Accelerating Clinical Evidence Synthesis with Large Language Models

Automatic medical discovery by AI is a dream of many. One step toward that goal is to create an AI model to understand clinical studies and synthesize clinical evidence from the literature. Clinical evidence synthesis currently relies on systematic reviews of clinical trials and retrospective analyses from medical literature. However, the rapid expansion of publications presents challenges in efficiently identifying, summarizing, and updating evidence. We introduce TrialMind, a generative AI-based pipeline for conducting medical systematic reviews, encompassing study search, screening, and data extraction phases. We utilize large language models (LLMs) to drive each pipeline component while incorporating human expert oversight to minimize errors. To facilitate evaluation, we also create a benchmark dataset TrialReviewBench, a custom dataset with 870 annotated clinical studies from 25 meta-analysis papers across various medical treatments. Our results demonstrate that TrialMind significantly improves the literature review process, achieving high recall rates (0.897-1.000) in study searching from over 20 million PubMed studies and outperforming traditional language model embeddings-based methods in screening (Recall@20 of 0.227-0.246 vs. 0.000-0.102). Furthermore, our approach surpasses direct GPT-4 performance in result extraction, with accuracy ranging from 0.65 to 0.84. We also support clinical evidence synthesis in forest plots, as validated by eight human annotators who preferred TrialMind over the GPT-4 baseline with a winning rate of 62.5%-100% across the involved reviews. Our findings suggest that an LLM-based clinical evidence synthesis approach, such as TrialMind, can enable reliable and high-quality clinical evidence synthesis to improve clinical research efficiency.

KG-FIT: Knowledge Graph Fine-Tuning Upon Open-World Knowledge

Knowledge Graph Embedding (KGE) techniques are crucial in learning compact representations of entities and relations within a knowledge graph, facilitating efficient reasoning and knowledge discovery. While existing methods typically focus either on training KGE models solely based on graph structure or fine-tuning pre-trained language models with classification data in KG, KG-FIT leverages LLM-guided refinement to construct a semantically coherent hierarchical structure of entity clusters. By incorporating this hierarchical knowledge along with textual information during the fine-tuning process, KG-FIT effectively captures both global semantics from the LLM and local semantics from the KG. Extensive experiments on the benchmark datasets FB15K-237, YAGO3-10, and PrimeKG demonstrate the superiority of KG-FIT over state-of-the-art pre-trained language model-based methods, achieving improvements of 14.4%, 13.5%, and 11.9% in the Hits@10 metric for the link prediction task, respectively. Furthermore, KG-FIT yields substantial performance gains of 12.6%, 6.7%, and 17.7% compared to the structure-based base models upon which it is built. These results highlight the effectiveness of KG-FIT in incorporating open-world knowledge from LLMs to significantly enhance the expressiveness and informativeness of KG embeddings.

AutoRD: An Automatic and End-to-End System for Rare Disease Knowledge Graph Construction Based on Ontologies-enhanced Large Language Models

Objectives: Our objective is to create an end-to-end system called AutoRD, which automates extracting information from clinical text about rare diseases. We have conducted various tests to evaluate the performance of AutoRD and highlighted its strengths and limitations in this paper. Materials and Methods: Our system, AutoRD, is a software pipeline involving data preprocessing, entity extraction, relation extraction, entity calibration, and knowledge graph construction. We implement this using large language models and medical knowledge graphs developed from open-source medical ontologies. We quantitatively evaluate our system on entity extraction, relation extraction, and the performance of knowledge graph construction. Results: AutoRD achieves an overall F1 score of 47.3%, a 14.4% improvement compared to the base LLM. In detail, AutoRD achieves an overall entity extraction F1 score of 56.1% (rare_disease: 83.5%, disease: 35.8%, symptom_and_sign: 46.1%, anaphor: 67.5%) and an overall relation extraction F1 score of 38.6% (produces: 34.7%, increases_risk_of: 12.4%, is_a: 37.4%, is_acronym: 44.1%, is_synonym: 16.3%, anaphora: 57.5%). Our qualitative experiment also demonstrates that the performance in constructing the knowledge graph is commendable. Discussion: AutoRD demonstrates the potential of LLM applications in rare disease detection. This improvement is attributed to several design, including the integration of ontologies-enhanced LLMs. Conclusion: AutoRD is an automated end-to-end system for extracting rare disease information from text to build knowledge graphs. It uses ontologies-enhanced LLMs for a robust medical knowledge base. The superior performance of AutoRD is validated by experimental evaluations, demonstrating the potential of LLMs in healthcare.

PILOT: Legal Case Outcome Prediction with Case Law

Machine learning shows promise in predicting the outcome of legal cases, but most research has concentrated on civil law cases rather than case law systems. We identified two unique challenges in making legal case outcome predictions with case law. First, it is crucial to identify relevant precedent cases that serve as fundamental evidence for judges during decision-making. Second, it is necessary to consider the evolution of legal principles over time, as early cases may adhere to different legal contexts. In this paper, we proposed a new model named PILOT (PredictIng Legal case OuTcome) for case outcome prediction. It comprises two modules for relevant case retrieval and temporal pattern handling, respectively. To benchmark the performance of existing legal case outcome prediction models, we curated a dataset from a large-scale case law database. We demonstrate the importance of accurately identifying precedent cases and mitigating the temporal shift when making predictions for case law, as our method shows a significant improvement over the prior methods that focus on civil law case outcome predictions.

Learn to Refuse: Making Large Language Models More Controllable and Reliable through Knowledge Scope Limitation and Refusal Mechanism

Large language models (LLMs) have demonstrated impressive language understanding and generation capabilities, enabling them to answer a wide range of questions across various domains. However, these models are not flawless and often produce responses that contain errors or misinformation. These inaccuracies, commonly referred to as hallucinations, render LLMs unreliable and even unusable in many scenarios. In this paper, our focus is on mitigating the issue of hallucination in LLMs, particularly in the context of question-answering. Instead of attempting to answer all questions, we explore a refusal mechanism that instructs LLMs to refuse to answer challenging questions in order to avoid errors. We then propose a simple yet effective solution called Learn to Refuse (L2R), which incorporates the refusal mechanism to enable LLMs to recognize and refuse to answer questions that they find difficult to address. To achieve this, we utilize a structured knowledge base to represent all the LLM's understanding of the world, enabling it to provide traceable gold knowledge. This knowledge base is separate from the LLM and initially empty, and it is progressively expanded with validated knowledge. When an LLM encounters questions outside its domain, the system recognizes its knowledge scope and determines whether it can answer the question independently. Additionally, we introduce a method for automatically and efficiently expanding the knowledge base of LLMs. Through qualitative and quantitative analysis, we demonstrate that our approach enhances the controllability and reliability of LLMs.

AutoAM: An End-To-End Neural Model for Automatic and Universal Argument Mining

Argument mining is to analyze argument structure and extract important argument information from unstructured text. An argument mining system can help people automatically gain causal and logical information behind the text. As argumentative corpus gradually increases, like more people begin to argue and debate on social media, argument mining from them is becoming increasingly critical. However, argument mining is still a big challenge in natural language tasks due to its difficulty, and relative techniques are not mature. For example, research on non-tree argument mining needs to be done more. Most works just focus on extracting tree structure argument information. Moreover, current methods cannot accurately describe and capture argument relations and do not predict their types. In this paper, we propose a novel neural model called AutoAM to solve these problems. We first introduce the argument component attention mechanism in our model. It can capture the relevant information between argument components, so our model can better perform argument mining. Our model is a universal end-to-end framework, which can analyze argument structure without constraints like tree structure and complete three subtasks of argument mining in one model. The experiment results show that our model outperforms the existing works on several metrics in two public datasets.

Enhancing Reasoning Capabilities of Large Language Models: A Graph-Based Verification Approach

Large Language Models (LLMs) have showcased impressive reasoning capabilities, particularly when guided by specifically designed prompts in complex reasoning tasks such as math word problems. These models typically solve tasks using a chain-of-thought approach, which not only bolsters their reasoning abilities but also provides valuable insights into their problem-solving process. However, there is still significant room for enhancing the reasoning abilities of LLMs. Some studies suggest that the integration of an LLM output verifier can boost reasoning accuracy without necessitating additional model training. In this paper, we follow these studies and introduce a novel graph-based method to further augment the reasoning capabilities of LLMs. We posit that multiple solutions to a reasoning task, generated by an LLM, can be represented as a reasoning graph due to the logical connections between intermediate steps from different reasoning paths. Therefore, we propose the Reasoning Graph Verifier (RGV) to analyze and verify the solutions generated by LLMs. By evaluating these graphs, models can yield more accurate and reliable results.Our experimental results show that our graph-based verification method not only significantly enhances the reasoning abilities of LLMs but also outperforms existing verifier methods in terms of improving these models' reasoning performance.

DiagGPT: An LLM-based Chatbot with Automatic Topic Management for Task-Oriented Dialogue

Large Language Models (LLMs), such as ChatGPT, are becoming increasingly sophisticated, demonstrating capabilities that closely resemble those of humans. These AI models are playing an essential role in assisting humans with a wide array of tasks in daily life. A significant application of AI is its use as a chat agent, responding to human inquiries across various domains. Current LLMs have shown proficiency in answering general questions. However, basic question-answering dialogue often falls short in complex diagnostic scenarios, such as legal or medical consultations. These scenarios typically necessitate Task-Oriented Dialogue (TOD), wherein an AI chat agent needs to proactively pose questions and guide users towards specific task completion. Previous fine-tuning models have underperformed in TOD, and current LLMs do not inherently possess this capability. In this paper, we introduce DiagGPT (Dialogue in Diagnosis GPT), an innovative method that extends LLMs to TOD scenarios. Our experiments reveal that DiagGPT exhibits outstanding performance in conducting TOD with users, demonstrating its potential for practical applications.