Towards Generalist Biomedical AI

Medicine is inherently multimodal, with rich data modalities spanning text, imaging, genomics, and more. Generalist biomedical artificial intelligence (AI) systems that flexibly encode, integrate, and interpret this data at scale can potentially enable impactful applications ranging from scientific discovery to care delivery. To enable the development of these models, we first curate MultiMedBench, a new multimodal biomedical benchmark. MultiMedBench encompasses 14 diverse tasks such as medical question answering, mammography and dermatology image interpretation, radiology report generation and summarization, and genomic variant calling. We then introduce Med-PaLM Multimodal (Med-PaLM M), our proof of concept for a generalist biomedical AI system. Med-PaLM M is a large multimodal generative model that flexibly encodes and interprets biomedical data including clinical language, imaging, and genomics with the same set of model weights. Med-PaLM M reaches performance competitive with or exceeding the state of the art on all MultiMedBench tasks, often surpassing specialist models by a wide margin. We also report examples of zero-shot generalization to novel medical concepts and tasks, positive transfer learning across tasks, and emergent zero-shot medical reasoning. To further probe the capabilities and limitations of Med-PaLM M, we conduct a radiologist evaluation of model-generated (and human) chest X-ray reports and observe encouraging performance across model scales. In a side-by-side ranking on 246 retrospective chest X-rays, clinicians express a pairwise preference for Med-PaLM M reports over those produced by radiologists in up to 40.50% of cases, suggesting potential clinical utility. While considerable work is needed to validate these models in real-world use cases, our results represent a milestone towards the development of generalist biomedical AI systems.

PaLM 2 Technical Report

We introduce PaLM 2, a new state-of-the-art language model that has better multilingual and reasoning capabilities and is more compute-efficient than its predecessor PaLM. PaLM 2 is a Transformer-based model trained using a mixture of objectives. Through extensive evaluations on English and multilingual language, and reasoning tasks, we demonstrate that PaLM 2 has significantly improved quality on downstream tasks across different model sizes, while simultaneously exhibiting faster and more efficient inference compared to PaLM. This improved efficiency enables broader deployment while also allowing the model to respond faster, for a more natural pace of interaction. PaLM 2 demonstrates robust reasoning capabilities exemplified by large improvements over PaLM on BIG-Bench and other reasoning tasks. PaLM 2 exhibits stable performance on a suite of responsible AI evaluations, and enables inference-time control over toxicity without additional overhead or impact on other capabilities. Overall, PaLM 2 achieves state-of-the-art performance across a diverse set of tasks and capabilities. When discussing the PaLM 2 family, it is important to distinguish between pre-trained models (of various sizes), fine-tuned variants of these models, and the user-facing products that use these models. In particular, user-facing products typically include additional pre- and post-processing steps. Additionally, the underlying models may evolve over time. Therefore, one should not expect the performance of user-facing products to exactly match the results reported in this report.

PaLM-E: An Embodied Multimodal Language Model

Large language models excel at a wide range of complex tasks. However, enabling general inference in the real world, e.g., for robotics problems, raises the challenge of grounding. We propose embodied language models to directly incorporate real-world continuous sensor modalities into language models and thereby establish the link between words and percepts. Input to our embodied language model are multi-modal sentences that interleave visual, continuous state estimation, and textual input encodings. We train these encodings end-to-end, in conjunction with a pre-trained large language model, for multiple embodied tasks including sequential robotic manipulation planning, visual question answering, and captioning. Our evaluations show that PaLM-E, a single large embodied multimodal model, can address a variety of embodied reasoning tasks, from a variety of observation modalities, on multiple embodiments, and further, exhibits positive transfer: the model benefits from diverse joint training across internet-scale language, vision, and visual-language domains. Our largest model, PaLM-E-562B with 562B parameters, in addition to being trained on robotics tasks, is a visual-language generalist with state-of-the-art performance on OK-VQA, and retains generalist language capabilities with increasing scale.

Large Language Models Encode Clinical Knowledge

Large language models (LLMs) have demonstrated impressive capabilities in natural language understanding and generation, but the quality bar for medical and clinical applications is high. Today, attempts to assess models' clinical knowledge typically rely on automated evaluations on limited benchmarks. There is no standard to evaluate model predictions and reasoning across a breadth of tasks. To address this, we present MultiMedQA, a benchmark combining six existing open question answering datasets spanning professional medical exams, research, and consumer queries; and HealthSearchQA, a new free-response dataset of medical questions searched online. We propose a framework for human evaluation of model answers along multiple axes including factuality, precision, possible harm, and bias. In addition, we evaluate PaLM (a 540-billion parameter LLM) and its instruction-tuned variant, Flan-PaLM, on MultiMedQA. Using a combination of prompting strategies, Flan-PaLM achieves state-of-the-art accuracy on every MultiMedQA multiple-choice dataset (MedQA, MedMCQA, PubMedQA, MMLU clinical topics), including 67.6% accuracy on MedQA (US Medical License Exam questions), surpassing prior state-of-the-art by over 17%. However, human evaluation reveals key gaps in Flan-PaLM responses. To resolve this we introduce instruction prompt tuning, a parameter-efficient approach for aligning LLMs to new domains using a few exemplars. The resulting model, Med-PaLM, performs encouragingly, but remains inferior to clinicians. We show that comprehension, recall of knowledge, and medical reasoning improve with model scale and instruction prompt tuning, suggesting the potential utility of LLMs in medicine. Our human evaluations reveal important limitations of today's models, reinforcing the importance of both evaluation frameworks and method development in creating safe, helpful LLM models for clinical applications.

Efficiently Scaling Transformer Inference

We study the problem of efficient generative inference for Transformer models, in one of its most challenging settings: large deep models, with tight latency targets and long sequence lengths. Better understanding of the engineering tradeoffs for inference for large Transformer-based models is important as use cases of these models are growing rapidly throughout application areas. We develop a simple analytical model for inference efficiency to select the best multi-dimensional partitioning techniques optimized for TPU v4 slices based on the application requirements. We combine these with a suite of low-level optimizations to achieve a new Pareto frontier on the latency and model FLOPS utilization (MFU) tradeoffs on 500B+ parameter models that outperforms the FasterTransformer suite of benchmarks. We further show that with appropriate partitioning, the lower memory requirements of multiquery attention (i.e. multiple query heads share single key/value head) enables scaling up to 32x larger context lengths. Finally, we achieve a low-batch-size latency of 29ms per token during generation (using int8 weight quantization) and a 76% MFU during large-batch-size processing of input tokens, while supporting a long 2048-token context length on the PaLM 540B parameter model.

Scaling Instruction-Finetuned Language Models

Finetuning language models on a collection of datasets phrased as instructions has been shown to improve model performance and generalization to unseen tasks. In this paper we explore instruction finetuning with a particular focus on (1) scaling the number of tasks, (2) scaling the model size, and (3) finetuning on chain-of-thought data. We find that instruction finetuning with the above aspects dramatically improves performance on a variety of model classes (PaLM, T5, U-PaLM), prompting setups (zero-shot, few-shot, CoT), and evaluation benchmarks (MMLU, BBH, TyDiQA, MGSM, open-ended generation). For instance, Flan-PaLM 540B instruction-finetuned on 1.8K tasks outperforms PALM 540B by a large margin (+9.4% on average). Flan-PaLM 540B achieves state-of-the-art performance on several benchmarks, such as 75.2% on five-shot MMLU. We also publicly release Flan-T5 checkpoints, which achieve strong few-shot performance even compared to much larger models, such as PaLM 62B. Overall, instruction finetuning is a general method for improving the performance and usability of pretrained language models.

Transcending Scaling Laws with 0.1% Extra Compute

Scaling language models improves performance but comes with significant computational costs. This paper proposes UL2R, a method that substantially improves existing language models and their scaling curves with a relatively tiny amount of extra compute. The key idea is to continue training a state-of-the-art large language model (e.g., PaLM) on a few more steps with UL2's mixture-of-denoiser objective. We show that, with almost negligible extra computational costs and no new sources of data, we are able to substantially improve the scaling properties of large language models on downstream metrics. In this paper, we continue training PaLM with UL2R, introducing a new set of models at 8B, 62B, and 540B scale which we call U-PaLM. Impressively, at 540B scale, we show an approximately 2x computational savings rate where U-PaLM achieves the same performance as the final PaLM 540B model at around half its computational budget (i.e., saving $\sim$4.4 million TPUv4 hours). We further show that this improved scaling curve leads to 'emergent abilities' on challenging BIG-Bench tasks -- for instance, U-PaLM does much better than PaLM on some tasks or demonstrates better quality at much smaller scale (62B as opposed to 540B). Overall, we show that U-PaLM outperforms PaLM on many few-shot setups, i.e., English NLP tasks (e.g., commonsense reasoning, question answering), reasoning tasks with chain-of-thought (e.g., GSM8K), multilingual tasks (MGSM, TydiQA), MMLU and challenging BIG-Bench tasks. Finally, we provide qualitative examples showing the new capabilities of U-PaLM for single and multi-span infilling.

Challenging BIG-Bench Tasks and Whether Chain-of-Thought Can Solve Them

BIG-Bench (Srivastava et al., 2022) is a diverse evaluation suite that focuses on tasks believed to be beyond the capabilities of current language models. Language models have already made good progress on this benchmark, with the best model in the BIG-Bench paper outperforming average reported human-rater results on 65% of the BIG-Bench tasks via few-shot prompting. But on what tasks do language models fall short of average human-rater performance, and are those tasks actually unsolvable by current language models? In this work, we focus on a suite of 23 challenging BIG-Bench tasks which we call BIG-Bench Hard (BBH). These are the task for which prior language model evaluations did not outperform the average human-rater. We find that applying chain-of-thought (CoT) prompting to BBH tasks enables PaLM to surpass the average human-rater performance on 10 of the 23 tasks, and Codex (code-davinci-002) to surpass the average human-rater performance on 17 of the 23 tasks. Since many tasks in BBH require multi-step reasoning, few-shot prompting without CoT, as done in the BIG-Bench evaluations (Srivastava et al., 2022), substantially underestimates the best performance and capabilities of language models, which is better captured via CoT prompting. As further analysis, we explore the interaction between CoT and model scale on BBH, finding that CoT enables emergent task performance on several BBH tasks with otherwise flat scaling curves.

Understanding HTML with Large Language Models

Large language models (LLMs) have shown exceptional performance on a variety of natural language tasks. Yet, their capabilities for HTML understanding -- i.e., parsing the raw HTML of a webpage, with applications to automation of web-based tasks, crawling, and browser-assisted retrieval -- have not been fully explored. We contribute HTML understanding models (fine-tuned LLMs) and an in-depth analysis of their capabilities under three tasks: (i) Semantic Classification of HTML elements, (ii) Description Generation for HTML inputs, and (iii) Autonomous Web Navigation of HTML pages. While previous work has developed dedicated architectures and training procedures for HTML understanding, we show that LLMs pretrained on standard natural language corpora transfer remarkably well to HTML understanding tasks. For instance, fine-tuned LLMs are 12% more accurate at semantic classification compared to models trained exclusively on the task dataset. Moreover, when fine-tuned on data from the MiniWoB benchmark, LLMs successfully complete 50% more tasks using 192x less data compared to the previous best supervised model. Out of the LLMs we evaluate, we show evidence that T5-based models are ideal due to their bidirectional encoder-decoder architecture. To promote further research on LLMs for HTML understanding, we create and open-source a large-scale HTML dataset distilled and auto-labeled from CommonCrawl.

PaLM: Scaling Language Modeling with Pathways

Large language models have been shown to achieve remarkable performance across a variety of natural language tasks using few-shot learning, which drastically reduces the number of task-specific training examples needed to adapt the model to a particular application. To further our understanding of the impact of scale on few-shot learning, we trained a 540-billion parameter, densely activated, Transformer language model, which we call Pathways Language Model PaLM. We trained PaLM on 6144 TPU v4 chips using Pathways, a new ML system which enables highly efficient training across multiple TPU Pods. We demonstrate continued benefits of scaling by achieving state-of-the-art few-shot learning results on hundreds of language understanding and generation benchmarks. On a number of these tasks, PaLM 540B achieves breakthrough performance, outperforming the finetuned state-of-the-art on a suite of multi-step reasoning tasks, and outperforming average human performance on the recently released BIG-bench benchmark. A significant number of BIG-bench tasks showed discontinuous improvements from model scale, meaning that performance steeply increased as we scaled to our largest model. PaLM also has strong capabilities in multilingual tasks and source code generation, which we demonstrate on a wide array of benchmarks. We additionally provide a comprehensive analysis on bias and toxicity, and study the extent of training data memorization with respect to model scale. Finally, we discuss the ethical considerations related to large language models and discuss potential mitigation strategies.