Birju Patel
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View article: MedHELM: Holistic Evaluation of Large Language Models for Medical Tasks
MedHELM: Holistic Evaluation of Large Language Models for Medical Tasks Open
While large language models (LLMs) achieve near-perfect scores on medical licensing exams, these evaluations inadequately reflect the complexity and diversity of real-world clinical practice. We introduce MedHELM, an extensible evaluation …
View article: MedAlign: A Clinician-Generated Dataset for Instruction Following with Electronic Medical Records
MedAlign: A Clinician-Generated Dataset for Instruction Following with Electronic Medical Records Open
The ability of large language models (LLMs) to follow natural language instructions with human-level fluency suggests many opportunities in healthcare to reduce administrative burden and improve quality of care. However, evaluating LLMs on…
View article: MedAlign: A Clinician-Generated Dataset for Instruction Following with Electronic Medical Records
MedAlign: A Clinician-Generated Dataset for Instruction Following with Electronic Medical Records Open
The ability of large language models (LLMs) to follow natural language instructions with human-level fluency suggests many opportunities in healthcare to reduce administrative burden and improve quality of care. However, evaluating LLMs on…
View article: The shaky foundations of large language models and foundation models for electronic health records
The shaky foundations of large language models and foundation models for electronic health records Open
View article: QUEST-AI: A System for Question Generation, Verification, and Refinement using AI for USMLE-Style Exams
QUEST-AI: A System for Question Generation, Verification, and Refinement using AI for USMLE-Style Exams Open
The United States Medical Licensing Examination (USMLE) is a critical step in assessing the competence of future physicians, yet the process of creating exam questions and study materials is both time-consuming and costly. While Large Lang…
View article: The Shaky Foundations of Clinical Foundation Models: A Survey of Large Language Models and Foundation Models for EMRs
The Shaky Foundations of Clinical Foundation Models: A Survey of Large Language Models and Foundation Models for EMRs Open
The successes of foundation models such as ChatGPT and AlphaFold have spurred significant interest in building similar models for electronic medical records (EMRs) to improve patient care and hospital operations. However, recent hype has o…
View article: ODP261 Non-Ketotic Hyperosmolar Hyperglycemia Induced Hemichorea-Dystonia Syndrome, Without Radiologic Striatopathy
ODP261 Non-Ketotic Hyperosmolar Hyperglycemia Induced Hemichorea-Dystonia Syndrome, Without Radiologic Striatopathy Open
Background Movement disorder is an uncommon complication of Hyperglycemic crisis. It is often associated with diabetic striatopathy which is a clinico-radiologic entity that is associated with acute changes of the contralateral basal gangl…
View article: ODP067 Long-term Systemic Steroid Use And Its Impact on In-hospital Outcomes Among Patients Admitted With Acute Pericarditis
ODP067 Long-term Systemic Steroid Use And Its Impact on In-hospital Outcomes Among Patients Admitted With Acute Pericarditis Open
Background Early use of systemic steroids in the acute setting of acute pericarditis has been associated with increased recurrence rate and a longer course of treatment. It is not clear if long-term systemic steroids use, has a similar unf…
View article: ODP065 Impact of Comorbid Adrenal Insufficiency on Outcomes During Hospitalization For Cardiogenic Shock
ODP065 Impact of Comorbid Adrenal Insufficiency on Outcomes During Hospitalization For Cardiogenic Shock Open
Background The catabolic stress associated with cardiogenic shock requires a robust metabolic, neuroendocrine, and immunologic response to mitigate, and adrenocortical hormones play a huge role in this process. On the other hand, excessive…
View article: ODP062 Clinical Outcomes of Cardiogenic Shock Hospitalization Among Patients with Long-term Systemic Steroid Use
ODP062 Clinical Outcomes of Cardiogenic Shock Hospitalization Among Patients with Long-term Systemic Steroid Use Open
Background Cardiogenic shock is a state of immense stress, and our innate human response depends on a robust metabolic, neuroendocrine, and immunologic reserves. Long term use of systemic corticosteroids takes its toll on all aspects of th…
View article: ODP066 Impact of Comorbid Adrenal Insufficiency on Outcomes of Infective Endocarditis Hospitalizations
ODP066 Impact of Comorbid Adrenal Insufficiency on Outcomes of Infective Endocarditis Hospitalizations Open
Background Adrenocortical integrity is vital to mounting an appropriate response to a potentially deleterious endovascular infection such as infectious endocarditis. Likewise, adrenocortical hormones affect how cytokine storms lead to seco…
View article: User-centred design for machine learning in health care: a case study from care management
User-centred design for machine learning in health care: a case study from care management Open
Objectives Few machine learning (ML) models are successfully deployed in clinical practice. One of the common pitfalls across the field is inappropriate problem formulation: designing ML to fit the data rather than to address a real-world …
View article: Assessment of Adherence to Reporting Guidelines by Commonly Used Clinical Prediction Models From a Single Vendor
Assessment of Adherence to Reporting Guidelines by Commonly Used Clinical Prediction Models From a Single Vendor Open
These findings suggest that consistent reporting recommendations for clinical predictive models are needed for model developers to share necessary information for model deployment. The many published guidelines would, collectively, require…
View article: Nursing Workflow Change in a COVID-19 Inpatient Unit Following the Deployment of Inpatient Telehealth: Observational Study Using a Real-Time Locating System
Nursing Workflow Change in a COVID-19 Inpatient Unit Following the Deployment of Inpatient Telehealth: Observational Study Using a Real-Time Locating System Open
Background The COVID-19 pandemic prompted widespread implementation of telehealth, including in the inpatient setting, with the goals to reduce potential pathogen exposure events and personal protective equipment (PPE) utilization. Nursing…
View article: Evaluating algorithmic fairness in the presence of clinical guidelines: the case of atherosclerotic cardiovascular disease risk estimation
Evaluating algorithmic fairness in the presence of clinical guidelines: the case of atherosclerotic cardiovascular disease risk estimation Open
Objectives The American College of Cardiology and the American Heart Association guidelines on primary prevention of atherosclerotic cardiovascular disease (ASCVD) recommend using 10-year ASCVD risk estimation models to initiate statin tre…
View article: Nursing Workflow Change in a COVID-19 Inpatient Unit Following the Deployment of Inpatient Telehealth: Observational Study Using a Real-Time Locating System (Preprint)
Nursing Workflow Change in a COVID-19 Inpatient Unit Following the Deployment of Inpatient Telehealth: Observational Study Using a Real-Time Locating System (Preprint) Open
BACKGROUND The COVID-19 pandemic prompted widespread implementation of telehealth, including in the inpatient setting, with the goals to reduce potential pathogen exposure events and personal protective equipment (PPE) utilization. Nursin…
View article: Building a Learning Health System: Creating an Analytical Workflow for Evidence Generation to Inform Institutional Clinical Care Guidelines
Building a Learning Health System: Creating an Analytical Workflow for Evidence Generation to Inform Institutional Clinical Care Guidelines Open
Background One key aspect of a learning health system (LHS) is utilizing data generated during care delivery to inform clinical care. However, institutional guidelines that utilize observational data are rare and require months to create, …
View article: Evaluating algorithmic fairness in the presence of clinical guidelines: the case of atherosclerotic cardiovascular disease risk estimation
Evaluating algorithmic fairness in the presence of clinical guidelines: the case of atherosclerotic cardiovascular disease risk estimation Open
The American College of Cardiology and the American Heart Association guidelines on primary prevention of atherosclerotic cardiovascular disease (ASCVD) recommend using 10-year ASCVD risk estimation models to initiate statin treatment. For…
View article: Low adherence to existing model reporting guidelines by commonly used clinical prediction models
Low adherence to existing model reporting guidelines by commonly used clinical prediction models Open
Objective To assess whether the documentation available for commonly used machine learning models developed by an electronic health record (EHR) vendor provides information requested by model reporting guidelines. Materials and Methods We …
View article: Learning decision thresholds for risk stratification models from aggregate clinician behavior
Learning decision thresholds for risk stratification models from aggregate clinician behavior Open
Using a risk stratification model to guide clinical practice often requires the choice of a cutoff—called the decision threshold—on the model’s output to trigger a subsequent action such as an electronic alert. Choosing this cutoff is not …
View article: A survey of extant organizational and computational setups for deploying predictive models in health systems
A survey of extant organizational and computational setups for deploying predictive models in health systems Open
Objective Artificial intelligence (AI) and machine learning (ML) enabled healthcare is now feasible for many health systems, yet little is known about effective strategies of system architecture and governance mechanisms for implementation…
View article: Using a Real-Time Locating System to Evaluate the Impact of Telemedicine in an Emergency Department During COVID-19: Observational Study
Using a Real-Time Locating System to Evaluate the Impact of Telemedicine in an Emergency Department During COVID-19: Observational Study Open
Background Telemedicine has been deployed by health care systems in response to the COVID-19 pandemic to enable health care workers to provide remote care for both outpatients and inpatients. Although it is reasonable to suspect telemedici…
View article: Using a Real-Time Locating System to Evaluate the Impact of Telemedicine in an Emergency Department During COVID-19: Observational Study (Preprint)
Using a Real-Time Locating System to Evaluate the Impact of Telemedicine in an Emergency Department During COVID-19: Observational Study (Preprint) Open
BACKGROUND Telemedicine has been deployed by health care systems in response to the COVID-19 pandemic to enable health care workers to provide remote care for both outpatients and inpatients. Although it is reasonable to suspect telemedic…
View article: Learning Decision Thresholds for Risk-Stratification Models from Aggregate Clinician Behavior
Learning Decision Thresholds for Risk-Stratification Models from Aggregate Clinician Behavior Open
Using a risk-stratification model to guide clinical practice often requires the choice of a cutoff - called the decision threshold - on the model’s output to trigger a subsequent action such as an electronic alert. Choosing this cutoff is …
View article: Corrigendum to: Rapid Deployment of Inpatient Telemedicine In Response to COVID-19 Across Three Health Systems
Corrigendum to: Rapid Deployment of Inpatient Telemedicine In Response to COVID-19 Across Three Health Systems Open
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View article: Estimating the efficacy of symptom-based screening for COVID-19
Estimating the efficacy of symptom-based screening for COVID-19 Open
There is substantial interest in using presenting symptoms to prioritize testing for COVID-19 and establish symptom-based surveillance. However, little is currently known about the specificity of COVID-19 symptoms. To assess the feasibilit…
View article: Rapid Deployment of Inpatient Telemedicine In Response to COVID-19 Across Three Health Systems
Rapid Deployment of Inpatient Telemedicine In Response to COVID-19 Across Three Health Systems Open
Objective To reduce pathogen exposure, conserve personal protective equipment, and facilitate health care personnel work participation in the setting of the COVID-19 pandemic, three affiliated institutions rapidly and independently deploye…
View article: Isolated Pancreatic Transection Secondary to Abdominal Blunt Trauma - A Case Report
Isolated Pancreatic Transection Secondary to Abdominal Blunt Trauma - A Case Report Open
View article: Impact of Race, Ethnicity, and Multimodality Biomarkers on the Incidence of New-Onset Heart Failure With Preserved Ejection Fraction (from the Multi-Ethnic Study of Atherosclerosis)
Impact of Race, Ethnicity, and Multimodality Biomarkers on the Incidence of New-Onset Heart Failure With Preserved Ejection Fraction (from the Multi-Ethnic Study of Atherosclerosis) Open
View article: Effect of comprehensive cardiovascular disease risk management on longitudinal changes in carotid artery intima-media thickness in a community-based prevention clinic
Effect of comprehensive cardiovascular disease risk management on longitudinal changes in carotid artery intima-media thickness in a community-based prevention clinic Open
In a cohort of patients receiving comprehensive CVD risk reduction therapy, delipidation of subclinical carotid plaque and reductions in CIMT predominantly occurred within 2 years, and correlated with changes in traditional biomarkers. The…