ACI-BENCH: a Novel Ambient Clinical Intelligence Dataset for Benchmarking Automatic Visit Note Generation

Recent immense breakthroughs in generative models such as in GPT4 have precipitated re-imagined ubiquitous usage of these models in all applications. One area that can benefit by improvements in artificial intelligence (AI) is healthcare. The note generation task from doctor-patient encounters, and its associated electronic medical record documentation, is one of the most arduous time-consuming tasks for physicians. It is also a natural prime potential beneficiary to advances in generative models. However with such advances, benchmarking is more critical than ever. Whether studying model weaknesses or developing new evaluation metrics, shared open datasets are an imperative part of understanding the current state-of-the-art. Unfortunately as clinic encounter conversations are not routinely recorded and are difficult to ethically share due to patient confidentiality, there are no sufficiently large clinic dialogue-note datasets to benchmark this task. Here we present the Ambient Clinical Intelligence Benchmark (ACI-BENCH) corpus, the largest dataset to date tackling the problem of AI-assisted note generation from visit dialogue. We also present the benchmark performances of several common state-of-the-art approaches.

An Investigation of Evaluation Metrics for Automated Medical Note Generation

Recent studies on automatic note generation have shown that doctors can save significant amounts of time when using automatic clinical note generation (Knoll et al., 2022). Summarization models have been used for this task to generate clinical notes as summaries of doctor-patient conversations (Krishna et al., 2021; Cai et al., 2022). However, assessing which model would best serve clinicians in their daily practice is still a challenging task due to the large set of possible correct summaries, and the potential limitations of automatic evaluation metrics. In this paper, we study evaluation methods and metrics for the automatic generation of clinical notes from medical conversations. In particular, we propose new task-specific metrics and we compare them to SOTA evaluation metrics in text summarization and generation, including: (i) knowledge-graph embedding-based metrics, (ii) customized model-based metrics, (iii) domain-adapted/fine-tuned metrics, and (iv) ensemble metrics. To study the correlation between the automatic metrics and manual judgments, we evaluate automatic notes/summaries by comparing the system and reference facts and computing the factual correctness, and the hallucination and omission rates for critical medical facts. This study relied on seven datasets manually annotated by domain experts. Our experiments show that automatic evaluation metrics can have substantially different behaviors on different types of clinical notes datasets. However, the results highlight one stable subset of metrics as the most correlated with human judgments with a relevant aggregation of different evaluation criteria.

Explicit and Implicit Semantic Ranking Framework

The core challenge in numerous real-world applications is to match an inquiry to the best document from a mutable and finite set of candidates. Existing industry solutions, especially latency-constrained services, often rely on similarity algorithms that sacrifice quality for speed. In this paper we introduce a generic semantic learning-to-rank framework, Self-training Semantic Cross-attention Ranking (sRank). This transformer-based framework uses linear pairwise loss with mutable training batch sizes and achieves quality gains and high efficiency, and has been applied effectively to show gains on two industry tasks at Microsoft over real-world large-scale data sets: Smart Reply (SR) and Ambient Clinical Intelligence (ACI). In Smart Reply, $sRank$ assists live customers with technical support by selecting the best reply from predefined solutions based on consumer and support agent messages. It achieves 11.7% gain in offline top-one accuracy on the SR task over the previous system, and has enabled 38.7% time reduction in composing messages in telemetry recorded since its general release in January 2021. In the ACI task, sRank selects relevant historical physician templates that serve as guidance for a text summarization model to generate higher quality medical notes. It achieves 35.5% top-one accuracy gain, along with 46% relative ROUGE-L gain in generated medical notes.