Shie Mannor
Publications
Simulating clinical interventions with a generative multimodal model of human physiology
Understanding how human health changes over time, and why responses to interventions vary between individuals, remains a central challenge in medicine. Here we present HealthFormer, a decoder-only transformer that models the human physiological trajectory generatively, by training on data from the Human Phenotype Project, a multi-visit cohort of over 15,000 deeply phenotyped individuals. We tokenise each participant's health trajectory across 667 measurements spanning seven domains: blood biomarkers, body composition, sleep physiology, continuous glucose monitoring, gut microbiome, wearable-derived physiology, and behaviour and medication exposure. We train HealthFormer to forecast individual physiological trajectories across these domains, and from this single generative objective a range of clinically relevant tasks can be expressed as queries on the model. We show that, without task-specific training, HealthFormer transfers to four independent cohorts and improves prediction for 27 of 30 incident-disease and mortality endpoints, exceeding established clinical risk scores in every comparison. We further show that the model can simulate interventions in silico: in a held-out personalised-nutrition trial, intervention-conditioned predictions recover individual six-month biomarker changes (e.g., Pearson r = 0.78 for diastolic blood pressure). Across 41 randomised intervention-outcome comparisons drawn from published trials, our results show that the predicted direction of effect agrees in every case, and the predicted mean falls within the reported 95% confidence interval in 30 cases. We position HealthFormer as an initial health world model, from which forecasting, risk stratification, and intervention-conditioned simulation arise as queries, providing a basis for clinical digital twins.
VLM-Guided Experience Replay
Recent advances in Large Language Models (LLMs) and Vision-Language Models (VLMs) have enabled powerful semantic and multimodal reasoning capabilities, creating new opportunities to enhance sample efficiency, high-level planning, and interpretability in reinforcement learning (RL). While prior work has integrated LLMs and VLMs into various components of RL, the replay buffer, a core component for storing and reusing experiences, remains unexplored. We propose addressing this gap by leveraging VLMs to guide the prioritization of experiences in the replay buffer. Our key idea is to use a frozen, pre-trained VLM (requiring no fine-tuning) as an automated evaluator to identify and prioritize promising sub-trajectories from the agent's experiences. Across scenarios, including game-playing and robotics, spanning both discrete and continuous domains, agents trained with our proposed prioritization method achieve 11-52% higher average success rates and improve sample efficiency by 19-45% compared to previous approaches. https://esharony.me/projects/vlm-rb/