Large language models (LLMs) have shown remarkable capabilities in various natural language processing tasks, yet they often struggle with maintaining factual accuracy, particularly in knowledge-intensive domains like healthcare. This study introduces LEAF: Learning and Evaluation Augmented by Fact-Checking, a novel approach designed to enhance the factual reliability of LLMs, with a focus on medical question answering (QA). LEAF utilizes a dual strategy to enhance the factual accuracy of responses from models such as Llama 3 70B Instruct and Llama 3 8B Instruct. The first strategy, Fact-Check-Then-RAG, improves Retrieval-Augmented Generation (RAG) by incorporating fact-checking results to guide the retrieval process without updating model parameters. The second strategy, Learning from Fact-Checks via Self-Training, involves supervised fine-tuning (SFT) on fact-checked responses or applying Simple Preference Optimization (SimPO) with fact-checking as a ranking mechanism, both updating LLM parameters from supervision. These findings suggest that integrating fact-checked responses whether through RAG enhancement or self-training enhances the reliability and factual correctness of LLM outputs, offering a promising solution for applications where information accuracy is crucial.

A vascular necrosis (AVN) of the femoral head is a common yet poten(cid:173) tially serious disorder which can be detected in its very early stages with magnetic resonance imaging. We have developed multi-layer perceptron networks, trained with conjugate gradient optimization, which diagnose A VN from single magnetic resonance images of the femoral head with 100% accuracy on training data and 97% accuracy on test data.

As the first-line diagnostic imaging modality, radiography plays an essential role in the early detection of developmental dysplasia of the hip (DDH). Clinically, the diagnosis of DDH relies on manual measurements and subjective evaluation of different anatomical features from pelvic radiographs. This process is inefficient and error-prone and requires years of clinical experience. In this study, we propose a deep learning-based system that automatically detects 14 keypoints from a radiograph, measures three anatomical angles (center-edge, T\"onnis, and Sharp angles), and classifies DDH hips as grades I-IV based on the Crowe criteria. Moreover, a novel data-driven scoring system is proposed to quantitatively integrate the information from the three angles for DDH diagnosis. The proposed keypoint detection model achieved a mean (95% confidence interval [CI]) average precision of 0.807 (0.804-0.810). The mean (95% CI) intraclass correlation coefficients between the center-edge, Tonnis, and Sharp angles measured by the proposed model and the ground-truth were 0.957 (0.952-0.962), 0.947 (0.941-0.953), and 0.953 (0.947-0.960), respectively, which were significantly higher than those of experienced orthopedic surgeons (p<0.0001). In addition, the mean (95% CI) test diagnostic agreement (Cohen's kappa) obtained using the proposed scoring system was 0.84 (0.83-0.85), which was significantly higher than those obtained from diagnostic criteria for individual angle (0.76 [0.75-0.77]) and orthopedists (0.71 [0.63-0.79]). To the best of our knowledge, this is the first study for objective DDH diagnosis by leveraging deep learning keypoint detection and integrating different anatomical measurements, which can provide reliable and explainable support for clinical decision-making.

As the first diagnostic imaging modality of avascular necrosis of the femoral head (AVNFH), accurately staging AVNFH from a plain radiograph is critical and challenging for orthopedists. Thus, we propose a deep learning-based AVNFH diagnosis system (AVN-net). The proposed AVN-net reads plain radiographs of the pelvis, conducts diagnosis, and visualizes results automatically. Deep convolutional neural networks are trained to provide an end-to-end diagnosis solution, covering femoral head detection, exam-view/sides identification, AVNFH diagnosis, and key clinical note generation subtasks. AVN-net is able to obtain state-of-the-art testing AUC of 0.95 (95% CI: 0.92-0.98) in AVNFH detection and significantly greater F1 scores (p<0.01) than less-to-moderately experienced orthopedists in all diagnostic tests. Furthermore, two real-world pilot studies were conducted for diagnosis support and education assistance, respectively, to assess the utility of AVN-net. The experimental results are promising. With the AVN-net diagnosis as a reference, the diagnostic accuracy and consistency of all orthopedists considerably improved while requiring only 1/4 of the time. Students self-studying the AVNFH diagnosis using AVN-net can learn better and faster than the control group. To the best of our knowledge, this study is the first research on the prospective use of a deep learning-based diagnosis system for AVNFH by conducting two pilot studies representing real-world application scenarios. We have demonstrated that the proposed AVN-net achieves expert-level AVNFH diagnosis performance, provides efficient support in clinical decision-making, and effectively passes clinical experience to students.

We propose approaches based on deep learning to localize objects in images when only a small training dataset is available and the images have low quality. That applies to many problems in medical image processing, and in particular to the analysis of fluoroscopic (low-dose) X-ray images, where the images have low contrast. We solve the problem by incorporating high-level information about the objects, which could be a simple geometrical model, like a circular outline, or a more complex statistical model. A simple geometrical representation can sufficiently describe some objects and only requires minimal labeling. Statistical shape models can be used to represent more complex objects. We propose computationally efficient two-stage approaches, which we call deep morphing, for both representations by fitting the representation to the output of a deep segmentation network.

Although many workers have applied neural nets to various types of I-dimensional medical data (e.g. ECG and EEG waveforms), little work has been done on applying neural nets to diagnosis directly from medical images.

Although many workers have applied neural nets to various types of I-dimensional medical data (e.g. ECG and EEG waveforms), little work has been done on applying neural nets to diagnosis directly from medical images.

Armando Manduca Dept. of Physiology and Biophysics Mayo Clinic Rochester, MN 55905 PaulChristy Dept. of Diagnostic Radiology Mayo Clinic Rochester, MN 55905 Richard Ehman Dept. of Diagnostic Radiology Mayo Clinic Rochester, MN 55905 Abstract Avascular necrosis (AVN) of the femoral head is a common yet potentially seriousdisorder which can be detected in its very early stages with magnetic resonance imaging. We have developed multi-layer perceptron networks, trained with conjugate gradient optimization, which diagnose AVN from single magnetic resonance images of the femoral head with 100% accuracy on training data and 97% accuracy on test data. 1 INTRODUCTION Diagnostic radiology may be a very natural field of application for neural networks, since a simple answer is desired from a complex image, and the learning process that human experts undergo is to a large extent a supervised learning experience based on looking at large numbers of images with known interpretations. Although many workers have applied neural nets to various types of I-dimensional medical data (e.g. ECG and EEG waveforms), little work has been done on applying neural nets to diagnosis directly from medical images. We chose the diagnosis of avascular necrosis from magnetic resonance images as an ideal initial problem, because: the area in question is small and well-defined, its size and shape do not vary greatly between individuals, the condition (if present) is usually visible even at low spatial and gray level resolution on a single image, and real data is readily available.