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.

On Cross-Domain Pre-Trained Language Models for Clinical Text Mining: How Do They Perform on Data-Constrained Fine-Tuning?

Pre-trained language models (PLMs) have been deployed in many natural language processing (NLP) tasks and in various domains. Language model pre-training from general or mixed domain rich data plus fine-tuning using small amounts of available data in a low resource domain demonstrated beneficial results by researchers. In this work, we question this statement and verify if BERT-based PLMs from the biomedical domain can perform well in clinical text mining tasks via fine-tuning. We test the state-of-the-art models, i.e. Bioformer which is pre-trained on a large amount of biomedical data from PubMed corpus. We use a historical n2c2 clinical NLP challenge dataset for fine-tuning its task-adapted version (BioformerApt), and show that their performances are actually very low. We also present our own end-to-end model, TransformerCRF, which is developed using Transformer and conditional random fields (CRFs) as encoder and decoder. We further create a new variation model by adding a CRF layer on top of PLM Bioformer (BioformerCRF). We investigate the performances of TransformerCRF on clinical text mining tasks by training from scratch using a limited amount of data, as well as the model BioformerCRF. Experimental evaluation shows that, in a \textit{constrained setting}, all tested models are \textit{far from ideal} regarding extreme low-frequency special token recognition, even though they can achieve relatively higher accuracy on overall text tagging. Our models including source codes will be hosted at \url{https://github.com/poethan/TransformerCRF}.

EDU-level Extractive Summarization with Varying Summary Lengths

Extractive models usually formulate text summarization as extracting top-k important sentences from document as summary. Few work exploited extracting finer-grained Elementary Discourse Unit (EDU) and there is little analysis and justification for the extractive unit selection. To fill such a gap, this paper firstly conducts oracle analysis to compare the upper bound of performance for models based on EDUs and sentences. The analysis provides evidences from both theoretical and experimental perspectives to justify that EDUs make more concise and precise summary than sentences without losing salient information. Then, considering this merit of EDUs, this paper further proposes EDU-level extractive model with Varying summary Lengths (EDU-VL) and develops the corresponding learning algorithm. EDU-VL learns to encode and predict probabilities of EDUs in document, and encode EDU-level candidate summaries with different lengths based on various $k$ values and select the best candidate summary in an end-to-end training manner. Finally, the proposed and developed approach is experimented on single and multi-document benchmark datasets and shows the improved performances in comparison with the state-of-the-art models.