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.

The results show that GPT -4 had the best accuracy of 61.6% and a weighted F1

Large Language Models (LLMs) have demonstrated exceptional capabilities across diverse natural language processing (NLP) tasks. The release of open-source LLMs like LLaMA and Qwen has triggered the development of numerous fine-tuned models tailored for various tasks and languages. In this paper, we explore an important question: is it possible to combine these specialized models to create a unified model with multi-task capabilities. We introduces Hierarchical Iterative Merging (Hi-Merging), a training-free method for unifying different specialized LLMs into a single model. Specifically, Hi-Merging employs model-wise and layer-wise pruning and scaling, guided by contribution analysis, to mitigate parameter conflicts. Extensive experiments on multiple-choice and question-answering tasks in both Chinese and English validate Hi-Merging's ability for multi-task learning. The results demonstrate that Hi-Merging consistently outperforms existing merging techniques and surpasses the performance of models fine-tuned on combined datasets in most scenarios. Code is available at: https://github.com/Applied-Machine-Learning-Lab/Hi-Merging.

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.

Clinical reasoning refers to the cognitive process that physicians employ in evaluating and managing patients. This process typically involves suggesting necessary examinations, diagnosing patients' diseases, and deciding on appropriate therapies, etc. Accurate clinical reasoning requires extensive medical knowledge and rich clinical experience, setting a high bar for physicians. This is particularly challenging in developing countries due to the overwhelming number of patients and limited physician resources, contributing significantly to global health inequity and necessitating automated clinical reasoning approaches. Recently, the emergence of large language models (LLMs) such as ChatGPT and GPT-4 have demonstrated their potential in clinical reasoning. However, these LLMs are prone to hallucination problems, and the reasoning process of LLMs may not align with the clinical decision path of physicians. In this study, we introduce a novel framework, In-Context Padding (ICP), designed to enhance LLMs with medical knowledge. Specifically, we infer critical clinical reasoning elements (referred to as knowledge seeds) and use these as anchors to guide the generation process of LLMs. Experiments on two clinical question datasets demonstrate that ICP significantly improves the clinical reasoning ability of LLMs.

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.

Integrating large language models (LLMs) into healthcare presents potential but faces challenges. Directly pre-training LLMs for domains like medicine is resource-heavy and sometimes unfeasible. Sole reliance on Supervised Fine-tuning (SFT) can result in overconfident predictions and may not tap into domain specific insights. Addressing these challenges, we present a multi-stage training method combining Domain-specific Continued Pre-training (DCPT), SFT, and Direct Preference Optimization (DPO). A notable contribution of our study is the introduction of a 3Gb Chinese Medicine (ChiMed) dataset, encompassing medical question answering, plain texts, knowledge graphs, and dialogues, segmented into three training stages. The medical LLM trained with our pipeline, Qilin-Med, exhibits significant performance boosts. In the CPT and SFT phases, it achieves 38.4% and 40.0% accuracy on the CMExam, surpassing Baichuan-7B's 33.5%. In the DPO phase, on the Huatuo-26M test set, it scores 16.66 in BLEU-1 and 27.44 in ROUGE1, outperforming the SFT's 12.69 and 24.21. This highlights the strength of our training approach in refining LLMs for medical applications.