Evaluation of General Large Language Models in Contextually Assessing Semantic Concepts Extracted from Adult Critical Care Electronic Health Record Notes

The field of healthcare has increasingly turned its focus towards Large Language Models (LLMs) due to their remarkable performance. However, their performance in actual clinical applications has been underexplored. Traditional evaluations based on question-answering tasks don't fully capture the nuanced contexts. This gap highlights the need for more in-depth and practical assessments of LLMs in real-world healthcare settings. Objective: We sought to evaluate the performance of LLMs in the complex clinical context of adult critical care medicine using systematic and comprehensible analytic methods, including clinician annotation and adjudication. Methods: We investigated the performance of three general LLMs in understanding and processing real-world clinical notes. Concepts from 150 clinical notes were identified by MetaMap and then labeled by 9 clinicians. Each LLM's proficiency was evaluated by identifying the temporality and negation of these concepts using different prompts for an in-depth analysis. Results: GPT-4 showed overall superior performance compared to other LLMs. In contrast, both GPT-3.5 and text-davinci-003 exhibit enhanced performance when the appropriate prompting strategies are employed. The GPT family models have demonstrated considerable efficiency, evidenced by their cost-effectiveness and time-saving capabilities. Conclusion: A comprehensive qualitative performance evaluation framework for LLMs is developed and operationalized. This framework goes beyond singular performance aspects. With expert annotations, this methodology not only validates LLMs' capabilities in processing complex medical data but also establishes a benchmark for future LLM evaluations across specialized domains.

Robustness of Object Recognition under Extreme Occlusion in Humans and Computational Models

Most objects in the visual world are partially occluded, but humans can recognize them without difficulty. However, it remains unknown whether object recognition models like convolutional neural networks (CNNs) can handle real-world occlusion. It is also a question whether efforts to make these models robust to constant mask occlusion are effective for real-world occlusion. We test both humans and the above-mentioned computational models in a challenging task of object recognition under extreme occlusion, where target objects are heavily occluded by irrelevant real objects in real backgrounds. Our results show that human vision is very robust to extreme occlusion while CNNs are not, even with modifications to handle constant mask occlusion. This implies that the ability to handle constant mask occlusion does not entail robustness to real-world occlusion. As a comparison, we propose another computational model that utilizes object parts/subparts in a compositional manner to build robustness to occlusion. This performs significantly better than CNN-based models on our task with error patterns similar to humans. These findings suggest that testing under extreme occlusion can better reveal the robustness of visual recognition, and that the principle of composition can encourage such robustness.