M-QALM: A Benchmark to Assess Clinical Reading Comprehension and Knowledge Recall in Large Language Models via Question Answering

There is vivid research on adapting Large Language Models (LLMs) to perform a variety of tasks in high-stakes domains such as healthcare. Despite their popularity, there is a lack of understanding of the extent and contributing factors that allow LLMs to recall relevant knowledge and combine it with presented information in the clinical and biomedical domain: a fundamental pre-requisite for success on down-stream tasks. Addressing this gap, we use Multiple Choice and Abstractive Question Answering to conduct a large-scale empirical study on 22 datasets in three generalist and three specialist biomedical sub-domains. Our multifaceted analysis of the performance of 15 LLMs, further broken down by sub-domain, source of knowledge and model architecture, uncovers success factors such as instruction tuning that lead to improved recall and comprehension. We further show that while recently proposed domain-adapted models may lack adequate knowledge, directly fine-tuning on our collected medical knowledge datasets shows encouraging results, even generalising to unseen specialist sub-domains. We complement the quantitative results with a skill-oriented manual error analysis, which reveals a significant gap between the models' capabilities to simply recall necessary knowledge and to integrate it with the presented context. To foster research and collaboration in this field we share M-QALM, our resources, standardised methodology, and evaluation results, with the research community to facilitate further advancements in clinical knowledge representation learning within language models.

Automated Clinical Coding for Outpatient Departments

Computerised clinical coding approaches aim to automate the process of assigning a set of codes to medical records. While there is active research pushing the state of the art on clinical coding for hospitalized patients, the outpatient setting -- where doctors tend to non-hospitalised patients -- is overlooked. Although both settings can be formalised as a multi-label classification task, they present unique and distinct challenges, which raises the question of whether the success of inpatient clinical coding approaches translates to the outpatient setting. This paper is the first to investigate how well state-of-the-art deep learning-based clinical coding approaches work in the outpatient setting at hospital scale. To this end, we collect a large outpatient dataset comprising over 7 million notes documenting over half a million patients. We adapt four state-of-the-art clinical coding approaches to this setting and evaluate their potential to assist coders. We find evidence that clinical coding in outpatient settings can benefit from more innovations in popular inpatient coding benchmarks. A deeper analysis of the factors contributing to the success -- amount and form of data and choice of document representation -- reveals the presence of easy-to-solve examples, the coding of which can be completely automated with a low error rate.

MetaWeather: Few-Shot Weather-Degraded Image Restoration via Degradation Pattern Matching

Real-world vision tasks frequently suffer from the appearance of adverse weather conditions including rain, fog, snow, and raindrops in captured images. Recently, several generic methods for restoring weather-degraded images have been proposed, aiming to remove multiple types of adverse weather effects present in the images. However, these methods have considered weather as discrete and mutually exclusive variables, leading to failure in generalizing to unforeseen weather conditions beyond the scope of the training data, such as the co-occurrence of rain, fog, and raindrops. To this end, weather-degraded image restoration models should have flexible adaptability to the current unknown weather condition to ensure reliable and optimal performance. The adaptation method should also be able to cope with data scarcity for real-world adaptation. This paper proposes MetaWeather, a few-shot weather-degraded image restoration method for arbitrary weather conditions. For this, we devise the core piece of MetaWeather, coined Degradation Pattern Matching Module (DPMM), which leverages representations from a few-shot support set by matching features between input and sample images under new weather conditions. In addition, we build meta-knowledge with episodic meta-learning on top of our MetaWeather architecture to provide flexible adaptability. In the meta-testing phase, we adopt a parameter-efficient fine-tuning method to preserve the prebuilt knowledge and avoid the overfitting problem. Experiments on the BID Task II.A dataset show our method achieves the best performance on PSNR and SSIM compared to state-of-the-art image restoration methods. Code is available at (TBA).

PULSAR at MEDIQA-Sum 2023: Large Language Models Augmented by Synthetic Dialogue Convert Patient Dialogues to Medical Records

This paper describes PULSAR, our system submission at the ImageClef 2023 MediQA-Sum task on summarising patient-doctor dialogues into clinical records. The proposed framework relies on domain-specific pre-training, to produce a specialised language model which is trained on task-specific natural data augmented by synthetic data generated by a black-box LLM. We find limited evidence towards the efficacy of domain-specific pre-training and data augmentation, while scaling up the language model yields the best performance gains. Our approach was ranked second and third among 13 submissions on task B of the challenge. Our code is available at https://github.com/yuping-wu/PULSAR.

PULSAR: Pre-training with Extracted Healthcare Terms for Summarising Patients' Problems and Data Augmentation with Black-box Large Language Models

Medical progress notes play a crucial role in documenting a patient's hospital journey, including his or her condition, treatment plan, and any updates for healthcare providers. Automatic summarisation of a patient's problems in the form of a problem list can aid stakeholders in understanding a patient's condition, reducing workload and cognitive bias. BioNLP 2023 Shared Task 1A focuses on generating a list of diagnoses and problems from the provider's progress notes during hospitalisation. In this paper, we introduce our proposed approach to this task, which integrates two complementary components. One component employs large language models (LLMs) for data augmentation; the other is an abstractive summarisation LLM with a novel pre-training objective for generating the patients' problems summarised as a list. Our approach was ranked second among all submissions to the shared task. The performance of our model on the development and test datasets shows that our approach is more robust on unknown data, with an improvement of up to 3.1 points over the same size of the larger model.

A Two-Stage Decoder for Efficient ICD Coding

Clinical notes in healthcare facilities are tagged with the International Classification of Diseases (ICD) code; a list of classification codes for medical diagnoses and procedures. ICD coding is a challenging multilabel text classification problem due to noisy clinical document inputs and long-tailed label distribution. Recent automated ICD coding efforts improve performance by encoding medical notes and codes with additional data and knowledge bases. However, most of them do not reflect how human coders generate the code: first, the coders select general code categories and then look for specific subcategories that are relevant to a patient's condition. Inspired by this, we propose a two-stage decoding mechanism to predict ICD codes. Our model uses the hierarchical properties of the codes to split the prediction into two steps: At first, we predict the parent code and then predict the child code based on the previous prediction. Experiments on the public MIMIC-III data set show that our model performs well in single-model settings without external data or knowledge.

Beyond Words: A Comprehensive Survey of Sentence Representations

Sentence representations have become a critical component in natural language processing applications, such as retrieval, question answering, and text classification. They capture the semantics and meaning of a sentence, enabling machines to understand and reason over human language. In recent years, significant progress has been made in developing methods for learning sentence representations, including unsupervised, supervised, and transfer learning approaches. In this paper, we provide an overview of the different methods for sentence representation learning, including both traditional and deep learning-based techniques. We provide a systematic organization of the literature on sentence representation learning, highlighting the key contributions and challenges in this area. Overall, our review highlights the progress made in sentence representation learning, the importance of this area in natural language processing, and the challenges that remain. We conclude with directions for future research, suggesting potential avenues for improving the quality and efficiency of sentence representations in NLP applications.

Mimic-IV-ICD: A new benchmark for eXtreme MultiLabel Classification

Clinical notes are assigned ICD codes - sets of codes for diagnoses and procedures. In the recent years, predictive machine learning models have been built for automatic ICD coding. However, there is a lack of widely accepted benchmarks for automated ICD coding models based on large-scale public EHR data. This paper proposes a public benchmark suite for ICD-10 coding using a large EHR dataset derived from MIMIC-IV, the most recent public EHR dataset. We implement and compare several popular methods for ICD coding prediction tasks to standardize data preprocessing and establish a comprehensive ICD coding benchmark dataset. This approach fosters reproducibility and model comparison, accelerating progress toward employing automated ICD coding in future studies. Furthermore, we create a new ICD-9 benchmark using MIMIC-IV data, providing more data points and a higher number of ICD codes than MIMIC-III. Our open-source code offers easy access to data processing steps, benchmark creation, and experiment replication for those with MIMIC-IV access, providing insights, guidance, and protocols to efficiently develop ICD coding models.

A Conditional Splitting Framework for Efficient Constituency Parsing

We introduce a generic seq2seq parsing framework that casts constituency parsing problems (syntactic and discourse parsing) into a series of conditional splitting decisions. Our parsing model estimates the conditional probability distribution of possible splitting points in a given text span and supports efficient top-down decoding, which is linear in number of nodes. The conditional splitting formulation together with efficient beam search inference facilitate structural consistency without relying on expensive structured inference. Crucially, for discourse analysis we show that in our formulation, discourse segmentation can be framed as a special case of parsing which allows us to perform discourse parsing without requiring segmentation as a pre-requisite. Experiments show that our model achieves good results on the standard syntactic parsing tasks under settings with/without pre-trained representations and rivals state-of-the-art (SoTA) methods that are more computationally expensive than ours. In discourse parsing, our method outperforms SoTA by a good margin.

RST Parsing from Scratch

We introduce a novel top-down end-to-end formulation of document-level discourse parsing in the Rhetorical Structure Theory (RST) framework. In this formulation, we consider discourse parsing as a sequence of splitting decisions at token boundaries and use a seq2seq network to model the splitting decisions. Our framework facilitates discourse parsing from scratch without requiring discourse segmentation as a prerequisite; rather, it yields segmentation as part of the parsing process. Our unified parsing model adopts a beam search to decode the best tree structure by searching through a space of high-scoring trees. With extensive experiments on the standard English RST discourse treebank, we demonstrate that our parser outperforms existing methods by a good margin in both end-to-end parsing and parsing with gold segmentation. More importantly, it does so without using any handcrafted features, making it faster and easily adaptable to new languages and domains.