Global rates of mental health concerns are rising, and there is increasing realization that existing models of mental health care will not adequately expand to meet the demand. With the emergence of large language models (LLMs) has come great optimism regarding their promise to create novel, large-scale solutions to support mental health. Despite their nascence, LLMs have already been applied to mental health related tasks. In this paper, we summarize the extant literature on efforts to use LLMs to provide mental health education, assessment, and intervention and highlight key opportunities for positive impact in each area. We then highlight risks associated with LLMs' application to mental health and encourage the adoption of strategies to mitigate these risks. The urgent need for mental health support must be balanced with responsible development, testing, and deployment of mental health LLMs. It is especially critical to ensure that mental health LLMs are fine-tuned for mental health, enhance mental health equity, and adhere to ethical standards and that people, including those with lived experience with mental health concerns, are involved in all stages from development through
We propose a method to predict toxicity and other textual attributes through the use of natural language processing (NLP) techniques for two recent events: the Ukraine-Russia and Hamas-Israel conflicts. This article provides a basis for exploration in future conflicts with hopes to mitigate risk through the analysis of social media before and after a conflict begins. Our work compiles several datasets from Twitter and Reddit for both conflicts in a before and after separation with an aim of predicting a future state of social media for avoidance. More specifically, we show that: (1) there is a noticeable difference in social media discussion leading up to and following a conflict and (2) social media discourse on platforms like Twitter and Reddit is useful in identifying future conflicts before they arise. Our results show that through the use of advanced NLP techniques (both supervised and unsupervised) toxicity and other attributes about language before and after a conflict is predictable with a low error of nearly 1.2 percent for both conflicts.
An increasing number of people now rely on online platforms to meet their health information needs. Thus identifying inconsistent or conflicting textual health information has become a safety-critical task. Health advice data poses a unique challenge where information that is accurate in the context of one diagnosis can be conflicting in the context of another. For example, people suffering from diabetes and hypertension often receive conflicting health advice on diet. This motivates the need for technologies which can provide contextualized, user-specific health advice. A crucial step towards contextualized advice is the ability to compare health advice statements and detect if and how they are conflicting. This is the task of health conflict detection (HCD). Given two pieces of health advice, the goal of HCD is to detect and categorize the type of conflict. It is a challenging task, as (i) automatically identifying and categorizing conflicts requires a deeper understanding of the semantics of the text, and (ii) the amount of available data is quite limited. In this study, we are the first to explore HCD in the context of pre-trained language models. We find that DeBERTa-v3 perfor
Understanding how neural networks rely on visual cues offers a human-interpretable view of their internal decision processes. The cue-conflict benchmark has been influential in probing shape-texture preference and in motivating the insight that stronger, human-like shape bias is often associated with improved in-domain performance. However, we find that the current stylization-based instantiation can yield unstable and ambiguous bias estimates. Specifically, stylization may not reliably instantiate perceptually valid and separable cues nor control their relative informativeness, ratio-based bias can obscure absolute cue sensitivity, and restricting evaluation to preselected classes can distort model predictions by ignoring the full decision space. Together, these factors can confound preference with cue validity, cue balance, and recognizability artifacts. We introduce REFINED-BIAS, an integrated dataset and evaluation framework for reliable and interpretable shape-texture bias diagnosis. REFINED-BIAS constructs balanced, human- and model- recognizable cue pairs using explicit definitions of shape and texture, and measures cue-specific sensitivity over the full label space via a ra
The growing demand for home healthcare calls for tools that can support care delivery. In this study, we explore automatic health assessment from voice using real-world home care visit data, leveraging the diverse patient information it contains. First, we utilize Large Language Models (LLMs) to integrate Subjective, Objective, Assessment, and Plan (SOAP) notes derived from unstructured audio transcripts and structured vital signs into a holistic illness score that reflects a patient's overall health. This compact representation facilitates cross-visit health status comparisons and downstream analysis. Next, we design a multi-stage preprocessing pipeline to extract short speech segments from target speakers in home care recordings for acoustic analysis. We then employ an Audio Language Model (ALM) to produce plain-language descriptions of vocal biomarkers and examine their association with individuals' health status. Our experimental results benchmark both commercial and open-source LLMs in estimating illness scores, demonstrating their alignment with actual clinical outcomes, and revealing that SOAP notes are substantially more informative than vital signs. Building on the illness
YouTube has rapidly emerged as a predominant platform for content consumption, effectively displacing conventional media such as television and news outlets. A part of the enormous video stream uploaded to this platform includes health-related content, both from official public health organizations, and from any individual or group that can make an account. The quality of information available on YouTube is a critical point of public health safety, especially when concerning major interventions, such as vaccination. This study differentiates itself from previous efforts of auditing YouTube videos on this topic by conducting a systematic daily collection of posted videos mentioning vaccination for the duration of 3 months. We show that the competition for the public's attention is between public health messaging by institutions and individual educators on one side, and commentators on society and politics on the other, the latest contributing the most to the videos expressing stances against vaccination. Videos opposing vaccination are more likely to mention politicians and publication media such as podcasts, reports, and news analysis, on the other hand, videos in favor are more li
Mobile health has the potential to revolutionize health care delivery and patient engagement. In this work, we discuss how integrating Artificial Intelligence into digital health applications-focused on supply chain, patient management, and capacity building, among other use cases-can improve the health system and public health performance. We present an Artificial Intelligence and Reinforcement Learning platform that allows the delivery of adaptive interventions whose impact can be optimized through experimentation and real-time monitoring. The system can integrate multiple data sources and digital health applications. The flexibility of this platform to connect to various mobile health applications and digital devices and send personalized recommendations based on past data and predictions can significantly improve the impact of digital tools on health system outcomes. The potential for resource-poor settings, where the impact of this approach on health outcomes could be more decisive, is discussed specifically. This framework is, however, similarly applicable to improving efficiency in health systems where scarcity is not an issue.
This Chapter examines the dynamics of conflict and collaboration in human-machine systems, with a particular focus on large-scale, internet-based collaborative platforms. While these platforms represent successful examples of collective knowledge production, they are also sites of significant conflict, as diverse participants with differing intentions and perspectives interact. The analysis identifies recurring patterns of interaction, including serial attacks, reciprocal revenge, and third-party interventions. These microstructures reveal the role of experience, cultural differences, and topic sensitivity in shaping human-human, human-machine, and machine-machine interactions. The chapter further investigates the role of algorithmic agents and bots, highlighting their dual nature: they enhance collaboration by automating tasks but can also contribute to persistent conflicts with both humans and other machines. We conclude with policy recommendations that emphasize transparency, balance, cultural sensitivity, and governance to maximize the benefits of human-machine synergy while minimizing potential detriments.
Artificial intelligence (AI) has shown great promise in revolutionizing the field of digital health by improving disease diagnosis, treatment, and prevention. This paper describes the Health Guardian platform, a non-commercial, scientific research-based platform developed by the IBM Digital Health team to rapidly translate AI research into cloud-based microservices. The platform can collect health-related data from various digital devices, including wearables and mobile applications. Its flexible architecture supports microservices that accept diverse data types such as text, audio, and video, expanding the range of digital health assessments and enabling holistic health evaluations by capturing voice, facial, and motion bio-signals. These microservices can be deployed to a clinical cohort specified through the Clinical Task Manager (CTM). The CTM then collects multi-modal, clinical data that can iteratively improve the accuracy of AI predictive models, discover new disease mechanisms, or identify novel biomarkers. This paper highlights three microservices with different input data types, including a text-based microservice for depression assessment, a video-based microservice for
The rapid spread of health misinformation on online social networks (OSNs) during global crises such as the COVID-19 pandemic poses challenges to public health, social stability, and institutional trust. Centrality metrics have long been pivotal in understanding the dynamics of information flow, particularly in the context of health misinformation. However, the increasing complexity and dynamism of online networks, especially during crises, highlight the limitations of these traditional approaches. This study introduces and compares three novel centrality metrics: dynamic influence centrality (DIC), health misinformation vulnerability centrality (MVC), and propagation centrality (PC). These metrics incorporate temporal dynamics, susceptibility, and multilayered network interactions. Using the FibVID dataset, we compared traditional and novel metrics to identify influential nodes, propagation pathways, and misinformation influencers. Traditional metrics identified 29 influential nodes, while the new metrics uncovered 24 unique nodes, resulting in 42 combined nodes, an increase of 44.83%. Baseline interventions reduced health misinformation by 50%, while incorporating the new metrics
Growth of the older adult population has led to an increasing interest in technology-supported aged care. However, the area has some challenges such as a lack of caregivers and limitations in understanding the emotional, social, physical, and mental well-being needs of seniors. Furthermore, there is a gap in the understanding between developers and ageing people of their requirements. Digital health can be important in supporting older adults wellbeing, emotional requirements, and social needs. Requirements Engineering (RE) is a major software engineering field, which can help to identify, elicit and prioritize the requirements of stakeholders and ensure that the systems meet standards for performance, reliability, and usability. We carried out a systematic review of the literature on RE for older adult digital health software. This was necessary to show the representatives of the current stage of understanding the needs of older adults in aged care digital health. Using established guidelines outlined by the Kitchenham method, the PRISMA and the PICO guideline, we developed a protocol, followed by the systematic exploration of eight databases. This resulted in 69 primary studies o
Objective: To enhance health literacy and accessibility of health information for a diverse patient population by developing a patient-centered artificial intelligence (AI) solution using large language models (LLMs) and Fast Healthcare Interoperability Resources (FHIR) application programming interfaces (APIs). Materials and Methods: The research involved developing LLM on FHIR, an open-source mobile application allowing users to interact with their health records using LLMs. The app is built on Stanford's Spezi ecosystem and uses OpenAI's GPT-4. A pilot study was conducted with the SyntheticMass patient dataset and evaluated by medical experts to assess the app's effectiveness in increasing health literacy. The evaluation focused on the accuracy, relevance, and understandability of the LLM's responses to common patient questions. Results: LLM on FHIR demonstrated varying but generally high degrees of accuracy and relevance in providing understandable health information to patients. The app effectively translated medical data into patient-friendly language and was able to adapt its responses to different patient profiles. However, challenges included variability in LLM responses a
The COVID-19 pandemic has highlighted the dire necessity to improve public health literacy for societal resilience. YouTube, the largest video-sharing social media platform, provides a vast repository of user-generated health information in a multi-media-rich format which may be easier for the public to understand and use if major concerns about content quality and accuracy are addressed. This study develops an automated solution to identify, retrieve and shortlist medically relevant and understandable YouTube videos that domain experts can subsequently review and recommend for disseminating and educating the public on the COVID-19 pandemic and similar public health outbreaks. Our approach leverages domain knowledge from human experts and machine learning and natural language processing methods to provide a scalable, replicable, and generalizable approach that can also be applied to enhance the management of many health conditions.
Health messages on social media are typically constructed through combinations of source cues, appeals, frames, and evidence, which jointly shape communication and persuasive effects. However, prior research has largely focused on single elements or simple pairwise interactions, offering insufficient insight into how multiple elements operate together in real-world digital environments. To address this gap, this study adopts a systems perspective to examine multi-element message combinations. Using 1.8 million health-related Weibo posts, we apply clustering analysis to identify recurring combinations and assess their relationships with communication effects. First, four recurring element combinations are identified: Institutional Authority, Narrative, Assertive Appeal, and Contextual Expression. These combinations function as core structures organized around two key elements. Second, stronger communication effects depend not only on core structures but also on peripheral elements aligned with these structures, with combinations of two to four peripheral elements generally showing greater advantages. Third, the optimal level of peripheral complexity varies with source influence, ind
Software engineering for digital health applications entails several challenges, including heterogeneous data acquisition, data standardization, software reuse, security, and privacy considerations. We explore these challenges and how our Stanford Spezi ecosystem addresses these challenges by providing a modular and standards-based open-source digital health ecosystem. Spezi enables developers to select and integrate modules according to their needs and facilitates an open-source community to democratize access to building digital health innovations.
Selecting the right monitoring level in Remote Patient Monitoring (RPM) systems for e-healthcare is crucial for balancing patient outcomes, various resources, and patient's quality of life. A prior work has used one-dimensional health representations, but patient health is inherently multidimensional and typically consists of many measurable physiological factors. In this paper, we introduce a multidimensional health state model within the RPM framework and use dynamic programming to study optimal monitoring strategies. Our analysis reveals that the optimal control is characterized by switching curves (for two-dimensional health states) or switching hyper-surfaces (in general): patients switch to intensive monitoring when health measurements cross a specific multidimensional surface. We further study how the optimal switching curve varies for different medical conditions and model parameters. This finding of the optimal control structure provides actionable insights for clinicians and aids in resource planning. The tunable modeling framework enhances the applicability and effectiveness of RPM services across various medical conditions.
Large Vision-Language Models (LVLMs) have demonstrated impressive capabilities for capturing and reasoning over multimodal inputs. However, these models are prone to parametric knowledge conflicts, which arise from inconsistencies of represented knowledge between their vision and language components. In this paper, we formally define the problem of $\textbf{cross-modality parametric knowledge conflict}$ and present a systematic approach to detect, interpret, and mitigate them. We introduce a pipeline that identifies conflicts between visual and textual answers, showing a persistently high conflict rate across modalities in recent LVLMs regardless of the model size. We further investigate how these conflicts interfere with the inference process and propose a contrastive metric to discern the conflicting samples from the others. Building on these insights, we develop a novel dynamic contrastive decoding method that removes undesirable logits inferred from the less confident modality components based on answer confidence. For models that do not provide logits, we also introduce two prompt-based strategies to mitigate the conflicts. Our methods achieve promising improvements in accurac
Large AI models, or foundation models, are models recently emerging with massive scales both parameter-wise and data-wise, the magnitudes of which can reach beyond billions. Once pretrained, large AI models demonstrate impressive performance in various downstream tasks. A prime example is ChatGPT, whose capability has compelled people's imagination about the far-reaching influence that large AI models can have and their potential to transform different domains of our lives. In health informatics, the advent of large AI models has brought new paradigms for the design of methodologies. The scale of multi-modal data in the biomedical and health domain has been ever-expanding especially since the community embraced the era of deep learning, which provides the ground to develop, validate, and advance large AI models for breakthroughs in health-related areas. This article presents a comprehensive review of large AI models, from background to their applications. We identify seven key sectors in which large AI models are applicable and might have substantial influence, including 1) bioinformatics; 2) medical diagnosis; 3) medical imaging; 4) medical informatics; 5) medical education; 6) pu
This review underscores the vital role of interoperability in digital health, advocating for a standardized framework. It focuses on implementing a Fast Healthcare Interoperability Resources (FHIR) server, addressing technical, semantic, and process challenges. FHIR's adaptability ensures uniformity within Primary Care Health Information Systems, fostering interoperability. Patient data management complexities highlight the pivotal role of semantic interoperability in seamless patient care. FHIR standards enhance these efforts, offering multiple pathways for data search. The ADR-guided FHIR server implementation systematically addresses challenges related to patient identity, biometrics, and data security. The detailed development phases emphasize architecture, API integration, and security. The concluding stages incorporate forward-looking approaches, including HHIMS Synthetic Dataset testing. Envisioning FHIR integration as transformative, it anticipates a responsive healthcare environment aligned with the evolving digital health landscape, ensuring comprehensive, dynamic, and interconnected systems for efficient data exchange and access.
Linking clinical narratives to standardized vocabularies and coding systems is a key component of unlocking the information in medical text for analysis. However, many domains of medical concepts lack well-developed terminologies that can support effective coding of medical text. We present a framework for developing natural language processing (NLP) technologies for automated coding of under-studied types of medical information, and demonstrate its applicability via a case study on physical mobility function. Mobility is a component of many health measures, from post-acute care and surgical outcomes to chronic frailty and disability, and is coded in the International Classification of Functioning, Disability, and Health (ICF). However, mobility and other types of functional activity remain under-studied in medical informatics, and neither the ICF nor commonly-used medical terminologies capture functional status terminology in practice. We investigated two data-driven paradigms, classification and candidate selection, to link narrative observations of mobility to standardized ICF codes, using a dataset of clinical narratives from physical therapy encounters. Recent advances in lang