搜索结果：Gastroenterology

Miscalibrated confidence scores are a practical obstacle to deploying AI in clinical settings. A model that is always overconfident offers no useful signal for deferral. We present a multi-agent framework that combines domain-specific specialist agents with Two-Phase Verification and S-Score Weighted Fusion to improve both calibration and discrimination in medical multiple-choice question answering. Four specialist agents (respiratory, cardiology, neurology, gastroenterology) generate independent diagnoses using Qwen2.5-7B-Instruct. Each diagnosis is then subjected to a two-phase self-verification process that measures internal consistency and produces a Specialist Confidence Score (S-score). The S-scores drive a weighted fusion strategy that selects the final answer and calibrates the reported confidence. We evaluate across four experimental settings, covering 100-question and 250-question high-disagreement subsets of both MedQA-USMLE and MedMCQA. Calibration improvement is the central finding, with ECE reduced by 49-74% across all four settings, including the harder MedMCQA benchmark where these gains persist even when absolute accuracy is constrained by knowledge-intensive recal

Accurate segmentation of gastrointestinal (GI) organs in magnetic resonance enterography (MRE) is critical for diagnosing inflammatory bowel disease (IBD). However, anatomical variability, class imbalance, and low tissue contrast hinder reliable automation. This study proposes a dual-stage deep learning framework for organ-specific segmentation of GI structures from coronal MRE images to address these challenges. A publicly available MRE dataset of 3,195 coronal T2-weighted HASTE slices from 114 IBD patients was used. Initially, a DenseNet201-UNet++ model generated coarse masks for ROI extraction. A DenseNet121-SelfONN-UNet model was then trained on organ-specific patches. Extensive data augmentation, normalization, five-fold cross-validation, and class-specific weighting were applied to mitigate severe class imbalance, particularly for the appendix. The initial stage achieved strong organ localization but underperformed for the appendix; class weighting improved its DSC from 6.76% to 85.76%. The second-stage DenseNet121-SelfONN-UNet significantly enhanced segmentation across all GI structures, with notable DSC gains (cecum +23.62%, sigmoid +18.57%, rectum +17.99%, small intestine

Multimodal Large Language Models (MLLMs) show promise in gastroenterology, yet their performance against comprehensive clinical workflows and human benchmarks remains unverified. To systematically evaluate state-of-the-art MLLMs across a panoramic gastrointestinal endoscopy workflow and determine their clinical utility compared with human endoscopists. We constructed GI-Bench, a benchmark encompassing 20 fine-grained lesion categories. Twelve MLLMs were evaluated across a five-stage clinical workflow: anatomical localization, lesion identification, diagnosis, findings description, and management. Model performance was benchmarked against three junior endoscopists and three residency trainees using Macro-F1, mean Intersection-over-Union (mIoU), and multi-dimensional Likert scale. Gemini-3-Pro achieved state-of-the-art performance. In diagnostic reasoning, top-tier models (Macro-F1 0.641) outperformed trainees (0.492) and rivaled junior endoscopists (0.727; p>0.05). However, a critical "spatial grounding bottleneck" persisted; human lesion localization (mIoU >0.506) significantly outperformed the best model (0.345; p<0.05). Furthermore, qualitative analysis revealed a "fluen

Inpainting, the process of filling missing or corrupted image parts, has broad applications in medical imaging. However, generating anatomically accurate synthetic polyp images for clinical AI is a largely underexplored problem. In specialized fields like gastroenterology, inaccuracies in generated images can lead to false patterns and significant errors in downstream diagnosis. To ensure reliability, models require direct feedback from domain experts like oncologists. We propose PrefPaint, an interactive system that incorporates expert human feedback into Stable Diffusion Inpainting. By using D3PO instead of full RLHF, our approach bypasses the need for computationally expensive reward models, making it a highly practical choice for resource-constrained clinical settings. Furthermore, we introduce a streamlined web-based interface to facilitate this expert-in-the-loop training. Central to this platform is the Model Tree versioning interface, a novel HCI concept that visualizes the evolutionary progression of fine-tuned models. This interactive interface provides a smooth and intuitive user experience, making it easier to offer feedback and manage the fine-tuning process. User stud

Vision-language foundation models (VLMs) show promise for diverse imaging tasks but often underperform on medical benchmarks. Prior efforts to improve performance include model finetuning, which requires large domain-specific datasets and significant compute, or manual prompt engineering, which is hard to generalize and often inaccessible to medical institutions seeking to deploy these tools. These challenges motivate interest in approaches that draw on a model's embedded knowledge while abstracting away dependence on human-designed prompts to enable scalable, weight-agnostic performance improvements. To explore this, we adapt the Declarative Self-improving Python (DSPy) framework for structured automated prompt optimization in medical vision-language systems through a comprehensive, formal evaluation. We implement prompting pipelines for five medical imaging tasks across radiology, gastroenterology, and dermatology, evaluating 10 open-source VLMs with four prompt optimization techniques. Optimized pipelines achieved a median relative improvement of 53% over zero-shot prompting baselines, with the largest gains ranging from 300% to 3,400% on tasks where zero-shot performance is low

The rapid advancement of large language models(LLMs) has prompted significant interest in their potential applications in medical domains. This paper presents a comprehensive benchmark evaluation of 27 state-of-the-art LLMs on Chinese medical examination questions, encompassing seven medical specialties across two professional levels. We introduce a robust evaluation framework that assesses model performance on 2,800 carefully curated questions from cardiovascular, gastroenterology, hematology, infectious diseases, nephrology, neurology, and respiratory medicine domains. Our dataset distinguishes between attending physician and senior physician difficulty levels, providing nuanced insights into model capabilities across varying complexity. Our empirical analysis reveals substantial performance variations among models, with Mixtral-8x7B achieving the highest overall accuracy of 74.25%, followed by DeepSeek-R1-671B at 64.07%. Notably, we observe no consistent correlation between model size and performance, as evidenced by the strong performance of smaller mixture-of-experts architectures. The evaluation demonstrates significant performance gaps between medical specialties, with model

This study presents the first comprehensive evaluation of thinking budget mechanisms in medical reasoning tasks, revealing fundamental scaling laws between computational resources and reasoning quality. We systematically evaluated two major model families, Qwen3 (1.7B to 235B parameters) and DeepSeek-R1 (1.5B to 70B parameters), across 15 medical datasets spanning diverse specialties and difficulty levels. Through controlled experiments with thinking budgets ranging from zero to unlimited tokens, we establish logarithmic scaling relationships where accuracy improvements follow a predictable pattern with both thinking budget and model size. Our findings identify three distinct efficiency regimes: high-efficiency (0 to 256 tokens) suitable for real-time applications, balanced (256 to 512 tokens) offering optimal cost-performance tradeoffs for routine clinical support, and high-accuracy (above 512 tokens) justified only for critical diagnostic tasks. Notably, smaller models demonstrate disproportionately larger benefits from extended thinking, with 15 to 20% improvements compared to 5 to 10% for larger models, suggesting a complementary relationship where thinking budget provides grea

Clinical ML workflows are often fragmented and inefficient: triage, task selection, and model deployment are handled by a patchwork of task-specific networks. These pipelines are rarely aligned with data-science practice, reducing efficiency and increasing operational cost. They also lack data-driven model identification (from imaging/tabular inputs) and standardized delivery of model outputs. We present a framework that employs a single vision-language model (VLM) in two complementary, modular roles. First (Solution 1): the VLM acts as an aware model-card matcher that routes an incoming image to the appropriate specialist model via a three-stage workflow (modality -> primary abnormality -> model-card ID). Reliability is improved by (i) stage-wise prompts enabling early termination via "None"/"Other" and (ii) a calibrated top-2 answer selector with a stage-wise cutoff. This raises routing accuracy by +9 and +11 percentage points on the training and held-out splits, respectively, compared with a baseline router, and improves held-out calibration (lower Expected Calibration Error, ECE). Second (Solution 2): we fine-tune the same VLM on specialty-specific datasets so that one mo

The significant breakthroughs of Medical Multi-Modal Large Language Models (Med-MLLMs) renovate modern healthcare with robust information synthesis and medical decision support. However, these models are often evaluated on benchmarks that are unsuitable for the Med-MLLMs due to the complexity of real-world diagnostics across diverse specialties. To address this gap, we introduce Asclepius, a novel Med-MLLM benchmark that comprehensively assesses Med-MLLMs in terms of: distinct medical specialties (cardiovascular, gastroenterology, etc.) and different diagnostic capacities (perception, disease analysis, etc.). Grounded in 3 proposed core principles, Asclepius ensures a comprehensive evaluation by encompassing 15 medical specialties, stratifying into 3 main categories and 8 sub-categories of clinical tasks, and exempting overlap with existing VQA dataset. We further provide an in-depth analysis of 6 Med-MLLMs and compare them with 3 human specialists, providing insights into their competencies and limitations in various medical contexts. Our work not only advances the understanding of Med-MLLMs' capabilities but also sets a precedent for future evaluations and the safe deployment of

This paper presents a deep learning framework for the multi-class classification of gastrointestinal abnormalities in Video Capsule Endoscopy (VCE) frames. The aim is to automate the identification of ten GI abnormality classes, including angioectasia, bleeding, and ulcers, thereby reducing the diagnostic burden on gastroenterologists. Utilizing an ensemble of DenseNet and ResNet architectures, the proposed model achieves an overall accuracy of 94\% across a well-structured dataset. Precision scores range from 0.56 for erythema to 1.00 for worms, with recall rates peaking at 98% for normal findings. This study emphasizes the importance of robust data preprocessing techniques, including normalization and augmentation, in enhancing model performance. The contributions of this work lie in developing an effective AI-driven tool that streamlines the diagnostic process in gastroenterology, ultimately improving patient care and clinical outcomes.

Background: Colonoscopy, a crucial diagnostic tool in gastroenterology, depends heavily on superior bowel preparation. ChatGPT, a large language model with emergent intelligence which also exhibits potential in medical applications. This study aims to assess the accuracy and consistency of ChatGPT in using the Boston Bowel Preparation Scale (BBPS) for colonoscopy assessment. Methods: We retrospectively collected 233 colonoscopy images from 2020 to 2023. These images were evaluated using the BBPS by 3 senior endoscopists and 3 novice endoscopists. Additionally, ChatGPT also assessed these images, having been divided into three groups and undergone specific Fine-tuning. Consistency was evaluated through two rounds of testing. Results: In the initial round, ChatGPT's accuracy varied between 48.93% and 62.66%, trailing the endoscopists' accuracy of 76.68% to 77.83%. Kappa values for ChatGPT was between 0.52 and 0.53, compared to 0.75 to 0.87 for the endoscopists. Conclusion: While ChatGPT shows promise in bowel preparation scoring, it currently does not match the accuracy and consistency of experienced endoscopists. Future research should focus on in-depth Fine-tuning.

In the pharmaceutical industry, the use of artificial intelligence (AI) has seen consistent growth over the past decade. This rise is attributed to major advancements in statistical machine learning methodologies, computational capabilities and the increased availability of large datasets. AI techniques are applied throughout different stages of drug development, ranging from drug discovery to post-marketing benefit-risk assessment. Kolluri et al. provided a review of several case studies that span these stages, featuring key applications such as protein structure prediction, success probability estimation, subgroup identification, and AI-assisted clinical trial monitoring. From a regulatory standpoint, there was a notable uptick in submissions incorporating AI components in 2021. The most prevalent therapeutic areas leveraging AI were oncology (27%), psychiatry (15%), gastroenterology (12%), and neurology (11%). The paradigm of personalized or precision medicine has gained significant traction in recent research, partly due to advancements in AI techniques \cite{hamburg2010path}. This shift has had a transformative impact on the pharmaceutical industry. Departing from the traditio

To address overfitting and enhance model generalization in gastroenterological polyp size assessment, our study introduces Feature-Selection Gates (FSG) or Hard-Attention Gates (HAG) alongside Gradient Routing (GR) for dynamic feature selection. This technique aims to boost Convolutional Neural Networks (CNNs) and Vision Transformers (ViTs) by promoting sparse connectivity, thereby reducing overfitting and enhancing generalization. HAG achieves this through sparsification with learnable weights, serving as a regularization strategy. GR further refines this process by optimizing HAG parameters via dual forward passes, independently from the main model, to improve feature re-weighting. Our evaluation spanned multiple datasets, including CIFAR-100 for a broad impact assessment and specialized endoscopic datasets (REAL-Colon, Misawa, and SUN) focusing on polyp size estimation, covering over 200 polyps in more than 370,000 frames. The findings indicate that our HAG-enhanced networks substantially enhance performance in both binary and triclass classification tasks related to polyp sizing. Specifically, CNNs experienced an F1 Score improvement to 87.8% in binary classification, while in

In the recent years, artificial intelligence (AI) and its leading subtypes, machine learning (ML) and deep learning (DL) and their applications are spreading very fast in various aspects such as medicine. Today the most important challenge of developing accurate algorithms for medical prediction, detection, diagnosis, treatment and prognosis is data. ERCPMP is an Endoscopic Image and Video Dataset for Recognition of Colorectal Polyps Morphology and Pathology. This dataset contains demographic, morphological and pathological data, endoscopic images and videos of 191 patients with colorectal polyps. Morphological data is included based on the latest international gastroenterology classification references such as Paris, Pit and JNET classification. Pathological data includes the diagnosis of the polyps including Tubular, Villous, Tubulovillous, Hyperplastic, Serrated, Inflammatory and Adenocarcinoma with Dysplasia Grade & Differentiation. The current version of this dataset is published and available on Elsevier Mendeley Dataverse and since it is under development, the latest version is accessible via: https://databiox.com.

This paper presents a method to efficiently classify the gastroenterologic section of images derived from Video Capsule Endoscopy (VCE) studies by exploring the combination of a Convolutional Neural Network (CNN) for classification with the time-series analysis properties of a Hidden Markov Model (HMM). It is demonstrated that successive time-series analysis identifies and corrects errors in the CNN output. Our approach achieves an accuracy of $98.04\%$ on the Rhode Island (RI) Gastroenterology dataset. This allows for precise localization within the gastrointestinal (GI) tract while requiring only approximately 1M parameters and thus, provides a method suitable for low power devices

Wireless Capsule Endoscopy (WCE) is being increasingly used as an alternative imaging modality for complete and non-invasive screening of the gastrointestinal tract. Although this is advantageous in reducing unnecessary hospital admissions, it also demands that a WCE diagnostic protocol be in place so larger populations can be effectively screened. This calls for training and education protocols attuned specifically to this modality. Like training in other modalities such as traditional endoscopy, CT, MRI, etc., a WCE training protocol would require an atlas comprising of a large corpora of images that show vivid descriptions of pathologies and abnormalities, ideally observed over a period of time. Since such comprehensive atlases are presently lacking in WCE, in this work, we propose a deep learning method for utilizing already available studies across different institutions for the creation of a realistic WCE atlas using StyleGAN. We identify clinically relevant attributes in WCE such that synthetic images can be generated with selected attributes on cue. Beyond this, we also simulate several disease progression scenarios. The generated images are evaluated for realism and plausi