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Precision Physical Activity Prescription via Reinforcement Learning for Functional Actions

arXiv.org Machine Learning

Physical activity (PA) plays an important role in maintaining and improving health. Daily steps have been a key PA measure that is easily accessible with common wearable devices. However, methods are lacking to recommend a personalized optimal distribution of daily steps over a period of time for the best of certain health biomarkers. In this paper, we fill this void based on the data from the All of Us Research Program which includes months of step counts as well as repeated measurements of key health biomarkers. We develop a new offline reinforcement learning (RL) algorithm to learn personalized and optimal PA distributions associated with cardiometabolic risk, where the action is a function representing the daily step distribution over a period of time. Simulation studies demonstrate the advantage of the proposed approach over existing continuous-action RL methods. The learned optimal policy from the All of Us data generally suggests people take more daily steps and also follow a more consistent pattern of PA over time while offering tailored recommendations for subgroups in blood glucose level, body mass index, blood pressure, age, and sex.


Hyperparameter Transfer for Dense Associative Memories

arXiv.org Machine Learning

Dense Associative Memory (DenseAM) is a promising family of AI architectures that is represented by a neural network performing temporal dynamics on an energy landscape. While hyperparameter transfer methods are well-studied for feed-forward networks, these methods have not been developed for settings in which weights are shared across layers and within the layer, which is common in DenseAMs. Additionally, DenseAMs utilize rapidly peaking activation functions that are rarely used in feed-forward architectures. The confluence of these aspects makes DenseAM a challenging framework for using existing methods for hyperparameter transfer. Our work initiates the development of hyperparameter transfer methods for this class of models. We derive explicit prescriptions for how the hyperparameters tuned on small models can be transferred to models trained at scale. We demonstrate excellent agreement between these theoretical findings and empirical results.






SupplementaryMaterial

Neural Information Processing Systems

This work was supported by Institute of Information & Communications Technology Planning & Evaluation (IITP) grant (No.2019-0-00075, Artificial Intelligence Graduate School Program(KAIST)), National Research Foundation of Korea (NRF) grant (NRF2020H1D3A2A03100945) andDataVoucher grant(2021-DV-I-P-00114), funded bythe Koreagovernment(MSIT). The dataset contains question-SQL pairs if the question is answerable. Are relationships between individual instances made explicit (e.g., users' movie ratings, socialnetworklinks)? N/A. Arethereanyerrors,sourcesofnoise,orredundanciesinthedataset? Question templates are created to have slots that are later filled with pre-defined values and records from the database. EHRSQL is based on patients in MIMIC-III and eICU.


Clinician-Directed Large Language Model Software Generation for Therapeutic Interventions in Physical Rehabilitation

arXiv.org Artificial Intelligence

Digital health interventions increasingly deliver home exercise programs via sensor-equipped devices such as smartphones, enabling remote monitoring of adherence and performance. However, current software is usually authored before clinical encounters as libraries of modules for broad impairment categories. At the point of care, clinicians can only choose from these modules and adjust a few parameters (for example, duration or repetitions). As a result, individual limitations, goals, and environmental constraints are often not reflected, limiting personalization and benefit. We propose a paradigm in which large language models (LLMs) act as constrained translators that convert clinicians' exercise prescriptions into intervention software. Clinicians remain the decision makers: they design exercises during the encounter, tailored to each patient's impairments, goals, and environment, and the LLM generates matching software. We conducted a prospective single-arm feasibility study with 20 licensed physical and occupational therapists who created 40 individualized upper extremity programs for a standardized patient; 100% of prescriptions were translated into executable software, compared with 55% under a representative template-based digital health intervention (p < 0.01). LLM-generated software correctly delivered 99.7% of instructions and monitored performance with 88.4% accuracy (95% confidence interval, 0.843-0.915). Overall, 90% of therapists judged the system safe for patient interaction and 75% expressed willingness to adopt it in practice. To our knowledge, this is the first prospective evaluation of clinician-directed intervention software generation with an LLM in health care, demonstrating feasibility and motivating larger trials in real patient populations.


Many-to-One Adversarial Consensus: Exposing Multi-Agent Collusion Risks in AI-Based Healthcare

arXiv.org Artificial Intelligence

Abstract--The integration of large language models (LLMs) into healthcare IoT systems promises faster decisions and improved medical support. LLMs are also deployed as multi-agent teams to assist AI doctors by debating, voting, or advising on decisions. However, when multiple assistant agents interact, coordinated adversaries can collude to create false consensus, pushing an AI doctor toward harmful prescriptions. We develop an experimental framework with scripted and unscripted doctor agents, adversarial assistants, and a verifier agent that checks decisions against clinical guidelines. Using 50 representative clinical questions, we find that collusion drives the Attack Success Rate (ASR) and Harmful Recommendation Rates (HRR) up to 100% in unprotected systems. This work provides the first systematic evidence of collusion risk in AI healthcare and demonstrates a practical, lightweight defence that ensures guideline fidelity. Artificial intelligence (AI) is increasingly integrated into healthcare IoT systems, supporting tasks such as remote patient monitoring, diagnosis, and treatment recommendations. In this setting, ensuring the security and trustworthiness of AI decisions is critical, since medical errors caused by unsafe recommendations can severely harm patients [1]. However, AI doctors and LLM-based clinical decision agents face multiple vulnerabilities.


Conversational LLMs Simplify Secure Clinical Data Access, Understanding, and Analysis

arXiv.org Artificial Intelligence

Large-scale clinical databases offer opportunities for medical research, but their complexity creates barriers to effective use. The Medical Information Mart for Intensive Care (MIMIC-IV), one of the world's largest open-source electronic health record databases, traditionally requires both SQL proficiency and clinical domain expertise. We introduce M3, a system that enables natural language querying of MIMIC-IV data through the Model Context Protocol. With a single command, M3 retrieves MIMIC-IV from PhysioNet, launches a local SQLite instance or connects to hosted BigQuery, and allows researchers to pose clinical questions in plain English. We evaluated M3 using one hundred questions from the EHRSQL 2024 benchmark with two language models: the proprietary Claude Sonnet 4 achieved 94% accuracy, while the open-source gpt-oss-20B (deployable locally on consumer hardware) achieved 93% accuracy. Both models translate natural language into SQL, execute queries against MIMIC-IV, and return structured results alongside the underlying query for verification. Error analysis revealed that most failures stemmed from complex temporal reasoning or ambiguous question phrasing rather than fundamental architectural limitations. The comparable performance of a smaller open-source model demonstrates that privacy-preserving local deployment is viable for sensitive clinical data analysis. M3 lowers technical barriers to critical care data analysis while maintaining security through OAuth2 authentication, query validation, and comprehensive audit logging.