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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. CheckEHR utilizes an eight-stage process and shows promising results in both few-shot and zero-shot settings.
Schema-learning and rebinding as mechanisms of in-context learning and emergence
In-context learning (ICL) is one of the most powerful and most unexpected capabilities to emerge in recent transformer-based large language models (LLMs). Yet the mechanisms that underlie it are poorly understood. In this paper, we demonstrate that comparable ICL capabilities can be acquired by an alternative sequence prediction learning method using clone-structured causal graphs (CSCGs). Moreover, a key property of CSCGs is that, unlike transformer-based LLMs, they are {\em interpretable}, which considerably simplifies the task of explaining how ICL works. Specifically, we show that it uses a combination of (a) learning template (schema) circuits for pattern completion, (b) retrieving relevant templates in a context-sensitive manner, and (c) rebinding of novel tokens to appropriate slots in the templates. We go on to marshall evidence for the hypothesis that similar mechanisms underlie ICL in LLMs. For example, we find that, with CSCGs as with LLMs, different capabilities emerge at different levels of overparameterization, suggesting that overparameterization helps in learning more complex template (schema) circuits. By showing how ICL can be achieved with small models and datasets, we open up a path to novel architectures, and take a vital step towards a more general understanding of the mechanics behind this important capability.