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The medical adoption of NLP tools requires interpretability by end users, yet traditional explainable AI (XAI) methods are misaligned with clinical reasoning and lack clinician input. We introduce CHiRPE (Clinical High-Risk Prediction with Explainability), an NLP pipeline that takes transcribed semi-structured clinical interviews to: (i) predict psychosis risk; and (ii) generate novel SHAP explanation formats co-developed with clinicians. Trained on 944 semi-structured interview transcripts across 24 international clinics of the AMP-SCZ study, the CHiRPE pipeline integrates symptom-domain mapping, LLM summarisation, and BERT classification. CHiRPE achieved over 90% accuracy across three BERT variants and outperformed baseline models. Explanation formats were evaluated by 28 clinical experts who indicated a strong preference for our novel concept-guided explanations, especially hybrid graph-and-text summary formats. CHiRPE demonstrates that clinically-guided model development produces both accurate and interpretable results. Our next step is focused on real-world testing across our 24 international sites.

We evaluate the impact of large language model-based clinical decision support in live care. In partnership with Penda Health, a network of primary care clinics in Nairobi, Kenya, we studied AI Consult, a tool that serves as a safety net for clinicians by identifying potential documentation and clinical decision-making errors. AI Consult integrates into clinician workflows, activating only when needed and preserving clinician autonomy. We conducted a quality improvement study, comparing outcomes for 39,849 patient visits performed by clinicians with or without access to AI Consult across 15 clinics. Visits were rated by independent physicians to identify clinical errors. Clinicians with access to AI Consult made relatively fewer errors: 16% fewer diagnostic errors and 13% fewer treatment errors. In absolute terms, the introduction of AI Consult would avert diagnostic errors in 22,000 visits and treatment errors in 29,000 visits annually at Penda alone. In a survey of clinicians with AI Consult, all clinicians said that AI Consult improved the quality of care they delivered, with 75% saying the effect was "substantial". These results required a clinical workflow-aligned AI Consult i

Clinical text classification requires choosing between specialized fine-tuned models (BERT variants) and general-purpose large language models (LLMs), yet neither dominates across all instances. We introduce Learning to Defer for clinical text (L2D-Clinical), a framework that learns when a BERT classifier should defer to an LLM based on uncertainty signals and text characteristics. Unlike prior L2D work that defers to human experts assumed universally superior, our approach enables adaptive deferral-improving accuracy when the LLM complements BERT. We evaluate on two English clinical tasks: (1) ADE detection (ADE Corpus V2), where BioBERT (F1=0.911) outperforms the LLM (F1=0.765), and (2) treatment outcome classification (MIMIC-IV with multi-LLM consensus ground truth), where GPT-5-nano (F1=0.967) outperforms ClinicalBERT (F1=0.887). On ADE, L2D-Clinical achieves F1=0.928 (+1.7 points over BERT) by selectively deferring 7% of instances where the LLM's high recall compensates for BERT's misses. On MIMIC, L2D-Clinical achieves F1=0.980 (+9.3 points over BERT) by deferring only 16.8\% of cases to the LLM. The key insight is that L2D-Clinical learns to selectively leverage LLM strength

Diffusion-weighted magnetic resonance imaging (DW-MRI) derived scalar maps are effective for assessing neurodegenerative diseases and microstructural properties of white matter in large number of brain conditions. However, DW-MRI inherently limits the combination of data from multiple acquisition sites without harmonization to mitigate scanner-specific biases. While the widely used ComBAT method reduces site effects in research, its reliance on linear covariate relationships, homogeneous populations, fixed site numbers, and well populated sites constrains its clinical use. To overcome these limitations, we propose Clinical-ComBAT, a method designed for real-world clinical scenarios. Clinical-ComBAT harmonizes each site independently, enabling flexibility as new data and clinics are introduced. It incorporates a non-linear polynomial data model, site-specific harmonization referenced to a normative site, and variance priors adaptable to small cohorts. It further includes hyperparameter tuning and a goodness-of-fit metric for harmonization assessment. We demonstrate its effectiveness on simulated and real data, showing improved alignment of diffusion metrics and enhanced applicabilit

Advances in markerless motion capture are expanding access to biomechanical movement analysis, making it feasible to obtain high-quality movement data from outpatient clinics, inpatient hospitals, therapy, and even home. Expanding access to movement data in these diverse contexts makes the challenge of performing downstream analytics all the more acute. Creating separate bespoke analysis code for all the tasks end users might want is both intractable and does not take advantage of the common features of human movement underlying them all. Recent studies have shown that fine-tuning language models to accept tokenized movement as an additional modality enables successful descriptive captioning of movement. Here, we explore whether such a multimodal motion-language model can answer detailed, clinically meaningful questions about movement. We collected over 30 hours of biomechanics from nearly 500 participants, many with movement impairments from a variety of etiologies, performing a range of movements used in clinical outcomes assessments. After tokenizing these movement trajectories, we created a multimodal dataset of motion-related questions and answers spanning a range of tasks. We

Movement directly reflects neurological and musculoskeletal health, yet objective biomechanical assessment is rarely available in routine care. We introduce Portable Biomechanics Laboratory (PBL), a secure platform for fitting biomechanical models to video collected with a handheld, moving, smartphone. We validate this approach on over 15 hours of data synchronized to ground truth motion capture, finding mean joint-angle errors < 3$°$ and pelvis-translation errors of a few centimeters across patients with neurological-injury, lower-limb prosthesis users, pediatric in-patients, and controls. In > 5 hours of prospective deployments to neurosurgery and sports-medicine clinics, PBL was easy to setup, yielded highly reliable gait metrics (ICC > 0.9), and detected clinically relevant differences. For cervical-myelopathy patients, its measurement of gait quality correlated with modified Japanese Orthopedic Association (mJOA) scores and were responsive to clinical intervention. Handheld smartphone video can therefore deliver accurate, scalable, and low-burden biomechanical measurement, enabling greatly increased monitoring of movement impairments. We release the first clinically-v

Artificial intelligence is poised to augment dermatological care by enabling scalable image-based diagnostics. Yet, the development of robust and equitable models remains hindered by datasets that fail to capture the clinical and demographic complexity of real-world practice. This complexity stems from region-specific disease distributions, wide variation in skin tones, and the underrepresentation of outpatient scenarios from non-Western populations. We introduce DermaCon-IN, a prospectively curated dermatology dataset comprising 5,450 clinical images from 3,002 patients across outpatient clinics in South India. Each image is annotated by board-certified dermatologists with 245 distinct diagnoses, structured under a hierarchical, aetiology-based taxonomy adapted from Rook's classification. The dataset captures a wide spectrum of dermatologic conditions and tonal variation commonly seen in Indian outpatient care. We benchmark a range of architectures, including convolutional models (ResNet, DenseNet, EfficientNet), transformer-based models (ViT, MaxViT, Swin), and Concept Bottleneck Models to establish baseline performance and explore how anatomical and concept-level cues may be int

Federated Learning (FL) offers a promising approach for training clinical AI models without centralizing sensitive patient data. However, its real-world adoption is hindered by challenges related to privacy, resource constraints, and compliance. Existing Differential Privacy (DP) approaches often apply uniform noise, which disproportionately degrades model performance, even among well-compliant institutions. In this work, we propose a novel compliance-aware FL framework that enhances DP by adaptively adjusting noise based on quantifiable client compliance scores. Additionally, we introduce a compliance scoring tool based on key healthcare and security standards to promote secure, inclusive, and equitable participation across diverse clinical settings. Extensive experiments on public datasets demonstrate that integrating under-resourced, less compliant clinics with highly regulated institutions yields accuracy improvements of up to 15% over traditional FL. This work advances FL by balancing privacy, compliance, and performance, making it a viable solution for real-world clinical workflows in global healthcare.

A key task in ML is to optimize models at various stages, e.g. by choosing hyperparameters or picking a stopping point. A traditional ML approach is to use validation loss, i.e. to apply the training loss function on a validation set to guide these optimizations. However, ML for healthcare has a distinct goal from traditional ML: Models must perform well relative to specific clinical requirements, vs. relative to the loss function used for training. These clinical requirements can be captured more precisely by tailored metrics. Since many optimization tasks do not require the driving metric to be differentiable, they allow a wider range of options, including the use of metrics tailored to be clinically-relevant. In this paper we describe two controlled experiments which show how the use of clinically-tailored metrics provide superior model optimization compared to validation loss, in the sense of better performance on the clinical task. The use of clinically-relevant metrics for optimization entails some extra effort, to define the metrics and to code them into the pipeline. But it can yield models that better meet the central goal of ML for healthcare: strong performance in the cl

Dynamic treatment regimes have been proposed to personalize treatment decisions by utilizing historical patient data, but they may not always improve on the current standard of care. It is thus meaningful to integrate the standard of care into the evaluation of treatment strategies, and previous works have suggested doing so through the concept of clinical utility. Here we will focus on the comparative component of clinical utility as the average outcome had the full population received treatment based on the proposed dynamic treatment regime in comparison to the full population receiving the ``standard" treatment assignment mechanism, such as a physician's choice. Clinical trials to evaluate clinical utility are rarely conducted, and thus, previous works have proposed an emulated clinical trial framework using observational data. However, only one simple estimator was previously suggested, and the practical details of how one would conduct this emulated trial were not detailed. Here, we illuminate these details and propose several estimators of clinical utility based on estimators proposed in the dynamic treatment regime literature. We illustrate the considerations and the estimat

We present a novel contribution to Spanish clinical natural language processing by introducing the largest publicly available clinical corpus, ClinText-SP, along with a state-of-the-art clinical encoder language model, RigoBERTa Clinical. Our corpus was meticulously curated from diverse open sources, including clinical cases from medical journals and annotated corpora from shared tasks, providing a rich and diverse dataset that was previously difficult to access. RigoBERTa Clinical, developed through domain-adaptive pretraining on this comprehensive dataset, significantly outperforms existing models on multiple clinical NLP benchmarks. By publicly releasing both the dataset and the model, we aim to empower the research community with robust resources that can drive further advancements in clinical NLP and ultimately contribute to improved healthcare applications.

Clinical trials assessing neurological treatment are challenging due to the diversity of brain function, and the difficulty in quantifying it. Traditional treatment studies in epilepsy use seizure frequency as the primary outcome measure, which may overlooking meaningful improvements in patients' quality of life. This paper introduces the Clinical Instrument for Measuring Patient Anecdotes in Clinical Trials (Clinical IMPACT), a novel tool designed to capture qualitative non-seizure improvement across neurological domains. The Clinical IMPACT incorporates open-ended inquiries that allow participants or caregivers to identify and select anecdotal evidence of their most significant treatment benefits. A blinded panel of experts ranks these anecdotes, facilitating a rigorous statistical analysis using the Wilcoxon Rank-Sum Test to detect treatment efficacy. The approach is resistant to type 1 error, yet comprehensive in its ability to capture real-world effects on quality of life. The potential of the Clinical IMPACT tool to enhance sensitivity while also providing qualitative insights that can inform patients, healthcare providers, and regulatory bodies about treatment effects makes

Clinical gait analysis (CGA) using computer vision is an emerging field in artificial intelligence that faces barriers of accessible, real-world data, and clear task objectives. This paper lays the foundation for current developments in CGA as well as vision-based methods and datasets suitable for gait analysis. We introduce The Gait Abnormality in Video Dataset (GAVD) in response to our review of over 150 current gait-related computer vision datasets, which highlighted the need for a large and accessible gait dataset clinically annotated for CGA. GAVD stands out as the largest video gait dataset, comprising 1874 sequences of normal, abnormal and pathological gaits. Additionally, GAVD includes clinically annotated RGB data sourced from publicly available content on online platforms. It also encompasses over 400 subjects who have undergone clinical grade visual screening to represent a diverse range of abnormal gait patterns, captured in various settings, including hospital clinics and urban uncontrolled outdoor environments. We demonstrate the validity of the dataset and utility of action recognition models for CGA using pretrained models Temporal Segment Networks(TSN) and SlowFast