Open (Clinical) LLMs are Sensitive to Instruction Phrasings

Instruction-tuned Large Language Models (LLMs) can perform a wide range of tasks given natural language instructions to do so, but they are sensitive to how such instructions are phrased. This issue is especially concerning in healthcare, as clinicians are unlikely to be experienced prompt engineers and the potential consequences of inaccurate outputs are heightened in this domain. This raises a practical question: How robust are instruction-tuned LLMs to natural variations in the instructions provided for clinical NLP tasks? We collect prompts from medical doctors across a range of tasks and quantify the sensitivity of seven LLMs -- some general, others specialized -- to natural (i.e., non-adversarial) instruction phrasings. We find that performance varies substantially across all models, and that -- perhaps surprisingly -- domain-specific models explicitly trained on clinical data are especially brittle, compared to their general domain counterparts. Further, arbitrary phrasing differences can affect fairness, e.g., valid but distinct instructions for mortality prediction yield a range both in overall performance, and in terms of differences between demographic groups.

Detection and Measurement of Syntactic Templates in Generated Text

Recent work on evaluating the diversity of text generated by LLMs has focused on word-level features. Here we offer an analysis of syntactic features to characterize general repetition in models, beyond frequent n-grams. Specifically, we define syntactic templates and show that models tend to produce templated text in downstream tasks at a higher rate than what is found in human-reference texts. We find that most (76%) templates in model-generated text can be found in pre-training data (compared to only 35% of human-authored text), and are not overwritten during fine-tuning processes such as RLHF. This connection to the pre-training data allows us to analyze syntactic templates in models where we do not have the pre-training data. We also find that templates as features are able to differentiate between models, tasks, and domains, and are useful for qualitatively evaluating common model constructions. Finally, we demonstrate the use of templates as a useful tool for analyzing style memorization of training data in LLMs.

Investigating Mysteries of CoT-Augmented Distillation

Eliciting "chain of thought" (CoT) rationales -- sequences of token that convey a "reasoning" process -- has been shown to consistently improve LLM performance on tasks like question answering. More recent efforts have shown that such rationales can also be used for model distillation: Including CoT sequences (elicited from a large "teacher" model) in addition to target labels when fine-tuning a small student model yields (often substantial) improvements. In this work we ask: Why and how does this additional training signal help in model distillation? We perform ablations to interrogate this, and report some potentially surprising results. Specifically: (1) Placing CoT sequences after labels (rather than before) realizes consistently better downstream performance -- this means that no student "reasoning" is necessary at test time to realize gains. (2) When rationales are appended in this way, they need not be coherent reasoning sequences to yield improvements; performance increases are robust to permutations of CoT tokens, for example. In fact, (3) a small number of key tokens are sufficient to achieve improvements equivalent to those observed when full rationales are used in model distillation.

Learning from Natural Language Explanations for Generalizable Entity Matching

Entity matching is the task of linking records from different sources that refer to the same real-world entity. Past work has primarily treated entity linking as a standard supervised learning problem. However, supervised entity matching models often do not generalize well to new data, and collecting exhaustive labeled training data is often cost prohibitive. Further, recent efforts have adopted LLMs for this task in few/zero-shot settings, exploiting their general knowledge. But LLMs are prohibitively expensive for performing inference at scale for real-world entity matching tasks. As an efficient alternative, we re-cast entity matching as a conditional generation task as opposed to binary classification. This enables us to "distill" LLM reasoning into smaller entity matching models via natural language explanations. This approach achieves strong performance, especially on out-of-domain generalization tests (10.85% F-1) where standalone generative methods struggle. We perform ablations that highlight the importance of explanations, both for performance and model robustness.

Automatically Extracting Numerical Results from Randomized Controlled Trials with Large Language Models

Meta-analyses statistically aggregate the findings of different randomized controlled trials (RCTs) to assess treatment effectiveness. Because this yields robust estimates of treatment effectiveness, results from meta-analyses are considered the strongest form of evidence. However, rigorous evidence syntheses are time-consuming and labor-intensive, requiring manual extraction of data from individual trials to be synthesized. Ideally, language technologies would permit fully automatic meta-analysis, on demand. This requires accurately extracting numerical results from individual trials, which has been beyond the capabilities of natural language processing (NLP) models to date. In this work, we evaluate whether modern large language models (LLMs) can reliably perform this task. We annotate (and release) a modest but granular evaluation dataset of clinical trial reports with numerical findings attached to interventions, comparators, and outcomes. Using this dataset, we evaluate the performance of seven LLMs applied zero-shot for the task of conditionally extracting numerical findings from trial reports. We find that massive LLMs that can accommodate lengthy inputs are tantalizingly close to realizing fully automatic meta-analysis, especially for dichotomous (binary) outcomes (e.g., mortality). However, LLMs -- including ones trained on biomedical texts -- perform poorly when the outcome measures are complex and tallying the results requires inference. This work charts a path toward fully automatic meta-analysis of RCTs via LLMs, while also highlighting the limitations of existing models for this aim.

Standardizing the Measurement of Text Diversity: A Tool and a Comparative Analysis of Scores

The diversity across outputs generated by large language models shapes the perception of their quality and utility. Prompt leaks, templated answer structure, and canned responses across different interactions are readily noticed by people, but there is no standard score to measure this aspect of model behavior. In this work we empirically investigate diversity scores on English texts. We find that computationally efficient compression algorithms capture information similar to what is measured by slow to compute $n$-gram overlap homogeneity scores. Further, a combination of measures -- compression ratios, self-repetition of long $n$-grams and Self-BLEU and BERTScore -- are sufficient to report, as they have low mutual correlation with each other. The applicability of scores extends beyond analysis of generative models; for example, we highlight applications on instruction-tuning datasets and human-produced texts. We release a diversity score package to facilitate research and invite consistency across reports.

How Much Annotation is Needed to Compare Summarization Models?

Modern instruction-tuned models have become highly capable in text generation tasks such as summarization, and are expected to be released at a steady pace. In practice one may now wish to choose confidently, but with minimal effort, the best performing summarization model when applied to a new domain or purpose. In this work, we empirically investigate the test sample size necessary to select a preferred model in the context of news summarization. Empirical results reveal that comparative evaluation converges quickly for both automatic and human evaluation, with clear preferences for a system emerging from under 100 examples. The human preference data allows us to quantify how well automatic scores can reproduce preference rankings across a variety of downstream summarization tasks. We find that, while automatic metrics are stable at smaller sample sizes, only some automatic metrics are able to moderately predict model win rates according to human preference.

Leveraging ChatGPT in Pharmacovigilance Event Extraction: An Empirical Study

With the advent of large language models (LLMs), there has been growing interest in exploring their potential for medical applications. This research aims to investigate the ability of LLMs, specifically ChatGPT, in the context of pharmacovigilance event extraction, of which the main goal is to identify and extract adverse events or potential therapeutic events from textual medical sources. We conduct extensive experiments to assess the performance of ChatGPT in the pharmacovigilance event extraction task, employing various prompts and demonstration selection strategies. The findings demonstrate that while ChatGPT demonstrates reasonable performance with appropriate demonstration selection strategies, it still falls short compared to fully fine-tuned small models. Additionally, we explore the potential of leveraging ChatGPT for data augmentation. However, our investigation reveals that the inclusion of synthesized data into fine-tuning may lead to a decrease in performance, possibly attributed to noise in the ChatGPT-generated labels. To mitigate this, we explore different filtering strategies and find that, with the proper approach, more stable performance can be achieved, although constant improvement remains elusive.

GenAudit: Fixing Factual Errors in Language Model Outputs with Evidence

LLMs can generate factually incorrect statements even when provided access to reference documents. Such errors can be dangerous in high-stakes applications (e.g., document-grounded QA for healthcare or finance). We present GenAudit -- a tool intended to assist fact-checking LLM responses for document-grounded tasks. GenAudit suggests edits to the LLM response by revising or removing claims that are not supported by the reference document, and also presents evidence from the reference for facts that do appear to have support. We train models to execute these tasks, and design an interactive interface to present suggested edits and evidence to users. Comprehensive evaluation by human raters shows that GenAudit can detect errors in 8 different LLM outputs when summarizing documents from diverse domains. To ensure that most errors are flagged by the system, we propose a method that can increase the error recall while minimizing impact on precision. We will release our tool (GenAudit) and fact-checking model for public use.

Towards Reducing Diagnostic Errors with Interpretable Risk Prediction

Many diagnostic errors occur because clinicians cannot easily access relevant information in patient Electronic Health Records (EHRs). In this work we propose a method to use LLMs to identify pieces of evidence in patient EHR data that indicate increased or decreased risk of specific diagnoses; our ultimate aim is to increase access to evidence and reduce diagnostic errors. In particular, we propose a Neural Additive Model to make predictions backed by evidence with individualized risk estimates at time-points where clinicians are still uncertain, aiming to specifically mitigate delays in diagnosis and errors stemming from an incomplete differential. To train such a model, it is necessary to infer temporally fine-grained retrospective labels of eventual "true" diagnoses. We do so with LLMs, to ensure that the input text is from before a confident diagnosis can be made. We use an LLM to retrieve an initial pool of evidence, but then refine this set of evidence according to correlations learned by the model. We conduct an in-depth evaluation of the usefulness of our approach by simulating how it might be used by a clinician to decide between a pre-defined list of differential diagnoses.