Realizing personalized medicine at scale calls for methods that distill insights from longitudinal patient journeys, which can be viewed as a sequence of medical events. Foundation models pretrained on large-scale medical event data represent a promising direction for scaling real-world evidence generation and generalizing to diverse downstream tasks. Using Epic Cosmos, a dataset with medical events from de-identified longitudinal health records for 16.3 billion encounters over 300 million unique patient records from 310 health systems, we introduce the Curiosity models, a family of decoder-only transformer models pretrained on 118 million patients representing 115 billion discrete medical events (151 billion tokens). We present the largest scaling-law study of medical event data, establishing a methodology for pretraining and revealing power-law scaling relationships for compute, tokens, and model size. Consequently, we pretrained a series of compute-optimal models with up to 1 billion parameters. Conditioned on a patient's real-world history, Curiosity autoregressively predicts the next medical event to simulate patient health timelines. We studied 78 real-world tasks, including diagnosis prediction, disease prognosis, and healthcare operations. Remarkably for a foundation model with generic pretraining and simulation-based inference, Curiosity generally outperformed or matched task-specific supervised models on these tasks, without requiring task-specific fine-tuning or few-shot examples. Curiosity's predictive power consistently improves as the model and pretraining scale. Our results show that Curiosity, a generative medical event foundation model, can effectively capture complex clinical dynamics, providing an extensible and generalizable framework to support clinical decision-making, streamline healthcare operations, and improve patient outcomes.

Training task-oriented dialog agents based on reinforcement learning is time-consuming and requires a large number of interactions with real users. How to grasp dialog policy within limited dialog experiences remains an obstacle that makes the agent training process less efficient. In addition, most previous frameworks start training by randomly choosing training samples, which differs from the human learning method and hurts the efficiency and stability of training. Therefore, we propose Scheduled Curiosity-Deep Dyna-Q (SC-DDQ), a curiosity-driven curriculum learning framework based on a state-of-the-art model-based reinforcement learning dialog model, Deep Dyna-Q (DDQ). Furthermore, we designed learning schedules for SC-DDQ and DDQ, respectively, following two opposite training strategies: classic curriculum learning and its reverse version. Our results show that by introducing scheduled learning and curiosity, the new framework leads to a significant improvement over the DDQ and Deep Q-learning(DQN). Surprisingly, we found that traditional curriculum learning was not always effective. Specifically, according to the experimental results, the easy-first and difficult-first strategies are more suitable for SC-DDQ and DDQ. To analyze our results, we adopted the entropy of sampled actions to depict action exploration and found that training strategies with high entropy in the first stage and low entropy in the last stage lead to better performance.

A computer algorithm equipped with a form of artificial curiosity can learn to solve tricky problems even when it isn't immediately clear what actions might help it reach this goal. Researchers at the University of California, Berkeley, developed an "intrinsic curiosity model" to make their learning algorithm work even when there isn't a strong feedback signal. The curiosity model developed by this team sees the AI software controlling a virtual agent in a video game seek to maximize its understanding of its environment and especially aspects of that environment that affect it. There have been previous efforts to give AI agents curiosity, but these have tended to work in a more simplistic way. The trick may help address a shortcoming of today's most powerful machine-learning techniques, and it could point to ways of making machines better at solving real-world problems.