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) public health; and 7) medical robotics. We examine their challenges, followed by a critical discussion about potential future directions and pitfalls of large AI models in transforming the field of health informatics.

With the increasing demands on quality healthcare and the raising cost of care, pervasive healthcare is considered as a technological solutions to address the global health issues. In particular, the recent advances in Internet of Things have led to the development of Internet of Medical Things (IoMT). Although such low cost and pervasive sensing devices could potentially transform the current reactive care to preventative care, the security and privacy issues of such sensing system are often overlooked. As the medical devices capture and process very sensitive personal health data, the devices and their associated communications have to be very secured to protect the user’s privacy. However, the miniaturized IoMT devices have very limited computation power and fairly limited security schemes can be implemented in such devices. In addition, with the widespread use of IoMT devices, managing and ensuring the security of IoMT systems are very challenging and which are the major issues hindering the adoption of IoMT for clinical applications. In this paper, the security and privacy challenges, requirements, threats, and future research directions in the domain of IoMT are reviewed providing a general overview of the state-of-the-art approaches.

Medical image analysis plays an important role in clinical diagnosis. In this paper, we examine the recent Segment Anything Model (SAM) on medical images, and report both quantitative and qualitative zero-shot segmentation results on nine medical image segmentation benchmarks, covering various imaging modalities, such as optical coherence tomography (OCT), magnetic resonance imaging (MRI), and computed tomography (CT), as well as different applications including dermatology, ophthalmology, and radiology. Those benchmarks are representative and commonly used in model development. Our experimental results indicate that while SAM presents remarkable segmentation performance on images from the general domain, its zero-shot segmentation ability remains restricted for out-of-distribution images, e.g., medical images. In addition, SAM exhibits inconsistent zero-shot segmentation performance across different unseen medical domains. For certain structured targets, e.g., blood vessels, the zero-shot segmentation of SAM completely failed. In contrast, a simple fine-tuning of it with a small amount of data could lead to remarkable improvement of the segmentation quality, showing the great potential and feasibility of using fine-tuned SAM to achieve accurate medical image segmentation for a precision diagnostics. Our study indicates the versatility of generalist vision foundation models on medical imaging, and their great potential to achieve desired performance through fine-turning and eventually address the challenges associated with accessing large and diverse medical datasets in support of clinical diagnostics.

A daily dietary assessment method named 24-hour dietary recall has commonly been used in nutritional epidemiology studies to capture detailed information of the food eaten by the participants to help understand their dietary behaviour. However, in this self-reporting technique, the food types and the portion size reported highly depends on users' subjective judgement which may lead to a biased and inaccurate dietary analysis result. As a result, a variety of visual-based dietary assessment approaches have been proposed recently. While these methods show promises in tackling issues in nutritional epidemiology studies, several challenges and forthcoming opportunities, as detailed in this study, still exist. This study provides an overview of computing algorithms, mathematical models and methodologies used in the field of image-based dietary assessment. It also provides a comprehensive comparison of the state of the art approaches in food recognition and volume/weight estimation in terms of their processing speed, model accuracy, efficiency and constraints. It will be followed by a discussion on deep learning method and its efficacy in dietary assessment. After a comprehensive exploration, we found that integrated dietary assessment systems combining with different approaches could be the potential solution to tackling the challenges in accurate dietary intake assessment.

Conventional approaches to dietary assessment are primarily grounded in self-reporting methods or structured interviews conducted under the supervision of dietitians. These methods, however, are often subjective, potentially inaccurate, and time-intensive. Although artificial intelligence (AI)-based solutions have been devised to automate the dietary assessment process, prior AI methodologies tackle dietary assessment in a fragmented landscape (e.g., merely recognizing food types or estimating portion size), and encounter challenges in their ability to generalize across a diverse range of food categories, dietary behaviors, and cultural contexts. Recently, the emergence of multimodal foundation models, such as GPT-4V, has exhibited transformative potential across a wide range of tasks (e.g., scene understanding and image captioning) in various research domains. These models have demonstrated remarkable generalist intelligence and accuracy, owing to their large-scale pre-training on broad datasets and substantially scaled model size. In this study, we explore the application of GPT-4V powering multimodal ChatGPT for dietary assessment, along with prompt engineering and passive monitoring techniques. We evaluated the proposed pipeline using a self-collected, semi free-living dietary intake dataset comprising 16 real-life eating episodes, captured through wearable cameras. Our findings reveal that GPT-4V excels in food detection under challenging conditions without any fine-tuning or adaptation using food-specific datasets. By guiding the model with specific language prompts (e.g., African cuisine), it shifts from recognizing common staples like rice and bread to accurately identifying regional dishes like banku and ugali. Another GPT-4V's standout feature is its contextual awareness. GPT-4V can leverage surrounding objects as scale references to deduce the portion sizes of food items, further facilitating the process of dietary assessment.