Advances in large language models (LLMs) have empowered a variety of applications. However, there is still a significant gap in research when it comes to understanding and enhancing the capabilities of LLMs in the field of mental health. In this work, we present a comprehensive evaluation of multiple LLMs on various mental health prediction tasks via online text data, including Alpaca, Alpaca-LoRA, FLAN-T5, GPT-3.5, and GPT-4. We conduct a broad range of experiments, covering zero-shot prompting, few-shot prompting, and instruction fine-tuning. The results indicate a promising yet limited performance of LLMs with zero-shot and few-shot prompt designs for mental health tasks. More importantly, our experiments show that instruction finetuning can significantly boost the performance of LLMs for all tasks simultaneously. Our best-finetuned models, Mental-Alpaca and Mental-FLAN-T5, outperform the best prompt design of GPT-3.5 (25 and 15 times bigger) by 10.9% on balanced accuracy and the best of GPT-4 (250 and 150 times bigger) by 4.8%. They further perform on par with the state-of-the-art task-specific language model. We also conduct an exploratory case study on LLMs' capability on mental health reasoning tasks, illustrating the promising capability of certain models such as GPT-4. We summarize our findings into a set of action guidelines for potential methods to enhance LLMs' capability for mental health tasks. Meanwhile, we also emphasize the important limitations before achieving deployability in real-world mental health settings, such as known racial and gender bias. We highlight the important ethical risks accompanying this line of research.

Despite the plethora of telehealth applications to assist home-based older adults and healthcare providers, basic messaging and phone calls are still the most common communication methods, which suffer from limited availability, information loss, and process inefficiencies. One promising solution to facilitate patient-provider communication is to leverage large language models (LLMs) with their powerful natural conversation and summarization capability. However, there is a limited understanding of LLMs' role during the communication. We first conducted two interview studies with both older adults (N=10) and healthcare providers (N=9) to understand their needs and opportunities for LLMs in patient-provider asynchronous communication. Based on the insights, we built an LLM-powered communication system, Talk2Care, and designed interactive components for both groups: (1) For older adults, we leveraged the convenience and accessibility of voice assistants (VAs) and built an LLM-powered conversational interface for effective information collection. (2) For health providers, we built an LLM-based dashboard to summarize and present important health information based on older adults' conversations with the VA. We further conducted two user studies with older adults and providers to evaluate the usability of the system. The results showed that Talk2Care could facilitate the communication process, enrich the health information collected from older adults, and considerably save providers' efforts and time. We envision our work as an initial exploration of LLMs' capability in the intersection of healthcare and interpersonal communication.

Foundation Models that are capable of processing and generating multi-modal data have transformed AI’s role in medicine. However, a key limitation of their reliability is hallucination, where inaccurate or fabricated information can impact clinical decisions and patient safety. We define medical hallucination as any instance in which a model generates misleading medical content. This paper examines the unique characteristics, causes, and implications of medical hallucinations, with a particular focus on how these errors manifest themselves in real-world clinical scenarios. Our contributions include (1) a taxonomy for understanding and addressing medical hallucinations, (2) benchmarking models using medical hallucination dataset and physician-annotated LLM responses to real medical cases, providing direct insight into the clinical impact of hallucinations, and (3) a multi-national clinician survey on their experiences with medical hallucinations. Our results reveal that inference techniques such as Chain-of-Thought (CoT) and Search Augmented Generation can effectively reduce hallucination rates. However, despite these improvements, non-trivial levels of hallucination persist. These findings underscore the ethical and practical imperative for robust detection and mitigation strategies, establishing a foundation for regulatory policies that prioritize patient safety and maintain clinical integrity as AI becomes more integrated into healthcare. The feedback from clinicians highlights the urgent need for not only technical advances but also for clearer ethical and regulatory guidelines to ensure patient safety. A repository organizing the paper resources, summaries, and additional information is available at https://github.com/mitmedialab/medical_hallucination.

Today’s AI systems for medical decision support often succeed on benchmark datasets in research papers but fail in real-world deployment. This work focuses on the decision making of sepsis, an acute life-threatening systematic infection that requires an early diagnosis with high uncertainty from the clinician. Our aim is to explore the design requirements for AI systems that can support clinical experts in making better decisions for the early diagnosis of sepsis. The study begins with a formative study investigating why clinical experts abandon an existing AI-powered Sepsis predictive module in their electrical health record (EHR) system. We argue that a human-centered AI system needs to support human experts in the intermediate stages of a medical decision-making process (e.g., generating hypotheses or gathering data), instead of focusing only on the final decision. Therefore, we build SepsisLab based on a state-of-the-art AI algorithm and extend it to predict the future projection of sepsis development, visualize the prediction uncertainty, and propose actionable suggestions (i.e., which additional laboratory tests can be collected) to reduce such uncertainty. Through heuristic evaluation with six clinicians using our prototype system, we demonstrate that SepsisLab enables a promising human-AI collaboration paradigm for the future of AI-assisted sepsis diagnosis and other high-stakes medical decision making.

There is a growing body of research revealing that longitudinal passive sensing data from smartphones and wearable devices can capture daily behavior signals for human behavior modeling, such as depression detection. Most prior studies build and evaluate machine learning models using data collected from a single population. However, to ensure that a behavior model can work for a larger group of users, its generalizability needs to be verified on multiple datasets from different populations. We present the first work evaluating cross-dataset generalizability of longitudinal behavior models, using depression detection as an application. We collect multiple longitudinal passive mobile sensing datasets with over 500 users from two institutes over a two-year span, leading to four institute-year datasets. Using the datasets, we closely re-implement and evaluated nine prior depression detection algorithms. Our experiment reveals the lack of model generalizability of these methods. We also implement eight recently popular domain generalization algorithms from the machine learning community. Our results indicate that these methods also do not generalize well on our datasets, with barely any advantage over the naive baseline of guessing the majority. We then present two new algorithms with better generalizability. Our new algorithm, Reorder, significantly and consistently outperforms existing methods on most cross-dataset generalization setups. However, the overall advantage is incremental and still has great room for improvement. Our analysis reveals that the individual differences (both within and between populations) may play the most important role in the cross-dataset generalization challenge. Finally, we provide an open-source benchmark platform GLOBEM- short for Generalization of Longitudinal BEhavior Modeling - to consolidate all 19 algorithms. GLOBEM can support researchers in using, developing, and evaluating different longitudinal behavior modeling methods. We call for researchers' attention to model generalizability evaluation for future longitudinal human behavior modeling studies.

Explainable AI (XAI) has established itself as an important component of AI-driven interactive systems. With Augmented Reality (AR) becoming more integrated in daily lives, the role of XAI also becomes essential in AR because end-users will frequently interact with intelligent services. However, it is unclear how to design effective XAI experiences for AR. We propose XAIR, a design framework that addresses when, what, and how to provide explanations of AI output in AR. The framework was based on a multi-disciplinary literature review of XAI and HCI research, a large-scale survey probing 500+ end-users’ preferences for AR-based explanations, and three workshops with 12 experts collecting their insights about XAI design in AR. XAIR’s utility and effectiveness was verified via a study with 10 designers and another study with 12 end-users. XAIR can provide guidelines for designers, inspiring them to identify new design opportunities and achieve effective XAI designs in AR.