Daily Papers

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.

Daily progress notes are common types in the electronic health record (EHR) where healthcare providers document the patient's daily progress and treatment plans. The EHR is designed to document all the care provided to patients, but it also enables note bloat with extraneous information that distracts from the diagnoses and treatment plans. Applications of natural language processing (NLP) in the EHR is a growing field with the majority of methods in information extraction. Few tasks use NLP methods for downstream diagnostic decision support. We introduced the 2022 National NLP Clinical Challenge (N2C2) Track 3: Progress Note Understanding - Assessment and Plan Reasoning as one step towards a new suite of tasks. The Assessment and Plan Reasoning task focuses on the most critical components of progress notes, Assessment and Plan subsections where health problems and diagnoses are contained. The goal of the task was to develop and evaluate NLP systems that automatically predict causal relations between the overall status of the patient contained in the Assessment section and its relation to each component of the Plan section which contains the diagnoses and treatment plans. The goal of the task was to identify and prioritize diagnoses as the first steps in diagnostic decision support to find the most relevant information in long documents like daily progress notes. We present the results of 2022 n2c2 Track 3 and provide a description of the data, evaluation, participation and system performance.

A crucial step within secondary analysis of electronic health records (EHRs) is to identify the patient cohort under investigation. While EHRs contain medical billing codes that aim to represent the conditions and treatments patients may have, much of the information is only present in the patient notes. Therefore, it is critical to develop robust algorithms to infer patients' conditions and treatments from their written notes. In this paper, we introduce a dataset for patient phenotyping, a task that is defined as the identification of whether a patient has a given medical condition (also referred to as clinical indication or phenotype) based on their patient note. Nursing Progress Notes and Discharge Summaries from the Intensive Care Unit of a large tertiary care hospital were manually annotated for the presence of several high-context phenotypes relevant to treatment and risk of re-hospitalization. This dataset contains 1102 Discharge Summaries and 1000 Nursing Progress Notes. Each Discharge Summary and Progress Note has been annotated by at least two expert human annotators (one clinical researcher and one resident physician). Annotated phenotypes include treatment non-adherence, chronic pain, advanced/metastatic cancer, as well as 10 other phenotypes. This dataset can be utilized for academic and industrial research in medicine and computer science, particularly within the field of medical 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.

Objective: We develop a deep learning framework based on the pre-trained Bidirectional Encoder Representations from Transformers (BERT) model using unstructured clinical notes from electronic health records (EHRs) to predict the risk of disease progression from Mild Cognitive Impairment (MCI) to Alzheimer's Disease (AD). Materials and Methods: We identified 3657 patients diagnosed with MCI together with their progress notes from Northwestern Medicine Enterprise Data Warehouse (NMEDW) between 2000-2020. The progress notes no later than the first MCI diagnosis were used for the prediction. We first preprocessed the notes by deidentification, cleaning and splitting, and then pretrained a BERT model for AD (AD-BERT) based on the publicly available Bio+Clinical BERT on the preprocessed notes. The embeddings of all the sections of a patient's notes processed by AD-BERT were combined by MaxPooling to compute the probability of MCI-to-AD progression. For replication, we conducted a similar set of experiments on 2563 MCI patients identified at Weill Cornell Medicine (WCM) during the same timeframe. Results: Compared with the 7 baseline models, the AD-BERT model achieved the best performance on both datasets, with Area Under receiver operating characteristic Curve (AUC) of 0.8170 and F1 score of 0.4178 on NMEDW dataset and AUC of 0.8830 and F1 score of 0.6836 on WCM dataset. Conclusion: We developed a deep learning framework using BERT models which provide an effective solution for prediction of MCI-to-AD progression using clinical note analysis.

Sifting through vast textual data and summarizing key information imposes a substantial burden on how clinicians allocate their time. Although large language models (LLMs) have shown immense promise in natural language processing (NLP) tasks, their efficacy across diverse clinical summarization tasks has not yet been rigorously examined. In this work, we employ domain adaptation methods on eight LLMs, spanning six datasets and four distinct summarization tasks: radiology reports, patient questions, progress notes, and doctor-patient dialogue. Our thorough quantitative assessment reveals trade-offs between models and adaptation methods in addition to instances where recent advances in LLMs may not lead to improved results. Further, in a clinical reader study with six physicians, we depict that summaries from the best adapted LLM are preferable to human summaries in terms of completeness and correctness. Our ensuing qualitative analysis delineates mutual challenges faced by both LLMs and human experts. Lastly, we correlate traditional quantitative NLP metrics with reader study scores to enhance our understanding of how these metrics align with physician preferences. Our research marks the first evidence of LLMs outperforming human experts in clinical text summarization across multiple tasks. This implies that integrating LLMs into clinical workflows could alleviate documentation burden, empowering clinicians to focus more on personalized patient care and other irreplaceable human aspects of medicine.

Social and behavioral determinants of health (SDOH) play a significant role in shaping health outcomes, and extracting these determinants from clinical notes is a first step to help healthcare providers systematically identify opportunities to provide appropriate care and address disparities. Progress on using NLP methods for this task has been hindered by the lack of high-quality publicly available labeled data, largely due to the privacy and regulatory constraints on the use of real patients' information. This paper introduces a new dataset, SDOH-NLI, that is based on publicly available notes and which we release publicly. We formulate SDOH extraction as a natural language inference (NLI) task, and provide binary textual entailment labels obtained from human raters for a cross product of a set of social history snippets as premises and SDOH factors as hypotheses. Our dataset differs from standard NLI benchmarks in that our premises and hypotheses are obtained independently. We evaluate both "off-the-shelf" entailment models as well as models fine-tuned on our data, and highlight the ways in which our dataset appears more challenging than commonly used NLI datasets.

Generative models in vision have seen rapid progress due to algorithmic improvements and the availability of high-quality image datasets. In this paper, we offer contributions in both these areas to enable similar progress in audio modeling. First, we detail a powerful new WaveNet-style autoencoder model that conditions an autoregressive decoder on temporal codes learned from the raw audio waveform. Second, we introduce NSynth, a large-scale and high-quality dataset of musical notes that is an order of magnitude larger than comparable public datasets. Using NSynth, we demonstrate improved qualitative and quantitative performance of the WaveNet autoencoder over a well-tuned spectral autoencoder baseline. Finally, we show that the model learns a manifold of embeddings that allows for morphing between instruments, meaningfully interpolating in timbre to create new types of sounds that are realistic and expressive.

The discharge summary is a one of critical documents in the patient journey, encompassing all events experienced during hospitalization, including multiple visits, medications, tests, surgery/procedures, and admissions/discharge. Providing a summary of the patient's progress is crucial, as it significantly influences future care and planning. Consequently, clinicians face the laborious and resource-intensive task of manually collecting, organizing, and combining all the necessary data for a discharge summary. Therefore, we propose "NOTE", which stands for "Notable generation Of patient Text summaries through an Efficient approach based on direct preference optimization". NOTE is based on Medical Information Mart for Intensive Care- III dataset and summarizes a single hospitalization of a patient. Patient events are sequentially combined and used to generate a discharge summary for each hospitalization. In the present circumstances, large language models' application programming interfaces (LLMs' APIs) are widely available, but importing and exporting medical data presents significant challenges due to privacy protection policies in healthcare institutions. Moreover, to ensure optimal performance, it is essential to implement a lightweight model for internal server or program within the hospital. Therefore, we utilized DPO and parameter efficient fine tuning (PEFT) techniques to apply a fine-tuning method that guarantees superior performance. To demonstrate the practical application of the developed NOTE, we provide a webpage-based demonstration software. In the future, we will aim to deploy the software available for actual use by clinicians in hospital. NOTE can be utilized to generate various summaries not only discharge summaries but also throughout a patient's journey, thereby alleviating the labor-intensive workload of clinicians and aiming for increased efficiency.

In this work, we propose an approach for collecting completion usage logs from the users in an IDE and using them to train a machine learning based model for ranking completion candidates. We developed a set of features that describe completion candidates and their context, and deployed their anonymized collection in the Early Access Program of IntelliJ-based IDEs. We used the logs to collect a dataset of code completions from users, and employed it to train a ranking CatBoost model. Then, we evaluated it in two settings: on a held-out set of the collected completions and in a separate A/B test on two different groups of users in the IDE. Our evaluation shows that using a simple ranking model trained on the past user behavior logs significantly improved code completion experience. Compared to the default heuristics-based ranking, our model demonstrated a decrease in the number of typing actions necessary to perform the completion in the IDE from 2.073 to 1.832. The approach adheres to privacy requirements and legal constraints, since it does not require collecting personal information, performing all the necessary anonymization on the client's side. Importantly, it can be improved continuously: implementing new features, collecting new data, and evaluating new models - this way, we have been using it in production since the end of 2020.

We here summarize our experience running a challenge with open data for musical genre recognition. Those notes motivate the task and the challenge design, show some statistics about the submissions, and present the results.

This paper describes a service learning project used in an upper-level and graduate-level database systems course. Students complete a small database project for a real client. The final product must match the client specification and needs, and include the database design and the final working database system with embedded user documentation. The solution must be implemented in a way to make it as easy to use as possible for the client. Students are expected to conduct professional meetings with their clients to understand the project, analyze the project's requirements, as well as design and implement the solution to the project. Students must have each milestone approved before starting the next phase of the project. The student learning objectives of a database system semester project are to: analyze a client's information system problem and determine the requirements for the solution; design a suitable database solution to the problem; use software design and development tools to design and develop a solution to the problem; communicate and interact with a client on a professional level; prepare effective documentation for both non-technical and technical software users; and interact ethically with all persons involved with a project. The broader impact objectives of a database system semester project are to: provide needed database solutions for organizations and businesses in the local area; provide a resume and portfolio-building opportunity for the students; provide a measure for assessing how well the program meets it mission; provide a mechanism for implementing service-based learning; provide a mechanism for outreach to local-area organizations and businesses; and provide a starting-point for undergraduate research projects.

Scholarly writing presents a complex space that generally follows a methodical procedure to plan and produce both rationally sound and creative compositions. Recent works involving large language models (LLM) demonstrate considerable success in text generation and revision tasks; however, LLMs still struggle to provide structural and creative feedback on the document level that is crucial to academic writing. In this paper, we introduce a novel taxonomy that categorizes scholarly writing behaviors according to intention, writer actions, and the information types of the written data. We also provide ManuScript, an original dataset annotated with a simplified version of our taxonomy to show writer actions and the intentions behind them. Motivated by cognitive writing theory, our taxonomy for scientific papers includes three levels of categorization in order to trace the general writing flow and identify the distinct writer activities embedded within each higher-level process. ManuScript intends to provide a complete picture of the scholarly writing process by capturing the linearity and non-linearity of writing trajectory, such that writing assistants can provide stronger feedback and suggestions on an end-to-end level. The collected writing trajectories are viewed at https://minnesotanlp.github.io/REWARD_demo/

These are the notes for an undergraduate course at the University of Edinburgh, 2021-2023. Assuming basic knowledge of ring theory, group theory and linear algebra, the notes lay out the theory of field extensions and their Galois groups, up to and including the fundamental theorem of Galois theory. Also included are a section on ruler and compass constructions, a proof that solvable polynomials have solvable Galois groups, and the classification of finite fields.

Video has become a popular media form for information sharing and consumption. However, taking notes while watching a video requires significant time and effort. To address this, we propose a novel interactive system, NoTeeline, for taking real-time, personalized notes. NoTeeline lets users quickly jot down keypoints (micronotes), which are automatically expanded into full-fledged notes that capture the content of the user's micronotes and are consistent with the user's writing style. In a within-subjects study (N=12), we found that NoTeeline helps users create high-quality notes that capture the essence of their micronotes with a higher factual correctness (93.2%) while accurately reflecting their writing style. While using NoTeeline, participants experienced significantly reduced mental effort, captured satisfactory notes while writing 47% less text, and completed notetaking with 43.9% less time compared to a manual notetaking baseline.

This study explores the proactive ability of LLMs to seek user support. We propose metrics to evaluate the trade-off between performance improvements and user burden, and investigate whether LLMs can determine when to request help under varying information availability. Our experiments show that without external feedback, many LLMs struggle to recognize their need for user support. The findings highlight the importance of external signals and provide insights for future research on improving support-seeking strategies. Source code: https://github.com/appier-research/i-need-help

The unequal distribution of educational opportunities carries the risk of having a long-term negative impact on general social peace, a country's economy and basic democratic structures. In contrast to this observable development is the rapid technological progress in the field of artificial intelligence (AI). Progress makes it possible to solve various problems in the field of education as well. In order to effectively exploit the advantages that arise from the use of AI, prospective teacher training students need appropriate AI skills, which must already be taught during their studies. In a first step, the added value of this technology will be demonstrated using a concrete example. This article is therefore about conducting an exploratory pilot study to test the Individual Educational Chatbot (IEC-V1) prototype, in which the levels can be individually determined in order to generate appropriate answers depending on the requirements. The results show that this is an important function for prospective teachers, and that there is great interest in taking a closer look at this technology in order to be able to better support learners in the future. The data shows that experience has already been gained with chatbots, but that there is still room for improvement. It also shows that IEC-V1 is already working well. The knowledge gained will be used for the further development of the prototype to further improve the usability of the chatbot. Overall, it is shown that useful AI applications can be effectively integrated into learning situations even without proprietary systems and that important data protection requirements can be complied with.

Following each patient visit, physicians draft long semi-structured clinical summaries called SOAP notes. While invaluable to clinicians and researchers, creating digital SOAP notes is burdensome, contributing to physician burnout. In this paper, we introduce the first complete pipelines to leverage deep summarization models to generate these notes based on transcripts of conversations between physicians and patients. After exploring a spectrum of methods across the extractive-abstractive spectrum, we propose Cluster2Sent, an algorithm that (i) extracts important utterances relevant to each summary section; (ii) clusters together related utterances; and then (iii) generates one summary sentence per cluster. Cluster2Sent outperforms its purely abstractive counterpart by 8 ROUGE-1 points, and produces significantly more factual and coherent sentences as assessed by expert human evaluators. For reproducibility, we demonstrate similar benefits on the publicly available AMI dataset. Our results speak to the benefits of structuring summaries into sections and annotating supporting evidence when constructing summarization corpora.