The application of Large Language Models (LLMs) to various clinical applications has attracted growing research attention. However, real-world clinical decision-making differs significantly from the standardized, exam-style scenarios commonly used in current efforts. In this paper, we present the RiskAgent system to perform a broad range of medical risk predictions, covering over 387 risk scenarios across diverse complex diseases, e.g., cardiovascular disease and cancer. RiskAgent is designed to collaborate with hundreds of clinical decision tools, i.e., risk calculators and scoring systems that are supported by evidence-based medicine. To evaluate our method, we have built the first benchmark MedRisk specialized for risk prediction, including 12,352 questions spanning 154 diseases, 86 symptoms, 50 specialties, and 24 organ systems. The results show that our RiskAgent, with 8 billion model parameters, achieves 76.33% accuracy, outperforming the most recent commercial LLMs, o1, o3-mini, and GPT-4.5, and doubling the 38.39% accuracy of GPT-4o. On rare diseases, e.g., Idiopathic Pulmonary Fibrosis (IPF), RiskAgent outperforms o1 and GPT-4.5 by 27.27% and 45.46% accuracy, respectively. Finally, we further conduct a generalization evaluation on an external evidence-based diagnosis benchmark and show that our RiskAgent achieves the best results. These encouraging results demonstrate the great potential of our solution for diverse diagnosis domains. To improve the adaptability of our model in different scenarios, we have built and open-sourced a family of models ranging from 1 billion to 70 billion parameters. Our code, data, and models are all available at https://github.com/AI-in-Health/RiskAgent.

Multi-organ diseases present significant challenges due to their simultaneous impact on multiple organ systems, necessitating complex and adaptive treatment strategies. Despite recent advancements in AI-powered healthcare decision support systems, existing solutions are limited to individual organ systems. They often ignore the intricate dependencies between organ system and thereby fails to provide holistic treatment recommendations that are useful in practice. We propose a novel hierarchical multi-agent reinforcement learning (HMARL) framework to address these challenges. This framework uses dedicated agents for each organ system, and model dynamic through explicit inter-agent communication channels, enabling coordinated treatment strategies across organs. Furthermore, we introduce a dual-layer state representation technique to contextualize patient conditions at various hierarchical levels, enhancing the treatment accuracy and relevance. Through extensive qualitative and quantitative evaluations in managing sepsis (a complex multi-organ disease), our approach demonstrates its ability to learn effective treatment policies that significantly improve patient survival rates. This framework marks a substantial advancement in clinical decision support systems, pioneering a comprehensive approach for multi-organ treatment recommendations.

"Just Accepted" papers have undergone full peer review and have been accepted for publication in Radiology: Artificial Intelligence. This article will undergo copyediting, layout, and proof review before it is published in its final version. Please note that during production of the final copyedited article, errors may be discovered which could affect the content. To design multidisease classifiers for body CT scans for three different organ systems using automatically extracted labels from radiology text reports. This retrospective study included a total of 12,092 patients (mean age 57 18; 6,172 women) for model development and testing (from 2012–2017).

To develop a high throughput multi-label annotator for body Computed Tomography (CT) reports that can be applied to a variety of diseases, organs, and cases. First, we used a dictionary approach to develop a rule-based algorithm (RBA) for extraction of disease labels from radiology text reports. We targeted three organ systems (lungs/pleura, liver/gallbladder, kidneys/ureters) with four diseases per system based on their prevalence in our dataset. To expand the algorithm beyond pre-defined keywords, an attention-guided recurrent neural network (RNN) was trained using the RBA-extracted labels to classify the reports as being positive for one or more diseases or normal for each organ system. Confounding effects on model performance were evaluated using random or pre-trained embedding as well as different sizes of training datasets. Performance was evaluated using the receiver operating characteristic (ROC) area under the curve (AUC) against 2,158 manually obtained labels. Our model extracted disease labels from 261,229 radiology reports of 112,501 unique subjects. Pre-trained models outperformed random embedding across all diseases. As the training dataset size was reduced, performance was robust except for a few diseases with relatively small number of cases. Pre-trained Classification AUCs achieved > 0.95 for all five disease outcomes across all three organ systems. Our label-extracting pipeline was able to encompass a variety of cases and diseases by generalizing beyond strict rules with exceptional accuracy. As a framework, this model can be easily adapted to enable automated labeling of hospital-scale medical data sets for training image-based disease classifiers.

Despite diverse efforts to mine various modalities of medical data, the conversations between physicians and patients at the time of care remain an untapped source of insights. In this paper, we leverage this data to extract structured information that might assist physicians with post-visit documentation in electronic health records, potentially lightening the clerical burden. In this exploratory study, we describe a new dataset consisting of conversation transcripts, post-visit summaries, corresponding supporting evidence (in the transcript), and structured labels. We focus on the tasks of recognizing relevant diagnoses and abnormalities in the review of organ systems (RoS). One methodological challenge is that the conversations are long (around 1500 words), making it difficult for modern deep-learning models to use them as input. To address this challenge, we extract noteworthy utterances---parts of the conversation likely to be cited as evidence supporting some summary sentence. We find that by first filtering for (predicted) noteworthy utterances, we can significantly boost predictive performance for recognizing both diagnoses and RoS abnormalities.

That's the advice of scientists who claim our instinctive reactions act as a'red signal' that stops our brain from making mistakes. Our'gut feelings' are part of an elaborate protective system that prompts us to slow down and evaluate a situation, or avoid it completely, scientists said. If you don't make decisions by'going with your gut', you may want to start now. The research, from Florida State University in Tallahassee, advances our understanding of the gut-to-brain circuit - a poorly understood part of the body. 'The neuroscience of gut feelings has come a long way in my lifetime,' said study coauthor and Florida State neuroscientist Dr Linda Rinaman.