Z. Chen
Publications
Towards Precision Therapy in Hepatocellular Carcinoma: A Clinical-Reasoning LLM for Risk Stratification and Treatment Guidance
Hepatocellular carcinoma (HCC) is a common malignancy and a leading cause of cancer-related mortality. Current guidelines and staging systems provide coarse categories, but often miss within-stage heterogeneity and the clinical context in electronic medical records (EMRs). We present HCC-STAR (Hepatocellular Carcinoma Staging, Treatment And pRognosis), a clinically aligned large language model that reads routine EMR narratives and jointly outputs risk score-based staging, ranked guideline-consistent treatments with evidence-based rationales, and individualized survival estimates. We curated about 30,000 HCC cases from SEER and expanded them into EMR-style narrative training data using a clinician-validated, prompt-based augmentation workflow. On this corpus, we developed a knowledge-aligned reasoning framework optimized with a step-verifiable composite reward, moving beyond text-level memorization of clinical guidelines. In a multi-center cohort of 6,668 patients from 12 hospitals in China, HCC-STAR achieved state-of-the-art performance in treatment recommendation and risk stratification compared with clinical guidelines and competitive models, including GPT-5 and Gemini-2.5 Pro. Hypothetical overall-survival analysis showed a median survival of 51 months under adherence to HCC-STAR recommendations, compared with 29 and 32 months under BCLC and CNLC. In clinician-centric evaluations, blinded hepatobiliary specialists rated HCC-STAR's reasoning and evidence-based justifications as trustworthy. The model surpassed resident and attending physicians in treatment accuracy and helped physicians make more accurate decisions faster when used as an assistant. These findings support HCC-STAR as a reliable and verifiable decision-support system for risk stratification and precision therapy in HCC.
A Survey on Large Language Models for Critical Societal Domains: Finance, Healthcare, and Law
In the fast-evolving domain of artificial intelligence, large language models (LLMs) such as GPT-3 and GPT-4 are revolutionizing the landscapes of finance, healthcare, and law: domains characterized by their reliance on professional expertise, challenging data acquisition, high-stakes, and stringent regulatory compliance. This survey offers a detailed exploration of the methodologies, applications, challenges, and forward-looking opportunities of LLMs within these high-stakes sectors. We highlight the instrumental role of LLMs in enhancing diagnostic and treatment methodologies in healthcare, innovating financial analytics, and refining legal interpretation and compliance strategies. Moreover, we critically examine the ethics for LLM applications in these fields, pointing out the existing ethical concerns and the need for transparent, fair, and robust AI systems that respect regulatory norms. By presenting a thorough review of current literature and practical applications, we showcase the transformative impact of LLMs, and outline the imperative for interdisciplinary cooperation, methodological advancements, and ethical vigilance. Through this lens, we aim to spark dialogue and inspire future research dedicated to maximizing the benefits of LLMs while mitigating their risks in these precision-dependent sectors. To facilitate future research on LLMs in these critical societal domains, we also initiate a reading list that tracks the latest advancements under this topic, which will be continually updated: \url{https://github.com/czyssrs/LLM_X_papers}.