clinical note
A teacher-teacher framework for clinical language representation learning
In recent years, there has been a proliferation of ready-to-use large language models (LLMs) designed for various applications, both general-purpose and domain-specific. Instead of advocating for the development of a new model or continuous pretraining of an existing one, this paper introduces a pragmatic teacher-teacher framework to facilitate mutual learning between two pre-existing models.By leveraging two teacher models possessing complementary knowledge, we introduce a LIghtweight kNowledge alignmEnt (LINE) module aimed at harmonizing their knowledge within a unified representation space. This framework is particularly valuable in clinical settings, where stringent regulations and privacy considerations dictate the handling of detailed clinical notes. Our trained LINE module excels in capturing critical information from clinical notes, leveraging highly de-identified data. Validation and downstream tasks further demonstrate the effectiveness of the proposed framework.
EHRCon: Dataset for Checking Consistency between Unstructured Notes and Structured Tables in Electronic Health Records
Electronic Health Records (EHRs) are integral for storing comprehensive patient medical records, combining structured data (e.g., medications) with detailed clinical notes (e.g., physician notes). These elements are essential for straightforward data retrieval and provide deep, contextual insights into patient care. However, they often suffer from discrepancies due to unintuitive EHR system designs and human errors, posing serious risks to patient safety. To address this, we developed EHRCon, a new dataset and task specifically designed to ensure data consistency between structured tables and unstructured notes in EHRs.EHRCon was crafted in collaboration with healthcare professionals using the MIMIC-III EHR dataset, and includes manual annotations of 3,943 entities across 105 clinical notes checked against database entries for consistency.EHRCon has two versions, one using the original MIMIC-III schema, and another using the OMOP CDM schema, in order to increase its applicability and generalizability. Furthermore, leveraging the capabilities of large language models, we introduce CheckEHR, a novel framework for verifying the consistency between clinical notes and database tables.
DiReCT: Diagnostic Reasoning for Clinical Notes via Large Language Models
Large language models (LLMs) have recently showcased remarkable capabilities, spanning a wide range of tasks and applications, including those in the medical domain. Models like GPT-4 excel in medical question answering but may face challenges in the lack of interpretability when handling complex tasks in real clinical settings. We thus introduce the diagnostic reasoning dataset for clinical notes (DiReCT), aiming at evaluating the reasoning ability and interpretability of LLMs compared to human doctors. It contains 511 clinical notes, each meticulously annotated by physicians, detailing the diagnostic reasoning process from observations in a clinical note to the final diagnosis. Additionally, a diagnostic knowledge graph is provided to offer essential knowledge for reasoning, which may not be covered in the training data of existing LLMs. Evaluations of leading LLMs on DiReCT bring out a significant gap between their reasoning ability and that of human doctors, highlighting the critical need for models that can reason effectively in real-world clinical scenarios.
FuseMoE: Mixture-of-Experts Transformers for Fleximodal Fusion
As machine learning models in critical fields increasingly grapple with multi-modal data, they face the dual challenges of handling a wide array of modalities, often incomplete due to missing elements, and the temporal irregularity and sparsity of collected samples. Successfully leveraging this complex data, while overcoming the scarcity of high-quality training samples, is key to improving these models' predictive performance. We introduce "FuseMoE", a mixture-of-experts framework incorporated with an innovative gating function. Designed to integrate a diverse number of modalities, FuseMoE is effective in managing scenarios with missing modalities and irregularly sampled data trajectories. Theoretically, our unique gating function contributes to enhanced convergence rates, leading to better performance in multiple downstream tasks. The practical utility of FuseMoE in the real world is validated by a diverse set of challenging prediction tasks.