The accelerated evolution of large language models has raised questions about their comparative performance across domains of practical importance. GPT-4 by OpenAI introduced advances in reasoning, multimodality, and task generalization, establishing itself as a valuable tool in education, clinical diagnosis, and academic writing, though it was accompanied by several flaws. Released in August 2025, GPT-5 incorporates a system-of-models architecture designed for task-specific optimization and, based on both anecdotal accounts and emerging evidence from the literature, demonstrates stronger performance than its predecessor in medical contexts. This study provides one of the first systematic comparisons of GPT-4 and GPT-5 using human raters from linguistics and clinical fields. Twenty experts evaluated model-generated outputs across five domains: lesson planning, assignment evaluation, clinical diagnosis, research generation, and ethical reasoning, based on predefined criteria. Mixed-effects models revealed that GPT-5 significantly outperformed GPT-4 in lesson planning, clinical diagnosis, research generation, and ethical reasoning, while both models performed comparably in assignment assessment. The findings highlight the potential of GPT-5 to serve as a context-sensitive and domain-specialized tool, offering tangible benefits for education, clinical practice, and academic research, while also advancing ethical reasoning. These results contribute to one of the earliest empirical evaluations of the evolving capabilities and practical promise of GPT-5.

Full-process clinical diagnosis in the real world encompasses the entire diagnostic workflow that begins with only an ambiguous chief complaint. While artificial intelligence (AI), particularly large language models (LLMs), is transforming clinical diagnosis, its role remains largely as an assistant to physicians. This AI-assisted working pattern makes AI can only answer specific medical questions at certain parts within the diagnostic process, but lack the ability to drive the entire diagnostic process starting from an ambiguous complaint, which still relies heavily on human physicians. This gap limits AI's ability to fully reduce physicians' workload and enhance diagnostic efficiency. To address this, we propose a paradigm shift that reverses the relationship between physicians and AI: repositioning AI as the primary director, with physicians serving as its assistants. So we present DxDirector-7B, an LLM endowed with advanced deep thinking capabilities, enabling it to drive the full-process diagnosis with minimal physician involvement. Furthermore, DxDirector-7B establishes a robust accountability framework for misdiagnoses, delineating responsibility between AI and human physicians. In evaluations across rare, complex, and real-world cases under full-process diagnosis setting, DxDirector-7B not only achieves significant superior diagnostic accuracy but also substantially reduces physician workload than state-of-the-art medical LLMs as well as general-purpose LLMs. Fine-grained analyses across multiple clinical departments and tasks validate its efficacy, with expert evaluations indicating its potential to serve as a viable substitute for medical specialists. These findings mark a new era where AI, traditionally a physicians' assistant, now drives the entire diagnostic process to drastically reduce physicians' workload, indicating an efficient and accurate diagnostic solution.

Depression is a widespread mental disorder that affects millions worldwide. While automated depression assessment shows promise, most studies rely on limited or non-clinically validated data, and often prioritize complex model design over real-world effectiveness. In this paper, we aim to unveil the landscape of clinical depression assessment. We introduce C-MIND, a clinical neuropsychiatric multimodal diagnosis dataset collected over two years from real hospital visits. Each participant completes three structured psychiatric tasks and receives a final diagnosis from expert clinicians, with informative audio, video, transcript, and functional near-infrared spectroscopy (fNIRS) signals recorded. Using C-MIND, we first analyze behavioral signatures relevant to diagnosis. We train a range of classical models to quantify how different tasks and modalities contribute to diagnostic performance, and dissect the effectiveness of their combinations. We then explore whether LLMs can perform psychiatric reasoning like clinicians and identify their clear limitations in realistic clinical settings. In response, we propose to guide the reasoning process with clinical expertise and consistently improves LLM diagnostic performance by up to 10% in Macro-F1 score. We aim to build an infrastructure for clinical depression assessment from both data and algorithmic perspectives, enabling C-MIND to facilitate grounded and reliable research for mental healthcare.

Cognitive decline often surfaces in language years before diagnosis. It is frequently non-experts, such as those closest to the patient, who first sense a change and raise concern. As LLMs become integrated into daily communication and used over prolonged periods, it may even be an LLM that notices something is off. But what exactly do they notice--and should be noticing--when making that judgment? This paper investigates how dementia is perceived through language by non-experts. We presented transcribed picture descriptions to non-expert humans and LLMs, asking them to intuitively judge whether each text was produced by someone healthy or with dementia. We introduce an explainable method that uses LLMs to extract high-level, expert-guided features representing these picture descriptions, and use logistic regression to model human and LLM perceptions and compare with clinical diagnoses. Our analysis reveals that human perception of dementia is inconsistent and relies on a narrow, and sometimes misleading, set of cues. LLMs, by contrast, draw on a richer, more nuanced feature set that aligns more closely with clinical patterns. Still, both groups show a tendency toward false negatives, frequently overlooking dementia cases. Through our interpretable framework and the insights it provides, we hope to help non-experts better recognize the linguistic signs that matter.

Disease progression prediction based on patients' evolving health information is challenging when true disease states are unknown due to diagnostic capabilities or high costs. For example, the absence of gold-standard neurological diagnoses hinders distinguishing Alzheimer's disease (AD) from related conditions such as AD-related dementias (ADRDs), including Lewy body dementia (LBD). Combining temporally dependent surrogate labels and health markers may improve disease prediction. However, existing literature models informative surrogate labels and observed variables that reflect the underlying states using purely generative approaches, limiting the ability to predict future states. We propose integrating the conventional hidden Markov model as a generative model with a time-varying discriminative classification model to simultaneously handle potentially misspecified surrogate labels and incorporate important markers of disease progression. We develop an adaptive forward-backward algorithm with subjective labels for estimation, and utilize the modified posterior and Viterbi algorithms to predict the progression of future states or new patients based on objective markers only. Importantly, the adaptation eliminates the need to model the marginal distribution of longitudinal markers, a requirement in traditional algorithms. Asymptotic properties are established, and significant improvement with finite samples is demonstrated via simulation studies. Analysis of the neuropathological dataset of the National Alzheimer's Coordinating Center (NACC) shows much improved accuracy in distinguishing LBD from AD.

Artificial intelligence has significantly advanced healthcare, particularly through large language models (LLMs) that excel in medical question answering benchmarks. However, their real-world clinical application remains limited due to the complexities of doctor-patient interactions. To address this, we introduce \textbf{AI Hospital}, a multi-agent framework simulating dynamic medical interactions between \emph{Doctor} as player and NPCs including \emph{Patient}, \emph{Examiner}, \emph{Chief Physician}. This setup allows for realistic assessments of LLMs in clinical scenarios. We develop the Multi-View Medical Evaluation (MVME) benchmark, utilizing high-quality Chinese medical records and NPCs to evaluate LLMs' performance in symptom collection, examination recommendations, and diagnoses. Additionally, a dispute resolution collaborative mechanism is proposed to enhance diagnostic accuracy through iterative discussions. Despite improvements, current LLMs exhibit significant performance gaps in multi-turn interactions compared to one-step approaches. Our findings highlight the need for further research to bridge these gaps and improve LLMs' clinical diagnostic capabilities. Our data, code, and experimental results are all open-sourced at \url{https://github.com/LibertFan/AI_Hospital}.

At present, the incidence and fatality rate of lung cancer in China rank first among all malignant tumors. Despite the continuous development and improvement of China's medical level, the overall 5-year survival rate of lung cancer patients is still lower than 20% and is staged. A number of studies have confirmed that early diagnosis and treatment of early stage lung cancer is of great significance to improve the prognosis of patients. In recent years, artificial intelligence technology has gradually begun to be applied in oncology. ai is used in cancer screening, clinical diagnosis, radiation therapy (image acquisition, at-risk organ segmentation, image calibration and delivery) and other aspects of rapid development. However, whether medical ai can be socialized depends on the public's attitude and acceptance to a certain extent. However, at present, there are few studies on the diagnosis of early lung cancer by AI technology combined with SCT scanning. In view of this, this study applied the combined method in early lung cancer screening, aiming to find a safe and efficient screening mode and provide a reference for clinical diagnosis and treatment.

Machine reasoning has made great progress in recent years owing to large language models (LLMs). In the clinical domain, however, most NLP-driven projects mainly focus on clinical classification or reading comprehension, and under-explore clinical reasoning for disease diagnosis due to the expensive rationale annotation with clinicians. In this work, we present a ``reasoning-aware'' diagnosis framework that rationalizes the diagnostic process via prompt-based learning in a time- and labor-efficient manner, and learns to reason over the prompt-generated rationales. Specifically, we address the clinical reasoning for disease diagnosis, where the LLM generates diagnostic rationales providing its insight on presented patient data and the reasoning path towards the diagnosis, namely Clinical Chain-of-Thought (Clinical CoT). We empirically demonstrate LLMs/LMs' ability of clinical reasoning via extensive experiments and analyses on both rationale generation and disease diagnosis in various settings. We further propose a novel set of criteria for evaluating machine-generated rationales' potential for real-world clinical settings, facilitating and benefiting future research in this area.

The cerebrospinal fluid (CSF) of 19 subjects who received a clinical diagnosis of Alzheimer's disease (AD) as well as of 5 pathological controls have been collected and analysed by Raman spectroscopy (RS). We investigated whether the raw and preprocessed Raman spectra could be used to distinguish AD from controls. First, we applied standard Machine Learning (ML) methods obtaining unsatisfactory results. Then, we applied ML to a set of topological descriptors extracted from raw spectra, achieving a very good classification accuracy (> 87%). Although our results are preliminary, they indicate that RS and topological analysis together may provide an effective combination to confirm or disprove a clinical diagnosis of AD. The next steps will include enlarging the dataset of CSF samples to validate the proposed method better and, possibly, to understand if topological data analysis could support the characterization of AD subtypes.

An in-depth genetic analysis can contribute to the issuance of a timely clinical diagnosis, to focus treatment on the specific condition being faced.A task that usually takes up to two weeks was reduced to just over five hours, thanks to an artificial intelligence system developed by Stanford University.Genetic analysis accelerated…