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Journal of Medical Internet Research
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AI-Enhanced Social Robotic Versus Computer-Based Virtual Patients for Clinical Reasoning Training in Medical Education: Observational Crossover Cohort Study
Background: Virtual patient (VP) simulations can be used to practice clinical reasoning (CR) in controlled learning environments. Traditional computer-based VP platforms often lack the authenticity and interactivity required for effective CR training. Artificial intelligence (AI)–enhanced social robotic VPs can enhance realism and engagement; however, quantitative evidence comparing them with conventional VP platforms remains limited. Objective: We compared medical students’ experience of an AI-
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MRD
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Monitoring of circulating tumor DNA allows early detection of disease relapse in patients with operable breast cancer
Mol Oncol. 2025 Nov 27. doi: 10.1002/1878-0261.70170. Online ahead of print.ABSTRACTBreast cancer is known for late recurrences, yet current follow-up lacks radiological or blood-based monitoring for systemic relapse. This study evaluated circulating tumor DNA (ctDNA) monitoring for early detection of systemic relapse after curative treatment. In this case-control study of 70 patients with operable breast cancer (35 with relapse and 35 without relapse), blood samples were collected every 6-12 mo
Monitoring of circulating tumor DNA allows early detection of disease relapse in patients with operable breast cancer
Mol Oncol. 2025 Nov 27. doi: 10.1002/1878-0261.70170. Online ahead of print.
ABSTRACT
Breast cancer is known for late recurrences, yet current follow-up lacks radiological or blood-based monitoring for systemic relapse. This study evaluated circulating tumor DNA (ctDNA) monitoring for early detection of systemic relapse after curative treatment. In this case-control study of 70 patients with operable breast cancer (35 with relapse and 35 without relapse), blood samples were collected every 6-12 months during a median 8.3-year follow-up. ctDNA was analyzed by targeted DNA sequencing using Oncomine™ Breast cfDNA Research Assay v2, and results were compared to genetic analysis of tumor and metastasis biopsies. ctDNA was detected at relapse in 19 of 35 (54%) patients with disease relapse and preceded clinical or radiological relapse detection in 17, with a median lead time of 10.3 months. In 13 (68%) patients, there was concordance with tumor mutations, and in seven patients, there was also concordance with metastasis. Among the relapse-free patients, seven were ctDNA-positive postsurgery, and only one of them had a match among the tumor variants. These findings suggest serial ctDNA analysis may enable earlier detection of systemic relapse in patients with operable breast cancer.
PMID:41307327 | DOI:10.1002/1878-0261.70170
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npj Digital Medicine
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Research progress in computer-aided diagnosis systems for lung cancer
npj Digital Medicine, Published online: 26 November 2025; doi:10.1038/s41746-025-02101-3Research progress in computer-aided diagnosis systems for lung cancer
Research progress in computer-aided diagnosis systems for lung cancer
npj Digital Medicine, Published online: 26 November 2025; doi:10.1038/s41746-025-02101-3
Research progress in computer-aided diagnosis systems for lung cancer-
cs.AI, q-bio.NC updates on arXiv.org
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Cognitive bias in LLM reasoning compromises interpretation of clinical oncology notes
arXiv:2511.20680v1 Announce Type: cross Abstract: Despite high performance on clinical benchmarks, large language models may reach correct conclusions through faulty reasoning, a failure mode with safety implications for oncology decision support that is not captured by accuracy-based evaluation. In this two-cohort retrospective study, we developed a hierarchical taxonomy of reasoning errors from GPT-4 chain-of-thought responses to real oncology notes and tested its clinical relevance. Using br
Cognitive bias in LLM reasoning compromises interpretation of clinical oncology notes
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cs.AI, q-bio.NC updates on arXiv.org
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Rigor in AI: Doing Rigorous AI Work Requires a Broader, Responsible AI-Informed Conception of Rigor
arXiv:2506.14652v2 Announce Type: replace-cross Abstract: In AI research and practice, rigor remains largely understood in terms of methodological rigor -- such as whether mathematical, statistical, or computational methods are correctly applied. We argue that this narrow conception of rigor has contributed to the concerns raised by the responsible AI community, including overblown claims about the capabilities of AI systems. Our position is that a broader conception of what rigorous AI researc
Rigor in AI: Doing Rigorous AI Work Requires a Broader, Responsible AI-Informed Conception of Rigor
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(Multiomics OR Omics) AND (Lung OR gastric OR Hepatocellular)
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Smart spatial omics (S2-omics) optimizes region of interest selection to capture molecular heterogeneity in diverse tissues
Nat Cell Biol. 2025 Nov 26. doi: 10.1038/s41556-025-01811-w. Online ahead of print.ABSTRACTSpatial omics technologies have transformed biomedical research by enabling high-resolution molecular profiling while preserving the native tissue architecture. These advances provide unprecedented insights into tissue structure and function. However, the high cost and time-intensive nature of spatial omics experiments necessitate careful experimental design, particularly in selecting regions of interest (
Smart spatial omics (S2-omics) optimizes region of interest selection to capture molecular heterogeneity in diverse tissues
Nat Cell Biol. 2025 Nov 26. doi: 10.1038/s41556-025-01811-w. Online ahead of print.
ABSTRACT
Spatial omics technologies have transformed biomedical research by enabling high-resolution molecular profiling while preserving the native tissue architecture. These advances provide unprecedented insights into tissue structure and function. However, the high cost and time-intensive nature of spatial omics experiments necessitate careful experimental design, particularly in selecting regions of interest (ROIs) from large tissue sections. Currently, ROI selection is performed manually, which introduces subjectivity, inconsistency and a lack of reproducibility. Previous studies have shown strong correlations between spatial molecular patterns and histological features, suggesting that readily available and cost-effective histology images can be leveraged to guide spatial omics experiments. Here we present Smart Spatial omics (S2-omics), an end-to-end workflow that automatically selects ROIs from histology images with the goal of maximizing molecular information content in the ROIs. Through comprehensive evaluations across multiple spatial omics platforms and tissue types, we demonstrate that S2-omics enables systematic and reproducible ROI selection and enhances the robustness and impact of downstream biological discovery.
PMID:41298871 | DOI:10.1038/s41556-025-01811-w
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npj Digital Medicine
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Information content as a health system screening tool for rare diseases
npj Digital Medicine, Published online: 25 November 2025; doi:10.1038/s41746-025-02096-xInformation content as a health system screening tool for rare diseases
Information content as a health system screening tool for rare diseases
npj Digital Medicine, Published online: 25 November 2025; doi:10.1038/s41746-025-02096-x
Information content as a health system screening tool for rare diseases-
cs.AI, q-bio.NC updates on arXiv.org
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Toward explainable AI approaches for breast imaging: adapting foundation models to diverse populations
arXiv:2511.17828v1 Announce Type: cross Abstract: Foundation models hold promise for specialized medical imaging tasks, though their effectiveness in breast imaging remains underexplored. This study leverages BiomedCLIP as a foundation model to address challenges in model generalization. BiomedCLIP was adapted for automated BI-RADS breast density classification using multi-modality mammographic data (synthesized 2D images, digital mammography, and digital breast tomosynthesis). Using 96,995 ima
Toward explainable AI approaches for breast imaging: adapting foundation models to diverse populations
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cs.AI, q-bio.NC updates on arXiv.org
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Towards Automating Data Access Permissions in AI Agents
arXiv:2511.17959v1 Announce Type: cross Abstract: As AI agents attempt to autonomously act on users' behalf, they raise transparency and control issues. We argue that permission-based access control is indispensable in providing meaningful control to the users, but conventional permission models are inadequate for the automated agentic execution paradigm. We therefore propose automated permission management for AI agents. Our key idea is to conduct a user study to identify the factors influenci
Towards Automating Data Access Permissions in AI Agents
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cs.AI, q-bio.NC updates on arXiv.org
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Reinforcement Learning for Portfolio Optimization with a Financial Goal and Defined Time Horizons
arXiv:2511.18076v1 Announce Type: cross Abstract: This research proposes an enhancement to the innovative portfolio optimization approach using the G-Learning algorithm, combined with parametric optimization via the GIRL algorithm (G-learning approach to the setting of Inverse Reinforcement Learning) as presented by. The goal is to maximize portfolio value by a target date while minimizing the investor's periodic contributions. Our model operates in a highly volatile market with a well-diversif
Reinforcement Learning for Portfolio Optimization with a Financial Goal and Defined Time Horizons
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cs.AI, q-bio.NC updates on arXiv.org
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The Alignment Paradox of Medical Large Language Models in Infertility Care: Decoupling Algorithmic Improvement from Clinical Decision-making Quality
arXiv:2511.18084v1 Announce Type: cross Abstract: Large language models (LLMs) are increasingly adopted in clinical decision support, yet aligning them with the multifaceted reasoning pathways of real-world medicine remains a major challenge. Using more than 8,000 infertility treatment records, we systematically evaluate four alignment strategies: Supervised Fine-Tuning (SFT), Direct Preference Optimization (DPO), Group Relative Policy Optimization (GRPO), and In-Context Learning (ICL) through
The Alignment Paradox of Medical Large Language Models in Infertility Care: Decoupling Algorithmic Improvement from Clinical Decision-making Quality
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cs.AI, q-bio.NC updates on arXiv.org
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Clinician-in-the-Loop Smart Home System to Detect Urinary Tract Infection Flare-Ups via Uncertainty-Aware Decision Support
arXiv:2511.18334v1 Announce Type: cross Abstract: Urinary tract infection (UTI) flare-ups pose a significant health risk for older adults with chronic conditions. These infections often go unnoticed until they become severe, making early detection through innovative smart home technologies crucial. Traditional machine learning (ML) approaches relying on simple binary classification for UTI detection offer limited utility to nurses and practitioners as they lack insight into prediction uncertain
Clinician-in-the-Loop Smart Home System to Detect Urinary Tract Infection Flare-Ups via Uncertainty-Aware Decision Support
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cs.AI, q-bio.NC updates on arXiv.org
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Are Large Vision Language Models Truly Grounded in Medical Images? Evidence from Italian Clinical Visual Question Answering
arXiv:2511.19220v1 Announce Type: cross Abstract: Large vision language models (VLMs) have achieved impressive performance on medical visual question answering benchmarks, yet their reliance on visual information remains unclear. We investigate whether frontier VLMs demonstrate genuine visual grounding when answering Italian medical questions by testing four state-of-the-art models: Claude Sonnet 4.5, GPT-4o, GPT-5-mini, and Gemini 2.0 flash exp. Using 60 questions from the EuropeMedQA Italian
Are Large Vision Language Models Truly Grounded in Medical Images? Evidence from Italian Clinical Visual Question Answering
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Journal of Medical Internet Research
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AI-Assisted Cardiovascular Risk Assessment by General Practitioners in Resource-Constrained Indonesian Settings Using a Conceptual Prototype: Randomized Controlled Study
Background: Preventive strategies integrated with digital health and artificial intelligence (AI), have significant potential to mitigate the global burden of atherosclerotic cardiovascular disease (ASCVD). AI-enabled clinical decision support (CDS) systems increasingly provide patient-specific insights beyond traditional risk factors. Despite these advances, their capacity to enhance clinical decision-making in resource-constrained settings remains largely unexplored. Objective: We conducted a
AI-Assisted Cardiovascular Risk Assessment by General Practitioners in Resource-Constrained Indonesian Settings Using a Conceptual Prototype: Randomized Controlled Study
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cs.AI, q-bio.NC updates on arXiv.org
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ConCISE: A Reference-Free Conciseness Evaluation Metric for LLM-Generated Answers
arXiv:2511.16846v1 Announce Type: cross Abstract: Large language models (LLMs) frequently generate responses that are lengthy and verbose, filled with redundant or unnecessary details. This diminishes clarity and user satisfaction, and it increases costs for model developers, especially with well-known proprietary models that charge based on the number of output tokens. In this paper, we introduce a novel reference-free metric for evaluating the conciseness of responses generated by LLMs. Our m
ConCISE: A Reference-Free Conciseness Evaluation Metric for LLM-Generated Answers
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cs.AI, q-bio.NC updates on arXiv.org
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Artificial Intelligence Index Report 2025
arXiv:2504.07139v3 Announce Type: replace Abstract: Welcome to the eighth edition of the AI Index report. The 2025 Index is our most comprehensive to date and arrives at an important moment, as AI's influence across society, the economy, and global governance continues to intensify. New in this year's report are in-depth analyses of the evolving landscape of AI hardware, novel estimates of inference costs, and new analyses of AI publication and patenting trends. We also introduce fresh data on
Artificial Intelligence Index Report 2025
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npj Digital Medicine
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Multimodal analysis of whole slide images in colorectal cancer
npj Digital Medicine, Published online: 24 November 2025; doi:10.1038/s41746-025-02095-yMultimodal analysis of whole slide images in colorectal cancer
Multimodal analysis of whole slide images in colorectal cancer
npj Digital Medicine, Published online: 24 November 2025; doi:10.1038/s41746-025-02095-y
Multimodal analysis of whole slide images in colorectal cancer-
(Multiomics OR Omics) AND (Pancreatic)
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Integrative analysis of genomic and transcriptomic data informs precancer progression in the pancreas
bioRxiv [Preprint]. 2025 Nov 4:2025.11.03.686234. doi: 10.1101/2025.11.03.686234.ABSTRACTPancreatic ductal adenocarcinoma (PDAC) arises from heterogeneous precursor lesions, including intraductal papillary mucinous neoplasms (IPMNs), but the features distinguishing indolent from progressive lesions remain unclear. We performed an integrative analysis of transcriptomic, genomic, and microenvironmental profiles of IPMNs to define multi-omic phenotypes. Using transfer learning, we projected IPMN-de
Integrative analysis of genomic and transcriptomic data informs precancer progression in the pancreas
bioRxiv [Preprint]. 2025 Nov 4:2025.11.03.686234. doi: 10.1101/2025.11.03.686234.
ABSTRACT
Pancreatic ductal adenocarcinoma (PDAC) arises from heterogeneous precursor lesions, including intraductal papillary mucinous neoplasms (IPMNs), but the features distinguishing indolent from progressive lesions remain unclear. We performed an integrative analysis of transcriptomic, genomic, and microenvironmental profiles of IPMNs to define multi-omic phenotypes. Using transfer learning, we projected IPMN-derived transcriptional programs onto spatial transcriptomic datasets from IPMNs and pancreatic intraepithelial neoplasias (PanINs). We identified two major phenotypes: one associated with cancer-associated fibroblasts and epithelial-to-mesenchymal transition, shared across IPMN, PanIN, and PDAC; and a second, glycolysis-enriched phenotype with a unique somatic mutation profile specific to IPMN. Spatial mapping further revealed grade-specific enrichment of transcriptional programs and distinct interactions with stromal and immune subtypes, underscoring the role of the precancer microenvironment in progression. These findings establish multi-omic phenotypes that unify genetic, transcriptional, and microenvironmental heterogeneity, providing a framework for distinguishing progressive from indolent precancers and a web-based public atlas for future exploration of these data and transcriptional phenotypes.
PMID:41279473 | PMC:PMC12637499 | DOI:10.1101/2025.11.03.686234
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MRD
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Knowledge-informed multimodal cfDNA analysis improves sensitivity and generalization in cancer detection
bioRxiv [Preprint]. 2025 Oct 21:2025.10.20.683167. doi: 10.1101/2025.10.20.683167.ABSTRACTLiquid biopsy offers a minimally invasive opportunity to detect and monitor cancers through analysis of cell-free DNA (cfDNA). However, current approaches face challenges of limited sensitivity at low tumor fractions, technical variability, and poor generalization across cohorts. Tumor-informed targeted methods offer high specificity but suffer from low sensitivity due to random sampling, tumor evolution an
Knowledge-informed multimodal cfDNA analysis improves sensitivity and generalization in cancer detection
bioRxiv [Preprint]. 2025 Oct 21:2025.10.20.683167. doi: 10.1101/2025.10.20.683167.
ABSTRACT
Liquid biopsy offers a minimally invasive opportunity to detect and monitor cancers through analysis of cell-free DNA (cfDNA). However, current approaches face challenges of limited sensitivity at low tumor fractions, technical variability, and poor generalization across cohorts. Tumor-informed targeted methods offer high specificity but suffer from low sensitivity due to random sampling, tumor evolution and adaptation (including resistance mechanisms), and other sources of heterogeneity. Conversely, tumor-naive genome-wide methods can increase sensitivity but often sacrifice specificity, particularly at low tumor fractions. We developed Fragmentomics Analysis for Tumor Evaluation with AI (Fate-AI), a multimodal framework that integrates fragmentomic and methylation-derived features from low-pass whole-genome sequencing (LPWGS) and cell-free methylated DNA immunoprecipitation and high-throughput sequencing (cfMeDIP-seq). It employs a knowledge-informed strategy to select recurrently altered genomic regions and tissue-specific methylation loci to combine the advantages of tumor-naive approaches with the specificity of tumor-informed approaches. This approach derives robust per-sample normalized features that mitigate batch effects and enhance cross-cohort reproducibility. We evaluated Fate-AI on a total of 1,219 plasma samples spanning ten cancer types and healthy controls from multiple laboratories and sequencing centers, including 432 newly profiled cases (280 with both cfMeDIP-seq and LPWGS) together with 787 samples from four independent public datasets. Fate-AI achieved superior sensitivity and specificity compared to state-of-the-art methods, detecting tumor-derived signals at fractions as low as 10-5 in experimental dilutions. Fate-AI scores correlated with disease stage and tracked longitudinal progression, anticipating relapse months before clinical progression. Furthermore, Fate-AI enabled tissue-of-origin classification, with AUCs ranging from 0.84 to 0.97 across six cancer types. Collectively, our results demonstrate that Fate-AI provides a sensitive, generalizable, and clinically actionable platform for early detection, minimal residual disease monitoring, and tissue-of-origin classification, supporting its potential as a liquid biopsy framework in precision oncology.
PMID:41278930 | PMC:PMC12633305 | DOI:10.1101/2025.10.20.683167
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Journal of Medical Internet Research
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Impact of Digital Interventions on the Treatment Burden of Patients With Chronic Conditions: Systematic Review
Background: Digital interventions can provide cost-effective, quality health care for patients with chronic conditions. Patients with chronic conditions often are burdened by a substantial load of adhering to a treatment regimen and suffer from impacts on their function and well-being. This treatment burden has consequences for treatment adherence and disease outcomes. Digital interventions have the potential to alleviate the burden, but they also may cause new challenges and an increased worklo