Discharge summaries in Electronic Health Records (EHRs) are crucial for clinical decision-making, but their length and complexity make information extraction challenging, especially when dealing with accumulated summaries across multiple patient admissions.

Timely access to laboratory values is critical for clinical decision-making, yet current approaches rely on invasive venous sampling and are intrinsically delayed. Electrocardiography (ECG), as a non-invasive and widely available signal, offers a promising modality for rapid laboratory estimation. Recent progress in deep learning has enabled the extraction of latent hematological signatures from ECGs. However, existing models are constrained by low signal-to-noise ratios, substantial inter-individual variability, limited data diversity, and suboptimal generalization, especially when adapted to low-lead wearable devices. In this work, we conduct an exploratory study leveraging transfer learning to fine-tune ECGFounder, a large-scale pre-trained ECG foundation model, on the Multimodal Clinical Monitoring in the Emergency Department (MC-MED) dataset from Stanford. We generated a corpus of more than 20 million standardized ten-second ECG segments to enhance sensitivity to subtle biochemical correlates. On internal validation, the model demonstrated strong predictive performance (area under the curve above 0.65) for thirty-three laboratory indicators, moderate performance (between 0.55 and 0.65) for fifty-nine indicators, and limited performance (below 0.55) for sixteen indicators. This study provides an efficient artificial-intelligence driven solution and establishes the feasibility scope for real-time, non-invasive estimation of laboratory values.

The recent boom of large language models (LLMs) has re-ignited the hope that artificial intelligence (AI) systems could aid medical diagnosis. Yet despite dazzling benchmark scores, LLM assistants have yet to deliver measurable improvements at the bedside. This scoping review aims to highlight the areas where AI is limited to make practical contributions in the clinical setting, specifically in dementia diagnosis and care. Standalone machine-learning models excel at pattern recognition but seldom provide actionable, interpretable guidance, eroding clinician trust. Adjacent use of LLMs by physicians did not result in better diagnostic accuracy or speed. Key limitations trace to the data-driven paradigm: black-box outputs which lack transparency, vulnerability to hallucinations, and weak causal reasoning. Hybrid approaches that combine statistical learning with expert rule-based knowledge, and involve clinicians throughout the process help bring back interpretability. They also fit better with existing clinical workflows, as seen in examples like PEIRS and ATHENA-CDS. Future decision-support should prioritise explanatory coherence by linking predictions to clinically meaningful causes. This can be done through neuro-symbolic or hybrid AI that combines the language ability of LLMs with human causal expertise. AI researchers have addressed this direction, with explainable AI and neuro-symbolic AI being the next logical steps in further advancement in AI. However, they are still based on data-driven knowledge integration instead of human-in-the-loop approaches. Future research should measure success not only by accuracy but by improvements in clinician understanding, workflow fit, and patient outcomes. A better understanding of what helps improve human-computer interactions is greatly needed for AI systems to become part of clinical practice.

Figure 1 presents examples of NotebookLM's shortcomings Importantly, using NotebookLM to educate medical professionals presently risks of misleading them, as NotebookLM's lack Inaccurate responses given by NotebookLM to user queries; output is stylized for visual clarity. NotebookLM advises the user to tell their patients that eating rocks is healthy, citing the user's document. Passages from Dihan et al. advocating for use of NotebookLM (Column 1) which are associated with clinical and/or ethical concerns "Though NotebookLM is a commercial entity that does not abide by patient privacy regulations, it does represent an " A podcast generator can improve the way Given any set of documents, and especially those containing complex documents, LLMs may misinterpret and subsequently misrepresent some of their contents. "Rather than requiring active visual engagement through reading, podcasts allow NotebookLM can neither identify misinformation contained within uploaded files nor incorporate relevant information beyond the uploaded content. "[NotebookLM's] citations are automatically generated for all content that NotebookLM pulls from within these materials, No funding was received for the publication of this article.

This is a pre-print version of an article published as: Hatherley, Joshua. Please cite that version. 2 Abstract: Artificial intelligence (AI) is expected to revolutionise the practice of medicine. Recent advancements in the field of deep learning have demonstrated success in variety of clinical tasks: detecting diabetic retinopathy from images, predicting hospital readmissions, aiding in the discovery of new drugs, etc. AI's progress in medicine, however, has led to concerns regarding the potential effects of this technology upon relationships of trust in clinical practice. In this paper, I will argue that there is merit to these concerns, since AI systems can be relied upon, and are capable of reliability, but cannot be trusted, and are not capable of trustworthiness. Insofar as patients are required to rely upon AI systems for their medical decision-making, there is potential for this to produce a deficit of trust in relationships in clinical practice.

The advent of Large Language Models (LLMs) offers potential solutions to address problems such as shortage of medical resources and low diagnostic consistency in psychiatric clinical practice. Despite this potential, a robust and comprehensive benchmarking framework to assess the efficacy of LLMs in authentic psychiatric clinical environments is absent. This has impeded the advancement of specialized LLMs tailored to psychiatric applications. In response to this gap, by incorporating clinical demands in psychiatry and clinical data, we proposed a benchmarking system, PsychBench, to evaluate the practical performance of LLMs in psychiatric clinical settings. We conducted a comprehensive quantitative evaluation of 16 LLMs using PsychBench, and investigated the impact of prompt design, chain-of-thought reasoning, input text length, and domain-specific knowledge fine-tuning on model performance. Through detailed error analysis, we identified strengths and potential limitations of the existing models and suggested directions for improvement. Subsequently, a clinical reader study involving 60 psychiatrists of varying seniority was conducted to further explore the practical benefits of existing LLMs as supportive tools for psychiatrists of varying seniority. Through the quantitative and reader evaluation, we show that while existing models demonstrate significant potential, they are not yet adequate as decision-making tools in psychiatric clinical practice. The reader study further indicates that, as an auxiliary tool, LLM could provide particularly notable support for junior psychiatrists, effectively enhancing their work efficiency and overall clinical quality. To promote research in this area, we will make the dataset and evaluation framework publicly available, with the hope of advancing the application of LLMs in psychiatric clinical settings.

Radiologists face increasing workload pressures amid growing imaging volumes, creating risks of burnout and delayed reporting times. While artificial intelligence (AI) based automated radiology report generation shows promise for reporting workflow optimization, evidence of its real-world impact on clinical accuracy and efficiency remains limited. This study evaluated the effect of draft reports on radiology reporting workflows by conducting a three reader multi-case study comparing standard versus AI-assisted reporting workflows. In both workflows, radiologists reviewed the cases and modified either a standard template (standard workflow) or an AI-generated draft report (AI-assisted workflow) to create the final report. For controlled evaluation, we used GPT-4 to generate simulated AI drafts and deliberately introduced 1-3 errors in half the cases to mimic real AI system performance. The AI-assisted workflow significantly reduced average reporting time from 573 to 435 seconds (p=0.003), without a statistically significant difference in clinically significant errors between workflows. These findings suggest that AI-generated drafts can meaningfully accelerate radiology reporting while maintaining diagnostic accuracy, offering a practical solution to address mounting workload challenges in clinical practice.

Explainable AI (XAI) holds the promise of advancing the implementation and adoption of AI-based tools in practice, especially in high-stakes environments like healthcare. However, most of the current research is disconnected from its practical applications and lacks input of end users. To address this, we conducted semi-structured interviews with clinicians to discuss their thoughts, hopes, and concerns. We find that clinicians generally think positively about developing AI-based tools for clinical practice, but they have concerns about how these will fit into their workflow and how it will impact clinician-patient relations. We further identify education of clinicians on AI as a crucial factor for the success of AI in healthcare and highlight aspects clinicians are looking for in (X)AI-based tools. In contrast to other studies, we take on a holistic and exploratory perspective to identify general requirements, which is necessary before moving on to testing specific (X)AI products for healthcare.

Objectives: To investigate clinicians' attitudes towards current automated interpretation of ECG and novel AI technologies and their perception of computer-assisted interpretation. Materials and Methods: We conducted a series of interviews with clinicians in the UK. Our study: (i) explores the potential for AI, specifically future 'human-like' computing approaches, to facilitate ECG interpretation and support clinical decision making, and (ii) elicits their opinions about the importance of explainability and trustworthiness of AI algorithms. Results: We performed inductive thematic analysis on interview transcriptions from 23 clinicians and identified the following themes: (i) a lack of trust in current systems, (ii) positive attitudes towards future AI applications and requirements for these, (iii) the relationship between the accuracy and explainability of algorithms, and (iv) opinions on education, possible deskilling, and the impact of AI on clinical competencies. Discussion: Clinicians do not trust current computerised methods, but welcome future 'AI' technologies. Where clinicians trust future AI interpretation to be accurate, they are less concerned that it is explainable. They also preferred ECG interpretation that demonstrated the results of the algorithm visually. Whilst clinicians do not fear job losses, they are concerned about deskilling and the need to educate the workforce to use AI responsibly. Conclusion: Clinicians are positive about the future application of AI in clinical decision-making. Accuracy is a key factor of uptake and visualisations are preferred over current computerised methods. This is viewed as a potential means of training and upskilling, in contrast to the deskilling that automation might be perceived to bring.

Knee osteoarthritis (OA) is a widespread chronic condition that impairs mobility and diminishes quality of life. Despite the proven benefits of exercise therapy and patient education in managing the OA symptoms pain and functional limitations, these strategies are often underutilized. Personalized outcome prediction models can help motivate and engage patients, but the accuracy of existing models in predicting changes in knee pain remains insufficiently examined. To validate existing models and introduce a concise personalized model predicting changes in knee pain before to after participating in a supervised education and exercise therapy program (GLA:D) for knee OA patients. Our models use self-reported patient information and functional measures. To refine the number of variables, we evaluated the variable importance and applied clinical reasoning. We trained random forest regression models and compared the rate of true predictions of our models with those utilizing average values. We evaluated the performance of a full, continuous, and concise model including all 34, all 11 continuous, and the six most predictive variables respectively. All three models performed similarly and were comparable to the existing model, with R-squares of 0.31-0.32 and RMSEs of 18.65-18.85 - despite our increased sample size. Allowing a deviation of 15 VAS points from the true change in pain, our concise model and utilizing the average values estimated the change in pain at 58% and 51% correctly, respectively. Our supplementary analysis led to similar outcomes. Our concise personalized prediction model more accurately predicts changes in knee pain following the GLA:D program compared to average pain improvement values. Neither the increase in sample size nor the inclusion of additional variables improved previous models. To improve predictions, new variables beyond those in the GLA:D are required.