Daily Papers

Doctor-patient consultations require multi-turn, context-aware communication tailored to diverse patient personas. Training or evaluating doctor LLMs in such settings requires realistic patient interaction systems. However, existing simulators often fail to reflect the full range of personas seen in clinical practice. To address this, we introduce PatientSim, a patient simulator that generates realistic and diverse patient personas for clinical scenarios, grounded in medical expertise. PatientSim operates using: 1) clinical profiles, including symptoms and medical history, derived from real-world data in the MIMIC-ED and MIMIC-IV datasets, and 2) personas defined by four axes: personality, language proficiency, medical history recall level, and cognitive confusion level, resulting in 37 unique combinations. We evaluated eight LLMs for factual accuracy and persona consistency. The top-performing open-source model, Llama 3.3, was validated by four clinicians to confirm the robustness of our framework. As an open-source, customizable platform, PatientSim provides a reproducible and scalable solution that can be customized for specific training needs. Offering a privacy-compliant environment, it serves as a robust testbed for evaluating medical dialogue systems across diverse patient presentations and shows promise as an educational tool for healthcare.

Large language models (LLMs) have demonstrated excellent capabilities in the field of biomedical question answering, but their application in real-world clinical consultations still faces core challenges. Existing systems rely on a one-way information transmission mode where patients must fully describe their symptoms in a single round, leading to nonspecific diagnostic recommendations when complaints are vague. Traditional multi-turn dialogue methods based on supervised learning are constrained by static data-driven paradigms, lacking generalizability and struggling to intelligently extract key clinical information. To address these limitations, we propose DoctorAgent-RL, a reinforcement learning (RL)-based multi-agent collaborative framework that models medical consultations as a dynamic decision-making process under uncertainty. The doctor agent continuously optimizes its questioning strategy within the RL framework through multi-turn interactions with the patient agent, dynamically adjusting its information-gathering path based on comprehensive rewards from the Consultation Evaluator. This RL fine-tuning mechanism enables LLMs to autonomously develop interaction strategies aligned with clinical reasoning logic, rather than superficially imitating patterns in existing dialogue data. Notably, we constructed MTMedDialog, the first English multi-turn medical consultation dataset capable of simulating patient interactions. Experiments demonstrate that DoctorAgent-RL outperforms existing models in both multi-turn reasoning capability and final diagnostic performance, demonstrating practical value in assisting clinical consultations. https://github.com/JarvisUSTC/DoctorAgent-RL

Recent LLMs have demonstrated remarkable performance in solving exam-like math word problems. However, the degree to which these numerical reasoning skills are effective in real-world scenarios, particularly in expert domains, is still largely unexplored. This paper introduces DocMath-Eval, a comprehensive benchmark specifically designed to evaluate the numerical reasoning and problem-solving capabilities of LLMs in the context of understanding and analyzing financial documents containing both text and tables. We evaluate a wide spectrum of 19 LLMs, including those specialized in coding and finance. We also incorporate different prompting strategies (i.e., Chain-of-Thoughts and Program-of-Thoughts) to comprehensively assess the capabilities and limitations of existing LLMs in DocMath-Eval. We found that, although the current best-performing system (i.e., GPT-4), can perform well on simple problems such as calculating the rate of increase in a financial metric within a short document context, it significantly lags behind human experts in more complex problems grounded in longer contexts. We believe DocMath-Eval can be used as a valuable benchmark to evaluate LLMs' capabilities to solve challenging numerical reasoning problems in expert domains. We will release the benchmark and code at https://github.com/yale-nlp/DocMath-Eval.

Analyzing unstructured data, such as complex documents, has been a persistent challenge in data processing. Large Language Models (LLMs) have shown promise in this regard, leading to recent proposals for declarative frameworks for LLM-powered unstructured data processing. However, these frameworks focus on reducing cost when executing user-specified operations using LLMs, rather than improving accuracy, executing most operations as-is. This is problematic for complex tasks and data, where LLM outputs for user-defined operations are often inaccurate, even with optimized prompts. We present DocETL, a system that optimizes complex document processing pipelines, while accounting for LLM shortcomings. DocETL offers a declarative interface for users to define such pipelines and uses an agent-based framework to automatically optimize them, leveraging novel agent-based rewrites (that we call {\em rewrite directives}) and an optimization and evaluation framework that we introduce. We introduce {\em (i)} logical rewriting of pipelines, tailored for LLM-based tasks, {\em (ii)} an agent-guided plan evaluation mechanism that synthesizes and orchestrates task-specific validation prompts, and {\em (iii)} an optimization algorithm that efficiently finds promising plans, considering the time constraints of LLM-based plan generation and evaluation. Our evaluation on three different unstructured document analysis tasks demonstrates that DocETL finds plans with outputs that are 1.34 to 4.6times higher quality (e.g., more accurate, comprehensive) than well-engineered baselines, addressing a critical gap in existing declarative frameworks for unstructured data analysis. DocETL is open-source at docetl.org, and as of October 2024, has amassed over 800 GitHub Stars, with users spanning a variety of domains.

Input constraints are useful for many software development tasks. For example, input constraints of a function enable the generation of valid inputs, i.e., inputs that follow these constraints, to test the function deeper. API functions of deep learning (DL) libraries have DL specific input constraints, which are described informally in the free form API documentation. Existing constraint extraction techniques are ineffective for extracting DL specific input constraints. To fill this gap, we design and implement a new technique, DocTer, to analyze API documentation to extract DL specific input constraints for DL API functions. DocTer features a novel algorithm that automatically constructs rules to extract API parameter constraints from syntactic patterns in the form of dependency parse trees of API descriptions. These rules are then applied to a large volume of API documents in popular DL libraries to extract their input parameter constraints. To demonstrate the effectiveness of the extracted constraints, DocTer uses the constraints to enable the automatic generation of valid and invalid inputs to test DL API functions. Our evaluation on three popular DL libraries (TensorFlow, PyTorch, and MXNet) shows that the precision of DocTer in extracting input constraints is 85.4%. DocTer detects 94 bugs from 174 API functions, including one previously unknown security vulnerability that is now documented in the CVE database, while a baseline technique without input constraints detects only 59 bugs. Most (63) of the 94 bugs are previously unknown, 54 of which have been fixed or confirmed by developers after we report them. In addition, DocTer detects 43 inconsistencies in documents, 39 of which are fixed or confirmed.

Large Language Models (LLMs) are increasingly employed in multi-turn conversational tasks, yet their pre-training data predominantly consists of continuous prose, creating a potential mismatch between required capabilities and training paradigms. We introduce a novel approach to address this discrepancy by synthesizing conversational data from existing text corpora. We present a pipeline that transforms a cluster of multiple related documents into an extended multi-turn, multi-topic information-seeking dialogue. Applying our pipeline to Wikipedia articles, we curate DocTalk, a multi-turn pre-training dialogue corpus consisting of over 730k long conversations. We hypothesize that exposure to such synthesized conversational structures during pre-training can enhance the fundamental multi-turn capabilities of LLMs, such as context memory and understanding. Empirically, we show that incorporating DocTalk during pre-training results in up to 40% gain in context memory and understanding, without compromising base performance. DocTalk is available at https://huggingface.co/datasets/AmazonScience/DocTalk.

In recent years, visually-rich document understanding has attracted increasing attention. Transformer-based pre-trained models have become the mainstream approach, yielding significant performance gains in this field. However, the self-attention mechanism's quadratic computational complexity hinders their efficiency and ability to process long documents. In this paper, we present DocMamba, a novel framework based on the state space model. It is designed to reduce computational complexity to linear while preserving global modeling capabilities. To further enhance its effectiveness in document processing, we introduce the Segment-First Bidirectional Scan (SFBS) to capture contiguous semantic information. Experimental results demonstrate that DocMamba achieves new state-of-the-art results on downstream datasets such as FUNSD, CORD, and SORIE, while significantly improving speed and reducing memory usage. Notably, experiments on the HRDoc confirm DocMamba's potential for length extrapolation. The code will be available online.

Multimodal Sarcasm Understanding (MSU) has a wide range of applications in the news field such as public opinion analysis and forgery detection. However, existing MSU benchmarks and approaches usually focus on sentence-level MSU. In document-level news, sarcasm clues are sparse or small and are often concealed in long text. Moreover, compared to sentence-level comments like tweets, which mainly focus on only a few trends or hot topics (e.g., sports events), content in the news is considerably diverse. Models created for sentence-level MSU may fail to capture sarcasm clues in document-level news. To fill this gap, we present a comprehensive benchmark for Document-level Multimodal Sarcasm Understanding (DocMSU). Our dataset contains 102,588 pieces of news with text-image pairs, covering 9 diverse topics such as health, business, etc. The proposed large-scale and diverse DocMSU significantly facilitates the research of document-level MSU in real-world scenarios. To take on the new challenges posed by DocMSU, we introduce a fine-grained sarcasm comprehension method to properly align the pixel-level image features with word-level textual features in documents. Experiments demonstrate the effectiveness of our method, showing that it can serve as a baseline approach to the challenging DocMSU. Our code and dataset are available at https://github.com/Dulpy/DocMSU.

The use of visually-rich documents (VRDs) in various fields has created a demand for Document AI models that can read and comprehend documents like humans, which requires the overcoming of technical, linguistic, and cognitive barriers. Unfortunately, the lack of appropriate datasets has significantly hindered advancements in the field. To address this issue, we introduce DocTrack, a VRD dataset really aligned with human eye-movement information using eye-tracking technology. This dataset can be used to investigate the challenges mentioned above. Additionally, we explore the impact of human reading order on document understanding tasks and examine what would happen if a machine reads in the same order as a human. Our results suggest that although Document AI models have made significant progress, they still have a long way to go before they can read VRDs as accurately, continuously, and flexibly as humans do. These findings have potential implications for future research and development of Document AI models. The data is available at https://github.com/hint-lab/doctrack.

We present a new formulation for structured information extraction (SIE) from visually rich documents. It aims to address the limitations of existing IOB tagging or graph-based formulations, which are either overly reliant on the correct ordering of input text or struggle with decoding a complex graph. Instead, motivated by anchor-based object detectors in vision, we represent an entity as an anchor word and a bounding box, and represent entity linking as the association between anchor words. This is more robust to text ordering, and maintains a compact graph for entity linking. The formulation motivates us to introduce 1) a DOCument TRansformer (DocTr) that aims at detecting and associating entity bounding boxes in visually rich documents, and 2) a simple pre-training strategy that helps learn entity detection in the context of language. Evaluations on three SIE benchmarks show the effectiveness of the proposed formulation, and the overall approach outperforms existing solutions.

The recent progress of large language models (LLMs), including ChatGPT and GPT-4, in comprehending and responding to human instructions has been remarkable. Nevertheless, these models typically perform better in English and have not been explicitly trained for the medical domain, resulting in suboptimal precision in diagnoses, drug recommendations, and other medical advice. Additionally, training and deploying a dialogue model is still believed to be impossible for hospitals, hindering the promotion of LLMs. To tackle these challenges, we have collected databases of medical dialogues in Chinese with ChatGPT's help and adopted several techniques to train an easy-deploy LLM. Remarkably, we were able to fine-tune the ChatGLM-6B on a single A100 80G in 13 hours, which means having a healthcare-purpose LLM can be very affordable. DoctorGLM is currently an early-stage engineering attempt and contain various mistakes. We are sharing it with the broader community to invite feedback and suggestions to improve its healthcare-focused capabilities: https://github.com/xionghonglin/DoctorGLM.

Doctors typically write in incomprehensible handwriting, making it difficult for both the general public and some pharmacists to understand the medications they have prescribed. It is not ideal for them to write the prescription quietly and methodically because they will be dealing with dozens of patients every day and will be swamped with work.As a result, their handwriting is illegible. This may result in reports or prescriptions consisting of short forms and cursive writing that a typical person or pharmacist won't be able to read properly, which will cause prescribed medications to be misspelled. However, some individuals are accustomed to writing prescriptions in regional languages because we all live in an area with a diversity of regional languages. It makes analyzing the content much more challenging. So, in this project, we'll use a recognition system to build a tool that can translate the handwriting of physicians in any language. This system will be made into an application which is fully autonomous in functioning. As the user uploads the prescription image the program will pre-process the image by performing image pre-processing, and word segmentations initially before processing the image for training. And it will be done for every language we require the model to detect. And as of the deduction model will be made using deep learning techniques including CNN, RNN, and LSTM, which are utilized to train the model. To match words from various languages that will be written in the system, Unicode will be used. Furthermore, fuzzy search and market basket analysis are employed to offer an end result that will be optimized from the pharmaceutical database and displayed to the user as a structured output.

Effective communication, specifically through documentation, is the beating heart of collaboration among contributors in software development. Recent advancements in language models (LMs) have enabled the introduction of a new type of actor in that ecosystem: LM-powered assistants capable of code generation, optimization, and maintenance. Our study investigates the efficacy of small language models (SLMs) for generating high-quality docstrings by assessing accuracy, conciseness, and clarity, benchmarking performance quantitatively through mathematical formulas and qualitatively through human evaluation using Likert scale. Further, we introduce DocuMint, as a large-scale supervised fine-tuning dataset with 100,000 samples. In quantitative experiments, Llama 3 8B achieved the best performance across all metrics, with conciseness and clarity scores of 0.605 and 64.88, respectively. However, under human evaluation, CodeGemma 7B achieved the highest overall score with an average of 8.3 out of 10 across all metrics. Fine-tuning the CodeGemma 2B model using the DocuMint dataset led to significant improvements in performance across all metrics, with gains of up to 22.5% in conciseness. The fine-tuned model and the dataset can be found in HuggingFace and the code can be found in the repository.

One of the critical biotic stress factors paddy farmers face is diseases caused by bacteria, fungi, and other organisms. These diseases affect plants' health severely and lead to significant crop loss. Most of these diseases can be identified by regularly observing the leaves and stems under expert supervision. In a country with vast agricultural regions and limited crop protection experts, manual identification of paddy diseases is challenging. Thus, to add a solution to this problem, it is necessary to automate the disease identification process and provide easily accessible decision support tools to enable effective crop protection measures. However, the lack of availability of public datasets with detailed disease information limits the practical implementation of accurate disease detection systems. This paper presents Paddy Doctor, a visual image dataset for identifying paddy diseases. Our dataset contains 16,225 annotated paddy leaf images across 13 classes (12 diseases and normal leaf). We benchmarked the Paddy Doctor dataset using a Convolutional Neural Network (CNN) and four transfer learning based models (VGG16, MobileNet, Xception, and ResNet34). The experimental results showed that ResNet34 achieved the highest F1-score of 97.50%. We release our dataset and reproducible code in the open source for community use.

Depression poses significant challenges to patients and healthcare organizations, necessitating efficient assessment methods. Existing paradigms typically focus on a patient-doctor way that overlooks multi-role interactions, such as family involvement in the evaluation and caregiving process. Moreover, current automatic depression detection (ADD) methods usually model depression detection as a classification or regression task, lacking interpretability for the decision-making process. To address these issues, we developed InterMind, a doctor-patient-family interactive depression assessment system empowered by large language models (LLMs). Our system enables patients and families to contribute descriptions, generates assistive diagnostic reports for doctors, and provides actionable insights, improving diagnostic precision and efficiency. To enhance LLMs' performance in psychological counseling and diagnostic interpretability, we integrate retrieval-augmented generation (RAG) and chain-of-thoughts (CoT) techniques for data augmentation, which mitigates the hallucination issue of LLMs in specific scenarios after instruction fine-tuning. Quantitative experiments and professional assessments by clinicians validate the effectiveness of our system.

Large Language Model (LLM)-based agents have demonstrated strong capabilities across a wide range of tasks, and their application in the medical domain holds particular promise due to the demand for high generalizability and reliance on interdisciplinary knowledge. However, existing medical agent systems often rely on static, manually crafted workflows that lack the flexibility to accommodate diverse diagnostic requirements and adapt to emerging clinical scenarios. Motivated by the success of automated machine learning (AutoML), this paper introduces a novel framework for the automated design of medical agent architectures. Specifically, we define a hierarchical and expressive agent search space that enables dynamic workflow adaptation through structured modifications at the node, structural, and framework levels. Our framework conceptualizes medical agents as graph-based architectures composed of diverse, functional node types and supports iterative self-improvement guided by diagnostic feedback. Experimental results on skin disease diagnosis tasks demonstrate that the proposed method effectively evolves workflow structures and significantly enhances diagnostic accuracy over time. This work represents the first fully automated framework for medical agent architecture design and offers a scalable, adaptable foundation for deploying intelligent agents in real-world clinical environments.

The recent success of Large Language Models (LLMs) has had a significant impact on the healthcare field, providing patients with medical advice, diagnostic information, and more. However, due to a lack of professional medical knowledge, patients are easily misled by generated erroneous information from LLMs, which may result in serious medical problems. To address this issue, we focus on tuning the LLMs to be medical assistants who collaborate with more experienced doctors. We first conduct a two-stage survey by inspiration-feedback to gain a broad understanding of the real needs of doctors for medical assistants. Based on this, we construct a Chinese medical dataset called DoctorFLAN to support the entire workflow of doctors, which includes 92K Q\&A samples from 22 tasks and 27 specialists. Moreover, we evaluate LLMs in doctor-oriented scenarios by constructing the DoctorFLAN-test containing 550 single-turn Q\&A and DotaBench containing 74 multi-turn conversations. The evaluation results indicate that being a medical assistant still poses challenges for existing open-source models, but DoctorFLAN can help them significantly. It demonstrates that the doctor-oriented dataset and benchmarks we construct can complement existing patient-oriented work and better promote medical LLMs research.

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.

The detailed clinical records drafted by doctors after each patient's visit are crucial for medical practitioners and researchers. Automating the creation of these notes with language models can reduce the workload of doctors. However, training such models can be difficult due to the limited public availability of conversations between patients and doctors. In this paper, we introduce NoteChat, a cooperative multi-agent framework leveraging Large Language Models (LLMs) for generating synthetic doctor-patient conversations conditioned on clinical notes. NoteChat consists of Planning, Roleplay, and Polish modules. We provide a comprehensive automatic and human evaluation of NoteChat, comparing it with state-of-the-art models, including OpenAI's ChatGPT and GPT-4. Results demonstrate that NoteChat facilitates high-quality synthetic doctor-patient conversations, underscoring the untapped potential of LLMs in healthcare. This work represents the first instance of multiple LLMs cooperating to complete a doctor-patient conversation conditioned on clinical notes, offering promising avenues for the intersection of AI and healthcare

This paper presents UMASS_BioNLP team participation in the MEDIQA-Chat 2023 shared task for Task-A and Task-C. We focus especially on Task-C and propose a novel LLMs cooperation system named a doctor-patient loop to generate high-quality conversation data sets. The experiment results demonstrate that our approaches yield reasonable performance as evaluated by automatic metrics such as ROUGE, medical concept recall, BLEU, and Self-BLEU. Furthermore, we conducted a comparative analysis between our proposed method and ChatGPT and GPT-4. This analysis also investigates the potential of utilizing cooperation LLMs to generate high-quality datasets.

In this paper, we present HuatuoGPT, a large language model (LLM) for medical consultation. The core recipe of HuatuoGPT is to leverage both distilled data from ChatGPT and real-world data from doctors in the supervised fine-tuned stage. The responses of ChatGPT are usually detailed, well-presented and informative while it cannot perform like a doctor in many aspects, e.g. for integrative diagnosis. We argue that real-world data from doctors would be complementary to distilled data in the sense the former could tame a distilled language model to perform like doctors. To better leverage the strengths of both data, we train a reward model to align the language model with the merits that both data bring, following an RLAIF (reinforced learning from AI feedback) fashion. To evaluate and benchmark the models, we propose a comprehensive evaluation scheme (including automatic and manual metrics). Experimental results demonstrate that HuatuoGPT achieves state-of-the-art results in performing medical consultation among open-source LLMs in GPT-4 evaluation, human evaluation, and medical benchmark datasets. It is worth noting that by using additional real-world data and RLAIF, the distilled language model (i.e., HuatuoGPT) outperforms its teacher model ChatGPT in most cases. Our code, data, and models are publicly available at https://github.com/FreedomIntelligence/HuatuoGPT. The online demo is available at https://www.HuatuoGPT.cn/.

In this paper, we introduce InMD-X, a collection of multiple large language models specifically designed to cater to the unique characteristics and demands of Internal Medicine Doctors (IMD). InMD-X represents a groundbreaking development in natural language processing, offering a suite of language models fine-tuned for various aspects of the internal medicine field. These models encompass a wide range of medical sub-specialties, enabling IMDs to perform more efficient and accurate research, diagnosis, and documentation. InMD-X's versatility and adaptability make it a valuable tool for improving the healthcare industry, enhancing communication between healthcare professionals, and advancing medical research. Each model within InMD-X is meticulously tailored to address specific challenges faced by IMDs, ensuring the highest level of precision and comprehensiveness in clinical text analysis and decision support. This paper provides an overview of the design, development, and evaluation of InMD-X, showcasing its potential to revolutionize the way internal medicine practitioners interact with medical data and information. We present results from extensive testing, demonstrating the effectiveness and practical utility of InMD-X in real-world medical scenarios.

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

Tumor documentation in Germany is largely done manually, requiring reading patient records and entering data into structured databases. Large language models (LLMs) could potentially enhance this process by improving efficiency and reliability. This evaluation tests eleven different open source LLMs with sizes ranging from 1-70 billion model parameters on three basic tasks of the tumor documentation process: identifying tumor diagnoses, assigning ICD-10 codes, and extracting the date of first diagnosis. For evaluating the LLMs on these tasks, a dataset of annotated text snippets based on anonymized doctors' notes from urology was prepared. Different prompting strategies were used to investigate the effect of the number of examples in few-shot prompting and to explore the capabilities of the LLMs in general. The models Llama 3.1 8B, Mistral 7B, and Mistral NeMo 12 B performed comparably well in the tasks. Models with less extensive training data or having fewer than 7 billion parameters showed notably lower performance, while larger models did not display performance gains. Examples from a different medical domain than urology could also improve the outcome in few-shot prompting, which demonstrates the ability of LLMs to handle tasks needed for tumor documentation. Open source LLMs show a strong potential for automating tumor documentation. Models from 7-12 billion parameters could offer an optimal balance between performance and resource efficiency. With tailored fine-tuning and well-designed prompting, these models might become important tools for clinical documentation in the future. The code for the evaluation is available from https://github.com/stefan-m-lenz/UroLlmEval. We also release the dataset as a new valuable resource that addresses the shortage of authentic and easily accessible benchmarks in German-language medical NLP.