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Mar 11

Text2MDT: Extracting Medical Decision Trees from Medical Texts

Knowledge of the medical decision process, which can be modeled as medical decision trees (MDTs), is critical to build clinical decision support systems. However, the current MDT construction methods rely heavily on time-consuming and laborious manual annotation. In this work, we propose a novel task, Text2MDT, to explore the automatic extraction of MDTs from medical texts such as medical guidelines and textbooks. We normalize the form of the MDT and create an annotated Text-to-MDT dataset in Chinese with the participation of medical experts. We investigate two different methods for the Text2MDT tasks: (a) an end-to-end framework which only relies on a GPT style large language models (LLM) instruction tuning to generate all the node information and tree structures. (b) The pipeline framework which decomposes the Text2MDT task to three subtasks. Experiments on our Text2MDT dataset demonstrate that: (a) the end-to-end method basd on LLMs (7B parameters or larger) show promising results, and successfully outperform the pipeline methods. (b) The chain-of-thought (COT) prompting method Wei2022ChainOT can improve the performance of the fine-tuned LLMs on the Text2MDT test set. (c) the lightweight pipelined method based on encoder-based pretrained models can perform comparably with LLMs with model complexity two magnititudes smaller. Our Text2MDT dataset is open-sourced at https://tianchi.aliyun.com/dataset/95414, and the source codes are open-sourced at https://github.com/michael-wzhu/text2dt.

Evaluation of Language Models in the Medical Context Under Resource-Constrained Settings

Since the emergence of the Transformer architecture, language model development has increased, driven by their promising potential. However, releasing these models into production requires properly understanding their behavior, particularly in sensitive domains such as medicine. Despite this need, the medical literature still lacks technical assessments of pre-trained language models, which are especially valuable in resource-constrained settings in terms of computational power or limited budget. To address this gap, we provide a comprehensive survey of language models in the medical domain. In addition, we selected a subset of these models for thorough evaluation, focusing on classification and text generation tasks. Our subset encompasses 53 models, ranging from 110 million to 13 billion parameters, spanning the three families of Transformer-based models and from diverse knowledge domains. This study employs a series of approaches for text classification together with zero-shot prompting instead of model training or fine-tuning, which closely resembles the limited resource setting in which many users of language models find themselves. Encouragingly, our findings reveal remarkable performance across various tasks and datasets, underscoring the latent potential of certain models to contain medical knowledge, even without domain specialization. Consequently, our study advocates for further exploration of model applications in medical contexts, particularly in resource-constrained settings. The code is available on https://github.com/anpoc/Language-models-in-medicine.

XF2T: Cross-lingual Fact-to-Text Generation for Low-Resource Languages

Multiple business scenarios require an automated generation of descriptive human-readable text from structured input data. Hence, fact-to-text generation systems have been developed for various downstream tasks like generating soccer reports, weather and financial reports, medical reports, person biographies, etc. Unfortunately, previous work on fact-to-text (F2T) generation has focused primarily on English mainly due to the high availability of relevant datasets. Only recently, the problem of cross-lingual fact-to-text (XF2T) was proposed for generation across multiple languages alongwith a dataset, XALIGN for eight languages. However, there has been no rigorous work on the actual XF2T generation problem. We extend XALIGN dataset with annotated data for four more languages: Punjabi, Malayalam, Assamese and Oriya. We conduct an extensive study using popular Transformer-based text generation models on our extended multi-lingual dataset, which we call XALIGNV2. Further, we investigate the performance of different text generation strategies: multiple variations of pretraining, fact-aware embeddings and structure-aware input encoding. Our extensive experiments show that a multi-lingual mT5 model which uses fact-aware embeddings with structure-aware input encoding leads to best results on average across the twelve languages. We make our code, dataset and model publicly available, and hope that this will help advance further research in this critical area.

DR.BENCH: Diagnostic Reasoning Benchmark for Clinical Natural Language Processing

The meaningful use of electronic health records (EHR) continues to progress in the digital era with clinical decision support systems augmented by artificial intelligence. A priority in improving provider experience is to overcome information overload and reduce the cognitive burden so fewer medical errors and cognitive biases are introduced during patient care. One major type of medical error is diagnostic error due to systematic or predictable errors in judgment that rely on heuristics. The potential for clinical natural language processing (cNLP) to model diagnostic reasoning in humans with forward reasoning from data to diagnosis and potentially reduce the cognitive burden and medical error has not been investigated. Existing tasks to advance the science in cNLP have largely focused on information extraction and named entity recognition through classification tasks. We introduce a novel suite of tasks coined as Diagnostic Reasoning Benchmarks, DR.BENCH, as a new benchmark for developing and evaluating cNLP models with clinical diagnostic reasoning ability. The suite includes six tasks from ten publicly available datasets addressing clinical text understanding, medical knowledge reasoning, and diagnosis generation. DR.BENCH is the first clinical suite of tasks designed to be a natural language generation framework to evaluate pre-trained language models. Experiments with state-of-the-art pre-trained generative language models using large general domain models and models that were continually trained on a medical corpus demonstrate opportunities for improvement when evaluated in DR. BENCH. We share DR. BENCH as a publicly available GitLab repository with a systematic approach to load and evaluate models for the cNLP community.

How far is Language Model from 100% Few-shot Named Entity Recognition in Medical Domain

Recent advancements in language models (LMs) have led to the emergence of powerful models such as Small LMs (e.g., T5) and Large LMs (e.g., GPT-4). These models have demonstrated exceptional capabilities across a wide range of tasks, such as name entity recognition (NER) in the general domain. (We define SLMs as pre-trained models with fewer parameters compared to models like GPT-3/3.5/4, such as T5, BERT, and others.) Nevertheless, their efficacy in the medical section remains uncertain and the performance of medical NER always needs high accuracy because of the particularity of the field. This paper aims to provide a thorough investigation to compare the performance of LMs in medical few-shot NER and answer How far is LMs from 100\% Few-shot NER in Medical Domain, and moreover to explore an effective entity recognizer to help improve the NER performance. Based on our extensive experiments conducted on 16 NER models spanning from 2018 to 2023, our findings clearly indicate that LLMs outperform SLMs in few-shot medical NER tasks, given the presence of suitable examples and appropriate logical frameworks. Despite the overall superiority of LLMs in few-shot medical NER tasks, it is important to note that they still encounter some challenges, such as misidentification, wrong template prediction, etc. Building on previous findings, we introduce a simple and effective method called RT (Retrieving and Thinking), which serves as retrievers, finding relevant examples, and as thinkers, employing a step-by-step reasoning process. Experimental results show that our proposed RT framework significantly outperforms the strong open baselines on the two open medical benchmark datasets

Exploring the Impact of Table-to-Text Methods on Augmenting LLM-based Question Answering with Domain Hybrid Data

Augmenting Large Language Models (LLMs) for Question Answering (QA) with domain specific data has attracted wide attention. However, domain data often exists in a hybrid format, including text and semi-structured tables, posing challenges for the seamless integration of information. Table-to-Text Generation is a promising solution by facilitating the transformation of hybrid data into a uniformly text-formatted corpus. Although this technique has been widely studied by the NLP community, there is currently no comparative analysis on how corpora generated by different table-to-text methods affect the performance of QA systems. In this paper, we address this research gap in two steps. First, we innovatively integrate table-to-text generation into the framework of enhancing LLM-based QA systems with domain hybrid data. Then, we utilize this framework in real-world industrial data to conduct extensive experiments on two types of QA systems (DSFT and RAG frameworks) with four representative methods: Markdown format, Template serialization, TPLM-based method, and LLM-based method. Based on the experimental results, we draw some empirical findings and explore the underlying reasons behind the success of some methods. We hope the findings of this work will provide a valuable reference for the academic and industrial communities in developing robust QA systems.

Cross-Lingual Transfer for Low-Resource Natural Language Processing

Natural Language Processing (NLP) has seen remarkable advances in recent years, particularly with the emergence of Large Language Models that have achieved unprecedented performance across many tasks. However, these developments have mainly benefited a small number of high-resource languages such as English. The majority of languages still face significant challenges due to the scarcity of training data and computational resources. To address this issue, this thesis focuses on cross-lingual transfer learning, a research area aimed at leveraging data and models from high-resource languages to improve NLP performance for low-resource languages. Specifically, we focus on Sequence Labeling tasks such as Named Entity Recognition, Opinion Target Extraction, and Argument Mining. The research is structured around three main objectives: (1) advancing data-based cross-lingual transfer learning methods through improved translation and annotation projection techniques, (2) developing enhanced model-based transfer learning approaches utilizing state-of-the-art multilingual models, and (3) applying these methods to real-world problems while creating open-source resources that facilitate future research in low-resource NLP. More specifically, this thesis presents a new method to improve data-based transfer with T-Projection, a state-of-the-art annotation projection method that leverages text-to-text multilingual models and machine translation systems. T-Projection significantly outperforms previous annotation projection methods by a wide margin. For model-based transfer, we introduce a constrained decoding algorithm that enhances cross-lingual Sequence Labeling in zero-shot settings using text-to-text models. Finally, we develop Medical mT5, the first multilingual text-to-text medical model, demonstrating the practical impact of our research on real-world applications.

Tool Calling: Enhancing Medication Consultation via Retrieval-Augmented Large Language Models

Large-scale language models (LLMs) have achieved remarkable success across various language tasks but suffer from hallucinations and temporal misalignment. To mitigate these shortcomings, Retrieval-augmented generation (RAG) has been utilized to provide external knowledge to facilitate the answer generation. However, applying such models to the medical domain faces several challenges due to the lack of domain-specific knowledge and the intricacy of real-world scenarios. In this study, we explore LLMs with RAG framework for knowledge-intensive tasks in the medical field. To evaluate the capabilities of LLMs, we introduce MedicineQA, a multi-round dialogue benchmark that simulates the real-world medication consultation scenario and requires LLMs to answer with retrieved evidence from the medicine database. MedicineQA contains 300 multi-round question-answering pairs, each embedded within a detailed dialogue history, highlighting the challenge posed by this knowledge-intensive task to current LLMs. We further propose a new Distill-Retrieve-Read framework instead of the previous Retrieve-then-Read. Specifically, the distillation and retrieval process utilizes a tool calling mechanism to formulate search queries that emulate the keyword-based inquiries used by search engines. With experimental results, we show that our framework brings notable performance improvements and surpasses the previous counterparts in the evidence retrieval process in terms of evidence retrieval accuracy. This advancement sheds light on applying RAG to the medical domain.

Medical mT5: An Open-Source Multilingual Text-to-Text LLM for The Medical Domain

Research on language technology for the development of medical applications is currently a hot topic in Natural Language Understanding and Generation. Thus, a number of large language models (LLMs) have recently been adapted to the medical domain, so that they can be used as a tool for mediating in human-AI interaction. While these LLMs display competitive performance on automated medical texts benchmarks, they have been pre-trained and evaluated with a focus on a single language (English mostly). This is particularly true of text-to-text models, which typically require large amounts of domain-specific pre-training data, often not easily accessible for many languages. In this paper, we address these shortcomings by compiling, to the best of our knowledge, the largest multilingual corpus for the medical domain in four languages, namely English, French, Italian and Spanish. This new corpus has been used to train Medical mT5, the first open-source text-to-text multilingual model for the medical domain. Additionally, we present two new evaluation benchmarks for all four languages with the aim of facilitating multilingual research in this domain. A comprehensive evaluation shows that Medical mT5 outperforms both encoders and similarly sized text-to-text models for the Spanish, French, and Italian benchmarks, while being competitive with current state-of-the-art LLMs in English.

LLMs-in-the-loop Part-1: Expert Small AI Models for Bio-Medical Text Translation

Machine translation is indispensable in healthcare for enabling the global dissemination of medical knowledge across languages. However, complex medical terminology poses unique challenges to achieving adequate translation quality and accuracy. This study introduces a novel "LLMs-in-the-loop" approach to develop supervised neural machine translation models optimized specifically for medical texts. While large language models (LLMs) have demonstrated powerful capabilities, this research shows that small, specialized models trained on high-quality in-domain (mostly synthetic) data can outperform even vastly larger LLMs. Custom parallel corpora in six languages were compiled from scientific articles, synthetically generated clinical documents, and medical texts. Our LLMs-in-the-loop methodology employs synthetic data generation, rigorous evaluation, and agent orchestration to enhance performance. We developed small medical translation models using the MarianMT base model. We introduce a new medical translation test dataset to standardize evaluation in this domain. Assessed using BLEU, METEOR, ROUGE, and BERT scores on this test set, our MarianMT-based models outperform Google Translate, DeepL, and GPT-4-Turbo. Results demonstrate that our LLMs-in-the-loop approach, combined with fine-tuning high-quality, domain-specific data, enables specialized models to outperform general-purpose and some larger systems. This research, part of a broader series on expert small models, paves the way for future healthcare-related AI developments, including deidentification and bio-medical entity extraction models. Our study underscores the potential of tailored neural translation models and the LLMs-in-the-loop methodology to advance the field through improved data generation, evaluation, agent, and modeling techniques.

Medical Graph RAG: Towards Safe Medical Large Language Model via Graph Retrieval-Augmented Generation

We introduce a novel graph-based Retrieval-Augmented Generation (RAG) framework specifically designed for the medical domain, called MedGraphRAG, aimed at enhancing Large Language Model (LLM) capabilities and generating evidence-based results, thereby improving safety and reliability when handling private medical data. Our comprehensive pipeline begins with a hybrid static-semantic approach to document chunking, significantly improving context capture over traditional methods. Extracted entities are used to create a three-tier hierarchical graph structure, linking entities to foundational medical knowledge sourced from medical papers and dictionaries. These entities are then interconnected to form meta-graphs, which are merged based on semantic similarities to develop a comprehensive global graph. This structure supports precise information retrieval and response generation. The retrieval process employs a U-retrieve method to balance global awareness and indexing efficiency of the LLM. Our approach is validated through a comprehensive ablation study comparing various methods for document chunking, graph construction, and information retrieval. The results not only demonstrate that our hierarchical graph construction method consistently outperforms state-of-the-art models on multiple medical Q\&A benchmarks, but also confirms that the responses generated include source documentation, significantly enhancing the reliability of medical LLMs in practical applications. Code will be at: https://github.com/MedicineToken/Medical-Graph-RAG/tree/main

Text Generation: A Systematic Literature Review of Tasks, Evaluation, and Challenges

Text generation has become more accessible than ever, and the increasing interest in these systems, especially those using large language models, has spurred an increasing number of related publications. We provide a systematic literature review comprising 244 selected papers between 2017 and 2024. This review categorizes works in text generation into five main tasks: open-ended text generation, summarization, translation, paraphrasing, and question answering. For each task, we review their relevant characteristics, sub-tasks, and specific challenges (e.g., missing datasets for multi-document summarization, coherence in story generation, and complex reasoning for question answering). Additionally, we assess current approaches for evaluating text generation systems and ascertain problems with current metrics. Our investigation shows nine prominent challenges common to all tasks and sub-tasks in recent text generation publications: bias, reasoning, hallucinations, misuse, privacy, interpretability, transparency, datasets, and computing. We provide a detailed analysis of these challenges, their potential solutions, and which gaps still require further engagement from the community. This systematic literature review targets two main audiences: early career researchers in natural language processing looking for an overview of the field and promising research directions, as well as experienced researchers seeking a detailed view of tasks, evaluation methodologies, open challenges, and recent mitigation strategies.

Generative Large Language Models Are All-purpose Text Analytics Engines: Text-to-text Learning Is All Your Need

Objective To solve major clinical natural language processing (NLP) tasks using a unified text-to-text learning architecture based on a generative large language model (LLM) via prompt tuning. Methods We formulated 7 key clinical NLP tasks as text-to-text learning and solved them using one unified generative clinical LLM, GatorTronGPT, developed using GPT-3 architecture and trained with up to 20 billion parameters. We adopted soft prompts (i.e., trainable vectors) with frozen LLM, where the LLM parameters were not updated (i.e., frozen) and only the vectors of soft prompts were updated, known as prompt tuning. We added additional soft prompts as a prefix to the input layer, which were optimized during the prompt tuning. We evaluated the proposed method using 7 clinical NLP tasks and compared them with previous task-specific solutions based on Transformer models. Results and Conclusion The proposed approach achieved state-of-the-art performance for 5 out of 7 major clinical NLP tasks using one unified generative LLM. Our approach outperformed previous task-specific transformer models by ~3% for concept extraction and 7% for relation extraction applied to social determinants of health, 3.4% for clinical concept normalization, 3.4~10% for clinical abbreviation disambiguation, and 5.5~9% for natural language inference. Our approach also outperformed a previously developed prompt-based machine reading comprehension (MRC) model, GatorTron-MRC, for clinical concept and relation extraction. The proposed approach can deliver the ``one model for all`` promise from training to deployment using a unified generative LLM.

Improving Medical Reasoning through Retrieval and Self-Reflection with Retrieval-Augmented Large Language Models

Recent proprietary large language models (LLMs), such as GPT-4, have achieved a milestone in tackling diverse challenges in the biomedical domain, ranging from multiple-choice questions to long-form generations. To address challenges that still cannot be handled with the encoded knowledge of LLMs, various retrieval-augmented generation (RAG) methods have been developed by searching documents from the knowledge corpus and appending them unconditionally or selectively to the input of LLMs for generation. However, when applying existing methods to different domain-specific problems, poor generalization becomes apparent, leading to fetching incorrect documents or making inaccurate judgments. In this paper, we introduce Self-BioRAG, a framework reliable for biomedical text that specializes in generating explanations, retrieving domain-specific documents, and self-reflecting generated responses. We utilize 84k filtered biomedical instruction sets to train Self-BioRAG that can assess its generated explanations with customized reflective tokens. Our work proves that domain-specific components, such as a retriever, domain-related document corpus, and instruction sets are necessary for adhering to domain-related instructions. Using three major medical question-answering benchmark datasets, experimental results of Self-BioRAG demonstrate significant performance gains by achieving a 7.2% absolute improvement on average over the state-of-the-art open-foundation model with a parameter size of 7B or less. Overall, we analyze that Self-BioRAG finds the clues in the question, retrieves relevant documents if needed, and understands how to answer with information from retrieved documents and encoded knowledge as a medical expert does. We release our data and code for training our framework components and model weights (7B and 13B) to enhance capabilities in biomedical and clinical domains.

TOP-Training: Target-Oriented Pretraining for Medical Extractive Question Answering

We study extractive question-answering in the medical domain (Medical-EQA). This problem has two main challenges: (i) domain specificity, as most AI models lack necessary domain knowledge, and (ii) extraction-based answering style, which restricts most autoregressive LLMs due to potential hallucinations. To handle those challenges, we propose TOP-Training, a target-oriented pre-training paradigm that stands out among all domain adaptation techniques with two desirable features: (i) TOP-Training moves one step further than popular domain-oriented fine-tuning since it not only moves closer to the target domain, but also familiarizes itself with the target dataset, and (ii) it does not assume the existence of a large set of unlabeled instances from the target domain. Specifically, for a target Medical-EQA dataset, we extract its entities and leverage large language models (LLMs) to generate synthetic texts containing those entities; we then demonstrate that pretraining on this synthetic text data yields better performance on the target Medical-EQA benchmarks. Overall, our contributions are threefold: (i) TOP-Training, a new pretraining technique to effectively adapt LLMs to better solve a target problem, (ii) TOP-Training has a wide application scope because it does not require the target problem to have a large set of unlabeled data, and (iii) our experiments highlight the limitations of autoregressive LLMs, emphasizing TOP-Training as a means to unlock the true potential of bidirectional LLMs.

Towards a Unified Language Model for Knowledge-Intensive Tasks Utilizing External Corpus

The advent of large language models (LLMs) has showcased their efficacy across various domains, yet they often hallucinate, especially in knowledge-intensive tasks that require external knowledge sources. To improve factual accuracy of language models, retrieval-augmented generation (RAG) has emerged as a popular solution. However, traditional retrieval modules often rely on large-scale document indexes, which can be disconnected from generative tasks. Through generative retrieval (GR) approach, language models can achieve superior retrieval performance by directly generating relevant document identifiers (DocIDs). However, the relationship between GR and downstream tasks, as well as the potential of LLMs in GR, remains unexplored. In this paper, we present a unified language model that utilizes external corpus to handle various knowledge-intensive tasks by seamlessly integrating generative retrieval, closed-book generation, and RAG. In order to achieve effective retrieval and generation through a unified continuous decoding process, we introduce the following mechanisms: (1) a ranking-oriented DocID decoding strategy, which improves ranking ability by directly learning from a DocID ranking list; (2) a continuous generation strategy to facilitate effective and efficient RAG; (3) well-designed auxiliary DocID understanding tasks to enhance the model's comprehension of DocIDs and their relevance to downstream tasks. Our approach is evaluated on the widely used KILT benchmark using two variants of backbone models: an encoder-decoder T5 model and a decoder-only LLM, Llama2. Experimental results showcase the superior performance of our models in both retrieval and downstream knowledge-intensive tasks.

A Multi-View Joint Learning Framework for Embedding Clinical Codes and Text Using Graph Neural Networks

Learning to represent free text is a core task in many clinical machine learning (ML) applications, as clinical text contains observations and plans not otherwise available for inference. State-of-the-art methods use large language models developed with immense computational resources and training data; however, applying these models is challenging because of the highly varying syntax and vocabulary in clinical free text. Structured information such as International Classification of Disease (ICD) codes often succinctly abstracts the most important facts of a clinical encounter and yields good performance, but is often not as available as clinical text in real-world scenarios. We propose a multi-view learning framework that jointly learns from codes and text to combine the availability and forward-looking nature of text and better performance of ICD codes. The learned text embeddings can be used as inputs to predictive algorithms independent of the ICD codes during inference. Our approach uses a Graph Neural Network (GNN) to process ICD codes, and Bi-LSTM to process text. We apply Deep Canonical Correlation Analysis (DCCA) to enforce the two views to learn a similar representation of each patient. In experiments using planned surgical procedure text, our model outperforms BERT models fine-tuned to clinical data, and in experiments using diverse text in MIMIC-III, our model is competitive to a fine-tuned BERT at a tiny fraction of its computational effort.

Generating EDU Extracts for Plan-Guided Summary Re-Ranking

Two-step approaches, in which summary candidates are generated-then-reranked to return a single summary, can improve ROUGE scores over the standard single-step approach. Yet, standard decoding methods (i.e., beam search, nucleus sampling, and diverse beam search) produce candidates with redundant, and often low quality, content. In this paper, we design a novel method to generate candidates for re-ranking that addresses these issues. We ground each candidate abstract on its own unique content plan and generate distinct plan-guided abstracts using a model's top beam. More concretely, a standard language model (a BART LM) auto-regressively generates elemental discourse unit (EDU) content plans with an extractive copy mechanism. The top K beams from the content plan generator are then used to guide a separate LM, which produces a single abstractive candidate for each distinct plan. We apply an existing re-ranker (BRIO) to abstractive candidates generated from our method, as well as baseline decoding methods. We show large relevance improvements over previously published methods on widely used single document news article corpora, with ROUGE-2 F1 gains of 0.88, 2.01, and 0.38 on CNN / Dailymail, NYT, and Xsum, respectively. A human evaluation on CNN / DM validates these results. Similarly, on 1k samples from CNN / DM, we show that prompting GPT-3 to follow EDU plans outperforms sampling-based methods by 1.05 ROUGE-2 F1 points. Code to generate and realize plans is available at https://github.com/griff4692/edu-sum.

Mamba Retriever: Utilizing Mamba for Effective and Efficient Dense Retrieval

In the information retrieval (IR) area, dense retrieval (DR) models use deep learning techniques to encode queries and passages into embedding space to compute their semantic relations. It is important for DR models to balance both efficiency and effectiveness. Pre-trained language models (PLMs), especially Transformer-based PLMs, have been proven to be effective encoders of DR models. However, the self-attention component in Transformer-based PLM results in a computational complexity that grows quadratically with sequence length, and thus exhibits a slow inference speed for long-text retrieval. Some recently proposed non-Transformer PLMs, especially the Mamba architecture PLMs, have demonstrated not only comparable effectiveness to Transformer-based PLMs on generative language tasks but also better efficiency due to linear time scaling in sequence length. This paper implements the Mamba Retriever to explore whether Mamba can serve as an effective and efficient encoder of DR model for IR tasks. We fine-tune the Mamba Retriever on the classic short-text MS MARCO passage ranking dataset and the long-text LoCoV0 dataset. Experimental results show that (1) on the MS MARCO passage ranking dataset and BEIR, the Mamba Retriever achieves comparable or better effectiveness compared to Transformer-based retrieval models, and the effectiveness grows with the size of the Mamba model; (2) on the long-text LoCoV0 dataset, the Mamba Retriever can extend to longer text length than its pre-trained length after fine-tuning on retrieval task, and it has comparable or better effectiveness compared to other long-text retrieval models; (3) the Mamba Retriever has superior inference speed for long-text retrieval. In conclusion, Mamba Retriever is both effective and efficient, making it a practical model, especially for long-text retrieval.

Graph of Records: Boosting Retrieval Augmented Generation for Long-context Summarization with Graphs

Retrieval-augmented generation (RAG) has revitalized Large Language Models (LLMs) by injecting non-parametric factual knowledge. Compared with long-context LLMs, RAG is considered an effective summarization tool in a more concise and lightweight manner, which can interact with LLMs multiple times using diverse queries to get comprehensive responses. However, the LLM-generated historical responses, which contain potentially insightful information, are largely neglected and discarded by existing approaches, leading to suboptimal results. In this paper, we propose graph of records (GoR), which leverages historical responses generated by LLMs to enhance RAG for long-context global summarization. Inspired by the retrieve-then-generate paradigm of RAG, we construct a graph by establishing an edge between the retrieved text chunks and the corresponding LLM-generated response. To further uncover the intricate correlations between them, GoR further features a graph neural network and an elaborately designed BERTScore-based objective for self-supervised model training, enabling seamless supervision signal backpropagation between reference summaries and node embeddings. We comprehensively compare GoR with 12 baselines across four long-context summarization datasets, and the results indicate that our proposed method reaches the best performance e.g., 15\%, 8\%, and 19\% improvement over retrievers w.r.t. Rouge-L, Rouge-1, and Rouge-2 on the WCEP dataset). Extensive experiments further demonstrate the effectiveness of GoR. Code is available at https://github.com/ulab-uiuc/GoR

Summarizing Patients Problems from Hospital Progress Notes Using Pre-trained Sequence-to-Sequence Models

Automatically summarizing patients' main problems from daily progress notes using natural language processing methods helps to battle against information and cognitive overload in hospital settings and potentially assists providers with computerized diagnostic decision support. Problem list summarization requires a model to understand, abstract, and generate clinical documentation. In this work, we propose a new NLP task that aims to generate a list of problems in a patient's daily care plan using input from the provider's progress notes during hospitalization. We investigate the performance of T5 and BART, two state-of-the-art seq2seq transformer architectures, in solving this problem. We provide a corpus built on top of progress notes from publicly available electronic health record progress notes in the Medical Information Mart for Intensive Care (MIMIC)-III. T5 and BART are trained on general domain text, and we experiment with a data augmentation method and a domain adaptation pre-training method to increase exposure to medical vocabulary and knowledge. Evaluation methods include ROUGE, BERTScore, cosine similarity on sentence embedding, and F-score on medical concepts. Results show that T5 with domain adaptive pre-training achieves significant performance gains compared to a rule-based system and general domain pre-trained language models, indicating a promising direction for tackling the problem summarization task.

Application of Deep Learning in Generating Structured Radiology Reports: A Transformer-Based Technique

Since radiology reports needed for clinical practice and research are written and stored in free-text narrations, extraction of relative information for further analysis is difficult. In these circumstances, natural language processing (NLP) techniques can facilitate automatic information extraction and transformation of free-text formats to structured data. In recent years, deep learning (DL)-based models have been adapted for NLP experiments with promising results. Despite the significant potential of DL models based on artificial neural networks (ANN) and convolutional neural networks (CNN), the models face some limitations to implement in clinical practice. Transformers, another new DL architecture, have been increasingly applied to improve the process. Therefore, in this study, we propose a transformer-based fine-grained named entity recognition (NER) architecture for clinical information extraction. We collected 88 abdominopelvic sonography reports in free-text formats and annotated them based on our developed information schema. The text-to-text transfer transformer model (T5) and Scifive, a pre-trained domain-specific adaptation of the T5 model, were applied for fine-tuning to extract entities and relations and transform the input into a structured format. Our transformer-based model in this study outperformed previously applied approaches such as ANN and CNN models based on ROUGE-1, ROUGE-2, ROUGE-L, and BLEU scores of 0.816, 0.668, 0.528, and 0.743, respectively, while providing an interpretable structured report.

Refining Text-to-Image Generation: Towards Accurate Training-Free Glyph-Enhanced Image Generation

Over the past few years, Text-to-Image (T2I) generation approaches based on diffusion models have gained significant attention. However, vanilla diffusion models often suffer from spelling inaccuracies in the text displayed within the generated images. The capability to generate visual text is crucial, offering both academic interest and a wide range of practical applications. To produce accurate visual text images, state-of-the-art techniques adopt a glyph-controlled image generation approach, consisting of a text layout generator followed by an image generator that is conditioned on the generated text layout. Nevertheless, our study reveals that these models still face three primary challenges, prompting us to develop a testbed to facilitate future research. We introduce a benchmark, LenCom-Eval, specifically designed for testing models' capability in generating images with Lengthy and Complex visual text. Subsequently, we introduce a training-free framework to enhance the two-stage generation approaches. We examine the effectiveness of our approach on both LenCom-Eval and MARIO-Eval benchmarks and demonstrate notable improvements across a range of evaluation metrics, including CLIPScore, OCR precision, recall, F1 score, accuracy, and edit distance scores. For instance, our proposed framework improves the backbone model, TextDiffuser, by more than 23\% and 13.5\% in terms of OCR word F1 on LenCom-Eval and MARIO-Eval, respectively. Our work makes a unique contribution to the field by focusing on generating images with long and rare text sequences, a niche previously unexplored by existing literature

Text2Node: a Cross-Domain System for Mapping Arbitrary Phrases to a Taxonomy

Electronic health record (EHR) systems are used extensively throughout the healthcare domain. However, data interchangeability between EHR systems is limited due to the use of different coding standards across systems. Existing methods of mapping coding standards based on manual human experts mapping, dictionary mapping, symbolic NLP and classification are unscalable and cannot accommodate large scale EHR datasets. In this work, we present Text2Node, a cross-domain mapping system capable of mapping medical phrases to concepts in a large taxonomy (such as SNOMED CT). The system is designed to generalize from a limited set of training samples and map phrases to elements of the taxonomy that are not covered by training data. As a result, our system is scalable, robust to wording variants between coding systems and can output highly relevant concepts when no exact concept exists in the target taxonomy. Text2Node operates in three main stages: first, the lexicon is mapped to word embeddings; second, the taxonomy is vectorized using node embeddings; and finally, the mapping function is trained to connect the two embedding spaces. We compared multiple algorithms and architectures for each stage of the training, including GloVe and FastText word embeddings, CNN and Bi-LSTM mapping functions, and node2vec for node embeddings. We confirmed the robustness and generalisation properties of Text2Node by mapping ICD-9-CM Diagnosis phrases to SNOMED CT and by zero-shot training at comparable accuracy. This system is a novel methodological contribution to the task of normalizing and linking phrases to a taxonomy, advancing data interchangeability in healthcare. When applied, the system can use electronic health records to generate an embedding that incorporates taxonomical medical knowledge to improve clinical predictive models.

A Survey of Controllable Text Generation using Transformer-based Pre-trained Language Models

Controllable Text Generation (CTG) is emerging area in the field of natural language generation (NLG). It is regarded as crucial for the development of advanced text generation technologies that better meet the specific constraints in practical applications. In recent years, methods using large-scale pre-trained language models (PLMs), in particular the widely used transformer-based PLMs, have become a new paradigm of NLG, allowing generation of more diverse and fluent text. However, due to the limited level of interpretability of deep neural networks, the controllability of these methods need to be guaranteed. To this end, controllable text generation using transformer-based PLMs has become a rapidly growing yet challenging new research hotspot. A diverse range of approaches have emerged in the recent 3-4 years, targeting different CTG tasks that require different types of controlled constraints. In this paper, we present a systematic critical review on the common tasks, main approaches, and evaluation methods in this area. Finally, we discuss the challenges that the field is facing, and put forward various promising future directions. To the best of our knowledge, this is the first survey paper to summarize the state-of-the-art CTG techniques from the perspective of Transformer-based PLMs. We hope it can help researchers and practitioners in the related fields to quickly track the academic and technological frontier, providing them with a landscape of the area and a roadmap for future research.

LLM Tree Search

This project aims to investigate a novel sequence generation method inspired by the AlphaGo paradigm, adapting it for use with large language models (LLMs). The proposed approach involves creating search trees of different possible completions and evaluating these completions based on model confidence. By considering various paths in the search tree and scoring them according to the model's confidence in each completion, we can generate diverse and high-quality sequences. This research explores the implementation of this paradigm by using confidence as a proxy for response quality akin to beam search vijayakumar2016diverse. The primary goal of this paper is to outline the paradigm and demonstrate its potential, rather than focusing on achieving perfect results. The paper will outline the reasons why we believe this paradigm has the potential to improve LLMs in the following manners: 1) increase output quality, 2) decrease errors, 3) eliminate or reduce the compound error problems, 4) generate diverse and creative completions, 5) allow for iterative problem-solving, and 6) self-training. We expect this approach to yield a set of diverse and coherent sequences, offering insights into balancing exploration and exploitation in sequence generation. Potential applications include creative text generation tasks, such as storytelling and content creation, as well as other natural language processing domains, like machine translation and automated summarization. The goal is that the model will be far more effective as it will be able to consider many possible variations allowing it to find the ideal completion. This research aims to contribute to the understanding of effective search strategies in sequence generation and their impact on generating high-quality, varied textual outputs.

CUDRT: Benchmarking the Detection of Human vs. Large Language Models Generated Texts

The proliferation of large language models (LLMs) has significantly enhanced text generation capabilities across various industries. However, these models' ability to generate human-like text poses substantial challenges in discerning between human and AI authorship. Despite the effectiveness of existing AI-generated text detectors, their development is hindered by the lack of comprehensive, publicly available benchmarks. Current benchmarks are limited to specific scenarios, such as question answering and text polishing, and predominantly focus on English texts, failing to capture the diverse applications and linguistic nuances of LLMs. To address these limitations, this paper constructs a comprehensive bilingual benchmark in both Chinese and English to evaluate mainstream AI-generated text detectors. We categorize LLM text generation into five distinct operations: Create, Update, Delete, Rewrite, and Translate (CUDRT), encompassing all current LLMs activities. We also establish a robust benchmark evaluation framework to support scalable and reproducible experiments. For each CUDRT category, we have developed extensive datasets to thoroughly assess detector performance. By employing the latest mainstream LLMs specific to each language, our datasets provide a thorough evaluation environment. Extensive experimental results offer critical insights for optimizing AI-generated text detectors and suggest future research directions to improve detection accuracy and generalizability across various scenarios.

BARTScore: Evaluating Generated Text as Text Generation

A wide variety of NLP applications, such as machine translation, summarization, and dialog, involve text generation. One major challenge for these applications is how to evaluate whether such generated texts are actually fluent, accurate, or effective. In this work, we conceptualize the evaluation of generated text as a text generation problem, modeled using pre-trained sequence-to-sequence models. The general idea is that models trained to convert the generated text to/from a reference output or the source text will achieve higher scores when the generated text is better. We operationalize this idea using BART, an encoder-decoder based pre-trained model, and propose a metric BARTScore with a number of variants that can be flexibly applied in an unsupervised fashion to evaluation of text from different perspectives (e.g. informativeness, fluency, or factuality). BARTScore is conceptually simple and empirically effective. It can outperform existing top-scoring metrics in 16 of 22 test settings, covering evaluation of 16 datasets (e.g., machine translation, text summarization) and 7 different perspectives (e.g., informativeness, factuality). Code to calculate BARTScore is available at https://github.com/neulab/BARTScore, and we have released an interactive leaderboard for meta-evaluation at http://explainaboard.nlpedia.ai/leaderboard/task-meval/ on the ExplainaBoard platform, which allows us to interactively understand the strengths, weaknesses, and complementarity of each metric.

Pre-training technique to localize medical BERT and enhance biomedical BERT

Pre-training large-scale neural language models on raw texts has made a significant contribution to improving transfer learning in natural language processing (NLP). With the introduction of transformer-based language models, such as bidirectional encoder representations from transformers (BERT), the performance of information extraction from a free text by NLP has significantly improved for both the general domain and medical domain; however, it is difficult to train specific BERT models that perform well for domains in which there are few publicly available databases of high quality and large size. We hypothesized that this problem can be addressed by up-sampling a domain-specific corpus and using it for pre-training with a larger corpus in a balanced manner. Our proposed method consists of a single intervention with one option: simultaneous pre-training after up-sampling and amplified vocabulary. We conducted three experiments and evaluated the resulting products. We confirmed that our Japanese medical BERT outperformed conventional baselines and the other BERT models in terms of the medical document classification task and that our English BERT pre-trained using both the general and medical-domain corpora performed sufficiently well for practical use in terms of the biomedical language understanding evaluation (BLUE) benchmark. Moreover, our enhanced biomedical BERT model, in which clinical notes were not used during pre-training, showed that both the clinical and biomedical scores of the BLUE benchmark were 0.3 points above that of the ablation model trained without our proposed method. Well-balanced pre-training by up-sampling instances derived from a corpus appropriate for the target task allows us to construct a high-performance BERT model.

Large Language Models to Identify Social Determinants of Health in Electronic Health Records

Social determinants of health (SDoH) have an important impact on patient outcomes but are incompletely collected from the electronic health records (EHR). This study researched the ability of large language models to extract SDoH from free text in EHRs, where they are most commonly documented, and explored the role of synthetic clinical text for improving the extraction of these scarcely documented, yet extremely valuable, clinical data. 800 patient notes were annotated for SDoH categories, and several transformer-based models were evaluated. The study also experimented with synthetic data generation and assessed for algorithmic bias. Our best-performing models were fine-tuned Flan-T5 XL (macro-F1 0.71) for any SDoH, and Flan-T5 XXL (macro-F1 0.70). The benefit of augmenting fine-tuning with synthetic data varied across model architecture and size, with smaller Flan-T5 models (base and large) showing the greatest improvements in performance (delta F1 +0.12 to +0.23). Model performance was similar on the in-hospital system dataset but worse on the MIMIC-III dataset. Our best-performing fine-tuned models outperformed zero- and few-shot performance of ChatGPT-family models for both tasks. These fine-tuned models were less likely than ChatGPT to change their prediction when race/ethnicity and gender descriptors were added to the text, suggesting less algorithmic bias (p<0.05). At the patient-level, our models identified 93.8% of patients with adverse SDoH, while ICD-10 codes captured 2.0%. Our method can effectively extracted SDoH information from clinic notes, performing better compare to GPT zero- and few-shot settings. These models could enhance real-world evidence on SDoH and aid in identifying patients needing social support.

EasyNER: A Customizable Easy-to-Use Pipeline for Deep Learning- and Dictionary-based Named Entity Recognition from Medical Text

Medical research generates a large number of publications with the PubMed database already containing >35 million research articles. Integration of the knowledge scattered across this large body of literature could provide key insights into physiological mechanisms and disease processes leading to novel medical interventions. However, it is a great challenge for researchers to utilize this information in full since the scale and complexity of the data greatly surpasses human processing abilities. This becomes especially problematic in cases of extreme urgency like the COVID-19 pandemic. Automated text mining can help extract and connect information from the large body of medical research articles. The first step in text mining is typically the identification of specific classes of keywords (e.g., all protein or disease names), so called Named Entity Recognition (NER). Here we present an end-to-end pipeline for NER of typical entities found in medical research articles, including diseases, cells, chemicals, genes/proteins, and species. The pipeline can access and process large medical research article collections (PubMed, CORD-19) or raw text and incorporates a series of deep learning models fine-tuned on the HUNER corpora collection. In addition, the pipeline can perform dictionary-based NER related to COVID-19 and other medical topics. Users can also load their own NER models and dictionaries to include additional entities. The output consists of publication-ready ranked lists and graphs of detected entities and files containing the annotated texts. An associated script allows rapid inspection of the results for specific entities of interest. As model use cases, the pipeline was deployed on two collections of autophagy-related abstracts from PubMed and on the CORD19 dataset, a collection of 764 398 research article abstracts related to COVID-19.

PromptMRG: Diagnosis-Driven Prompts for Medical Report Generation

Automatic medical report generation (MRG) is of great research value as it has the potential to relieve radiologists from the heavy burden of report writing. Despite recent advancements, accurate MRG remains challenging due to the need for precise clinical understanding and the identification of clinical findings. Moreover, the imbalanced distribution of diseases makes the challenge even more pronounced, as rare diseases are underrepresented in training data, making their diagnostic performance unreliable. To address these challenges, we propose diagnosis-driven prompts for medical report generation (PromptMRG), a novel framework that aims to improve the diagnostic accuracy of MRG with the guidance of diagnosis-aware prompts. Specifically, PromptMRG is based on encoder-decoder architecture with an extra disease classification branch. When generating reports, the diagnostic results from the classification branch are converted into token prompts to explicitly guide the generation process. To further improve the diagnostic accuracy, we design cross-modal feature enhancement, which retrieves similar reports from the database to assist the diagnosis of a query image by leveraging the knowledge from a pre-trained CLIP. Moreover, the disease imbalanced issue is addressed by applying an adaptive logit-adjusted loss to the classification branch based on the individual learning status of each disease, which overcomes the barrier of text decoder's inability to manipulate disease distributions. Experiments on two MRG benchmarks show the effectiveness of the proposed method, where it obtains state-of-the-art clinical efficacy performance on both datasets.

RoentGen: Vision-Language Foundation Model for Chest X-ray Generation

Multimodal models trained on large natural image-text pair datasets have exhibited astounding abilities in generating high-quality images. Medical imaging data is fundamentally different to natural images, and the language used to succinctly capture relevant details in medical data uses a different, narrow but semantically rich, domain-specific vocabulary. Not surprisingly, multi-modal models trained on natural image-text pairs do not tend to generalize well to the medical domain. Developing generative imaging models faithfully representing medical concepts while providing compositional diversity could mitigate the existing paucity of high-quality, annotated medical imaging datasets. In this work, we develop a strategy to overcome the large natural-medical distributional shift by adapting a pre-trained latent diffusion model on a corpus of publicly available chest x-rays (CXR) and their corresponding radiology (text) reports. We investigate the model's ability to generate high-fidelity, diverse synthetic CXR conditioned on text prompts. We assess the model outputs quantitatively using image quality metrics, and evaluate image quality and text-image alignment by human domain experts. We present evidence that the resulting model (RoentGen) is able to create visually convincing, diverse synthetic CXR images, and that the output can be controlled to a new extent by using free-form text prompts including radiology-specific language. Fine-tuning this model on a fixed training set and using it as a data augmentation method, we measure a 5% improvement of a classifier trained jointly on synthetic and real images, and a 3% improvement when trained on a larger but purely synthetic training set. Finally, we observe that this fine-tuning distills in-domain knowledge in the text-encoder and can improve its representation capabilities of certain diseases like pneumothorax by 25%.

Cross-lingual Argument Mining in the Medical Domain

Nowadays the medical domain is receiving more and more attention in applications involving Artificial Intelligence. Clinicians have to deal with an enormous amount of unstructured textual data to make a conclusion about patients' health in their everyday life. Argument mining helps to provide a structure to such data by detecting argumentative components in the text and classifying the relations between them. However, as it is the case for many tasks in Natural Language Processing in general and in medical text processing in particular, the large majority of the work on computational argumentation has been done only for English. This is also the case with the only dataset available for argumentation in the medical domain, namely, the annotated medical data of abstracts of Randomized Controlled Trials (RCT) from the MEDLINE database. In order to mitigate the lack of annotated data for other languages, we empirically investigate several strategies to perform argument mining and classification in medical texts for a language for which no annotated data is available. This project shows that automatically translating and project annotations from English to a target language (Spanish) is an effective way to generate annotated data without manual intervention. Furthermore, our experiments demonstrate that the translation and projection approach outperforms zero-shot cross-lingual approaches using a large masked multilingual language model. Finally, we show how the automatically generated data in Spanish can also be used to improve results in the original English evaluation setting.

DRT-o1: Optimized Deep Reasoning Translation via Long Chain-of-Thought

Recently, O1-like models have emerged as representative examples, illustrating the effectiveness of long chain-of-thought (CoT) in reasoning tasks such as math and coding tasks. In this paper, we introduce DRT-o1, an attempt to bring the success of long CoT to neural machine translation (MT). Specifically, in view of the literature books that might involve similes and metaphors, translating these texts to a target language is very difficult in practice due to cultural differences. In such cases, literal translation often fails to convey the intended meaning effectively. Even for professional human translators, considerable thought must be given to preserving semantics throughout the translation process. To simulate LLMs' long thought ability in MT, we first mine sentences containing similes or metaphors from existing literature books, and then develop a multi-agent framework to translate these sentences via long thought. In the multi-agent framework, a translator is used to iteratively translate the source sentence under the suggestions provided by an advisor. To ensure the effectiveness of the long thoughts, an evaluator is also employed to judge whether the translation in the current round is better than the previous one or not. In this manner, we collect tens of thousands of long-thought MT data, which is used to train our DRT-o1. The experimental results on literature translation demonstrate the effectiveness of the DRT-o1. Using Qwen2.5-7B and Qwen2.5-14B as the backbones, the improvement brought by DRT-o1 achieves 7.33~8.26 BLEU and 1.66~3.36 CometScore. Besides, DRT-o1-7B can outperform QwQ-32B-Preview by 7.82 BLEU and 1.46 CometScore, showing its effectiveness. The project is available at https://github.com/krystalan/DRT-o1

Question-Answering Model for Schizophrenia Symptoms and Their Impact on Daily Life using Mental Health Forums Data

In recent years, there is strong emphasis on mining medical data using machine learning techniques. A common problem is to obtain a noiseless set of textual documents, with a relevant content for the research question, and developing a Question Answering (QA) model for a specific medical field. The purpose of this paper is to present a new methodology for building a medical dataset and obtain a QA model for analysis of symptoms and impact on daily life for a specific disease domain. The ``Mental Health'' forum was used, a forum dedicated to people suffering from schizophrenia and different mental disorders. Relevant posts of active users, who regularly participate, were extrapolated providing a new method of obtaining low-bias content and without privacy issues. Furthermore, it is shown how to pre-process the dataset to convert it into a QA dataset. The Bidirectional Encoder Representations from Transformers (BERT), DistilBERT, RoBERTa, and BioBERT models were fine-tuned and evaluated via F1-Score, Exact Match, Precision and Recall. Accurate empirical experiments demonstrated the effectiveness of the proposed method for obtaining an accurate dataset for QA model implementation. By fine-tuning the BioBERT QA model, we achieved an F1 score of 0.885, showing a considerable improvement and outperforming the state-of-the-art model for mental disorders domain.

Enhancing Health Information Retrieval with RAG by Prioritizing Topical Relevance and Factual Accuracy

The exponential surge in online health information, coupled with its increasing use by non-experts, highlights the pressing need for advanced Health Information Retrieval models that consider not only topical relevance but also the factual accuracy of the retrieved information, given the potential risks associated with health misinformation. To this aim, this paper introduces a solution driven by Retrieval-Augmented Generation (RAG), which leverages the capabilities of generative Large Language Models (LLMs) to enhance the retrieval of health-related documents grounded in scientific evidence. In particular, we propose a three-stage model: in the first stage, the user's query is employed to retrieve topically relevant passages with associated references from a knowledge base constituted by scientific literature. In the second stage, these passages, alongside the initial query, are processed by LLMs to generate a contextually relevant rich text (GenText). In the last stage, the documents to be retrieved are evaluated and ranked both from the point of view of topical relevance and factual accuracy by means of their comparison with GenText, either through stance detection or semantic similarity. In addition to calculating factual accuracy, GenText can offer a layer of explainability for it, aiding users in understanding the reasoning behind the retrieval. Experimental evaluation of our model on benchmark datasets and against baseline models demonstrates its effectiveness in enhancing the retrieval of both topically relevant and factually accurate health information, thus presenting a significant step forward in the health misinformation mitigation problem.

Pre-trained Language Models for Keyphrase Generation: A Thorough Empirical Study

Neural models that do not rely on pre-training have excelled in the keyphrase generation task with large annotated datasets. Meanwhile, new approaches have incorporated pre-trained language models (PLMs) for their data efficiency. However, there lacks a systematic study of how the two types of approaches compare and how different design choices can affect the performance of PLM-based models. To fill in this knowledge gap and facilitate a more informed use of PLMs for keyphrase extraction and keyphrase generation, we present an in-depth empirical study. Formulating keyphrase extraction as sequence labeling and keyphrase generation as sequence-to-sequence generation, we perform extensive experiments in three domains. After showing that PLMs have competitive high-resource performance and state-of-the-art low-resource performance, we investigate important design choices including in-domain PLMs, PLMs with different pre-training objectives, using PLMs with a parameter budget, and different formulations for present keyphrases. Further results show that (1) in-domain BERT-like PLMs can be used to build strong and data-efficient keyphrase generation models; (2) with a fixed parameter budget, prioritizing model depth over width and allocating more layers in the encoder leads to better encoder-decoder models; and (3) introducing four in-domain PLMs, we achieve a competitive performance in the news domain and the state-of-the-art performance in the scientific domain.

Enhancing Large Language Models with Domain-specific Retrieval Augment Generation: A Case Study on Long-form Consumer Health Question Answering in Ophthalmology

Despite the potential of Large Language Models (LLMs) in medicine, they may generate responses lacking supporting evidence or based on hallucinated evidence. While Retrieval Augment Generation (RAG) is popular to address this issue, few studies implemented and evaluated RAG in downstream domain-specific applications. We developed a RAG pipeline with 70,000 ophthalmology-specific documents that retrieve relevant documents to augment LLMs during inference time. In a case study on long-form consumer health questions, we systematically evaluated the responses including over 500 references of LLMs with and without RAG on 100 questions with 10 healthcare professionals. The evaluation focuses on factuality of evidence, selection and ranking of evidence, attribution of evidence, and answer accuracy and completeness. LLMs without RAG provided 252 references in total. Of which, 45.3% hallucinated, 34.1% consisted of minor errors, and 20.6% were correct. In contrast, LLMs with RAG significantly improved accuracy (54.5% being correct) and reduced error rates (18.8% with minor hallucinations and 26.7% with errors). 62.5% of the top 10 documents retrieved by RAG were selected as the top references in the LLM response, with an average ranking of 4.9. The use of RAG also improved evidence attribution (increasing from 1.85 to 2.49 on a 5-point scale, P<0.001), albeit with slight decreases in accuracy (from 3.52 to 3.23, P=0.03) and completeness (from 3.47 to 3.27, P=0.17). The results demonstrate that LLMs frequently exhibited hallucinated and erroneous evidence in the responses, raising concerns for downstream applications in the medical domain. RAG substantially reduced the proportion of such evidence but encountered challenges.

GENIE: Generative Note Information Extraction model for structuring EHR data

Electronic Health Records (EHRs) hold immense potential for advancing healthcare, offering rich, longitudinal data that combines structured information with valuable insights from unstructured clinical notes. However, the unstructured nature of clinical text poses significant challenges for secondary applications. Traditional methods for structuring EHR free-text data, such as rule-based systems and multi-stage pipelines, are often limited by their time-consuming configurations and inability to adapt across clinical notes from diverse healthcare settings. Few systems provide a comprehensive attribute extraction for terminologies. While giant large language models (LLMs) like GPT-4 and LLaMA 405B excel at structuring tasks, they are slow, costly, and impractical for large-scale use. To overcome these limitations, we introduce GENIE, a Generative Note Information Extraction system that leverages LLMs to streamline the structuring of unstructured clinical text into usable data with standardized format. GENIE processes entire paragraphs in a single pass, extracting entities, assertion statuses, locations, modifiers, values, and purposes with high accuracy. Its unified, end-to-end approach simplifies workflows, reduces errors, and eliminates the need for extensive manual intervention. Using a robust data preparation pipeline and fine-tuned small scale LLMs, GENIE achieves competitive performance across multiple information extraction tasks, outperforming traditional tools like cTAKES and MetaMap and can handle extra attributes to be extracted. GENIE strongly enhances real-world applicability and scalability in healthcare systems. By open-sourcing the model and test data, we aim to encourage collaboration and drive further advancements in EHR structurization.

Next-Generation Database Interfaces: A Survey of LLM-based Text-to-SQL

Generating accurate SQL from natural language questions (text-to-SQL) is a long-standing challenge due to the complexities in user question understanding, database schema comprehension, and SQL generation. Conventional text-to-SQL systems, comprising human engineering and deep neural networks, have made substantial progress. Subsequently, pre-trained language models (PLMs) have been developed and utilized for text-to-SQL tasks, achieving promising performance. As modern databases become more complex, the corresponding user questions also grow more challenging, causing PLMs with parameter constraints to produce incorrect SQL. This necessitates more sophisticated and tailored optimization methods, which, in turn, restricts the applications of PLM-based systems. Recently, large language models (LLMs) have demonstrated significant capabilities in natural language understanding as the model scale increases. Therefore, integrating LLM-based implementation can bring unique opportunities, improvements, and solutions to text-to-SQL research. In this survey, we present a comprehensive review of LLM-based text-to-SQL. Specifically, we propose a brief overview of the technical challenges and the evolutionary process of text-to-SQL. Then, we provide a detailed introduction to the datasets and metrics designed to evaluate text-to-SQL systems. After that, we present a systematic analysis of recent advances in LLM-based text-to-SQL. Finally, we discuss the remaining challenges in this field and propose expectations for future research directions.

Soft Prompt Tuning for Augmenting Dense Retrieval with Large Language Models

Dense retrieval (DR) converts queries and documents into dense embeddings and measures the similarity between queries and documents in vector space. One of the challenges in DR is the lack of domain-specific training data. While DR models can learn from large-scale public datasets like MS MARCO through transfer learning, evidence shows that not all DR models and domains can benefit from transfer learning equally. Recently, some researchers have resorted to large language models (LLMs) to improve the zero-shot and few-shot DR models. However, the hard prompts or human-written prompts utilized in these works cannot guarantee the good quality of generated weak queries. To tackle this, we propose soft prompt tuning for augmenting DR (SPTAR): For each task, we leverage soft prompt-tuning to optimize a task-specific soft prompt on limited ground truth data and then prompt the LLMs to tag unlabeled documents with weak queries, yielding enough weak document-query pairs to train task-specific dense retrievers. We design a filter to select high-quality example document-query pairs in the prompt to further improve the quality of weak tagged queries. To the best of our knowledge, there is no prior work utilizing soft prompt tuning to augment DR models. The experiments demonstrate that SPTAR outperforms the unsupervised baselines BM25 and the recently proposed LLMs-based augmentation method for DR.

TrICy: Trigger-guided Data-to-text Generation with Intent aware Attention-Copy

Data-to-text (D2T) generation is a crucial task in many natural language understanding (NLU) applications and forms the foundation of task-oriented dialog systems. In the context of conversational AI solutions that can work directly with local data on the user's device, architectures utilizing large pre-trained language models (PLMs) are impractical for on-device deployment due to a high memory footprint. To this end, we propose TrICy, a novel lightweight framework for an enhanced D2T task that generates text sequences based on the intent in context and may further be guided by user-provided triggers. We leverage an attention-copy mechanism to predict out-of-vocabulary (OOV) words accurately. Performance analyses on E2E NLG dataset (BLEU: 66.43%, ROUGE-L: 70.14%), WebNLG dataset (BLEU: Seen 64.08%, Unseen 52.35%), and our Custom dataset related to text messaging applications, showcase our architecture's effectiveness. Moreover, we show that by leveraging an optional trigger input, data-to-text generation quality increases significantly and achieves the new SOTA score of 69.29% BLEU for E2E NLG. Furthermore, our analyses show that TrICy achieves at least 24% and 3% improvement in BLEU and METEOR respectively over LLMs like GPT-3, ChatGPT, and Llama 2. We also demonstrate that in some scenarios, performance improvement due to triggers is observed even when they are absent in training.

Most Language Models can be Poets too: An AI Writing Assistant and Constrained Text Generation Studio

Despite rapid advancement in the field of Constrained Natural Language Generation, little time has been spent on exploring the potential of language models which have had their vocabularies lexically, semantically, and/or phonetically constrained. We find that most language models generate compelling text even under significant constraints. We present a simple and universally applicable technique for modifying the output of a language model by compositionally applying filter functions to the language models vocabulary before a unit of text is generated. This approach is plug-and-play and requires no modification to the model. To showcase the value of this technique, we present an easy to use AI writing assistant called Constrained Text Generation Studio (CTGS). CTGS allows users to generate or choose from text with any combination of a wide variety of constraints, such as banning a particular letter, forcing the generated words to have a certain number of syllables, and/or forcing the words to be partial anagrams of another word. We introduce a novel dataset of prose that omits the letter e. We show that our method results in strictly superior performance compared to fine-tuning alone on this dataset. We also present a Huggingface space web-app presenting this technique called Gadsby. The code is available to the public here: https://github.com/Hellisotherpeople/Constrained-Text-Generation-Studio

VisRAG: Vision-based Retrieval-augmented Generation on Multi-modality Documents

Retrieval-augmented generation (RAG) is an effective technique that enables large language models (LLMs) to utilize external knowledge sources for generation. However, current RAG systems are solely based on text, rendering it impossible to utilize vision information like layout and images that play crucial roles in real-world multi-modality documents. In this paper, we introduce VisRAG, which tackles this issue by establishing a vision-language model (VLM)-based RAG pipeline. In this pipeline, instead of first parsing the document to obtain text, the document is directly embedded using a VLM as an image and then retrieved to enhance the generation of a VLM. Compared to traditional text-based RAG, VisRAG maximizes the retention and utilization of the data information in the original documents, eliminating the information loss introduced during the parsing process. We collect both open-source and synthetic data to train the retriever in VisRAG and explore a variety of generation methods. Experiments demonstrate that VisRAG outperforms traditional RAG in both the retrieval and generation stages, achieving a 25--39\% end-to-end performance gain over traditional text-based RAG pipeline. Further analysis reveals that VisRAG is effective in utilizing training data and demonstrates strong generalization capability, positioning it as a promising solution for RAG on multi-modality documents. Our code and data are available at https://github.com/openbmb/visrag .

Momentum Decoding: Open-ended Text Generation As Graph Exploration

Open-ended text generation with autoregressive language models (LMs) is one of the core tasks in natural language processing. However, maximization-based decoding methods (e.g., greedy/beam search) often lead to the degeneration problem, i.e., the generated text is unnatural and contains undesirable repetitions. Existing solutions to this problem either introduce randomness prone to incoherence or require a look-ahead mechanism that demands extra computational overhead. In this study, we formulate open-ended text generation from a new perspective, i.e., we view it as an exploration process within a directed graph. Thereby, we understand the phenomenon of degeneration as circular loops within the directed graph. Based on our formulation, we propose a novel decoding method -- momentum decoding -- which encourages the LM to greedily explore new nodes outside the current graph. Meanwhile, it also allows the LM to return to the existing nodes with a momentum downgraded by a pre-defined resistance function. We extensively test our approach on three benchmarks from different domains through automatic and human evaluations. The results show that momentum decoding performs comparably with the current state of the art while enjoying notably improved inference speed and computation FLOPs. Furthermore, we conduct a detailed analysis to reveal the merits and inner workings of our approach. Our codes and other related resources are publicly available at https://github.com/gmftbyGMFTBY/MomentumDecoding.

Survey of Hallucination in Natural Language Generation

Natural Language Generation (NLG) has improved exponentially in recent years thanks to the development of sequence-to-sequence deep learning technologies such as Transformer-based language models. This advancement has led to more fluent and coherent NLG, leading to improved development in downstream tasks such as abstractive summarization, dialogue generation and data-to-text generation. However, it is also apparent that deep learning based generation is prone to hallucinate unintended text, which degrades the system performance and fails to meet user expectations in many real-world scenarios. To address this issue, many studies have been presented in measuring and mitigating hallucinated texts, but these have never been reviewed in a comprehensive manner before. In this survey, we thus provide a broad overview of the research progress and challenges in the hallucination problem in NLG. The survey is organized into two parts: (1) a general overview of metrics, mitigation methods, and future directions; and (2) an overview of task-specific research progress on hallucinations in the following downstream tasks, namely abstractive summarization, dialogue generation, generative question answering, data-to-text generation, machine translation, and visual-language generation. This survey serves to facilitate collaborative efforts among researchers in tackling the challenge of hallucinated texts in NLG.

README: Bridging Medical Jargon and Lay Understanding for Patient Education through Data-Centric NLP

The advancement in healthcare has shifted focus toward patient-centric approaches, particularly in self-care and patient education, facilitated by access to Electronic Health Records (EHR). However, medical jargon in EHRs poses significant challenges in patient comprehension. To address this, we introduce a new task of automatically generating lay definitions, aiming to simplify complex medical terms into patient-friendly lay language. We first created the README dataset, an extensive collection of over 50,000 unique (medical term, lay definition) pairs and 300,000 mentions, each offering context-aware lay definitions manually annotated by domain experts. We have also engineered a data-centric Human-AI pipeline that synergizes data filtering, augmentation, and selection to improve data quality. We then used README as the training data for models and leveraged a Retrieval-Augmented Generation method to reduce hallucinations and improve the quality of model outputs. Our extensive automatic and human evaluations demonstrate that open-source mobile-friendly models, when fine-tuned with high-quality data, are capable of matching or even surpassing the performance of state-of-the-art closed-source large language models like ChatGPT. This research represents a significant stride in closing the knowledge gap in patient education and advancing patient-centric healthcare solutions.

AutoMIR: Effective Zero-Shot Medical Information Retrieval without Relevance Labels

Medical information retrieval (MIR) is essential for retrieving relevant medical knowledge from diverse sources, including electronic health records, scientific literature, and medical databases. However, achieving effective zero-shot dense retrieval in the medical domain poses substantial challenges due to the lack of relevance-labeled data. In this paper, we introduce a novel approach called Self-Learning Hypothetical Document Embeddings (SL-HyDE) to tackle this issue. SL-HyDE leverages large language models (LLMs) as generators to generate hypothetical documents based on a given query. These generated documents encapsulate key medical context, guiding a dense retriever in identifying the most relevant documents. The self-learning framework progressively refines both pseudo-document generation and retrieval, utilizing unlabeled medical corpora without requiring any relevance-labeled data. Additionally, we present the Chinese Medical Information Retrieval Benchmark (CMIRB), a comprehensive evaluation framework grounded in real-world medical scenarios, encompassing five tasks and ten datasets. By benchmarking ten models on CMIRB, we establish a rigorous standard for evaluating medical information retrieval systems. Experimental results demonstrate that SL-HyDE significantly surpasses existing methods in retrieval accuracy while showcasing strong generalization and scalability across various LLM and retriever configurations. CMIRB data and evaluation code are publicly available at: https://github.com/CMIRB-benchmark/CMIRB.

Synthetic Data Generation with Large Language Models for Personalized Community Question Answering

Personalization in Information Retrieval (IR) is a topic studied by the research community since a long time. However, there is still a lack of datasets to conduct large-scale evaluations of personalized IR; this is mainly due to the fact that collecting and curating high-quality user-related information requires significant costs and time investment. Furthermore, the creation of datasets for Personalized IR (PIR) tasks is affected by both privacy concerns and the need for accurate user-related data, which are often not publicly available. Recently, researchers have started to explore the use of Large Language Models (LLMs) to generate synthetic datasets, which is a possible solution to generate data for low-resource tasks. In this paper, we investigate the potential of Large Language Models (LLMs) for generating synthetic documents to train an IR system for a Personalized Community Question Answering task. To study the effectiveness of IR models fine-tuned on LLM-generated data, we introduce a new dataset, named Sy-SE-PQA. We build Sy-SE-PQA based on an existing dataset, SE-PQA, which consists of questions and answers posted on the popular StackExchange communities. Starting from questions in SE-PQA, we generate synthetic answers using different prompt techniques and LLMs. Our findings suggest that LLMs have high potential in generating data tailored to users' needs. The synthetic data can replace human-written training data, even if the generated data may contain incorrect information.

ConES: Concept Embedding Search for Parameter Efficient Tuning Large Vision Language Models

Large pre-trained vision-language models have shown great prominence in transferring pre-acquired knowledge to various domains and downstream tasks with appropriate prompting or tuning. Existing prevalent tuning methods can be generally categorized into three genres: 1) prompt engineering by creating suitable prompt texts, which is time-consuming and requires domain expertise; 2) or simply fine-tuning the whole model, which is extremely inefficient; 3) prompt tuning through parameterized prompt embeddings with the text encoder. Nevertheless, all methods rely on the text encoder for bridging the modality gap between vision and language. In this work, we question the necessity of the cumbersome text encoder for a more lightweight and efficient tuning paradigm as well as more representative prompt embeddings closer to the image representations. To achieve this, we propose a Concept Embedding Search (ConES) approach by optimizing prompt embeddings -- without the need of the text encoder -- to capture the 'concept' of the image modality through a variety of task objectives. By dropping the text encoder, we are able to significantly speed up the learning process, \eg, from about an hour to just ten minutes in our experiments for personalized text-to-image generation without impairing the generation quality. Moreover, our proposed approach is orthogonal to current existing tuning methods since the searched concept embeddings can be further utilized in the next stage of fine-tuning the pre-trained large models for boosting performance. Extensive experiments show that our approach can beat the prompt tuning and textual inversion methods in a variety of downstream tasks including objection detection, instance segmentation, and image generation. Our approach also shows better generalization capability for unseen concepts in specialized domains, such as the medical domain.

Lightweight Transformers for Clinical Natural Language Processing

Specialised pre-trained language models are becoming more frequent in NLP since they can potentially outperform models trained on generic texts. BioBERT and BioClinicalBERT are two examples of such models that have shown promise in medical NLP tasks. Many of these models are overparametrised and resource-intensive, but thanks to techniques like Knowledge Distillation (KD), it is possible to create smaller versions that perform almost as well as their larger counterparts. In this work, we specifically focus on development of compact language models for processing clinical texts (i.e. progress notes, discharge summaries etc). We developed a number of efficient lightweight clinical transformers using knowledge distillation and continual learning, with the number of parameters ranging from 15 million to 65 million. These models performed comparably to larger models such as BioBERT and ClinicalBioBERT and significantly outperformed other compact models trained on general or biomedical data. Our extensive evaluation was done across several standard datasets and covered a wide range of clinical text-mining tasks, including Natural Language Inference, Relation Extraction, Named Entity Recognition, and Sequence Classification. To our knowledge, this is the first comprehensive study specifically focused on creating efficient and compact transformers for clinical NLP tasks. The models and code used in this study can be found on our Huggingface profile at https://huggingface.co/nlpie and Github page at https://github.com/nlpie-research/Lightweight-Clinical-Transformers, respectively, promoting reproducibility of our results.

Enhancing Detail Preservation for Customized Text-to-Image Generation: A Regularization-Free Approach

Recent text-to-image generation models have demonstrated impressive capability of generating text-aligned images with high fidelity. However, generating images of novel concept provided by the user input image is still a challenging task. To address this problem, researchers have been exploring various methods for customizing pre-trained text-to-image generation models. Currently, most existing methods for customizing pre-trained text-to-image generation models involve the use of regularization techniques to prevent over-fitting. While regularization will ease the challenge of customization and leads to successful content creation with respect to text guidance, it may restrict the model capability, resulting in the loss of detailed information and inferior performance. In this work, we propose a novel framework for customized text-to-image generation without the use of regularization. Specifically, our proposed framework consists of an encoder network and a novel sampling method which can tackle the over-fitting problem without the use of regularization. With the proposed framework, we are able to customize a large-scale text-to-image generation model within half a minute on single GPU, with only one image provided by the user. We demonstrate in experiments that our proposed framework outperforms existing methods, and preserves more fine-grained details.

CRUD-RAG: A Comprehensive Chinese Benchmark for Retrieval-Augmented Generation of Large Language Models

Retrieval-Augmented Generation (RAG) is a technique that enhances the capabilities of large language models (LLMs) by incorporating external knowledge sources. This method addresses common LLM limitations, including outdated information and the tendency to produce inaccurate "hallucinated" content. However, the evaluation of RAG systems is challenging, as existing benchmarks are limited in scope and diversity. Most of the current benchmarks predominantly assess question-answering applications, overlooking the broader spectrum of situations where RAG could prove advantageous. Moreover, they only evaluate the performance of the LLM component of the RAG pipeline in the experiments, and neglect the influence of the retrieval component and the external knowledge database. To address these issues, this paper constructs a large-scale and more comprehensive benchmark, and evaluates all the components of RAG systems in various RAG application scenarios. Specifically, we have categorized the range of RAG applications into four distinct types-Create, Read, Update, and Delete (CRUD), each representing a unique use case. "Create" refers to scenarios requiring the generation of original, varied content. "Read" involves responding to intricate questions in knowledge-intensive situations. "Update" focuses on revising and rectifying inaccuracies or inconsistencies in pre-existing texts. "Delete" pertains to the task of summarizing extensive texts into more concise forms. For each of these CRUD categories, we have developed comprehensive datasets to evaluate the performance of RAG systems. We also analyze the effects of various components of the RAG system, such as the retriever, the context length, the knowledge base construction, and the LLM. Finally, we provide useful insights for optimizing the RAG technology for different scenarios.

Localising In-Domain Adaptation of Transformer-Based Biomedical Language Models

In the era of digital healthcare, the huge volumes of textual information generated every day in hospitals constitute an essential but underused asset that could be exploited with task-specific, fine-tuned biomedical language representation models, improving patient care and management. For such specialized domains, previous research has shown that fine-tuning models stemming from broad-coverage checkpoints can largely benefit additional training rounds over large-scale in-domain resources. However, these resources are often unreachable for less-resourced languages like Italian, preventing local medical institutions to employ in-domain adaptation. In order to reduce this gap, our work investigates two accessible approaches to derive biomedical language models in languages other than English, taking Italian as a concrete use-case: one based on neural machine translation of English resources, favoring quantity over quality; the other based on a high-grade, narrow-scoped corpus natively written in Italian, thus preferring quality over quantity. Our study shows that data quantity is a harder constraint than data quality for biomedical adaptation, but the concatenation of high-quality data can improve model performance even when dealing with relatively size-limited corpora. The models published from our investigations have the potential to unlock important research opportunities for Italian hospitals and academia. Finally, the set of lessons learned from the study constitutes valuable insights towards a solution to build biomedical language models that are generalizable to other less-resourced languages and different domain settings.

ClinLinker: Medical Entity Linking of Clinical Concept Mentions in Spanish

Advances in natural language processing techniques, such as named entity recognition and normalization to widely used standardized terminologies like UMLS or SNOMED-CT, along with the digitalization of electronic health records, have significantly advanced clinical text analysis. This study presents ClinLinker, a novel approach employing a two-phase pipeline for medical entity linking that leverages the potential of in-domain adapted language models for biomedical text mining: initial candidate retrieval using a SapBERT-based bi-encoder and subsequent re-ranking with a cross-encoder, trained by following a contrastive-learning strategy to be tailored to medical concepts in Spanish. This methodology, focused initially on content in Spanish, substantially outperforming multilingual language models designed for the same purpose. This is true even for complex scenarios involving heterogeneous medical terminologies and being trained on a subset of the original data. Our results, evaluated using top-k accuracy at 25 and other top-k metrics, demonstrate our approach's performance on two distinct clinical entity linking Gold Standard corpora, DisTEMIST (diseases) and MedProcNER (clinical procedures), outperforming previous benchmarks by 40 points in DisTEMIST and 43 points in MedProcNER, both normalized to SNOMED-CT codes. These findings highlight our approach's ability to address language-specific nuances and set a new benchmark in entity linking, offering a potent tool for enhancing the utility of digital medical records. The resulting system is of practical value, both for large scale automatic generation of structured data derived from clinical records, as well as for exhaustive extraction and harmonization of predefined clinical variables of interest.

Generating Synthetic Documents for Cross-Encoder Re-Rankers: A Comparative Study of ChatGPT and Human Experts

We investigate the usefulness of generative Large Language Models (LLMs) in generating training data for cross-encoder re-rankers in a novel direction: generating synthetic documents instead of synthetic queries. We introduce a new dataset, ChatGPT-RetrievalQA, and compare the effectiveness of models fine-tuned on LLM-generated and human-generated data. Data generated with generative LLMs can be used to augment training data, especially in domains with smaller amounts of labeled data. We build ChatGPT-RetrievalQA based on an existing dataset, human ChatGPT Comparison Corpus (HC3), consisting of public question collections with human responses and answers from ChatGPT. We fine-tune a range of cross-encoder re-rankers on either human-generated or ChatGPT-generated data. Our evaluation on MS MARCO DEV, TREC DL'19, and TREC DL'20 demonstrates that cross-encoder re-ranking models trained on ChatGPT responses are statistically significantly more effective zero-shot re-rankers than those trained on human responses. In a supervised setting, the human-trained re-rankers outperform the LLM-trained re-rankers. Our novel findings suggest that generative LLMs have high potential in generating training data for neural retrieval models. Further work is needed to determine the effect of factually wrong information in the generated responses and test our findings' generalizability with open-source LLMs. We release our data, code, and cross-encoders checkpoints for future work.

Large language models in healthcare and medical domain: A review

The deployment of large language models (LLMs) within the healthcare sector has sparked both enthusiasm and apprehension. These models exhibit the remarkable capability to provide proficient responses to free-text queries, demonstrating a nuanced understanding of professional medical knowledge. This comprehensive survey delves into the functionalities of existing LLMs designed for healthcare applications, elucidating the trajectory of their development, starting from traditional Pretrained Language Models (PLMs) to the present state of LLMs in healthcare sector. First, we explore the potential of LLMs to amplify the efficiency and effectiveness of diverse healthcare applications, particularly focusing on clinical language understanding tasks. These tasks encompass a wide spectrum, ranging from named entity recognition and relation extraction to natural language inference, multi-modal medical applications, document classification, and question-answering. Additionally, we conduct an extensive comparison of the most recent state-of-the-art LLMs in the healthcare domain, while also assessing the utilization of various open-source LLMs and highlighting their significance in healthcare applications. Furthermore, we present the essential performance metrics employed to evaluate LLMs in the biomedical domain, shedding light on their effectiveness and limitations. Finally, we summarize the prominent challenges and constraints faced by large language models in the healthcare sector, offering a holistic perspective on their potential benefits and shortcomings. This review provides a comprehensive exploration of the current landscape of LLMs in healthcare, addressing their role in transforming medical applications and the areas that warrant further research and development.

A Biomedical Entity Extraction Pipeline for Oncology Health Records in Portuguese

Textual health records of cancer patients are usually protracted and highly unstructured, making it very time-consuming for health professionals to get a complete overview of the patient's therapeutic course. As such limitations can lead to suboptimal and/or inefficient treatment procedures, healthcare providers would greatly benefit from a system that effectively summarizes the information of those records. With the advent of deep neural models, this objective has been partially attained for English clinical texts, however, the research community still lacks an effective solution for languages with limited resources. In this paper, we present the approach we developed to extract procedures, drugs, and diseases from oncology health records written in European Portuguese. This project was conducted in collaboration with the Portuguese Institute for Oncology which, besides holding over 10 years of duly protected medical records, also provided oncologist expertise throughout the development of the project. Since there is no annotated corpus for biomedical entity extraction in Portuguese, we also present the strategy we followed in annotating the corpus for the development of the models. The final models, which combined a neural architecture with entity linking, achieved F_1 scores of 88.6, 95.0, and 55.8 per cent in the mention extraction of procedures, drugs, and diseases, respectively.

xMEN: A Modular Toolkit for Cross-Lingual Medical Entity Normalization

Objective: To improve performance of medical entity normalization across many languages, especially when fewer language resources are available compared to English. Materials and Methods: We introduce xMEN, a modular system for cross-lingual medical entity normalization, which performs well in both low- and high-resource scenarios. When synonyms in the target language are scarce for a given terminology, we leverage English aliases via cross-lingual candidate generation. For candidate ranking, we incorporate a trainable cross-encoder model if annotations for the target task are available. We also evaluate cross-encoders trained in a weakly supervised manner based on machine-translated datasets from a high resource domain. Our system is publicly available as an extensible Python toolkit. Results: xMEN improves the state-of-the-art performance across a wide range of multilingual benchmark datasets. Weakly supervised cross-encoders are effective when no training data is available for the target task. Through the compatibility of xMEN with the BigBIO framework, it can be easily used with existing and prospective datasets. Discussion: Our experiments show the importance of balancing the output of general-purpose candidate generators with subsequent trainable re-rankers, which we achieve through a rank regularization term in the loss function of the cross-encoder. However, error analysis reveals that multi-word expressions and other complex entities are still challenging. Conclusion: xMEN exhibits strong performance for medical entity normalization in multiple languages, even when no labeled data and few terminology aliases for the target language are available. Its configuration system and evaluation modules enable reproducible benchmarks. Models and code are available online at the following URL: https://github.com/hpi-dhc/xmen

MedTrinity-25M: A Large-scale Multimodal Dataset with Multigranular Annotations for Medicine

This paper introduces MedTrinity-25M, a comprehensive, large-scale multimodal dataset for medicine, covering over 25 million images across 10 modalities, with multigranular annotations for more than 65 diseases. These enriched annotations encompass both global textual information, such as disease/lesion type, modality, region-specific descriptions, and inter-regional relationships, as well as detailed local annotations for regions of interest (ROIs), including bounding boxes, segmentation masks. Unlike existing approach which is limited by the availability of image-text pairs, we have developed the first automated pipeline that scales up multimodal data by generating multigranular visual and texual annotations (in the form of image-ROI-description triplets) without the need for any paired text descriptions. Specifically, data from over 90 different sources have been collected, preprocessed, and grounded using domain-specific expert models to identify ROIs related to abnormal regions. We then build a comprehensive knowledge base and prompt multimodal large language models to perform retrieval-augmented generation with the identified ROIs as guidance, resulting in multigranular texual descriptions. Compared to existing datasets, MedTrinity-25M provides the most enriched annotations, supporting a comprehensive range of multimodal tasks such as captioning and report generation, as well as vision-centric tasks like classification and segmentation. Pretraining on MedTrinity-25M, our model achieves state-of-the-art performance on VQA-RAD and PathVQA, surpassing both multimodal large language models and other representative SoTA approaches. This dataset can also be utilized to support large-scale pre-training of multimodal medical AI models, contributing to the development of future foundation models in the medical domain.

OCR Hinders RAG: Evaluating the Cascading Impact of OCR on Retrieval-Augmented Generation

Retrieval-augmented Generation (RAG) enhances Large Language Models (LLMs) by integrating external knowledge to reduce hallucinations and incorporate up-to-date information without retraining. As an essential part of RAG, external knowledge bases are commonly built by extracting structured data from unstructured PDF documents using Optical Character Recognition (OCR). However, given the imperfect prediction of OCR and the inherent non-uniform representation of structured data, knowledge bases inevitably contain various OCR noises. In this paper, we introduce OHRBench, the first benchmark for understanding the cascading impact of OCR on RAG systems. OHRBench includes 350 carefully selected unstructured PDF documents from six real-world RAG application domains, along with Q&As derived from multimodal elements in documents, challenging existing OCR solutions used for RAG To better understand OCR's impact on RAG systems, we identify two primary types of OCR noise: Semantic Noise and Formatting Noise and apply perturbation to generate a set of structured data with varying degrees of each OCR noise. Using OHRBench, we first conduct a comprehensive evaluation of current OCR solutions and reveal that none is competent for constructing high-quality knowledge bases for RAG systems. We then systematically evaluate the impact of these two noise types and demonstrate the vulnerability of RAG systems. Furthermore, we discuss the potential of employing Vision-Language Models (VLMs) without OCR in RAG systems. Code: https://github.com/opendatalab/OHR-Bench

CLIN-X: pre-trained language models and a study on cross-task transfer for concept extraction in the clinical domain

The field of natural language processing (NLP) has recently seen a large change towards using pre-trained language models for solving almost any task. Despite showing great improvements in benchmark datasets for various tasks, these models often perform sub-optimal in non-standard domains like the clinical domain where a large gap between pre-training documents and target documents is observed. In this paper, we aim at closing this gap with domain-specific training of the language model and we investigate its effect on a diverse set of downstream tasks and settings. We introduce the pre-trained CLIN-X (Clinical XLM-R) language models and show how CLIN-X outperforms other pre-trained transformer models by a large margin for ten clinical concept extraction tasks from two languages. In addition, we demonstrate how the transformer model can be further improved with our proposed task- and language-agnostic model architecture based on ensembles over random splits and cross-sentence context. Our studies in low-resource and transfer settings reveal stable model performance despite a lack of annotated data with improvements of up to 47 F1 points when only 250 labeled sentences are available. Our results highlight the importance of specialized language models as CLIN-X for concept extraction in non-standard domains, but also show that our task-agnostic model architecture is robust across the tested tasks and languages so that domain- or task-specific adaptations are not required.

Training Models to Extract Treatment Plans from Clinical Notes Using Contents of Sections with Headings

Objective: Using natural language processing (NLP) to find sentences that state treatment plans in a clinical note, would automate plan extraction and would further enable their use in tools that help providers and care managers. However, as in the most NLP tasks on clinical text, creating gold standard to train and test NLP models is tedious and expensive. Fortuitously, sometimes but not always clinical notes contain sections with a heading that identifies the section as a plan. Leveraging contents of such labeled sections as a noisy training data, we assessed accuracy of NLP models trained with the data. Methods: We used common variations of plan headings and rule-based heuristics to find plan sections with headings in clinical notes, and we extracted sentences from them and formed a noisy training data of plan sentences. We trained Support Vector Machine (SVM) and Convolutional Neural Network (CNN) models with the data. We measured accuracy of the trained models on the noisy dataset using ten-fold cross validation and separately on a set-aside manually annotated dataset. Results: About 13% of 117,730 clinical notes contained treatment plans sections with recognizable headings in the 1001 longitudinal patient records that were obtained from Cleveland Clinic under an IRB approval. We were able to extract and create a noisy training data of 13,492 plan sentences from the clinical notes. CNN achieved best F measures, 0.91 and 0.97 in the cross-validation and set-aside evaluation experiments respectively. SVM slightly underperformed with F measures of 0.89 and 0.96 in the same experiments. Conclusion: Our study showed that the training supervised learning models using noisy plan sentences was effective in identifying them in all clinical notes. More broadly, sections with informal headings in clinical notes can be a good source for generating effective training data.

OpenVid-1M: A Large-Scale High-Quality Dataset for Text-to-video Generation

Text-to-video (T2V) generation has recently garnered significant attention thanks to the large multi-modality model Sora. However, T2V generation still faces two important challenges: 1) Lacking a precise open sourced high-quality dataset. The previous popular video datasets, e.g. WebVid-10M and Panda-70M, are either with low quality or too large for most research institutions. Therefore, it is challenging but crucial to collect a precise high-quality text-video pairs for T2V generation. 2) Ignoring to fully utilize textual information. Recent T2V methods have focused on vision transformers, using a simple cross attention module for video generation, which falls short of thoroughly extracting semantic information from text prompt. To address these issues, we introduce OpenVid-1M, a precise high-quality dataset with expressive captions. This open-scenario dataset contains over 1 million text-video pairs, facilitating research on T2V generation. Furthermore, we curate 433K 1080p videos from OpenVid-1M to create OpenVidHD-0.4M, advancing high-definition video generation. Additionally, we propose a novel Multi-modal Video Diffusion Transformer (MVDiT) capable of mining both structure information from visual tokens and semantic information from text tokens. Extensive experiments and ablation studies verify the superiority of OpenVid-1M over previous datasets and the effectiveness of our MVDiT.