Large Language Models (LLMs) such as GPT & Llama have demonstrated significant achievements in summarization tasks but struggle with factual inaccuracies, a critical issue in clinical NLP applications where errors could lead to serious consequences. To counter the high costs and limited availability of expert-annotated data for factual alignment, this study introduces an innovative pipeline that utilizes >100B parameter GPT variants like GPT-3.5 & GPT-4 to act as synthetic experts to generate high-quality synthetics feedback aimed at enhancing factual consistency in clinical note summarization. Our research primarily focuses on edit feedback generated by these synthetic feedback experts without additional human annotations, mirroring and optimizing the practical scenario in which medical professionals refine AI system outputs. Although such 100B+ parameter GPT variants have proven to demonstrate expertise in various clinical NLP tasks, such as the Medical Licensing Examination, there is scant research on their capacity to act as synthetic feedback experts and deliver expert-level edit feedback for improving the generation quality of weaker (<10B parameter) LLMs like GPT-2 (1.5B) & Llama 2 (7B) in clinical domain. So in this work, we leverage 100B+ GPT variants to act as synthetic feedback experts offering expert-level edit feedback, that is used to reduce hallucinations and align weaker (<10B parameter) LLMs with medical facts using two distinct alignment algorithms (DPO & SALT), endeavoring to narrow the divide between AI-generated content and factual accuracy. This highlights the substantial potential of LLM-based synthetic edits in enhancing the alignment of clinical factuality.

This study examines the effect of prompt engineering on the performance of Large Language Models (LLMs) in clinical note generation. We introduce an Automatic Prompt Optimization (APO) framework to refine initial prompts and compare the outputs of medical experts, non-medical experts, and APO-enhanced GPT3.5 and GPT4. Results highlight GPT4 APO's superior performance in standardizing prompt quality across clinical note sections. A human-in-the-loop approach shows that experts maintain content quality post-APO, with a preference for their own modifications, suggesting the value of expert customization. We recommend a two-phase optimization process, leveraging APO-GPT4 for consistency and expert input for personalization.

Large Language Models (LLMs) like the GPT and LLaMA families have demonstrated exceptional capabilities in capturing and condensing critical contextual information and achieving state-of-the-art performance in the summarization task. However, community concerns about these models' hallucination issues continue to rise. LLMs sometimes generate factually hallucinated summaries, which can be extremely harmful in the clinical domain NLP tasks (e.g., clinical note summarization), where factually incorrect statements can lead to critically erroneous diagnoses. Fine-tuning LLMs using human feedback has shown the promise of aligning LLMs to be factually consistent during generation, but such training procedure requires high-quality human-annotated data, which can be extremely expensive to get in the clinical domain. In this work, we propose a new pipeline using ChatGPT instead of human experts to generate high-quality feedback data for improving factual consistency in the clinical note summarization task. We focus specifically on edit feedback because recent work discusses the shortcomings of human alignment via preference feedback in complex situations (such as clinical NLP tasks that require extensive expert knowledge), as well as some advantages of collecting edit feedback from domain experts. In addition, although GPT has reached the expert level in many clinical NLP tasks (e.g., USMLE QA), there is not much previous work discussing whether GPT can generate expert-level edit feedback for LMs in the clinical note summarization task. We hope to fill this gap. Finally, our evaluations demonstrate the potential use of GPT edits in human alignment, especially from a factuality perspective.