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Domain Generalization for Medical Imaging Classification with Linear-Dependency Regularization

Neural Information Processing Systems

Recently, we have witnessed great progress in the field of medical imaging classification by adopting deep neural networks. However, the recent advanced models still require accessing sufficiently large and representative datasets for training, which is often unfeasible in clinically realistic environments. When trained on limited datasets, the deep neural network is lack of generalization capability, as the trained deep neural network on data within a certain distribution (e.g. the data captured by a certain device vendor or patient population) may not be able to generalize to the data with another distribution. In this paper, we introduce a simple but effective approach to improve the generalization capability of deep neural networks in the field of medical imaging classification. Motivated by the observation that the domain variability of the medical images is to some extent compact, we propose to learn a representative feature space through variational encoding with a novel linear-dependency regularization term to capture the shareable information among medical data collected from different domains. As a result, the trained neural network is expected to equip with better generalization capability to the ``unseen medical data. Experimental results on two challenging medical imaging classification tasks indicate that our method can achieve better cross-domain generalization capability compared with state-of-the-art baselines.


Hierarchical Dual-Strategy Unlearning for Biomedical and Healthcare Intelligence Using Imperfect and Privacy-Sensitive Medical Data

Zhang, Yi, Xu, Tianxiang, Li, Zijian, Zhang, Chao, Zhang, Kunyu, Gao, Zhan, Li, Meinuo, Zhang, Xiaohan, Qi, Qichao, Chen, Bing

arXiv.org Artificial Intelligence

Abstract--Large language models (LLMs) exhibit exceptional performance but pose substantial privacy risks due to training data memorization, particularly within healthcare contexts involving imperfect or privacy-sensitive patient information. We present a hierarchical dual-strategy framework for selective knowledge unlearning that precisely removes specialized knowledge while preserving fundamental medical competencies. Our approach synergistically integrates geometric-constrained gradient updates to selectively modulate target parameters with concept-aware token-level interventions that distinguish between preservation-critical and unlearning-targeted tokens via a unified four-level medical concept hierarchy. Comprehensive evaluations on the MedMCQA (surgical) and MHQA (anxiety, depression, trauma) datasets demonstrate superior performance, achieving an 82.7% forgetting rate and 88.5% knowledge preservation. Notably, our framework maintains robust privacy guarantees while requiring modification of only 0.1% of parameters, addressing critical needs for regulatory compliance, auditability, and ethical standards in clinical research. Large language models (LLMs) have transformed healthcare informatics, demonstrating remarkable capabilities in medical question-answering and clinical decision support. However, their deployment faces significant challenges when dealing with imperfect medical data, which is characteristically incomplete, insufficiently labelled, imbalanced, or contains annotation noise [4].


SynLLM: A Comparative Analysis of Large Language Models for Medical Tabular Synthetic Data Generation via Prompt Engineering

Ilaty, Arshia, Shirazi, Hossein, Homayouni, Hajar

arXiv.org Artificial Intelligence

--Access to real-world medical data is often restricted due to privacy regulations, posing a significant barrier to the advancement of healthcare research. Synthetic data offers a promising alternative; however, generating realistic, clinically valid, and privacy-conscious records remains a major challenge. Recent advancements in Large Language Models (LLMs) offer new opportunities for structured data generation; however, existing approaches frequently lack systematic prompting strategies and comprehensive, multi-dimensional evaluation frameworks. In this paper, we present SynLLM, a modular framework for generating high-quality synthetic medical tabular data using 20 state-of-the-art open-source LLMs, including LLaMA, Mistral, and GPT variants, guided by structured prompts. We propose four distinct prompt types, ranging from example-driven to rule-based constraints, that encode schema, metadata, and domain knowledge to control generation without model fine-tuning. Our framework features a comprehensive evaluation pipeline that rigorously assesses generated data across statistical fidelity, clinical consistency, and privacy preservation. We evaluate SynLLM across three public medical datasets, including Diabetes, Cirrhosis, and Stroke, using 20 open-source LLMs. Our results show that prompt engineering significantly impacts data quality and privacy risk, with rule-based prompts achieving the best privacy-quality balance. SynLLM establishes that, when guided by well-designed prompts and evaluated with robust, multi-metric criteria, LLMs can generate synthetic medical data that is both clinically plausible and privacy-aware, paving the way for safer and more effective data sharing in healthcare research. Access to real-world medical data is frequently restricted due to privacy regulations, ethical constraints, and institutional barriers, posing a significant challenge for the development of AI-driven healthcare solutions. While data protection laws such as the Health Insurance Portability and Accountability Act (HIP AA) [11] and the General Data Protection Regulation (GDPR) [37] are essential for safeguarding patient confidentiality, they often hinder the availability of data for clinical model development and research.


Cross-patient Seizure Onset Zone Classification by Patient-Dependent Weight

Zhao, Xuyang, Sugano, Hidenori, Tanaka, Toshihisa

arXiv.org Artificial Intelligence

Identifying the seizure onset zone (SOZ) in patients with focal epilepsy is essential for surgical treatment and remains challenging due to its dependence on visual judgment by clinical experts. The development of machine learning can assist in diagnosis and has made promising progress. However, unlike data in other fields, medical data is usually collected from individual patients, and each patient has different illnesses, physical conditions, and medical histories, which leads to differences in the distribution of each patient's data. This makes it difficult for a machine learning model to achieve consistently reliable performance in every new patient dataset, which we refer to as the "cross-patient problem." In this paper, we propose a method to fine-tune a pretrained model using patient-specific weights for every new test patient to improve diagnostic performance. First, the supervised learning method is used to train a machine learning model. Next, using the intermediate features of the trained model obtained through the test patient data, the similarity between the test patient data and each training patient's data is defined to determine the weight of each training patient to be used in the following fine-tuning. Finally, we fine-tune all parameters in the pretrained model with training data and patient weights. In the experiment, the leave-one-patient-out method is used to evaluate the proposed method, and the results show improved classification accuracy for every test patient, with an average improvement of more than 10%.


Tree-of-Reasoning: Towards Complex Medical Diagnosis via Multi-Agent Reasoning with Evidence Tree

Peng, Qi, Cui, Jialin, Xie, Jiayuan, Cai, Yi, Li, Qing

arXiv.org Artificial Intelligence

Large language models (LLMs) have shown great potential in the medical domain. However, existing models still fall short when faced with complex medical diagnosis task in the real world. This is mainly because they lack sufficient reasoning depth, which leads to information loss or logical jumps when processing a large amount of specialized medical data, leading to diagnostic errors. To address these challenges, we propose Tree-of-Reasoning (ToR), a novel multi-agent framework designed to handle complex scenarios. Specifically, ToR introduces a tree structure that can clearly record the reasoning path of LLMs and the corresponding clinical evidence. At the same time, we propose a cross-validation mechanism to ensure the consistency of multi-agent decision-making, thereby improving the clinical reasoning ability of multi-agents in complex medical scenarios. Experimental results on real-world medical data show that our framework can achieve better performance than existing baseline methods.


Leveraging the Structure of Medical Data for Improved Representation Learning

Agostini, Andrea, Laguna, Sonia, Ryser, Alain, Ruiperez-Campillo, Samuel, Vandenhirtz, Moritz, Deperrois, Nicolas, Nooralahzadeh, Farhad, Krauthammer, Michael, Sutter, Thomas M., Vogt, Julia E.

arXiv.org Artificial Intelligence

Building generalizable medical AI systems requires pretraining strategies that are data-efficient and domain-aware. Unlike internet-scale corpora, clinical datasets such as MIMIC-CXR offer limited image counts and scarce annotations, but exhibit rich internal structure through multi-view imaging. We propose a self-supervised framework that leverages the inherent structure of medical datasets. Specifically, we treat paired chest X-rays (i.e., frontal and lateral views) as natural positive pairs, learning to reconstruct each view from sparse patches while aligning their latent embeddings. Our method requires no textual supervision and produces informative representations. Evaluated on MIMIC-CXR, we show strong performance compared to supervised objectives and baselines being trained without leveraging structure. This work provides a lightweight, modality-agnostic blueprint for domain-specific pretraining where data is structured but scarce


Forget-MI: Machine Unlearning for Forgetting Multimodal Information in Healthcare Settings

Hardan, Shahad, Taratynova, Darya, Essofi, Abdelmajid, Nandakumar, Karthik, Yaqub, Mohammad

arXiv.org Artificial Intelligence

Privacy preservation in AI is crucial, especially in healthcare, where models rely on sensitive patient data. In the emerging field of machine unlearning, existing methodologies struggle to remove patient data from trained multimodal architectures, which are widely used in healthcare. We propose Forget-MI, a novel machine unlearning method for multimodal medical data, by establishing loss functions and perturbation techniques. Our approach unlearns unimodal and joint representations of the data requested to be forgotten while preserving knowledge from the remaining data and maintaining comparable performance to the original model. We evaluate our results using performance on the forget dataset, performance on the test dataset, and Membership Inference Attack (MIA), which measures the attacker's ability to distinguish the forget dataset from the training dataset. Our model outperforms the existing approaches that aim to reduce MIA and the performance on the forget dataset while keeping an equivalent performance on the test set. Specifically, our approach reduces MIA by 0.202 and decreases AUC and F1 scores on the forget set by 0.221 and 0.305, respectively. Additionally, our performance on the test set matches that of the retrained model, while allowing forgetting. Code is available at https://github.com/BioMedIA-MBZUAI/Forget-MI.git


The Latent Space Hypothesis: Toward Universal Medical Representation Learning

Patel, Salil

arXiv.org Artificial Intelligence

Medical data range from genomic sequences and retinal photographs to structured laboratory results and unstructured clinical narratives. Although these modalities appear disparate, many encode convergent information about a single underlying physiological state. The Latent Space Hypothesis frames each observation as a projection of a unified, hierarchically organized manifold -- much like shadows cast by the same three-dimensional object. Within this learned geometric representation, an individual's health status occupies a point, disease progression traces a trajectory, and therapeutic intervention corresponds to a directed vector. Interpreting heterogeneous evidence in a shared space provides a principled way to re-examine eponymous conditions -- such as Parkinson's or Crohn's -- that often mask multiple pathophysiological entities and involve broader anatomical domains than once believed. By revealing sub-trajectories and patient-specific directions of change, the framework supplies a quantitative rationale for personalised diagnosis, longitudinal monitoring, and tailored treatment, moving clinical practice away from grouping by potentially misleading labels toward navigation of each person's unique trajectory. Challenges remain -- bias amplification, data scarcity for rare disorders, privacy, and the correlation-causation divide -- but scale-aware encoders, continual learning on longitudinal data streams, and perturbation-based validation offer plausible paths forward.


Concerns raised over AI trained on 57 million NHS medical records

New Scientist

An artificial intelligence model trained on the medical data of 57 million people who have used the National Health Service in England could one day assist doctors in predicting disease or forecast hospitalisation rates, its creators have claimed. However, other researchers say there are still significant privacy and data protection concerns around such large-scale use of health data, while even the AI's architects say they can't guarantee that it won't inadvertently reveal sensitive patient data. The model, called Foresight, was first developed in 2023. That initial version used OpenAI's GPT-3, the large language model (LLM) behind the first version of ChatGPT, and trained on 1.5 million real patient records from two London hospitals. Now, Chris Tomlinson at University College London and his colleagues have scaled up Foresight to create what they say is the world's first "national-scale generative AI model of health data" and the largest of its kind.


Baichuan-M1: Pushing the Medical Capability of Large Language Models

Wang, Bingning, Zhao, Haizhou, Zhou, Huozhi, Song, Liang, Xu, Mingyu, Cheng, Wei, Zeng, Xiangrong, Zhang, Yupeng, Huo, Yuqi, Wang, Zecheng, Zhao, Zhengyun, Pan, Da, Yang, Fan, Kou, Fei, Li, Fei, Chen, Fuzhong, Dong, Guosheng, Liu, Han, Zhang, Hongda, He, Jin, Yang, Jinjie, Wu, Kangxi, Wu, Kegeng, Su, Lei, Niu, Linlin, Sun, Linzhuang, Wang, Mang, Fan, Pengcheng, Shen, Qianli, Xin, Rihui, Dang, Shunya, Zhou, Songchi, Chen, Weipeng, Luo, Wenjing, Chen, Xin, Men, Xin, Lin, Xionghai, Dong, Xuezhen, Zhang, Yan, Duan, Yifei, Zhou, Yuyan, Ma, Zhi, Wu, Zhiying

arXiv.org Artificial Intelligence

The current generation of large language models (LLMs) is typically designed for broad, general-purpose applications, while domain-specific LLMs, especially in vertical fields like medicine, remain relatively scarce. In particular, the development of highly efficient and practical LLMs for the medical domain is challenging due to the complexity of medical knowledge and the limited availability of high-quality data. To bridge this gap, we introduce Baichuan-M1, a series of large language models specifically optimized for medical applications. Unlike traditional approaches that simply continue pretraining on existing models or apply post-training to a general base model, Baichuan-M1 is trained from scratch with a dedicated focus on enhancing medical capabilities. Our model is trained on 20 trillion tokens and incorporates a range of effective training methods that strike a balance between general capabilities and medical expertise. As a result, Baichuan-M1 not only performs strongly across general domains such as mathematics and coding but also excels in specialized medical fields. We have open-sourced Baichuan-M1-14B, a mini version of our model, which can be accessed through the following links.