GenAI4ELab/papercli-papers huggingface dataset:
KG-Rank: Enhancing Large Language Models for Medical QA with Knowledge Graphs and Ranking Techniques
Authors: Rui Yang; Haoran Liu; Edison Marrese-Taylor; Qingcheng Zeng; Yuhe Ke; Wanxin Li; Lechao Cheng; Qingyu Chen; James Caverlee; Yutaka Matsuo; Irene Li
Venue: ACL 2024 (Proceedings of the 23rd Workshop on Biomedical Natural Language Processing)

Abstract: Large Language Models (LLMs) have significantly advanced healthcare innovation on generation capabilities. However, their application in real clinical settings is challenging due to potential deviations from medical facts and inherent biases. In this work, we develop an augmented LLM framework, KG-Rank, which leverages a medical knowledge graph (KG) with ranking and re-ranking techniques, aiming to improve free-text question-answering (QA) in the medical domain. Specifically, upon receiving a question, we initially retrieve triplets from a medical KG to gather factual information. Subsequently, we innovatively apply ranking methods to refine the ordering of these triplets, aiming to yield more precise answers. To the best of our knowledge, KG-Rank is the first application of ranking models combined with KG in medical QA specifically for generating long answers. Evaluation of four selected medical QA datasets shows that KG-Rank achieves an improvement of over 18% in the ROUGE-L score. Moreover, we extend KG-Rank to open domains, where it realizes a 14% improvement in ROUGE-L, showing the effectiveness and potential of KG-Rank.
MedExQA: Medical Question Answering Benchmark with Multiple Explanations
Authors: Yunsoo Kim; Jinge Wu; Yusuf Abdulle; Honghan Wu
Venue: ACL 2024 (Proceedings of the 23rd Workshop on Biomedical Natural Language Processing)

Abstract: This paper introduces MedExQA, a novel benchmark in medical question-answering, to evaluate large language models’ (LLMs) understanding of medical knowledge through explanations. By constructing datasets across five distinct medical specialties that are underrepresented in current datasets and further incorporating multiple explanations for each question-answer pair, we address a major gap in current medical QA benchmarks which is the absence of comprehensive assessments of LLMs’ ability to generate nuanced medical explanations. Our work highlights the importance of explainability in medical LLMs, proposes an effective methodology for evaluating models beyond classification accuracy, and sheds light on one specific domain, speech language pathology, where current LLMs including GPT4 lack good understanding. Our results show generation evaluation with multiple explanations aligns better with human assessment, highlighting an opportunity for a more robust automated comprehension assessment for LLMs. To diversify open-source medical LLMs (currently mostly based on Llama2), this work also proposes a new medical model, MedPhi-2, based on Phi-2 (2.7B). The model outperformed medical LLMs based on Llama2-70B in generating explanations, showing its effectiveness in the resource-constrained medical domain. We will share our benchmark datasets and the trained model.
Do Clinicians Know How to Prompt? The Need for Automatic Prompt Optimization Help in Clinical Note Generation
Authors: Zonghai Yao; Ahmed Jaafar; Beining Wang; Zhichao Yang; Hong Yu
Venue: ACL 2024 (Proceedings of the 23rd Workshop on Biomedical Natural Language Processing)

Abstract: 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.
Domain-specific or Uncertainty-aware models: Does it really make a difference for biomedical text classification?
Authors: Aman Sinha; Timothee Mickus; Marianne Clausel; Mathieu Constant; Xavier Coubez
Venue: ACL 2024 (Proceedings of the 23rd Workshop on Biomedical Natural Language Processing)

Abstract: The success of pretrained language models (PLMs) across a spate of use-cases has led to significant investment from the NLP community towards building domain-specific foundational models. On the other hand, in mission critical settings such as biomedical applications, other aspects also factor in—chief of which is a model’s ability to produce reasonable estimates of its own uncertainty. In the present study, we discuss these two desiderata through the lens of how they shape the entropy of a model’s output probability distribution. We find that domain specificity and uncertainty awareness can often be successfully combined, but the exact task at hand weighs in much more strongly.
Can Rule-Based Insights Enhance LLMs for Radiology Report Classification? Introducing the RadPrompt Methodology.
Authors: Panagiotis Fytas; Anna Breger; Ian Selby; Simon Baker; Shahab Shahipasand; Anna Korhonen
Venue: ACL 2024 (Proceedings of the 23rd Workshop on Biomedical Natural Language Processing)

Abstract: Developing imaging models capable of detecting pathologies from chest X-rays can be cost and time-prohibitive for large datasets as it requires supervision to attain state-of-the-art performance. Instead, labels extracted from radiology reports may serve as distant supervision since these are routinely generated as part of clinical practice. Despite their widespread use, current rule-based methods for label extraction rely on extensive rule sets that are limited in their robustness to syntactic variability. To alleviate these limitations, we introduce RadPert, a rule-based system that integrates an uncertainty-aware information schema with a streamlined set of rules, enhancing performance. Additionally, we have developed RadPrompt, a multi-turn prompting strategy that leverages RadPert to bolster the zero-shot predictive capabilities of large language models, achieving a statistically significant improvement in weighted average F1 score over GPT-4 Turbo. Most notably, RadPrompt surpasses both its underlying models, showcasing the synergistic potential of LLMs with rule-based models. We have evaluated our methods on two English Corpora: the MIMIC-CXR gold-standard test set and a gold-standard dataset collected from the Cambridge University Hospitals.
Using Large Language Models to Evaluate Biomedical Query-Focused Summarisation
Authors: Hashem Hijazi; Diego Molla; Vincent Nguyen; Sarvnaz Karimi
Venue: ACL 2024 (Proceedings of the 23rd Workshop on Biomedical Natural Language Processing)

Abstract: Biomedical question-answering systems remain popular for biomedical experts interacting with the literature to answer their medical questions. However, these systems are difficult to evaluate in the absence of costly human experts. Therefore, automatic evaluation metrics are often used in this space. Traditional automatic metrics such as ROUGE or BLEU, which rely on token overlap, have shown a low correlation with humans. We present a study that uses large language models (LLMs) to automatically evaluate systems from an international challenge on biomedical semantic indexing and question answering, called BioASQ. We measure the agreement of LLM-produced scores against human judgements. We show that LLMs correlate similarly to lexical methods when using basic prompting techniques. However, by aggregating evaluators with LLMs or by fine-tuning, we find that our methods outperform the baselines by a large margin, achieving a Spearman correlation of 0.501 and 0.511, respectively.
Continuous Predictive Modeling of Clinical Notes and ICD Codes in Patient Health Records
Authors: Mireia Hernandez Caralt; Clarence Boon Liang Ng; Marek Rei
Venue: ACL 2024 (Proceedings of the 23rd Workshop on Biomedical Natural Language Processing)

Abstract: Electronic Health Records (EHR) serve as a valuable source of patient information, offering insights into medical histories, treatments, and outcomes. Previous research has developed systems for detecting applicable ICD codes that should be assigned while writing a given EHR document, mainly focusing on discharge summaries written at the end of a hospital stay. In this work, we investigate the potential of predicting these codes for the whole patient stay at different time points during their stay, even before they are officially assigned by clinicians. The development of methods to predict diagnoses and treatments earlier in advance could open opportunities for predictive medicine, such as identifying disease risks sooner, suggesting treatments, and optimizing resource allocation. Our experiments show that predictions regarding final ICD codes can be made already two days after admission and we propose a custom model that improves performance on this early prediction task.
Can GPT Redefine Medical Understanding? Evaluating GPT on Biomedical Machine Reading Comprehension
Authors: Shubham Vatsal; Ayush Singh
Venue: ACL 2024 (Proceedings of the 23rd Workshop on Biomedical Natural Language Processing)

Abstract: Large language models (LLMs) have shown remarkable performance on many tasks in different domains. However, their performance in contextual biomedical machine reading comprehension (MRC) has not been evaluated in depth. In this work, we evaluate GPT on four contextual biomedical MRC benchmarks. We experiment with different conventional prompting techniques as well as introduce our own novel prompting method. To solve some of the retrieval problems inherent to LLMs, we propose a prompting strategy named Implicit Retrieval Augmented Generation (RAG) that alleviates the need for using vector databases to retrieve important chunks in traditional RAG setups. Moreover, we report qualitative assessments on the natural language generation outputs from our approach. The results show that our new prompting technique is able to get the best performance in two out of four datasets and ranks second in rest of them. Experiments show that modern-day LLMs like GPT even in a zero-shot setting can outperform supervised models, leading to new state-of-the-art (SoTA) results on two of the benchmarks.
Get the Best out of 1B LLMs: Insights from Information Extraction on Clinical Documents
Authors: Saeed Farzi; Soumitra Ghosh; Alberto Lavelli; Bernardo Magnini
Venue: ACL 2024 (Proceedings of the 23rd Workshop on Biomedical Natural Language Processing)

Abstract: While the popularity of large, versatile language models like ChatGPT continues to rise, the landscape shifts when considering open-source models tailored to specific domains. Moreover, many areas, such as clinical documents, suffer from a scarcity of training data, often amounting to only a few hundred instances. Additionally, in certain settings, such as hospitals, cloud-based solutions pose privacy concerns, necessitating the deployment of language models on traditional hardware, such as single GPUs or powerful CPUs. To address these complexities, we conduct extensive experiments on both clinical entity detection and relation extraction in clinical documents using 1B parameter models. Our study delves into traditional fine-tuning, continuous pre-training in the medical domain, and instruction-tuning methods, providing valuable insights into their effectiveness in a multilingual setting. Our results underscore the importance of domain-specific models and pre-training for clinical natural language processing tasks. Furthermore, data augmentation using cross-lingual information improves performance in most cases, highlighting the potential for multilingual enhancements.
K-QA: A Real-World Medical Q&A Benchmark
Authors: Itay Manes; Naama Ronn; David Cohen; Ran Ilan Ber; Zehavi Horowitz-Kugler; Gabriel Stanovsky
Venue: ACL 2024 (Proceedings of the 23rd Workshop on Biomedical Natural Language Processing)

Abstract: Ensuring the accuracy of responses provided by large language models (LLMs) is crucial, particularly in clinical settings where incorrect information may directly impact patient health. To address this challenge, we construct K-QA, a dataset containing 1,212 patient questions originating from real-world conversations held on a popular clinical online platform. We employ a panel of in-house physicians to answer and manually decompose a subset of K-QA into self-contained statements. Additionally, we formulate two NLI-based evaluation metrics approximating recall and precision: (1) comprehensiveness, measuring the percentage of essential clinical information in the generated answer and (2) hallucination rate, measuring the number of statements from the physician-curated response contradicted by the LLM answer. Finally, we use K-QA along with these metrics to evaluate several state-of-the-art models, as well as the effect of in-context learning and medically-oriented augmented retrieval schemes developed by the authors. Our findings indicate that in-context learning improves the comprehensiveness of the models, and augmented retrieval is effective in reducing hallucinations. We will make K-QA available to to the community to spur research into medically accurate NLP applications.
Large Language Models for Biomedical Knowledge Graph Construction: Information extraction from EMR notes
Authors: Vahan Arsenyan; Spartak Bughdaryan; Fadi Shaya; Kent Wilson Small; Davit Shahnazaryan
Venue: ACL 2024 (Proceedings of the 23rd Workshop on Biomedical Natural Language Processing)

Abstract: The automatic construction of knowledge graphs (KGs) is an important research area in medicine, with far-reaching applications spanning drug discovery and clinical trial design. These applications hinge on the accurate identification of interactions among medical and biological entities. In this study, we propose an end-to-end machine learning solution based on large language models (LLMs) that utilize electronic medical record notes to construct KGs. The entities used in the KG construction process are diseases, factors, treatments, as well as manifestations that coexist with the patient while experiencing the disease. Given the critical need for high-quality performance in medical applications, we embark on a comprehensive assessment of 12 LLMs of various architectures, evaluating their performance and safety attributes. To gauge the quantitative efficacy of our approach by assessing both precision and recall, we manually annotate a dataset provided by the Macula and Retina Institute. We also assess the qualitative performance of LLMs, such as the ability to generate structured outputs or the tendency to hallucinate. The results illustrate that in contrast to encoder-only and encoder-decoder, decoder-only LLMs require further investigation. Additionally, we provide guided prompt design to utilize such LLMs. The application of the proposed methodology is demonstrated on age-related macular degeneration.
Document-level Clinical Entity and Relation extraction via Knowledge Base-Guided Generation
Authors: Kriti Bhattarai; Inez Y. Oh; Zachary B. Abrams; Albert M. Lai
Venue: ACL 2024 (Proceedings of the 23rd Workshop on Biomedical Natural Language Processing)

Abstract: Generative pre-trained transformer (GPT) models have shown promise in clinical entity and relation extraction tasks because of their precise extraction and contextual understanding capability. In this work, we further leverage the Unified Medical Language System (UMLS) knowledge base to accurately identify medical concepts and improve clinical entity and relation extraction at the document level. Our framework selects UMLS concepts relevant to the text and combines them with prompts to guide language models in extracting entities. Our experiments demonstrate that this initial concept mapping and the inclusion of these mapped concepts in the prompts improves extraction results compared to few-shot extraction tasks on generic language models that do not leverage UMLS. Further, our results show that this approach is more effective than the standard Retrieval Augmented Generation (RAG) technique, where retrieved data is compared with prompt embeddings to generate results. Overall, we find that integrating UMLS concepts with GPT models significantly improves entity and relation identification, outperforming the baseline and RAG models. By combining the precise concept mapping capability of knowledge-based approaches like UMLS with the contextual understanding capability of GPT, our method highlights the potential of these approaches in specialized domains like healthcare.
BiCAL: Bi-directional Contrastive Active Learning for Clinical Report Generation
Authors: Tianyi Wu; Jingqing Zhang; Wenjia Bai; Kai Sun
Venue: ACL 2024 (Proceedings of the 23rd Workshop on Biomedical Natural Language Processing)

Abstract: State-of-the-art performance by large pre-trained models in computer vision (CV) and natural language processing (NLP) suggests their potential for domain-specific tasks. However, training these models requires vast amounts of labelled data, a challenge in many domains due to the cost and expertise required for data labelling. Active Learning (AL) can mitigate this by selecting minimal yet informative data for model training. While AL has been mainly applied to single-modal tasks in the fields of NLP and CV, its application in multi-modal tasks remains underexplored. In this work, we proposed a novel AL strategy, Bidirectional Contrastive Active Learning strategy (BiCAL), that used both image and text latent spaces to identify contrastive samples to select batches to query for labels. BiCAL was robust to class imbalance data problems by its design, which is a problem that is commonly seen in training domain-specific models. We assessed BiCAL’s performance in domain-specific learning on the clinical report generation tasks from chest X-ray images. Our experiments showed that BiCAL outperforms State-of-the-art methods in clinical efficacy metrics, improving recall by 2.4% and F1 score by 9.5%, showcasing its effectiveness in actively training domain-specific multi-modal models.
Generation and De-Identification of Indian Clinical Discharge Summaries using LLMs
Authors: Sanjeet Singh; Shreya Gupta; Niralee Gupta; Naimish Sharma; Lokesh Srivastava; Vibhu Agarwal; Ashutosh Modi
Venue: ACL 2024 (Proceedings of the 23rd Workshop on Biomedical Natural Language Processing)

Abstract: The consequences of a healthcare data breach can be devastating for the patients, providers, and payers. The average financial impact of a data breach in recent months has been estimated to be close to USD 10 million. This is especially significant for healthcare organizations in India that are managing rapid digitization while still establishing data governance procedures that align with the letter and spirit of the law. Computer-based systems for de-identification of personal information are vulnerable to data drift, often rendering them ineffective in cross-institution settings. Therefore, a rigorous assessment of existing de-identification against local health datasets is imperative to support the safe adoption of digital health initiatives in India. Using a small set of de-identified patient discharge summaries provided by an Indian healthcare institution, in this paper, we report the nominal performance of de-identification algorithms (based on language models) trained on publicly available non-Indian datasets, pointing towards a lack of cross-institutional generalization. Similarly, experimentation with off-the-shelf de-identification systems reveals potential risks associated with the approach. To overcome data scarcity, we explore generating synthetic clinical reports (using publicly available and Indian summaries) by performing in-context learning over Large Language Models (LLMs). Our experiments demonstrate the use of generated reports as an effective strategy for creating high-performing de-identification systems with good generalization capabilities.
Pre-training data selection for biomedical domain adaptation using journal impact metrics
Authors: Mathieu Lai-king; Patrick Paroubek
Venue: ACL 2024 (Proceedings of the 23rd Workshop on Biomedical Natural Language Processing)

Abstract: Domain adaptation is a widely used method in natural language processing (NLP) to improve the performance of a language model within a specific domain. This method is particularly common in the biomedical domain, which sees regular publication of numerous scientific articles. PubMed, a significant corpus of text, is frequently used in the biomedical domain. The primary objective of this study is to explore whether refining a pre-training dataset using specific quality metrics for scientific papers can enhance the performance of the resulting model. To accomplish this, we employ two straightforward journal impact metrics and conduct experiments by continually pre-training BERT on various subsets of the complete PubMed training set, we then evaluate the resulting models on biomedical language understanding tasks from the BLURB benchmark. Our results show that pruning using journal impact metrics is not efficient. But we also show that pre-training using fewer abstracts (but with the same number of training steps) does not necessarily decrease the resulting model’s performance.
Leveraging LLMs and Web-based Visualizations for Profiling Bacterial Host Organisms and Genetic Toolboxes
Authors: Gilchan Park; Vivek Mutalik; Christopher Neely; Carlos Soto; Shinjae Yoo; Paramvir Dehal
Venue: ACL 2024 (Proceedings of the 23rd Workshop on Biomedical Natural Language Processing)

Abstract: Building genetic tools to engineer microorganisms is at the core of understanding and redesigning natural biological systems for useful purposes. Every project to build such a genetic toolbox for an organism starts with a survey of available tools. Despite a decade-long investment and advancement in the field, it is still challenging to mine information about a genetic tool published in the literature and connect that information to microbial genomics and other microbial databases. This information gap not only limits our ability to identify and adopt available tools to a new chassis but also conceals available opportunities to engineer a new microbial host. Recent advances in natural language processing (NLP), particularly large language models (LLMs), offer solutions by enabling efficient extraction of genetic terms and biological entities from a vast array of publications. This work present a method to automate this process, using text-mining to refine models with data from bioRxiv and other databases. We evaluated various LLMs to investigate their ability to recognize bacterial host organisms and genetic toolboxes for engineering. We demonstrate our methodology with a web application that integrates a conversational LLM and visualization tool, connecting user inquiries to genetic resources and literature findings, thereby saving researchers time, money and effort in their laboratory work.