Objective: The growing use of large language models (LLMs) stimulates a need for a comprehensive review of their applications and outcomes in mental health care contexts. This scoping review aims to critically analyze the existing development and applications of LLMs in mental health care, highlighting their successes and identifying their challenges and limitations in these specialized fields. Materials and Methods: A broad literature search was conducted in November 2023 using six databases (PubMed, Web of Science, Google Scholar, arXiv, medRxiv, and PsyArXiv) following the 2020 version of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A total of 313 publications were initially identified, and after applying the study inclusion criteria, 34 publications were selected for the final review. Results: We identified diverse applications of LLMs in mental health care, including diagnosis, therapy, patient engagement enhancement, etc. Key challenges include data availability and reliability, nuanced handling of mental states, and effective evaluation methods. Despite successes in accuracy and accessibility improvement, gaps in clinical applicability and ethical considerations were evident, pointing to the need for robust data, standardized evaluations, and interdisciplinary collaboration. Conclusion: LLMs show promising potential in advancing mental health care, with applications in diagnostics, and patient support. Continued advancements depend on collaborative, multidisciplinary efforts focused on framework enhancement, rigorous dataset development, technological refinement, and ethical integration to ensure the effective and safe application of LLMs in mental health care.
Large language models (LLMs), such as ChatGPT, have achieved substantial attention due to their impressive human language understanding and generation capabilities. Therefore, the application of LLMs in medicine to assist physicians and patient care emerges as a promising research direction in both artificial intelligence and clinical medicine. To this end, this survey provides a comprehensive overview of the current progress, applications, and challenges faced by LLMs in medicine. Specifically, we aim to address the following questions: 1) What are LLMs and how can medical LLMs be built? 2) What are the downstream performances of medical LLMs? 3) How can medical LLMs be utilized in real-world clinical practice? 4) What challenges arise from the use of medical LLMs? 5) How can we better construct and utilize medical LLMs? As a result, this survey aims to provide insights into the opportunities and challenges of LLMs in medicine and serve as a valuable resource for constructing practical and effective medical LLMs. A regularly updated list of practical guide resources of medical LLMs can be found at https://github.com/AI-in-Health/MedLLMsPracticalGuide.
Large Multimodal Models (LMMs) have demonstrated impressive performance across various vision and language tasks, yet their potential applications in recommendation tasks with visual assistance remain unexplored. To bridge this gap, we present a preliminary case study investigating the recommendation capabilities of GPT-4V(ison), a recently released LMM by OpenAI. We construct a series of qualitative test samples spanning multiple domains and employ these samples to assess the quality of GPT-4V's responses within recommendation scenarios. Evaluation results on these test samples prove that GPT-4V has remarkable zero-shot recommendation abilities across diverse domains, thanks to its robust visual-text comprehension capabilities and extensive general knowledge. However, we have also identified some limitations in using GPT-4V for recommendations, including a tendency to provide similar responses when given similar inputs. This report concludes with an in-depth discussion of the challenges and research opportunities associated with utilizing GPT-4V in recommendation scenarios. Our objective is to explore the potential of extending LMMs from vision and language tasks to recommendation tasks. We hope to inspire further research into next-generation multimodal generative recommendation models, which can enhance user experiences by offering greater diversity and interactivity. All images and prompts used in this report will be accessible at https://github.com/PALIN2018/Evaluate_GPT-4V_Rec.
Large Language Models (LLMs) have introduced a new era of proficiency in comprehending complex healthcare and biomedical topics. However, there is a noticeable lack of models in languages other than English and models that can interpret multi-modal input, which is crucial for global healthcare accessibility. In response, this study introduces Qilin-Med-VL, the first Chinese large vision-language model designed to integrate the analysis of textual and visual data. Qilin-Med-VL combines a pre-trained Vision Transformer (ViT) with a foundational LLM. It undergoes a thorough two-stage curriculum training process that includes feature alignment and instruction tuning. This method enhances the model's ability to generate medical captions and answer complex medical queries. We also release ChiMed-VL, a dataset consisting of more than 1M image-text pairs. This dataset has been carefully curated to enable detailed and comprehensive interpretation of medical data using various types of images.
Large language models exhibit promising general capabilities but often lack specialized knowledge for domain-specific tasks. Developing domain experts from a base model enables a range of applications without prohibitive training costs. This work demonstrates a method using continuous training and instruction fine-tuning to rapidly adapt Llama 2 base models to the Chinese medical domain. We first conduct continuous training on 1B tokens from Chinese medical references to teach relevant vocabulary and knowledge. The models are then fine-tuned on 54K examples sourced from the Chinese National Medical Licensing Examination. Experiments on Chinese medical data confirm the effectiveness of this approach, producing a model comparable to GPT-3.5-turbo while using way less computational resource. The resulting domain-specific model could be useful for various Chinese medical applications. More broadly, this provides a template for domain-specific training of large language models in areas where pre-trained models lack the required expertise, such as law, science, and engineering.
Integrating large language models (LLMs) into healthcare presents potential but faces challenges. Directly pre-training LLMs for domains like medicine is resource-heavy and sometimes unfeasible. Sole reliance on Supervised Fine-tuning (SFT) can result in overconfident predictions and may not tap into domain specific insights. Addressing these challenges, we present a multi-stage training method combining Domain-specific Continued Pre-training (DCPT), SFT, and Direct Preference Optimization (DPO). A notable contribution of our study is the introduction of a 3Gb Chinese Medicine (ChiMed) dataset, encompassing medical question answering, plain texts, knowledge graphs, and dialogues, segmented into three training stages. The medical LLM trained with our pipeline, Qilin-Med, exhibits significant performance boosts. In the CPT and SFT phases, it achieves 38.4% and 40.0% accuracy on the CMExam, surpassing Baichuan-7B's 33.5%. In the DPO phase, on the Huatuo-26M test set, it scores 16.66 in BLEU-1 and 27.44 in ROUGE1, outperforming the SFT's 12.69 and 24.21. This highlights the strength of our training approach in refining LLMs for medical applications.
The utilization of social media in epidemic surveillance has been well established. Nonetheless, bias is often introduced when pre-defined lexicons are used to retrieve relevant corpus. This study introduces a framework aimed at curating extensive dictionaries of medical colloquialisms and Unified Medical Language System (UMLS) concepts. The framework comprises three modules: a BERT-based Named Entity Recognition (NER) model that identifies medical entities from social media content, a deep-learning powered normalization module that standardizes the extracted entities, and a semi-supervised clustering module that assigns the most probable UMLS concept to each standardized entity. We applied this framework to COVID-19-related tweets from February 1, 2020, to April 30, 2022, generating a symptom dictionary (available at https://github.com/ningkko/UMLS_colloquialism/) composed of 9,249 standardized entities mapped to 876 UMLS concepts and 38,175 colloquial expressions. This framework demonstrates encouraging potential in addressing the constraints of keyword matching information retrieval in social media-based public health research.
* Accepted to ICHI 2023 (The 11th IEEE International Conference on
Healthcare Informatics) as a poster presentation
Recent advancements in large language models (LLMs) have transformed the field of question answering (QA). However, evaluating LLMs in the medical field is challenging due to the lack of standardized and comprehensive datasets. To address this gap, we introduce CMExam, sourced from the Chinese National Medical Licensing Examination. CMExam consists of 60K+ multiple-choice questions for standardized and objective evaluations, as well as solution explanations for model reasoning evaluation in an open-ended manner. For in-depth analyses of LLMs, we invited medical professionals to label five additional question-wise annotations, including disease groups, clinical departments, medical disciplines, areas of competency, and question difficulty levels. Alongside the dataset, we further conducted thorough experiments with representative LLMs and QA algorithms on CMExam. The results show that GPT-4 had the best accuracy of 61.6% and a weighted F1 score of 0.617. These results highlight a great disparity when compared to human accuracy, which stood at 71.6%. For explanation tasks, while LLMs could generate relevant reasoning and demonstrate improved performance after finetuning, they fall short of a desired standard, indicating ample room for improvement. To the best of our knowledge, CMExam is the first Chinese medical exam dataset to provide comprehensive medical annotations. The experiments and findings of LLM evaluation also provide valuable insights into the challenges and potential solutions in developing Chinese medical QA systems and LLM evaluation pipelines. The dataset and relevant code are available at https://github.com/williamliujl/CMExam.
Existing research efforts for multi-interest candidate matching in recommender systems mainly focus on improving model architecture or incorporating additional information, neglecting the importance of training schemes. This work revisits the training framework and uncovers two major problems hindering the expressiveness of learned multi-interest representations. First, the current training objective (i.e., uniformly sampled softmax) fails to effectively train discriminative representations in a multi-interest learning scenario due to the severe increase in easy negative samples. Second, a routing collapse problem is observed where each learned interest may collapse to express information only from a single item, resulting in information loss. To address these issues, we propose the REMI framework, consisting of an Interest-aware Hard Negative mining strategy (IHN) and a Routing Regularization (RR) method. IHN emphasizes interest-aware hard negatives by proposing an ideal sampling distribution and developing a Monte-Carlo strategy for efficient approximation. RR prevents routing collapse by introducing a novel regularization term on the item-to-interest routing matrices. These two components enhance the learned multi-interest representations from both the optimization objective and the composition information. REMI is a general framework that can be readily applied to various existing multi-interest candidate matching methods. Experiments on three real-world datasets show our method can significantly improve state-of-the-art methods with easy implementation and negligible computational overhead. The source code will be released.