Daily Papers

Excellence in a wide variety of medical applications poses considerable challenges for AI, requiring advanced reasoning, access to up-to-date medical knowledge and understanding of complex multimodal data. Gemini models, with strong general capabilities in multimodal and long-context reasoning, offer exciting possibilities in medicine. Building on these core strengths of Gemini, we introduce Med-Gemini, a family of highly capable multimodal models that are specialized in medicine with the ability to seamlessly use web search, and that can be efficiently tailored to novel modalities using custom encoders. We evaluate Med-Gemini on 14 medical benchmarks, establishing new state-of-the-art (SoTA) performance on 10 of them, and surpass the GPT-4 model family on every benchmark where a direct comparison is viable, often by a wide margin. On the popular MedQA (USMLE) benchmark, our best-performing Med-Gemini model achieves SoTA performance of 91.1% accuracy, using a novel uncertainty-guided search strategy. On 7 multimodal benchmarks including NEJM Image Challenges and MMMU (health & medicine), Med-Gemini improves over GPT-4V by an average relative margin of 44.5%. We demonstrate the effectiveness of Med-Gemini's long-context capabilities through SoTA performance on a needle-in-a-haystack retrieval task from long de-identified health records and medical video question answering, surpassing prior bespoke methods using only in-context learning. Finally, Med-Gemini's performance suggests real-world utility by surpassing human experts on tasks such as medical text summarization, alongside demonstrations of promising potential for multimodal medical dialogue, medical research and education. Taken together, our results offer compelling evidence for Med-Gemini's potential, although further rigorous evaluation will be crucial before real-world deployment in this safety-critical domain.

Accessing medical literature is difficult for laypeople as the content is written for specialists and contains medical jargon. Automated text simplification methods offer a potential means to address this issue. In this work, we propose a summarize-then-simplify two-stage strategy, which we call NapSS, identifying the relevant content to simplify while ensuring that the original narrative flow is preserved. In this approach, we first generate reference summaries via sentence matching between the original and the simplified abstracts. These summaries are then used to train an extractive summarizer, learning the most relevant content to be simplified. Then, to ensure the narrative consistency of the simplified text, we synthesize auxiliary narrative prompts combining key phrases derived from the syntactical analyses of the original text. Our model achieves results significantly better than the seq2seq baseline on an English medical corpus, yielding 3%~4% absolute improvements in terms of lexical similarity, and providing a further 1.1% improvement of SARI score when combined with the baseline. We also highlight shortcomings of existing evaluation methods, and introduce new metrics that take into account both lexical and high-level semantic similarity. A human evaluation conducted on a random sample of the test set further establishes the effectiveness of the proposed approach. Codes and models are released here: https://github.com/LuJunru/NapSS.

Summaries of medical text shall be faithful by being consistent and factual with source inputs, which is an important but understudied topic for safety and efficiency in healthcare. In this paper, we investigate and improve faithfulness in summarization on a broad range of medical summarization tasks. Our investigation reveals that current summarization models often produce unfaithful outputs for medical input text. We then introduce FaMeSumm, a framework to improve faithfulness by fine-tuning pre-trained language models based on medical knowledge. FaMeSumm performs contrastive learning on designed sets of faithful and unfaithful summaries, and it incorporates medical terms and their contexts to encourage faithful generation of medical terms. We conduct comprehensive experiments on three datasets in two languages: health question and radiology report summarization datasets in English, and a patient-doctor dialogue dataset in Chinese. Results demonstrate that FaMeSumm is flexible and effective by delivering consistent improvements over mainstream language models such as BART, T5, mT5, and PEGASUS, yielding state-of-the-art performances on metrics for faithfulness and general quality. Human evaluation by doctors also shows that FaMeSumm generates more faithful outputs. Our code is available at https://github.com/psunlpgroup/FaMeSumm .

Medical vision-and-language pre-training (Med-VLP) has shown promising improvements on many downstream medical tasks owing to its applicability to extracting generic representations from medical images and texts. Practically, there exist two typical types, i.e., the fusion-encoder type and the dual-encoder type, depending on whether a heavy fusion module is used. The former is superior at multi-modal tasks owing to the sufficient interaction between modalities; the latter is good at uni-modal and cross-modal tasks due to the single-modality encoding ability. To take advantage of these two types, we propose an effective yet straightforward scheme named PTUnifier to unify the two types. We first unify the input format by introducing visual and textual prompts, which serve as a feature bank that stores the most representative images/texts. By doing so, a single model could serve as a foundation model that processes various tasks adopting different input formats (i.e., image-only, text-only, and image-text-pair). Furthermore, we construct a prompt pool (instead of static ones) to improve diversity and scalability. Experimental results show that our approach achieves state-of-the-art results on a broad range of tasks, spanning uni-modal tasks (i.e., image/text classification and text summarization), cross-modal tasks (i.e., image-to-text generation and image-text/text-image retrieval), and multi-modal tasks (i.e., visual question answering), demonstrating the effectiveness of our approach. Note that the adoption of prompts is orthogonal to most existing Med-VLP approaches and could be a beneficial and complementary extension to these approaches.

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

To assess the effectiveness of any medical intervention, researchers must conduct a time-intensive and highly manual literature review. NLP systems can help to automate or assist in parts of this expensive process. In support of this goal, we release MS^2 (Multi-Document Summarization of Medical Studies), a dataset of over 470k documents and 20k summaries derived from the scientific literature. This dataset facilitates the development of systems that can assess and aggregate contradictory evidence across multiple studies, and is the first large-scale, publicly available multi-document summarization dataset in the biomedical domain. We experiment with a summarization system based on BART, with promising early results. We formulate our summarization inputs and targets in both free text and structured forms and modify a recently proposed metric to assess the quality of our system's generated summaries. Data and models are available at https://github.com/allenai/ms2

The goal of automated summarization techniques (Paice, 1990; Kupiec et al, 1995) is to condense text by focusing on the most critical information. Generative large language models (LLMs) have shown to be robust summarizers, yet traditional metrics struggle to capture resulting performance (Goyal et al, 2022) in more powerful LLMs. In safety-critical domains such as medicine, more rigorous evaluation is required, especially given the potential for LLMs to omit important information in the resulting summary. We propose MED-OMIT, a new omission benchmark for medical summarization. Given a doctor-patient conversation and a generated summary, MED-OMIT categorizes the chat into a set of facts and identifies which are omitted from the summary. We further propose to determine fact importance by simulating the impact of each fact on a downstream clinical task: differential diagnosis (DDx) generation. MED-OMIT leverages LLM prompt-based approaches which categorize the importance of facts and cluster them as supporting or negating evidence to the diagnosis. We evaluate MED-OMIT on a publicly-released dataset of patient-doctor conversations and find that MED-OMIT captures omissions better than alternative metrics.

The increasing size of language models raises great research interests in parameter-efficient fine-tuning such as LoRA that freezes the pre-trained model, and injects small-scale trainable parameters for multiple downstream tasks (e.g., summarization, question answering and translation). To further enhance the efficiency of fine-tuning, we propose a framework that integrates LoRA and structured layer pruning. The integrated framework is validated on two created deidentified medical report summarization datasets based on MIMIC-IV-Note and two public medical dialogue datasets. By tuning 0.6% parameters of the original model and pruning over 30% Transformer-layers, our framework can reduce 50% of GPU memory usage and speed up 100% of the training phase, while preserving over 92% generation qualities on free-text sequence-to-sequence tasks.

Following each patient visit, physicians draft long semi-structured clinical summaries called SOAP notes. While invaluable to clinicians and researchers, creating digital SOAP notes is burdensome, contributing to physician burnout. In this paper, we introduce the first complete pipelines to leverage deep summarization models to generate these notes based on transcripts of conversations between physicians and patients. After exploring a spectrum of methods across the extractive-abstractive spectrum, we propose Cluster2Sent, an algorithm that (i) extracts important utterances relevant to each summary section; (ii) clusters together related utterances; and then (iii) generates one summary sentence per cluster. Cluster2Sent outperforms its purely abstractive counterpart by 8 ROUGE-1 points, and produces significantly more factual and coherent sentences as assessed by expert human evaluators. For reproducibility, we demonstrate similar benefits on the publicly available AMI dataset. Our results speak to the benefits of structuring summaries into sections and annotating supporting evidence when constructing summarization corpora.

We present a corpus of 5,000 richly annotated abstracts of medical articles describing clinical randomized controlled trials. Annotations include demarcations of text spans that describe the Patient population enrolled, the Interventions studied and to what they were Compared, and the Outcomes measured (the `PICO' elements). These spans are further annotated at a more granular level, e.g., individual interventions within them are marked and mapped onto a structured medical vocabulary. We acquired annotations from a diverse set of workers with varying levels of expertise and cost. We describe our data collection process and the corpus itself in detail. We then outline a set of challenging NLP tasks that would aid searching of the medical literature and the practice of evidence-based medicine.

Sifting through vast textual data and summarizing key information imposes a substantial burden on how clinicians allocate their time. Although large language models (LLMs) have shown immense promise in natural language processing (NLP) tasks, their efficacy across diverse clinical summarization tasks has not yet been rigorously examined. In this work, we employ domain adaptation methods on eight LLMs, spanning six datasets and four distinct summarization tasks: radiology reports, patient questions, progress notes, and doctor-patient dialogue. Our thorough quantitative assessment reveals trade-offs between models and adaptation methods in addition to instances where recent advances in LLMs may not lead to improved results. Further, in a clinical reader study with six physicians, we depict that summaries from the best adapted LLM are preferable to human summaries in terms of completeness and correctness. Our ensuing qualitative analysis delineates mutual challenges faced by both LLMs and human experts. Lastly, we correlate traditional quantitative NLP metrics with reader study scores to enhance our understanding of how these metrics align with physician preferences. Our research marks the first evidence of LLMs outperforming human experts in clinical text summarization across multiple tasks. This implies that integrating LLMs into clinical workflows could alleviate documentation burden, empowering clinicians to focus more on personalized patient care and other irreplaceable human aspects of medicine.

Summaries generated from medical conversations can improve recall and understanding of care plans for patients and reduce documentation burden for doctors. Recent advancements in automatic speech recognition (ASR) and natural language understanding (NLU) offer potential solutions to generate these summaries automatically, but rigorous quantitative baselines for benchmarking research in this domain are lacking. In this paper, we bridge this gap for two tasks: classifying utterances from medical conversations according to (i) the SOAP section and (ii) the speaker role. Both are fundamental building blocks along the path towards an end-to-end, automated SOAP note for medical conversations. We provide details on a dataset that contains human and ASR transcriptions of medical conversations and corresponding machine learning optimized SOAP notes. We then present a systematic analysis in which we adapt an existing deep learning architecture to the two aforementioned tasks. The results suggest that modelling context in a hierarchical manner, which captures both word and utterance level context, yields substantial improvements on both classification tasks. Additionally, we develop and analyze a modular method for adapting our model to ASR output.

Textual health records of cancer patients are usually protracted and highly unstructured, making it very time-consuming for health professionals to get a complete overview of the patient's therapeutic course. As such limitations can lead to suboptimal and/or inefficient treatment procedures, healthcare providers would greatly benefit from a system that effectively summarizes the information of those records. With the advent of deep neural models, this objective has been partially attained for English clinical texts, however, the research community still lacks an effective solution for languages with limited resources. In this paper, we present the approach we developed to extract procedures, drugs, and diseases from oncology health records written in European Portuguese. This project was conducted in collaboration with the Portuguese Institute for Oncology which, besides holding over 10 years of duly protected medical records, also provided oncologist expertise throughout the development of the project. Since there is no annotated corpus for biomedical entity extraction in Portuguese, we also present the strategy we followed in annotating the corpus for the development of the models. The final models, which combined a neural architecture with entity linking, achieved F_1 scores of 88.6, 95.0, and 55.8 per cent in the mention extraction of procedures, drugs, and diseases, respectively.

Automatically summarizing patients' main problems from daily progress notes using natural language processing methods helps to battle against information and cognitive overload in hospital settings and potentially assists providers with computerized diagnostic decision support. Problem list summarization requires a model to understand, abstract, and generate clinical documentation. In this work, we propose a new NLP task that aims to generate a list of problems in a patient's daily care plan using input from the provider's progress notes during hospitalization. We investigate the performance of T5 and BART, two state-of-the-art seq2seq transformer architectures, in solving this problem. We provide a corpus built on top of progress notes from publicly available electronic health record progress notes in the Medical Information Mart for Intensive Care (MIMIC)-III. T5 and BART are trained on general domain text, and we experiment with a data augmentation method and a domain adaptation pre-training method to increase exposure to medical vocabulary and knowledge. Evaluation methods include ROUGE, BERTScore, cosine similarity on sentence embedding, and F-score on medical concepts. Results show that T5 with domain adaptive pre-training achieves significant performance gains compared to a rule-based system and general domain pre-trained language models, indicating a promising direction for tackling the problem summarization task.

Medical abstractive summarization faces the challenge of balancing faithfulness and informativeness. Current methods often sacrifice key information for faithfulness or introduce confabulations when prioritizing informativeness. While recent advancements in techniques like in-context learning (ICL) and fine-tuning have improved medical summarization, they often overlook crucial aspects such as faithfulness and informativeness without considering advanced methods like model reasoning and self-improvement. Moreover, the field lacks a unified benchmark, hindering systematic evaluation due to varied metrics and datasets. This paper addresses these gaps by presenting a comprehensive benchmark of six advanced abstractive summarization methods across three diverse datasets using five standardized metrics. Building on these findings, we propose uMedSum, a modular hybrid summarization framework that introduces novel approaches for sequential confabulation removal followed by key missing information addition, ensuring both faithfulness and informativeness. Our work improves upon previous GPT-4-based state-of-the-art (SOTA) medical summarization methods, significantly outperforming them in both quantitative metrics and qualitative domain expert evaluations. Notably, we achieve an average relative performance improvement of 11.8% in reference-free metrics over the previous SOTA. Doctors prefer uMedSum's summaries 6 times more than previous SOTA in difficult cases where there are chances of confabulations or missing information. These results highlight uMedSum's effectiveness and generalizability across various datasets and metrics, marking a significant advancement in medical summarization.

Summarization of clinical narratives is a long-standing research problem. Here, we introduce the task of hospital-course summarization. Given the documentation authored throughout a patient's hospitalization, generate a paragraph that tells the story of the patient admission. We construct an English, text-to-text dataset of 109,000 hospitalizations (2M source notes) and their corresponding summary proxy: the clinician-authored "Brief Hospital Course" paragraph written as part of a discharge note. Exploratory analyses reveal that the BHC paragraphs are highly abstractive with some long extracted fragments; are concise yet comprehensive; differ in style and content organization from the source notes; exhibit minimal lexical cohesion; and represent silver-standard references. Our analysis identifies multiple implications for modeling this complex, multi-document summarization task.

In doctor-patient conversations, identifying medically relevant information is crucial, posing the need for conversation summarization. In this work, we propose the first deployable real-time speech summarization system for real-world applications in industry, which generates a local summary after every N speech utterances within a conversation and a global summary after the end of a conversation. Our system could enhance user experience from a business standpoint, while also reducing computational costs from a technical perspective. Secondly, we present VietMed-Sum which, to our knowledge, is the first speech summarization dataset for medical conversations. Thirdly, we are the first to utilize LLM and human annotators collaboratively to create gold standard and synthetic summaries for medical conversation summarization. Finally, we present baseline results of state-of-the-art models on VietMed-Sum. All code, data (English-translated and Vietnamese) and models are available online: https://github.com/leduckhai/MultiMed

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.

Medical Dialogue Generation serves a critical role in telemedicine by facilitating the dissemination of medical expertise to patients. Existing studies focus on incorporating textual representations, which have limited their ability to represent the semantics of text, such as ignoring important medical entities. To enhance the model's understanding of the textual semantics and the medical knowledge including entities and relations, we introduce the use of Abstract Meaning Representations (AMR) to construct graphical representations that delineate the roles of language constituents and medical entities within the dialogues. In this paper, We propose a novel framework that models dialogues between patients and healthcare professionals using AMR graphs, where the neural networks incorporate textual and graphical knowledge with a dual attention mechanism. Experimental results show that our framework outperforms strong baseline models in medical dialogue generation, demonstrating the effectiveness of AMR graphs in enhancing the representations of medical knowledge and logical relationships. Furthermore, to support future research in this domain, we provide the corresponding source code at https://github.com/Bernard-Yang/MedDiaAMR.

Large language models, particularly GPT-3, are able to produce high quality summaries of general domain news articles in few- and zero-shot settings. However, it is unclear if such models are similarly capable in more specialized, high-stakes domains such as biomedicine. In this paper, we enlist domain experts (individuals with medical training) to evaluate summaries of biomedical articles generated by GPT-3, given zero supervision. We consider both single- and multi-document settings. In the former, GPT-3 is tasked with generating regular and plain-language summaries of articles describing randomized controlled trials; in the latter, we assess the degree to which GPT-3 is able to synthesize evidence reported across a collection of articles. We design an annotation scheme for evaluating model outputs, with an emphasis on assessing the factual accuracy of generated summaries. We find that while GPT-3 is able to summarize and simplify single biomedical articles faithfully, it struggles to provide accurate aggregations of findings over multiple documents. We release all data and annotations used in this work.

Background: Natural Language Processing (NLP) is widely used to extract clinical insights from Electronic Health Records (EHRs). However, the lack of annotated data, automated tools, and other challenges hinder the full utilisation of NLP for EHRs. Various Machine Learning (ML), Deep Learning (DL) and NLP techniques are studied and compared to understand the limitations and opportunities in this space comprehensively. Methodology: After screening 261 articles from 11 databases, we included 127 papers for full-text review covering seven categories of articles: 1) medical note classification, 2) clinical entity recognition, 3) text summarisation, 4) deep learning (DL) and transfer learning architecture, 5) information extraction, 6) Medical language translation and 7) other NLP applications. This study follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Result and Discussion: EHR was the most commonly used data type among the selected articles, and the datasets were primarily unstructured. Various ML and DL methods were used, with prediction or classification being the most common application of ML or DL. The most common use cases were: the International Classification of Diseases, Ninth Revision (ICD-9) classification, clinical note analysis, and named entity recognition (NER) for clinical descriptions and research on psychiatric disorders. Conclusion: We find that the adopted ML models were not adequately assessed. In addition, the data imbalance problem is quite important, yet we must find techniques to address this underlining problem. Future studies should address key limitations in studies, primarily identifying Lupus Nephritis, Suicide Attempts, perinatal self-harmed and ICD-9 classification.

Brief hospital course (BHC) summaries are common clinical documents generated by summarizing clinical notes. While large language models (LLMs) depict remarkable capabilities in automating real-world tasks, their capabilities for healthcare applications such as BHC synthesis have not been shown. To enable the adaptation of LLMs for BHC synthesis, we introduce a novel benchmark consisting of a pre-processed dataset extracted from MIMIC-IV notes, encapsulating clinical note, and brief hospital course (BHC) pairs. We assess the performance of two general-purpose LLMs and three healthcare-adapted LLMs to improve BHC synthesis from clinical notes. Using clinical notes as input for generating BHCs, we apply prompting-based (using in-context learning) and fine-tuning-based adaptation strategies to three open-source LLMs (Clinical-T5-Large, Llama2-13B, FLAN-UL2) and two proprietary LLMs (GPT-3.5, GPT-4). We quantitatively evaluate the performance of these LLMs across varying context-length inputs using conventional natural language similarity metrics. We further perform a qualitative study where five diverse clinicians blindly compare clinician-written BHCs and two LLM-generated BHCs for 30 samples across metrics of comprehensiveness, conciseness, factual correctness, and fluency. Overall, we present a new benchmark and pre-processed dataset for using LLMs in BHC synthesis from clinical notes. We observe high-quality summarization performance for both in-context proprietary and fine-tuned open-source LLMs using both quantitative metrics and a qualitative clinical reader study. We propose our work as a benchmark to motivate future works to adapt and assess the performance of LLMs in BHC synthesis.

Text summarization research has undergone several significant transformations with the advent of deep neural networks, pre-trained language models (PLMs), and recent large language models (LLMs). This survey thus provides a comprehensive review of the research progress and evolution in text summarization through the lens of these paradigm shifts. It is organized into two main parts: (1) a detailed overview of datasets, evaluation metrics, and summarization methods before the LLM era, encompassing traditional statistical methods, deep learning approaches, and PLM fine-tuning techniques, and (2) the first detailed examination of recent advancements in benchmarking, modeling, and evaluating summarization in the LLM era. By synthesizing existing literature and presenting a cohesive overview, this survey also discusses research trends, open challenges, and proposes promising research directions in summarization, aiming to guide researchers through the evolving landscape of summarization research.

Knowledge of the medical decision process, which can be modeled as medical decision trees (MDTs), is critical to build clinical decision support systems. However, the current MDT construction methods rely heavily on time-consuming and laborious manual annotation. In this work, we propose a novel task, Text2MDT, to explore the automatic extraction of MDTs from medical texts such as medical guidelines and textbooks. We normalize the form of the MDT and create an annotated Text-to-MDT dataset in Chinese with the participation of medical experts. We investigate two different methods for the Text2MDT tasks: (a) an end-to-end framework which only relies on a GPT style large language models (LLM) instruction tuning to generate all the node information and tree structures. (b) The pipeline framework which decomposes the Text2MDT task to three subtasks. Experiments on our Text2MDT dataset demonstrate that: (a) the end-to-end method basd on LLMs (7B parameters or larger) show promising results, and successfully outperform the pipeline methods. (b) The chain-of-thought (COT) prompting method Wei2022ChainOT can improve the performance of the fine-tuned LLMs on the Text2MDT test set. (c) the lightweight pipelined method based on encoder-based pretrained models can perform comparably with LLMs with model complexity two magnititudes smaller. Our Text2MDT dataset is open-sourced at https://tianchi.aliyun.com/dataset/95414, and the source codes are open-sourced at https://github.com/michael-wzhu/text2dt.

Medical research generates a large number of publications with the PubMed database already containing >35 million research articles. Integration of the knowledge scattered across this large body of literature could provide key insights into physiological mechanisms and disease processes leading to novel medical interventions. However, it is a great challenge for researchers to utilize this information in full since the scale and complexity of the data greatly surpasses human processing abilities. This becomes especially problematic in cases of extreme urgency like the COVID-19 pandemic. Automated text mining can help extract and connect information from the large body of medical research articles. The first step in text mining is typically the identification of specific classes of keywords (e.g., all protein or disease names), so called Named Entity Recognition (NER). Here we present an end-to-end pipeline for NER of typical entities found in medical research articles, including diseases, cells, chemicals, genes/proteins, and species. The pipeline can access and process large medical research article collections (PubMed, CORD-19) or raw text and incorporates a series of deep learning models fine-tuned on the HUNER corpora collection. In addition, the pipeline can perform dictionary-based NER related to COVID-19 and other medical topics. Users can also load their own NER models and dictionaries to include additional entities. The output consists of publication-ready ranked lists and graphs of detected entities and files containing the annotated texts. An associated script allows rapid inspection of the results for specific entities of interest. As model use cases, the pipeline was deployed on two collections of autophagy-related abstracts from PubMed and on the CORD19 dataset, a collection of 764 398 research article abstracts related to COVID-19.

The deployment of large language models (LLMs) within the healthcare sector has sparked both enthusiasm and apprehension. These models exhibit the remarkable capability to provide proficient responses to free-text queries, demonstrating a nuanced understanding of professional medical knowledge. This comprehensive survey delves into the functionalities of existing LLMs designed for healthcare applications, elucidating the trajectory of their development, starting from traditional Pretrained Language Models (PLMs) to the present state of LLMs in healthcare sector. First, we explore the potential of LLMs to amplify the efficiency and effectiveness of diverse healthcare applications, particularly focusing on clinical language understanding tasks. These tasks encompass a wide spectrum, ranging from named entity recognition and relation extraction to natural language inference, multi-modal medical applications, document classification, and question-answering. Additionally, we conduct an extensive comparison of the most recent state-of-the-art LLMs in the healthcare domain, while also assessing the utilization of various open-source LLMs and highlighting their significance in healthcare applications. Furthermore, we present the essential performance metrics employed to evaluate LLMs in the biomedical domain, shedding light on their effectiveness and limitations. Finally, we summarize the prominent challenges and constraints faced by large language models in the healthcare sector, offering a holistic perspective on their potential benefits and shortcomings. This review provides a comprehensive exploration of the current landscape of LLMs in healthcare, addressing their role in transforming medical applications and the areas that warrant further research and development.

We present PubMed 200k RCT, a new dataset based on PubMed for sequential sentence classification. The dataset consists of approximately 200,000 abstracts of randomized controlled trials, totaling 2.3 million sentences. Each sentence of each abstract is labeled with their role in the abstract using one of the following classes: background, objective, method, result, or conclusion. The purpose of releasing this dataset is twofold. First, the majority of datasets for sequential short-text classification (i.e., classification of short texts that appear in sequences) are small: we hope that releasing a new large dataset will help develop more accurate algorithms for this task. Second, from an application perspective, researchers need better tools to efficiently skim through the literature. Automatically classifying each sentence in an abstract would help researchers read abstracts more efficiently, especially in fields where abstracts may be long, such as the medical field.

Lay summarisation aims to jointly summarise and simplify a given text, thus making its content more comprehensible to non-experts. Automatic approaches for lay summarisation can provide significant value in broadening access to scientific literature, enabling a greater degree of both interdisciplinary knowledge sharing and public understanding when it comes to research findings. However, current corpora for this task are limited in their size and scope, hindering the development of broadly applicable data-driven approaches. Aiming to rectify these issues, we present two novel lay summarisation datasets, PLOS (large-scale) and eLife (medium-scale), each of which contains biomedical journal articles alongside expert-written lay summaries. We provide a thorough characterisation of our lay summaries, highlighting differing levels of readability and abstractiveness between datasets that can be leveraged to support the needs of different applications. Finally, we benchmark our datasets using mainstream summarisation approaches and perform a manual evaluation with domain experts, demonstrating their utility and casting light on the key challenges of this task.

Multi-document summarization (MDS) is a difficult task in Natural Language Processing, aiming to summarize information from several documents. However, the source documents are often insufficient to obtain a qualitative summary. We propose a retriever-guided model combined with non-parametric memory for summary generation. This model retrieves relevant candidates from a database and then generates the summary considering the candidates with a copy mechanism and the source documents. The retriever is implemented with Approximate Nearest Neighbor Search (ANN) to search large databases. Our method is evaluated on the MultiXScience dataset which includes scientific articles. Finally, we discuss our results and possible directions for future work.

Medical imaging is critical to the diagnosis and treatment of numerous medical problems, including many forms of cancer. Medical imaging reports distill the findings and observations of radiologists, creating an unstructured textual representation of unstructured medical images. Large-scale use of this text-encoded information requires converting the unstructured text to a structured, semantic representation. We explore the extraction and normalization of anatomical information in radiology reports that is associated with radiological findings. We investigate this extraction and normalization task using a span-based relation extraction model that jointly extracts entities and relations using BERT. This work examines the factors that influence extraction and normalization performance, including the body part/organ system, frequency of occurrence, span length, and span diversity. It discusses approaches for improving performance and creating high-quality semantic representations of radiological phenomena.

We provide a literature review about Automatic Text Summarization (ATS) systems. We consider a citation-based approach. We start with some popular and well-known papers that we have in hand about each topic we want to cover and we have tracked the "backward citations" (papers that are cited by the set of papers we knew beforehand) and the "forward citations" (newer papers that cite the set of papers we knew beforehand). In order to organize the different methods, we present the diverse approaches to ATS guided by the mechanisms they use to generate a summary. Besides presenting the methods, we also present an extensive review of the datasets available for summarization tasks and the methods used to evaluate the quality of the summaries. Finally, we present an empirical exploration of these methods using the CNN Corpus dataset that provides golden summaries for extractive and abstractive methods.

Current medical question answering systems have difficulty processing long, detailed and informally worded questions submitted by patients, called Consumer Health Questions (CHQs). To address this issue, we introduce a medical question understanding and answering system with knowledge grounding and semantic self-supervision. Our system is a pipeline that first summarizes a long, medical, user-written question, using a supervised summarization loss. Then, our system performs a two-step retrieval to return answers. The system first matches the summarized user question with an FAQ from a trusted medical knowledge base, and then retrieves a fixed number of relevant sentences from the corresponding answer document. In the absence of labels for question matching or answer relevance, we design 3 novel, self-supervised and semantically-guided losses. We evaluate our model against two strong retrieval-based question answering baselines. Evaluators ask their own questions and rate the answers retrieved by our baselines and own system according to their relevance. They find that our system retrieves more relevant answers, while achieving speeds 20 times faster. Our self-supervised losses also help the summarizer achieve higher scores in ROUGE, as well as in human evaluation metrics. We release our code to encourage further research.

This work introduces BioLORD, a new pre-training strategy for producing meaningful representations for clinical sentences and biomedical concepts. State-of-the-art methodologies operate by maximizing the similarity in representation of names referring to the same concept, and preventing collapse through contrastive learning. However, because biomedical names are not always self-explanatory, it sometimes results in non-semantic representations. BioLORD overcomes this issue by grounding its concept representations using definitions, as well as short descriptions derived from a multi-relational knowledge graph consisting of biomedical ontologies. Thanks to this grounding, our model produces more semantic concept representations that match more closely the hierarchical structure of ontologies. BioLORD establishes a new state of the art for text similarity on both clinical sentences (MedSTS) and biomedical concepts (MayoSRS).

Research on language technology for the development of medical applications is currently a hot topic in Natural Language Understanding and Generation. Thus, a number of large language models (LLMs) have recently been adapted to the medical domain, so that they can be used as a tool for mediating in human-AI interaction. While these LLMs display competitive performance on automated medical texts benchmarks, they have been pre-trained and evaluated with a focus on a single language (English mostly). This is particularly true of text-to-text models, which typically require large amounts of domain-specific pre-training data, often not easily accessible for many languages. In this paper, we address these shortcomings by compiling, to the best of our knowledge, the largest multilingual corpus for the medical domain in four languages, namely English, French, Italian and Spanish. This new corpus has been used to train Medical mT5, the first open-source text-to-text multilingual model for the medical domain. Additionally, we present two new evaluation benchmarks for all four languages with the aim of facilitating multilingual research in this domain. A comprehensive evaluation shows that Medical mT5 outperforms both encoders and similarly sized text-to-text models for the Spanish, French, and Italian benchmarks, while being competitive with current state-of-the-art LLMs in English.

Text summarization aims at compressing long documents into a shorter form that conveys the most important parts of the original document. Despite increased interest in the community and notable research effort, progress on benchmark datasets has stagnated. We critically evaluate key ingredients of the current research setup: datasets, evaluation metrics, and models, and highlight three primary shortcomings: 1) automatically collected datasets leave the task underconstrained and may contain noise detrimental to training and evaluation, 2) current evaluation protocol is weakly correlated with human judgment and does not account for important characteristics such as factual correctness, 3) models overfit to layout biases of current datasets and offer limited diversity in their outputs.

In recent years, the application of Large Language Models (LLMs) in healthcare has shown significant promise in improving the accessibility and dissemination of medical knowledge. This paper presents a detailed study of various LLMs trained on the MedQuAD medical question-answering dataset, with a focus on identifying the most effective model for providing accurate medical information. Among the models tested, the Sentence-t5 combined with Mistral 7B demonstrated superior performance, achieving a precision score of 0.762. This model's enhanced capabilities are attributed to its advanced pretraining techniques, robust architecture, and effective prompt construction methodologies. By leveraging these strengths, the Sentence-t5 + Mistral 7B model excels in understanding and generating precise medical answers. Our findings highlight the potential of integrating sophisticated LLMs in medical contexts to facilitate efficient and accurate medical knowledge retrieval, thus significantly enhancing patient education and support.

Nowadays the medical domain is receiving more and more attention in applications involving Artificial Intelligence. Clinicians have to deal with an enormous amount of unstructured textual data to make a conclusion about patients' health in their everyday life. Argument mining helps to provide a structure to such data by detecting argumentative components in the text and classifying the relations between them. However, as it is the case for many tasks in Natural Language Processing in general and in medical text processing in particular, the large majority of the work on computational argumentation has been done only for English. This is also the case with the only dataset available for argumentation in the medical domain, namely, the annotated medical data of abstracts of Randomized Controlled Trials (RCT) from the MEDLINE database. In order to mitigate the lack of annotated data for other languages, we empirically investigate several strategies to perform argument mining and classification in medical texts for a language for which no annotated data is available. This project shows that automatically translating and project annotations from English to a target language (Spanish) is an effective way to generate annotated data without manual intervention. Furthermore, our experiments demonstrate that the translation and projection approach outperforms zero-shot cross-lingual approaches using a large masked multilingual language model. Finally, we show how the automatically generated data in Spanish can also be used to improve results in the original English evaluation setting.

Document summarization is a task to shorten texts into concise and informative summaries. This paper introduces a novel dataset designed for summarizing multiple scientific articles into a section of a survey. Our contributions are: (1) SurveySum, a new dataset addressing the gap in domain-specific summarization tools; (2) two specific pipelines to summarize scientific articles into a section of a survey; and (3) the evaluation of these pipelines using multiple metrics to compare their performance. Our results highlight the importance of high-quality retrieval stages and the impact of different configurations on the quality of generated summaries.

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.

Objective:Develop and validate an algorithm for analyzing the layout of PDF clinical documents to improve the performance of downstream natural language processing tasks. Materials and Methods: We designed an algorithm to process clinical PDF documents and extract only clinically relevant text. The algorithm consists of several steps: initial text extraction using a PDF parser, followed by classification into categories such as body text, left notes, and footers using a Transformer deep neural network architecture, and finally an aggregation step to compile the lines of a given label in the text. We evaluated the technical performance of the body text extraction algorithm by applying it to a random sample of documents that were annotated. Medical performance was evaluated by examining the extraction of medical concepts of interest from the text in their respective sections. Finally, we tested an end-to-end system on a medical use case of automatic detection of acute infection described in the hospital report. Results:Our algorithm achieved per-line precision, recall, and F1 score of 98.4, 97.0, and 97.7, respectively, for body line extraction. The precision, recall, and F1 score per document for the acute infection detection algorithm were 82.54 (95CI 72.86-91.60), 85.24 (95CI 76.61-93.70), 83.87 (95CI 76, 92-90.08) with exploitation of the results of the advanced body extraction algorithm, respectively. Conclusion:We have developed and validated a system for extracting body text from clinical documents in PDF format by identifying their layout. We were able to demonstrate that this preprocessing allowed us to obtain better performances for a common downstream task, i.e., the extraction of medical concepts in their respective sections, thus proving the interest of this method on a clinical use case.

Contextual word embedding models such as ELMo (Peters et al., 2018) and BERT (Devlin et al., 2018) have dramatically improved performance for many natural language processing (NLP) tasks in recent months. However, these models have been minimally explored on specialty corpora, such as clinical text; moreover, in the clinical domain, no publicly-available pre-trained BERT models yet exist. In this work, we address this need by exploring and releasing BERT models for clinical text: one for generic clinical text and another for discharge summaries specifically. We demonstrate that using a domain-specific model yields performance improvements on three common clinical NLP tasks as compared to nonspecific embeddings. These domain-specific models are not as performant on two clinical de-identification tasks, and argue that this is a natural consequence of the differences between de-identified source text and synthetically non de-identified task text.

Continuity of care is crucial to ensuring positive health outcomes for patients discharged from an inpatient hospital setting, and improved information sharing can help. To share information, caregivers write discharge notes containing action items to share with patients and their future caregivers, but these action items are easily lost due to the lengthiness of the documents. In this work, we describe our creation of a dataset of clinical action items annotated over MIMIC-III, the largest publicly available dataset of real clinical notes. This dataset, which we call CLIP, is annotated by physicians and covers 718 documents representing 100K sentences. We describe the task of extracting the action items from these documents as multi-aspect extractive summarization, with each aspect representing a type of action to be taken. We evaluate several machine learning models on this task, and show that the best models exploit in-domain language model pre-training on 59K unannotated documents, and incorporate context from neighboring sentences. We also propose an approach to pre-training data selection that allows us to explore the trade-off between size and domain-specificity of pre-training datasets for this task.

There is enormous enthusiasm and concerns in using large language models (LLMs) in healthcare, yet current assumptions are all based on general-purpose LLMs such as ChatGPT. This study develops a clinical generative LLM, GatorTronGPT, using 277 billion words of mixed clinical and English text with a GPT-3 architecture of 20 billion parameters. GatorTronGPT improves biomedical natural language processing for medical research. Synthetic NLP models trained using GatorTronGPT generated text outperform NLP models trained using real-world clinical text. Physicians Turing test using 1 (worst) to 9 (best) scale shows that there is no significant difference in linguistic readability (p = 0.22; 6.57 of GatorTronGPT compared with 6.93 of human) and clinical relevance (p = 0.91; 7.0 of GatorTronGPT compared with 6.97 of human) and that physicians cannot differentiate them (p < 0.001). This study provides insights on the opportunities and challenges of LLMs for medical research and healthcare.

Plain language summarization with LLMs can be useful for improving textual accessibility of technical content. But how factual are these summaries in a high-stakes domain like medicine? This paper presents FactPICO, a factuality benchmark for plain language summarization of medical texts describing randomized controlled trials (RCTs), which are the basis of evidence-based medicine and can directly inform patient treatment. FactPICO consists of 345 plain language summaries of RCT abstracts generated from three LLMs (i.e., GPT-4, Llama-2, and Alpaca), with fine-grained evaluation and natural language rationales from experts. We assess the factuality of critical elements of RCTs in those summaries: Populations, Interventions, Comparators, Outcomes (PICO), as well as the reported findings concerning these. We also evaluate the correctness of the extra information (e.g., explanations) added by LLMs. Using FactPICO, we benchmark a range of existing factuality metrics, including the newly devised ones based on LLMs. We find that plain language summarization of medical evidence is still challenging, especially when balancing between simplicity and factuality, and that existing metrics correlate poorly with expert judgments on the instance level.

Most existing text summarization datasets are compiled from the news domain, where summaries have a flattened discourse structure. In such datasets, summary-worthy content often appears in the beginning of input articles. Moreover, large segments from input articles are present verbatim in their respective summaries. These issues impede the learning and evaluation of systems that can understand an article's global content structure as well as produce abstractive summaries with high compression ratio. In this work, we present a novel dataset, BIGPATENT, consisting of 1.3 million records of U.S. patent documents along with human written abstractive summaries. Compared to existing summarization datasets, BIGPATENT has the following properties: i) summaries contain a richer discourse structure with more recurring entities, ii) salient content is evenly distributed in the input, and iii) lesser and shorter extractive fragments are present in the summaries. Finally, we train and evaluate baselines and popular learning models on BIGPATENT to shed light on new challenges and motivate future directions for summarization research.

Clinical texts, represented in electronic medical records (EMRs), contain rich medical information and are essential for disease prediction, personalised information recommendation, clinical decision support, and medication pattern mining and measurement. Relation extractions between medication mentions and temporal information can further help clinicians better understand the patients' treatment history. To evaluate the performances of deep learning (DL) and large language models (LLMs) in medication extraction and temporal relations classification, we carry out an empirical investigation of MedTem project using several advanced learning structures including BiLSTM-CRF and CNN-BiLSTM for a clinical domain named entity recognition (NER), and BERT-CNN for temporal relation extraction (RE), in addition to the exploration of different word embedding techniques. Furthermore, we also designed a set of post-processing roles to generate structured output on medications and the temporal relation. Our experiments show that CNN-BiLSTM slightly wins the BiLSTM-CRF model on the i2b2-2009 clinical NER task yielding 75.67, 77.83, and 78.17 for precision, recall, and F1 scores using Macro Average. BERT-CNN model also produced reasonable evaluation scores 64.48, 67.17, and 65.03 for P/R/F1 using Macro Avg on the temporal relation extraction test set from i2b2-2012 challenges. Code and Tools from MedTem will be hosted at https://github.com/HECTA-UoM/MedTem

The burgeoning integration of 3D medical imaging into healthcare has led to a substantial increase in the workload of medical professionals. To assist clinicians in their diagnostic processes and alleviate their workload, the development of a robust system for retrieving similar case studies presents a viable solution. While the concept holds great promise, the field of 3D medical text-image retrieval is currently limited by the absence of robust evaluation benchmarks and curated datasets. To remedy this, our study presents a groundbreaking dataset, BIMCV-R (This dataset will be released upon acceptance.), which includes an extensive collection of 8,069 3D CT volumes, encompassing over 2 million slices, paired with their respective radiological reports. Expanding upon the foundational work of our dataset, we craft a retrieval strategy, MedFinder. This approach employs a dual-stream network architecture, harnessing the potential of large language models to advance the field of medical image retrieval beyond existing text-image retrieval solutions. It marks our preliminary step towards developing a system capable of facilitating text-to-image, image-to-text, and keyword-based retrieval tasks.

Automatically generating short summaries from users' online mental health posts could save counselors' reading time and reduce their fatigue so that they can provide timely responses to those seeking help for improving their mental state. Recent Transformers-based summarization models have presented a promising approach to abstractive summarization. They go beyond sentence selection and extractive strategies to deal with more complicated tasks such as novel word generation and sentence paraphrasing. Nonetheless, these models have a prominent shortcoming; their training strategy is not quite efficient, which restricts the model's performance. In this paper, we include a curriculum learning approach to reweigh the training samples, bringing about an efficient learning procedure. We apply our model on extreme summarization dataset of MentSum posts -- a dataset of mental health related posts from Reddit social media. Compared to the state-of-the-art model, our proposed method makes substantial gains in terms of Rouge and Bertscore evaluation metrics, yielding 3.5% (Rouge-1), 10.4% (Rouge-2), and 4.7% (Rouge-L), 1.5% (Bertscore) relative improvements.

We systematically investigate lightweight strategies to adapt large language models (LLMs) for the task of radiology report summarization (RRS). Specifically, we focus on domain adaptation via pretraining (on natural language, biomedical text, or clinical text) and via discrete prompting or parameter-efficient fine-tuning. Our results consistently achieve best performance by maximally adapting to the task via pretraining on clinical text and fine-tuning on RRS examples. Importantly, this method fine-tunes a mere 0.32% of parameters throughout the model, in contrast to end-to-end fine-tuning (100% of parameters). Additionally, we study the effect of in-context examples and out-of-distribution (OOD) training before concluding with a radiologist reader study and qualitative analysis. Our findings highlight the importance of domain adaptation in RRS and provide valuable insights toward developing effective natural language processing solutions for clinical tasks.

Automatic summarisation is a popular approach to reduce a document to its main arguments. Recent research in the area has focused on neural approaches to summarisation, which can be very data-hungry. However, few large datasets exist and none for the traditionally popular domain of scientific publications, which opens up challenging research avenues centered on encoding large, complex documents. In this paper, we introduce a new dataset for summarisation of computer science publications by exploiting a large resource of author provided summaries and show straightforward ways of extending it further. We develop models on the dataset making use of both neural sentence encoding and traditionally used summarisation features and show that models which encode sentences as well as their local and global context perform best, significantly outperforming well-established baseline methods.

One essential task in information extraction from the medical corpus is drug name recognition. Compared with text sources come from other domains, the medical text is special and has unique characteristics. In addition, the medical text mining poses more challenges, e.g., more unstructured text, the fast growing of new terms addition, a wide range of name variation for the same drug. The mining is even more challenging due to the lack of labeled dataset sources and external knowledge, as well as multiple token representations for a single drug name that is more common in the real application setting. Although many approaches have been proposed to overwhelm the task, some problems remained with poor F-score performance (less than 0.75). This paper presents a new treatment in data representation techniques to overcome some of those challenges. We propose three data representation techniques based on the characteristics of word distribution and word similarities as a result of word embedding training. The first technique is evaluated with the standard NN model, i.e., MLP (Multi-Layer Perceptrons). The second technique involves two deep network classifiers, i.e., DBN (Deep Belief Networks), and SAE (Stacked Denoising Encoders). The third technique represents the sentence as a sequence that is evaluated with a recurrent NN model, i.e., LSTM (Long Short Term Memory). In extracting the drug name entities, the third technique gives the best F-score performance compared to the state of the art, with its average F-score being 0.8645.

The current state of adoption of well-structured electronic health records and integration of digital methods for storing medical patient data in structured formats can often considered as inferior compared to the use of traditional, unstructured text based patient data documentation. Data mining in the field of medical data analysis often needs to rely solely on processing of unstructured data to retrieve relevant data. In natural language processing (NLP), statistical models have been shown successful in various tasks like part-of-speech tagging, relation extraction (RE) and named entity recognition (NER). In this work, we present GERNERMED, the first open, neural NLP model for NER tasks dedicated to detect medical entity types in German text data. Here, we avoid the conflicting goals of protection of sensitive patient data from training data extraction and the publication of the statistical model weights by training our model on a custom dataset that was translated from publicly available datasets in foreign language by a pretrained neural machine translation model. The sample code and the statistical model is available at: https://github.com/frankkramer-lab/GERNERMED

Medical vision-and-language models (MVLMs) have attracted substantial interest due to their capability to offer a natural language interface for interpreting complex medical data. Their applications are versatile and have the potential to improve diagnostic accuracy and decision-making for individual patients while also contributing to enhanced public health monitoring, disease surveillance, and policy-making through more efficient analysis of large data sets. MVLMS integrate natural language processing with medical images to enable a more comprehensive and contextual understanding of medical images alongside their corresponding textual information. Unlike general vision-and-language models trained on diverse, non-specialized datasets, MVLMs are purpose-built for the medical domain, automatically extracting and interpreting critical information from medical images and textual reports to support clinical decision-making. Popular clinical applications of MVLMs include automated medical report generation, medical visual question answering, medical multimodal segmentation, diagnosis and prognosis and medical image-text retrieval. Here, we provide a comprehensive overview of MVLMs and the various medical tasks to which they have been applied. We conduct a detailed analysis of various vision-and-language model architectures, focusing on their distinct strategies for cross-modal integration/exploitation of medical visual and textual features. We also examine the datasets used for these tasks and compare the performance of different models based on standardized evaluation metrics. Furthermore, we highlight potential challenges and summarize future research trends and directions. The full collection of papers and codes is available at: https://github.com/YtongXie/Medical-Vision-and-Language-Tasks-and-Methodologies-A-Survey.

Clinical notes in Electronic Health Records (EHR) present rich documented information of patients to inference phenotype for disease diagnosis and study patient characteristics for cohort selection. Unsupervised user embedding aims to encode patients into fixed-length vectors without human supervisions. Medical concepts extracted from the clinical notes contain rich connections between patients and their clinical categories. However, existing unsupervised approaches of user embeddings from clinical notes do not explicitly incorporate medical concepts. In this study, we propose a concept-aware unsupervised user embedding that jointly leverages text documents and medical concepts from two clinical corpora, MIMIC-III and Diabetes. We evaluate user embeddings on both extrinsic and intrinsic tasks, including phenotype classification, in-hospital mortality prediction, patient retrieval, and patient relatedness. Experiments on the two clinical corpora show our approach exceeds unsupervised baselines, and incorporating medical concepts can significantly improve the baseline performance.

Automatic medical text simplification can assist providers with patient-friendly communication and make medical texts more accessible, thereby improving health literacy. But curating a quality corpus for this task requires the supervision of medical experts. In this work, we present Med-EASi (textbf{Med}ical dataset for textbf{E}laborative and textbf{A}bstractive textbf{Si}mplification), a uniquely crowdsourced and finely annotated dataset for supervised simplification of short medical texts. Its expert-layman-AI collaborative annotations facilitate controllability over text simplification by marking four kinds of textual transformations: elaboration, replacement, deletion, and insertion. To learn medical text simplification, we fine-tune T5-large with four different styles of input-output combinations, leading to two control-free and two controllable versions of the model. We add two types of controllability into text simplification, by using a multi-angle training approach: position-aware, which uses in-place annotated inputs and outputs, and position-agnostic, where the model only knows the contents to be edited, but not their positions. Our results show that our fine-grained annotations improve learning compared to the unannotated baseline. Furthermore, position-aware control generates better simplification than the position-agnostic one. The data and code are available at https://github.com/Chandrayee/CTRL-SIMP.

Text summarization is a critical Natural Language Processing (NLP) task with applications ranging from information retrieval to content generation. Leveraging Large Language Models (LLMs) has shown remarkable promise in enhancing summarization techniques. This paper embarks on an exploration of text summarization with a diverse set of LLMs, including MPT-7b-instruct, falcon-7b-instruct, and OpenAI ChatGPT text-davinci-003 models. The experiment was performed with different hyperparameters and evaluated the generated summaries using widely accepted metrics such as the Bilingual Evaluation Understudy (BLEU) Score, Recall-Oriented Understudy for Gisting Evaluation (ROUGE) Score, and Bidirectional Encoder Representations from Transformers (BERT) Score. According to the experiment, text-davinci-003 outperformed the others. This investigation involved two distinct datasets: CNN Daily Mail and XSum. Its primary objective was to provide a comprehensive understanding of the performance of Large Language Models (LLMs) when applied to different datasets. The assessment of these models' effectiveness contributes valuable insights to researchers and practitioners within the NLP domain. This work serves as a resource for those interested in harnessing the potential of LLMs for text summarization and lays the foundation for the development of advanced Generative AI applications aimed at addressing a wide spectrum of business challenges.

Sequence-to-sequence models have recently gained the state of the art performance in summarization. However, not too many large-scale high-quality datasets are available and almost all the available ones are mainly news articles with specific writing style. Moreover, abstractive human-style systems involving description of the content at a deeper level require data with higher levels of abstraction. In this paper, we present WikiHow, a dataset of more than 230,000 article and summary pairs extracted and constructed from an online knowledge base written by different human authors. The articles span a wide range of topics and therefore represent high diversity styles. We evaluate the performance of the existing methods on WikiHow to present its challenges and set some baselines to further improve it.

Evaluating automatically-generated text summaries is a challenging task. While there have been many interesting approaches, they still fall short of human evaluations. We present RISE, a new approach for evaluating summaries by leveraging techniques from information retrieval. RISE is first trained as a retrieval task using a dual-encoder retrieval setup, and can then be subsequently utilized for evaluating a generated summary given an input document, without gold reference summaries. RISE is especially well suited when working on new datasets where one may not have reference summaries available for evaluation. We conduct comprehensive experiments on the SummEval benchmark (Fabbri et al., 2021) and the results show that RISE has higher correlation with human evaluations compared to many past approaches to summarization evaluation. Furthermore, RISE also demonstrates data-efficiency and generalizability across languages.

Scientific article summarization is challenging: large, annotated corpora are not available, and the summary should ideally include the article's impacts on research community. This paper provides novel solutions to these two challenges. We 1) develop and release the first large-scale manually-annotated corpus for scientific papers (on computational linguistics) by enabling faster annotation, and 2) propose summarization methods that integrate the authors' original highlights (abstract) and the article's actual impacts on the community (citations), to create comprehensive, hybrid summaries. We conduct experiments to demonstrate the efficacy of our corpus in training data-driven models for scientific paper summarization and the advantage of our hybrid summaries over abstracts and traditional citation-based summaries. Our large annotated corpus and hybrid methods provide a new framework for scientific paper summarization research.

This paper presents the formal release of MedMentions, a new manually annotated resource for the recognition of biomedical concepts. What distinguishes MedMentions from other annotated biomedical corpora is its size (over 4,000 abstracts and over 350,000 linked mentions), as well as the size of the concept ontology (over 3 million concepts from UMLS 2017) and its broad coverage of biomedical disciplines. In addition to the full corpus, a sub-corpus of MedMentions is also presented, comprising annotations for a subset of UMLS 2017 targeted towards document retrieval. To encourage research in Biomedical Named Entity Recognition and Linking, data splits for training and testing are included in the release, and a baseline model and its metrics for entity linking are also described.

Clinical notes contain rich data, which is unexploited in predictive modeling compared to structured data. In this work, we developed a new text representation Clinical XLNet for clinical notes which also leverages the temporal information of the sequence of the notes. We evaluated our models on prolonged mechanical ventilation prediction problem and our experiments demonstrated that Clinical XLNet outperforms the best baselines consistently.

We present a statistical model for German medical natural language processing trained for named entity recognition (NER) as an open, publicly available model. The work serves as a refined successor to our first GERNERMED model which is substantially outperformed by our work. We demonstrate the effectiveness of combining multiple techniques in order to achieve strong results in entity recognition performance by the means of transfer-learning on pretrained deep language models (LM), word-alignment and neural machine translation. Due to the sparse situation on open, public medical entity recognition models for German texts, this work offers benefits to the German research community on medical NLP as a baseline model. Since our model is based on public English data, its weights are provided without legal restrictions on usage and distribution. The sample code and the statistical model is available at: https://github.com/frankkramer-lab/GERNERMED-pp

In recent years, research in text summarization has mainly focused on the news domain, where texts are typically short and have strong layout features. The task of full-book summarization presents additional challenges which are hard to tackle with current resources, due to their limited size and availability in English only. To overcome these limitations, we present "Echoes from Alexandria", or in shortened form, "Echoes", a large resource for multilingual book summarization. Echoes features three novel datasets: i) Echo-Wiki, for multilingual book summarization, ii) Echo-XSum, for extremely-compressive multilingual book summarization, and iii) Echo-FairySum, for extractive book summarization. To the best of our knowledge, Echoes, with its thousands of books and summaries, is the largest resource, and the first to be multilingual, featuring 5 languages and 25 language pairs. In addition to Echoes, we also introduce a new extractive-then-abstractive baseline, and, supported by our experimental results and manual analysis of the summaries generated, we argue that this baseline is more suitable for book summarization than purely-abstractive approaches. We release our resource and software at https://github.com/Babelscape/echoes-from-alexandria in the hope of fostering innovative research in multilingual book summarization.

With the advent of large language models, methods for abstractive summarization have made great strides, creating potential for use in applications to aid knowledge workers processing unwieldy document collections. One such setting is the Civil Rights Litigation Clearinghouse (CRLC) (https://clearinghouse.net),which posts information about large-scale civil rights lawsuits, serving lawyers, scholars, and the general public. Today, summarization in the CRLC requires extensive training of lawyers and law students who spend hours per case understanding multiple relevant documents in order to produce high-quality summaries of key events and outcomes. Motivated by this ongoing real-world summarization effort, we introduce Multi-LexSum, a collection of 9,280 expert-authored summaries drawn from ongoing CRLC writing. Multi-LexSum presents a challenging multi-document summarization task given the length of the source documents, often exceeding two hundred pages per case. Furthermore, Multi-LexSum is distinct from other datasets in its multiple target summaries, each at a different granularity (ranging from one-sentence "extreme" summaries to multi-paragraph narrations of over five hundred words). We present extensive analysis demonstrating that despite the high-quality summaries in the training data (adhering to strict content and style guidelines), state-of-the-art summarization models perform poorly on this task. We release Multi-LexSum for further research in summarization methods as well as to facilitate development of applications to assist in the CRLC's mission at https://multilexsum.github.io.

Systematic literature review is essential for evidence-based medicine, requiring comprehensive analysis of clinical trial publications. However, the application of artificial intelligence (AI) models for medical literature mining has been limited by insufficient training and evaluation across broad therapeutic areas and diverse tasks. Here, we present LEADS, an AI foundation model for study search, screening, and data extraction from medical literature. The model is trained on 633,759 instruction data points in LEADSInstruct, curated from 21,335 systematic reviews, 453,625 clinical trial publications, and 27,015 clinical trial registries. We showed that LEADS demonstrates consistent improvements over four cutting-edge generic large language models (LLMs) on six tasks. Furthermore, LEADS enhances expert workflows by providing supportive references following expert requests, streamlining processes while maintaining high-quality results. A study with 16 clinicians and medical researchers from 14 different institutions revealed that experts collaborating with LEADS achieved a recall of 0.81 compared to 0.77 experts working alone in study selection, with a time savings of 22.6%. In data extraction tasks, experts using LEADS achieved an accuracy of 0.85 versus 0.80 without using LEADS, alongside a 26.9% time savings. These findings highlight the potential of specialized medical literature foundation models to outperform generic models, delivering significant quality and efficiency benefits when integrated into expert workflows for medical literature mining.

With recent advancements in the area of Natural Language Processing, the focus is slowly shifting from a purely English-centric view towards more language-specific solutions, including German. Especially practical for businesses to analyze their growing amount of textual data are text summarization systems, which transform long input documents into compressed and more digestible summary texts. In this work, we assess the particular landscape of German abstractive text summarization and investigate the reasons why practically useful solutions for abstractive text summarization are still absent in industry. Our focus is two-fold, analyzing a) training resources, and b) publicly available summarization systems. We are able to show that popular existing datasets exhibit crucial flaws in their assumptions about the original sources, which frequently leads to detrimental effects on system generalization and evaluation biases. We confirm that for the most popular training dataset, MLSUM, over 50% of the training set is unsuitable for abstractive summarization purposes. Furthermore, available systems frequently fail to compare to simple baselines, and ignore more effective and efficient extractive summarization approaches. We attribute poor evaluation quality to a variety of different factors, which are investigated in more detail in this work: A lack of qualitative (and diverse) gold data considered for training, understudied (and untreated) positional biases in some of the existing datasets, and the lack of easily accessible and streamlined pre-processing strategies or analysis tools. We provide a comprehensive assessment of available models on the cleaned datasets, and find that this can lead to a reduction of more than 20 ROUGE-1 points during evaluation. The code for dataset filtering and reproducing results can be found online at https://github.com/dennlinger/summaries

In this paper, we consider enhancing medical visual-language pre-training (VLP) with domain-specific knowledge, by exploiting the paired image-text reports from the radiological daily practice. In particular, we make the following contributions: First, unlike existing works that directly process the raw reports, we adopt a novel triplet extraction module to extract the medical-related information, avoiding unnecessary complexity from language grammar and enhancing the supervision signals; Second, we propose a novel triplet encoding module with entity translation by querying a knowledge base, to exploit the rich domain knowledge in medical field, and implicitly build relationships between medical entities in the language embedding space; Third, we propose to use a Transformer-based fusion model for spatially aligning the entity description with visual signals at the image patch level, enabling the ability for medical diagnosis; Fourth, we conduct thorough experiments to validate the effectiveness of our architecture, and benchmark on numerous public benchmarks, e.g., ChestX-ray14, RSNA Pneumonia, SIIM-ACR Pneumothorax, COVIDx CXR-2, COVID Rural, and EdemaSeverity. In both zero-shot and fine-tuning settings, our model has demonstrated strong performance compared with the former methods on disease classification and grounding.

Summarization is the task of compressing source document(s) into coherent and succinct passages. This is a valuable tool to present users with concise and accurate sketch of the top ranked documents related to their queries. Query-based multi-document summarization (qMDS) addresses this pervasive need, but the research is severely limited due to lack of training and evaluation datasets as existing single-document and multi-document summarization datasets are inadequate in form and scale. We propose a scalable approach called AQuaMuSe to automatically mine qMDS examples from question answering datasets and large document corpora. Our approach is unique in the sense that it can general a dual dataset -- for extractive and abstractive summaries both. We publicly release a specific instance of an AQuaMuSe dataset with 5,519 query-based summaries, each associated with an average of 6 input documents selected from an index of 355M documents from Common Crawl. Extensive evaluation of the dataset along with baseline summarization model experiments are provided.

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.

Advances in natural language processing techniques, such as named entity recognition and normalization to widely used standardized terminologies like UMLS or SNOMED-CT, along with the digitalization of electronic health records, have significantly advanced clinical text analysis. This study presents ClinLinker, a novel approach employing a two-phase pipeline for medical entity linking that leverages the potential of in-domain adapted language models for biomedical text mining: initial candidate retrieval using a SapBERT-based bi-encoder and subsequent re-ranking with a cross-encoder, trained by following a contrastive-learning strategy to be tailored to medical concepts in Spanish. This methodology, focused initially on content in Spanish, substantially outperforming multilingual language models designed for the same purpose. This is true even for complex scenarios involving heterogeneous medical terminologies and being trained on a subset of the original data. Our results, evaluated using top-k accuracy at 25 and other top-k metrics, demonstrate our approach's performance on two distinct clinical entity linking Gold Standard corpora, DisTEMIST (diseases) and MedProcNER (clinical procedures), outperforming previous benchmarks by 40 points in DisTEMIST and 43 points in MedProcNER, both normalized to SNOMED-CT codes. These findings highlight our approach's ability to address language-specific nuances and set a new benchmark in entity linking, offering a potent tool for enhancing the utility of digital medical records. The resulting system is of practical value, both for large scale automatic generation of structured data derived from clinical records, as well as for exhaustive extraction and harmonization of predefined clinical variables of interest.

The introduction of computerized medical records in hospitals has reduced burdensome operations like manual writing and information fetching. However, the data contained in medical records are still far underutilized, primarily because extracting them from unstructured textual medical records takes time and effort. Information Extraction, a subfield of Natural Language Processing, can help clinical practitioners overcome this limitation, using automated text-mining pipelines. In this work, we created the first Italian neuropsychiatric Named Entity Recognition dataset, PsyNIT, and used it to develop a Large Language Model for this task. Moreover, we conducted several experiments with three external independent datasets to implement an effective multicenter model, with overall F1-score 84.77%, Precision 83.16%, Recall 86.44%. The lessons learned are: (i) the crucial role of a consistent annotation process and (ii) a fine-tuning strategy that combines classical methods with a "few-shot" approach. This allowed us to establish methodological guidelines that pave the way for future implementations in this field and allow Italian hospitals to tap into important research opportunities.

The exponential surge in online health information, coupled with its increasing use by non-experts, highlights the pressing need for advanced Health Information Retrieval models that consider not only topical relevance but also the factual accuracy of the retrieved information, given the potential risks associated with health misinformation. To this aim, this paper introduces a solution driven by Retrieval-Augmented Generation (RAG), which leverages the capabilities of generative Large Language Models (LLMs) to enhance the retrieval of health-related documents grounded in scientific evidence. In particular, we propose a three-stage model: in the first stage, the user's query is employed to retrieve topically relevant passages with associated references from a knowledge base constituted by scientific literature. In the second stage, these passages, alongside the initial query, are processed by LLMs to generate a contextually relevant rich text (GenText). In the last stage, the documents to be retrieved are evaluated and ranked both from the point of view of topical relevance and factual accuracy by means of their comparison with GenText, either through stance detection or semantic similarity. In addition to calculating factual accuracy, GenText can offer a layer of explainability for it, aiding users in understanding the reasoning behind the retrieval. Experimental evaluation of our model on benchmark datasets and against baseline models demonstrates its effectiveness in enhancing the retrieval of both topically relevant and factually accurate health information, thus presenting a significant step forward in the health misinformation mitigation problem.

Learning to represent free text is a core task in many clinical machine learning (ML) applications, as clinical text contains observations and plans not otherwise available for inference. State-of-the-art methods use large language models developed with immense computational resources and training data; however, applying these models is challenging because of the highly varying syntax and vocabulary in clinical free text. Structured information such as International Classification of Disease (ICD) codes often succinctly abstracts the most important facts of a clinical encounter and yields good performance, but is often not as available as clinical text in real-world scenarios. We propose a multi-view learning framework that jointly learns from codes and text to combine the availability and forward-looking nature of text and better performance of ICD codes. The learned text embeddings can be used as inputs to predictive algorithms independent of the ICD codes during inference. Our approach uses a Graph Neural Network (GNN) to process ICD codes, and Bi-LSTM to process text. We apply Deep Canonical Correlation Analysis (DCCA) to enforce the two views to learn a similar representation of each patient. In experiments using planned surgical procedure text, our model outperforms BERT models fine-tuned to clinical data, and in experiments using diverse text in MIMIC-III, our model is competitive to a fine-tuned BERT at a tiny fraction of its computational effort.

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.

This paper is dedicated to the design and evaluation of the first AMR parser tailored for clinical notes. Our objective was to facilitate the precise transformation of the clinical notes into structured AMR expressions, thereby enhancing the interpretability and usability of clinical text data at scale. Leveraging the colon cancer dataset from the Temporal Histories of Your Medical Events (THYME) corpus, we adapted a state-of-the-art AMR parser utilizing continuous training. Our approach incorporates data augmentation techniques to enhance the accuracy of AMR structure predictions. Notably, through this learning strategy, our parser achieved an impressive F1 score of 88% on the THYME corpus's colon cancer dataset. Moreover, our research delved into the efficacy of data required for domain adaptation within the realm of clinical notes, presenting domain adaptation data requirements for AMR parsing. This exploration not only underscores the parser's robust performance but also highlights its potential in facilitating a deeper understanding of clinical narratives through structured semantic representations.

Text summarization has been a crucial problem in natural language processing (NLP) for several decades. It aims to condense lengthy documents into shorter versions while retaining the most critical information. Various methods have been proposed for text summarization, including extractive and abstractive summarization. The emergence of large language models (LLMs) like GPT3 and ChatGPT has recently created significant interest in using these models for text summarization tasks. Recent studies goyal2022news, zhang2023benchmarking have shown that LLMs-generated news summaries are already on par with humans. However, the performance of LLMs for more practical applications like aspect or query-based summaries is underexplored. To fill this gap, we conducted an evaluation of ChatGPT's performance on four widely used benchmark datasets, encompassing diverse summaries from Reddit posts, news articles, dialogue meetings, and stories. Our experiments reveal that ChatGPT's performance is comparable to traditional fine-tuning methods in terms of Rouge scores. Moreover, we highlight some unique differences between ChatGPT-generated summaries and human references, providing valuable insights into the superpower of ChatGPT for diverse text summarization tasks. Our findings call for new directions in this area, and we plan to conduct further research to systematically examine the characteristics of ChatGPT-generated summaries through extensive human evaluation.

Biomedical literature often uses complex language and inaccessible professional terminologies. That is why simplification plays an important role in improving public health literacy. Applying Natural Language Processing (NLP) models to automate such tasks allows for quick and direct accessibility for lay readers. In this work, we investigate the ability of state-of-the-art large language models (LLMs) on the task of biomedical abstract simplification, using the publicly available dataset for plain language adaptation of biomedical abstracts (PLABA). The methods applied include domain fine-tuning and prompt-based learning (PBL) on: 1) Encoder-decoder models (T5, SciFive, and BART), 2) Decoder-only GPT models (GPT-3.5 and GPT-4) from OpenAI and BioGPT, and 3) Control-token mechanisms on BART-based models. We used a range of automatic evaluation metrics, including BLEU, ROUGE, SARI, and BERTscore, and also conducted human evaluations. BART-Large with Control Token (BART-L-w-CT) mechanisms reported the highest SARI score of 46.54 and T5-base reported the highest BERTscore 72.62. In human evaluation, BART-L-w-CTs achieved a better simplicity score over T5-Base (2.9 vs. 2.2), while T5-Base achieved a better meaning preservation score over BART-L-w-CTs (3.1 vs. 2.6). We also categorised the system outputs with examples, hoping this will shed some light for future research on this task. Our code, fine-tuned models, and data splits are available at https://github.com/HECTA-UoM/PLABA-MU

Extensive efforts in the past have been directed toward the development of summarization datasets. However, a predominant number of these resources have been (semi)-automatically generated, typically through web data crawling, resulting in subpar resources for training and evaluating summarization systems, a quality compromise that is arguably due to the substantial costs associated with generating ground-truth summaries, particularly for diverse languages and specialized domains. To address this issue, we present ACLSum, a novel summarization dataset carefully crafted and evaluated by domain experts. In contrast to previous datasets, ACLSum facilitates multi-aspect summarization of scientific papers, covering challenges, approaches, and outcomes in depth. Through extensive experiments, we evaluate the quality of our resource and the performance of models based on pretrained language models and state-of-the-art large language models (LLMs). Additionally, we explore the effectiveness of extractive versus abstractive summarization within the scholarly domain on the basis of automatically discovered aspects. Our results corroborate previous findings in the general domain and indicate the general superiority of end-to-end aspect-based summarization. Our data is released at https://github.com/sobamchan/aclsum.

We introduce extreme summarization, a new single-document summarization task which does not favor extractive strategies and calls for an abstractive modeling approach. The idea is to create a short, one-sentence news summary answering the question "What is the article about?". We collect a real-world, large-scale dataset for this task by harvesting online articles from the British Broadcasting Corporation (BBC). We propose a novel abstractive model which is conditioned on the article's topics and based entirely on convolutional neural networks. We demonstrate experimentally that this architecture captures long-range dependencies in a document and recognizes pertinent content, outperforming an oracle extractive system and state-of-the-art abstractive approaches when evaluated automatically and by humans.

The quadratic computational and memory complexities of large Transformers have limited their scalability for long document summarization. In this paper, we propose Hepos, a novel efficient encoder-decoder attention with head-wise positional strides to effectively pinpoint salient information from the source. We further conduct a systematic study of existing efficient self-attentions. Combined with Hepos, we are able to process ten times more tokens than existing models that use full attentions. For evaluation, we present a new dataset, GovReport, with significantly longer documents and summaries. Results show that our models produce significantly higher ROUGE scores than competitive comparisons, including new state-of-the-art results on PubMed. Human evaluation also shows that our models generate more informative summaries with fewer unfaithful errors.

Low-resource extractive text summarization is a vital but heavily underexplored area of research. Prior literature either focuses on abstractive text summarization or prompts a large language model (LLM) like GPT-3 directly to generate summaries. In this work, we propose MixSumm for low-resource extractive text summarization. Specifically, MixSumm prompts an open-source LLM, LLaMA-3-70b, to generate documents that mix information from multiple topics as opposed to generating documents without mixup, and then trains a summarization model on the generated dataset. We use ROUGE scores and L-Eval, a reference-free LLaMA-3-based evaluation method to measure the quality of generated summaries. We conduct extensive experiments on a challenging text summarization benchmark comprising the TweetSumm, WikiHow, and ArXiv/PubMed datasets and show that our LLM-based data augmentation framework outperforms recent prompt-based approaches for low-resource extractive summarization. Additionally, our results also demonstrate effective knowledge distillation from LLaMA-3-70b to a small BERT-based extractive summarizer.

We investigate pre-training techniques for abstractive multi-document summarization (MDS), which is much less studied than summarizing single documents. Though recent work has demonstrated the effectiveness of highlighting information salience for pre-training strategy design, it struggles to generate abstractive and reflective summaries, which are critical properties for MDS. To this end, we present PELMS, a pre-trained model that uses objectives based on semantic coherence heuristics and faithfulness constraints with un-labeled multi-document inputs, to promote the generation of concise, fluent, and faithful summaries. To support the training of PELMS, we compile MultiPT, a multi-document pre-training corpus containing over 93 million documents to form more than 3 million unlabeled topic-centric document clusters, covering diverse genres such as product reviews, news, and general knowledge. We perform extensive evaluation of PELMS in low-shot settings on a wide range of MDS datasets. Our approach consistently outperforms competitive comparisons with respect to overall informativeness, abstractiveness, coherence, and faithfulness.

We introduce a novel graph-based Retrieval-Augmented Generation (RAG) framework specifically designed for the medical domain, called MedGraphRAG, aimed at enhancing Large Language Model (LLM) capabilities and generating evidence-based results, thereby improving safety and reliability when handling private medical data. Our comprehensive pipeline begins with a hybrid static-semantic approach to document chunking, significantly improving context capture over traditional methods. Extracted entities are used to create a three-tier hierarchical graph structure, linking entities to foundational medical knowledge sourced from medical papers and dictionaries. These entities are then interconnected to form meta-graphs, which are merged based on semantic similarities to develop a comprehensive global graph. This structure supports precise information retrieval and response generation. The retrieval process employs a U-retrieve method to balance global awareness and indexing efficiency of the LLM. Our approach is validated through a comprehensive ablation study comparing various methods for document chunking, graph construction, and information retrieval. The results not only demonstrate that our hierarchical graph construction method consistently outperforms state-of-the-art models on multiple medical Q\&A benchmarks, but also confirms that the responses generated include source documentation, significantly enhancing the reliability of medical LLMs in practical applications. Code will be at: https://github.com/MedicineToken/Medical-Graph-RAG/tree/main

Recently, the increasing demand for superior medical services has highlighted the discrepancies in the medical infrastructure. With big data, especially texts, forming the foundation of medical services, there is an exigent need for effective natural language processing (NLP) solutions tailored to the healthcare domain. Conventional approaches leveraging pre-trained models present promising results in this domain and current large language models (LLMs) offer advanced foundation for medical text processing. However, most medical LLMs are trained only with supervised fine-tuning (SFT), even though it efficiently empowers LLMs to understand and respond to medical instructions but is ineffective in learning domain knowledge and aligning with human preference. Another engineering barrier that prevents current medical LLM from better text processing ability is their restricted context length (e.g., 2,048 tokens), making it hard for the LLMs to process long context, which is frequently required in the medical domain. In this work, we propose ChiMed-GPT, a new benchmark LLM designed explicitly for Chinese medical domain, with enlarged context length to 4,096 tokens and undergoes a comprehensive training regime with pre-training, SFT, and RLHF. Evaluations on real-world tasks including information extraction, question answering, and dialogue generation demonstrate ChiMed-GPT's superior performance over general domain LLMs. Furthermore, we analyze possible biases through prompting ChiMed-GPT to perform attitude scales regarding discrimination of patients, so as to contribute to further responsible development of LLMs in the medical domain. The code and model are released at https://github.com/synlp/ChiMed-GPT.

One of the biggest challenges that prohibit the use of many current NLP methods in clinical settings is the availability of public datasets. In this work, we present MeDAL, a large medical text dataset curated for abbreviation disambiguation, designed for natural language understanding pre-training in the medical domain. We pre-trained several models of common architectures on this dataset and empirically showed that such pre-training leads to improved performance and convergence speed when fine-tuning on downstream medical tasks.

In this work, we model abstractive text summarization using Attentional Encoder-Decoder Recurrent Neural Networks, and show that they achieve state-of-the-art performance on two different corpora. We propose several novel models that address critical problems in summarization that are not adequately modeled by the basic architecture, such as modeling key-words, capturing the hierarchy of sentence-to-word structure, and emitting words that are rare or unseen at training time. Our work shows that many of our proposed models contribute to further improvement in performance. We also propose a new dataset consisting of multi-sentence summaries, and establish performance benchmarks for further research.

Keeping track of scientific challenges, advances and emerging directions is a fundamental part of research. However, researchers face a flood of papers that hinders discovery of important knowledge. In biomedicine, this directly impacts human lives. To address this problem, we present a novel task of extraction and search of scientific challenges and directions, to facilitate rapid knowledge discovery. We construct and release an expert-annotated corpus of texts sampled from full-length papers, labeled with novel semantic categories that generalize across many types of challenges and directions. We focus on a large corpus of interdisciplinary work relating to the COVID-19 pandemic, ranging from biomedicine to areas such as AI and economics. We apply a model trained on our data to identify challenges and directions across the corpus and build a dedicated search engine. In experiments with 19 researchers and clinicians using our system, we outperform a popular scientific search engine in assisting knowledge discovery. Finally, we show that models trained on our resource generalize to the wider biomedical domain and to AI papers, highlighting its broad utility. We make our data, model and search engine publicly available. https://challenges.apps.allenai.org/

In tackling the challenge of Multi-Document Summarization (MDS), numerous methods have been proposed, spanning both extractive and abstractive summarization techniques. However, each approach has its own limitations, making it less effective to rely solely on either one. An emerging and promising strategy involves a synergistic fusion of extractive and abstractive summarization methods. Despite the plethora of studies in this domain, research on the combined methodology remains scarce, particularly in the context of Vietnamese language processing. This paper presents a novel Vietnamese MDS framework leveraging a two-component pipeline architecture that integrates extractive and abstractive techniques. The first component employs an extractive approach to identify key sentences within each document. This is achieved by a modification of the pre-trained BERT network, which derives semantically meaningful phrase embeddings using siamese and triplet network structures. The second component utilizes the VBD-LLaMA2-7B-50b model for abstractive summarization, ultimately generating the final summary document. Our proposed framework demonstrates a positive performance, attaining ROUGE-2 scores of 39.6% on the VN-MDS dataset and outperforming the state-of-the-art baselines.

Previous research in multi-document news summarization has typically concentrated on collating information that all sources agree upon. However, to our knowledge, the summarization of diverse information dispersed across multiple articles about an event has not been previously investigated. The latter imposes a different set of challenges for a summarization model. In this paper, we propose a new task of summarizing diverse information encountered in multiple news articles encompassing the same event. To facilitate this task, we outlined a data collection schema for identifying diverse information and curated a dataset named DiverseSumm. The dataset includes 245 news stories, with each story comprising 10 news articles and paired with a human-validated reference. Moreover, we conducted a comprehensive analysis to pinpoint the position and verbosity biases when utilizing Large Language Model (LLM)-based metrics for evaluating the coverage and faithfulness of the summaries, as well as their correlation with human assessments. We applied our findings to study how LLMs summarize multiple news articles by analyzing which type of diverse information LLMs are capable of identifying. Our analyses suggest that despite the extraordinary capabilities of LLMs in single-document summarization, the proposed task remains a complex challenge for them mainly due to their limited coverage, with GPT-4 only able to cover less than 40% of the diverse information on average.

The rapid increase in unstructured data across various fields has made multi-document comprehension and summarization a critical task. Traditional approaches often fail to capture relevant context, maintain logical consistency, and extract essential information from lengthy documents. This paper explores the use of Long-context Large Language Models (LLMs) for multi-document summarization, demonstrating their exceptional capacity to grasp extensive connections, provide cohesive summaries, and adapt to various industry domains and integration with enterprise applications/systems. The paper discusses the workflow of multi-document summarization for effectively deploying long-context LLMs, supported by case studies in legal applications, enterprise functions such as HR, finance, and sourcing, as well as in the medical and news domains. These case studies show notable enhancements in both efficiency and accuracy. Technical obstacles, such as dataset diversity, model scalability, and ethical considerations like bias mitigation and factual accuracy, are carefully analyzed. Prospective research avenues are suggested to augment the functionalities and applications of long-context LLMs, establishing them as pivotal tools for transforming information processing across diverse sectors and enterprise applications.

Summary sentences produced by abstractive summarization models may be coherent and comprehensive, but they lack control and rely heavily on reference summaries. The BRIO training paradigm assumes a non-deterministic distribution to reduce the model's dependence on reference summaries, and improve model performance during inference. This paper presents a straightforward but effective technique to improve abstractive summaries by fine-tuning pre-trained language models, and training them with the BRIO paradigm. We build a text summarization dataset for Vietnamese, called VieSum. We perform experiments with abstractive summarization models trained with the BRIO paradigm on the CNNDM and the VieSum datasets. The results show that the models, trained on basic hardware, outperform all existing abstractive summarization models, especially for Vietnamese.

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.

This paper introduces a novel, entity-aware metric, termed as Radiological Report (Text) Evaluation (RaTEScore), to assess the quality of medical reports generated by AI models. RaTEScore emphasizes crucial medical entities such as diagnostic outcomes and anatomical details, and is robust against complex medical synonyms and sensitive to negation expressions. Technically, we developed a comprehensive medical NER dataset, RaTE-NER, and trained an NER model specifically for this purpose. This model enables the decomposition of complex radiological reports into constituent medical entities. The metric itself is derived by comparing the similarity of entity embeddings, obtained from a language model, based on their types and relevance to clinical significance. Our evaluations demonstrate that RaTEScore aligns more closely with human preference than existing metrics, validated both on established public benchmarks and our newly proposed RaTE-Eval benchmark.

Abstractive summarization is the task of compressing a long document into a coherent short document while retaining salient information. Modern abstractive summarization methods are based on deep neural networks which often require large training datasets. Since collecting summarization datasets is an expensive and time-consuming task, practical industrial settings are usually low-resource. In this paper, we study a challenging low-resource setting of summarizing long legal briefs with an average source document length of 4268 words and only 120 available (document, summary) pairs. To account for data scarcity, we used a modern pretrained abstractive summarizer BART (Lewis et al., 2020), which only achieves 17.9 ROUGE-L as it struggles with long documents. We thus attempt to compress these long documents by identifying salient sentences in the source which best ground the summary, using a novel algorithm based on GPT-2 (Radford et al., 2019) language model perplexity scores, that operates within the low resource regime. On feeding the compressed documents to BART, we observe a 6.0 ROUGE-L improvement. Our method also beats several competitive salience detection baselines. Furthermore, the identified salient sentences tend to agree with an independent human labeling by domain experts.

Electronic health records (EHR) contain narrative notes that provide extensive details on the medical condition and management of patients. Natural language processing (NLP) of clinical notes can use observed frequencies of clinical terms as predictive features for downstream applications such as clinical decision making and patient trajectory prediction. However, due to the vast number of highly similar and related clinical concepts, a more effective modeling strategy is to represent clinical terms as semantic embeddings via representation learning and use the low dimensional embeddings as feature vectors for predictive modeling. To achieve efficient representation, fine-tuning pretrained language models with biomedical knowledge graphs may generate better embeddings for biomedical terms than those from standard language models alone. These embeddings can effectively discriminate synonymous pairs of from those that are unrelated. However, they often fail to capture different degrees of similarity or relatedness for concepts that are hierarchical in nature. To overcome this limitation, we propose HiPrBERT, a novel biomedical term representation model trained on additionally complied data that contains hierarchical structures for various biomedical terms. We modify an existing contrastive loss function to extract information from these hierarchies. Our numerical experiments demonstrate that HiPrBERT effectively learns the pair-wise distance from hierarchical information, resulting in a substantially more informative embeddings for further biomedical applications

The majority of available text summarization datasets include short-form source documents that lack long-range causal and temporal dependencies, and often contain strong layout and stylistic biases. While relevant, such datasets will offer limited challenges for future generations of text summarization systems. We address these issues by introducing BookSum, a collection of datasets for long-form narrative summarization. Our dataset covers source documents from the literature domain, such as novels, plays and stories, and includes highly abstractive, human written summaries on three levels of granularity of increasing difficulty: paragraph-, chapter-, and book-level. The domain and structure of our dataset poses a unique set of challenges for summarization systems, which include: processing very long documents, non-trivial causal and temporal dependencies, and rich discourse structures. To facilitate future work, we trained and evaluated multiple extractive and abstractive summarization models as baselines for our dataset.

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.

Large-language models have recently demonstrated impressive zero-shot capabilities in a variety of natural language tasks such as summarization, dialogue generation, and question-answering. Despite many promising applications in clinical medicine, adoption of these models in real-world settings has been largely limited by their tendency to generate incorrect and sometimes even toxic statements. In this study, we develop Almanac, a large language model framework augmented with retrieval capabilities for medical guideline and treatment recommendations. Performance on a novel dataset of clinical scenarios (n = 130) evaluated by a panel of 5 board-certified and resident physicians demonstrates significant increases in factuality (mean of 18% at p-value < 0.05) across all specialties, with improvements in completeness and safety. Our results demonstrate the potential for large language models to be effective tools in the clinical decision-making process, while also emphasizing the importance of careful testing and deployment to mitigate their shortcomings.

We address the problem of abstractive summarization in two directions: proposing a novel dataset and a new model. First, we collect Reddit TIFU dataset, consisting of 120K posts from the online discussion forum Reddit. We use such informal crowd-generated posts as text source, in contrast with existing datasets that mostly use formal documents as source such as news articles. Thus, our dataset could less suffer from some biases that key sentences usually locate at the beginning of the text and favorable summary candidates are already inside the text in similar forms. Second, we propose a novel abstractive summarization model named multi-level memory networks (MMN), equipped with multi-level memory to store the information of text from different levels of abstraction. With quantitative evaluation and user studies via Amazon Mechanical Turk, we show the Reddit TIFU dataset is highly abstractive and the MMN outperforms the state-of-the-art summarization models.

Automatic summarization of legal case judgements has traditionally been attempted by using extractive summarization methods. However, in recent years, abstractive summarization models are gaining popularity since they can generate more natural and coherent summaries. Legal domain-specific pre-trained abstractive summarization models are now available. Moreover, general-domain pre-trained Large Language Models (LLMs), such as ChatGPT, are known to generate high-quality text and have the capacity for text summarization. Hence it is natural to ask if these models are ready for off-the-shelf application to automatically generate abstractive summaries for case judgements. To explore this question, we apply several state-of-the-art domain-specific abstractive summarization models and general-domain LLMs on Indian court case judgements, and check the quality of the generated summaries. In addition to standard metrics for summary quality, we check for inconsistencies and hallucinations in the summaries. We see that abstractive summarization models generally achieve slightly higher scores than extractive models in terms of standard summary evaluation metrics such as ROUGE and BLEU. However, we often find inconsistent or hallucinated information in the generated abstractive summaries. Overall, our investigation indicates that the pre-trained abstractive summarization models and LLMs are not yet ready for fully automatic deployment for case judgement summarization; rather a human-in-the-loop approach including manual checks for inconsistencies is more suitable at present.

Text summarization is one of the most critical Natural Language Processing (NLP) tasks. More and more researches are conducted in this field every day. Pre-trained transformer-based encoder-decoder models have begun to gain popularity for these tasks. This paper proposes two methods to address this task and introduces a novel dataset named pn-summary for Persian abstractive text summarization. The models employed in this paper are mT5 and an encoder-decoder version of the ParsBERT model (i.e., a monolingual BERT model for Persian). These models are fine-tuned on the pn-summary dataset. The current work is the first of its kind and, by achieving promising results, can serve as a baseline for any future work.

Large language models (LLMs) are capable of generating coherent summaries from very long contexts given a user query. Extracting and properly citing evidence spans could help improve the transparency and reliability of these summaries. At the same time, LLMs suffer from positional biases in terms of which information they understand and attend to, which could affect evidence citation. Whereas previous work has focused on evidence citation with predefined levels of granularity (e.g. sentence, paragraph, document, etc.), we propose the task of long-context query focused summarization with unstructured evidence citation. We show how existing systems struggle to generate and properly cite unstructured evidence from their context, and that evidence tends to be "lost-in-the-middle". To help mitigate this, we create the Summaries with Unstructured Evidence Text dataset (SUnsET), a synthetic dataset generated using a novel domain-agnostic pipeline which can be used as supervision to adapt LLMs to this task. We demonstrate across 5 LLMs of different sizes and 4 datasets with varying document types and lengths that LLMs adapted with SUnsET data generate more relevant and factually consistent evidence than their base models, extract evidence from more diverse locations in their context, and can generate more relevant and consistent summaries.

The rapid expansion of scientific literature in computer science presents challenges in tracking research trends and extracting key insights. Existing datasets provide metadata but lack structured summaries that capture core contributions and methodologies. We introduce CS-PaperSum, a large-scale dataset of 91,919 papers from 31 top-tier computer science conferences, enriched with AI-generated structured summaries using ChatGPT. To assess summary quality, we conduct embedding alignment analysis and keyword overlap analysis, demonstrating strong preservation of key concepts. We further present a case study on AI research trends, highlighting shifts in methodologies and interdisciplinary crossovers, including the rise of self-supervised learning, retrieval-augmented generation, and multimodal AI. Our dataset enables automated literature analysis, research trend forecasting, and AI-driven scientific discovery, providing a valuable resource for researchers, policymakers, and scientific information retrieval systems.

Competitive Debate's increasingly technical nature has left competitors looking for tools to accelerate evidence production. We find that the unique type of extractive summarization performed by competitive debaters - summarization with a bias towards a particular target meaning - can be performed using the latest innovations in unsupervised pre-trained text vectorization models. We introduce CX_DB8, a queryable word-level extractive summarizer and evidence creation framework, which allows for rapid, biasable summarization of arbitarily sized texts. CX_DB8s usage of the embedding framework Flair means that as the underlying models improve, CX_DB8 will also improve. We observe that CX_DB8 also functions as a semantic search engine, and has application as a supplement to traditional "find" functionality in programs and webpages. CX_DB8 is currently used by competitive debaters and is made available to the public at https://github.com/Hellisotherpeople/CX_DB8

Traditional sequence-to-sequence (seq2seq) models and other variations of the attention-mechanism such as hierarchical attention have been applied to the text summarization problem. Though there is a hierarchy in the way humans use language by forming paragraphs from sentences and sentences from words, hierarchical models have usually not worked that much better than their traditional seq2seq counterparts. This effect is mainly because either the hierarchical attention mechanisms are too sparse using hard attention or noisy using soft attention. In this paper, we propose a method based on extracting the highlights of a document; a key concept that is conveyed in a few sentences. In a typical text summarization dataset consisting of documents that are 800 tokens in length (average), capturing long-term dependencies is very important, e.g., the last sentence can be grouped with the first sentence of a document to form a summary. LSTMs (Long Short-Term Memory) proved useful for machine translation. However, they often fail to capture long-term dependencies while modeling long sequences. To address these issues, we have adapted Neural Semantic Encoders (NSE) to text summarization, a class of memory-augmented neural networks by improving its functionalities and proposed a novel hierarchical NSE that outperforms similar previous models significantly. The quality of summarization was improved by augmenting linguistic factors, namely lemma, and Part-of-Speech (PoS) tags, to each word in the dataset for improved vocabulary coverage and generalization. The hierarchical NSE model on factored dataset outperformed the state-of-the-art by nearly 4 ROUGE points. We further designed and used the first GPU-based self-critical Reinforcement Learning model.

Bidirectional Encoder Representations from Transformers (BERT) represents the latest incarnation of pretrained language models which have recently advanced a wide range of natural language processing tasks. In this paper, we showcase how BERT can be usefully applied in text summarization and propose a general framework for both extractive and abstractive models. We introduce a novel document-level encoder based on BERT which is able to express the semantics of a document and obtain representations for its sentences. Our extractive model is built on top of this encoder by stacking several inter-sentence Transformer layers. For abstractive summarization, we propose a new fine-tuning schedule which adopts different optimizers for the encoder and the decoder as a means of alleviating the mismatch between the two (the former is pretrained while the latter is not). We also demonstrate that a two-staged fine-tuning approach can further boost the quality of the generated summaries. Experiments on three datasets show that our model achieves state-of-the-art results across the board in both extractive and abstractive settings. Our code is available at https://github.com/nlpyang/PreSumm

Given the recent introduction of multiple language models and the ongoing demand for improved Natural Language Processing tasks, particularly summarization, this work provides a comprehensive benchmarking of 20 recent language models, focusing on smaller ones for the news summarization task. In this work, we systematically test the capabilities and effectiveness of these models in summarizing news article texts which are written in different styles and presented in three distinct datasets. Specifically, we focus in this study on zero-shot and few-shot learning settings and we apply a robust evaluation methodology that combines different evaluation concepts including automatic metrics, human evaluation, and LLM-as-a-judge. Interestingly, including demonstration examples in the few-shot learning setting did not enhance models' performance and, in some cases, even led to worse quality of the generated summaries. This issue arises mainly due to the poor quality of the gold summaries that have been used as reference summaries, which negatively impacts the models' performance. Furthermore, our study's results highlight the exceptional performance of GPT-3.5-Turbo and GPT-4, which generally dominate due to their advanced capabilities. However, among the public models evaluated, certain models such as Qwen1.5-7B, SOLAR-10.7B-Instruct-v1.0, Meta-Llama-3-8B and Zephyr-7B-Beta demonstrated promising results. These models showed significant potential, positioning them as competitive alternatives to large models for the task of news summarization.

Since the emergence of the Transformer architecture, language model development has increased, driven by their promising potential. However, releasing these models into production requires properly understanding their behavior, particularly in sensitive domains such as medicine. Despite this need, the medical literature still lacks technical assessments of pre-trained language models, which are especially valuable in resource-constrained settings in terms of computational power or limited budget. To address this gap, we provide a comprehensive survey of language models in the medical domain. In addition, we selected a subset of these models for thorough evaluation, focusing on classification and text generation tasks. Our subset encompasses 53 models, ranging from 110 million to 13 billion parameters, spanning the three families of Transformer-based models and from diverse knowledge domains. This study employs a series of approaches for text classification together with zero-shot prompting instead of model training or fine-tuning, which closely resembles the limited resource setting in which many users of language models find themselves. Encouragingly, our findings reveal remarkable performance across various tasks and datasets, underscoring the latent potential of certain models to contain medical knowledge, even without domain specialization. Consequently, our study advocates for further exploration of model applications in medical contexts, particularly in resource-constrained settings. The code is available on https://github.com/anpoc/Language-models-in-medicine.

The increasing use of tools and solutions based on Large Language Models (LLMs) for various tasks in the medical domain has become a prominent trend. Their use in this highly critical and sensitive domain has thus raised important questions about their robustness, especially in response to variations in input, and the reliability of the generated outputs. This study addresses these questions by constructing a textual dataset based on the ICD-10-CM code descriptions, widely used in US hospitals and containing many clinical terms, and their easily reproducible rephrasing. We then benchmarked existing embedding models, either generalist or specialized in the clinical domain, in a semantic search task where the goal was to correctly match the rephrased text to the original description. Our results showed that generalist models performed better than clinical models, suggesting that existing clinical specialized models are more sensitive to small changes in input that confuse them. The highlighted problem of specialized models may be due to the fact that they have not been trained on sufficient data, and in particular on datasets that are not diverse enough to have a reliable global language understanding, which is still necessary for accurate handling of medical documents.

Specialised pre-trained language models are becoming more frequent in NLP since they can potentially outperform models trained on generic texts. BioBERT and BioClinicalBERT are two examples of such models that have shown promise in medical NLP tasks. Many of these models are overparametrised and resource-intensive, but thanks to techniques like Knowledge Distillation (KD), it is possible to create smaller versions that perform almost as well as their larger counterparts. In this work, we specifically focus on development of compact language models for processing clinical texts (i.e. progress notes, discharge summaries etc). We developed a number of efficient lightweight clinical transformers using knowledge distillation and continual learning, with the number of parameters ranging from 15 million to 65 million. These models performed comparably to larger models such as BioBERT and ClinicalBioBERT and significantly outperformed other compact models trained on general or biomedical data. Our extensive evaluation was done across several standard datasets and covered a wide range of clinical text-mining tasks, including Natural Language Inference, Relation Extraction, Named Entity Recognition, and Sequence Classification. To our knowledge, this is the first comprehensive study specifically focused on creating efficient and compact transformers for clinical NLP tasks. The models and code used in this study can be found on our Huggingface profile at https://huggingface.co/nlpie and Github page at https://github.com/nlpie-research/Lightweight-Clinical-Transformers, respectively, promoting reproducibility of our results.

Generating accurate and concise textual summaries from multimodal documents is challenging, especially when dealing with visually complex content like scientific posters. We introduce PosterSum, a novel benchmark to advance the development of vision-language models that can understand and summarize scientific posters into research paper abstracts. Our dataset contains 16,305 conference posters paired with their corresponding abstracts as summaries. Each poster is provided in image format and presents diverse visual understanding challenges, such as complex layouts, dense text regions, tables, and figures. We benchmark state-of-the-art Multimodal Large Language Models (MLLMs) on PosterSum and demonstrate that they struggle to accurately interpret and summarize scientific posters. We propose Segment & Summarize, a hierarchical method that outperforms current MLLMs on automated metrics, achieving a 3.14% gain in ROUGE-L. This will serve as a starting point for future research on poster summarization.

Codification of free-text clinical narratives have long been recognised to be beneficial for secondary uses such as funding, insurance claim processing and research. The current scenario of assigning codes is a manual process which is very expensive, time-consuming and error prone. In recent years, many researchers have studied the use of Natural Language Processing (NLP), related Machine Learning (ML) and Deep Learning (DL) methods and techniques to resolve the problem of manual coding of clinical narratives and to assist human coders to assign clinical codes more accurately and efficiently. This systematic literature review provides a comprehensive overview of automated clinical coding systems that utilises appropriate NLP, ML and DL methods and techniques to assign ICD codes to discharge summaries. We have followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses(PRISMA) guidelines and conducted a comprehensive search of publications from January, 2010 to December 2020 in four academic databases- PubMed, ScienceDirect, Association for Computing Machinery(ACM) Digital Library, and the Association for Computational Linguistics(ACL) Anthology. We reviewed 7,556 publications; 38 met the inclusion criteria. This review identified: datasets having discharge summaries; NLP techniques along with some other data extraction processes, different feature extraction and embedding techniques. To measure the performance of classification methods, different evaluation metrics are used. Lastly, future research directions are provided to scholars who are interested in automated ICD code assignment. Efforts are still required to improve ICD code prediction accuracy, availability of large-scale de-identified clinical corpora with the latest version of the classification system. This can be a platform to guide and share knowledge with the less experienced coders and researchers.

Current summarization systems yield generic summaries that are disconnected from users' preferences and expectations. To address this limitation, we present CTRLsum, a novel framework for controllable summarization. Our approach enables users to control multiple aspects of generated summaries by interacting with the summarization system through textual input in the form of a set of keywords or descriptive prompts. Using a single unified model, CTRLsum is able to achieve a broad scope of summary manipulation at inference time without requiring additional human annotations or pre-defining a set of control aspects during training. We quantitatively demonstrate the effectiveness of our approach on three domains of summarization datasets and five control aspects: 1) entity-centric and 2) length-controllable summarization, 3) contribution summarization on scientific papers, 4) invention purpose summarization on patent filings, and 5) question-guided summarization on news articles in a reading comprehension setting. Moreover, when used in a standard, uncontrolled summarization setting, CTRLsum achieves state-of-the-art results on the CNN/DailyMail dataset. Code and model checkpoints are available at https://github.com/salesforce/ctrl-sum

The discharge summary is a one of critical documents in the patient journey, encompassing all events experienced during hospitalization, including multiple visits, medications, tests, surgery/procedures, and admissions/discharge. Providing a summary of the patient's progress is crucial, as it significantly influences future care and planning. Consequently, clinicians face the laborious and resource-intensive task of manually collecting, organizing, and combining all the necessary data for a discharge summary. Therefore, we propose "NOTE", which stands for "Notable generation Of patient Text summaries through an Efficient approach based on direct preference optimization". NOTE is based on Medical Information Mart for Intensive Care- III dataset and summarizes a single hospitalization of a patient. Patient events are sequentially combined and used to generate a discharge summary for each hospitalization. In the present circumstances, large language models' application programming interfaces (LLMs' APIs) are widely available, but importing and exporting medical data presents significant challenges due to privacy protection policies in healthcare institutions. Moreover, to ensure optimal performance, it is essential to implement a lightweight model for internal server or program within the hospital. Therefore, we utilized DPO and parameter efficient fine tuning (PEFT) techniques to apply a fine-tuning method that guarantees superior performance. To demonstrate the practical application of the developed NOTE, we provide a webpage-based demonstration software. In the future, we will aim to deploy the software available for actual use by clinicians in hospital. NOTE can be utilized to generate various summaries not only discharge summaries but also throughout a patient's journey, thereby alleviating the labor-intensive workload of clinicians and aiming for increased efficiency.

Clinical data in hospitals are increasingly accessible for research through clinical data warehouses, however these documents are unstructured. It is therefore necessary to extract information from medical reports to conduct clinical studies. Transfer learning with BERT-like models such as CamemBERT has allowed major advances, especially for named entity recognition. However, these models are trained for plain language and are less efficient on biomedical data. This is why we propose a new French public biomedical dataset on which we have continued the pre-training of CamemBERT. Thus, we introduce a first version of CamemBERT-bio, a specialized public model for the French biomedical domain that shows 2.54 points of F1 score improvement on average on different biomedical named entity recognition tasks. Our findings demonstrate the success of continual pre-training from a French model and contrast with recent proposals on the same domain and language. One of our key contributions highlights the importance of using a standard evaluation protocol that enables a clear view of the current state-of-the-art for French biomedical models.

Objective: Using natural language processing (NLP) to find sentences that state treatment plans in a clinical note, would automate plan extraction and would further enable their use in tools that help providers and care managers. However, as in the most NLP tasks on clinical text, creating gold standard to train and test NLP models is tedious and expensive. Fortuitously, sometimes but not always clinical notes contain sections with a heading that identifies the section as a plan. Leveraging contents of such labeled sections as a noisy training data, we assessed accuracy of NLP models trained with the data. Methods: We used common variations of plan headings and rule-based heuristics to find plan sections with headings in clinical notes, and we extracted sentences from them and formed a noisy training data of plan sentences. We trained Support Vector Machine (SVM) and Convolutional Neural Network (CNN) models with the data. We measured accuracy of the trained models on the noisy dataset using ten-fold cross validation and separately on a set-aside manually annotated dataset. Results: About 13% of 117,730 clinical notes contained treatment plans sections with recognizable headings in the 1001 longitudinal patient records that were obtained from Cleveland Clinic under an IRB approval. We were able to extract and create a noisy training data of 13,492 plan sentences from the clinical notes. CNN achieved best F measures, 0.91 and 0.97 in the cross-validation and set-aside evaluation experiments respectively. SVM slightly underperformed with F measures of 0.89 and 0.96 in the same experiments. Conclusion: Our study showed that the training supervised learning models using noisy plan sentences was effective in identifying them in all clinical notes. More broadly, sections with informal headings in clinical notes can be a good source for generating effective training data.

Text summarization (TS) is a natural language processing (NLP) subtask pertaining to the automatic formulation of a concise and coherent summary that covers the major concepts and topics from one or multiple documents. Recent advancements in deep learning have led to the development of abstractive summarization transformer-based models, which outperform classical approaches. In any case, research in this field focuses on high resource languages such as English, while the corresponding work for low resource languages is still underdeveloped. Taking the above into account, this paper proposes a series of novel TS models for Greek news articles. The proposed models were thoroughly evaluated on the same dataset against GreekBART, which is the state-of-the-art model in Greek abstractive news summarization. Our evaluation results reveal that most of the proposed models significantly outperform GreekBART on various evaluation metrics. We make our evaluation code public, aiming to increase the reproducibility of this work and facilitate future research in the field.

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.

Extracting patient information from unstructured text is a critical task in health decision-support and clinical research. Large language models (LLMs) have shown the potential to accelerate clinical curation via few-shot in-context learning, in contrast to supervised learning which requires much more costly human annotations. However, despite drastic advances in modern LLMs such as GPT-4, they still struggle with issues regarding accuracy and interpretability, especially in mission-critical domains such as health. Here, we explore a general mitigation framework using self-verification, which leverages the LLM to provide provenance for its own extraction and check its own outputs. This is made possible by the asymmetry between verification and generation, where the latter is often much easier than the former. Experimental results show that our method consistently improves accuracy for various LLMs in standard clinical information extraction tasks. Additionally, self-verification yields interpretations in the form of a short text span corresponding to each output, which makes it very efficient for human experts to audit the results, paving the way towards trustworthy extraction of clinical information in resource-constrained scenarios. To facilitate future research in this direction, we release our code and prompts.

In real-world scenarios with naturally occurring datasets, reference summaries are noisy and may contain information that cannot be inferred from the source text. On large news corpora, removing low quality samples has been shown to reduce model hallucinations. Yet, for smaller, and/or noisier corpora, filtering is detrimental to performance. To improve reference quality while retaining all data, we propose a new approach: to selectively re-write unsupported reference sentences to better reflect source data. We automatically generate a synthetic dataset of positive and negative revisions by corrupting supported sentences and learn to revise reference sentences with contrastive learning. The intensity of revisions is treated as a controllable attribute so that, at inference, diverse candidates can be over-generated-then-rescored to balance faithfulness and abstraction. To test our methods, we extract noisy references from publicly available MIMIC-III discharge summaries for the task of hospital-course summarization, and vary the data on which models are trained. According to metrics and human evaluation, models trained on revised clinical references are much more faithful, informative, and fluent than models trained on original or filtered data.

We introduce a dataset of high-quality human-authored summaries of news articles in Norwegian. The dataset is intended for benchmarking the abstractive summarisation capabilities of generative language models. Each document in the dataset is provided with three different candidate gold-standard summaries written by native Norwegian speakers, and all summaries are provided in both of the written variants of Norwegian -- Bokm{\aa}l and Nynorsk. The paper describes details on the data creation effort as well as an evaluation of existing open LLMs for Norwegian on the dataset. We also provide insights from a manual human evaluation, comparing human-authored to model-generated summaries. Our results indicate that the dataset provides a challenging LLM benchmark for Norwegian summarisation capabilities

In this paper we present a hybrid method for the automatic detection of dermatological pathologies in medical reports. We use a large language model combined with medical ontologies to predict, given a first appointment or follow-up medical report, the pathology a person may suffer from. The results show that teaching the model to learn the type, severity and location on the body of a dermatological pathology, as well as in which order it has to learn these three features, significantly increases its accuracy. The article presents the demonstration of state-of-the-art results for classification of medical texts with a precision of 0.84, micro and macro F1-score of 0.82 and 0.75, and makes both the method and the data set used available to the community.

Automatic summarization is the process of reducing a text document in order to generate a summary that retains the most important points of the original document. In this work, we study two problems - i) summarizing a text document as set of keywords/caption, for image recommedation, ii) generating opinion summary which good mix of relevancy and sentiment with the text document. Intially, we present our work on an recommending images for enhancing a substantial amount of existing plain text news articles. We use probabilistic models and word similarity heuristics to generate captions and extract Key-phrases which are re-ranked using a rank aggregation framework with relevance feedback mechanism. We show that such rank aggregation and relevant feedback which are typically used in Tagging Documents, Text Information Retrieval also helps in improving image retrieval. These queries are fed to the Yahoo Search Engine to obtain relevant images 1. Our proposed method is observed to perform better than all existing baselines. Additonally, We propose a set of submodular functions for opinion summarization. Opinion summarization has built in it the tasks of summarization and sentiment detection. However, it is not easy to detect sentiment and simultaneously extract summary. The two tasks conflict in the sense that the demand of compression may drop sentiment bearing sentences, and the demand of sentiment detection may bring in redundant sentences. However, using submodularity we show how to strike a balance between the two requirements. Our functions generate summaries such that there is good correlation between document sentiment and summary sentiment along with good ROUGE score. We also compare the performances of the proposed submodular functions.

In this paper, we introduce a large-scale Indonesian summarization dataset. We harvest articles from Liputan6.com, an online news portal, and obtain 215,827 document-summary pairs. We leverage pre-trained language models to develop benchmark extractive and abstractive summarization methods over the dataset with multilingual and monolingual BERT-based models. We include a thorough error analysis by examining machine-generated summaries that have low ROUGE scores, and expose both issues with ROUGE it-self, as well as with extractive and abstractive summarization models.

The recent success of prompting large language models like GPT-3 has led to a paradigm shift in NLP research. In this paper, we study its impact on text summarization, focusing on the classic benchmark domain of news summarization. First, we investigate how GPT-3 compares against fine-tuned models trained on large summarization datasets. We show that not only do humans overwhelmingly prefer GPT-3 summaries, prompted using only a task description, but these also do not suffer from common dataset-specific issues such as poor factuality. Next, we study what this means for evaluation, particularly the role of gold standard test sets. Our experiments show that both reference-based and reference-free automatic metrics cannot reliably evaluate GPT-3 summaries. Finally, we evaluate models on a setting beyond generic summarization, specifically keyword-based summarization, and show how dominant fine-tuning approaches compare to prompting. To support further research, we release: (a) a corpus of 10K generated summaries from fine-tuned and prompt-based models across 4 standard summarization benchmarks, (b) 1K human preference judgments comparing different systems for generic- and keyword-based summarization.

Machine translation is indispensable in healthcare for enabling the global dissemination of medical knowledge across languages. However, complex medical terminology poses unique challenges to achieving adequate translation quality and accuracy. This study introduces a novel "LLMs-in-the-loop" approach to develop supervised neural machine translation models optimized specifically for medical texts. While large language models (LLMs) have demonstrated powerful capabilities, this research shows that small, specialized models trained on high-quality in-domain (mostly synthetic) data can outperform even vastly larger LLMs. Custom parallel corpora in six languages were compiled from scientific articles, synthetically generated clinical documents, and medical texts. Our LLMs-in-the-loop methodology employs synthetic data generation, rigorous evaluation, and agent orchestration to enhance performance. We developed small medical translation models using the MarianMT base model. We introduce a new medical translation test dataset to standardize evaluation in this domain. Assessed using BLEU, METEOR, ROUGE, and BERT scores on this test set, our MarianMT-based models outperform Google Translate, DeepL, and GPT-4-Turbo. Results demonstrate that our LLMs-in-the-loop approach, combined with fine-tuning high-quality, domain-specific data, enables specialized models to outperform general-purpose and some larger systems. This research, part of a broader series on expert small models, paves the way for future healthcare-related AI developments, including deidentification and bio-medical entity extraction models. Our study underscores the potential of tailored neural translation models and the LLMs-in-the-loop methodology to advance the field through improved data generation, evaluation, agent, and modeling techniques.

Automatic text summarization aims to produce a brief but crucial summary for the input documents. Both extractive and abstractive methods have witnessed great success in English datasets in recent years. However, there has been a minimal exploration of text summarization in Chinese, limited by the lack of large-scale datasets. In this paper, we present a large-scale Chinese news summarization dataset CNewSum, which consists of 304,307 documents and human-written summaries for the news feed. It has long documents with high-abstractive summaries, which can encourage document-level understanding and generation for current summarization models. An additional distinguishing feature of CNewSum is that its test set contains adequacy and deducibility annotations for the summaries. The adequacy level measures the degree of summary information covered by the document, and the deducibility indicates the reasoning ability the model needs to generate the summary. These annotations can help researchers analyze and target their model performance bottleneck. We examine recent methods on CNewSum and release our dataset to provide a solid testbed for automatic Chinese summarization research.

In this report, we introduce SciFive, a domain-specific T5 model that has been pre-trained on large biomedical corpora. Our model outperforms the current SOTA methods (i.e. BERT, BioBERT, Base T5) on tasks in named entity relation, relation extraction, natural language inference, and question-answering. We show that text-generation methods have significant potential in a broad array of biomedical NLP tasks, particularly those requiring longer, more complex outputs. Our results support the exploration of more difficult text generation tasks and the development of new methods in this area

When writing a summary, humans tend to choose content from one or two sentences and merge them into a single summary sentence. However, the mechanisms behind the selection of one or multiple source sentences remain poorly understood. Sentence fusion assumes multi-sentence input; yet sentence selection methods only work with single sentences and not combinations of them. There is thus a crucial gap between sentence selection and fusion to support summarizing by both compressing single sentences and fusing pairs. This paper attempts to bridge the gap by ranking sentence singletons and pairs together in a unified space. Our proposed framework attempts to model human methodology by selecting either a single sentence or a pair of sentences, then compressing or fusing the sentence(s) to produce a summary sentence. We conduct extensive experiments on both single- and multi-document summarization datasets and report findings on sentence selection and abstraction.

Large language models (LLMs) have shown potential in biomedical applications, leading to efforts to fine-tune them on domain-specific data. However, the effectiveness of this approach remains unclear. This study evaluates the performance of biomedically fine-tuned LLMs against their general-purpose counterparts on a variety of clinical tasks. We evaluated their performance on clinical case challenges from the New England Journal of Medicine (NEJM) and the Journal of the American Medical Association (JAMA) and on several clinical tasks (e.g., information extraction, document summarization, and clinical coding). Using benchmarks specifically chosen to be likely outside the fine-tuning datasets of biomedical models, we found that biomedical LLMs mostly perform inferior to their general-purpose counterparts, especially on tasks not focused on medical knowledge. While larger models showed similar performance on case tasks (e.g., OpenBioLLM-70B: 66.4% vs. Llama-3-70B-Instruct: 65% on JAMA cases), smaller biomedical models showed more pronounced underperformance (e.g., OpenBioLLM-8B: 30% vs. Llama-3-8B-Instruct: 64.3% on NEJM cases). Similar trends were observed across the CLUE (Clinical Language Understanding Evaluation) benchmark tasks, with general-purpose models often performing better on text generation, question answering, and coding tasks. Our results suggest that fine-tuning LLMs to biomedical data may not provide the expected benefits and may potentially lead to reduced performance, challenging prevailing assumptions about domain-specific adaptation of LLMs and highlighting the need for more rigorous evaluation frameworks in healthcare AI. Alternative approaches, such as retrieval-augmented generation, may be more effective in enhancing the biomedical capabilities of LLMs without compromising their general knowledge.

Generating synthetic text addresses the challenge of data availability in privacy-sensitive domains such as healthcare. This study explores the applicability of synthetic data in real-world medical settings. We introduce MedSyn, a novel medical text generation framework that integrates large language models with a Medical Knowledge Graph (MKG). We use MKG to sample prior medical information for the prompt and generate synthetic clinical notes with GPT-4 and fine-tuned LLaMA models. We assess the benefit of synthetic data through application in the ICD code prediction task. Our research indicates that synthetic data can increase the classification accuracy of vital and challenging codes by up to 17.8% compared to settings without synthetic data. Furthermore, to provide new data for further research in the healthcare domain, we present the largest open-source synthetic dataset of clinical notes for the Russian language, comprising over 41k samples covering 219 ICD-10 codes.

How do we most effectively treat a disease or condition? Ideally, we could consult a database of evidence gleaned from clinical trials to answer such questions. Unfortunately, no such database exists; clinical trial results are instead disseminated primarily via lengthy natural language articles. Perusing all such articles would be prohibitively time-consuming for healthcare practitioners; they instead tend to depend on manually compiled systematic reviews of medical literature to inform care. NLP may speed this process up, and eventually facilitate immediate consult of published evidence. The Evidence Inference dataset was recently released to facilitate research toward this end. This task entails inferring the comparative performance of two treatments, with respect to a given outcome, from a particular article (describing a clinical trial) and identifying supporting evidence. For instance: Does this article report that chemotherapy performed better than surgery for five-year survival rates of operable cancers? In this paper, we collect additional annotations to expand the Evidence Inference dataset by 25\%, provide stronger baseline models, systematically inspect the errors that these make, and probe dataset quality. We also release an abstract only (as opposed to full-texts) version of the task for rapid model prototyping. The updated corpus, documentation, and code for new baselines and evaluations are available at http://evidence-inference.ebm-nlp.com/.

This paper presents medBERTde, a pre-trained German BERT model specifically designed for the German medical domain. The model has been trained on a large corpus of 4.7 Million German medical documents and has been shown to achieve new state-of-the-art performance on eight different medical benchmarks covering a wide range of disciplines and medical document types. In addition to evaluating the overall performance of the model, this paper also conducts a more in-depth analysis of its capabilities. We investigate the impact of data deduplication on the model's performance, as well as the potential benefits of using more efficient tokenization methods. Our results indicate that domain-specific models such as medBERTde are particularly useful for longer texts, and that deduplication of training data does not necessarily lead to improved performance. Furthermore, we found that efficient tokenization plays only a minor role in improving model performance, and attribute most of the improved performance to the large amount of training data. To encourage further research, the pre-trained model weights and new benchmarks based on radiological data are made publicly available for use by the scientific community.

We present a new dataset for machine comprehension in the medical domain. Our dataset uses clinical case reports with around 100,000 gap-filling queries about these cases. We apply several baselines and state-of-the-art neural readers to the dataset, and observe a considerable gap in performance (20% F1) between the best human and machine readers. We analyze the skills required for successful answering and show how reader performance varies depending on the applicable skills. We find that inferences using domain knowledge and object tracking are the most frequently required skills, and that recognizing omitted information and spatio-temporal reasoning are the most difficult for the machines.

Summarization based on text extraction is inherently limited, but generation-style abstractive methods have proven challenging to build. In this work, we propose a fully data-driven approach to abstractive sentence summarization. Our method utilizes a local attention-based model that generates each word of the summary conditioned on the input sentence. While the model is structurally simple, it can easily be trained end-to-end and scales to a large amount of training data. The model shows significant performance gains on the DUC-2004 shared task compared with several strong baselines.

We present NEWSROOM, a summarization dataset of 1.3 million articles and summaries written by authors and editors in newsrooms of 38 major news publications. Extracted from search and social media metadata between 1998 and 2017, these high-quality summaries demonstrate high diversity of summarization styles. In particular, the summaries combine abstractive and extractive strategies, borrowing words and phrases from articles at varying rates. We analyze the extraction strategies used in NEWSROOM summaries against other datasets to quantify the diversity and difficulty of our new data, and train existing methods on the data to evaluate its utility and challenges.

In this paper, we present RTSUM, an unsupervised summarization framework that utilizes relation triples as the basic unit for summarization. Given an input document, RTSUM first selects salient relation triples via multi-level salience scoring and then generates a concise summary from the selected relation triples by using a text-to-text language model. On the basis of RTSUM, we also develop a web demo for an interpretable summarizing tool, providing fine-grained interpretations with the output summary. With support for customization options, our tool visualizes the salience for textual units at three distinct levels: sentences, relation triples, and phrases. The codes,are publicly available.

The rapid development of multimodal large language models (MLLMs), such as GPT-4V, has led to significant advancements. However, these models still face challenges in medical multimodal capabilities due to limitations in the quantity and quality of medical vision-text data, stemming from data privacy concerns and high annotation costs. While pioneering approaches utilize PubMed's large-scale, de-identified medical image-text pairs to address these limitations, they still fall short due to inherent data noise. To tackle this, we refined medical image-text pairs from PubMed and employed MLLMs (GPT-4V) in an 'unblinded' capacity to denoise and reformat the data, resulting in the creation of the PubMedVision dataset with 1.3 million medical VQA samples. Our validation demonstrates that: (1) PubMedVision can significantly enhance the medical multimodal capabilities of current MLLMs, showing significant improvement in benchmarks including the MMMU Health & Medicine track; (2) manual checks by medical experts and empirical results validate the superior data quality of our dataset compared to other data construction methods. Using PubMedVision, we train a 34B medical MLLM HuatuoGPT-Vision, which shows superior performance in medical multimodal scenarios among open-source MLLMs.

Recent advances in large language models have led to renewed interest in natural language processing in healthcare using the free text of clinical notes. One distinguishing characteristic of clinical notes is their long time span over multiple long documents. The unique structure of clinical notes creates a new design choice: when the context length for a language model predictor is limited, which part of clinical notes should we choose as the input? Existing studies either choose the inputs with domain knowledge or simply truncate them. We propose a framework to analyze the sections with high predictive power. Using MIMIC-III, we show that: 1) predictive power distribution is different between nursing notes and discharge notes and 2) combining different types of notes could improve performance when the context length is large. Our findings suggest that a carefully selected sampling function could enable more efficient information extraction from clinical notes.

The utilization of large language models (LLMs) in the Healthcare domain has generated both excitement and concern due to their ability to effectively respond to freetext queries with certain professional knowledge. This survey outlines the capabilities of the currently developed LLMs for Healthcare and explicates their development process, with the aim of providing an overview of the development roadmap from traditional Pretrained Language Models (PLMs) to LLMs. Specifically, we first explore the potential of LLMs to enhance the efficiency and effectiveness of various Healthcare applications highlighting both the strengths and limitations. Secondly, we conduct a comparison between the previous PLMs and the latest LLMs, as well as comparing various LLMs with each other. Then we summarize related Healthcare training data, training methods, optimization strategies, and usage. Finally, the unique concerns associated with deploying LLMs in Healthcare settings are investigated, particularly regarding fairness, accountability, transparency and ethics. Our survey provide a comprehensive investigation from perspectives of both computer science and Healthcare specialty. Besides the discussion about Healthcare concerns, we supports the computer science community by compiling a collection of open source resources, such as accessible datasets, the latest methodologies, code implementations, and evaluation benchmarks in the Github. Summarily, we contend that a significant paradigm shift is underway, transitioning from PLMs to LLMs. This shift encompasses a move from discriminative AI approaches to generative AI approaches, as well as a shift from model-centered methodologies to datacentered methodologies.

Novel neural architectures, training strategies, and the availability of large-scale corpora haven been the driving force behind recent progress in abstractive text summarization. However, due to the black-box nature of neural models, uninformative evaluation metrics, and scarce tooling for model and data analysis, the true performance and failure modes of summarization models remain largely unknown. To address this limitation, we introduce SummVis, an open-source tool for visualizing abstractive summaries that enables fine-grained analysis of the models, data, and evaluation metrics associated with text summarization. Through its lexical and semantic visualizations, the tools offers an easy entry point for in-depth model prediction exploration across important dimensions such as factual consistency or abstractiveness. The tool together with several pre-computed model outputs is available at https://github.com/robustness-gym/summvis.

Existing models based on artificial neural networks (ANNs) for sentence classification often do not incorporate the context in which sentences appear, and classify sentences individually. However, traditional sentence classification approaches have been shown to greatly benefit from jointly classifying subsequent sentences, such as with conditional random fields. In this work, we present an ANN architecture that combines the effectiveness of typical ANN models to classify sentences in isolation, with the strength of structured prediction. Our model achieves state-of-the-art results on two different datasets for sequential sentence classification in medical abstracts.

The scarcity of comprehensive up-to-date studies on evaluation metrics for text summarization and the lack of consensus regarding evaluation protocols continue to inhibit progress. We address the existing shortcomings of summarization evaluation methods along five dimensions: 1) we re-evaluate 14 automatic evaluation metrics in a comprehensive and consistent fashion using neural summarization model outputs along with expert and crowd-sourced human annotations, 2) we consistently benchmark 23 recent summarization models using the aforementioned automatic evaluation metrics, 3) we assemble the largest collection of summaries generated by models trained on the CNN/DailyMail news dataset and share it in a unified format, 4) we implement and share a toolkit that provides an extensible and unified API for evaluating summarization models across a broad range of automatic metrics, 5) we assemble and share the largest and most diverse, in terms of model types, collection of human judgments of model-generated summaries on the CNN/Daily Mail dataset annotated by both expert judges and crowd-source workers. We hope that this work will help promote a more complete evaluation protocol for text summarization as well as advance research in developing evaluation metrics that better correlate with human judgments.

Automatic summarization methods have been studied on a variety of domains, including news and scientific articles. Yet, legislation has not previously been considered for this task, despite US Congress and state governments releasing tens of thousands of bills every year. In this paper, we introduce BillSum, the first dataset for summarization of US Congressional and California state bills (https://github.com/FiscalNote/BillSum). We explain the properties of the dataset that make it more challenging to process than other domains. Then, we benchmark extractive methods that consider neural sentence representations and traditional contextual features. Finally, we demonstrate that models built on Congressional bills can be used to summarize California bills, thus, showing that methods developed on this dataset can transfer to states without human-written summaries.

Extractive summaries are usually presented as lists of sentences with no expected cohesion between them. In this paper, we aim to enforce cohesion whilst controlling for informativeness and redundancy in summaries, in cases where the input exhibits high redundancy. The pipeline controls for redundancy in long inputs as it is consumed, and balances informativeness and cohesion during sentence selection. Our sentence selector simulates human memory to keep track of topics --modeled as lexical chains--, enforcing cohesive ties between noun phrases. Across a variety of domains, our experiments revealed that it is possible to extract highly cohesive summaries that nevertheless read as informative to humans as summaries extracted by only accounting for informativeness or redundancy. The extracted summaries exhibit smooth topic transitions between sentences as signaled by lexical chains, with chains spanning adjacent or near-adjacent sentences.

Neural abstractive summarization models have led to promising results in summarizing relatively short documents. We propose the first model for abstractive summarization of single, longer-form documents (e.g., research papers). Our approach consists of a new hierarchical encoder that models the discourse structure of a document, and an attentive discourse-aware decoder to generate the summary. Empirical results on two large-scale datasets of scientific papers show that our model significantly outperforms state-of-the-art models.

Biomedical data and benchmarks are highly valuable yet very limited in low-resource languages other than English such as Vietnamese. In this paper, we make use of a state-of-the-art translation model in English-Vietnamese to translate and produce both pretrained as well as supervised data in the biomedical domains. Thanks to such large-scale translation, we introduce ViPubmedT5, a pretrained Encoder-Decoder Transformer model trained on 20 million translated abstracts from the high-quality public PubMed corpus. ViPubMedT5 demonstrates state-of-the-art results on two different biomedical benchmarks in summarization and acronym disambiguation. Further, we release ViMedNLI - a new NLP task in Vietnamese translated from MedNLI using the recently public En-vi translation model and carefully refined by human experts, with evaluations of existing methods against ViPubmedT5.

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

Previous studies reveal that Electronic Health Records (EHR), which have been widely adopted in the U.S. to allow patients to access their personal medical information, do not have high readability to patients due to the prevalence of medical jargon. Tailoring medical notes to individual comprehension by identifying jargon that is difficult for each person will enhance the utility of generative models. We present the first quantitative analysis to measure the impact of role-playing in LLM in medical term extraction. By comparing the results of Mechanical Turk workers over 20 sentences, our study demonstrates that LLM role-playing improves F1 scores in 95% of cases across 14 different socio-demographic backgrounds. Furthermore, applying role-playing with in-context learning outperformed the previous state-of-the-art models. Our research showed that ChatGPT can improve traditional medical term extraction systems by utilizing role-play to deliver personalized patient education, a potential that previous models had not achieved.

Recent studies have found that summaries generated by large language models (LLMs) are favored by human annotators over the original reference summaries in commonly used summarization datasets. Therefore, we investigate a new learning paradigm of text summarization models that considers the LLMs as the reference or the gold-standard oracle on commonly used summarization datasets such as the CNN/DailyMail dataset. To examine the standard practices that are aligned with the new learning setting, we propose a novel training method that is based on contrastive learning with LLMs as a summarization quality evaluator. For this reward-based training method, we investigate two different methods of utilizing LLMs for summary quality evaluation, namely GPTScore and GPTRank. Our experiments on the CNN/DailyMail dataset demonstrate that smaller summarization models trained by our proposed method can achieve performance equal to or surpass that of the reference LLMs, as evaluated by the LLMs themselves. This underscores the efficacy of our proposed paradigm in enhancing model performance over the standard maximum likelihood estimation (MLE) training method, and its efficiency since it only requires a small budget to access the LLMs. We release the training scripts, model outputs, and LLM-based evaluation results to facilitate future studies.

Producing a reduced version of a source text, as in generic or focused summarization, inherently involves two distinct subtasks: deciding on targeted content and generating a coherent text conveying it. While some popular approaches address summarization as a single end-to-end task, prominent works support decomposed modeling for individual subtasks. Further, semi-automated text reduction is also very appealing, where users may identify targeted content while models would generate a corresponding coherent summary. In this paper, we focus on the second subtask, of generating coherent text given pre-selected content. Concretely, we formalize Controlled Text Reduction as a standalone task, whose input is a source text with marked spans of targeted content ("highlighting"). A model then needs to generate a coherent text that includes all and only the target information. We advocate the potential of such models, both for modular fully-automatic summarization, as well as for semi-automated human-in-the-loop use cases. Facilitating proper research, we crowdsource high-quality dev and test datasets for the task. Further, we automatically generate a larger "silver" training dataset from available summarization benchmarks, leveraging a pretrained summary-source alignment model. Finally, employing these datasets, we present a supervised baseline model, showing promising results and insightful analyses.

Recent work has shown that large language models (LLMs) are capable of generating summaries zero-shot (i.e., without explicit supervision) that, under human assessment, are often comparable or even preferred to manually composed reference summaries. However, this prior work has focussed almost exclusively on evaluating news article summarization. How do zero-shot summarizers perform in other (potentially more specialized) domains? In this work we evaluate zero-shot generated summaries across specialized domains including biomedical articles, and legal bills (in addition to standard news benchmarks for reference). We focus especially on the factuality of outputs. We acquire annotations from domain experts to identify inconsistencies in summaries and systematically categorize these errors. We analyze whether the prevalence of a given domain in the pretraining corpus affects extractiveness and faithfulness of generated summaries of articles in this domain. We release all collected annotations to facilitate additional research toward measuring and realizing factually accurate summarization, beyond news articles. The dataset can be downloaded from https://github.com/sanjanaramprasad/zero_shot_faceval_domains

Summarization datasets are often assembled either by scraping naturally occurring public-domain summaries -- which are nearly always in difficult-to-work-with technical domains -- or by using approximate heuristics to extract them from everyday text -- which frequently yields unfaithful summaries. In this work, we turn to a slower but more straightforward approach to developing summarization benchmark data: We hire highly-qualified contractors to read stories and write original summaries from scratch. To amortize reading time, we collect five summaries per document, with the first giving an overview and the subsequent four addressing specific questions. We use this protocol to collect SQuALITY, a dataset of question-focused summaries built on the same public-domain short stories as the multiple-choice dataset QuALITY (Pang et al., 2021). Experiments with state-of-the-art summarization systems show that our dataset is challenging and that existing automatic evaluation metrics are weak indicators of quality.

Medical systematic reviews typically require assessing all the documents retrieved by a search. The reason is two-fold: the task aims for ``total recall''; and documents retrieved using Boolean search are an unordered set, and thus it is unclear how an assessor could examine only a subset. Screening prioritisation is the process of ranking the (unordered) set of retrieved documents, allowing assessors to begin the downstream processes of the systematic review creation earlier, leading to earlier completion of the review, or even avoiding screening documents ranked least relevant. Screening prioritisation requires highly effective ranking methods. Pre-trained language models are state-of-the-art on many IR tasks but have yet to be applied to systematic review screening prioritisation. In this paper, we apply several pre-trained language models to the systematic review document ranking task, both directly and fine-tuned. An empirical analysis compares how effective neural methods compare to traditional methods for this task. We also investigate different types of document representations for neural methods and their impact on ranking performance. Our results show that BERT-based rankers outperform the current state-of-the-art screening prioritisation methods. However, BERT rankers and existing methods can actually be complementary, and thus, further improvements may be achieved if used in conjunction.

Large language models (LLMs) hold great promise in summarizing medical evidence. Most recent studies focus on the application of proprietary LLMs. Using proprietary LLMs introduces multiple risk factors, including a lack of transparency and vendor dependency. While open-source LLMs allow better transparency and customization, their performance falls short compared to proprietary ones. In this study, we investigated to what extent fine-tuning open-source LLMs can further improve their performance in summarizing medical evidence. Utilizing a benchmark dataset, MedReview, consisting of 8,161 pairs of systematic reviews and summaries, we fine-tuned three broadly-used, open-sourced LLMs, namely PRIMERA, LongT5, and Llama-2. Overall, the fine-tuned LLMs obtained an increase of 9.89 in ROUGE-L (95% confidence interval: 8.94-10.81), 13.21 in METEOR score (95% confidence interval: 12.05-14.37), and 15.82 in CHRF score (95% confidence interval: 13.89-16.44). The performance of fine-tuned LongT5 is close to GPT-3.5 with zero-shot settings. Furthermore, smaller fine-tuned models sometimes even demonstrated superior performance compared to larger zero-shot models. The above trends of improvement were also manifested in both human and GPT4-simulated evaluations. Our results can be applied to guide model selection for tasks demanding particular domain knowledge, such as medical evidence summarization.

Linking clinical narratives to standardized vocabularies and coding systems is a key component of unlocking the information in medical text for analysis. However, many domains of medical concepts lack well-developed terminologies that can support effective coding of medical text. We present a framework for developing natural language processing (NLP) technologies for automated coding of under-studied types of medical information, and demonstrate its applicability via a case study on physical mobility function. Mobility is a component of many health measures, from post-acute care and surgical outcomes to chronic frailty and disability, and is coded in the International Classification of Functioning, Disability, and Health (ICF). However, mobility and other types of functional activity remain under-studied in medical informatics, and neither the ICF nor commonly-used medical terminologies capture functional status terminology in practice. We investigated two data-driven paradigms, classification and candidate selection, to link narrative observations of mobility to standardized ICF codes, using a dataset of clinical narratives from physical therapy encounters. Recent advances in language modeling and word embedding were used as features for established machine learning models and a novel deep learning approach, achieving a macro F-1 score of 84% on linking mobility activity reports to ICF codes. Both classification and candidate selection approaches present distinct strengths for automated coding in under-studied domains, and we highlight that the combination of (i) a small annotated data set; (ii) expert definitions of codes of interest; and (iii) a representative text corpus is sufficient to produce high-performing automated coding systems. This study has implications for the ongoing growth of NLP tools for a variety of specialized applications in clinical care and research.

Electronic health records contain an enormous amount of valuable information, but many are recorded in free text. Information extraction is the strategy to transform the sequence of characters into structured data, which can be employed for secondary analysis. However, the traditional information extraction components, such as named entity recognition and relation extraction, require annotated data to optimize the model parameters, which has become one of the major bottlenecks in building information extraction systems. With the large language models achieving good performances on various downstream NLP tasks without parameter tuning, it becomes possible to use large language models for zero-shot information extraction. In this study, we aim to explore whether the most popular large language model, ChatGPT, can extract useful information from the radiological reports. We first design the prompt template for the interested information in the CT reports. Then, we generate the prompts by combining the prompt template with the CT reports as the inputs of ChatGPT to obtain the responses. A post-processing module is developed to transform the responses into structured extraction results. We conducted the experiments with 847 CT reports collected from Peking University Cancer Hospital. The experimental results indicate that ChatGPT can achieve competitive performances for some extraction tasks compared with the baseline information extraction system, but some limitations need to be further improved.

Information retrieval (IR) is essential in biomedical knowledge acquisition and clinical decision support. While recent progress has shown that language model encoders perform better semantic retrieval, training such models requires abundant query-article annotations that are difficult to obtain in biomedicine. As a result, most biomedical IR systems only conduct lexical matching. In response, we introduce BioCPT, a first-of-its-kind Contrastively Pre-trained Transformer model for zero-shot biomedical IR. To train BioCPT, we collected an unprecedented scale of 255 million user click logs from PubMed. With such data, we use contrastive learning to train a pair of closely-integrated retriever and re-ranker. Experimental results show that BioCPT sets new state-of-the-art performance on five biomedical IR tasks, outperforming various baselines including much larger models such as GPT-3-sized cpt-text-XL. In addition, BioCPT also generates better biomedical article and sentence representations for semantic evaluations. As such, BioCPT can be readily applied to various real-world biomedical IR tasks. BioCPT API and code are publicly available at https://github.com/ncbi/BioCPT.

Automatic document summarization aims to produce a concise summary covering the input document's salient information. Within a report document, the salient information can be scattered in the textual and non-textual content. However, existing document summarization datasets and methods usually focus on the text and filter out the non-textual content. Missing tabular data can limit produced summaries' informativeness, especially when summaries require covering quantitative descriptions of critical metrics in tables. Existing datasets and methods cannot meet the requirements of summarizing long text and multiple tables in each report. To deal with the scarcity of available data, we propose FINDSum, the first large-scale dataset for long text and multi-table summarization. Built on 21,125 annual reports from 3,794 companies, it has two subsets for summarizing each company's results of operations and liquidity. To summarize the long text and dozens of tables in each report, we present three types of summarization methods. Besides, we propose a set of evaluation metrics to assess the usage of numerical information in produced summaries. Dataset analyses and experimental results indicate the importance of jointly considering input textual and tabular data when summarizing report documents.

Recent advancements in language models (LMs) have led to the emergence of powerful models such as Small LMs (e.g., T5) and Large LMs (e.g., GPT-4). These models have demonstrated exceptional capabilities across a wide range of tasks, such as name entity recognition (NER) in the general domain. (We define SLMs as pre-trained models with fewer parameters compared to models like GPT-3/3.5/4, such as T5, BERT, and others.) Nevertheless, their efficacy in the medical section remains uncertain and the performance of medical NER always needs high accuracy because of the particularity of the field. This paper aims to provide a thorough investigation to compare the performance of LMs in medical few-shot NER and answer How far is LMs from 100\% Few-shot NER in Medical Domain, and moreover to explore an effective entity recognizer to help improve the NER performance. Based on our extensive experiments conducted on 16 NER models spanning from 2018 to 2023, our findings clearly indicate that LLMs outperform SLMs in few-shot medical NER tasks, given the presence of suitable examples and appropriate logical frameworks. Despite the overall superiority of LLMs in few-shot medical NER tasks, it is important to note that they still encounter some challenges, such as misidentification, wrong template prediction, etc. Building on previous findings, we introduce a simple and effective method called RT (Retrieving and Thinking), which serves as retrievers, finding relevant examples, and as thinkers, employing a step-by-step reasoning process. Experimental results show that our proposed RT framework significantly outperforms the strong open baselines on the two open medical benchmark datasets

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.

Existing text summarization systems have made significant progress in recent years but typically generates summaries in a single step. The one-shot summarization setting is sometimes inadequate, however, as the generated summary may contain hallucinations or overlook important details related to the reader's interests. In this paper, we address this limitation by proposing SummIt, an iterative text summarization framework based on large language models like ChatGPT. Our framework enables the model to refine the generated summary iteratively through self-evaluation and feedback, closely resembling the iterative process humans undertake when drafting and revising summaries. We also explore using in-context learning to guide the rationale generation and summary refinement. Furthermore, we explore the potential benefits of integrating knowledge and topic extractors into the framework to enhance summary faithfulness and controllability. We evaluate the performance of our framework on three benchmark summarization datasets through empirical and qualitative analyses. We also conduct a human evaluation to validate the effectiveness of the model's refinements and find a potential issue of over-correction. Our code is available at https://github.com/hpzhang94/summ_it.

Objective: To transform heterogeneous clinical data from electronic health records into clinically meaningful constructed features using data driven method that rely, in part, on temporal relations among data. Materials and Methods: The clinically meaningful representations of medical concepts and patients are the key for health analytic applications. Most of existing approaches directly construct features mapped to raw data (e.g., ICD or CPT codes), or utilize some ontology mapping such as SNOMED codes. However, none of the existing approaches leverage EHR data directly for learning such concept representation. We propose a new way to represent heterogeneous medical concepts (e.g., diagnoses, medications and procedures) based on co-occurrence patterns in longitudinal electronic health records. The intuition behind the method is to map medical concepts that are co-occuring closely in time to similar concept vectors so that their distance will be small. We also derive a simple method to construct patient vectors from the related medical concept vectors. Results: For qualitative evaluation, we study similar medical concepts across diagnosis, medication and procedure. In quantitative evaluation, our proposed representation significantly improves the predictive modeling performance for onset of heart failure (HF), where classification methods (e.g. logistic regression, neural network, support vector machine and K-nearest neighbors) achieve up to 23% improvement in area under the ROC curve (AUC) using this proposed representation. Conclusion: We proposed an effective method for patient and medical concept representation learning. The resulting representation can map relevant concepts together and also improves predictive modeling performance.

This paper introduces CaseSumm, a novel dataset for long-context summarization in the legal domain that addresses the need for longer and more complex datasets for summarization evaluation. We collect 25.6K U.S. Supreme Court (SCOTUS) opinions and their official summaries, known as "syllabuses." Our dataset is the largest open legal case summarization dataset, and is the first to include summaries of SCOTUS decisions dating back to 1815. We also present a comprehensive evaluation of LLM-generated summaries using both automatic metrics and expert human evaluation, revealing discrepancies between these assessment methods. Our evaluation shows Mistral 7b, a smaller open-source model, outperforms larger models on most automatic metrics and successfully generates syllabus-like summaries. In contrast, human expert annotators indicate that Mistral summaries contain hallucinations. The annotators consistently rank GPT-4 summaries as clearer and exhibiting greater sensitivity and specificity. Further, we find that LLM-based evaluations are not more correlated with human evaluations than traditional automatic metrics. Furthermore, our analysis identifies specific hallucinations in generated summaries, including precedent citation errors and misrepresentations of case facts. These findings demonstrate the limitations of current automatic evaluation methods for legal summarization and highlight the critical role of human evaluation in assessing summary quality, particularly in complex, high-stakes domains. CaseSumm is available at https://huggingface.co/datasets/ChicagoHAI/CaseSumm

Natural Language Processing (NLP) has seen remarkable advances in recent years, particularly with the emergence of Large Language Models that have achieved unprecedented performance across many tasks. However, these developments have mainly benefited a small number of high-resource languages such as English. The majority of languages still face significant challenges due to the scarcity of training data and computational resources. To address this issue, this thesis focuses on cross-lingual transfer learning, a research area aimed at leveraging data and models from high-resource languages to improve NLP performance for low-resource languages. Specifically, we focus on Sequence Labeling tasks such as Named Entity Recognition, Opinion Target Extraction, and Argument Mining. The research is structured around three main objectives: (1) advancing data-based cross-lingual transfer learning methods through improved translation and annotation projection techniques, (2) developing enhanced model-based transfer learning approaches utilizing state-of-the-art multilingual models, and (3) applying these methods to real-world problems while creating open-source resources that facilitate future research in low-resource NLP. More specifically, this thesis presents a new method to improve data-based transfer with T-Projection, a state-of-the-art annotation projection method that leverages text-to-text multilingual models and machine translation systems. T-Projection significantly outperforms previous annotation projection methods by a wide margin. For model-based transfer, we introduce a constrained decoding algorithm that enhances cross-lingual Sequence Labeling in zero-shot settings using text-to-text models. Finally, we develop Medical mT5, the first multilingual text-to-text medical model, demonstrating the practical impact of our research on real-world applications.

We present an empirical study in favor of a cascade architecture to neural text summarization. Summarization practices vary widely but few other than news summarization can provide a sufficient amount of training data enough to meet the requirement of end-to-end neural abstractive systems which perform content selection and surface realization jointly to generate abstracts. Such systems also pose a challenge to summarization evaluation, as they force content selection to be evaluated along with text generation, yet evaluation of the latter remains an unsolved problem. In this paper, we present empirical results showing that the performance of a cascaded pipeline that separately identifies important content pieces and stitches them together into a coherent text is comparable to or outranks that of end-to-end systems, whereas a pipeline architecture allows for flexible content selection. We finally discuss how we can take advantage of a cascaded pipeline in neural text summarization and shed light on important directions for future research.

Identifying disease phenotypes from electronic health records (EHRs) is critical for numerous secondary uses. Manually encoding physician knowledge into rules is particularly challenging for rare diseases due to inadequate EHR coding, necessitating review of clinical notes. Large language models (LLMs) offer promise in text understanding but may not efficiently handle real-world clinical documentation. We propose a zero-shot LLM-based method enriched by retrieval-augmented generation and MapReduce, which pre-identifies disease-related text snippets to be used in parallel as queries for the LLM to establish diagnosis. We show that this method as applied to pulmonary hypertension (PH), a rare disease characterized by elevated arterial pressures in the lungs, significantly outperforms physician logic rules (F_1 score of 0.62 vs. 0.75). This method has the potential to enhance rare disease cohort identification, expanding the scope of robust clinical research and care gap identification.

In the rapidly evolving digital era, there is an increasing demand for concise information as individuals seek to distil key insights from various sources. Recent attention from researchers on Multi-document Summarisation (MDS) has resulted in diverse datasets covering customer reviews, academic papers, medical and legal documents, and news articles. However, the English-centric nature of these datasets has created a conspicuous void for multilingual datasets in today's globalised digital landscape, where linguistic diversity is celebrated. Media platforms such as British Broadcasting Corporation (BBC) have disseminated news in 20+ languages for decades. With only 380 million people speaking English natively as their first language, accounting for less than 5% of the global population, the vast majority primarily relies on other languages. These facts underscore the need for inclusivity in MDS research, utilising resources from diverse languages. Recognising this gap, we present the Multilingual Dataset for Multi-document Summarisation (M2DS), which, to the best of our knowledge, is the first dataset of its kind. It includes document-summary pairs in five languages from BBC articles published during the 2010-2023 period. This paper introduces M2DS, emphasising its unique multilingual aspect, and includes baseline scores from state-of-the-art MDS models evaluated on our dataset.

We introduce WikiLingua, a large-scale, multilingual dataset for the evaluation of crosslingual abstractive summarization systems. We extract article and summary pairs in 18 languages from WikiHow, a high quality, collaborative resource of how-to guides on a diverse set of topics written by human authors. We create gold-standard article-summary alignments across languages by aligning the images that are used to describe each how-to step in an article. As a set of baselines for further studies, we evaluate the performance of existing cross-lingual abstractive summarization methods on our dataset. We further propose a method for direct crosslingual summarization (i.e., without requiring translation at inference time) by leveraging synthetic data and Neural Machine Translation as a pre-training step. Our method significantly outperforms the baseline approaches, while being more cost efficient during inference.

Traditionally, Text Simplification is treated as a monolingual translation task where sentences between source texts and their simplified counterparts are aligned for training. However, especially for longer input documents, summarizing the text (or dropping less relevant content altogether) plays an important role in the simplification process, which is currently not reflected in existing datasets. Simultaneously, resources for non-English languages are scarce in general and prohibitive for training new solutions. To tackle this problem, we pose core requirements for a system that can jointly summarize and simplify long source documents. We further describe the creation of a new dataset for joint Text Simplification and Summarization based on German Wikipedia and the German children's lexicon "Klexikon", consisting of almost 2900 documents. We release a document-aligned version that particularly highlights the summarization aspect, and provide statistical evidence that this resource is well suited to simplification as well. Code and data are available on Github: https://github.com/dennlinger/klexikon

With the rapid development of artificial intelligence, large language models (LLMs) have shown promising capabilities in mimicking human-level language comprehension and reasoning. This has sparked significant interest in applying LLMs to enhance various aspects of healthcare, ranging from medical education to clinical decision support. However, medicine involves multifaceted data modalities and nuanced reasoning skills, presenting challenges for integrating LLMs. This paper provides a comprehensive review on the applications and implications of LLMs in medicine. It begins by examining the fundamental applications of general-purpose and specialized LLMs, demonstrating their utilities in knowledge retrieval, research support, clinical workflow automation, and diagnostic assistance. Recognizing the inherent multimodality of medicine, the review then focuses on multimodal LLMs, investigating their ability to process diverse data types like medical imaging and EHRs to augment diagnostic accuracy. To address LLMs' limitations regarding personalization and complex clinical reasoning, the paper explores the emerging development of LLM-powered autonomous agents for healthcare. Furthermore, it summarizes the evaluation methodologies for assessing LLMs' reliability and safety in medical contexts. Overall, this review offers an extensive analysis on the transformative potential of LLMs in modern medicine. It also highlights the pivotal need for continuous optimizations and ethical oversight before these models can be effectively integrated into clinical practice. Visit https://github.com/mingze-yuan/Awesome-LLM-Healthcare for an accompanying GitHub repository containing latest papers.

A law practitioner has to go through numerous lengthy legal case proceedings for their practices of various categories, such as land dispute, corruption, etc. Hence, it is important to summarize these documents, and ensure that summaries contain phrases with intent matching the category of the case. To the best of our knowledge, there is no evaluation metric that evaluates a summary based on its intent. We propose an automated intent-based summarization metric, which shows a better agreement with human evaluation as compared to other automated metrics like BLEU, ROUGE-L etc. in terms of human satisfaction. We also curate a dataset by annotating intent phrases in legal documents, and show a proof of concept as to how this system can be automated. Additionally, all the code and data to generate reproducible results is available on Github.

Medical applications challenge today's text categorization techniques by demanding both high accuracy and ease-of-interpretation. Although deep learning has provided a leap ahead in accuracy, this leap comes at the sacrifice of interpretability. To address this accuracy-interpretability challenge, we here introduce, for the first time, a text categorization approach that leverages the recently introduced Tsetlin Machine. In all brevity, we represent the terms of a text as propositional variables. From these, we capture categories using simple propositional formulae, such as: if "rash" and "reaction" and "penicillin" then Allergy. The Tsetlin Machine learns these formulae from a labelled text, utilizing conjunctive clauses to represent the particular facets of each category. Indeed, even the absence of terms (negated features) can be used for categorization purposes. Our empirical comparison with Na\"ive Bayes, decision trees, linear support vector machines (SVMs), random forest, long short-term memory (LSTM) neural networks, and other techniques, is quite conclusive. The Tsetlin Machine either performs on par with or outperforms all of the evaluated methods on both the 20 Newsgroups and IMDb datasets, as well as on a non-public clinical dataset. On average, the Tsetlin Machine delivers the best recall and precision scores across the datasets. Finally, our GPU implementation of the Tsetlin Machine executes 5 to 15 times faster than the CPU implementation, depending on the dataset. We thus believe that our novel approach can have a significant impact on a wide range of text analysis applications, forming a promising starting point for deeper natural language understanding with the Tsetlin Machine.

Recent pre-trained language models (PLMs) achieve promising results in existing abstractive summarization datasets. However, existing summarization benchmarks overlap in time with the standard pre-training corpora and finetuning datasets. Hence, the strong performance of PLMs may rely on the parametric knowledge that is memorized during pre-training and fine-tuning. Moreover, the knowledge memorized by PLMs may quickly become outdated, which affects the generalization performance of PLMs on future data. In this work, we propose TempoSum, a novel benchmark that contains data samples from 2010 to 2022, to understand the temporal generalization ability of abstractive summarization models. Through extensive human evaluation, we show that parametric knowledge stored in summarization models significantly affects the faithfulness of the generated summaries on future data. Moreover, existing faithfulness enhancement methods cannot reliably improve the faithfulness of summarization models on future data. Finally, we discuss several recommendations to the research community on how to evaluate and improve the temporal generalization capability of text summarization models.

This paper introduces PMIndiaSum, a new multilingual and massively parallel headline summarization corpus focused on languages in India. Our corpus covers four language families, 14 languages, and the largest to date, 196 language pairs. It provides a testing ground for all cross-lingual pairs. We detail our workflow to construct the corpus, including data acquisition, processing, and quality assurance. Furthermore, we publish benchmarks for monolingual, cross-lingual, and multilingual summarization by fine-tuning, prompting, as well as translate-and-summarize. Experimental results confirm the crucial role of our data in aiding the summarization of Indian texts. Our dataset is publicly available and can be freely modified and re-distributed.

How well can large language models (LLMs) generate summaries? We develop new datasets and conduct human evaluation experiments to evaluate the zero-shot generation capability of LLMs across five distinct summarization tasks. Our findings indicate a clear preference among human evaluators for LLM-generated summaries over human-written summaries and summaries generated by fine-tuned models. Specifically, LLM-generated summaries exhibit better factual consistency and fewer instances of extrinsic hallucinations. Due to the satisfactory performance of LLMs in summarization tasks (even surpassing the benchmark of reference summaries), we believe that most conventional works in the field of text summarization are no longer necessary in the era of LLMs. However, we recognize that there are still some directions worth exploring, such as the creation of novel datasets with higher quality and more reliable evaluation methods.

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.

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.

The advancement of natural language processing (NLP) in biology hinges on models' ability to interpret intricate biomedical literature. Traditional models often struggle with the complex and domain-specific language in this field. In this paper, we present BioMamba, a pre-trained model specifically designed for biomedical text mining. BioMamba builds upon the Mamba architecture and is pre-trained on an extensive corpus of biomedical literature. Our empirical studies demonstrate that BioMamba significantly outperforms models like BioBERT and general-domain Mamba across various biomedical tasks. For instance, BioMamba achieves a 100 times reduction in perplexity and a 4 times reduction in cross-entropy loss on the BioASQ test set. We provide an overview of the model architecture, pre-training process, and fine-tuning techniques. Additionally, we release the code and trained model to facilitate further research.

This paper introduces MedExQA, a novel benchmark in medical question-answering, to evaluate large language models' (LLMs) understanding of medical knowledge through explanations. By constructing datasets across five distinct medical specialties that are underrepresented in current datasets and further incorporating multiple explanations for each question-answer pair, we address a major gap in current medical QA benchmarks which is the absence of comprehensive assessments of LLMs' ability to generate nuanced medical explanations. Our work highlights the importance of explainability in medical LLMs, proposes an effective methodology for evaluating models beyond classification accuracy, and sheds light on one specific domain, speech language pathology, where current LLMs including GPT4 lack good understanding. Our results show generation evaluation with multiple explanations aligns better with human assessment, highlighting an opportunity for a more robust automated comprehension assessment for LLMs. To diversify open-source medical LLMs (currently mostly based on Llama2), this work also proposes a new medical model, MedPhi-2, based on Phi-2 (2.7B). The model outperformed medical LLMs based on Llama2-70B in generating explanations, showing its effectiveness in the resource-constrained medical domain. We will share our benchmark datasets and the trained model.

Radiology reports are one of the main forms of communication between radiologists and other clinicians and contain important information for patient care. In order to use this information for research and automated patient care programs, it is necessary to convert the raw text into structured data suitable for analysis. State-of-the-art natural language processing (NLP) domain-specific contextual word embeddings have been shown to achieve impressive accuracy for these tasks in medicine, but have yet to be utilized for section structure segmentation. In this work, we pre-trained a contextual embedding BERT model using breast radiology reports and developed a classifier that incorporated the embedding with auxiliary global textual features in order to perform section segmentation. This model achieved a 98% accuracy at segregating free text reports sentence by sentence into sections of information outlined in the Breast Imaging Reporting and Data System (BI-RADS) lexicon, a significant improvement over the Classic BERT model without auxiliary information. We then evaluated whether using section segmentation improved the downstream extraction of clinically relevant information such as modality/procedure, previous cancer, menopausal status, the purpose of the exam, breast density, and breast MRI background parenchymal enhancement. Using the BERT model pre-trained on breast radiology reports combined with section segmentation resulted in an overall accuracy of 95.9% in the field extraction tasks. This is a 17% improvement compared to an overall accuracy of 78.9% for field extraction with models using Classic BERT embeddings and not using section segmentation. Our work shows the strength of using BERT in radiology report analysis and the advantages of section segmentation in identifying key features of patient factors recorded in breast radiology reports.

Whilst there has been growing progress in Entity Linking (EL) for general language, existing datasets fail to address the complex nature of health terminology in layman's language. Meanwhile, there is a growing need for applications that can understand the public's voice in the health domain. To address this we introduce a new corpus called COMETA, consisting of 20k English biomedical entity mentions from Reddit expert-annotated with links to SNOMED CT, a widely-used medical knowledge graph. Our corpus satisfies a combination of desirable properties, from scale and coverage to diversity and quality, that to the best of our knowledge has not been met by any of the existing resources in the field. Through benchmark experiments on 20 EL baselines from string- to neural-based models we shed light on the ability of these systems to perform complex inference on entities and concepts under 2 challenging evaluation scenarios. Our experimental results on COMETA illustrate that no golden bullet exists and even the best mainstream techniques still have a significant performance gap to fill, while the best solution relies on combining different views of data.

Many large language models (LLMs) for medicine have largely been evaluated on short texts, and their ability to handle longer sequences such as a complete electronic health record (EHR) has not been systematically explored. Assessing these models on long sequences is crucial since prior work in the general domain has demonstrated performance degradation of LLMs on longer texts. Motivated by this, we introduce LongBoX, a collection of seven medical datasets in text-to-text format, designed to investigate model performance on long sequences. Preliminary experiments reveal that both medical LLMs (e.g., BioGPT) and strong general domain LLMs (e.g., FLAN-T5) struggle on this benchmark. We further evaluate two techniques designed for long-sequence handling: (i) local-global attention, and (ii) Fusion-in-Decoder (FiD). Our results demonstrate mixed results with long-sequence handling - while scores on some datasets increase, there is substantial room for improvement. We hope that LongBoX facilitates the development of more effective long-sequence techniques for the medical domain. Data and source code are available at https://github.com/Mihir3009/LongBoX.