Learning to Generate and Evaluate Fact-checking Explanations with Transformers

In an era increasingly dominated by digital platforms, the spread of misinformation poses a significant challenge, highlighting the need for solutions capable of assessing information veracity. Our research contributes to the field of Explainable Artificial Antelligence (XAI) by developing transformer-based fact-checking models that contextualise and justify their decisions by generating human-accessible explanations. Importantly, we also develop models for automatic evaluation of explanations for fact-checking verdicts across different dimensions such as \texttt{(self)-contradiction}, \texttt{hallucination}, \texttt{convincingness} and \texttt{overall quality}. By introducing human-centred evaluation methods and developing specialised datasets, we emphasise the need for aligning Artificial Intelligence (AI)-generated explanations with human judgements. This approach not only advances theoretical knowledge in XAI but also holds practical implications by enhancing the transparency, reliability and users' trust in AI-driven fact-checking systems. Furthermore, the development of our metric learning models is a first step towards potentially increasing efficiency and reducing reliance on extensive manual assessment. Based on experimental results, our best performing generative model \textsc{ROUGE-1} score of 47.77, demonstrating superior performance in generating fact-checking explanations, particularly when provided with high-quality evidence. Additionally, the best performing metric learning model showed a moderately strong correlation with human judgements on objective dimensions such as \texttt{(self)-contradiction and \texttt{hallucination}, achieving a Matthews Correlation Coefficient (MCC) of around 0.7.}

Representation Learning of Structured Data for Medical Foundation Models

Large Language Models (LLMs) have demonstrated remarkable performance across various domains, including healthcare. However, their ability to effectively represent structured non-textual data, such as the alphanumeric medical codes used in records like ICD-10 or SNOMED-CT, is limited and has been particularly exposed in recent research. This paper examines the challenges LLMs face in processing medical codes due to the shortcomings of current tokenization methods. As a result, we introduce the UniStruct architecture to design a multimodal medical foundation model of unstructured text and structured data, which addresses these challenges by adapting subword tokenization techniques specifically for the structured medical codes. Our approach is validated through model pre-training on both an extensive internal medical database and a public repository of structured medical records. Trained on over 1 billion tokens on the internal medical database, the proposed model achieves up to a 23% improvement in evaluation metrics, with around 2% gain attributed to our proposed tokenization. Additionally, when evaluated on the EHRSHOT public benchmark with a 1/1000 fraction of the pre-training data, the UniStruct model improves performance on over 42% of the downstream tasks. Our approach not only enhances the representation and generalization capabilities of patient-centric models but also bridges a critical gap in representation learning models' ability to handle complex structured medical data, alongside unstructured text.

Seemingly Plausible Distractors in Multi-Hop Reasoning: Are Large Language Models Attentive Readers?

State-of-the-art Large Language Models (LLMs) are accredited with an increasing number of different capabilities, ranging from reading comprehension, over advanced mathematical and reasoning skills to possessing scientific knowledge. In this paper we focus on their multi-hop reasoning capability: the ability to identify and integrate information from multiple textual sources. Given the concerns with the presence of simplifying cues in existing multi-hop reasoning benchmarks, which allow models to circumvent the reasoning requirement, we set out to investigate, whether LLMs are prone to exploiting such simplifying cues. We find evidence that they indeed circumvent the requirement to perform multi-hop reasoning, but they do so in more subtle ways than what was reported about their fine-tuned pre-trained language model (PLM) predecessors. Motivated by this finding, we propose a challenging multi-hop reasoning benchmark, by generating seemingly plausible multi-hop reasoning chains, which ultimately lead to incorrect answers. We evaluate multiple open and proprietary state-of-the-art LLMs, and find that their performance to perform multi-hop reasoning is affected, as indicated by up to 45% relative decrease in F1 score when presented with such seemingly plausible alternatives. We conduct a deeper analysis and find evidence that while LLMs tend to ignore misleading lexical cues, misleading reasoning paths indeed present a significant challenge.

MEDSAGE: Enhancing Robustness of Medical Dialogue Summarization to ASR Errors with LLM-generated Synthetic Dialogues

Automatic Speech Recognition (ASR) systems are pivotal in transcribing speech into text, yet the errors they introduce can significantly degrade the performance of downstream tasks like summarization. This issue is particularly pronounced in clinical dialogue summarization, a low-resource domain where supervised data for fine-tuning is scarce, necessitating the use of ASR models as black-box solutions. Employing conventional data augmentation for enhancing the noise robustness of summarization models is not feasible either due to the unavailability of sufficient medical dialogue audio recordings and corresponding ASR transcripts. To address this challenge, we propose MEDSAGE, an approach for generating synthetic samples for data augmentation using Large Language Models (LLMs). Specifically, we leverage the in-context learning capabilities of LLMs and instruct them to generate ASR-like errors based on a few available medical dialogue examples with audio recordings. Experimental results show that LLMs can effectively model ASR noise, and incorporating this noisy data into the training process significantly improves the robustness and accuracy of medical dialogue summarization systems. This approach addresses the challenges of noisy ASR outputs in critical applications, offering a robust solution to enhance the reliability of clinical dialogue summarization.

LLMs are not Zero-Shot Reasoners for Biomedical Information Extraction

Large Language Models (LLMs) are increasingly adopted for applications in healthcare, reaching the performance of domain experts on tasks such as question answering and document summarisation. Despite their success on these tasks, it is unclear how well LLMs perform on tasks that are traditionally pursued in the biomedical domain, such as structured information extration. To breach this gap, in this paper, we systematically benchmark LLM performance in Medical Classification and Named Entity Recognition (NER) tasks. We aim to disentangle the contribution of different factors to the performance, particularly the impact of LLMs' task knowledge and reasoning capabilities, their (parametric) domain knowledge, and addition of external knowledge. To this end we evaluate various open LLMs -- including BioMistral and Llama-2 models -- on a diverse set of biomedical datasets, using standard prompting, Chain-of-Thought (CoT) and Self-Consistency based reasoning as well as Retrieval-Augmented Generation (RAG) with PubMed and Wikipedia corpora. Counter-intuitively, our results reveal that standard prompting consistently outperforms more complex techniques across both tasks, laying bare the limitations in the current application of CoT, self-consistency and RAG in the biomedical domain. Our findings suggest that advanced prompting methods developed for knowledge- or reasoning-intensive tasks, such as CoT or RAG, are not easily portable to biomedical tasks where precise structured outputs are required. This highlights the need for more effective integration of external knowledge and reasoning mechanisms in LLMs to enhance their performance in real-world biomedical applications.

uMedSum: A Unified Framework for Advancing Medical Abstractive Summarization

Medical abstractive summarization faces the challenge of balancing faithfulness and informativeness. Current methods often sacrifice key information for faithfulness or introduce confabulations when prioritizing informativeness. While recent advancements in techniques like in-context learning (ICL) and fine-tuning have improved medical summarization, they often overlook crucial aspects such as faithfulness and informativeness without considering advanced methods like model reasoning and self-improvement. Moreover, the field lacks a unified benchmark, hindering systematic evaluation due to varied metrics and datasets. This paper addresses these gaps by presenting a comprehensive benchmark of six advanced abstractive summarization methods across three diverse datasets using five standardized metrics. Building on these findings, we propose uMedSum, a modular hybrid summarization framework that introduces novel approaches for sequential confabulation removal followed by key missing information addition, ensuring both faithfulness and informativeness. Our work improves upon previous GPT-4-based state-of-the-art (SOTA) medical summarization methods, significantly outperforming them in both quantitative metrics and qualitative domain expert evaluations. Notably, we achieve an average relative performance improvement of 11.8% in reference-free metrics over the previous SOTA. Doctors prefer uMedSum's summaries 6 times more than previous SOTA in difficult cases where there are chances of confabulations or missing information. These results highlight uMedSum's effectiveness and generalizability across various datasets and metrics, marking a significant advancement in medical summarization.

Investigating a Benchmark for Training-set free Evaluation of Linguistic Capabilities in Machine Reading Comprehension

Performance of NLP systems is typically evaluated by collecting a large-scale dataset by means of crowd-sourcing to train a data-driven model and evaluate it on a held-out portion of the data. This approach has been shown to suffer from spurious correlations and the lack of challenging examples that represent the diversity of natural language. Instead, we examine a framework for evaluating optimised models in training-set free setting on synthetically generated challenge sets. We find that despite the simplicity of the generation method, the data can compete with crowd-sourced datasets with regard to naturalness and lexical diversity for the purpose of evaluating the linguistic capabilities of MRC models. We conduct further experiments and show that state-of-the-art language model-based MRC systems can learn to succeed on the challenge set correctly, although, without capturing the general notion of the evaluated phenomenon.

M-QALM: A Benchmark to Assess Clinical Reading Comprehension and Knowledge Recall in Large Language Models via Question Answering

There is vivid research on adapting Large Language Models (LLMs) to perform a variety of tasks in high-stakes domains such as healthcare. Despite their popularity, there is a lack of understanding of the extent and contributing factors that allow LLMs to recall relevant knowledge and combine it with presented information in the clinical and biomedical domain: a fundamental pre-requisite for success on down-stream tasks. Addressing this gap, we use Multiple Choice and Abstractive Question Answering to conduct a large-scale empirical study on 22 datasets in three generalist and three specialist biomedical sub-domains. Our multifaceted analysis of the performance of 15 LLMs, further broken down by sub-domain, source of knowledge and model architecture, uncovers success factors such as instruction tuning that lead to improved recall and comprehension. We further show that while recently proposed domain-adapted models may lack adequate knowledge, directly fine-tuning on our collected medical knowledge datasets shows encouraging results, even generalising to unseen specialist sub-domains. We complement the quantitative results with a skill-oriented manual error analysis, which reveals a significant gap between the models' capabilities to simply recall necessary knowledge and to integrate it with the presented context. To foster research and collaboration in this field we share M-QALM, our resources, standardised methodology, and evaluation results, with the research community to facilitate further advancements in clinical knowledge representation learning within language models.

Which Side Are You On? A Multi-task Dataset for End-to-End Argument Summarisation and Evaluation

With the recent advances of large language models (LLMs), it is no longer infeasible to build an automated debate system that helps people to synthesise persuasive arguments. Previous work attempted this task by integrating multiple components. In our work, we introduce an argument mining dataset that captures the end-to-end process of preparing an argumentative essay for a debate, which covers the tasks of claim and evidence identification (Task 1 ED), evidence convincingness ranking (Task 2 ECR), argumentative essay summarisation and human preference ranking (Task 3 ASR) and metric learning for automated evaluation of resulting essays, based on human feedback along argument quality dimensions (Task 4 SQE). Our dataset contains 14k examples of claims that are fully annotated with the various properties supporting the aforementioned tasks. We evaluate multiple generative baselines for each of these tasks, including representative LLMs. We find, that while they show promising results on individual tasks in our benchmark, their end-to-end performance on all four tasks in succession deteriorates significantly, both in automated measures as well as in human-centred evaluation. This challenge presented by our proposed dataset motivates future research on end-to-end argument mining and summarisation. The repository of this project is available at https://github.com/HarrywillDr/ArgSum-Datatset

Automated Clinical Coding for Outpatient Departments

Computerised clinical coding approaches aim to automate the process of assigning a set of codes to medical records. While there is active research pushing the state of the art on clinical coding for hospitalized patients, the outpatient setting -- where doctors tend to non-hospitalised patients -- is overlooked. Although both settings can be formalised as a multi-label classification task, they present unique and distinct challenges, which raises the question of whether the success of inpatient clinical coding approaches translates to the outpatient setting. This paper is the first to investigate how well state-of-the-art deep learning-based clinical coding approaches work in the outpatient setting at hospital scale. To this end, we collect a large outpatient dataset comprising over 7 million notes documenting over half a million patients. We adapt four state-of-the-art clinical coding approaches to this setting and evaluate their potential to assist coders. We find evidence that clinical coding in outpatient settings can benefit from more innovations in popular inpatient coding benchmarks. A deeper analysis of the factors contributing to the success -- amount and form of data and choice of document representation -- reveals the presence of easy-to-solve examples, the coding of which can be completely automated with a low error rate.