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Temporal and cross-site validation of an AI system for self-harm detection

Adequate self-harm surveillance is a key part of suicide prevention. Our previous research demonstrated that an artificial intelligence (AI)-based system could effectively detect self-harm in emergency department triage notes. However, the system was developed using data from a single hospital, raising concerns about its generalisability. Here, we aim to validate the system prospectively and externally to better understand its portability across hospitals. We leveraged emergency department data from two Australi…

PLOS Digital Health · Health

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A novel use of AI for prediction of clinical deterioration in a post-acute hospital

There is a growing literature on the prediction of risk of deterioration in hospital settings, including by leveraging artificial intelligence (AI) models. However, this literature has focused on acute-care hospitals, rather than post-acute facilities, where the risk of deterioration remains high. Post-acute facilities tend to have lower digital maturity and poorer data foundations, as well as less rich physiologic data, making the implementation of AI tools for deterioration challenging. In this study, we demon…

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Evidence-backed problem

A Real-World Evaluation of Large Language Model-Generated Hospital Courses in Pediatrics

Background Large language model (LLM)-generated hospital courses are increasingly integrated into electronic health records (EHRs), yet their accuracy and safety in pediatric populations remain poorly characterized. Objective To evaluate the accuracy, text quality, and perceived potential harm of EHR-integrated and LLM-generated hospital courses in pediatric inpatient care during early clinical implementation. Methods We conducted a descriptive evaluation from June 10 to August 8, 2025, at an academic freestandi…

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Evaluating the Accuracy, Empathy, and Readability of Generative AI Versus Registered Nurses in Discharge Planning: A Vignette-Based Study

Aim To compare the multidimensional performance of discharge instructions generated by generative AI (GPT-4) versus those created by clinical registered nurses across three dimensions-accuracy, empathy and readability-and to explore the impact of patient. Design A prospective, double-blind, vignette-based cross-sectional study. Methods Five standardized multidisciplinary discharge scenarios were constructed. Discharge instructions were generated independently by five registered nurses and GPT-4. Fifteen clinical…

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An Interpretable Machine Learning Framework with Clinical Nomogram for Predicting In-Hospital Mortality in Acute Ischemic Stroke Using High-Granularity Bedside Data

This multicenter study developed and validated an interpretable machine learning model integrating granular nursing and emergency department data collected within the first 24 hours to predict in-hospital mortality in acute ischemic stroke (AIS). We analyzed a retrospective cohort of 5,014 adult AIS patients from three tertiary academic centers (2019-2023). Centers A and B (n=3,512) formed the development cohort; Center C (n=1,502) served as the external validation cohort. Sixty-three predictors across seven dom…

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Reinventing the echocardiography workflow: from manual quantification to artificial intelligence-driven comprehensive interpretation

Echocardiography remains the cornerstone of cardiovascular imaging. However, traditional workflows including manual acquisition, sequential measurement, and expert interpretation face challenges from increased clinical demand, workforce shortage, and the physical burden of repetitive scanning. Artificial intelligence (AI) has begun to address these issues, transitioning from proof-of-concept to prospective clinical evaluations. Recent evidence suggests that AI integration reduces examination time and automates m…

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Evidence-backed gain

Adaptation of a fair individualized polysocial risk score for hospitalization risk prediction

Objectives We adapted the individualized polysocial risk score (iPsRS), a machine learning model originally developed for patients with type 2 diabetes, to evaluate its generalizability in predicting 1-year hospitalization risk in a disease-agnostic adult cohort, with attention to fairness and explainability. Materials and methods The study utilized de-identified electronic health record data from a retrospective cohort of 17 857 adult patients at the University of Florida Health. The original iPsRS framework wa…

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A large language models-assisted and expert-corrected workflow for preoperative anesthesia assessment drafts: A single-centre exploratory feasibility study

Large language models (LLMs) may help organize clinical information, but their use in perioperative settings requires careful evaluation because errors may have immediate safety implications. This study aimed to describe the feasibility and perceived usefulness of a single-centre, expert-corrected LLM workflow for preparing preoperative anesthesia assessment drafts for complex consultation cases. Secondary aims were to describe error patterns identified by anesthesiologists and to explore residents' perceptions…

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Artificial Intelligence-Assisted Chest Radiography: A Prospective Crossover Multi-Reader Study on Diagnostic Performance and Workflow Efficiency

To evaluate the impact of four commercially available AI solutions for chest radiography on diagnostic performance, workflow efficiency, and clinical decision-making in a real-world setting. In this prospective, monocentric, crossover reader study, five readers (one to six years of experience) assessed 1200 consecutive patients undergoing chest radiography (1861 total radiographs) for pulmonary infiltrates, pleural effusions, mediastinal masses, pneumothorax, and pulmonary nodules under five conditions: without…

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EXPRESS: Relation between Albumin-Corrected Anion Gap and In-Hospital Mortality in Patients with Traumatic Lung Injury: A Multicenter Retrospective Cohort Study and the Development of Machine Learning-Based Prediction Models

Background The anion gap is primarily utilized as an indicator for evaluating acid-base imbalances in critically ill patients. However, its accuracy is reduced in such patients due to low albumin levels. The albumin-corrected anion gap (ACAG) enhances the accuracy of assessing acid-base imbalances. Individuals with traumatic lung injury (TLI) in the intensive care unit (ICU) often have severe metabolic acidosis and hypoalbuminemia. Nevertheless, the association of ACAG with the prognosis of patients with TLI is…

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Diagnostic accuracy of electronic medical record retrieval methods and a large language model for identifying cardiovascular events: a multisite retrospective validation study in a medical system in the United States

To compare the diagnostic accuracy of four available automated electronic medical record (EMR) retrieval methods, including a large language model (LLM)-assisted workflow, against manual chart adjudication for identifying cardiovascular events. Retrospective diagnostic accuracy study. Three sites within a single US tertiary health system. Two adult cohorts with previously adjudicated cardiovascular outcomes were included. Cohort 1 included 2258 patients treated with immune checkpoint inhibitors, and Cohort 2 inc…

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TrialTriage, a Semiautonomous Prescreening Workflow for Resolving Ambiguity in Phase I Oncology Trial Eligibility: Development and Proof-of-Concept Study Using Synthetic Cases

Enrollment in phase I oncology trials remains low largely because potentially eligible patients are not identified and evaluated quickly enough. Current clinical trial matching systems can identify candidate patients from the electronic health record, but cases with missing or uncertain eligibility data are often routed for offline manual review. This delay impedes clarification and prolongs the final eligibility determination. This study evaluated TrialTriage, a semiautonomous system built on the n8n platform a…

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TrialTriage, a Semiautonomous Prescreening Workflow for Resolving Ambiguity in Phase I Oncology Trial Eligibility: Development and Proof-of-Concept Study Using Synthetic Cases

Trustworthy artificial intelligence for rural health care

Regional, rural and remote Australians experience poorer health outcomes and substantially higher rates of suicide and self-harm than those in major cities. Artificial intelligence could support earlier identification of distress, safer triage and more timely care alongside telehealth and clinical decision support, but only if it is treated as a health intervention with explicit safety nets and independent evaluation. We propose a minimum viable governance model, including Indigenous partnership, language safety…

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Mapping the Evolving AI Preferences and Care Needs in Orthopedic Transitional Care From Hospitals to Home: Cross-Sectional Study

Enhanced recovery after surgery protocols have shortened orthopedic hospital stays but have shifted rehabilitation and safety-monitoring tasks to patients and families after discharge. In this study, AI refers to patient-facing digital systems for orthopedic transitional care, including large language model chatbots, computer vision or platform-based monitoring tools, and wearable sensor-enabled systems for education, rehabilitation guidance, motion correction, and risk alerts. However, patient-reported preferen…

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Mapping the Evolving AI Preferences and Care Needs in Orthopedic Transitional Care From Hospitals to Home: Cross-Sectional Study

The Sydney Triage to Admission Risk Tool With Artificial Intelligence (START-AI) to Support Decision Making in Emergency Departments: Model Explainability and Feature Importance Analysis

Objective Evaluate the importance of specific variables contributing to a recently reported Artificial Intelligence (AI) prediction model called Sydney Triage to Admission Risk Tool with Artificial Intelligence (START-AI) to predict inpatient admission from the Emergency Department (ED). Methods A model explainability analysis was undertaken using single-centre ED electronic medical record data over 2 years. The START-AI model, which comprises ensemble machine learning and a transformer-based algorithm to enhanc…

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