Recent advancements in Retrieval-Augmented Language Models (RALMs) have demonstrated their efficacy in knowledge-intensive tasks. However, existing evaluation benchmarks often assume a single optimal approach to leveraging retrieved information, failing to account for varying user needs. This paper introduces a novel evaluation framework that systematically assesses RALMs under three user need cases-Context-Exclusive, Context-First, and Memory-First-across three distinct context settings: Context Matching, Knowledge Conflict, and Information Irrelevant. By varying both user instructions and the nature of retrieved information, our approach captures the complexities of real-world applications where models must adapt to diverse user requirements. Through extensive experiments on multiple QA datasets, including HotpotQA, DisentQA, and our newly constructed synthetic URAQ dataset, we find that restricting memory usage improves robustness in adversarial retrieval conditions but decreases peak performance with ideal retrieval results and model family dominates behavioral differences. Our findings highlight the necessity of user-centric evaluations in the development of retrieval-augmented systems and provide insights into optimizing model performance across varied retrieval contexts. We will release our code and URAQ dataset upon acceptance of the paper.

There is a significant gap between patient needs and available mental health support today. In this paper, we aim to thoroughly examine the potential of using Large Language Models (LLMs) to assist professional psychotherapy. To this end, we propose a new benchmark, CBT-BENCH, for the systematic evaluation of cognitive behavioral therapy (CBT) assistance. We include three levels of tasks in CBT-BENCH: I: Basic CBT knowledge acquisition, with the task of multiple-choice questions; II: Cognitive model understanding, with the tasks of cognitive distortion classification, primary core belief classification, and fine-grained core belief classification; III: Therapeutic response generation, with the task of generating responses to patient speech in CBT therapy sessions. These tasks encompass key aspects of CBT that could potentially be enhanced through AI assistance, while also outlining a hierarchy of capability requirements, ranging from basic knowledge recitation to engaging in real therapeutic conversations. We evaluated representative LLMs on our benchmark. Experimental results indicate that while LLMs perform well in reciting CBT knowledge, they fall short in complex real-world scenarios requiring deep analysis of patients' cognitive structures and generating effective responses, suggesting potential future work.

Instruction Fine-Tuning (IFT) significantly enhances the zero-shot capabilities of pretrained Large Language Models (LLMs). While coding data is known to boost reasoning abilities during LLM pretraining, its role in activating internal reasoning capacities during IFT remains understudied. This paper investigates a key question: How does coding data impact LLMs' reasoning capacities during the IFT stage? To explore this, we thoroughly examine the impact of coding data across different coding data proportions, model families, sizes, and reasoning domains, from various perspectives. Specifically, we create three IFT datasets with increasing coding data proportions, fine-tune six LLM backbones across different families and scales on these datasets, evaluate the tuned models' performance across twelve tasks in three reasoning domains, and analyze the outcomes from three broad-to-granular perspectives: overall, domain-level, and task-specific. Our holistic analysis provides valuable insights in each perspective. First, coding data tuning enhances the overall reasoning capabilities of LLMs across different model families and scales. Moreover, the effect of coding data varies among different domains but shows consistent trends across model families and scales within each domain. Additionally, coding data generally yields comparable task-specific benefits across different model families, with the optimal coding data proportions in IFT datasets being task-specific.

Automatically evaluating vision-language tasks is challenging, especially when it comes to reflecting human judgments due to limitations in accounting for fine-grained details. Although GPT-4V has shown promising results in various multi-modal tasks, leveraging GPT-4V as a generalist evaluator for these tasks has not yet been systematically explored. We comprehensively validate GPT-4V's capabilities for evaluation purposes, addressing tasks ranging from foundational image-to-text and text-to-image synthesis to high-level image-to-image translations and multi-images to text alignment. We employ two evaluation methods, single-answer grading and pairwise comparison, using GPT-4V. Notably, GPT-4V shows promising agreement with humans across various tasks and evaluation methods, demonstrating immense potential for multi-modal LLMs as evaluators. Despite limitations like restricted visual clarity grading and real-world complex reasoning, its ability to provide human-aligned scores enriched with detailed explanations is promising for universal automatic evaluator.

Large Language Models (LLMs) have demonstrated significant enhancements in instruction-following abilities through instruction tuning, achieving notable performances across various tasks. Previous research has focused on fine-tuning medical domain-specific LLMs using an extensive array of medical-specific data, incorporating millions of pieces of biomedical literature to augment their medical capabilities. However, existing medical instruction-tuned LLMs have been constrained by the limited scope of tasks and instructions available, restricting the efficacy of instruction tuning and adversely affecting performance in the general domain. In this paper, we fine-tune LLaMA-series models using 52k diverse, machine-generated, medical instruction-following data, MedInstruct-52k, resulting in the model AlpaCare. Comprehensive experimental results on both general and medical-specific domain free-form instruction evaluations showcase AlpaCare's strong medical proficiency and generalizability compared to previous instruction-tuned models in both medical and general domains. We provide public access to our MedInstruct-52k dataset and a clinician-crafted free-form instruction test set, MedInstruct-test, along with our codebase, to foster further research and development. Our project page is available at https://github.com/XZhang97666/AlpaCare.

Health conditions among patients in intensive care units (ICUs) are monitored via electronic health records (EHRs), composed of numerical time series and lengthy clinical note sequences, both taken at irregular time intervals. Dealing with such irregularity in every modality, and integrating irregularity into multimodal representations to improve medical predictions, is a challenging problem. Our method first addresses irregularity in each single modality by (1) modeling irregular time series by dynamically incorporating hand-crafted imputation embeddings into learned interpolation embeddings via a gating mechanism, and (2) casting a series of clinical note representations as multivariate irregular time series and tackling irregularity via a time attention mechanism. We further integrate irregularity in multimodal fusion with an interleaved attention mechanism across temporal steps. To the best of our knowledge, this is the first work to thoroughly model irregularity in multimodalities for improving medical predictions. Our proposed methods for two medical prediction tasks consistently outperforms state-of-the-art (SOTA) baselines in each single modality and multimodal fusion scenarios. Specifically, we observe relative improvements of 6.5\%, 3.6\%, and 4.3\% in F1 for time series, clinical notes, and multimodal fusion, respectively. These results demonstrate the effectiveness of our methods and the importance of considering irregularity in multimodal EHRs.

Large language models (LLMs) demonstrate remarkable medical expertise, but data privacy concerns impede their direct use in healthcare environments. Although offering improved data privacy protection, domain-specific small language models (SLMs) often underperform LLMs, emphasizing the need for methods that reduce this performance gap while alleviating privacy concerns. In this paper, we present a simple yet effective method that harnesses LLMs' medical proficiency to boost SLM performance in medical tasks under privacy-restricted scenarios. Specifically, we mitigate patient privacy issues by extracting keywords from medical data and prompting the LLM to generate a medical knowledge-intensive context by simulating clinicians' thought processes. This context serves as additional input for SLMs, augmenting their decision-making capabilities. Our method significantly enhances performance in both few-shot and full training settings across three medical knowledge-intensive tasks, achieving up to a 22.57% increase in absolute accuracy compared to SLM fine-tuning without context, and sets new state-of-the-art results in two medical tasks within privacy-restricted scenarios. Further out-of-domain testing and experiments in two general domain datasets showcase its generalizability and broad applicability.

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

Survival analysis is a technique to predict the times of specific outcomes, and is widely used in predicting the outcomes for intensive care unit (ICU) trauma patients. Recently, deep learning models have drawn increasing attention in healthcare. However, there is a lack of deep learning methods that can model the relationship between measurements, clinical notes and mortality outcomes. In this paper we introduce BERTSurv, a deep learning survival framework which applies Bidirectional Encoder Representations from Transformers (BERT) as a language representation model on unstructured clinical notes, for mortality prediction and survival analysis. We also incorporate clinical measurements in BERTSurv. With binary cross-entropy (BCE) loss, BERTSurv can predict mortality as a binary outcome (mortality prediction). With partial log-likelihood (PLL) loss, BERTSurv predicts the probability of mortality as a time-to-event outcome (survival analysis). We apply BERTSurv on Medical Information Mart for Intensive Care III (MIMIC III) trauma patient data. For mortality prediction, BERTSurv obtained an area under the curve of receiver operating characteristic curve (AUC-ROC) of 0.86, which is an improvement of 3.6% over baseline of multilayer perceptron (MLP) without notes. For survival analysis, BERTSurv achieved a concordance index (C-index) of 0.7. In addition, visualizations of BERT's attention heads help to extract patterns in clinical notes and improve model interpretability by showing how the model assigns weights to different inputs.