From statistics to deep learning: Using large language models in psychiatric research

Large Language Models: A Historical and Sociocultural Perspective.

This research paper delves into the inherent vulnerabilities and potential threats posed by large language models (LLMs), focusing on their implications across diverse applications such as natural language processing and data privacy. The study aims to identify and analyze these risks comprehensively, emphasizing the importance of mitigating strategies to prevent exploitation and misuse in LLM deployments. In recent years, LLMs have revolutionized fields like automated content generation, sentiment analysis, and conversational agents, yet their immense capabilities also raise significant security concerns. Vulnerabilities such as bias amplification, adversarial attacks, and unintended data leakage can undermine trust and compromise user privacy. Through a systematic examination of these challenges, this paper proposes safeguarding measures crucial for responsibly harnessing the potential of LLMs while minimizing associated risks. It underscores the necessity of rigorous security protocols, including robust encryption methods, enhanced authentication mechanisms, and continuous monitoring frameworks. Furthermore, the research discusses regulatory implications and ethical considerations surrounding LLM usage, advocating for transparency, accountability, and stakeholder engagement in policy- making and deployment practices. By synthesizing insights from current literature and real-world case studies, this study provides a comprehensive framework for stakeholders—developers, policymakers, and users—to navigate the complex landscape of LLM security effectively. Ultimately, this research aims to inform future advancements in LLM technology, ensuring its safe and beneficial integration into various domains while mitigating potential risks to individuals and society as a whole. Keywords— Adversarial attacks on LLMs, Bias in LLMs, Data privacy in LLMs, Ethical considerations LLMs, Exploitation of LLMs, Large Language Models (LLMs), Misuse of LLMs, Mitigation strategies for LLMs, Natural Language Processing (NLP), Regulatory frameworks LLMs, Responsible deployment of LLMs, Risks of LLMs, Security implications of LLMs, Threats to LLMs, Vulnerabilities in LLMs.

PurposeThe rapid rise of large language models (LLMs) has propelled them to the forefront of applications in natural language processing (NLP). This paper aims to present a comprehensive examination of the research landscape in LLMs, providing an overview of the prevailing themes and topics within this dynamic domain.Design/methodology/approachDrawing from an extensive corpus of 198 records published between 1996 to 2023 from the relevant academic database encompassing journal articles, books, book chapters, conference papers and selected working papers, this study delves deep into the multifaceted world of LLM research. In this study, the authors employed the BERTopic algorithm, a recent advancement in topic modeling, to conduct a comprehensive analysis of the data after it had been meticulously cleaned and preprocessed. BERTopic leverages the power of transformer-based language models like bidirectional encoder representations from transformers (BERT) to generate more meaningful and coherent topics. This approach facilitates the identification of hidden patterns within the data, enabling authors to uncover valuable insights that might otherwise have remained obscure. The analysis revealed four distinct clusters of topics in LLM research: “language and NLP”, “education and teaching”, “clinical and medical applications” and “speech and recognition techniques”. Each cluster embodies a unique aspect of LLM application and showcases the breadth of possibilities that LLM technology has to offer. In addition to presenting the research findings, this paper identifies key challenges and opportunities in the realm of LLMs. It underscores the necessity for further investigation in specific areas, including the paramount importance of addressing potential biases, transparency and explainability, data privacy and security, and responsible deployment of LLM technology.FindingsThe analysis revealed four distinct clusters of topics in LLM research: “language and NLP”, “education and teaching”, “clinical and medical applications” and “speech and recognition techniques”. Each cluster embodies a unique aspect of LLM application and showcases the breadth of possibilities that LLM technology has to offer. In addition to presenting the research findings, this paper identifies key challenges and opportunities in the realm of LLMs. It underscores the necessity for further investigation in specific areas, including the paramount importance of addressing potential biases, transparency and explainability, data privacy and security, and responsible deployment of LLM technology.Practical implicationsThis classification offers practical guidance for researchers, developers, educators, and policymakers to focus efforts and resources. The study underscores the importance of addressing challenges in LLMs, including potential biases, transparency, data privacy, and responsible deployment. Policymakers can utilize this information to shape regulations, while developers can tailor technology development based on the diverse applications identified. The findings also emphasize the need for interdisciplinary collaboration and highlight ethical considerations, providing a roadmap for navigating the complex landscape of LLM research and applications.Originality/valueThis study stands out as the first to examine the evolution of LLMs across such a long time frame and across such diversified disciplines. It provides a unique perspective on the key areas of LLM research, highlighting the breadth and depth of LLM’s evolution.

BACKGROUND Large language models (LLMs) can generate outputs understandable by humans, such as answers to medical questions and radiology reports. With the rapid development of LLMs, clinicians face a growing challenge in determining the most suitable algorithms to support their work. OBJECTIVE We aimed to provide clinicians and other health care practitioners with systematic guidance in selecting an LLM that is relevant and appropriate to their needs and facilitate the integration process of LLMs in health care. METHODS We conducted a literature search of full-text publications in English on clinical applications of LLMs published between January 1, 2022, and March 31, 2025, on PubMed, ScienceDirect, Scopus, and IEEE Xplore. We excluded papers from journals below a set citation threshold, as well as papers that did not focus on LLMs, were not research based, or did not involve clinical applications. We also conducted a literature search on arXiv within the same investigated period and included papers on the clinical applications of innovative multimodal LLMs. This led to a total of 270 studies. RESULTS We collected 330 LLMs and recorded their application frequency in clinical tasks and frequency of best performance in their context. On the basis of a 5-stage clinical workflow, we found that stages 2, 3, and 4 are key stages in the clinical workflow, involving numerous clinical subtasks and LLMs. However, the diversity of LLMs that may perform optimally in each context remains limited. GPT-3.5 and GPT-4 were the most versatile models in the 5-stage clinical workflow, applied to 52% (29/56) and 71% (40/56) of the clinical subtasks, respectively, and they performed best in 29% (16/56) and 54% (30/56) of the clinical subtasks, respectively. General-purpose LLMs may not perform well in specialized areas as they often require lightweight prompt engineering methods or fine-tuning techniques based on specific datasets to improve model performance. Most LLMs with multimodal abilities are closed-source models and, therefore, lack of transparency, model customization, and fine-tuning for specific clinical tasks and may also pose challenges regarding data protection and privacy, which are common requirements in clinical settings. CONCLUSIONS In this review, we found that LLMs may help clinicians in a variety of clinical tasks. However, we did not find evidence of generalist clinical LLMs successfully applicable to a wide range of clinical tasks. Therefore, their clinical deployment remains challenging. On the basis of this review, we propose an interactive online guideline for clinicians to select suitable LLMs by clinical task. With a clinical perspective and free of unnecessary technical jargon, this guideline may be used as a reference to successfully apply LLMs in clinical settings.

Pre-trained Large Language Models (LLMs) have revolutionised Natural Language Processing (NLP) tasks, but often struggle when applied to specialised domains such as healthcare. The traditional approach of pre-training on large datasets followed by task-specific fine-tuning is resource-intensive and poorly aligned with the constraints of many healthcare settings. This presents a significant challenge for deploying LLM-based NLP solutions in medical contexts, where data privacy, computational resources, and domain-specific language pose unique obstacles.This study aims to develop and evaluate efficient methods for adapting smaller LLMs to healthcare-specific datasets and tasks. We seek to identify pre-training approaches that can effectively instil healthcare competency in compact LLMs under tight computational budgets, a crucial capability for responsible and sustainable deployment in local healthcare settings.We explore three specialised pre-training methods to adapt smaller LLMs to different healthcare datasets: traditional Masked Language modelling (MLM), Deep Contrastive Learning for Unsupervised Textual Representations (DeCLUTR), and a novel approach utilising metadata categories from healthcare settings. These methods are assessed across multiple healthcare datasets, with a focus on downstream document classification tasks. We evaluate the performance of the resulting LLMs through classification accuracy and analysis of the derived embedding spaces.Contrastively trained models consistently outperform other approaches on classification tasks, delivering strong performance with limited labelled data and fewer model parameter updates. While our novel metadata-based pre-training does not further improve classifications across datasets, it yields interesting embedding cluster separability. Importantly, all domain-adapted LLMs outperform their publicly available, general-purpose base models, validating the importance of domain specialisation.This research demonstrates the efficacy of specialised pre-training methods in adapting compact LLMs to healthcare tasks, even under resource constraints. We provide guidelines for pre-training specialised healthcare LLMs and motivate continued inquiry into contrastive objectives. Our findings underscore the potential of these approaches for aligning small LLMs with privacy-sensitive medical tasks, offering a path toward more efficient and responsible NLP deployment in healthcare settings. This work contributes to the broader goal of making advanced NLP techniques accessible and effective in specialised domains, particularly where resource limitations and data sensitivity are significant concerns.

How Can <i>IJDS</i> Authors, Reviewers, and Editors Use (and Misuse) Generative AI?

Large pre-trained language models such as GPT-3 [10], Codex [11], and Google's language model [7] are now capable of generating code from natural language specifications of programmer intent. We view these developments with a mixture of optimism and caution. On the optimistic side, such large language models have the potential to improve productivity by providing an automated AI pair programmer for every programmer in the world. On the cautionary side, since these large language models do not understand program semantics, they offer no guarantees about quality of the suggested code. In this paper, we present an approach to augment these large language models with post-processing steps based on program analysis and synthesis techniques, that understand the syntax and semantics of programs. Further, we show that such techniques can make use of user feedback and improve with usage. We present our experiences from building and evaluating such a tool Jigsaw, targeted at synthesizing code for using Python Pandas API using multi-modal inputs. Our experience suggests that as these large language models evolve for synthesizing code from intent, Jigsaw has an important role to play in improving the accuracy of the systems.

A Large and Diverse Arabic Corpus for Language Modeling

With the introduction of ChatGPT in late November 2022, large language models based on artificial intelligence have gained worldwide recognition. These language models are trained on vast amounts of data, enabling them to process complex tasks in seconds and provide detailed, high-level text-based responses. To provide an overview of the most widely discussed large language models, ChatGPT and GPT‑4, with afocus on potential applications for patient-centered radiology. APubMed search of both large language models was performed using the terms "ChatGPT" and "GPT-4", with subjective selection and completion in the form of anarrative review. The generic nature of language models holds great promise for radiology, enabling both patients and referrers to facilitate understanding of radiological findings, overcome language barriers, and improve the quality of informed consent discussions. This could represent asignificant step towards patient-centered or person-centered radiology. Large language models represent apromising tool for improving the communication of findings, interdisciplinary collaboration, and workflow in radiology. However, important privacy issues and the reliable applicability of these models in medicine remain to be addressed.

Purpose This study aims to explore the integration of large language models (LLMs) and vision-language models (VLMs) in robotics, highlighting their potential benefits and the safety challenges they introduce, including robustness issues, adversarial vulnerabilities, privacy concerns and ethical implications. Design/methodology/approach This survey conducts a comprehensive analysis of the safety risks associated with LLM- and VLM-powered robotic systems. The authors review existing literature, analyze key challenges, evaluate current mitigation strategies and propose future research directions. Findings The study identifies that ensuring the safety of LLM-/VLM-driven robots requires a multi-faceted approach. While current mitigation strategies address certain risks, gaps remain in real-time monitoring, adversarial robustness and ethical safeguards. Originality/value This study offers a structured and comprehensive overview of the safety challenges in LLM-/VLM-driven robotics. It contributes to ongoing discussions by integrating technical, ethical and regulatory perspectives to guide future advancements in safe and responsible artificial intelligence-driven robotics.

Large language models (LLMs) and large visual-language models (LVLMs) have exhibited near-human levels of knowledge, image comprehension, and reasoning abilities, and their performance has undergone evaluation in some healthcare domains. However, a systematic evaluation of their capabilities in cervical cytology screening has yet to be conducted. Here, we constructed CCBench, a benchmark dataset dedicated to the evaluation of LLMs and LVLMs in cervical cytology screening, and developed a GPT-based semi-automatic evaluation pipeline to assess the performance of six LLMs (GPT-4, Bard, Claude-2.0, LLaMa-2, Qwen-Max, and ERNIE-Bot-4.0) and five LVLMs (GPT-4V, Gemini, LLaVA, Qwen-VL, and ViLT) on this dataset. CCBench comprises 773 question-answer (QA) pairs and 420 visual-question-answer (VQA) triplets, making it the first dataset in cervical cytology to include both QA and VQA data. We found that LLMs and LVLMs demonstrate promising accuracy and specialization in cervical cytology screening. GPT-4 achieved the best performance on the QA dataset, with an accuracy of 70.5% for close-ended questions and average expert evaluation score of 6.9/10 for open-ended questions. On the VQA dataset, Gemini achieved the highest accuracy for close-ended questions at 67.8%, while GPT-4V attained the highest expert evaluation score of 6.1/10 for open-ended questions. Besides, LLMs and LVLMs revealed varying abilities in answering questions across different topics and difficulty levels. However, their performance remains inferior to the expertise exhibited by cytopathology professionals, and the risk of generating misinformation could lead to potential harm. Therefore, substantial improvements are required before these models can be reliably deployed in clinical practice.

To evaluate the accuracy and reasoning capabilities of large multimodal language models compared with those of neuroradiology subspecialty-trained radiologists in neuroradiology case interpretation. This experimental study used custom-made 401 radiologic quizzes derived from articles published in RadioGraphics covering neuroradiology and head and neck topics (October 2020 to February 2024). We prompted the GPT-4 Turbo with Vision (GPT-4V), GPT-4 Omni, Gemini Flash, and Claude models to provide the top three differential diagnoses with a rationale and describe examination characteristics such as imaging modality, sequence, use of contrast, image plane, and body part. The temperature was adjusted to 0 and 1 (T1). Two neuroradiologists answered the same questions. The accuracies of the large language models (LLMs) and the neuroradiologists were compared using generalized estimating equations. Three neuroradiologists assessed the rationale provided by the LLMs for their differential diagnoses using four-point scales, separately for specific lesion locations and imaging findings, and evaluated the presence of hallucinations and the overall acceptability of the responses. Top-3 accuracy (i.e., correct answers present among top-3 differential diagnoses) of LLMs ranged from 29.9% (120 of 401) to 49.4% (198 of 401, obtained with GPT-4V in the T1 setting), while radiologists achieved 80.3% (322 of 401) and 68.3% (274 of 401), respectively (P < 0.001). Regarding the rationale for differential diagnoses, GPT-4V (T1) accurately identified both the specific lesion location and imaging findings in 30.7% (123 of 401) and 12.9% (16 of 124) of cases without textual clinical history. Hallucinations occurred in 4.5% (18 of 401), and only 29.4% (118 of 401) of the LLM-generated analyses were deemed acceptable. GPT-4V (T1) demonstrated high accuracy in identifying the imaging modality (97.4% [800 of 821]) and scanned body parts (92.2% [756 of 820]). LLMs remarkably underperformed compared with neuroradiologists and showed unsatisfactory reasoning for their differential diagnoses, with performance declining further in cases without textual input of clinical history. These findings highlight the limitations of current multimodal LLMs in neuroradiological interpretation and their reliance on text input.

BackgroundLarge Language Models (LLMs), advanced AI tools based on transformer architectures, demonstrate significant potential in clinical medicine by enhancing decision support, diagnostics, and medical education. However, their integration into clinical workflows requires rigorous evaluation to ensure reliability, safety, and ethical alignment.ObjectiveThis systematic review examines the evaluation parameters and methodologies applied to LLMs in clinical medicine, highlighting their capabilities, limitations, and application trends.MethodsA comprehensive review of the literature was conducted across PubMed, Scopus, Web of Science, IEEE Xplore, and arXiv databases, encompassing both peer-reviewed and preprint studies. Studies were screened against predefined inclusion and exclusion criteria to identify original research evaluating LLM performance in medical contexts.ResultsThe results reveal a growing interest in leveraging LLM tools in clinical settings, with 761 studies meeting the inclusion criteria. While general-domain LLMs, particularly ChatGPT and GPT-4, dominated evaluations (93.55%), medical-domain LLMs accounted for only 6.45%. Accuracy emerged as the most commonly assessed parameter (21.78%). Despite these advancements, the evidence base highlights certain limitations and biases across the included studies, emphasizing the need for careful interpretation and robust evaluation frameworks.ConclusionsThe exponential growth in LLM research underscores their transformative potential in healthcare. However, addressing challenges such as ethical risks, evaluation variability, and underrepresentation of critical specialties will be essential. Future efforts should prioritize standardized frameworks to ensure safe, effective, and equitable LLM integration in clinical practice.

The widespread use of online geoinformation platforms, such as Google Earth Engine (GEE), has produced numerous scripts. Extracting domain knowledge from these crowdsourced scripts supports understanding of geoprocessing workflows. Small Language Models (SLMs) are effective for semantic embedding but struggle with complex code; Large Language Models (LLMs) can summarize scripts, yet lack consistent geoscience terminology to express knowledge. In this paper, we propose Geo-CLASS, a knowledge extraction framework for geospatial analysis scripts that coordinates large and small language models. Specifically, we designed domain-specific schemas and a schema-aware prompt strategy to guide LLMs to generate and associate entity descriptions, and employed SLMs to standardize the outputs by mapping these descriptions to a constructed geoscience knowledge base. Experiments on 237 GEE scripts, selected from 295,943 scripts in total, demonstrated that our framework outperformed LLM baselines, including Llama-3, GPT-3.5 and GPT-4o. In comparison, the proposed framework improved accuracy in recognizing entities and relations by up to 31.9% and 12.0%, respectively. Ablation studies and performance analysis further confirmed the effectiveness of key components and the robustness of the framework. Geo-CLASS has the potential to enable the construction of geoprocessing modeling knowledge graphs, facilitate domain-specific reasoning and advance script generation via Retrieval-Augmented Generation (RAG).

This narrative review focuses on the integration of large language models (LLMs), such as GPT-4 and Gemini, into breast imaging. LLMs excel in understanding, processing, and generating human-like text, with potential applications ranging widely from decision-making to radiology reporting support. LLMs show promise in addressing current critical challenges, including rising demands for imaging services concurrent with an increasing shortage in the radiologist workforce. Their ability to integrate clinical guidelines and generate standardized, evidence-based reports has the potential to improve diagnostic consistency and reduce inter-reader variability. Emerging multimodal capabilities further extend their utility, enabling the integration of textual and visual data for tasks such as tumor classification and decision-making. Despite these advancements, significant challenges remain. LLMs often suffer from limitations such as hallucinations, biases in training datasets, and domain-specific knowledge gaps. These issues can affect their reliability, particularly in nuanced tasks like Breast Imaging Reporting and Data System categorization and multimodal image assessment. Moreover, ethical concerns about data privacy, biased outputs, and regulatory compliance must be addressed before effective deployment in the clinical setting. Current studies suggest that while LLMs can complement human expertise, their performance still lags behind that of radiologists in key areas, particularly in tasks requiring complex medical reasoning or direct image analysis. Looking ahead, LLMs are poised to play a crucial role in breast imaging by optimizing workflows, supporting multidisciplinary meetings, and improving patient education. However, their successful integration will depend on proper context training, robust validation, and ethical oversight, with human supervision as a crucial safeguard. EVIDENCE LEVEL: 5. TECHNICAL EFFICACY: Stage 2.