Resource library

The success of foundation models such as ChatGPT and AlphaFold has spurred significant interest in building similar models for electronic medical records (EMRs) to improve patient care and hospital operations. However, recent hype has obscured critical gaps in our understanding of these models’ capabilities. In this narrative review, we examine 84 foundation models trained on nonimaging EMR data (i.e., clinical…

While the general machine learning (ML) community has benefited from public datasets, tasks, and models, the progress of ML in healthcare has been hampered by a lack of such shared assets. The success of foundation models creates new challenges for healthcare ML by requiring access to shared pretrained models to validate performance benefits. We help address these challenges through three…

Electronic phenotyping entails using electronic health records (EHRs) to identify patients with specific health outcomes and determine when those outcomes occurred. Unstructured clinical notes, which contain a vast amount of information, are a valuable resource for electronic phenotyping. However, traditional methods, such as rule-based labeling functions or neural networks, require significant manual effort to tune and may not generalize well…

Temporal distribution shift negatively impacts the performance of clinical prediction models over time. Pretraining foundation models using self-supervised learning on electronic health records (EHR) may be effective in acquiring informative global patterns that can improve the robustness of task-specific models. The objective was to evaluate the utility of EHR foundation models in improving the in-distribution (ID) and out-of-distribution (OOD) performance…

We present a self-supervised, time-to-event (TTE) foundation model called MOTOR (Many Outcome Time Oriented Representations) which is pretrained on timestamped sequences of events in electronic health records (EHR) and health insurance claims. TTE models are used for estimating the probability distribution of the time until a specific event occurs, which is an important task in medical settings. TTE models provide…

Although individual psychotherapy is generally effective for a range of mental health conditions, little is known about the momentto-moment language use of effective therapists. Increased access to computational power, coupled with a rise in computermediated communication (telehealth), makes feasible the large-scale analyses of language use during psychotherapy. Transparent methodological approaches are lacking, however. Here we present novel methods to increase…

Background: Given the costs of machine learning implementation, a systematic approach to prioritizing which models to implement into clinical practice may be valuable. Objective: The primary objective was to determine the health care attributes respondents at 2 pediatric institutions rate as important when prioritizing machine learning model implementation. The secondary objective was to describe their perspectives on implementation using a…

Large language models (LLMs) have been shown to be able to perform new tasks based on a few demonstrations or natural language instructions. While these capabilities have led to widespread adoption, most LLMs are developed by resource-rich organizations and are frequently kept from the public. As a step towards democratizing this powerful technology, we present BLOOM, a 176B-parameter open-access language…

Temporal dataset shift associated with changes in healthcare over time is a barrier to deploying machine learning-based clinical decision support systems. Algorithms that learn robust models by estimating invariant properties across time periods for domain generalization (DG) and unsupervised domain adaptation (UDA) might be suitable to proactively mitigate dataset shift. The objective was to characterize the impact of temporal dataset…