Health AI Developer Foundations

Robust medical Machine Learning (ML) models have the potential to revolutionize healthcare by accelerating clinical research, improving workflows and outcomes, and producing novel insights or capabilities. Developing such ML models from scratch is cost prohibitive and requires substantial compute, data, and time (e.g., expert labeling). To address these challenges, we introduce Health AI Developer Foundations (HAI-DEF), a suite of pre-trained, domain-specific foundation models, tools, and recipes to accelerate building ML for health applications. The models cover various modalities and domains, including radiology (X-rays and computed tomography), histopathology, dermatological imaging, and audio. These models provide domain specific embeddings that facilitate AI development with less labeled data, shorter training times, and reduced computational costs compared to traditional approaches. In addition, we utilize a common interface and style across these models, and prioritize usability to enable developers to integrate HAI-DEF efficiently. We present model evaluations across various tasks and conclude with a discussion of their application and evaluation, covering the importance of ensuring efficacy, fairness, and equity. Finally, while HAI-DEF and specifically the foundation models lower the barrier to entry for ML in healthcare, we emphasize the importance of validation with problem- and population-specific data for each desired usage setting. This technical report will be updated over time as more modalities and features are added.

Can Few-shot Work in Long-Context? Recycling the Context to Generate Demonstrations

Despite recent advancements in Large Language Models (LLMs), their performance on tasks involving long contexts remains sub-optimal. In-Context Learning (ICL) with few-shot examples may be an appealing solution to enhance LLM performance in this scenario; However, naively adding ICL examples with long context introduces challenges, including substantial token overhead added for each few-shot example and context mismatch between the demonstrations and the target query. In this work, we propose to automatically generate few-shot examples for long context QA tasks by recycling contexts. Specifically, given a long input context (1-3k tokens) and a query, we generate additional query-output pairs from the given context as few-shot examples, while introducing the context only once. This ensures that the demonstrations are leveraging the same context as the target query while only adding a small number of tokens to the prompt. We further enhance each demonstration by instructing the model to explicitly identify the relevant paragraphs before the answer, which improves performance while providing fine-grained attribution to the answer source. We apply our method on multiple LLMs and obtain substantial improvements on various QA datasets with long context, especially when the answer lies within the middle of the context. Surprisingly, despite introducing only single-hop ICL examples, LLMs also successfully generalize to multi-hop long-context QA using our approach.

Multi-turn Reinforcement Learning from Preference Human Feedback

Reinforcement Learning from Human Feedback (RLHF) has become the standard approach for aligning Large Language Models (LLMs) with human preferences, allowing LLMs to demonstrate remarkable abilities in various tasks. Existing methods work by emulating the preferences at the single decision (turn) level, limiting their capabilities in settings that require planning or multi-turn interactions to achieve a long-term goal. In this paper, we address this issue by developing novel methods for Reinforcement Learning (RL) from preference feedback between two full multi-turn conversations. In the tabular setting, we present a novel mirror-descent-based policy optimization algorithm for the general multi-turn preference-based RL problem, and prove its convergence to Nash equilibrium. To evaluate performance, we create a new environment, Education Dialogue, where a teacher agent guides a student in learning a random topic, and show that a deep RL variant of our algorithm outperforms RLHF baselines. Finally, we show that in an environment with explicit rewards, our algorithm recovers the same performance as a reward-based RL baseline, despite relying solely on a weaker preference signal.

The Temporal Structure of Language Processing in the Human Brain Corresponds to The Layered Hierarchy of Deep Language Models

Deep Language Models (DLMs) provide a novel computational paradigm for understanding the mechanisms of natural language processing in the human brain. Unlike traditional psycholinguistic models, DLMs use layered sequences of continuous numerical vectors to represent words and context, allowing a plethora of emerging applications such as human-like text generation. In this paper we show evidence that the layered hierarchy of DLMs may be used to model the temporal dynamics of language comprehension in the brain by demonstrating a strong correlation between DLM layer depth and the time at which layers are most predictive of the human brain. Our ability to temporally resolve individual layers benefits from our use of electrocorticography (ECoG) data, which has a much higher temporal resolution than noninvasive methods like fMRI. Using ECoG, we record neural activity from participants listening to a 30-minute narrative while also feeding the same narrative to a high-performing DLM (GPT2-XL). We then extract contextual embeddings from the different layers of the DLM and use linear encoding models to predict neural activity. We first focus on the Inferior Frontal Gyrus (IFG, or Broca's area) and then extend our model to track the increasing temporal receptive window along the linguistic processing hierarchy from auditory to syntactic and semantic areas. Our results reveal a connection between human language processing and DLMs, with the DLM's layer-by-layer accumulation of contextual information mirroring the timing of neural activity in high-order language areas.

AI Increases Global Access to Reliable Flood Forecasts

Floods are one of the most common and impactful natural disasters, with a disproportionate impact in developing countries that often lack dense streamflow monitoring networks. Accurate and timely warnings are critical for mitigating flood risks, but accurate hydrological simulation models typically must be calibrated to long data records in each watershed where they are applied. We developed an Artificial Intelligence (AI) model to predict extreme hydrological events at timescales up to 7 days in advance. This model significantly outperforms current state of the art global hydrology models (the Copernicus Emergency Management Service Global Flood Awareness System) across all continents, lead times, and return periods. AI is especially effective at forecasting in ungauged basins, which is important because only a few percent of the world's watersheds have stream gauges, with a disproportionate number of ungauged basins in developing countries that are especially vulnerable to the human impacts of flooding. We produce forecasts of extreme events in South America and Africa that achieve reliability approaching the current state of the art in Europe and North America, and we achieve reliability at between 4 and 6-day lead times that are similar to current state of the art nowcasts (0-day lead time). Additionally, we achieve accuracies over 10-year return period events that are similar to current accuracies over 2-year return period events, meaning that AI can provide warnings earlier and over larger and more impactful events. The model that we develop in this paper has been incorporated into an operational early warning system that produces publicly available (free and open) forecasts in real time in over 80 countries. This work using AI and open data highlights a need for increasing the availability of hydrological data to continue to improve global access to reliable flood warnings.

Using generative AI to investigate medical imagery models and datasets

AI models have shown promise in many medical imaging tasks. However, our ability to explain what signals these models have learned is severely lacking. Explanations are needed in order to increase the trust in AI-based models, and could enable novel scientific discovery by uncovering signals in the data that are not yet known to experts. In this paper, we present a method for automatic visual explanations leveraging team-based expertise by generating hypotheses of what visual signals in the images are correlated with the task. We propose the following 4 steps: (i) Train a classifier to perform a given task (ii) Train a classifier guided StyleGAN-based image generator (StylEx) (iii) Automatically detect and visualize the top visual attributes that the classifier is sensitive towards (iv) Formulate hypotheses for the underlying mechanisms, to stimulate future research. Specifically, we present the discovered attributes to an interdisciplinary panel of experts so that hypotheses can account for social and structural determinants of health. We demonstrate results on eight prediction tasks across three medical imaging modalities: retinal fundus photographs, external eye photographs, and chest radiographs. We showcase examples of attributes that capture clinically known features, confounders that arise from factors beyond physiological mechanisms, and reveal a number of physiologically plausible novel attributes. Our approach has the potential to enable researchers to better understand, improve their assessment, and extract new knowledge from AI-based models. Importantly, we highlight that attributes generated by our framework can capture phenomena beyond physiology or pathophysiology, reflecting the real world nature of healthcare delivery and socio-cultural factors. Finally, we intend to release code to enable researchers to train their own StylEx models and analyze their predictive tasks.

Factually Consistent Summarization via Reinforcement Learning with Textual Entailment Feedback

Despite the seeming success of contemporary grounded text generation systems, they often tend to generate factually inconsistent text with respect to their input. This phenomenon is emphasized in tasks like summarization, in which the generated summaries should be corroborated by their source article. In this work, we leverage recent progress on textual entailment models to directly address this problem for abstractive summarization systems. We use reinforcement learning with reference-free, textual entailment rewards to optimize for factual consistency and explore the ensuing trade-offs, as improved consistency may come at the cost of less informative or more extractive summaries. Our results, according to both automatic metrics and human evaluation, show that our method considerably improves the faithfulness, salience, and conciseness of the generated summaries.

Dynamic Planning in Open-Ended Dialogue using Reinforcement Learning

Despite recent advances in natural language understanding and generation, and decades of research on the development of conversational bots, building automated agents that can carry on rich open-ended conversations with humans "in the wild" remains a formidable challenge. In this work we develop a real-time, open-ended dialogue system that uses reinforcement learning (RL) to power a bot's conversational skill at scale. Our work pairs the succinct embedding of the conversation state generated using SOTA (supervised) language models with RL techniques that are particularly suited to a dynamic action space that changes as the conversation progresses. Trained using crowd-sourced data, our novel system is able to substantially exceeds the (strong) baseline supervised model with respect to several metrics of interest in a live experiment with real users of the Google Assistant.

TRUE: Re-evaluating Factual Consistency Evaluation

Grounded text generation systems often generate text that contains factual inconsistencies, hindering their real-world applicability. Automatic factual consistency evaluation may help alleviate this limitation by accelerating evaluation cycles, filtering inconsistent outputs and augmenting training data. While attracting increasing attention, such evaluation metrics are usually developed and evaluated in silo for a single task or dataset, slowing their adoption. Moreover, previous meta-evaluation protocols focused on system-level correlations with human annotations, which leave the example-level accuracy of such metrics unclear. In this work, we introduce TRUE: a comprehensive study of factual consistency metrics on a standardized collection of existing texts from diverse tasks, manually annotated for factual consistency. Our standardization enables an example-level meta-evaluation protocol that is more actionable and interpretable than previously reported correlations, yielding clearer quality measures. Across diverse state-of-the-art metrics and 11 datasets we find that large-scale NLI and question generation-and-answering-based approaches achieve strong and complementary results. We recommend those methods as a starting point for model and metric developers, and hope TRUE will foster progress towards even better methods.

Flood forecasting with machine learning models in an operational framework

The operational flood forecasting system by Google was developed to provide accurate real-time flood warnings to agencies and the public, with a focus on riverine floods in large, gauged rivers. It became operational in 2018 and has since expanded geographically. This forecasting system consists of four subsystems: data validation, stage forecasting, inundation modeling, and alert distribution. Machine learning is used for two of the subsystems. Stage forecasting is modeled with the Long Short-Term Memory (LSTM) networks and the Linear models. Flood inundation is computed with the Thresholding and the Manifold models, where the former computes inundation extent and the latter computes both inundation extent and depth. The Manifold model, presented here for the first time, provides a machine-learning alternative to hydraulic modeling of flood inundation. When evaluated on historical data, all models achieve sufficiently high-performance metrics for operational use. The LSTM showed higher skills than the Linear model, while the Thresholding and Manifold models achieved similar performance metrics for modeling inundation extent. During the 2021 monsoon season, the flood warning system was operational in India and Bangladesh, covering flood-prone regions around rivers with a total area of 287,000 km2, home to more than 350M people. More than 100M flood alerts were sent to affected populations, to relevant authorities, and to emergency organizations. Current and future work on the system includes extending coverage to additional flood-prone locations, as well as improving modeling capabilities and accuracy.