Unified Chest X-ray and Radiology Report Generation Model with Multi-view Chest X-rays

Generated synthetic data in medical research can substitute privacy and security-sensitive data with a large-scale curated dataset, reducing data collection and annotation costs. As part of this effort, we propose UniXGen, a unified chest X-ray and report generation model, with the following contributions. First, we design a unified model for bidirectional chest X-ray and report generation by adopting a vector quantization method to discretize chest X-rays into discrete visual tokens and formulating both tasks as sequence generation tasks. Second, we introduce several special tokens to generate chest X-rays with specific views that can be useful when the desired views are unavailable. Furthermore, UniXGen can flexibly take various inputs from single to multiple views to take advantage of the additional findings available in other X-ray views. We adopt an efficient transformer for computational and memory efficiency to handle the long-range input sequence of multi-view chest X-rays with high resolution and long paragraph reports. In extensive experiments, we show that our unified model has a synergistic effect on both generation tasks, as opposed to training only the task-specific models. We also find that view-specific special tokens can distinguish between different views and properly generate specific views even if they do not exist in the dataset, and utilizing multi-view chest X-rays can faithfully capture the abnormal findings in the additional X-rays. The source code is publicly available at: https://github.com/ttumyche/UniXGen.

Deep Imbalanced Time-series Forecasting via Local Discrepancy Density

Time-series forecasting models often encounter abrupt changes in a given period of time which generally occur due to unexpected or unknown events. Despite their scarce occurrences in the training set, abrupt changes incur loss that significantly contributes to the total loss. Therefore, they act as noisy training samples and prevent the model from learning generalizable patterns, namely the normal states. Based on our findings, we propose a reweighting framework that down-weights the losses incurred by abrupt changes and up-weights those by normal states. For the reweighting framework, we first define a measurement termed Local Discrepancy (LD) which measures the degree of abruptness of a change in a given period of time. Since a training set is mostly composed of normal states, we then consider how frequently the temporal changes appear in the training set based on LD. Our reweighting framework is applicable to existing time-series forecasting models regardless of the architectures. Through extensive experiments on 12 time-series forecasting models over eight datasets with various in-output sequence lengths, we demonstrate that applying our reweighting framework reduces MSE by 10.1% on average and by up to 18.6% in the state-of-the-art model.

EHRSQL: A Practical Text-to-SQL Benchmark for Electronic Health Records

We present a new text-to-SQL dataset for electronic health records (EHRs). The utterances were collected from 222 hospital staff, including physicians, nurses, insurance review and health records teams, and more. To construct the QA dataset on structured EHR data, we conducted a poll at a university hospital and templatized the responses to create seed questions. Then, we manually linked them to two open-source EHR databases, MIMIC-III and eICU, and included them with various time expressions and held-out unanswerable questions in the dataset, which were all collected from the poll. Our dataset poses a unique set of challenges: the model needs to 1) generate SQL queries that reflect a wide range of needs in the hospital, including simple retrieval and complex operations such as calculating survival rate, 2) understand various time expressions to answer time-sensitive questions in healthcare, and 3) distinguish whether a given question is answerable or unanswerable based on the prediction confidence. We believe our dataset, EHRSQL, could serve as a practical benchmark to develop and assess QA models on structured EHR data and take one step further towards bridging the gap between text-to-SQL research and its real-life deployment in healthcare. EHRSQL is available at https://github.com/glee4810/EHRSQL.

Significantly improving zero-shot X-ray pathology classification via fine-tuning pre-trained image-text encoders

Deep neural networks have been successfully adopted to diverse domains including pathology classification based on medical images. However, large-scale and high-quality data to train powerful neural networks are rare in the medical domain as the labeling must be done by qualified experts. Researchers recently tackled this problem with some success by taking advantage of models pre-trained on large-scale general domain data. Specifically, researchers took contrastive image-text encoders (e.g., CLIP) and fine-tuned it with chest X-ray images and paired reports to perform zero-shot pathology classification, thus completely removing the need for pathology-annotated images to train a classification model. Existing studies, however, fine-tuned the pre-trained model with the same contrastive learning objective, and failed to exploit the multi-labeled nature of medical image-report pairs. In this paper, we propose a new fine-tuning strategy based on sentence sampling and positive-pair loss relaxation for improving the downstream zero-shot pathology classification performance, which can be applied to any pre-trained contrastive image-text encoders. Our method consistently showed dramatically improved zero-shot pathology classification performance on four different chest X-ray datasets and 3 different pre-trained models (5.77% average AUROC increase). In particular, fine-tuning CLIP with our method showed much comparable or marginally outperformed to board-certified radiologists (0.619 vs 0.625 in F1 score and 0.530 vs 0.544 in MCC) in zero-shot classification of five prominent diseases from the CheXpert dataset.

UniHPF : Universal Healthcare Predictive Framework with Zero Domain Knowledge

Despite the abundance of Electronic Healthcare Records (EHR), its heterogeneity restricts the utilization of medical data in building predictive models. To address this challenge, we propose Universal Healthcare Predictive Framework (UniHPF), which requires no medical domain knowledge and minimal pre-processing for multiple prediction tasks. Experimental results demonstrate that UniHPF is capable of building large-scale EHR models that can process any form of medical data from distinct EHR systems. We believe that our findings can provide helpful insights for further research on the multi-source learning of EHRs.

Universal EHR Federated Learning Framework

Federated learning (FL) is the most practical multi-source learning method for electronic healthcare records (EHR). Despite its guarantee of privacy protection, the wide application of FL is restricted by two large challenges: the heterogeneous EHR systems, and the non-i.i.d. data characteristic. A recent research proposed a framework that unifies heterogeneous EHRs, named UniHPF. We attempt to address both the challenges simultaneously by combining UniHPF and FL. Our study is the first approach to unify heterogeneous EHRs into a single FL framework. This combination provides an average of 3.4% performance gain compared to local learning. We believe that our framework is practically applicable in the real-world FL.

Self-supervised predictive coding and multimodal fusion advance patient deterioration prediction in fine-grained time resolution

In the Emergency Department (ED), accurate prediction of critical events using Electronic Health Records (EHR) allows timely intervention and effective resource allocation. Though many studies have suggested automatic prediction methods, their coarse-grained time resolutions limit their practical usage. Therefore, in this study, we propose an hourly prediction method of critical events in ED, i.e., mortality and vasopressor need. Through extensive experiments, we show that both 1) bi-modal fusion between EHR text and time-series data and 2) self-supervised predictive regularization using L2 loss between normalized context vector and EHR future time-series data improve predictive performance, especially the far-future prediction. Our uni-modal/bi-modal/bi-modal self-supervision scored 0.846/0.877/0.897 (0.824/0.855/0.886) and 0.817/0.820/0.858 (0.807/0.81/0.855) with mortality (far-future mortality) and with vasopressor need (far-future vasopressor need) prediction data in AUROC, respectively.

Specializing Multi-domain NMT via Penalizing Low Mutual Information

Multi-domain Neural Machine Translation (NMT) trains a single model with multiple domains. It is appealing because of its efficacy in handling multiple domains within one model. An ideal multi-domain NMT should learn distinctive domain characteristics simultaneously, however, grasping the domain peculiarity is a non-trivial task. In this paper, we investigate domain-specific information through the lens of mutual information (MI) and propose a new objective that penalizes low MI to become higher. Our method achieved the state-of-the-art performance among the current competitive multi-domain NMT models. Also, we empirically show our objective promotes low MI to be higher resulting in domain-specialized multi-domain NMT.

Do Language Models Understand Measurements?

Recent success of pre-trained language models (PLMs) has stimulated interest in their ability to understand and work with numbers. Yet, the numerical reasoning over measurements has not been formally studied despite their importance. In this study, we show that PLMs lack the capability required for reasoning over measurements. Furthermore, we find that a language model trained on a measurement-rich corpus shows better performance on understanding measurements. We propose a simple embedding strategy to better distinguish between numbers and units, which leads to a significant improvement in the probing tasks.

Correlation between Alignment-Uniformity and Performance of Dense Contrastive Representations

Recently, dense contrastive learning has shown superior performance on dense prediction tasks compared to instance-level contrastive learning. Despite its supremacy, the properties of dense contrastive representations have not yet been carefully studied. Therefore, we analyze the theoretical ideas of dense contrastive learning using a standard CNN and straightforward feature matching scheme rather than propose a new complex method. Inspired by the analysis of the properties of instance-level contrastive representations through the lens of alignment and uniformity on the hypersphere, we employ and extend the same lens for the dense contrastive representations to analyze their underexplored properties. We discover the core principle in constructing a positive pair of dense features and empirically proved its validity. Also, we introduces a new scalar metric that summarizes the correlation between alignment-and-uniformity and downstream performance. Using this metric, we study various facets of densely learned contrastive representations such as how the correlation changes over single- and multi-object datasets or linear evaluation and dense prediction tasks. The source code is publicly available at: https://github.com/SuperSupermoon/DenseCL-analysis