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Dec 3

Evolving Diagnostic Agents in a Virtual Clinical Environment

In this paper, we present a framework for training large language models (LLMs) as diagnostic agents with reinforcement learning, enabling them to manage multi-turn diagnostic processes, adaptively select examinations, and commit to final diagnoses. Unlike instruction-tuned models trained on static case summaries, our method acquires diagnostic strategies through interactive exploration and outcome-based feedback. Our contributions are fourfold: (i) We present DiagGym, a diagnostics world model trained with electronic health records that emits examination outcomes conditioned on patient history and recommended examination, serving as a virtual clinical environment for realistic diagnosis training and evaluation; (ii) We train DiagAgent via end-to-end, multi-turn reinforcement learning to learn diagnostic policies that optimize both information yield and diagnostic accuracy; (iii) We introduce DiagBench, a diagnostic benchmark comprising 750 cases with physician-validated examination recommendations and 99 cases annotated with 973 physician-written rubrics on diagnosis process; (iv) we demonstrate superior performance across diverse diagnostic settings. DiagAgent significantly outperforms 10 state-of-the-art LLMs, including DeepSeek-v3 and GPT-4o, as well as two prompt-engineered agents. In single-turn settings, DiagAgent achieves 9.34% higher diagnostic accuracy and 44.03% improvement in examination recommendation hit ratio. In end-to-end settings, it delivers 15.12% increase in diagnostic accuracy and 23.09% boost in examination recommendation F1 score. In rubric-based evaluation, it surpasses the next-best model, Claude-sonnet-4, by 7.1% in weighted rubric score. These findings indicate that learning policies in interactive clinical environments confers dynamic and clinically meaningful diagnostic management abilities unattainable through passive training alone.

Quantifying the Reasoning Abilities of LLMs on Real-world Clinical Cases

Recent advancements in reasoning-enhanced large language models (LLMs), such as DeepSeek-R1 and OpenAI-o3, have demonstrated significant progress. However, their application in professional medical contexts remains underexplored, particularly in evaluating the quality of their reasoning processes alongside final outputs. Here, we introduce MedR-Bench, a benchmarking dataset of 1,453 structured patient cases, annotated with reasoning references derived from clinical case reports. Spanning 13 body systems and 10 specialties, it includes both common and rare diseases. To comprehensively evaluate LLM performance, we propose a framework encompassing three critical examination recommendation, diagnostic decision-making, and treatment planning, simulating the entire patient care journey. To assess reasoning quality, we present the Reasoning Evaluator, a novel automated system that objectively scores free-text reasoning responses based on efficiency, actuality, and completeness using dynamic cross-referencing and evidence checks. Using this benchmark, we evaluate five state-of-the-art reasoning LLMs, including DeepSeek-R1, OpenAI-o3-mini, and Gemini-2.0-Flash Thinking, etc. Our results show that current LLMs achieve over 85% accuracy in relatively simple diagnostic tasks when provided with sufficient examination results. However, performance declines in more complex tasks, such as examination recommendation and treatment planning. While reasoning outputs are generally reliable, with factuality scores exceeding 90%, critical reasoning steps are frequently missed. These findings underscore both the progress and limitations of clinical LLMs. Notably, open-source models like DeepSeek-R1 are narrowing the gap with proprietary systems, highlighting their potential to drive accessible and equitable advancements in healthcare.

  • 10 authors
·
Mar 6

RJUA-QA: A Comprehensive QA Dataset for Urology

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

  • 17 authors
·
Dec 15, 2023

Neural Rankers for Effective Screening Prioritisation in Medical Systematic Review Literature Search

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.

  • 4 authors
·
Dec 18, 2022

GPT Takes the Bar Exam

Nearly all jurisdictions in the United States require a professional license exam, commonly referred to as "the Bar Exam," as a precondition for law practice. To even sit for the exam, most jurisdictions require that an applicant completes at least seven years of post-secondary education, including three years at an accredited law school. In addition, most test-takers also undergo weeks to months of further, exam-specific preparation. Despite this significant investment of time and capital, approximately one in five test-takers still score under the rate required to pass the exam on their first try. In the face of a complex task that requires such depth of knowledge, what, then, should we expect of the state of the art in "AI?" In this research, we document our experimental evaluation of the performance of OpenAI's `text-davinci-003` model, often-referred to as GPT-3.5, on the multistate multiple choice (MBE) section of the exam. While we find no benefit in fine-tuning over GPT-3.5's zero-shot performance at the scale of our training data, we do find that hyperparameter optimization and prompt engineering positively impacted GPT-3.5's zero-shot performance. For best prompt and parameters, GPT-3.5 achieves a headline correct rate of 50.3% on a complete NCBE MBE practice exam, significantly in excess of the 25% baseline guessing rate, and performs at a passing rate for both Evidence and Torts. GPT-3.5's ranking of responses is also highly-correlated with correctness; its top two and top three choices are correct 71% and 88% of the time, respectively, indicating very strong non-entailment performance. While our ability to interpret these results is limited by nascent scientific understanding of LLMs and the proprietary nature of GPT, we believe that these results strongly suggest that an LLM will pass the MBE component of the Bar Exam in the near future.

  • 2 authors
·
Dec 29, 2022

T2Ranking: A large-scale Chinese Benchmark for Passage Ranking

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

  • 11 authors
·
Apr 7, 2023

Development of an NLP-driven computer-based test guide for visually impaired students

In recent years, advancements in Natural Language Processing (NLP) techniques have revolutionized the field of accessibility and exclusivity of testing, particularly for visually impaired students (VIS). CBT has shown in years back its relevance in terms of administering exams electronically, making the test process easier, providing quicker and more accurate results, and offering greater flexibility and accessibility for candidates. Yet, its relevance was not felt by the visually impaired students as they cannot access printed documents. Hence, in this paper, we present an NLP-driven Computer-Based Test guide for visually impaired students. It employs a speech technology pre-trained methods to provide real-time assistance and support to visually impaired students. The system utilizes NLP technologies to convert the text-based questions and the associated options in a machine-readable format. Subsequently, the speech technology pre-trained model processes the converted text enabling the VIS to comprehend and analyze the content. Furthermore, we validated that this pre-trained model is not perverse by testing for accuracy using sample audio datasets labels (A, B, C, D, E, F, G) to compare with the voice recordings obtained from 20 VIS which is been predicted by the system to attain values for precision, recall, and F1-scores. These metrics are used to assess the performance of the pre-trained model and have indicated that it is proficient enough to give its better performance to the evaluated system. The methodology adopted for this system is Object Oriented Analysis and Design Methodology (OOADM) where Objects are discussed and built by modeling real-world instances.

  • 3 authors
·
Jan 22, 2024

Talent-Interview: Web-Client Cheating Detection for Online Exams

Online exams are more attractive after the Covid-19 pandemic. Furthermore, during recruitment, online exams are used. However, there are more cheating possibilities for online exams. Assigning a proctor for each exam increases cost. At this point, automatic proctor systems detect possible cheating status. This article proposes an end-to-end system and submodules to get better results for online proctoring. Object detection, face recognition, human voice detection, and segmentation are used in our system. Furthermore, our proposed model works on the PCs of users, meaning a client-based system. So, server cost is eliminated. As far as we know, it is the first time the client-based online proctoring system has been used for recruitment. Online exams are more attractive after the Covid-19 pandemic. Furthermore, during recruitment, online exams are used. However, there are more cheating possibilities for online exams. Assigning a proctor for each exam increases cost. At this point, automatic proctor systems detect possible cheating status. This article proposes an end-to-end system and submodules to get better results for online proctoring. Object detection, face recognition, human voice detection, and segmentation are used in our system. Furthermore, our proposed model works on the PCs of users, meaning a client-based system. So, server cost is eliminated. As far as we know, it is the first time the client-based online proctoring system has been used for recruitment. Furthermore, this cheating system works at https://www.talent-interview.com/tr/.

  • 2 authors
·
Nov 17, 2023

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

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

  • 4 authors
·
Oct 31, 2024

Overview of the TREC 2023 deep learning track

This is the fifth year of the TREC Deep Learning track. As in previous years, we leverage the MS MARCO datasets that made hundreds of thousands of human-annotated training labels available for both passage and document ranking tasks. We mostly repeated last year's design, to get another matching test set, based on the larger, cleaner, less-biased v2 passage and document set, with passage ranking as primary and document ranking as a secondary task (using labels inferred from passage). As we did last year, we sample from MS MARCO queries that were completely held out, unused in corpus construction, unlike the test queries in the first three years. This approach yields a more difficult test with more headroom for improvement. Alongside the usual MS MARCO (human) queries from MS MARCO, this year we generated synthetic queries using a fine-tuned T5 model and using a GPT-4 prompt. The new headline result this year is that runs using Large Language Model (LLM) prompting in some way outperformed runs that use the "nnlm" approach, which was the best approach in the previous four years. Since this is the last year of the track, future iterations of prompt-based ranking can happen in other tracks. Human relevance assessments were applied to all query types, not just human MS MARCO queries. Evaluation using synthetic queries gave similar results to human queries, with system ordering agreement of τ=0.8487. However, human effort was needed to select a subset of the synthetic queries that were usable. We did not see clear evidence of bias, where runs using GPT-4 were favored when evaluated using synthetic GPT-4 queries, or where runs using T5 were favored when evaluated on synthetic T5 queries.

  • 8 authors
·
Jul 10

GPT-4 passes most of the 297 written Polish Board Certification Examinations

Introduction: Recently, the effectiveness of Large Language Models (LLMs) has increased rapidly, allowing them to be used in a great number of applications. However, the risks posed by the generation of false information through LLMs significantly limit their applications in sensitive areas such as healthcare, highlighting the necessity for rigorous validations to determine their utility and reliability. To date, no study has extensively compared the performance of LLMs on Polish medical examinations across a broad spectrum of specialties on a very large dataset. Objectives: This study evaluated the performance of three Generative Pretrained Transformer (GPT) models on the Polish Board Certification Exam (Pa\'nstwowy Egzamin Specjalizacyjny, PES) dataset, which consists of 297 tests. Methods: We developed a software program to download and process PES exams and tested the performance of GPT models using OpenAI Application Programming Interface. Results: Our findings reveal that GPT-3.5 did not pass any of the analyzed exams. In contrast, the GPT-4 models demonstrated the capability to pass the majority of the exams evaluated, with the most recent model, gpt-4-0125, successfully passing 222 (75%) of them. The performance of the GPT models varied significantly, displaying excellence in exams related to certain specialties while completely failing others. Conclusions: The significant progress and impressive performance of LLM models hold great promise for the increased application of AI in the field of medicine in Poland. For instance, this advancement could lead to the development of AI-based medical assistants for healthcare professionals, enhancing the efficiency and accuracy of medical services.

  • 3 authors
·
Apr 29, 2024

Capabilities of GPT-4 on Medical Challenge Problems

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

  • 5 authors
·
Mar 20, 2023

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

Recent advancements in large language models (LLMs) have transformed the field of question answering (QA). However, evaluating LLMs in the medical field is challenging due to the lack of standardized and comprehensive datasets. To address this gap, we introduce CMExam, sourced from the Chinese National Medical Licensing Examination. CMExam consists of 60K+ multiple-choice questions for standardized and objective evaluations, as well as solution explanations for model reasoning evaluation in an open-ended manner. For in-depth analyses of LLMs, we invited medical professionals to label five additional question-wise annotations, including disease groups, clinical departments, medical disciplines, areas of competency, and question difficulty levels. Alongside the dataset, we further conducted thorough experiments with representative LLMs and QA algorithms on CMExam. The results show that GPT-4 had the best accuracy of 61.6% and a weighted F1 score of 0.617. These results highlight a great disparity when compared to human accuracy, which stood at 71.6%. For explanation tasks, while LLMs could generate relevant reasoning and demonstrate improved performance after finetuning, they fall short of a desired standard, indicating ample room for improvement. To the best of our knowledge, CMExam is the first Chinese medical exam dataset to provide comprehensive medical annotations. The experiments and findings of LLM evaluation also provide valuable insights into the challenges and potential solutions in developing Chinese medical QA systems and LLM evaluation pipelines. The dataset and relevant code are available at https://github.com/williamliujl/CMExam.

  • 11 authors
·
Jun 5, 2023

Are Large Language Models True Healthcare Jacks-of-All-Trades? Benchmarking Across Health Professions Beyond Physician Exams

Recent advancements in Large Language Models (LLMs) have demonstrated their potential in delivering accurate answers to questions about world knowledge. Despite this, existing benchmarks for evaluating LLMs in healthcare predominantly focus on medical doctors, leaving other critical healthcare professions underrepresented. To fill this research gap, we introduce the Examinations for Medical Personnel in Chinese (EMPEC), a pioneering large-scale healthcare knowledge benchmark in traditional Chinese. EMPEC consists of 157,803 exam questions across 124 subjects and 20 healthcare professions, including underrepresented occupations like Optometrists and Audiologists. Each question is tagged with its release time and source, ensuring relevance and authenticity. We conducted extensive experiments on 17 LLMs, including proprietary, open-source models, general domain models and medical specific models, evaluating their performance under various settings. Our findings reveal that while leading models like GPT-4 achieve over 75\% accuracy, they still struggle with specialized fields and alternative medicine. Surprisingly, general-purpose LLMs outperformed medical-specific models, and incorporating EMPEC's training data significantly enhanced performance. Additionally, the results on questions released after the models' training cutoff date were consistent with overall performance trends, suggesting that the models' performance on the test set can predict their effectiveness in addressing unseen healthcare-related queries. The transition from traditional to simplified Chinese characters had a negligible impact on model performance, indicating robust linguistic versatility. Our study underscores the importance of expanding benchmarks to cover a broader range of healthcare professions to better assess the applicability of LLMs in real-world healthcare scenarios.

  • 4 authors
·
Jun 17, 2024

Evaluation of GPT-3.5 and GPT-4 for supporting real-world information needs in healthcare delivery

Despite growing interest in using large language models (LLMs) in healthcare, current explorations do not assess the real-world utility and safety of LLMs in clinical settings. Our objective was to determine whether two LLMs can serve information needs submitted by physicians as questions to an informatics consultation service in a safe and concordant manner. Sixty six questions from an informatics consult service were submitted to GPT-3.5 and GPT-4 via simple prompts. 12 physicians assessed the LLM responses' possibility of patient harm and concordance with existing reports from an informatics consultation service. Physician assessments were summarized based on majority vote. For no questions did a majority of physicians deem either LLM response as harmful. For GPT-3.5, responses to 8 questions were concordant with the informatics consult report, 20 discordant, and 9 were unable to be assessed. There were 29 responses with no majority on "Agree", "Disagree", and "Unable to assess". For GPT-4, responses to 13 questions were concordant, 15 discordant, and 3 were unable to be assessed. There were 35 responses with no majority. Responses from both LLMs were largely devoid of overt harm, but less than 20% of the responses agreed with an answer from an informatics consultation service, responses contained hallucinated references, and physicians were divided on what constitutes harm. These results suggest that while general purpose LLMs are able to provide safe and credible responses, they often do not meet the specific information need of a given question. A definitive evaluation of the usefulness of LLMs in healthcare settings will likely require additional research on prompt engineering, calibration, and custom-tailoring of general purpose models.

  • 18 authors
·
Apr 26, 2023

MeSH Term Suggestion for Systematic Review Literature Search

High-quality medical systematic reviews require comprehensive literature searches to ensure the recommendations and outcomes are sufficiently reliable. Indeed, searching for relevant medical literature is a key phase in constructing systematic reviews and often involves domain (medical researchers) and search (information specialists) experts in developing the search queries. Queries in this context are highly complex, based on Boolean logic, include free-text terms and index terms from standardised terminologies (e.g., MeSH), and are difficult and time-consuming to build. The use of MeSH terms, in particular, has been shown to improve the quality of the search results. However, identifying the correct MeSH terms to include in a query is difficult: information experts are often unfamiliar with the MeSH database and unsure about the appropriateness of MeSH terms for a query. Naturally, the full value of the MeSH terminology is often not fully exploited. This paper investigates methods to suggest MeSH terms based on an initial Boolean query that includes only free-text terms. These methods promise to automatically identify highly effective MeSH terms for inclusion in a systematic review query. Our study contributes an empirical evaluation of several MeSH term suggestion methods. We perform an extensive analysis of the retrieval, ranking, and refinement of MeSH term suggestions for each method and how these suggestions impact the effectiveness of Boolean queries.

  • 5 authors
·
Dec 1, 2021

SuRe: Summarizing Retrievals using Answer Candidates for Open-domain QA of LLMs

Large language models (LLMs) have made significant advancements in various natural language processing tasks, including question answering (QA) tasks. While incorporating new information with the retrieval of relevant passages is a promising way to improve QA with LLMs, the existing methods often require additional fine-tuning which becomes infeasible with recent LLMs. Augmenting retrieved passages via prompting has the potential to address this limitation, but this direction has been limitedly explored. To this end, we design a simple yet effective framework to enhance open-domain QA (ODQA) with LLMs, based on the summarized retrieval (SuRe). SuRe helps LLMs predict more accurate answers for a given question, which are well-supported by the summarized retrieval that could be viewed as an explicit rationale extracted from the retrieved passages. Specifically, SuRe first constructs summaries of the retrieved passages for each of the multiple answer candidates. Then, SuRe confirms the most plausible answer from the candidate set by evaluating the validity and ranking of the generated summaries. Experimental results on diverse ODQA benchmarks demonstrate the superiority of SuRe, with improvements of up to 4.6% in exact match (EM) and 4.0% in F1 score over standard prompting approaches. SuRe also can be integrated with a broad range of retrieval methods and LLMs. Finally, the generated summaries from SuRe show additional advantages to measure the importance of retrieved passages and serve as more preferred rationales by models and humans.

  • 8 authors
·
Apr 16, 2024

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

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

  • 4 authors
·
Jun 4, 2024

Using clarification questions to improve software developers' Web search

Context: Recent research indicates that Web queries written by software developers are not very successful in retrieving relevant results, performing measurably worse compared to general purpose Web queries. Most approaches up to this point have addressed this problem with software engineering-specific automated query reformulation techniques, which work without developer involvement but are limited by the content of the original query. In other words, these techniques automatically improve the existing query but can not contribute new, previously unmentioned, concepts. Objective: In this paper, we propose a technique to guide software developers in manually improving their own Web search queries. We examine a conversational approach that follows unsuccessful queries with a clarification question aimed at eliciting additional query terms, thus providing to the developer a clear dimension along which the query could be improved. Methods: We describe a set of clarification questions derived from a corpus of software developer queries and a neural approach to recommending them for a newly issued query. Results: Our evaluation indicates that the recommendation technique is accurate, predicting a valid clarification question 80% of the time and outperforms simple baselines, as well as, state-of-the-art Learning To Rank (LTR) baselines. Conclusion: As shown in the experimental results, the described approach is capable at recommending appropriate clarification questions to software developers and considered useful by a sample of developers ranging from novices to experienced professionals.

  • 2 authors
·
Jul 26, 2022

Multi-CPR: A Multi Domain Chinese Dataset for Passage Retrieval

Passage retrieval is a fundamental task in information retrieval (IR) research, which has drawn much attention recently. In the English field, the availability of large-scale annotated dataset (e.g, MS MARCO) and the emergence of deep pre-trained language models (e.g, BERT) has resulted in a substantial improvement of existing passage retrieval systems. However, in the Chinese field, especially for specific domains, passage retrieval systems are still immature due to quality-annotated dataset being limited by scale. Therefore, in this paper, we present a novel multi-domain Chinese dataset for passage retrieval (Multi-CPR). The dataset is collected from three different domains, including E-commerce, Entertainment video and Medical. Each dataset contains millions of passages and a certain amount of human annotated query-passage related pairs. We implement various representative passage retrieval methods as baselines. We find that the performance of retrieval models trained on dataset from general domain will inevitably decrease on specific domain. Nevertheless, a passage retrieval system built on in-domain annotated dataset can achieve significant improvement, which indeed demonstrates the necessity of domain labeled data for further optimization. We hope the release of the Multi-CPR dataset could benchmark Chinese passage retrieval task in specific domain and also make advances for future studies.

  • 10 authors
·
Mar 7, 2022

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

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

  • 7 authors
·
Aug 9, 2023

Worse than Random? An Embarrassingly Simple Probing Evaluation of Large Multimodal Models in Medical VQA

Large Multimodal Models (LMMs) have shown remarkable progress in the field of medical Visual Question Answering (Med-VQA), achieving high accuracy on existing benchmarks. However, their reliability under robust evaluation is questionable. This study reveals that state-of-the-art models, when subjected to simple probing evaluation, perform worse than random guessing on medical diagnosis questions. To address this critical evaluation problem, we introduce the Probing Evaluation for Medical Diagnosis (ProbMed) dataset to rigorously assess LMM performance in medical imaging through probing evaluation and procedural diagnosis. Particularly, probing evaluation features pairing original questions with negation questions with hallucinated attributes, while procedural diagnosis requires reasoning across various diagnostic dimensions for each image, including modality recognition, organ identification, clinical findings, abnormalities, and positional grounding. Our evaluation reveals that top-performing models like GPT-4V and Gemini Pro perform worse than random guessing on specialized diagnostic questions, indicating significant limitations in handling fine-grained medical inquiries. Besides, models like LLaVA-Med struggle even with more general questions, and results from CheXagent demonstrate the transferability of expertise across different modalities of the same organ, showing that specialized domain knowledge is still crucial for improving performance. This study underscores the urgent need for more robust evaluation to ensure the reliability of LMMs in critical fields like medical diagnosis, and current LMMs are still far from applicable to those fields.

  • 4 authors
·
May 30, 2024

Judging the Judges: A Collection of LLM-Generated Relevance Judgements

Using Large Language Models (LLMs) for relevance assessments offers promising opportunities to improve Information Retrieval (IR), Natural Language Processing (NLP), and related fields. Indeed, LLMs hold the promise of allowing IR experimenters to build evaluation collections with a fraction of the manual human labor currently required. This could help with fresh topics on which there is still limited knowledge and could mitigate the challenges of evaluating ranking systems in low-resource scenarios, where it is challenging to find human annotators. Given the fast-paced recent developments in the domain, many questions concerning LLMs as assessors are yet to be answered. Among the aspects that require further investigation, we can list the impact of various components in a relevance judgment generation pipeline, such as the prompt used or the LLM chosen. This paper benchmarks and reports on the results of a large-scale automatic relevance judgment evaluation, the LLMJudge challenge at SIGIR 2024, where different relevance assessment approaches were proposed. In detail, we release and benchmark 42 LLM-generated labels of the TREC 2023 Deep Learning track relevance judgments produced by eight international teams who participated in the challenge. Given their diverse nature, these automatically generated relevance judgments can help the community not only investigate systematic biases caused by LLMs but also explore the effectiveness of ensemble models, analyze the trade-offs between different models and human assessors, and advance methodologies for improving automated evaluation techniques. The released resource is available at the following link: https://llm4eval.github.io/LLMJudge-benchmark/

  • 9 authors
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Feb 19 2

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

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

  • 6 authors
·
Aug 1, 2024

Towards Accurate Differential Diagnosis with Large Language Models

An accurate differential diagnosis (DDx) is a cornerstone of medical care, often reached through an iterative process of interpretation that combines clinical history, physical examination, investigations and procedures. Interactive interfaces powered by Large Language Models (LLMs) present new opportunities to both assist and automate aspects of this process. In this study, we introduce an LLM optimized for diagnostic reasoning, and evaluate its ability to generate a DDx alone or as an aid to clinicians. 20 clinicians evaluated 302 challenging, real-world medical cases sourced from the New England Journal of Medicine (NEJM) case reports. Each case report was read by two clinicians, who were randomized to one of two assistive conditions: either assistance from search engines and standard medical resources, or LLM assistance in addition to these tools. All clinicians provided a baseline, unassisted DDx prior to using the respective assistive tools. Our LLM for DDx exhibited standalone performance that exceeded that of unassisted clinicians (top-10 accuracy 59.1% vs 33.6%, [p = 0.04]). Comparing the two assisted study arms, the DDx quality score was higher for clinicians assisted by our LLM (top-10 accuracy 51.7%) compared to clinicians without its assistance (36.1%) (McNemar's Test: 45.7, p < 0.01) and clinicians with search (44.4%) (4.75, p = 0.03). Further, clinicians assisted by our LLM arrived at more comprehensive differential lists than those without its assistance. Our study suggests that our LLM for DDx has potential to improve clinicians' diagnostic reasoning and accuracy in challenging cases, meriting further real-world evaluation for its ability to empower physicians and widen patients' access to specialist-level expertise.

  • 28 authors
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Nov 30, 2023 1

Biomed-Enriched: A Biomedical Dataset Enriched with LLMs for Pretraining and Extracting Rare and Hidden Content

We introduce Biomed-Enriched, a biomedical text dataset constructed from PubMed via a two-stage annotation process. In the first stage, a large language model annotates 400K paragraphs from PubMed scientific articles, assigning scores for their type (review, study, clinical case, other), domain (clinical, biomedical, other), and educational quality. The educational quality score (rated 1 to 5) estimates how useful a paragraph is for college-level learning. These annotations are then used to fine-tune a small language model, which propagates the labels across the full PMC-OA corpus. The resulting metadata allows us to extract refined subsets, including 2M clinical case paragraphs with over 450K high-quality ones from articles with commercial-use licenses, and to construct several variants via quality filtering and domain upsampling. Clinical text is typically difficult to access due to privacy constraints, as hospital records cannot be publicly shared. Hence, our dataset provides an alternative large-scale, openly available collection of clinical cases from PubMed, making it a valuable resource for biomedical and clinical NLP. Preliminary continual-pretraining experiments with OLMo2 suggest these curated subsets enable targeted improvements, with clinical upsampling boosting performance by ~5% on MMLU ProfMed and educational quality filtering improving MedQA and MedMCQA by ~1%. Combinations of these techniques led to faster convergence, reaching same performance with a third of training tokens, indicating potential for more efficient and effective biomedical pretraining strategies.

  • 3 authors
·
Jun 25 1

Application of NotebookLM, a Large Language Model with Retrieval-Augmented Generation, for Lung Cancer Staging

Purpose: In radiology, large language models (LLMs), including ChatGPT, have recently gained attention, and their utility is being rapidly evaluated. However, concerns have emerged regarding their reliability in clinical applications due to limitations such as hallucinations and insufficient referencing. To address these issues, we focus on the latest technology, retrieval-augmented generation (RAG), which enables LLMs to reference reliable external knowledge (REK). Specifically, this study examines the utility and reliability of a recently released RAG-equipped LLM (RAG-LLM), NotebookLM, for staging lung cancer. Materials and methods: We summarized the current lung cancer staging guideline in Japan and provided this as REK to NotebookLM. We then tasked NotebookLM with staging 100 fictional lung cancer cases based on CT findings and evaluated its accuracy. For comparison, we performed the same task using a gold-standard LLM, GPT-4 Omni (GPT-4o), both with and without the REK. Results: NotebookLM achieved 86% diagnostic accuracy in the lung cancer staging experiment, outperforming GPT-4o, which recorded 39% accuracy with the REK and 25% without it. Moreover, NotebookLM demonstrated 95% accuracy in searching reference locations within the REK. Conclusion: NotebookLM successfully performed lung cancer staging by utilizing the REK, demonstrating superior performance compared to GPT-4o. Additionally, it provided highly accurate reference locations within the REK, allowing radiologists to efficiently evaluate the reliability of NotebookLM's responses and detect possible hallucinations. Overall, this study highlights the potential of NotebookLM, a RAG-LLM, in image diagnosis.

  • 8 authors
·
Oct 8, 2024

ReviewerGPT? An Exploratory Study on Using Large Language Models for Paper Reviewing

Given the rapid ascent of large language models (LLMs), we study the question: (How) can large language models help in reviewing of scientific papers or proposals? We first conduct some pilot studies where we find that (i) GPT-4 outperforms other LLMs (Bard, Vicuna, Koala, Alpaca, LLaMa, Dolly, OpenAssistant, StableLM), and (ii) prompting with a specific question (e.g., to identify errors) outperforms prompting to simply write a review. With these insights, we study the use of LLMs (specifically, GPT-4) for three tasks: 1. Identifying errors: We construct 13 short computer science papers each with a deliberately inserted error, and ask the LLM to check for the correctness of these papers. We observe that the LLM finds errors in 7 of them, spanning both mathematical and conceptual errors. 2. Verifying checklists: We task the LLM to verify 16 closed-ended checklist questions in the respective sections of 15 NeurIPS 2022 papers. We find that across 119 {checklist question, paper} pairs, the LLM had an 86.6% accuracy. 3. Choosing the "better" paper: We generate 10 pairs of abstracts, deliberately designing each pair in such a way that one abstract was clearly superior than the other. The LLM, however, struggled to discern these relatively straightforward distinctions accurately, committing errors in its evaluations for 6 out of the 10 pairs. Based on these experiments, we think that LLMs have a promising use as reviewing assistants for specific reviewing tasks, but not (yet) for complete evaluations of papers or proposals.

  • 2 authors
·
Jun 1, 2023

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

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

  • 5 authors
·
Aug 4, 2020

reStructured Pre-training

In this work, we try to decipher the internal connection of NLP technology development in the past decades, searching for essence, which rewards us with a (potential) new learning paradigm for NLP tasks, dubbed as reStructured Pre-training (RST). In such a paradigm, the role of data will be re-emphasized, and model pre-training and fine-tuning of downstream tasks are viewed as a process of data storing and accessing. Based on that, we operationalize the simple principle that a good storage mechanism should not only have the ability to cache a large amount of data but also consider the ease of access. We achieve this by pre-training models over restructured data that consist of a variety of valuable information instead of raw data after overcoming several engineering challenges. Experimentally, RST models not only surpass strong competitors (e.g., T0) on 52/55 popular datasets from a variety of NLP tasks, but also achieve superior performance in National College Entrance Examination - English (Gaokao-English),the most authoritative examination in China. Specifically, the proposed system Qin achieves 40 points higher than the average scores made by students and 15 points higher than GPT3 with 1/16 parameters. In particular, Qin gets a high score of 138.5 (the full mark is 150) in the 2018 English exam (national paper III). We have released the Gaokao Benchmark with an online submission platform. In addition, we test our model in the 2022 College Entrance Examination English that happened a few days ago (2022.06.08), and it gets a total score of 134 (v.s. GPT3's 108).

  • 2 authors
·
Jun 22, 2022

Exploring Large Language Models for Specialist-level Oncology Care

Large language models (LLMs) have shown remarkable progress in encoding clinical knowledge and responding to complex medical queries with appropriate clinical reasoning. However, their applicability in subspecialist or complex medical settings remains underexplored. In this work, we probe the performance of AMIE, a research conversational diagnostic AI system, in the subspecialist domain of breast oncology care without specific fine-tuning to this challenging domain. To perform this evaluation, we curated a set of 50 synthetic breast cancer vignettes representing a range of treatment-naive and treatment-refractory cases and mirroring the key information available to a multidisciplinary tumor board for decision-making (openly released with this work). We developed a detailed clinical rubric for evaluating management plans, including axes such as the quality of case summarization, safety of the proposed care plan, and recommendations for chemotherapy, radiotherapy, surgery and hormonal therapy. To improve performance, we enhanced AMIE with the inference-time ability to perform web search retrieval to gather relevant and up-to-date clinical knowledge and refine its responses with a multi-stage self-critique pipeline. We compare response quality of AMIE with internal medicine trainees, oncology fellows, and general oncology attendings under both automated and specialist clinician evaluations. In our evaluations, AMIE outperformed trainees and fellows demonstrating the potential of the system in this challenging and important domain. We further demonstrate through qualitative examples, how systems such as AMIE might facilitate conversational interactions to assist clinicians in their decision making. However, AMIE's performance was overall inferior to attending oncologists suggesting that further research is needed prior to consideration of prospective uses.

  • 21 authors
·
Nov 5, 2024

Large Language Models Illuminate a Progressive Pathway to Artificial Healthcare Assistant: A Review

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.

  • 11 authors
·
Nov 3, 2023

How to Index Item IDs for Recommendation Foundation Models

Recommendation foundation model utilizes large language models (LLM) for recommendation by converting recommendation tasks into natural language tasks. It enables generative recommendation which directly generates the item(s) to recommend rather than calculating a ranking score for each and every candidate item in traditional recommendation models, simplifying the recommendation pipeline from multi-stage filtering to single-stage filtering. To avoid generating excessively long text and hallucinated recommendation when deciding which item(s) to recommend, creating LLM-compatible item IDs to uniquely identify each item is essential for recommendation foundation models. In this study, we systematically examine the item indexing problem for recommendation foundation models, using P5 as an example of backbone model. To emphasize the importance of item indexing, we first discuss the issues of several trivial item indexing methods, such as independent indexing, title indexing, and random indexing. We then propose four simple yet effective solutions, including sequential indexing, collaborative indexing, semantic (content-based) indexing, and hybrid indexing. Our study highlights the significant influence of item indexing methods on the performance of LLM-based recommendation, and our results on real-world datasets validate the effectiveness of our proposed solutions. The research also demonstrates how recent advances on language modeling and traditional IR principles such as indexing can help each other for better learning and inference.

  • 4 authors
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May 11, 2023

Susu Box or Piggy Bank: Assessing Cultural Commonsense Knowledge between Ghana and the U.S

Recent work has highlighted the culturally-contingent nature of commonsense knowledge. We introduce AMAMMER{epsilon}, a test set of 525 multiple-choice questions designed to evaluate the commonsense knowledge of English LLMs, relative to the cultural contexts of Ghana and the United States. To create AMAMMER{epsilon}, we select a set of multiple-choice questions (MCQs) from existing commonsense datasets and rewrite them in a multi-stage process involving surveys of Ghanaian and U.S. participants. In three rounds of surveys, participants from both pools are solicited to (1) write correct and incorrect answer choices, (2) rate individual answer choices on a 5-point Likert scale, and (3) select the best answer choice from the newly-constructed MCQ items, in a final validation step. By engaging participants at multiple stages, our procedure ensures that participant perspectives are incorporated both in the creation and validation of test items, resulting in high levels of agreement within each pool. We evaluate several off-the-shelf English LLMs on AMAMMER{epsilon}. Uniformly, models prefer answers choices that align with the preferences of U.S. annotators over Ghanaian annotators. Additionally, when test items specify a cultural context (Ghana or the U.S.), models exhibit some ability to adapt, but performance is consistently better in U.S. contexts than Ghanaian. As large resources are devoted to the advancement of English LLMs, our findings underscore the need for culturally adaptable models and evaluations to meet the needs of diverse English-speaking populations around the world.

  • 3 authors
·
Oct 21, 2024

Large Language Models Encode Clinical Knowledge

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

  • 30 authors
·
Dec 26, 2022

LegalVis: Exploring and Inferring Precedent Citations in Legal Documents

To reduce the number of pending cases and conflicting rulings in the Brazilian Judiciary, the National Congress amended the Constitution, allowing the Brazilian Supreme Court (STF) to create binding precedents (BPs), i.e., a set of understandings that both Executive and lower Judiciary branches must follow. The STF's justices frequently cite the 58 existing BPs in their decisions, and it is of primary relevance that judicial experts could identify and analyze such citations. To assist in this problem, we propose LegalVis, a web-based visual analytics system designed to support the analysis of legal documents that cite or could potentially cite a BP. We model the problem of identifying potential citations (i.e., non-explicit) as a classification problem. However, a simple score is not enough to explain the results; that is why we use an interpretability machine learning method to explain the reason behind each identified citation. For a compelling visual exploration of documents and BPs, LegalVis comprises three interactive visual components: the first presents an overview of the data showing temporal patterns, the second allows filtering and grouping relevant documents by topic, and the last one shows a document's text aiming to interpret the model's output by pointing out which paragraphs are likely to mention the BP, even if not explicitly specified. We evaluated our identification model and obtained an accuracy of 96%; we also made a quantitative and qualitative analysis of the results. The usefulness and effectiveness of LegalVis were evaluated through two usage scenarios and feedback from six domain experts.

  • 4 authors
·
Mar 3, 2022

Maybe you are looking for CroQS: Cross-modal Query Suggestion for Text-to-Image Retrieval

Query suggestion, a technique widely adopted in information retrieval, enhances system interactivity and the browsing experience of document collections. In cross-modal retrieval, many works have focused on retrieving relevant items from natural language queries, while few have explored query suggestion solutions. In this work, we address query suggestion in cross-modal retrieval, introducing a novel task that focuses on suggesting minimal textual modifications needed to explore visually consistent subsets of the collection, following the premise of ''Maybe you are looking for''. To facilitate the evaluation and development of methods, we present a tailored benchmark named CroQS. This dataset comprises initial queries, grouped result sets, and human-defined suggested queries for each group. We establish dedicated metrics to rigorously evaluate the performance of various methods on this task, measuring representativeness, cluster specificity, and similarity of the suggested queries to the original ones. Baseline methods from related fields, such as image captioning and content summarization, are adapted for this task to provide reference performance scores. Although relatively far from human performance, our experiments reveal that both LLM-based and captioning-based methods achieve competitive results on CroQS, improving the recall on cluster specificity by more than 115% and representativeness mAP by more than 52% with respect to the initial query. The dataset, the implementation of the baseline methods and the notebooks containing our experiments are available here: https://paciosoft.com/CroQS-benchmark/

  • 6 authors
·
Dec 18, 2024

Knowledge-Augmented Large Language Models for Personalized Contextual Query Suggestion

Large Language Models (LLMs) excel at tackling various natural language tasks. However, due to the significant costs involved in re-training or fine-tuning them, they remain largely static and difficult to personalize. Nevertheless, a variety of applications could benefit from generations that are tailored to users' preferences, goals, and knowledge. Among them is web search, where knowing what a user is trying to accomplish, what they care about, and what they know can lead to improved search experiences. In this work, we propose a novel and general approach that augments an LLM with relevant context from users' interaction histories with a search engine in order to personalize its outputs. Specifically, we construct an entity-centric knowledge store for each user based on their search and browsing activities on the web, which is then leveraged to provide contextually relevant LLM prompt augmentations. This knowledge store is light-weight, since it only produces user-specific aggregate projections of interests and knowledge onto public knowledge graphs, and leverages existing search log infrastructure, thereby mitigating the privacy, compliance, and scalability concerns associated with building deep user profiles for personalization. We then validate our approach on the task of contextual query suggestion, which requires understanding not only the user's current search context but also what they historically know and care about. Through a number of experiments based on human evaluation, we show that our approach is significantly better than several other LLM-powered baselines, generating query suggestions that are contextually more relevant, personalized, and useful.

  • 5 authors
·
Nov 9, 2023

kNN-Embed: Locally Smoothed Embedding Mixtures For Multi-interest Candidate Retrieval

Candidate generation is the first stage in recommendation systems, where a light-weight system is used to retrieve potentially relevant items for an input user. These candidate items are then ranked and pruned in later stages of recommender systems using a more complex ranking model. Since candidate generation is the top of the recommendation funnel, it is important to retrieve a high-recall candidate set to feed into downstream ranking models. A common approach for candidate generation is to leverage approximate nearest neighbor (ANN) search from a single dense query embedding; however, this approach this can yield a low-diversity result set with many near duplicates. As users often have multiple interests, candidate retrieval should ideally return a diverse set of candidates reflective of the user's multiple interests. To this end, we introduce kNN-Embed, a general approach to improving diversity in dense ANN-based retrieval. kNN-Embed represents each user as a smoothed mixture over learned item clusters that represent distinct `interests' of the user. By querying each of a user's mixture component in proportion to their mixture weights, we retrieve a high-diversity set of candidates reflecting elements from each of a user's interests. We experimentally compare kNN-Embed to standard ANN candidate retrieval, and show significant improvements in overall recall and improved diversity across three datasets. Accompanying this work, we open source a large Twitter follow-graph dataset, to spur further research in graph-mining and representation learning for recommender systems.

  • 6 authors
·
May 12, 2022

Automatic assessment of text-based responses in post-secondary education: A systematic review

Text-based open-ended questions in academic formative and summative assessments help students become deep learners and prepare them to understand concepts for a subsequent conceptual assessment. However, grading text-based questions, especially in large courses, is tedious and time-consuming for instructors. Text processing models continue progressing with the rapid development of Artificial Intelligence (AI) tools and Natural Language Processing (NLP) algorithms. Especially after breakthroughs in Large Language Models (LLM), there is immense potential to automate rapid assessment and feedback of text-based responses in education. This systematic review adopts a scientific and reproducible literature search strategy based on the PRISMA process using explicit inclusion and exclusion criteria to study text-based automatic assessment systems in post-secondary education, screening 838 papers and synthesizing 93 studies. To understand how text-based automatic assessment systems have been developed and applied in education in recent years, three research questions are considered. All included studies are summarized and categorized according to a proposed comprehensive framework, including the input and output of the system, research motivation, and research outcomes, aiming to answer the research questions accordingly. Additionally, the typical studies of automated assessment systems, research methods, and application domains in these studies are investigated and summarized. This systematic review provides an overview of recent educational applications of text-based assessment systems for understanding the latest AI/NLP developments assisting in text-based assessments in higher education. Findings will particularly benefit researchers and educators incorporating LLMs such as ChatGPT into their educational activities.

  • 5 authors
·
Aug 30, 2023

Can Generalist Foundation Models Outcompete Special-Purpose Tuning? Case Study in Medicine

Generalist foundation models such as GPT-4 have displayed surprising capabilities in a wide variety of domains and tasks. Yet, there is a prevalent assumption that they cannot match specialist capabilities of fine-tuned models. For example, most explorations to date on medical competency benchmarks have leveraged domain-specific training, as exemplified by efforts on BioGPT and Med-PaLM. We build on a prior study of GPT-4's capabilities on medical challenge benchmarks in the absence of special training. Rather than using simple prompting to highlight the model's out-of-the-box capabilities, we perform a systematic exploration of prompt engineering. We find that prompting innovation can unlock deeper specialist capabilities and show that GPT-4 easily tops prior leading results for medical benchmarks. The prompting methods we explore are general purpose, and make no specific use of domain expertise, removing the need for expert-curated content. Our experimental design carefully controls for overfitting during the prompt engineering process. We introduce Medprompt, based on a composition of several prompting strategies. With Medprompt, GPT-4 achieves state-of-the-art results on all nine of the benchmark datasets in the MultiMedQA suite. The method outperforms leading specialist models such as Med-PaLM 2 by a significant margin with an order of magnitude fewer calls to the model. Steering GPT-4 with Medprompt achieves a 27% reduction in error rate on the MedQA dataset over the best methods to date achieved with specialist models and surpasses a score of 90% for the first time. Beyond medical problems, we show the power of Medprompt to generalize to other domains and provide evidence for the broad applicability of the approach via studies of the strategy on exams in electrical engineering, machine learning, philosophy, accounting, law, nursing, and clinical psychology.

  • 18 authors
·
Nov 27, 2023

MeSH Suggester: A Library and System for MeSH Term Suggestion for Systematic Review Boolean Query Construction

Boolean query construction is often critical for medical systematic review literature search. To create an effective Boolean query, systematic review researchers typically spend weeks coming up with effective query terms and combinations. One challenge to creating an effective systematic review Boolean query is the selection of effective MeSH Terms to include in the query. In our previous work, we created neural MeSH term suggestion methods and compared them to state-of-the-art MeSH term suggestion methods. We found neural MeSH term suggestion methods to be highly effective. In this demonstration, we build upon our previous work by creating (1) a Web-based MeSH term suggestion prototype system that allows users to obtain suggestions from a number of underlying methods and (2) a Python library that implements ours and others' MeSH term suggestion methods and that is aimed at researchers who want to further investigate, create or deploy such type of methods. We describe the architecture of the web-based system and how to use it for the MeSH term suggestion task. For the Python library, we describe how the library can be used for advancing further research and experimentation, and we validate the results of the methods contained in the library on standard datasets. Our web-based prototype system is available at http://ielab-mesh-suggest.uqcloud.net, while our Python library is at https://github.com/ielab/meshsuggestlib.

  • 3 authors
·
Dec 18, 2022

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

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

  • 2 authors
·
Sep 30, 2023

Toward a traceable, explainable, and fairJD/Resume recommendation system

In the last few decades, companies are interested to adopt an online automated recruitment process in an international recruitment environment. The problem is that the recruitment of employees through the manual procedure is a time and money consuming process. As a result, processing a significant number of applications through conventional methods can lead to the recruitment of clumsy individuals. Different JD/Resume matching model architectures have been proposed and reveal a high accuracy level in selecting relevant candidatesfor the required job positions. However, the development of an automatic recruitment system is still one of the main challenges. The reason is that the development of a fully automated recruitment system is a difficult task and poses different challenges. For example, providing a detailed matching explanation for the targeted stakeholders is needed to ensure a transparent recommendation. There are several knowledge bases that represent skills and competencies (e.g, ESCO, O*NET) that are used to identify the candidate and the required job skills for a matching purpose. Besides, modernpre-trained language models are fine-tuned for this context such as identifying lines where a specific feature was introduced. Typically, pre-trained language models use transfer-based machine learning models to be fine-tuned for a specific field. In this proposal, our aim is to explore how modern language models (based on transformers) can be combined with knowledge bases and ontologies to enhance the JD/Resume matching process. Our system aims at using knowledge bases and features to support the explainability of the JD/Resume matching. Finally, given that multiple software components, datasets, ontology, andmachine learning models will be explored, we aim at proposing a fair, ex-plainable, and traceable architecture for a Resume/JD matching purpose.

  • 3 authors
·
Feb 2, 2022

Multiple Choice Questions: Reasoning Makes Large Language Models (LLMs) More Self-Confident Even When They Are Wrong

One of the most widely used methods to evaluate LLMs are Multiple Choice Question (MCQ) tests. MCQ benchmarks enable the testing of LLM knowledge on almost any topic at scale as the results can be processed automatically. To help the LLM answer, a few examples called few shots can be included in the prompt. Moreover, the LLM can be asked to answer the question directly with the selected option or to first provide the reasoning and then the selected answer, which is known as chain of thought. In addition to checking whether the selected answer is correct, the evaluation can look at the LLM-estimated probability of its response as an indication of the confidence of the LLM in the response. In this paper, we study how the LLM confidence in its answer depends on whether the model has been asked to answer directly or to provide the reasoning before answering. The results of the evaluation of questions on a wide range of topics in seven different models show that LLMs are more confident in their answers when they provide reasoning before the answer. This occurs regardless of whether the selected answer is correct. Our hypothesis is that this behavior is due to the reasoning that modifies the probability of the selected answer, as the LLM predicts the answer based on the input question and the reasoning that supports the selection made. Therefore, LLM estimated probabilities seem to have intrinsic limitations that should be understood in order to use them in evaluation procedures. Interestingly, the same behavior has been observed in humans, for whom explaining an answer increases confidence in its correctness.

  • 5 authors
·
Jan 16 2

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

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

  • 3 authors
·
Apr 8, 2024

Towards Expert-Level Medical Question Answering with Large Language Models

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

  • 31 authors
·
May 16, 2023 2

Multi-view-guided Passage Reranking with Large Language Models

Recent advances in large language models (LLMs) have shown impressive performance in passage reranking tasks. Despite their success, LLM-based methods still face challenges in efficiency and sensitivity to external biases. (1) Existing models rely mostly on autoregressive generation and sliding window strategies to rank passages, which incur heavy computational overhead as the number of passages increases. (2) External biases, such as position or selection bias, hinder the model's ability to accurately represent passages and increase input-order sensitivity. To address these limitations, we introduce a novel passage reranking model, called Multi-View-guided Passage Reranking (MVP). MVP is a non-generative LLM-based reranking method that encodes query-passage information into diverse view embeddings without being influenced by external biases. For each view, it combines query-aware passage embeddings to produce a distinct anchor vector, which is then used to directly compute relevance scores in a single decoding step. In addition, it employs an orthogonal loss to make the views more distinctive. Extensive experiments demonstrate that MVP, with just 220M parameters, matches the performance of much larger 7B-scale fine-tuned models while achieving a 100x reduction in inference latency. Notably, the 3B-parameter variant of MVP achieves state-of-the-art performance on both in-domain and out-of-domain benchmarks. The source code is available at: https://github.com/bulbna/MVP

  • 4 authors
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Sep 9