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Mar 18

Large Language Models Encode Clinical Knowledge

Large language models (LLMs) have demonstrated impressive capabilities in natural language understanding and generation, but the quality bar for medical and clinical applications is high. Today, attempts to assess models' clinical knowledge typically rely on automated evaluations on limited benchmarks. There is no standard to evaluate model predictions and reasoning across a breadth of tasks. To address this, we present MultiMedQA, a benchmark combining six existing open question answering datasets spanning professional medical exams, research, and consumer queries; and HealthSearchQA, a new free-response dataset of medical questions searched online. We propose a framework for human evaluation of model answers along multiple axes including factuality, precision, possible harm, and bias. In addition, we evaluate PaLM (a 540-billion parameter LLM) and its instruction-tuned variant, Flan-PaLM, on MultiMedQA. Using a combination of prompting strategies, Flan-PaLM achieves state-of-the-art accuracy on every MultiMedQA multiple-choice dataset (MedQA, MedMCQA, PubMedQA, MMLU clinical topics), including 67.6% accuracy on MedQA (US Medical License Exam questions), surpassing prior state-of-the-art by over 17%. However, human evaluation reveals key gaps in Flan-PaLM responses. To resolve this we introduce instruction prompt tuning, a parameter-efficient approach for aligning LLMs to new domains using a few exemplars. The resulting model, Med-PaLM, performs encouragingly, but remains inferior to clinicians. We show that comprehension, recall of knowledge, and medical reasoning improve with model scale and instruction prompt tuning, suggesting the potential utility of LLMs in medicine. Our human evaluations reveal important limitations of today's models, reinforcing the importance of both evaluation frameworks and method development in creating safe, helpful LLM models for clinical applications.

RJUA-QA: A Comprehensive QA Dataset for Urology

We introduce RJUA-QA, a novel medical dataset for question answering (QA) and reasoning with clinical evidence, contributing to bridge the gap between general large language models (LLMs) and medical-specific LLM applications. RJUA-QA is derived from realistic clinical scenarios and aims to facilitate LLMs in generating reliable diagnostic and advice. The dataset contains 2,132 curated Question-Context-Answer pairs, corresponding about 25,000 diagnostic records and clinical cases. The dataset covers 67 common urological disease categories, where the disease coverage exceeds 97.6\% of the population seeking medical services in urology. Each data instance in RJUA-QA comprises: (1) a question mirroring real patient to inquiry about clinical symptoms and medical conditions, (2) a context including comprehensive expert knowledge, serving as a reference for medical examination and diagnosis, (3) a doctor response offering the diagnostic conclusion and suggested examination guidance, (4) a diagnosed clinical disease as the recommended diagnostic outcome, and (5) clinical advice providing recommendations for medical examination. RJUA-QA is the first medical QA dataset for clinical reasoning over the patient inquiries, where expert-level knowledge and experience are required for yielding diagnostic conclusions and medical examination advice. A comprehensive evaluation is conducted to evaluate the performance of both medical-specific and general LLMs on the RJUA-QA dataset.

Benchmarks for Pirá 2.0, a Reading Comprehension Dataset about the Ocean, the Brazilian Coast, and Climate Change

Pir\'a is a reading comprehension dataset focused on the ocean, the Brazilian coast, and climate change, built from a collection of scientific abstracts and reports on these topics. This dataset represents a versatile language resource, particularly useful for testing the ability of current machine learning models to acquire expert scientific knowledge. Despite its potential, a detailed set of baselines has not yet been developed for Pir\'a. By creating these baselines, researchers can more easily utilize Pir\'a as a resource for testing machine learning models across a wide range of question answering tasks. In this paper, we define six benchmarks over the Pir\'a dataset, covering closed generative question answering, machine reading comprehension, information retrieval, open question answering, answer triggering, and multiple choice question answering. As part of this effort, we have also produced a curated version of the original dataset, where we fixed a number of grammar issues, repetitions, and other shortcomings. Furthermore, the dataset has been extended in several new directions, so as to face the aforementioned benchmarks: translation of supporting texts from English into Portuguese, classification labels for answerability, automatic paraphrases of questions and answers, and multiple choice candidates. The results described in this paper provide several points of reference for researchers interested in exploring the challenges provided by the Pir\'a dataset.

Towards Evaluating and Building Versatile Large Language Models for Medicine

In this study, we present MedS-Bench, a comprehensive benchmark designed to evaluate the performance of large language models (LLMs) in clinical contexts. Unlike existing benchmarks that focus on multiple-choice question answering, MedS-Bench spans 11 high-level clinical tasks, including clinical report summarization, treatment recommendations, diagnosis, named entity recognition, and medical concept explanation, among others. We evaluated six leading LLMs, e.g., MEDITRON, Mistral, InternLM 2, Llama 3, GPT-4, and Claude-3.5 using few-shot prompting, and found that even the most sophisticated models struggle with these complex tasks. To address these limitations, we developed MedS-Ins, a large-scale instruction tuning dataset for medicine. MedS-Ins comprises 58 medically oriented language corpora, totaling 13.5 million samples across 122 tasks. To demonstrate the dataset's utility, we conducted a proof-of-concept experiment by performing instruction tuning on a lightweight, open-source medical language model. The resulting model, MMedIns-Llama 3, significantly outperformed existing models across nearly all clinical tasks. To promote further advancements in the application of LLMs to clinical challenges, we have made the MedS-Ins dataset fully accessible and invite the research community to contribute to its expansion.Additionally, we have launched a dynamic leaderboard for MedS-Bench, which we plan to regularly update the test set to track progress and enhance the adaptation of general LLMs to the medical domain. Leaderboard: https://henrychur.github.io/MedS-Bench/. Github: https://github.com/MAGIC-AI4Med/MedS-Ins.

From Beginner to Expert: Modeling Medical Knowledge into General LLMs

Recently, large language model (LLM) based artificial intelligence (AI) systems have demonstrated remarkable capabilities in natural language understanding and generation. However, these models face a significant challenge when it comes to sensitive applications, such as reasoning over medical knowledge and answering medical questions in a physician-like manner. Prior studies attempted to overcome this challenge by increasing the model size (>100B) to learn more general medical knowledge, while there is still room for improvement in LLMs with smaller-scale model sizes (<100B). In this work, we start from a pre-trained general LLM model (AntGLM-10B) and fine-tune it from a medical beginner towards a medical expert (called AntGLM-Med-10B), which leverages a 3-stage optimization procedure, i.e., general medical knowledge injection, medical domain instruction tuning, and specific medical task adaptation. Our contributions are threefold: (1) We specifically investigate how to adapt a pre-trained general LLM in medical domain, especially for a specific medical task. (2) We collect and construct large-scale medical datasets for each stage of the optimization process. These datasets encompass various data types and tasks, such as question-answering, medical reasoning, multi-choice questions, and medical conversations. (3) Specifically for multi-choice questions in the medical domain, we propose a novel Verification-of-Choice approach for prompting engineering, which significantly enhances the reasoning ability of LLMs. Remarkably, by combining the above approaches, our AntGLM-Med-10B model can outperform the most of LLMs on PubMedQA, including both general and medical LLMs, even when these LLMs have larger model size.

CUPCase: Clinically Uncommon Patient Cases and Diagnoses Dataset

Medical benchmark datasets significantly contribute to developing Large Language Models (LLMs) for medical knowledge extraction, diagnosis, summarization, and other uses. Yet, current benchmarks are mainly derived from exam questions given to medical students or cases described in the medical literature, lacking the complexity of real-world patient cases that deviate from classic textbook abstractions. These include rare diseases, uncommon presentations of common diseases, and unexpected treatment responses. Here, we construct Clinically Uncommon Patient Cases and Diagnosis Dataset (CUPCase) based on 3,562 real-world case reports from BMC, including diagnoses in open-ended textual format and as multiple-choice options with distractors. Using this dataset, we evaluate the ability of state-of-the-art LLMs, including both general-purpose and Clinical LLMs, to identify and correctly diagnose a patient case, and test models' performance when only partial information about cases is available. Our findings show that general-purpose GPT-4o attains the best performance in both the multiple-choice task (average accuracy of 87.9%) and the open-ended task (BERTScore F1 of 0.764), outperforming several LLMs with a focus on the medical domain such as Meditron-70B and MedLM-Large. Moreover, GPT-4o was able to maintain 87% and 88% of its performance with only the first 20% of tokens of the case presentation in multiple-choice and free text, respectively, highlighting the potential of LLMs to aid in early diagnosis in real-world cases. CUPCase expands our ability to evaluate LLMs for clinical decision support in an open and reproducible manner.

PMC-LLaMA: Towards Building Open-source Language Models for Medicine

Recently, Large Language Models (LLMs) have showcased remarkable capabilities in natural language understanding. While demonstrating proficiency in everyday conversations and question-answering situations, these models frequently struggle in domains that require precision, such as medical applications, due to their lack of domain-specific knowledge. In this paper, we describe the procedure for building a powerful, open-source language model specifically designed for medicine applications, termed as PMC-LLaMA. Our contributions are threefold: (i) we systematically investigate the process of adapting a general-purpose foundation language model towards medical domain, this involves data-centric knowledge injection through the integration of 4.8M biomedical academic papers and 30K medical textbooks, as well as comprehensive fine-tuning for alignment with domain-specific instructions; (ii) we contribute a large-scale, comprehensive dataset for instruction tuning. This dataset encompasses medical question-answering (QA), rationale for reasoning, and conversational dialogues, comprising a total of 202M tokens; (iii) we conduct thorough ablation studies to demonstrate the effectiveness of each proposed component. While evaluating on various public medical question-answering benchmarks, our lightweight PMCLLaMA, which consists of only 13 billion parameters, exhibits superior performance, even surpassing ChatGPT. All models, codes, datasets can be found in https://github.com/chaoyi-wu/PMC-LLaMA.

Capabilities of GPT-4 on Medical Challenge Problems

Large language models (LLMs) have demonstrated remarkable capabilities in natural language understanding and generation across various domains, including medicine. We present a comprehensive evaluation of GPT-4, a state-of-the-art LLM, on medical competency examinations and benchmark datasets. GPT-4 is a general-purpose model that is not specialized for medical problems through training or engineered to solve clinical tasks. Our analysis covers two sets of official practice materials for the USMLE, a three-step examination program used to assess clinical competency and grant licensure in the United States. We also evaluate performance on the MultiMedQA suite of benchmark datasets. Beyond measuring model performance, experiments were conducted to investigate the influence of test questions containing both text and images on model performance, probe for memorization of content during training, and study probability calibration, which is of critical importance in high-stakes applications like medicine. Our results show that GPT-4, without any specialized prompt crafting, exceeds the passing score on USMLE by over 20 points and outperforms earlier general-purpose models (GPT-3.5) as well as models specifically fine-tuned on medical knowledge (Med-PaLM, a prompt-tuned version of Flan-PaLM 540B). In addition, GPT-4 is significantly better calibrated than GPT-3.5, demonstrating a much-improved ability to predict the likelihood that its answers are correct. We also explore the behavior of the model qualitatively through a case study that shows the ability of GPT-4 to explain medical reasoning, personalize explanations to students, and interactively craft new counterfactual scenarios around a medical case. Implications of the findings are discussed for potential uses of GPT-4 in medical education, assessment, and clinical practice, with appropriate attention to challenges of accuracy and safety.

VNHSGE: VietNamese High School Graduation Examination Dataset for Large Language Models

The VNHSGE (VietNamese High School Graduation Examination) dataset, developed exclusively for evaluating large language models (LLMs), is introduced in this article. The dataset, which covers nine subjects, was generated from the Vietnamese National High School Graduation Examination and comparable tests. 300 literary essays have been included, and there are over 19,000 multiple-choice questions on a range of topics. The dataset assesses LLMs in multitasking situations such as question answering, text generation, reading comprehension, visual question answering, and more by including both textual data and accompanying images. Using ChatGPT and BingChat, we evaluated LLMs on the VNHSGE dataset and contrasted their performance with that of Vietnamese students to see how well they performed. The results show that ChatGPT and BingChat both perform at a human level in a number of areas, including literature, English, history, geography, and civics education. They still have space to grow, though, especially in the areas of mathematics, physics, chemistry, and biology. The VNHSGE dataset seeks to provide an adequate benchmark for assessing the abilities of LLMs with its wide-ranging coverage and variety of activities. We intend to promote future developments in the creation of LLMs by making this dataset available to the scientific community, especially in resolving LLMs' limits in disciplines involving mathematics and the natural sciences.

Benchmarking Large Language Models on CMExam -- A Comprehensive Chinese Medical Exam Dataset

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.

MedSumm: A Multimodal Approach to Summarizing Code-Mixed Hindi-English Clinical Queries

In the healthcare domain, summarizing medical questions posed by patients is critical for improving doctor-patient interactions and medical decision-making. Although medical data has grown in complexity and quantity, the current body of research in this domain has primarily concentrated on text-based methods, overlooking the integration of visual cues. Also prior works in the area of medical question summarisation have been limited to the English language. This work introduces the task of multimodal medical question summarization for codemixed input in a low-resource setting. To address this gap, we introduce the Multimodal Medical Codemixed Question Summarization MMCQS dataset, which combines Hindi-English codemixed medical queries with visual aids. This integration enriches the representation of a patient's medical condition, providing a more comprehensive perspective. We also propose a framework named MedSumm that leverages the power of LLMs and VLMs for this task. By utilizing our MMCQS dataset, we demonstrate the value of integrating visual information from images to improve the creation of medically detailed summaries. This multimodal strategy not only improves healthcare decision-making but also promotes a deeper comprehension of patient queries, paving the way for future exploration in personalized and responsive medical care. Our dataset, code, and pre-trained models will be made publicly available.

A Preliminary Study of o1 in Medicine: Are We Closer to an AI Doctor?

Large language models (LLMs) have exhibited remarkable capabilities across various domains and tasks, pushing the boundaries of our knowledge in learning and cognition. The latest model, OpenAI's o1, stands out as the first LLM with an internalized chain-of-thought technique using reinforcement learning strategies. While it has demonstrated surprisingly strong capabilities on various general language tasks, its performance in specialized fields such as medicine remains unknown. To this end, this report provides a comprehensive exploration of o1 on different medical scenarios, examining 3 key aspects: understanding, reasoning, and multilinguality. Specifically, our evaluation encompasses 6 tasks using data from 37 medical datasets, including two newly constructed and more challenging question-answering (QA) tasks based on professional medical quizzes from the New England Journal of Medicine (NEJM) and The Lancet. These datasets offer greater clinical relevance compared to standard medical QA benchmarks such as MedQA, translating more effectively into real-world clinical utility. Our analysis of o1 suggests that the enhanced reasoning ability of LLMs may (significantly) benefit their capability to understand various medical instructions and reason through complex clinical scenarios. Notably, o1 surpasses the previous GPT-4 in accuracy by an average of 6.2% and 6.6% across 19 datasets and two newly created complex QA scenarios. But meanwhile, we identify several weaknesses in both the model capability and the existing evaluation protocols, including hallucination, inconsistent multilingual ability, and discrepant metrics for evaluation. We release our raw data and model outputs at https://ucsc-vlaa.github.io/o1_medicine/ for future research.

Towards Expert-Level Medical Question Answering with Large Language Models

Recent artificial intelligence (AI) systems have reached milestones in "grand challenges" ranging from Go to protein-folding. The capability to retrieve medical knowledge, reason over it, and answer medical questions comparably to physicians has long been viewed as one such grand challenge. Large language models (LLMs) have catalyzed significant progress in medical question answering; Med-PaLM was the first model to exceed a "passing" score in US Medical Licensing Examination (USMLE) style questions with a score of 67.2% on the MedQA dataset. However, this and other prior work suggested significant room for improvement, especially when models' answers were compared to clinicians' answers. Here we present Med-PaLM 2, which bridges these gaps by leveraging a combination of base LLM improvements (PaLM 2), medical domain finetuning, and prompting strategies including a novel ensemble refinement approach. Med-PaLM 2 scored up to 86.5% on the MedQA dataset, improving upon Med-PaLM by over 19% and setting a new state-of-the-art. We also observed performance approaching or exceeding state-of-the-art across MedMCQA, PubMedQA, and MMLU clinical topics datasets. We performed detailed human evaluations on long-form questions along multiple axes relevant to clinical applications. In pairwise comparative ranking of 1066 consumer medical questions, physicians preferred Med-PaLM 2 answers to those produced by physicians on eight of nine axes pertaining to clinical utility (p < 0.001). We also observed significant improvements compared to Med-PaLM on every evaluation axis (p < 0.001) on newly introduced datasets of 240 long-form "adversarial" questions to probe LLM limitations. While further studies are necessary to validate the efficacy of these models in real-world settings, these results highlight rapid progress towards physician-level performance in medical question answering.

KazQAD: Kazakh Open-Domain Question Answering Dataset

We introduce KazQAD -- a Kazakh open-domain question answering (ODQA) dataset -- that can be used in both reading comprehension and full ODQA settings, as well as for information retrieval experiments. KazQAD contains just under 6,000 unique questions with extracted short answers and nearly 12,000 passage-level relevance judgements. We use a combination of machine translation, Wikipedia search, and in-house manual annotation to ensure annotation efficiency and data quality. The questions come from two sources: translated items from the Natural Questions (NQ) dataset (only for training) and the original Kazakh Unified National Testing (UNT) exam (for development and testing). The accompanying text corpus contains more than 800,000 passages from the Kazakh Wikipedia. As a supplementary dataset, we release around 61,000 question-passage-answer triples from the NQ dataset that have been machine-translated into Kazakh. We develop baseline retrievers and readers that achieve reasonable scores in retrieval (NDCG@10 = 0.389 MRR = 0.382), reading comprehension (EM = 38.5 F1 = 54.2), and full ODQA (EM = 17.8 F1 = 28.7) settings. Nevertheless, these results are substantially lower than state-of-the-art results for English QA collections, and we think that there should still be ample room for improvement. We also show that the current OpenAI's ChatGPTv3.5 is not able to answer KazQAD test questions in the closed-book setting with acceptable quality. The dataset is freely available under the Creative Commons licence (CC BY-SA) at https://github.com/IS2AI/KazQAD.

CLIPSyntel: CLIP and LLM Synergy for Multimodal Question Summarization in Healthcare

In the era of modern healthcare, swiftly generating medical question summaries is crucial for informed and timely patient care. Despite the increasing complexity and volume of medical data, existing studies have focused solely on text-based summarization, neglecting the integration of visual information. Recognizing the untapped potential of combining textual queries with visual representations of medical conditions, we introduce the Multimodal Medical Question Summarization (MMQS) Dataset. This dataset, a major contribution to our work, pairs medical queries with visual aids, facilitating a richer and more nuanced understanding of patient needs. We also propose a framework, utilizing the power of Contrastive Language Image Pretraining(CLIP) and Large Language Models(LLMs), consisting of four modules that identify medical disorders, generate relevant context, filter medical concepts, and craft visually aware summaries. Our comprehensive framework harnesses the power of CLIP, a multimodal foundation model, and various general-purpose LLMs, comprising four main modules: the medical disorder identification module, the relevant context generation module, the context filtration module for distilling relevant medical concepts and knowledge, and finally, a general-purpose LLM to generate visually aware medical question summaries. Leveraging our MMQS dataset, we showcase how visual cues from images enhance the generation of medically nuanced summaries. This multimodal approach not only enhances the decision-making process in healthcare but also fosters a more nuanced understanding of patient queries, laying the groundwork for future research in personalized and responsive medical care

The Potential of LLMs in Medical Education: Generating Questions and Answers for Qualification Exams

Recent research on large language models (LLMs) has primarily focused on their adaptation and application in specialized domains. The application of LLMs in the medical field is mainly concentrated on tasks such as the automation of medical report generation, summarization, diagnostic reasoning, and question-and-answer interactions between doctors and patients. The challenge of becoming a good teacher is more formidable than that of becoming a good student, and this study pioneers the application of LLMs in the field of medical education. In this work, we investigate the extent to which LLMs can generate medical qualification exam questions and corresponding answers based on few-shot prompts. Utilizing a real-world Chinese dataset of elderly chronic diseases, we tasked the LLMs with generating open-ended questions and answers based on a subset of sampled admission reports across eight widely used LLMs, including ERNIE 4, ChatGLM 4, Doubao, Hunyuan, Spark 4, Qwen, Llama 3, and Mistral. Furthermore, we engaged medical experts to manually evaluate these open-ended questions and answers across multiple dimensions. The study found that LLMs, after using few-shot prompts, can effectively mimic real-world medical qualification exam questions, whereas there is room for improvement in the correctness, evidence-based statements, and professionalism of the generated answers. Moreover, LLMs also demonstrate a decent level of ability to correct and rectify reference answers. Given the immense potential of artificial intelligence in the medical field, the task of generating questions and answers for medical qualification exams aimed at medical students, interns and residents can be a significant focus of future research.

Improving Retrieval-Augmented Generation in Medicine with Iterative Follow-up Questions

The emergent abilities of large language models (LLMs) have demonstrated great potential in solving medical questions. They can possess considerable medical knowledge, but may still hallucinate and are inflexible in the knowledge updates. While Retrieval-Augmented Generation (RAG) has been proposed to enhance the medical question-answering capabilities of LLMs with external knowledge bases, it may still fail in complex cases where multiple rounds of information-seeking are required. To address such an issue, we propose iterative RAG for medicine (i-MedRAG), where LLMs can iteratively ask follow-up queries based on previous information-seeking attempts. In each iteration of i-MedRAG, the follow-up queries will be answered by a vanilla RAG system and they will be further used to guide the query generation in the next iteration. Our experiments show the improved performance of various LLMs brought by i-MedRAG compared with vanilla RAG on complex questions from clinical vignettes in the United States Medical Licensing Examination (USMLE), as well as various knowledge tests in the Massive Multitask Language Understanding (MMLU) dataset. Notably, our zero-shot i-MedRAG outperforms all existing prompt engineering and fine-tuning methods on GPT-3.5, achieving an accuracy of 69.68\% on the MedQA dataset. In addition, we characterize the scaling properties of i-MedRAG with different iterations of follow-up queries and different numbers of queries per iteration. Our case studies show that i-MedRAG can flexibly ask follow-up queries to form reasoning chains, providing an in-depth analysis of medical questions. To the best of our knowledge, this is the first-of-its-kind study on incorporating follow-up queries into medical RAG.

ChroniclingAmericaQA: A Large-scale Question Answering Dataset based on Historical American Newspaper Pages

Question answering (QA) and Machine Reading Comprehension (MRC) tasks have significantly advanced in recent years due to the rapid development of deep learning techniques and, more recently, large language models. At the same time, many benchmark datasets have become available for QA and MRC tasks. However, most existing large-scale benchmark datasets have been created predominantly using synchronous document collections like Wikipedia or the Web. Archival document collections, such as historical newspapers, contain valuable information from the past that is still not widely used to train large language models. To further contribute to advancing QA and MRC tasks and to overcome the limitation of previous datasets, we introduce ChroniclingAmericaQA, a large-scale dataset with 485K question-answer pairs created based on the historical newspaper collection Chronicling America. Our dataset is constructed from a subset of the Chronicling America newspaper collection spanning 120 years. One of the significant challenges for utilizing digitized historical newspaper collections is the low quality of OCR text. Therefore, to enable realistic testing of QA models, our dataset can be used in three different ways: answering questions from raw and noisy content, answering questions from cleaner, corrected version of the content, as well as answering questions from scanned images of newspaper pages. This and the fact that ChroniclingAmericaQA spans the longest time period among available QA datasets make it quite a unique and useful resource.

Alloprof: a new French question-answer education dataset and its use in an information retrieval case study

Teachers and students are increasingly relying on online learning resources to supplement the ones provided in school. This increase in the breadth and depth of available resources is a great thing for students, but only provided they are able to find answers to their queries. Question-answering and information retrieval systems have benefited from public datasets to train and evaluate their algorithms, but most of these datasets have been in English text written by and for adults. We introduce a new public French question-answering dataset collected from Alloprof, a Quebec-based primary and high-school help website, containing 29 349 questions and their explanations in a variety of school subjects from 10 368 students, with more than half of the explanations containing links to other questions or some of the 2 596 reference pages on the website. We also present a case study of this dataset in an information retrieval task. This dataset was collected on the Alloprof public forum, with all questions verified for their appropriateness and the explanations verified both for their appropriateness and their relevance to the question. To predict relevant documents, architectures using pre-trained BERT models were fine-tuned and evaluated. This dataset will allow researchers to develop question-answering, information retrieval and other algorithms specifically for the French speaking education context. Furthermore, the range of language proficiency, images, mathematical symbols and spelling mistakes will necessitate algorithms based on a multimodal comprehension. The case study we present as a baseline shows an approach that relies on recent techniques provides an acceptable performance level, but more work is necessary before it can reliably be used and trusted in a production setting.

SynDARin: Synthesising Datasets for Automated Reasoning in Low-Resource Languages

Question Answering (QA) datasets have been instrumental in developing and evaluating Large Language Model (LLM) capabilities. However, such datasets are scarce for languages other than English due to the cost and difficulties of collection and manual annotation. This means that producing novel models and measuring the performance of multilingual LLMs in low-resource languages is challenging. To mitigate this, we propose SynDARin, a method for generating and validating QA datasets for low-resource languages. We utilize parallel content mining to obtain human-curated paragraphs between English and the target language. We use the English data as context to generate synthetic multiple-choice (MC) question-answer pairs, which are automatically translated and further validated for quality. Combining these with their designated non-English human-curated paragraphs form the final QA dataset. The method allows to maintain the content quality, reduces the likelihood of factual errors, and circumvents the need for costly annotation. To test the method, we created a QA dataset with 1.2K samples for the Armenian language. The human evaluation shows that 98% of the generated English data maintains quality and diversity in the question types and topics, while the translation validation pipeline can filter out sim70% of data with poor quality. We use the dataset to benchmark state-of-the-art LLMs, showing their inability to achieve human accuracy with some model performances closer to random chance. This shows that the generated dataset is non-trivial and can be used to evaluate reasoning capabilities in low-resource language.

MMLU-CF: A Contamination-free Multi-task Language Understanding Benchmark

Multiple-choice question (MCQ) datasets like Massive Multitask Language Understanding (MMLU) are widely used to evaluate the commonsense, understanding, and problem-solving abilities of large language models (LLMs). However, the open-source nature of these benchmarks and the broad sources of training data for LLMs have inevitably led to benchmark contamination, resulting in unreliable evaluation results. To alleviate this issue, we propose a contamination-free and more challenging MCQ benchmark called MMLU-CF. This benchmark reassesses LLMs' understanding of world knowledge by averting both unintentional and malicious data leakage. To avoid unintentional data leakage, we source data from a broader domain and design three decontamination rules. To prevent malicious data leakage, we divide the benchmark into validation and test sets with similar difficulty and subject distributions. The test set remains closed-source to ensure reliable results, while the validation set is publicly available to promote transparency and facilitate independent verification. Our evaluation of mainstream LLMs reveals that the powerful GPT-4o achieves merely a 5-shot score of 73.4% and a 0-shot score of 71.9% on the test set, which indicates the effectiveness of our approach in creating a more rigorous and contamination-free evaluation standard. The GitHub repository is available at https://github.com/microsoft/MMLU-CF and the dataset refers to https://huggingface.co/datasets/microsoft/MMLU-CF.

Explanatory Argument Extraction of Correct Answers in Resident Medical Exams

Developing the required technology to assist medical experts in their everyday activities is currently a hot topic in the Artificial Intelligence research field. Thus, a number of large language models (LLMs) and automated benchmarks have recently been proposed with the aim of facilitating information extraction in Evidence-Based Medicine (EBM) using natural language as a tool for mediating in human-AI interaction. The most representative benchmarks are limited to either multiple-choice or long-form answers and are available only in English. In order to address these shortcomings, in this paper we present a new dataset which, unlike previous work: (i) includes not only explanatory arguments for the correct answer, but also arguments to reason why the incorrect answers are not correct; (ii) the explanations are written originally by medical doctors to answer questions from the Spanish Residency Medical Exams. Furthermore, this new benchmark allows us to setup a novel extractive task which consists of identifying the explanation of the correct answer written by medical doctors. An additional benefit of our setting is that we can leverage the extractive QA paradigm to automatically evaluate performance of LLMs without resorting to costly manual evaluation by medical experts. Comprehensive experimentation with language models for Spanish shows that sometimes multilingual models fare better than monolingual ones, even outperforming models which have been adapted to the medical domain. Furthermore, results across the monolingual models are mixed, with supposedly smaller and inferior models performing competitively. In any case, the obtained results show that our novel dataset and approach can be an effective technique to help medical practitioners in identifying relevant evidence-based explanations for medical questions.

Wrong Answers Can Also Be Useful: PlausibleQA -- A Large-Scale QA Dataset with Answer Plausibility Scores

Large Language Models (LLMs) are revolutionizing information retrieval, with chatbots becoming an important source for answering user queries. As by their design, LLMs prioritize generating correct answers, the value of highly plausible yet incorrect answers (candidate answers) tends to be overlooked. However, such answers can still prove useful, for example, they can play a crucial role in tasks like Multiple-Choice Question Answering (MCQA) and QA Robustness Assessment (QARA). Existing QA datasets primarily focus on correct answers without explicit consideration of the plausibility of other candidate answers, limiting opportunity for more nuanced evaluations of models. To address this gap, we introduce PlausibleQA, a large-scale dataset comprising 10,000 questions and 100,000 candidate answers, each annotated with plausibility scores and justifications for their selection. Additionally, the dataset includes 900,000 justifications for pairwise comparisons between candidate answers, further refining plausibility assessments. We evaluate PlausibleQA through human assessments and empirical experiments, demonstrating its utility in MCQA and QARA analysis. Our findings show that plausibility-aware approaches are effective for MCQA distractor generation and QARA. We release PlausibleQA as a resource for advancing QA research and enhancing LLM performance in distinguishing plausible distractors from correct answers.

MMSci: A Multimodal Multi-Discipline Dataset for PhD-Level Scientific Comprehension

The rapid advancement of Large Language Models (LLMs) and Large Multimodal Models (LMMs) has heightened the demand for AI-based scientific assistants capable of understanding scientific articles and figures. Despite progress, there remains a significant gap in evaluating models' comprehension of professional, graduate-level, and even PhD-level scientific content. Current datasets and benchmarks primarily focus on relatively simple scientific tasks and figures, lacking comprehensive assessments across diverse advanced scientific disciplines. To bridge this gap, we collected a multimodal, multidisciplinary dataset from open-access scientific articles published in Nature Communications journals. This dataset spans 72 scientific disciplines, ensuring both diversity and quality. We created benchmarks with various tasks and settings to comprehensively evaluate LMMs' capabilities in understanding scientific figures and content. Our evaluation revealed that these tasks are highly challenging: many open-source models struggled significantly, and even GPT-4V and GPT-4o faced difficulties. We also explored using our dataset as training resources by constructing visual instruction-following data, enabling the 7B LLaVA model to achieve performance comparable to GPT-4V/o on our benchmark. Additionally, we investigated the use of our interleaved article texts and figure images for pre-training LMMs, resulting in improvements on the material generation task. The source dataset, including articles, figures, constructed benchmarks, and visual instruction-following data, is open-sourced.

MRAMG-Bench: A BeyondText Benchmark for Multimodal Retrieval-Augmented Multimodal Generation

Recent advancements in Retrieval-Augmented Generation (RAG) have shown remarkable performance in enhancing response accuracy and relevance by integrating external knowledge into generative models. However, existing RAG methods primarily focus on providing text-only answers, even in multimodal retrieval-augmented generation scenarios. In this work, we introduce the Multimodal Retrieval-Augmented Multimodal Generation (MRAMG) task, which aims to generate answers that combine both text and images, fully leveraging the multimodal data within a corpus. Despite the importance of this task, there is a notable absence of a comprehensive benchmark to effectively evaluate MRAMG performance. To bridge this gap, we introduce the MRAMG-Bench, a carefully curated, human-annotated dataset comprising 4,346 documents, 14,190 images, and 4,800 QA pairs, sourced from three categories: Web Data, Academic Papers, and Lifestyle. The dataset incorporates diverse difficulty levels and complex multi-image scenarios, providing a robust foundation for evaluating multimodal generation tasks. To facilitate rigorous evaluation, our MRAMG-Bench incorporates a comprehensive suite of both statistical and LLM-based metrics, enabling a thorough analysis of the performance of popular generative models in the MRAMG task. Besides, we propose an efficient multimodal answer generation framework that leverages both LLMs and MLLMs to generate multimodal responses. Our datasets are available at: https://huggingface.co/MRAMG.

A Toolbox for Surfacing Health Equity Harms and Biases in Large Language Models

Large language models (LLMs) hold immense promise to serve complex health information needs but also have the potential to introduce harm and exacerbate health disparities. Reliably evaluating equity-related model failures is a critical step toward developing systems that promote health equity. In this work, we present resources and methodologies for surfacing biases with potential to precipitate equity-related harms in long-form, LLM-generated answers to medical questions and then conduct an empirical case study with Med-PaLM 2, resulting in the largest human evaluation study in this area to date. Our contributions include a multifactorial framework for human assessment of LLM-generated answers for biases, and EquityMedQA, a collection of seven newly-released datasets comprising both manually-curated and LLM-generated questions enriched for adversarial queries. Both our human assessment framework and dataset design process are grounded in an iterative participatory approach and review of possible biases in Med-PaLM 2 answers to adversarial queries. Through our empirical study, we find that the use of a collection of datasets curated through a variety of methodologies, coupled with a thorough evaluation protocol that leverages multiple assessment rubric designs and diverse rater groups, surfaces biases that may be missed via narrower evaluation approaches. Our experience underscores the importance of using diverse assessment methodologies and involving raters of varying backgrounds and expertise. We emphasize that while our framework can identify specific forms of bias, it is not sufficient to holistically assess whether the deployment of an AI system promotes equitable health outcomes. We hope the broader community leverages and builds on these tools and methods towards realizing a shared goal of LLMs that promote accessible and equitable healthcare for all.

MedAgentsBench: Benchmarking Thinking Models and Agent Frameworks for Complex Medical Reasoning

Large Language Models (LLMs) have shown impressive performance on existing medical question-answering benchmarks. This high performance makes it increasingly difficult to meaningfully evaluate and differentiate advanced methods. We present MedAgentsBench, a benchmark that focuses on challenging medical questions requiring multi-step clinical reasoning, diagnosis formulation, and treatment planning-scenarios where current models still struggle despite their strong performance on standard tests. Drawing from seven established medical datasets, our benchmark addresses three key limitations in existing evaluations: (1) the prevalence of straightforward questions where even base models achieve high performance, (2) inconsistent sampling and evaluation protocols across studies, and (3) lack of systematic analysis of the interplay between performance, cost, and inference time. Through experiments with various base models and reasoning methods, we demonstrate that the latest thinking models, DeepSeek R1 and OpenAI o3, exhibit exceptional performance in complex medical reasoning tasks. Additionally, advanced search-based agent methods offer promising performance-to-cost ratios compared to traditional approaches. Our analysis reveals substantial performance gaps between model families on complex questions and identifies optimal model selections for different computational constraints. Our benchmark and evaluation framework are publicly available at https://github.com/gersteinlab/medagents-benchmark.

Question-Answering Model for Schizophrenia Symptoms and Their Impact on Daily Life using Mental Health Forums Data

In recent years, there is strong emphasis on mining medical data using machine learning techniques. A common problem is to obtain a noiseless set of textual documents, with a relevant content for the research question, and developing a Question Answering (QA) model for a specific medical field. The purpose of this paper is to present a new methodology for building a medical dataset and obtain a QA model for analysis of symptoms and impact on daily life for a specific disease domain. The ``Mental Health'' forum was used, a forum dedicated to people suffering from schizophrenia and different mental disorders. Relevant posts of active users, who regularly participate, were extrapolated providing a new method of obtaining low-bias content and without privacy issues. Furthermore, it is shown how to pre-process the dataset to convert it into a QA dataset. The Bidirectional Encoder Representations from Transformers (BERT), DistilBERT, RoBERTa, and BioBERT models were fine-tuned and evaluated via F1-Score, Exact Match, Precision and Recall. Accurate empirical experiments demonstrated the effectiveness of the proposed method for obtaining an accurate dataset for QA model implementation. By fine-tuning the BioBERT QA model, we achieved an F1 score of 0.885, showing a considerable improvement and outperforming the state-of-the-art model for mental disorders domain.

Tool Calling: Enhancing Medication Consultation via Retrieval-Augmented Large Language Models

Large-scale language models (LLMs) have achieved remarkable success across various language tasks but suffer from hallucinations and temporal misalignment. To mitigate these shortcomings, Retrieval-augmented generation (RAG) has been utilized to provide external knowledge to facilitate the answer generation. However, applying such models to the medical domain faces several challenges due to the lack of domain-specific knowledge and the intricacy of real-world scenarios. In this study, we explore LLMs with RAG framework for knowledge-intensive tasks in the medical field. To evaluate the capabilities of LLMs, we introduce MedicineQA, a multi-round dialogue benchmark that simulates the real-world medication consultation scenario and requires LLMs to answer with retrieved evidence from the medicine database. MedicineQA contains 300 multi-round question-answering pairs, each embedded within a detailed dialogue history, highlighting the challenge posed by this knowledge-intensive task to current LLMs. We further propose a new Distill-Retrieve-Read framework instead of the previous Retrieve-then-Read. Specifically, the distillation and retrieval process utilizes a tool calling mechanism to formulate search queries that emulate the keyword-based inquiries used by search engines. With experimental results, we show that our framework brings notable performance improvements and surpasses the previous counterparts in the evidence retrieval process in terms of evidence retrieval accuracy. This advancement sheds light on applying RAG to the medical domain.

MediConfusion: Can you trust your AI radiologist? Probing the reliability of multimodal medical foundation models

Multimodal Large Language Models (MLLMs) have tremendous potential to improve the accuracy, availability, and cost-effectiveness of healthcare by providing automated solutions or serving as aids to medical professionals. Despite promising first steps in developing medical MLLMs in the past few years, their capabilities and limitations are not well-understood. Recently, many benchmark datasets have been proposed that test the general medical knowledge of such models across a variety of medical areas. However, the systematic failure modes and vulnerabilities of such models are severely underexplored with most medical benchmarks failing to expose the shortcomings of existing models in this safety-critical domain. In this paper, we introduce MediConfusion, a challenging medical Visual Question Answering (VQA) benchmark dataset, that probes the failure modes of medical MLLMs from a vision perspective. We reveal that state-of-the-art models are easily confused by image pairs that are otherwise visually dissimilar and clearly distinct for medical experts. Strikingly, all available models (open-source or proprietary) achieve performance below random guessing on MediConfusion, raising serious concerns about the reliability of existing medical MLLMs for healthcare deployment. We also extract common patterns of model failure that may help the design of a new generation of more trustworthy and reliable MLLMs in healthcare.

TurkishMMLU: Measuring Massive Multitask Language Understanding in Turkish

Multiple choice question answering tasks evaluate the reasoning, comprehension, and mathematical abilities of Large Language Models (LLMs). While existing benchmarks employ automatic translation for multilingual evaluation, this approach is error-prone and potentially introduces culturally biased questions, especially in social sciences. We introduce the first multitask, multiple-choice Turkish QA benchmark, TurkishMMLU, to evaluate LLMs' understanding of the Turkish language. TurkishMMLU includes over 10,000 questions, covering 9 different subjects from Turkish high-school education curricula. These questions are written by curriculum experts, suitable for the high-school curricula in Turkey, covering subjects ranging from natural sciences and math questions to more culturally representative topics such as Turkish Literature and the history of the Turkish Republic. We evaluate over 20 LLMs, including multilingual open-source (e.g., Gemma, Llama, MT5), closed-source (GPT 4o, Claude, Gemini), and Turkish-adapted (e.g., Trendyol) models. We provide an extensive evaluation, including zero-shot and few-shot evaluation of LLMs, chain-of-thought reasoning, and question difficulty analysis along with model performance. We provide an in-depth analysis of the Turkish capabilities and limitations of current LLMs to provide insights for future LLMs for the Turkish language. We publicly release our code for the dataset and evaluation: https://github.com/ArdaYueksel/TurkishMMLU.

MoreHopQA: More Than Multi-hop Reasoning

Most existing multi-hop datasets are extractive answer datasets, where the answers to the questions can be extracted directly from the provided context. This often leads models to use heuristics or shortcuts instead of performing true multi-hop reasoning. In this paper, we propose a new multi-hop dataset, MoreHopQA, which shifts from extractive to generative answers. Our dataset is created by utilizing three existing multi-hop datasets: HotpotQA, 2WikiMultihopQA, and MuSiQue. Instead of relying solely on factual reasoning, we enhance the existing multi-hop questions by adding another layer of questioning that involves one, two, or all three of the following types of reasoning: commonsense, arithmetic, and symbolic. Our dataset is created through a semi-automated process, resulting in a dataset with 1,118 samples that have undergone human verification. We then use our dataset to evaluate five different large language models: Mistral 7B, Gemma 7B, Llama 3 (8B and 70B), and GPT-4. We also design various cases to analyze the reasoning steps in the question-answering process. Our results show that models perform well on initial multi-hop questions but struggle with our extended questions, indicating that our dataset is more challenging than previous ones. Our analysis of question decomposition reveals that although models can correctly answer questions, only a portion - 38.7% for GPT-4 and 33.4% for Llama3-70B - achieve perfect reasoning, where all corresponding sub-questions are answered correctly. Evaluation code and data are available at https://github.com/Alab-NII/morehopqa

Retrieval Helps or Hurts? A Deeper Dive into the Efficacy of Retrieval Augmentation to Language Models

While large language models (LMs) demonstrate remarkable performance, they encounter challenges in providing accurate responses when queried for information beyond their pre-trained memorization. Although augmenting them with relevant external information can mitigate these issues, failure to consider the necessity of retrieval may adversely affect overall performance. Previous research has primarily focused on examining how entities influence retrieval models and knowledge recall in LMs, leaving other aspects relatively unexplored. In this work, our goal is to offer a more detailed, fact-centric analysis by exploring the effects of combinations of entities and relations. To facilitate this, we construct a new question answering (QA) dataset called WiTQA (Wikipedia Triple Question Answers). This dataset includes questions about entities and relations of various popularity levels, each accompanied by a supporting passage. Our extensive experiments with diverse LMs and retrievers reveal when retrieval does not consistently enhance LMs from the viewpoints of fact-centric popularity.Confirming earlier findings, we observe that larger LMs excel in recalling popular facts. However, they notably encounter difficulty with infrequent entity-relation pairs compared to retrievers. Interestingly, they can effectively retain popular relations of less common entities. We demonstrate the efficacy of our finer-grained metric and insights through an adaptive retrieval system that selectively employs retrieval and recall based on the frequencies of entities and relations in the question.

Medical Adaptation of Large Language and Vision-Language Models: Are We Making Progress?

Several recent works seek to develop foundation models specifically for medical applications, adapting general-purpose large language models (LLMs) and vision-language models (VLMs) via continued pretraining on publicly available biomedical corpora. These works typically claim that such domain-adaptive pretraining (DAPT) improves performance on downstream medical tasks, such as answering medical licensing exam questions. In this paper, we compare seven public "medical" LLMs and two VLMs against their corresponding base models, arriving at a different conclusion: all medical VLMs and nearly all medical LLMs fail to consistently improve over their base models in the zero-/few-shot prompting regime for medical question-answering (QA) tasks. For instance, across the tasks and model pairs we consider in the 3-shot setting, medical LLMs only outperform their base models in 12.1% of cases, reach a (statistical) tie in 49.8% of cases, and are significantly worse than their base models in the remaining 38.2% of cases. Our conclusions are based on (i) comparing each medical model head-to-head, directly against the corresponding base model; (ii) optimizing the prompts for each model separately; and (iii) accounting for statistical uncertainty in comparisons. While these basic practices are not consistently adopted in the literature, our ablations show that they substantially impact conclusions. Our findings suggest that state-of-the-art general-domain models may already exhibit strong medical knowledge and reasoning capabilities, and offer recommendations to strengthen the conclusions of future studies.

MedExpQA: Multilingual Benchmarking of Large Language Models for Medical Question Answering

Large Language Models (LLMs) have the potential of facilitating the development of Artificial Intelligence technology to assist medical experts for interactive decision support, which has been demonstrated by their competitive performances in Medical QA. However, while impressive, the required quality bar for medical applications remains far from being achieved. Currently, LLMs remain challenged by outdated knowledge and by their tendency to generate hallucinated content. Furthermore, most benchmarks to assess medical knowledge lack reference gold explanations which means that it is not possible to evaluate the reasoning of LLMs predictions. Finally, the situation is particularly grim if we consider benchmarking LLMs for languages other than English which remains, as far as we know, a totally neglected topic. In order to address these shortcomings, in this paper we present MedExpQA, the first multilingual benchmark based on medical exams to evaluate LLMs in Medical Question Answering. To the best of our knowledge, MedExpQA includes for the first time reference gold explanations written by medical doctors which can be leveraged to establish various gold-based upper-bounds for comparison with LLMs performance. Comprehensive multilingual experimentation using both the gold reference explanations and Retrieval Augmented Generation (RAG) approaches show that performance of LLMs still has large room for improvement, especially for languages other than English. Furthermore, and despite using state-of-the-art RAG methods, our results also demonstrate the difficulty of obtaining and integrating readily available medical knowledge that may positively impact results on downstream evaluations for Medical Question Answering. So far the benchmark is available in four languages, but we hope that this work may encourage further development to other languages.

Listening to the Wise Few: Select-and-Copy Attention Heads for Multiple-Choice QA

A standard way to evaluate the abilities of LLM involves presenting a multiple-choice question and selecting the option with the highest logit as the model's predicted answer. However, such a format for evaluating LLMs has limitations, since even if the model knows the correct answer, it may struggle to select the corresponding letter simply due to difficulties in following this rigid format. To address this, we introduce new scores that better capture and reveal model's underlying knowledge: the Query-Key Score (QK-score), derived from the interaction between query and key representations in attention heads, and the Attention Score, based on attention weights. These scores are extracted from specific select-and-copy heads, which show consistent performance across popular Multi-Choice Question Answering (MCQA) datasets. Based on these scores, our method improves knowledge extraction, yielding up to 16\% gain for LLaMA2-7B and up to 10\% for larger models on popular MCQA benchmarks. At the same time, the accuracy on a simple synthetic dataset, where the model explicitly knows the right answer, increases by almost 60\%, achieving nearly perfect accuracy, therefore demonstrating the method's efficiency in mitigating MCQA format limitations. To support our claims, we conduct experiments on models ranging from 7 billion to 70 billion parameters in both zero- and few-shot setups.

MEDEC: A Benchmark for Medical Error Detection and Correction in Clinical Notes

Several studies showed that Large Language Models (LLMs) can answer medical questions correctly, even outperforming the average human score in some medical exams. However, to our knowledge, no study has been conducted to assess the ability of language models to validate existing or generated medical text for correctness and consistency. In this paper, we introduce MEDEC (https://github.com/abachaa/MEDEC), the first publicly available benchmark for medical error detection and correction in clinical notes, covering five types of errors (Diagnosis, Management, Treatment, Pharmacotherapy, and Causal Organism). MEDEC consists of 3,848 clinical texts, including 488 clinical notes from three US hospital systems that were not previously seen by any LLM. The dataset has been used for the MEDIQA-CORR shared task to evaluate seventeen participating systems [Ben Abacha et al., 2024]. In this paper, we describe the data creation methods and we evaluate recent LLMs (e.g., o1-preview, GPT-4, Claude 3.5 Sonnet, and Gemini 2.0 Flash) for the tasks of detecting and correcting medical errors requiring both medical knowledge and reasoning capabilities. We also conducted a comparative study where two medical doctors performed the same task on the MEDEC test set. The results showed that MEDEC is a sufficiently challenging benchmark to assess the ability of models to validate existing or generated notes and to correct medical errors. We also found that although recent LLMs have a good performance in error detection and correction, they are still outperformed by medical doctors in these tasks. We discuss the potential factors behind this gap, the insights from our experiments, the limitations of current evaluation metrics, and share potential pointers for future research.

Biomedical knowledge graph-optimized prompt generation for large language models

Large Language Models (LLMs) are being adopted at an unprecedented rate, yet still face challenges in knowledge-intensive domains like biomedicine. Solutions such as pre-training and domain-specific fine-tuning add substantial computational overhead, requiring further domain expertise. Here, we introduce a token-optimized and robust Knowledge Graph-based Retrieval Augmented Generation (KG-RAG) framework by leveraging a massive biomedical KG (SPOKE) with LLMs such as Llama-2-13b, GPT-3.5-Turbo and GPT-4, to generate meaningful biomedical text rooted in established knowledge. Compared to the existing RAG technique for Knowledge Graphs, the proposed method utilizes minimal graph schema for context extraction and uses embedding methods for context pruning. This optimization in context extraction results in more than 50% reduction in token consumption without compromising the accuracy, making a cost-effective and robust RAG implementation on proprietary LLMs. KG-RAG consistently enhanced the performance of LLMs across diverse biomedical prompts by generating responses rooted in established knowledge, accompanied by accurate provenance and statistical evidence (if available) to substantiate the claims. Further benchmarking on human curated datasets, such as biomedical true/false and multiple-choice questions (MCQ), showed a remarkable 71% boost in the performance of the Llama-2 model on the challenging MCQ dataset, demonstrating the framework's capacity to empower open-source models with fewer parameters for domain specific questions. Furthermore, KG-RAG enhanced the performance of proprietary GPT models, such as GPT-3.5 and GPT-4. In summary, the proposed framework combines explicit and implicit knowledge of KG and LLM in a token optimized fashion, thus enhancing the adaptability of general-purpose LLMs to tackle domain-specific questions in a cost-effective fashion.

Multiple Choice Questions and Large Languages Models: A Case Study with Fictional Medical Data

Large Language Models (LLMs) like ChatGPT demonstrate significant potential in the medical field, often evaluated using multiple-choice questions (MCQs) similar to those found on the USMLE. Despite their prevalence in medical education, MCQs have limitations that might be exacerbated when assessing LLMs. To evaluate the effectiveness of MCQs in assessing the performance of LLMs, we developed a fictional medical benchmark focused on a non-existent gland, the Glianorex. This approach allowed us to isolate the knowledge of the LLM from its test-taking abilities. We used GPT-4 to generate a comprehensive textbook on the Glianorex in both English and French and developed corresponding multiple-choice questions in both languages. We evaluated various open-source, proprietary, and domain-specific LLMs using these questions in a zero-shot setting. The models achieved average scores around 67%, with minor performance differences between larger and smaller models. Performance was slightly higher in English than in French. Fine-tuned medical models showed some improvement over their base versions in English but not in French. The uniformly high performance across models suggests that traditional MCQ-based benchmarks may not accurately measure LLMs' clinical knowledge and reasoning abilities, instead highlighting their pattern recognition skills. This study underscores the need for more robust evaluation methods to better assess the true capabilities of LLMs in medical contexts.

On the Compositional Generalization of Multimodal LLMs for Medical Imaging

Multimodal large language models (MLLMs) hold significant potential in the medical field, but their capabilities are often limited by insufficient data in certain medical domains, highlighting the need for understanding what kinds of images can be used by MLLMs for generalization. Current research suggests that multi-task training outperforms single-task as different tasks can benefit each other, but they often overlook the internal relationships within these tasks, providing limited guidance on selecting datasets to enhance specific tasks. To analyze this phenomenon, we attempted to employ compositional generalization (CG)-the ability of models to understand novel combinations by recombining learned elements-as a guiding framework. Since medical images can be precisely defined by Modality, Anatomical area, and Task, naturally providing an environment for exploring CG. Therefore, we assembled 106 medical datasets to create Med-MAT for comprehensive experiments. The experiments confirmed that MLLMs can use CG to understand unseen medical images and identified CG as one of the main drivers of the generalization observed in multi-task training. Additionally, further studies demonstrated that CG effectively supports datasets with limited data and delivers consistent performance across different backbones, highlighting its versatility and broad applicability. Med-MAT is publicly available at https://github.com/FreedomIntelligence/Med-MAT.

Empowering Large Language Models in Wireless Communication: A Novel Dataset and Fine-Tuning Framework

In this work, we develop a specialized dataset aimed at enhancing the evaluation and fine-tuning of large language models (LLMs) specifically for wireless communication applications. The dataset includes a diverse set of multi-hop questions, including true/false and multiple-choice types, spanning varying difficulty levels from easy to hard. By utilizing advanced language models for entity extraction and question generation, rigorous data curation processes are employed to maintain high quality and relevance. Additionally, we introduce a Pointwise V-Information (PVI) based fine-tuning method, providing a detailed theoretical analysis and justification for its use in quantifying the information content of training data with 2.24\% and 1.31\% performance boost for different models compared to baselines, respectively. To demonstrate the effectiveness of the fine-tuned models with the proposed methodologies on practical tasks, we also consider different tasks, including summarizing optimization problems from technical papers and solving the mathematical problems related to non-orthogonal multiple access (NOMA), which are generated by using the proposed multi-agent framework. Simulation results show significant performance gain in summarization tasks with 20.9\% in the ROUGE-L metrics. We also study the scaling laws of fine-tuning LLMs and the challenges LLMs face in the field of wireless communications, offering insights into their adaptation to wireless communication tasks. This dataset and fine-tuning methodology aim to enhance the training and evaluation of LLMs, contributing to advancements in LLMs for wireless communication research and applications.

Uhura: A Benchmark for Evaluating Scientific Question Answering and Truthfulness in Low-Resource African Languages

Evaluations of Large Language Models (LLMs) on knowledge-intensive tasks and factual accuracy often focus on high-resource languages primarily because datasets for low-resource languages (LRLs) are scarce. In this paper, we present Uhura -- a new benchmark that focuses on two tasks in six typologically-diverse African languages, created via human translation of existing English benchmarks. The first dataset, Uhura-ARC-Easy, is composed of multiple-choice science questions. The second, Uhura-TruthfulQA, is a safety benchmark testing the truthfulness of models on topics including health, law, finance, and politics. We highlight the challenges creating benchmarks with highly technical content for LRLs and outline mitigation strategies. Our evaluation reveals a significant performance gap between proprietary models such as GPT-4o and o1-preview, and Claude models, and open-source models like Meta's LLaMA and Google's Gemma. Additionally, all models perform better in English than in African languages. These results indicate that LMs struggle with answering scientific questions and are more prone to generating false claims in low-resource African languages. Our findings underscore the necessity for continuous improvement of multilingual LM capabilities in LRL settings to ensure safe and reliable use in real-world contexts. We open-source the Uhura Benchmark and Uhura Platform to foster further research and development in NLP for LRLs.

A Comparative Study of Open-Source Large Language Models, GPT-4 and Claude 2: Multiple-Choice Test Taking in Nephrology

In recent years, there have been significant breakthroughs in the field of natural language processing, particularly with the development of large language models (LLMs). These LLMs have showcased remarkable capabilities on various benchmarks. In the healthcare field, the exact role LLMs and other future AI models will play remains unclear. There is a potential for these models in the future to be used as part of adaptive physician training, medical co-pilot applications, and digital patient interaction scenarios. The ability of AI models to participate in medical training and patient care will depend in part on their mastery of the knowledge content of specific medical fields. This study investigated the medical knowledge capability of LLMs, specifically in the context of internal medicine subspecialty multiple-choice test-taking ability. We compared the performance of several open-source LLMs (Koala 7B, Falcon 7B, Stable-Vicuna 13B, and Orca Mini 13B), to GPT-4 and Claude 2 on multiple-choice questions in the field of Nephrology. Nephrology was chosen as an example of a particularly conceptually complex subspecialty field within internal medicine. The study was conducted to evaluate the ability of LLM models to provide correct answers to nephSAP (Nephrology Self-Assessment Program) multiple-choice questions. The overall success of open-sourced LLMs in answering the 858 nephSAP multiple-choice questions correctly was 17.1% - 25.5%. In contrast, Claude 2 answered 54.4% of the questions correctly, whereas GPT-4 achieved a score of 73.3%. We show that current widely used open-sourced LLMs do poorly in their ability for zero-shot reasoning when compared to GPT-4 and Claude 2. The findings of this study potentially have significant implications for the future of subspecialty medical training and patient care.

Effective Transfer Learning for Identifying Similar Questions: Matching User Questions to COVID-19 FAQs

People increasingly search online for answers to their medical questions but the rate at which medical questions are asked online significantly exceeds the capacity of qualified people to answer them. This leaves many questions unanswered or inadequately answered. Many of these questions are not unique, and reliable identification of similar questions would enable more efficient and effective question answering schema. COVID-19 has only exacerbated this problem. Almost every government agency and healthcare organization has tried to meet the informational need of users by building online FAQs, but there is no way for people to ask their question and know if it is answered on one of these pages. While many research efforts have focused on the problem of general question similarity, these approaches do not generalize well to domains that require expert knowledge to determine semantic similarity, such as the medical domain. In this paper, we show how a double fine-tuning approach of pretraining a neural network on medical question-answer pairs followed by fine-tuning on medical question-question pairs is a particularly useful intermediate task for the ultimate goal of determining medical question similarity. While other pretraining tasks yield an accuracy below 78.7% on this task, our model achieves an accuracy of 82.6% with the same number of training examples, an accuracy of 80.0% with a much smaller training set, and an accuracy of 84.5% when the full corpus of medical question-answer data is used. We also describe a currently live system that uses the trained model to match user questions to COVID-related FAQs.

T2Ranking: A large-scale Chinese Benchmark for Passage Ranking

Passage ranking involves two stages: passage retrieval and passage re-ranking, which are important and challenging topics for both academics and industries in the area of Information Retrieval (IR). However, the commonly-used datasets for passage ranking usually focus on the English language. For non-English scenarios, such as Chinese, the existing datasets are limited in terms of data scale, fine-grained relevance annotation and false negative issues. To address this problem, we introduce T2Ranking, a large-scale Chinese benchmark for passage ranking. T2Ranking comprises more than 300K queries and over 2M unique passages from real-world search engines. Expert annotators are recruited to provide 4-level graded relevance scores (fine-grained) for query-passage pairs instead of binary relevance judgments (coarse-grained). To ease the false negative issues, more passages with higher diversities are considered when performing relevance annotations, especially in the test set, to ensure a more accurate evaluation. Apart from the textual query and passage data, other auxiliary resources are also provided, such as query types and XML files of documents which passages are generated from, to facilitate further studies. To evaluate the dataset, commonly used ranking models are implemented and tested on T2Ranking as baselines. The experimental results show that T2Ranking is challenging and there is still scope for improvement. The full data and all codes are available at https://github.com/THUIR/T2Ranking/

Datasets for Large Language Models: A Comprehensive Survey

This paper embarks on an exploration into the Large Language Model (LLM) datasets, which play a crucial role in the remarkable advancements of LLMs. The datasets serve as the foundational infrastructure analogous to a root system that sustains and nurtures the development of LLMs. Consequently, examination of these datasets emerges as a critical topic in research. In order to address the current lack of a comprehensive overview and thorough analysis of LLM datasets, and to gain insights into their current status and future trends, this survey consolidates and categorizes the fundamental aspects of LLM datasets from five perspectives: (1) Pre-training Corpora; (2) Instruction Fine-tuning Datasets; (3) Preference Datasets; (4) Evaluation Datasets; (5) Traditional Natural Language Processing (NLP) Datasets. The survey sheds light on the prevailing challenges and points out potential avenues for future investigation. Additionally, a comprehensive review of the existing available dataset resources is also provided, including statistics from 444 datasets, covering 8 language categories and spanning 32 domains. Information from 20 dimensions is incorporated into the dataset statistics. The total data size surveyed surpasses 774.5 TB for pre-training corpora and 700M instances for other datasets. We aim to present the entire landscape of LLM text datasets, serving as a comprehensive reference for researchers in this field and contributing to future studies. Related resources are available at: https://github.com/lmmlzn/Awesome-LLMs-Datasets.

MedAgents: Large Language Models as Collaborators for Zero-shot Medical Reasoning

Large Language Models (LLMs), despite their remarkable progress across various general domains, encounter significant barriers in medicine and healthcare. This field faces unique challenges such as domain-specific terminologies and the reasoning over specialized knowledge. To address these obstinate issues, we propose a novel Multi-disciplinary Collaboration (MC) framework for the medical domain that leverages role-playing LLM-based agents who participate in a collaborative multi-round discussion, thereby enhancing LLM proficiency and reasoning capabilities. This training-free and interpretable framework encompasses five critical steps: gathering domain experts, proposing individual analyses, summarising these analyses into a report, iterating over discussions until a consensus is reached, and ultimately making a decision. Our work particularly focuses on the zero-shot scenario, our results on nine data sets (MedQA, MedMCQA, PubMedQA, and six subtasks from MMLU) establish that our proposed MC framework excels at mining and harnessing the medical expertise in LLMs, as well as extending its reasoning abilities. Based on these outcomes, we further conduct a human evaluation to pinpoint and categorize common errors within our method, as well as ablation studies aimed at understanding the impact of various factors on overall performance. Our code can be found at https://github.com/gersteinlab/MedAgents.

SPIQA: A Dataset for Multimodal Question Answering on Scientific Papers

Seeking answers to questions within long scientific research articles is a crucial area of study that aids readers in quickly addressing their inquiries. However, existing question-answering (QA) datasets based on scientific papers are limited in scale and focus solely on textual content. To address this limitation, we introduce SPIQA (Scientific Paper Image Question Answering), the first large-scale QA dataset specifically designed to interpret complex figures and tables within the context of scientific research articles across various domains of computer science. Leveraging the breadth of expertise and ability of multimodal large language models (MLLMs) to understand figures, we employ automatic and manual curation to create the dataset. We craft an information-seeking task involving multiple images that cover a wide variety of plots, charts, tables, schematic diagrams, and result visualizations. SPIQA comprises 270K questions divided into training, validation, and three different evaluation splits. Through extensive experiments with 12 prominent foundational models, we evaluate the ability of current multimodal systems to comprehend the nuanced aspects of research articles. Additionally, we propose a Chain-of-Thought (CoT) evaluation strategy with in-context retrieval that allows fine-grained, step-by-step assessment and improves model performance. We further explore the upper bounds of performance enhancement with additional textual information, highlighting its promising potential for future research and the dataset's impact on revolutionizing how we interact with scientific literature.

Harnessing the Power of Prompt-based Techniques for Generating School-Level Questions using Large Language Models

Designing high-quality educational questions is a challenging and time-consuming task. In this work, we propose a novel approach that utilizes prompt-based techniques to generate descriptive and reasoning-based questions. However, current question-answering (QA) datasets are inadequate for conducting our experiments on prompt-based question generation (QG) in an educational setting. Therefore, we curate a new QG dataset called EduProbe for school-level subjects, by leveraging the rich content of NCERT textbooks. We carefully annotate this dataset as quadruples of 1) Context: a segment upon which the question is formed; 2) Long Prompt: a long textual cue for the question (i.e., a longer sequence of words or phrases, covering the main theme of the context); 3) Short Prompt: a short textual cue for the question (i.e., a condensed representation of the key information or focus of the context); 4) Question: a deep question that aligns with the context and is coherent with the prompts. We investigate several prompt-based QG methods by fine-tuning pre-trained transformer-based large language models (LLMs), namely PEGASUS, T5, MBART, and BART. Moreover, we explore the performance of two general-purpose pre-trained LLMs such as Text-Davinci-003 and GPT-3.5-Turbo without any further training. By performing automatic evaluation, we show that T5 (with long prompt) outperforms all other models, but still falls short of the human baseline. Under human evaluation criteria, TextDavinci-003 usually shows better results than other models under various prompt settings. Even in the case of human evaluation criteria, QG models mostly fall short of the human baseline. Our code and dataset are available at: https://github.com/my625/PromptQG

PMC-Patients: A Large-scale Dataset of Patient Notes and Relations Extracted from Case Reports in PubMed Central

Objective: Data unavailability has been one of the biggest barriers in clinical natural language processing. This paper is aimed at providing a large-scale and publicly available patient note dataset, named PMC-Patients, with relevant articles and similar patients annotations. The ultimate goal of PMC-Patients is to facilitate the development of retrieval-based clinical decision support systems. Materials and Methods: To collect PMC-Patients, we extract patient notes from case reports in PubMed Central by recognizing certain section patterns. Patient-article relevance and patient-patient similarity are annotated by citation relationships in PubMed. In addition, we perform three tasks with PMC-Patients to demonstrate its utility in providing clinical decision support for a given patient, including (1) classifying whether another patient is similar, (2) retrieving similar patients in PMC-Patients, and (3) retrieving relevant articles in PubMed. Results: We collect and release PMC-Patients under the CC BY-NC-SA license, which becomes the largest publicly available patient note dataset so far. PMC-Patients contains 167k patient notes that are annotated with 3.1M relevant articles and 293k similar patients. Qualitative and quantitative analyses reveal the high quality and richness of our dataset. Experiments show that classifying the similarity of patient pairs is relatively easy, but it is hard to retrieve similar patients or relevant articles for a given patient from a large set of candidates. Conclusion: We present PMC-Patients, a large-scale dataset of patient notes with high quality, easy access, diverse conditions, and rich annotations. The proposed dataset can also serve as a hard benchmark for evaluating retrieval-based clinical decision support systems.

A Vietnamese Dataset for Evaluating Machine Reading Comprehension

Over 97 million people speak Vietnamese as their native language in the world. However, there are few research studies on machine reading comprehension (MRC) for Vietnamese, the task of understanding a text and answering questions related to it. Due to the lack of benchmark datasets for Vietnamese, we present the Vietnamese Question Answering Dataset (UIT-ViQuAD), a new dataset for the low-resource language as Vietnamese to evaluate MRC models. This dataset comprises over 23,000 human-generated question-answer pairs based on 5,109 passages of 174 Vietnamese articles from Wikipedia. In particular, we propose a new process of dataset creation for Vietnamese MRC. Our in-depth analyses illustrate that our dataset requires abilities beyond simple reasoning like word matching and demands single-sentence and multiple-sentence inferences. Besides, we conduct experiments on state-of-the-art MRC methods for English and Chinese as the first experimental models on UIT-ViQuAD. We also estimate human performance on the dataset and compare it to the experimental results of powerful machine learning models. As a result, the substantial differences between human performance and the best model performance on the dataset indicate that improvements can be made on UIT-ViQuAD in future research. Our dataset is freely available on our website to encourage the research community to overcome challenges in Vietnamese MRC.

VLSP 2021 - ViMRC Challenge: Vietnamese Machine Reading Comprehension

One of the emerging research trends in natural language understanding is machine reading comprehension (MRC) which is the task to find answers to human questions based on textual data. Existing Vietnamese datasets for MRC research concentrate solely on answerable questions. However, in reality, questions can be unanswerable for which the correct answer is not stated in the given textual data. To address the weakness, we provide the research community with a benchmark dataset named UIT-ViQuAD 2.0 for evaluating the MRC task and question answering systems for the Vietnamese language. We use UIT-ViQuAD 2.0 as a benchmark dataset for the challenge on Vietnamese MRC at the Eighth Workshop on Vietnamese Language and Speech Processing (VLSP 2021). This task attracted 77 participant teams from 34 universities and other organizations. In this article, we present details of the organization of the challenge, an overview of the methods employed by shared-task participants, and the results. The highest performances are 77.24% in F1-score and 67.43% in Exact Match on the private test set. The Vietnamese MRC systems proposed by the top 3 teams use XLM-RoBERTa, a powerful pre-trained language model based on the transformer architecture. The UIT-ViQuAD 2.0 dataset motivates researchers to further explore the Vietnamese machine reading comprehension task and related tasks such as question answering, question generation, and natural language inference.

OLAPH: Improving Factuality in Biomedical Long-form Question Answering

In the medical domain, numerous scenarios necessitate the long-form generation ability of large language models (LLMs). Specifically, when addressing patients' questions, it is essential that the model's response conveys factual claims, highlighting the need for an automated method to evaluate those claims. Thus, we introduce MedLFQA, a benchmark dataset reconstructed using long-form question-answering datasets related to the biomedical domain. We use MedLFQA to facilitate the automatic evaluations of factuality. We also propose OLAPH, a simple and novel framework that enables the improvement of factuality through automatic evaluations. The OLAPH framework iteratively trains LLMs to mitigate hallucinations using sampling predictions and preference optimization. In other words, we iteratively set the highest-scoring response as a preferred response derived from sampling predictions and train LLMs to align with the preferred response that improves factuality. We highlight that, even on evaluation metrics not used during training, LLMs trained with our OLAPH framework demonstrate significant performance improvement in factuality. Our findings reveal that a 7B LLM trained with our OLAPH framework can provide long answers comparable to the medical experts' answers in terms of factuality. We believe that our work could shed light on gauging the long-text generation ability of LLMs in the medical domain. Our code and datasets are available at https://github.com/dmis-lab/OLAPH}{https://github.com/dmis-lab/OLAPH.

Addressing cognitive bias in medical language models

There is increasing interest in the application large language models (LLMs) to the medical field, in part because of their impressive performance on medical exam questions. While promising, exam questions do not reflect the complexity of real patient-doctor interactions. In reality, physicians' decisions are shaped by many complex factors, such as patient compliance, personal experience, ethical beliefs, and cognitive bias. Taking a step toward understanding this, our hypothesis posits that when LLMs are confronted with clinical questions containing cognitive biases, they will yield significantly less accurate responses compared to the same questions presented without such biases. In this study, we developed BiasMedQA, a benchmark for evaluating cognitive biases in LLMs applied to medical tasks. Using BiasMedQA we evaluated six LLMs, namely GPT-4, Mixtral-8x70B, GPT-3.5, PaLM-2, Llama 2 70B-chat, and the medically specialized PMC Llama 13B. We tested these models on 1,273 questions from the US Medical Licensing Exam (USMLE) Steps 1, 2, and 3, modified to replicate common clinically-relevant cognitive biases. Our analysis revealed varying effects for biases on these LLMs, with GPT-4 standing out for its resilience to bias, in contrast to Llama 2 70B-chat and PMC Llama 13B, which were disproportionately affected by cognitive bias. Our findings highlight the critical need for bias mitigation in the development of medical LLMs, pointing towards safer and more reliable applications in healthcare.

Fine-tuning Large Language Models with Human-inspired Learning Strategies in Medical Question Answering

Training Large Language Models (LLMs) incurs substantial data-related costs, motivating the development of data-efficient training methods through optimised data ordering and selection. Human-inspired learning strategies, such as curriculum learning, offer possibilities for efficient training by organising data according to common human learning practices. Despite evidence that fine-tuning with curriculum learning improves the performance of LLMs for natural language understanding tasks, its effectiveness is typically assessed using a single model. In this work, we extend previous research by evaluating both curriculum-based and non-curriculum-based learning strategies across multiple LLMs, using human-defined and automated data labels for medical question answering. Our results indicate a moderate impact of using human-inspired learning strategies for fine-tuning LLMs, with maximum accuracy gains of 1.77% per model and 1.81% per dataset. Crucially, we demonstrate that the effectiveness of these strategies varies significantly across different model-dataset combinations, emphasising that the benefits of a specific human-inspired strategy for fine-tuning LLMs do not generalise. Additionally, we find evidence that curriculum learning using LLM-defined question difficulty outperforms human-defined difficulty, highlighting the potential of using model-generated measures for optimal curriculum design.

CLR-Bench: Evaluating Large Language Models in College-level Reasoning

Large language models (LLMs) have demonstrated their remarkable performance across various language understanding tasks. While emerging benchmarks have been proposed to evaluate LLMs in various domains such as mathematics and computer science, they merely measure the accuracy in terms of the final prediction on multi-choice questions. However, it remains insufficient to verify the essential understanding of LLMs given a chosen choice. To fill this gap, we present CLR-Bench to comprehensively evaluate the LLMs in complex college-level reasoning. Specifically, (i) we prioritize 16 challenging college disciplines in computer science and artificial intelligence. The dataset contains 5 types of questions, while each question is associated with detailed explanations from experts. (ii) To quantify a fair evaluation of LLMs' reasoning ability, we formalize the criteria with two novel metrics. QrightarrowA is utilized to measure the performance of direct answer prediction, and QrightarrowAR effectively considers the joint ability to answer the question and provide rationale simultaneously. Extensive experiments are conducted with 40 LLMs over 1,018 discipline-specific questions. The results demonstrate the key insights that LLMs, even the best closed-source LLM, i.e., GPT-4 turbo, tend to `guess' the college-level answers. It shows a dramatic decrease in accuracy from 63.31% QrightarrowA to 39.00% QrightarrowAR, indicating an unsatisfactory reasoning ability.

The Limited Impact of Medical Adaptation of Large Language and Vision-Language Models

Several recent works seek to develop foundation models specifically for medical applications, adapting general-purpose large language models (LLMs) and vision-language models (VLMs) via continued pretraining on publicly available biomedical corpora. These works typically claim that such domain-adaptive pretraining (DAPT) improves performance on downstream medical tasks, such as answering medical licensing exam questions. In this paper, we compare ten public "medical" LLMs and two VLMs against their corresponding base models, arriving at a different conclusion: all medical VLMs and nearly all medical LLMs fail to consistently improve over their base models in the zero-/few-shot prompting and supervised fine-tuning regimes for medical question-answering (QA). For instance, across all tasks and model pairs we consider in the 3-shot setting, medical LLMs only outperform their base models in 22.7% of cases, reach a (statistical) tie in 36.8% of cases, and are significantly worse than their base models in the remaining 40.5% of cases. Our conclusions are based on (i) comparing each medical model head-to-head, directly against the corresponding base model; (ii) optimizing the prompts for each model separately in zero-/few-shot prompting; and (iii) accounting for statistical uncertainty in comparisons. While these basic practices are not consistently adopted in the literature, our ablations show that they substantially impact conclusions. Meanwhile, we find that after fine-tuning on specific QA tasks, medical LLMs can show performance improvements, but the benefits do not carry over to tasks based on clinical notes. Our findings suggest that state-of-the-art general-domain models may already exhibit strong medical knowledge and reasoning capabilities, and offer recommendations to strengthen the conclusions of future studies.

LongHealth: A Question Answering Benchmark with Long Clinical Documents

Background: Recent advancements in large language models (LLMs) offer potential benefits in healthcare, particularly in processing extensive patient records. However, existing benchmarks do not fully assess LLMs' capability in handling real-world, lengthy clinical data. Methods: We present the LongHealth benchmark, comprising 20 detailed fictional patient cases across various diseases, with each case containing 5,090 to 6,754 words. The benchmark challenges LLMs with 400 multiple-choice questions in three categories: information extraction, negation, and sorting, challenging LLMs to extract and interpret information from large clinical documents. Results: We evaluated nine open-source LLMs with a minimum of 16,000 tokens and also included OpenAI's proprietary and cost-efficient GPT-3.5 Turbo for comparison. The highest accuracy was observed for Mixtral-8x7B-Instruct-v0.1, particularly in tasks focused on information retrieval from single and multiple patient documents. However, all models struggled significantly in tasks requiring the identification of missing information, highlighting a critical area for improvement in clinical data interpretation. Conclusion: While LLMs show considerable potential for processing long clinical documents, their current accuracy levels are insufficient for reliable clinical use, especially in scenarios requiring the identification of missing information. The LongHealth benchmark provides a more realistic assessment of LLMs in a healthcare setting and highlights the need for further model refinement for safe and effective clinical application. We make the benchmark and evaluation code publicly available.