Personalized Clinical Note Generation from Doctor-Patient Conversations

In this work, we present a novel technique to improve the quality of draft clinical notes for physicians. This technique is concentrated on the ability to model implicit physician conversation styles and note preferences. We also introduce a novel technique for the enrollment of new physicians when a limited number of clinical notes paired with conversations are available for that physician, without the need to re-train a model to support them. We show that our technique outperforms the baseline model by improving the ROUGE-2 score of the History of Present Illness section by 13.8%, the Physical Examination section by 88.6%, and the Assessment & Plan section by 50.8%.

Comparing Two Model Designs for Clinical Note Generation; Is an LLM a Useful Evaluator of Consistency?

Following an interaction with a patient, physicians are responsible for the submission of clinical documentation, often organized as a SOAP note. A clinical note is not simply a summary of the conversation but requires the use of appropriate medical terminology. The relevant information can then be extracted and organized according to the structure of the SOAP note. In this paper we analyze two different approaches to generate the different sections of a SOAP note based on the audio recording of the conversation, and specifically examine them in terms of note consistency. The first approach generates the sections independently, while the second method generates them all together. In this work we make use of PEGASUS-X Transformer models and observe that both methods lead to similar ROUGE values (less than 1% difference) and have no difference in terms of the Factuality metric. We perform a human evaluation to measure aspects of consistency and demonstrate that LLMs like Llama2 can be used to perform the same tasks with roughly the same agreement as the human annotators. Between the Llama2 analysis and the human reviewers we observe a Cohen Kappa inter-rater reliability of 0.79, 1.00, and 0.32 for consistency of age, gender, and body part injury, respectively. With this we demonstrate the usefulness of leveraging an LLM to measure quality indicators that can be identified by humans but are not currently captured by automatic metrics. This allows scaling evaluation to larger data sets, and we find that clinical note consistency improves by generating each new section conditioned on the output of all previously generated sections.