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David G. T. Barrett

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Machine Learning Artificial Intelligence Computation and Language Computer Vision

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preprint2026arXiv

Towards Conversational Medical AI with Eyes, Ears and a Voice

The practice of medicine relies not only upon skillful dialogue but also on the nuanced exchange and interpretation of rich auditory and visual cues between doctors and patients. Building on the low-latency voice and video processing capabilities of Gemini, we introduce AI co-clinician, a first-of-its-kind conversational AI system utilizing continuous streams of audio-visual data from live patient conversations to inform real-time clinical decisions. Its dual-agent architecture balances deep clinical reasoning with the low latency required for natural dialogue. To assess this system, we implemented a video-based interface emulating telemedicine consultations. We crafted 20 standardized outpatient scenarios requiring proactive real-time auditory and visual reasoning and designed "TelePACES" evaluation criteria alongside case-specific rubrics. In a randomized, interface-blinded, crossover simulation study (n = 120 encounters) with 10 internal medicine residents as patient actors, we compared AI co-clinician with primary care physicians (PCPs), GPT-Realtime, and a baseline agent. AI co-clinician approached PCPs in key TelePACES dimensions, including management plans and differential diagnosis, while significantly outperforming GPT-Realtime across all general criteria. While our agent demonstrated parity with PCPs in case-specific triage measures, physicians maintained superior overall performance in case-specific assessments. Although AI co-clinician marks a significant advance in real-time telemedical AI, gaps remain in physical examination and disease-specific reasoning. Our work shows that text-only approaches fail to capture the true challenges of medical consultation and suggests that high-stakes real-time diagnostic AI is most safely advanced in collaborative, triadic models where AI can be a supportive co-clinician for doctors and patients.

preprint2022arXiv

Implicit Gradient Regularization

Gradient descent can be surprisingly good at optimizing deep neural networks without overfitting and without explicit regularization. We find that the discrete steps of gradient descent implicitly regularize models by penalizing gradient descent trajectories that have large loss gradients. We call this Implicit Gradient Regularization (IGR) and we use backward error analysis to calculate the size of this regularization. We confirm empirically that implicit gradient regularization biases gradient descent toward flat minima, where test errors are small and solutions are robust to noisy parameter perturbations. Furthermore, we demonstrate that the implicit gradient regularization term can be used as an explicit regularizer, allowing us to control this gradient regularization directly. More broadly, our work indicates that backward error analysis is a useful theoretical approach to the perennial question of how learning rate, model size, and parameter regularization interact to determine the properties of overparameterized models optimized with gradient descent.

preprint2021arXiv

On the Origin of Implicit Regularization in Stochastic Gradient Descent

For infinitesimal learning rates, stochastic gradient descent (SGD) follows the path of gradient flow on the full batch loss function. However moderately large learning rates can achieve higher test accuracies, and this generalization benefit is not explained by convergence bounds, since the learning rate which maximizes test accuracy is often larger than the learning rate which minimizes training loss. To interpret this phenomenon we prove that for SGD with random shuffling, the mean SGD iterate also stays close to the path of gradient flow if the learning rate is small and finite, but on a modified loss. This modified loss is composed of the original loss function and an implicit regularizer, which penalizes the norms of the minibatch gradients. Under mild assumptions, when the batch size is small the scale of the implicit regularization term is proportional to the ratio of the learning rate to the batch size. We verify empirically that explicitly including the implicit regularizer in the loss can enhance the test accuracy when the learning rate is small.

preprint2020arXiv

Spectral Inference Networks: Unifying Deep and Spectral Learning

We present Spectral Inference Networks, a framework for learning eigenfunctions of linear operators by stochastic optimization. Spectral Inference Networks generalize Slow Feature Analysis to generic symmetric operators, and are closely related to Variational Monte Carlo methods from computational physics. As such, they can be a powerful tool for unsupervised representation learning from video or graph-structured data. We cast training Spectral Inference Networks as a bilevel optimization problem, which allows for online learning of multiple eigenfunctions. We show results of training Spectral Inference Networks on problems in quantum mechanics and feature learning for videos on synthetic datasets. Our results demonstrate that Spectral Inference Networks accurately recover eigenfunctions of linear operators and can discover interpretable representations from video in a fully unsupervised manner.