Effective physician-patient communications in pre-diagnostic environments, and most specifically in complex and sensitive medical areas such as infertility, are critical but consume a lot of time and, therefore, cause clinic workflows to become inefficient. Recent advancements in Large Language Models (LLMs) offer a potential solution for automating conversational medical history-taking and improving diagnostic accuracy. This study evaluates the feasibility and performance of LLMs in those tasks for infertility cases. An AI-driven conversational system was developed to simulate physician-patient interactions with ChatGPT-4o and ChatGPT-4o-mini. A total of 70 real-world infertility cases were processed, generating 420 diagnostic histories. Model performance was assessed using F1 score, Differential Diagnosis (DDs) Accuracy, and Accuracy of Infertility Type Judgment (ITJ). ChatGPT-4o-mini outperformed ChatGPT-4o in information extraction accuracy (F1 score: 0.9258 vs. 0.9029, p = 0.045, d = 0.244) and demonstrated higher completeness in medical history-taking (97.58% vs. 77.11%), suggesting that ChatGPT-4o-mini is more effective in extracting detailed patient information, which is cr
Objective: Reproducibility is a core tenet of scientific research. A reproducible study is one where the results can be recreated by different investigators in different circumstances using the same methodology and materials. Unfortunately, reproducibility is not a standard to which the majority of research is currently adherent. Methods: We objectively evaluated 300 trials in the field of Obstetrics and Gynecology for fourteen indicators of reproducibility. These indicators include availability of data, analysis scripts, pre-registration information, study protocols and whether or not the study was available via Open Access. We also assessed the trials for financial conflict of interest statements and source of funding. Results: Of the 300 trials in our sample, 208 contained empirical data that could be assessed for reproducibility. None of the trials in our sample provided a link to their protocols or provided a statement on availability of materials. None were replication studies. Just 10.58% provided a statement regarding their data availability, while only 5.82% provided a statement on preregistration. 25.85% failed to report the presence or absence of conflicts of interest an
Clinician skepticism toward opaque AI hinders adoption in high-stakes healthcare. We present AICare, an interactive and interpretable AI copilot for collaborative clinical decision-making. By analyzing longitudinal electronic health records, AICare grounds dynamic risk predictions in scrutable visualizations and LLM-driven diagnostic recommendations. Through a within-subjects counterbalanced study with 16 clinicians across nephrology and obstetrics, we comprehensively evaluated AICare using objective measures (task completion time and error rate), subjective assessments (NASA-TLX, SUS, and confidence ratings), and semi-structured interviews. Our findings indicate AICare's reduced cognitive workload. Beyond performance metrics, qualitative analysis reveals that trust is actively constructed through verification, with interaction strategies diverging by expertise: junior clinicians used the system as cognitive scaffolding to structure their analysis, while experts engaged in adversarial verification to challenge the AI's logic. This work offers design implications for creating AI systems that function as transparent partners, accommodating diverse reasoning styles to augment rather t
Social media platforms like TikTok have become a key source of health information, with studies reporting inaccuracies in posts. As Large Language Model (LLM) providers increasingly integrate LLMs into digital platforms to fact-check content (e.g., Grok and Perplexity on X and WhatsApp, respectively) and are being used by people to fact-check information, deploying these systems in critical areas such as reproductive health without rigorous evaluation can cause serious harm. We introduce RELIANCE, an expert-annotated dataset of health information on TikTok surrounding pregnancy and postpartum queries, serving as both an analysis of the reproductive health information landscape and an evaluation of LLMs' capabilities in fact-checking this content. Our dataset comprises 409 annotated sentences from 336 videos across 56 clinician-reviewed queries, annotated by three expert clinicians in Obstetrics, Gynecology, and Internal Medicine. Our findings reveal that nearly 60\% of the health information in the videos we sampled is accurate. Furthermore, LLM evaluations reveal a gap between evaluating specific claims and evaluating the entire content (15\%). We believe that our methodology, dat
Ovarian cancer is the deadliest gynecological malignancy; accurate and objective segmentation of adnexal masses and functional ovaries in ultrasound (US) remains challenging due to operator variability and morphological complexity. We present OvAi Focus (SynDiag s.r.l., Italy), a stand-alone AI software medical device that performs multi-class semantic segmentation of functional ovaries and adnexal masses, distinguishing cystic from solid components. The system was trained and independently validated on a multicenter dataset of 1,081 adult women from 6 centers across Italy and Israel. Segmentation achieved DICE scores of 0.87 (complete lesion), 0.85 (cystic), 0.68 (solid), and 0.62 (functional ovary), in line with or superior to state-of-the-art approaches across heterogeneous acquisition settings.
Parametric differential equations of the form du/dt = f(u, x, t, p) are fundamental in science and engineering. While deep learning frameworks such as the Fourier Neural Operator (FNO) can efficiently approximate solutions, they struggle with inverse problems, sensitivity estimation (du/dp), and concept drift. We address these limitations by introducing a sensitivity-based regularization strategy, called Sensitivity-Constrained Fourier Neural Operators (SC-FNO). SC-FNO achieves high accuracy in predicting solution paths and consistently outperforms standard FNO and FNO with physics-informed regularization. It improves performance in parameter inversion tasks, scales to high-dimensional parameter spaces (tested with up to 82 parameters), and reduces both data and training requirements. These gains are achieved with a modest increase in training time (30% to 130% per epoch) and generalize across various types of differential equations and neural operators. Code and selected experiments are available at: https://github.com/AMBehroozi/SC_Neural_Operators
This study evaluates whether large language models (LLMs) exhibit biases towards medical professionals. Fictitious candidate resumes were created to control for identity factors while maintaining consistent qualifications. Three LLMs (GPT-4, Claude-3-haiku, and Mistral-Large) were tested using a standardized prompt to evaluate resumes for specific residency programs. Explicit bias was tested by changing gender and race information, while implicit bias was tested by changing names while hiding race and gender. Physician data from the Association of American Medical Colleges was used to compare with real-world demographics. 900,000 resumes were evaluated. All LLMs exhibited significant gender and racial biases across medical specialties. Gender preferences varied, favoring male candidates in surgery and orthopedics, while preferring females in dermatology, family medicine, obstetrics and gynecology, pediatrics, and psychiatry. Claude-3 and Mistral-Large generally favored Asian candidates, while GPT-4 preferred Black and Hispanic candidates in several specialties. Tests revealed strong preferences towards Hispanic females and Asian males in various specialties. Compared to real-world
Background and Purpose: Increasing the number of arcs in volumetric modulated arc therapy (VMAT) allows for better intensity modulation and may improve plan quality. However, this leads to longer delivery times, which may cause patient discomfort and increase intra-fractional motion. In this study, it was investigated whether the delivery of different VMAT plans in different fractions may improve the dosimetric quality and delivery efficiency for the treatment of patients with complex tumor geometries. Materials and Methods: A direct aperture optimization algorithm was developed which allows for the simultaneous optimization of different VMAT plans to be delivered in different fractions, based on their cumulative physical dose. Each VMAT plan is constrained to deliver a uniform dose within the target volume, such that the entire treatment does not alter the fractionation scheme and is robust against inter-fractional setup errors. This approach was evaluated in-silico for ten patients with gynecological and head-and-neck cancer. Results: For all patients, fraction-variant treatments achieved better target coverage and reduced the dose to critical organs-at-risk compared to fraction-
Recent advances in deep learning have transformed computer-assisted intervention and surgical video analysis, driving improvements not only in surgical training, intraoperative decision support, and patient outcomes, but also in postoperative documentation and surgical discovery. Central to these developments is the availability of large, high-quality annotated datasets. In gynecologic laparoscopy, surgical scene understanding and action recognition are fundamental for building intelligent systems that assist surgeons during operations and provide deeper analysis after surgery. However, existing datasets are often limited by small scale, narrow task focus, or insufficiently detailed annotations, limiting their utility for comprehensive, end-to-end workflow analysis. To address these limitations, we introduce GynSurg, the largest and most diverse multi-task dataset for gynecologic laparoscopic surgery to date. GynSurg provides rich annotations across multiple tasks, supporting applications in action recognition, semantic segmentation, surgical documentation, and discovery of novel procedural insights. We demonstrate the dataset quality and versatility by benchmarking state-of-the-ar
The International Society of Ultrasound advocates Intrapartum Ultrasound (US) Imaging in Obstetrics and Gynecology (ISUOG) to monitor labour progression through changes in fetal head position. Two reliable ultrasound-derived parameters that are used to predict outcomes of instrumental vaginal delivery are the angle of progression (AoP) and head-symphysis distance (HSD). In this work, as part of the Intrapartum Ultrasounds Grand Challenge (IUGC) 2024, we propose an automated fetal biometry measurement pipeline to reduce intra- and inter-observer variability and improve measurement reliability. Our pipeline consists of three key tasks: (i) classification of standard planes (SP) from US videos, (ii) segmentation of fetal head and pubic symphysis from the detected SPs, and (iii) computation of the AoP and HSD from the segmented regions. We perform sparse sampling to mitigate class imbalances and reduce spurious correlations in task (i), and utilize ensemble-based deep learning methods for task (i) and (ii) to enhance generalizability under different US acquisition settings. Finally, to promote robustness in task iii) with respect to the structural fidelity of measurements, we retain th
Segmentation of the fetal and maternal structures, particularly intrapartum ultrasound imaging as advocated by the International Society of Ultrasound in Obstetrics and Gynecology (ISUOG) for monitoring labor progression, is a crucial first step for quantitative diagnosis and clinical decision-making. This requires specialized analysis by obstetrics professionals, in a task that i) is highly time- and cost-consuming and ii) often yields inconsistent results. The utility of automatic segmentation algorithms for biometry has been proven, though existing results remain suboptimal. To push forward advancements in this area, the Grand Challenge on Pubic Symphysis-Fetal Head Segmentation (PSFHS) was held alongside the 26th International Conference on Medical Image Computing and Computer Assisted Intervention (MICCAI 2023). This challenge aimed to enhance the development of automatic segmentation algorithms at an international scale, providing the largest dataset to date with 5,101 intrapartum ultrasound images collected from two ultrasound machines across three hospitals from two institutions. The scientific community's enthusiastic participation led to the selection of the top 8 out of
This study presents a comparative evaluation of a Variational Autoencoder (VAE) enhanced with Minimum Description Length (MDL) regularization against a Standard Autoencoder for reconstructing high-dimensional gynecological data. The MDL-VAE exhibits significantly lower reconstruction errors (MSE, MAE, RMSE) and more structured latent representations, driven by effective KL divergence regularization. Statistical analyses confirm these performance improvements are significant. Furthermore, the MDL-VAE shows consistent training and validation losses and achieves efficient inference times, underscoring its robustness and practical viability. Our findings suggest that incorporating MDL principles into VAE architectures can substantially improve data reconstruction and generalization, making it a promising approach for advanced applications in healthcare data modeling and analysis.
3GPP Integrated Access and Backhaul (IAB) allows operators to deploy outdoor mm-wave access networks in a cost-efficient manner, by reusing the same spectrum in access and backhaul. In IAB networks the performance bottleneck is the wireless backhaul segment, where efficient forwarding strategies are needed to effectively use the available capacity. In addition, the performance of the mm-wave IAB backhaul segment is contingent on the availability of line of sight (LoS) conditions in the selected deployment sites. To mitigate LoS dependence, in this paper, we propose to complement the mm-wave backhaul segment of IAB networks with additional Sub6 backhaul links, which contribute to the capacity and robustness of the backhaul network. We refer to IAB networks combining Sub6 and mm-wave links in the backhaul as Sub6 enhanced IAB networks. In this context, the main contribution of this paper is PHaul, a forwarding engine for Sub6 enhanced IAB networks that accomodates different traffic engineering criteria, and combines an offline path selection heuristic with an online Deep Reinforcement Learning (DRL) agent based on Proximal Policy Optimization (PPO). By leveraging a network digital tw
Clinical free-text notes contain vital patient information. They are structured into labelled sections; recognizing these sections has been shown to support clinical decision-making and downstream NLP tasks. In this paper, we advance clinical section segmentation through three key contributions. First, we curate a new de-identified, section-labeled obstetrics notes dataset, to supplement the medical domains covered in public corpora such as MIMIC-III, on which most existing segmentation approaches are trained. Second, we systematically evaluate transformer-based supervised models for section segmentation on a curated subset of MIMIC-III (in-domain), and on the new obstetrics dataset (out-of-domain). Third, we conduct the first head-to-head comparison of supervised models for medical section segmentation with zero-shot large language models. Our results show that while supervised models perform strongly in-domain, their performance drops substantially out-of-domain. In contrast, zero-shot models demonstrate robust out-of-domain adaptability once hallucinated section headers are corrected. These findings underscore the importance of developing domain-specific clinical resources and h
Purpose: To develop clinically relevant test cases for commissioning Model-Based Dose Calculation Algorithms (MBDCAs) for 192Ir High Dose Rate (HDR) gynecologic brachytherapy following the workflow proposed by the TG-186 report and the WGDCAB report 372. Acquisition and Validation Methods: Two cervical cancer intracavitary HDR brachytherapy patient models were created, using either uniformly structured regions or realistic segmentation. The computed tomography (CT) images of the models were converted to DICOM CT images via MATLAB and imported into two Treatment Planning Systems (TPSs) with MBDCA capability. The clinical segmentation was expanded to include additional organs at risk. The actual clinical treatment plan was generally maintained, with the source replaced by a generic 192Ir HDR source. Dose to medium in medium calculations were performed using the MBDCA option of each TPS, and three different Monte Carlo (MC) simulation codes. MC results agreed within statistical uncertainty, while comparisons between MBDCA and MC dose distributions highlighted both strengths and limitations of the studied MBDCAs, suggesting potential approaches to overcome the challenges. Data Format a
Purpose: Accurate segmentation of clinical target volumes (CTV) and organs-at-risk is crucial for optimizing gynecologic brachytherapy (GYN-BT) treatment planning. However, anatomical variability, low soft-tissue contrast in CT imaging, and limited annotated datasets pose significant challenges. This study presents GynBTNet, a novel multi-stage learning framework designed to enhance segmentation performance through self-supervised pretraining and hierarchical fine-tuning strategies. Methods: GynBTNet employs a three-stage training strategy: (1) self-supervised pretraining on large-scale CT datasets using sparse submanifold convolution to capture robust anatomical representations, (2) supervised fine-tuning on a comprehensive multi-organ segmentation dataset to refine feature extraction, and (3) task-specific fine-tuning on a dedicated GYN-BT dataset to optimize segmentation performance for clinical applications. The model was evaluated against state-of-the-art methods using the Dice Similarity Coefficient (DSC), 95th percentile Hausdorff Distance (HD95), and Average Surface Distance (ASD). Results: Our GynBTNet achieved superior segmentation performance, significantly outperforming
A growing share of the world's population is being born via assisted reproductive technology (ART), including in-vitro fertilisation (IVF). However, two concerns persist. First, ART pregnancies correlate with predictors of poor outcomes at birth--and it is unclear whether this relationship is causal. Second, the emotional and financial costs associated with ART-use might exacerbate defensive medical behaviour, where physicians intervene more than necessary to reduce the risk of adverse medical outcomes and litigation. We address the challenge of identifying the pure effect of ART-use on both maternal and infant outcomes at birth by leveraging exogenous variation in the success of ART cycles. We compare the obstetric outcomes for ART-conceived births with those of spontaneously-conceived births after a failed ART treatment. Moreover, we flexibly adjust for key confounders using double machine learning. We do this using clinical registry ART data and administrative maternal and infant data from New South Wales (NSW) between 2009-2017. We find that ART slightly decreases the risk of obstetric interventions, lowering the risk of a caesarean section and increasing the rate of spontaneou
The rapid development of large language models (LLMs) has transformed many industries, including healthcare. However, previous medical LLMs have largely focused on leveraging general medical knowledge to provide responses, without accounting for patient variability and lacking true personalization at the individual level. To address this, we propose a novel method called personalized medical language model (PMLM), which explores and optimizes personalized LLMs through recommendation systems and reinforcement learning (RL). Specifically, by utilizing self-informed and peer-informed personalization, PMLM captures changes in behaviors and preferences to design initial personalized prompts tailored to individual needs. We further refine these initial personalized prompts through RL, ultimately enhancing the precision of LLM guidance. Notably, the personalized prompt are hard prompt, which grants PMLM high adaptability and reusability, allowing it to directly leverage high-quality proprietary LLMs. We evaluate PMLM using real-world obstetrics and gynecology data, and the experimental results demonstrate that PMLM achieves personalized responses, and it provides more refined and individu
Automated Machine Learning (AutoML) technology can lower barriers in data work yet still requires human intervention to be functional. However, the complex and collaborative process resulting from humans and machines trading off work makes it difficult to trace what was done, by whom (or what), and when. In this research, we construct a taxonomy of data work artifacts that captures AutoML and human processes. We present a rigorous methodology for its creation and discuss its transferability to the visual design process. We operationalize the taxonomy through the development of AutoMLTrace, a visual interactive sketch showing both the context and temporality of human-ML/AI collaboration in data work. Finally, we demonstrate the utility of our approach via a usage scenario with an enterprise software development team. Collectively, our research process and findings explore challenges and fruitful avenues for developing data visualization tools that interrogate the sociotechnical relationships in automated data work.
As large language models (LLMs) become primary sources of health information for millions, their accuracy in women's health remains critically unexamined. We introduce the Women's Health Benchmark (WHB), the first benchmark evaluating LLM performance specifically in women's health. Our benchmark comprises 96 rigorously validated model stumps covering five medical specialties (obstetrics and gynecology, emergency medicine, primary care, oncology, and neurology), three query types (patient query, clinician query, and evidence/policy query), and eight error types (dosage/medication errors, missing critical information, outdated guidelines/treatment recommendations, incorrect treatment advice, incorrect factual information, missing/incorrect differential diagnosis, missed urgency, and inappropriate recommendations). We evaluated 13 state-of-the-art LLMs and revealed alarming gaps: current models show approximately 60\% failure rates on the women's health benchmark, with performance varying dramatically across specialties and error types. Notably, models universally struggle with "missed urgency" indicators, while newer models like GPT-5 show significant improvements in avoiding inappro