Assessing The Potential Of Mid-Sized Language Models For Clinical QA

Large language models, such as GPT-4 and Med-PaLM, have shown impressive performance on clinical tasks; however, they require access to compute, are closed-source, and cannot be deployed on device. Mid-size models such as BioGPT-large, BioMedLM, LLaMA 2, and Mistral 7B avoid these drawbacks, but their capacity for clinical tasks has been understudied. To help assess their potential for clinical use and help researchers decide which model they should use, we compare their performance on two clinical question-answering (QA) tasks: MedQA and consumer query answering. We find that Mistral 7B is the best performing model, winning on all benchmarks and outperforming models trained specifically for the biomedical domain. While Mistral 7B's MedQA score of 63.0% approaches the original Med-PaLM, and it often can produce plausible responses to consumer health queries, room for improvement still exists. This study provides the first head-to-head assessment of open source mid-sized models on clinical tasks.

Closing the AI generalization gap by adjusting for dermatology condition distribution differences across clinical settings

Recently, there has been great progress in the ability of artificial intelligence (AI) algorithms to classify dermatological conditions from clinical photographs. However, little is known about the robustness of these algorithms in real-world settings where several factors can lead to a loss of generalizability. Understanding and overcoming these limitations will permit the development of generalizable AI that can aid in the diagnosis of skin conditions across a variety of clinical settings. In this retrospective study, we demonstrate that differences in skin condition distribution, rather than in demographics or image capture mode are the main source of errors when an AI algorithm is evaluated on data from a previously unseen source. We demonstrate a series of steps to close this generalization gap, requiring progressively more information about the new source, ranging from the condition distribution to training data enriched for data less frequently seen during training. Our results also suggest comparable performance from end-to-end fine tuning versus fine tuning solely the classification layer on top of a frozen embedding model. Our approach can inform the adaptation of AI algorithms to new settings, based on the information and resources available.