utilizing a deep neural network (DNN) module to merge blood features with chronic disease semantics into a latent space. In our experiments, we observe that clinicalBERT and PubMed-BERT, when combined with attention fusion, can achieve an accuracy of 73% in multiclass chronic diseases and diabetes prediction. By transforming laboratory test values into textual descriptions and employing the Flan T-5 model, we achieved a 76% Area Under the ROC Curve (AUROC), demonstrating the effectiveness of leveraging numerical text data for training and inference in language models. This approach significantly improves the accuracy of early-stage diabetes prediction.

This study harnesses state-of-the-art AI technology for chronic disease management, specifically in detecting various mental disorders through user-generated textual content. Existing studies typically rely on fully supervised machine learning, which presents challenges such as the labor-intensive manual process of annotating extensive training data for each disease and the need to design specialized deep learning architectures for each problem. To address such challenges, we propose a novel framework that leverages advanced AI techniques, including large language models and multi-prompt engineering. Specifically, we address two key technical challenges in data-driven chronic disease management: (1) developing personalized prompts to represent each user's uniqueness and (2) incorporating medical knowledge into prompts to provide context for chronic disease detection, instruct learning objectives, and operationalize prediction goals. We evaluate our method using four mental disorders, which are prevalent chronic diseases worldwide, as research cases. On the depression detection task, our method (F1 = 0.975~0.978) significantly outperforms traditional supervised learning paradigms, including feature engineering (F1 = 0.760) and architecture engineering (F1 = 0.756). Meanwhile, our approach demonstrates success in few-shot learning, i.e., requiring only a minimal number of training examples to detect chronic diseases based on user-generated textual content (i.e., only 2, 10, or 100 subjects). Moreover, our method can be generalized to other mental disorder detection tasks, including anorexia, pathological gambling, and self-harm (F1 = 0.919~0.978).

In this study, we investigated the application of bio-inspired optimization algorithms, including Genetic Algorithm, Particle Swarm Optimization, and Whale Optimization Algorithm, for feature selection in chronic disease prediction. The primary goal was to enhance the predictive accuracy of models streamline data dimensionality, and make predictions more interpretable and actionable. The research encompassed a comparative analysis of the three bio-inspired feature selection approaches across diverse chronic diseases, including diabetes, cancer, kidney, and cardiovascular diseases. Performance metrics such as accuracy, precision, recall, and f1 score are used to assess the effectiveness of the algorithms in reducing the number of features needed for accurate classification. The results in general demonstrate that the bio-inspired optimization algorithms are effective in reducing the number of features required for accurate classification. However, there have been variations in the performance of the algorithms on different datasets. The study highlights the importance of data pre-processing and cleaning in ensuring the reliability and effectiveness of the analysis. This study contributes to the advancement of predictive analytics in the realm of chronic diseases. The potential impact of this work extends to early intervention, precision medicine, and improved patient outcomes, providing new avenues for the delivery of healthcare services tailored to individual needs. The findings underscore the potential benefits of using bio-inspired optimization algorithms for feature selection in chronic disease prediction, offering valuable insights for improving healthcare outcomes.