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Yossi Matias

Yossi Matias contributes to research discovery and scholarly infrastructure.

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Published work

7 published item(s)

preprint2026arXiv

Evaluating the Utility of Personal Health Records in Personalized Health AI

Patient-managed Personal Health Records (PHRs) promises to empower patients to better understand their health; but information in the record is complex, potentially hindering insights. In this study, we assess the potential of large language models (LLMs, Gemini 3.0 Flash) to provide helpful answers to user health queries, when provided clinical data from PHRs as context. A total of 2,257 user queries were drawn from 3 different distributions to represent patient questions: shorter web search queries, longer questions derived from templates of chatbot conversations, and questions patients asked to their healthcare team (patient calls). Queries were matched with de-identified PHRs (from a pool of 1,945). Gemini responses were generated (1) without PHR context; (2) with a basic summary of demographics, conditions, and medications; (3) with full, extensive clinical notes. For evaluation, we leveraged an existing rating framework (SHARP), and developed a new framework for specific error modes when interpreting PHRs. Evaluation was performed using autoraters for the full set, and with clinician ratings for a subset (n=95), with both sets of raters knowing the full PHR context. We see significant improvements in the helpfulness of answers to all question types with PHR data (p < 0.001, paired t-test). We also observe potential gains in safety, accuracy, relevance and personalization of answers. Our PHR evaluation framework further identifies gaps in LLM understanding of particular aspects of complex PHRs, such as temporal disorientation, and rare but meaningful confabulations. These results suggest potential for PHR data to help people with a wide range of user needs; and provide a framework for monitoring for gaps in LLM answers based on PHR context. This study motivates further work to assess and realize potential benefits to users from understanding their health records.

preprint2026arXiv

Hallucinations Undermine Trust; Metacognition is a Way Forward

Despite significant strides in factual reliability, errors -- often termed hallucinations -- remain a major concern for generative AI, especially as LLMs are increasingly expected to be helpful in more complex or nuanced setups. Yet even in the simplest setting -- factoid question-answering with clear ground truth-frontier models without external tools continue to hallucinate. We argue that most factuality gains in this domain have come from expanding the model's knowledge boundary (encoding more facts) rather than improving awareness of that boundary (distinguishing known from unknown). We conjecture that the latter is inherently difficult: models may lack the discriminative power to perfectly separate truths from errors, creating an unavoidable tradeoff between eliminating hallucinations and preserving utility. This tradeoff dissolves under a different framing. If we understand hallucinations as confident errors -- incorrect information delivered without appropriate qualification -- a third path emerges beyond the answer-or-abstain dichotomy: expressing uncertainty. We propose faithful uncertainty: aligning linguistic uncertainty with intrinsic uncertainty. This is one facet of metacognition -- the ability to be aware of one's own uncertainty and to act on it. For direct interaction, acting on uncertainty means communicating it honestly; for agentic systems, it becomes the control layer governing when to search and what to trust. Metacognition is thus essential for LLMs to be both trustworthy and capable; we conclude by highlighting open problems for progress towards this objective.

preprint2022arXiv

Discovering novel systemic biomarkers in photos of the external eye

External eye photos were recently shown to reveal signs of diabetic retinal disease and elevated HbA1c. In this paper, we evaluate if external eye photos contain information about additional systemic medical conditions. We developed a deep learning system (DLS) that takes external eye photos as input and predicts multiple systemic parameters, such as those related to the liver (albumin, AST); kidney (eGFR estimated using the race-free 2021 CKD-EPI creatinine equation, the urine ACR); bone & mineral (calcium); thyroid (TSH); and blood count (Hgb, WBC, platelets). Development leveraged 151,237 images from 49,015 patients with diabetes undergoing diabetic eye screening in 11 sites across Los Angeles county, CA. Evaluation focused on 9 pre-specified systemic parameters and leveraged 3 validation sets (A, B, C) spanning 28,869 patients with and without diabetes undergoing eye screening in 3 independent sites in Los Angeles County, CA, and the greater Atlanta area, GA. We compared against baseline models incorporating available clinicodemographic variables (e.g. age, sex, race/ethnicity, years with diabetes). Relative to the baseline, the DLS achieved statistically significant superior performance at detecting AST>36, calcium<8.6, eGFR<60, Hgb<11, platelets<150, ACR>=300, and WBC<4 on validation set A (a patient population similar to the development sets), where the AUC of DLS exceeded that of the baseline by 5.2-19.4%. On validation sets B and C, with substantial patient population differences compared to the development sets, the DLS outperformed the baseline for ACR>=300 and Hgb<11 by 7.3-13.2%. Our findings provide further evidence that external eye photos contain important biomarkers of systemic health spanning multiple organ systems. Further work is needed to investigate whether and how these biomarkers can be translated into clinical impact.

preprint2022arXiv

Dynamic Planning in Open-Ended Dialogue using Reinforcement Learning

Despite recent advances in natural language understanding and generation, and decades of research on the development of conversational bots, building automated agents that can carry on rich open-ended conversations with humans &#34;in the wild&#34; remains a formidable challenge. In this work we develop a real-time, open-ended dialogue system that uses reinforcement learning (RL) to power a bot&#39;s conversational skill at scale. Our work pairs the succinct embedding of the conversation state generated using SOTA (supervised) language models with RL techniques that are particularly suited to a dynamic action space that changes as the conversation progresses. Trained using crowd-sourced data, our novel system is able to substantially exceeds the (strong) baseline supervised model with respect to several metrics of interest in a live experiment with real users of the Google Assistant.

preprint2022arXiv

TRUE: Re-evaluating Factual Consistency Evaluation

Grounded text generation systems often generate text that contains factual inconsistencies, hindering their real-world applicability. Automatic factual consistency evaluation may help alleviate this limitation by accelerating evaluation cycles, filtering inconsistent outputs and augmenting training data. While attracting increasing attention, such evaluation metrics are usually developed and evaluated in silo for a single task or dataset, slowing their adoption. Moreover, previous meta-evaluation protocols focused on system-level correlations with human annotations, which leave the example-level accuracy of such metrics unclear. In this work, we introduce TRUE: a comprehensive survey and assessment of factual consistency metrics on a standardized collection of existing texts from diverse tasks, manually annotated for factual consistency. Our standardization enables an example-level meta-evaluation protocol that is more actionable and interpretable than previously reported correlations, yielding clearer quality measures. Across diverse state-of-the-art metrics and 11 datasets we find that large-scale NLI and question generation-and-answering-based approaches achieve strong and complementary results. We recommend those methods as a starting point for model and metric developers, and hope TRUE will foster progress towards even better evaluation methods.

preprint2020arXiv

Adversarially Robust Streaming Algorithms via Differential Privacy

A streaming algorithm is said to be adversarially robust if its accuracy guarantees are maintained even when the data stream is chosen maliciously, by an adaptive adversary. We establish a connection between adversarial robustness of streaming algorithms and the notion of differential privacy. This connection allows us to design new adversarially robust streaming algorithms that outperform the current state-of-the-art constructions for many interesting regimes of parameters.

preprint2020arXiv

Detecting Deficient Coverage in Colonoscopies

Colonoscopy is the tool of choice for preventing Colorectal Cancer, by detecting and removing polyps before they become cancerous. However, colonoscopy is hampered by the fact that endoscopists routinely miss 22-28% of polyps. While some of these missed polyps appear in the endoscopist&#39;s field of view, others are missed simply because of substandard coverage of the procedure, i.e. not all of the colon is seen. This paper attempts to rectify the problem of substandard coverage in colonoscopy through the introduction of the C2D2 (Colonoscopy Coverage Deficiency via Depth) algorithm which detects deficient coverage, and can thereby alert the endoscopist to revisit a given area. More specifically, C2D2 consists of two separate algorithms: the first performs depth estimation of the colon given an ordinary RGB video stream; while the second computes coverage given these depth estimates. Rather than compute coverage for the entire colon, our algorithm computes coverage locally, on a segment-by-segment basis; C2D2 can then indicate in real-time whether a particular area of the colon has suffered from deficient coverage, and if so the endoscopist can return to that area. Our coverage algorithm is the first such algorithm to be evaluated in a large-scale way; while our depth estimation technique is the first calibration-free unsupervised method applied to colonoscopies. The C2D2 algorithm achieves state of the art results in the detection of deficient coverage. On synthetic sequences with ground truth, it is 2.4 times more accurate than human experts; while on real sequences, C2D2 achieves a 93.0% agreement with experts.