UMass-BioNLP at MEDIQA-M3G 2024: DermPrompt -- A Systematic Exploration of Prompt Engineering with GPT-4V for Dermatological Diagnosis

This paper presents our team's participation in the MEDIQA-ClinicalNLP2024 shared task B. We present a novel approach to diagnosing clinical dermatology cases by integrating large multimodal models, specifically leveraging the capabilities of GPT-4V under a retriever and a re-ranker framework. Our investigation reveals that GPT-4V, when used as a retrieval agent, can accurately retrieve the correct skin condition 85% of the time using dermatological images and brief patient histories. Additionally, we empirically show that Naive Chain-of-Thought (CoT) works well for retrieval while Medical Guidelines Grounded CoT is required for accurate dermatological diagnosis. Further, we introduce a Multi-Agent Conversation (MAC) framework and show its superior performance and potential over the best CoT strategy. The experiments suggest that using naive CoT for retrieval and multi-agent conversation for critique-based diagnosis, GPT-4V can lead to an early and accurate diagnosis of dermatological conditions. The implications of this work extend to improving diagnostic workflows, supporting dermatological education, and enhancing patient care by providing a scalable, accessible, and accurate diagnostic tool.

AesExpert: Towards Multi-modality Foundation Model for Image Aesthetics Perception

The highly abstract nature of image aesthetics perception (IAP) poses significant challenge for current multimodal large language models (MLLMs). The lack of human-annotated multi-modality aesthetic data further exacerbates this dilemma, resulting in MLLMs falling short of aesthetics perception capabilities. To address the above challenge, we first introduce a comprehensively annotated Aesthetic Multi-Modality Instruction Tuning (AesMMIT) dataset, which serves as the footstone for building multi-modality aesthetics foundation models. Specifically, to align MLLMs with human aesthetics perception, we construct a corpus-rich aesthetic critique database with 21,904 diverse-sourced images and 88K human natural language feedbacks, which are collected via progressive questions, ranging from coarse-grained aesthetic grades to fine-grained aesthetic descriptions. To ensure that MLLMs can handle diverse queries, we further prompt GPT to refine the aesthetic critiques and assemble the large-scale aesthetic instruction tuning dataset, i.e. AesMMIT, which consists of 409K multi-typed instructions to activate stronger aesthetic capabilities. Based on the AesMMIT database, we fine-tune the open-sourced general foundation models, achieving multi-modality Aesthetic Expert models, dubbed AesExpert. Extensive experiments demonstrate that the proposed AesExpert models deliver significantly better aesthetic perception performances than the state-of-the-art MLLMs, including the most advanced GPT-4V and Gemini-Pro-Vision. Source data will be available at https://github.com/yipoh/AesExpert.

ClinicalMamba: A Generative Clinical Language Model on Longitudinal Clinical Notes

The advancement of natural language processing (NLP) systems in healthcare hinges on language model ability to interpret the intricate information contained within clinical notes. This process often requires integrating information from various time points in a patient's medical history. However, most earlier clinical language models were pretrained with a context length limited to roughly one clinical document. In this study, We introduce ClinicalMamba, a specialized version of the Mamba language model, pretrained on a vast corpus of longitudinal clinical notes to address the unique linguistic characteristics and information processing needs of the medical domain. ClinicalMamba, with 130 million and 2.8 billion parameters, demonstrates a superior performance in modeling clinical language across extended text lengths compared to Mamba and clinical Llama. With few-shot learning, ClinicalMamba achieves notable benchmarks in speed and accuracy, outperforming existing clinical language models and general domain large models like GPT-4 in longitudinal clinical notes information extraction tasks.

JMLR: Joint Medical LLM and Retrieval Training for Enhancing Reasoning and Professional Question Answering Capability

With the explosive growth of medical data and the rapid development of artificial intelligence technology, precision medicine has emerged as a key to enhancing the quality and efficiency of healthcare services. In this context, Large Language Models (LLMs) play an increasingly vital role in medical knowledge acquisition and question-answering systems. To further improve the performance of these systems in the medical domain, we introduce an innovative method that jointly trains an Information Retrieval (IR) system and an LLM during the fine-tuning phase. This approach, which we call Joint Medical LLM and Retrieval Training (JMLR), is designed to overcome the challenges faced by traditional models in handling medical question-answering tasks. By employing a synchronized training mechanism, JMLR reduces the demand for computational resources and enhances the model's ability to leverage medical knowledge for reasoning and answering questions. Our experimental results demonstrate that JMLR-13B (81.2% on Amboos, 61.3% on MedQA) outperforms models using conventional pre-training and fine-tuning Meditron-70B (76.4% on AMBOSS, 60.3% on MedQA). For models of the same 7B scale, JMLR-7B(68.7% on Amboos, 51.7% on MedQA) significantly outperforms other public models (Meditron-7B: 50.1%, 47.9%), proving its superiority in terms of cost (our training time: 37 hours, traditional method: 144 hours), efficiency, and effectiveness in medical question-answering tasks. Through this work, we provide a new and efficient knowledge enhancement tool for healthcare, demonstrating the great potential of integrating IR and LLM training in precision medical information retrieval and question-answering systems.

AesBench: An Expert Benchmark for Multimodal Large Language Models on Image Aesthetics Perception

With collective endeavors, multimodal large language models (MLLMs) are undergoing a flourishing development. However, their performances on image aesthetics perception remain indeterminate, which is highly desired in real-world applications. An obvious obstacle lies in the absence of a specific benchmark to evaluate the effectiveness of MLLMs on aesthetic perception. This blind groping may impede the further development of more advanced MLLMs with aesthetic perception capacity. To address this dilemma, we propose AesBench, an expert benchmark aiming to comprehensively evaluate the aesthetic perception capacities of MLLMs through elaborate design across dual facets. (1) We construct an Expert-labeled Aesthetics Perception Database (EAPD), which features diversified image contents and high-quality annotations provided by professional aesthetic experts. (2) We propose a set of integrative criteria to measure the aesthetic perception abilities of MLLMs from four perspectives, including Perception (AesP), Empathy (AesE), Assessment (AesA) and Interpretation (AesI). Extensive experimental results underscore that the current MLLMs only possess rudimentary aesthetic perception ability, and there is still a significant gap between MLLMs and humans. We hope this work can inspire the community to engage in deeper explorations on the aesthetic potentials of MLLMs. Source data will be available at https://github.com/yipoh/AesBench.

README: Bridging Medical Jargon and Lay Understanding for Patient Education through Data-Centric NLP

The advancement in healthcare has shifted focus toward patient-centric approaches, particularly in self-care and patient education, facilitated by access to Electronic Health Records (EHR). However, medical jargon in EHRs poses significant challenges in patient comprehension. To address this, we introduce a new task of automatically generating lay definitions, aiming to simplify complex medical terms into patient-friendly lay language. We first created the README dataset, an extensive collection of over 20,000 unique medical terms and 300,000 mentions, each offering context-aware lay definitions manually annotated by domain experts. We have also engineered a data-centric Human-AI pipeline that synergizes data filtering, augmentation, and selection to improve data quality. We then used README as the training data for models and leveraged a Retrieval-Augmented Generation (RAG) method to reduce hallucinations and improve the quality of model outputs. Our extensive automatic and human evaluations demonstrate that open-source mobile-friendly models, when fine-tuned with high-quality data, are capable of matching or even surpassing the performance of state-of-the-art closed-source large language models like ChatGPT. This research represents a significant stride in closing the knowledge gap in patient education and advancing patient-centric healthcare solutions

Surpassing GPT-4 Medical Coding with a Two-Stage Approach

Recent advances in large language models (LLMs) show potential for clinical applications, such as clinical decision support and trial recommendations. However, the GPT-4 LLM predicts an excessive number of ICD codes for medical coding tasks, leading to high recall but low precision. To tackle this challenge, we introduce LLM-codex, a two-stage approach to predict ICD codes that first generates evidence proposals using an LLM and then employs an LSTM-based verification stage. The LSTM learns from both the LLM's high recall and human expert's high precision, using a custom loss function. Our model is the only approach that simultaneously achieves state-of-the-art results in medical coding accuracy, accuracy on rare codes, and sentence-level evidence identification to support coding decisions without training on human-annotated evidence according to experiments on the MIMIC dataset.

Do Physicians Know How to Prompt? The Need for Automatic Prompt Optimization Help in Clinical Note Generation

This study examines the effect of prompt engineering on the performance of Large Language Models (LLMs) in clinical note generation. We introduce an Automatic Prompt Optimization (APO) framework to refine initial prompts and compare the outputs of medical experts, non-medical experts, and APO-enhanced GPT3.5 and GPT4. Results highlight GPT4 APO's superior performance in standardizing prompt quality across clinical note sections. A human-in-the-loop approach shows that experts maintain content quality post-APO, with a preference for their own modifications, suggesting the value of expert customization. We recommend a two-phase optimization process, leveraging APO-GPT4 for consistency and expert input for personalization.

SELF-EXPLAIN: Teaching Large Language Models to Reason Complex Questions by Themselves

Large language models (LLMs) can generate intermediate reasoning steps. To elicit the reliable reasoning, the common practice is to employ few-shot chain-of-thought prompting, where several in-context demonstrations for reasoning are prepended to the question. However, such chain-of-thought examples are expensive to craft, especially for professional domains, and can have high variance depending on human annotators. Therefore, this work investigates whether LLMs can teach themselves to reason without human-crafted demonstrations. We propose SELF-EXPLAIN to generate CoT examples by LLMs inspired by "encoding specificity" in human memory retrieval. We find using self-explanations makes LLMs more confident, more calibrated and less biased when answering complex questions. Moreover, we find prompting with self-explanations can even significantly outperform using human-crafted CoTs on several complex question answering dataset.

BioInstruct: Instruction Tuning of Large Language Models for Biomedical Natural Language Processing

To enhance the performance of large language models (LLMs) in biomedical natural language processing (BioNLP) by introducing a domain-specific instruction dataset and examining its impact when combined with multi-task learning principles. We created the BioInstruct, comprising 25,005 instructions to instruction-tune LLMs(LLaMA 1 & 2, 7B & 13B version). The instructions were created by prompting the GPT-4 language model with three-seed samples randomly drawn from an 80 human curated instructions. We employed Low-Rank Adaptation(LoRA) for parameter-efficient fine-tuning. We then evaluated these instruction-tuned LLMs on several BioNLP tasks, which can be grouped into three major categories: question answering(QA), information extraction(IE), and text generation(GEN). We also examined whether categories(e.g., QA, IE, and generation) of instructions impact model performance. Comparing with LLMs without instruction-tuned, our instruction-tuned LLMs demonstrated marked performance gains: 17.3% in QA, 5.7% in IE, and 96% in Generation tasks. Our 7B-parameter instruction-tuned LLaMA 1 model was competitive or even surpassed other LLMs in the biomedical domain that were also fine-tuned from LLaMA 1 with vast domain-specific data or a variety of tasks. Our results also show that the performance gain is significantly higher when instruction fine-tuning is conducted with closely related tasks. Our findings align with the observations of multi-task learning, suggesting the synergies between two tasks. The BioInstruct dataset serves as a valuable resource and instruction tuned LLMs lead to the best performing BioNLP applications.