Current medical practice depends on standardized treatment frameworks and empirical methodologies that neglect individual patient variations, leading to suboptimal health outcomes. We develop a comprehensive system integrating Large Language Models (LLMs), Conditional Tabular Generative Adversarial Networks (CTGAN), T-learner counterfactual models, and contextual bandit approaches to provide customized, data-informed clinical recommendations. The approach utilizes LLMs to process unstructured medical narratives into structured datasets (93.2% accuracy), uses CTGANs to produce realistic synthetic patient data (55% accuracy via two-sample verification), deploys T-learners to forecast patient-specific treatment responses (84.3% accuracy), and integrates prior-informed contextual bandits to enhance online therapeutic selection by effectively balancing exploration of new possibilities with exploitation of existing knowledge. Testing on stage III colon cancer datasets revealed that our KernelUCB approach obtained 0.60-0.61 average reward scores across 5,000 rounds, exceeding other reference methods. This comprehensive system overcomes cold-start limitations in online learning environments, improves computational effectiveness, and constitutes notable progress toward individualized medicine adapted to specific patient characteristics.

Stigmatizing language results in healthcare inequities, yet there is no universally accepted or standardized lexicon defining which words, terms, or phrases constitute stigmatizing language in healthcare. We conducted a systematic search of the literature to identify existing stigmatizing language lexicons and then analyzed them comparatively to examine: 1) similarities and discrepancies between these lexicons, and 2) the distribution of positive, negative, or neutral terms based on an established sentiment dataset. Our search identified four lexicons. The analysis results revealed moderate semantic similarity among them, and that most stigmatizing terms are related to judgmental expressions by clinicians to describe perceived negative behaviors. Sentiment analysis showed a predominant proportion of negatively classified terms, though variations exist across lexicons. Our findings underscore the need for a standardized lexicon and highlight challenges in defining stigmatizing language in clinical texts.

Large language models (LLMs), including zero-shot and few-shot paradigms, have shown promising capabilities in clinical text generation. However, real-world applications face two key challenges: (1) patient data is highly unstructured, heterogeneous, and scattered across multiple note types and (2) clinical notes are often long and semantically dense, making naive prompting infeasible due to context length constraints and the risk of omitting clinically relevant information. We introduce CLI-RAG (Clinically Informed Retrieval-Augmented Generation), a domain-specific framework for structured and clinically grounded text generation using LLMs. It incorporates a novel hierarchical chunking strategy that respects clinical document structure and introduces a task-specific dual-stage retrieval mechanism. The global stage identifies relevant note types using evidence-based queries, while the local stage extracts high-value content within those notes creating relevance at both document and section levels. We apply the system to generate structured progress notes for individual hospital visits using 15 clinical note types from the MIMIC-III dataset. Experiments show that it preserves temporal and semantic alignment across visits, achieving an average alignment score of 87.7%, surpassing the 80.7% baseline from real clinician-authored notes. The generated outputs also demonstrate high consistency across LLMs, reinforcing deterministic behavior essential for reproducibility, reliability, and clinical trust.

The increasing demand for multilingual capabilities in healthcare underscores the need for AI models adept at processing diverse languages, particularly in clinical documentation and decision-making. Arabic, with its complex morphology, syntax, and diglossia, poses unique challenges for natural language processing (NLP) in medical contexts. This case study evaluates Sporo AraSum, a language model tailored for Arabic clinical documentation, against JAIS, the leading Arabic NLP model. Using synthetic datasets and modified PDQI-9 metrics modified ourselves for the purposes of assessing model performances in a different language. The study assessed the models' performance in summarizing patient-physician interactions, focusing on accuracy, comprehensiveness, clinical utility, and linguistic-cultural competence. Results indicate that Sporo AraSum significantly outperforms JAIS in AI-centric quantitative metrics and all qualitative attributes measured in our modified version of the PDQI-9. AraSum's architecture enables precise and culturally sensitive documentation, addressing the linguistic nuances of Arabic while mitigating risks of AI hallucinations. These findings suggest that Sporo AraSum is better suited to meet the demands of Arabic-speaking healthcare environments, offering a transformative solution for multilingual clinical workflows. Future research should incorporate real-world data to further validate these findings and explore broader integration into healthcare systems.

AI-powered medical scribes have emerged as a promising solution to alleviate the documentation burden in healthcare. Ambient AI scribes provide real-time transcription and automated data entry into Electronic Health Records (EHRs), with the potential to improve efficiency, reduce costs, and enhance scalability. Despite early success, the accuracy of AI scribes remains critical, as errors can lead to significant clinical consequences. Additionally, AI scribes face challenges in handling the complexity and variability of medical language and ensuring the privacy of sensitive patient data. This case study aims to evaluate Sporo Health's AI scribe, a multi-agent system leveraging fine-tuned medical LLMs, by comparing its performance with OpenAI's GPT-4o Mini on multiple performance metrics. Using a dataset of de-identified patient conversation transcripts, AI-generated summaries were compared to clinician-generated notes (the ground truth) based on clinical content recall, precision, and F1 scores. Evaluations were further supplemented by clinician satisfaction assessments using a modified Physician Documentation Quality Instrument revision 9 (PDQI-9), rated by both a medical student and a physician. The results show that Sporo AI consistently outperformed GPT-4o Mini, achieving higher recall, precision, and overall F1 scores. Moreover, the AI generated summaries provided by Sporo were rated more favorably in terms of accuracy, comprehensiveness, and relevance, with fewer hallucinations. These findings demonstrate that Sporo AI Scribe is an effective and reliable tool for clinical documentation, enhancing clinician workflows while maintaining high standards of privacy and security.

Accurate and comprehensive clinical documentation is crucial for delivering high-quality healthcare, facilitating effective communication among providers, and ensuring compliance with regulatory requirements. However, manual transcription and data entry processes can be time-consuming, error-prone, and susceptible to inconsistencies, leading to incomplete or inaccurate medical records. This paper proposes a novel approach to augment clinical documentation by leveraging synthetic data generation techniques to generate realistic and diverse clinical transcripts. We present a methodology that combines state-of-the-art generative models, such as Generative Adversarial Networks (GANs) and Variational Autoencoders (VAEs), with real-world clinical transcript and other forms of clinical data to generate synthetic transcripts. These synthetic transcripts can then be used to supplement existing documentation workflows, providing additional training data for natural language processing models and enabling more accurate and efficient transcription processes. Through extensive experiments on a large dataset of anonymized clinical transcripts, we demonstrate the effectiveness of our approach in generating high-quality synthetic transcripts that closely resemble real-world data. Quantitative evaluation metrics, including perplexity scores and BLEU scores, as well as qualitative assessments by domain experts, validate the fidelity and utility of the generated synthetic transcripts. Our findings highlight synthetic data generation's potential to address clinical documentation challenges, improving patient care, reducing administrative burdens, and enhancing healthcare system efficiency.

Comprehensive clinical documentation is crucial for effective healthcare delivery, yet it poses a significant burden on healthcare professionals, leading to burnout, increased medical errors, and compromised patient safety. This paper explores the potential of generative AI (Artificial Intelligence) to streamline the clinical documentation process, specifically focusing on generating SOAP (Subjective, Objective, Assessment, Plan) and BIRP (Behavior, Intervention, Response, Plan) notes. We present a case study demonstrating the application of natural language processing (NLP) and automatic speech recognition (ASR) technologies to transcribe patient-clinician interactions, coupled with advanced prompting techniques to generate draft clinical notes using large language models (LLMs). The study highlights the benefits of this approach, including time savings, improved documentation quality, and enhanced patient-centered care. Additionally, we discuss ethical considerations, such as maintaining patient confidentiality and addressing model biases, underscoring the need for responsible deployment of generative AI in healthcare settings. The findings suggest that generative AI has the potential to revolutionize clinical documentation practices, alleviating administrative burdens and enabling healthcare professionals to focus more on direct patient care.

Among the many challenges that physicians face, one of the most cumbersome is clinical documentation. In a study published by the Journal of Graduate Medical Education, it was found that nearly 92% of physicians surveyed reported that "documentation obligations are excessive," and 73% reported that clinical documentation often has a negative impact on patient care. The goal behind detailed clinical documentation is to ultimately ensure great record keeping: in an ideal world, a comprehensive patient chart enables any treating provider to see a patient's entire medical and treatment history. Furthermore, the healthcare system has been built in such a way that documentation plays a critical administrative role. Healthcare organizations use patient charts to code and bill for services provided.

This is the first episode in our series Smarter health. American health care is complex. In the first episode in our series Smarter health, we explore the potential of AI in health care -- from predicting patient risk, to diagnostics, to just helping physicians make better decisions. Today, On Point: We consider whether AI's potential can be realized in our financially-motivated health care system. Welcome to an On Point special series: Smarter health: Artificial intelligence and the future of American health care. In the not so distant future, artificial intelligence and machine learning technologies could transform the health care you receive, whether you're aware of it or not. Here are just a couple of examples. Dr. Vindell Washington is chief clinical officer at Verily Life Sciences, which is owned by Google's parent company, Alphabet. Washington oversees the development of Onduo. Technology that weaves together multiple streams of complex, daily medical data in order to guide and personalize health care decisions across entire patient populations. VINDELL WASHINGTON [Tape]: You might have a blood pressure cuff reading, you may have a blood sugar reading, you may have some logging that you've done.

In fall 2020, MIT's School of Engineering and Takeda Pharmaceuticals Company Limited launched the MIT-Takeda Program, a collaboration to support members of the MIT community working at the intersection of artificial intelligence and human health. Housed at the Abdul Latif Jameel Clinic for Machine Learning in Health, the collaboration aims to use artificial intelligence to both benefit human health and aid in drug development. Combining technology with cutting-edge health research, the program's participants hope to improve health outcomes across the world. Thus far, the partnership has supported joint research efforts focused on topics such as automated inspection in sterile pharmaceutical manufacturing and machine learning for liver phenotyping. Every year, the program also funds graduate fellowships to support students pursuing research on a broad range of issues tied to health and AI.