The Limited Impact of Medical Adaptation of Large Language and Vision-Language Models

Several recent works seek to develop foundation models specifically for medical applications, adapting general-purpose large language models (LLMs) and vision-language models (VLMs) via continued pretraining on publicly available biomedical corpora. These works typically claim that such domain-adaptive pretraining (DAPT) improves performance on downstream medical tasks, such as answering medical licensing exam questions. In this paper, we compare ten public "medical" LLMs and two VLMs against their corresponding base models, arriving at a different conclusion: all medical VLMs and nearly all medical LLMs fail to consistently improve over their base models in the zero-/few-shot prompting and supervised fine-tuning regimes for medical question-answering (QA). For instance, across all tasks and model pairs we consider in the 3-shot setting, medical LLMs only outperform their base models in 22.7% of cases, reach a (statistical) tie in 36.8% of cases, and are significantly worse than their base models in the remaining 40.5% of cases. Our conclusions are based on (i) comparing each medical model head-to-head, directly against the corresponding base model; (ii) optimizing the prompts for each model separately in zero-/few-shot prompting; and (iii) accounting for statistical uncertainty in comparisons. While these basic practices are not consistently adopted in the literature, our ablations show that they substantially impact conclusions. Meanwhile, we find that after fine-tuning on specific QA tasks, medical LLMs can show performance improvements, but the benefits do not carry over to tasks based on clinical notes. Our findings suggest that state-of-the-art general-domain models may already exhibit strong medical knowledge and reasoning capabilities, and offer recommendations to strengthen the conclusions of future studies.

Medical Adaptation of Large Language and Vision-Language Models: Are We Making Progress?

Several recent works seek to develop foundation models specifically for medical applications, adapting general-purpose large language models (LLMs) and vision-language models (VLMs) via continued pretraining on publicly available biomedical corpora. These works typically claim that such domain-adaptive pretraining (DAPT) improves performance on downstream medical tasks, such as answering medical licensing exam questions. In this paper, we compare seven public "medical" LLMs and two VLMs against their corresponding base models, arriving at a different conclusion: all medical VLMs and nearly all medical LLMs fail to consistently improve over their base models in the zero-/few-shot prompting regime for medical question-answering (QA) tasks. For instance, across the tasks and model pairs we consider in the 3-shot setting, medical LLMs only outperform their base models in 12.1% of cases, reach a (statistical) tie in 49.8% of cases, and are significantly worse than their base models in the remaining 38.2% of cases. Our conclusions are based on (i) comparing each medical model head-to-head, directly against the corresponding base model; (ii) optimizing the prompts for each model separately; and (iii) accounting for statistical uncertainty in comparisons. While these basic practices are not consistently adopted in the literature, our ablations show that they substantially impact conclusions. Our findings suggest that state-of-the-art general-domain models may already exhibit strong medical knowledge and reasoning capabilities, and offer recommendations to strengthen the conclusions of future studies.

Online Data Collection for Efficient Semiparametric Inference

While many works have studied statistical data fusion, they typically assume that the various datasets are given in advance. However, in practice, estimation requires difficult data collection decisions like determining the available data sources, their costs, and how many samples to collect from each source. Moreover, this process is often sequential because the data collected at a given time can improve collection decisions in the future. In our setup, given access to multiple data sources and budget constraints, the agent must sequentially decide which data source to query to efficiently estimate a target parameter. We formalize this task using Online Moment Selection, a semiparametric framework that applies to any parameter identified by a set of moment conditions. Interestingly, the optimal budget allocation depends on the (unknown) true parameters. We present two online data collection policies, Explore-then-Commit and Explore-then-Greedy, that use the parameter estimates at a given time to optimally allocate the remaining budget in the future steps. We prove that both policies achieve zero regret (assessed by asymptotic MSE) relative to an oracle policy. We empirically validate our methods on both synthetic and real-world causal effect estimation tasks, demonstrating that the online data collection policies outperform their fixed counterparts.

Failure Modes of LLMs for Causal Reasoning on Narratives

In this work, we investigate the causal reasoning abilities of large language models (LLMs) through the representative problem of inferring causal relationships from narratives. We find that even state-of-the-art language models rely on unreliable shortcuts, both in terms of the narrative presentation and their parametric knowledge. For example, LLMs tend to determine causal relationships based on the topological ordering of events (i.e., earlier events cause later ones), resulting in lower performance whenever events are not narrated in their exact causal order. Similarly, we demonstrate that LLMs struggle with long-term causal reasoning and often fail when the narratives are long and contain many events. Additionally, we show LLMs appear to rely heavily on their parametric knowledge at the expense of reasoning over the provided narrative. This degrades their abilities whenever the narrative opposes parametric knowledge. We extensively validate these failure modes through carefully controlled synthetic experiments, as well as evaluations on real-world narratives. Finally, we observe that explicitly generating a causal graph generally improves performance while naive chain-of-thought is ineffective. Collectively, our results distill precise failure modes of current state-of-the-art models and can pave the way for future techniques to enhance causal reasoning in LLMs.

The Fragility of Fairness: Causal Sensitivity Analysis for Fair Machine Learning

Fairness metrics are a core tool in the fair machine learning literature (FairML), used to determine that ML models are, in some sense, "fair". Real-world data, however, are typically plagued by various measurement biases and other violated assumptions, which can render fairness assessments meaningless. We adapt tools from causal sensitivity analysis to the FairML context, providing a general framework which (1) accommodates effectively any combination of fairness metric and bias that can be posed in the "oblivious setting"; (2) allows researchers to investigate combinations of biases, resulting in non-linear sensitivity; and (3) enables flexible encoding of domain-specific constraints and assumptions. Employing this framework, we analyze the sensitivity of the most common parity metrics under 3 varieties of classifier across 14 canonical fairness datasets. Our analysis reveals the striking fragility of fairness assessments to even minor dataset biases. We show that causal sensitivity analysis provides a powerful and necessary toolkit for gauging the informativeness of parity metric evaluations. Our repository is available here: https://github.com/Jakefawkes/fragile_fair.

LLM-Select: Feature Selection with Large Language Models

In this paper, we demonstrate a surprising capability of large language models (LLMs): given only input feature names and a description of a prediction task, they are capable of selecting the most predictive features, with performance rivaling the standard tools of data science. Remarkably, these models exhibit this capacity across various query mechanisms. For example, we zero-shot prompt an LLM to output a numerical importance score for a feature (e.g., "blood pressure") in predicting an outcome of interest (e.g., "heart failure"), with no additional context. In particular, we find that the latest models, such as GPT-4, can consistently identify the most predictive features regardless of the query mechanism and across various prompting strategies. We illustrate these findings through extensive experiments on real-world data, where we show that LLM-based feature selection consistently achieves strong performance competitive with data-driven methods such as the LASSO, despite never having looked at the downstream training data. Our findings suggest that LLMs may be useful not only for selecting the best features for training but also for deciding which features to collect in the first place. This could potentially benefit practitioners in domains like healthcare, where collecting high-quality data comes at a high cost.

Understanding Hallucinations in Diffusion Models through Mode Interpolation

Colloquially speaking, image generation models based upon diffusion processes are frequently said to exhibit "hallucinations," samples that could never occur in the training data. But where do such hallucinations come from? In this paper, we study a particular failure mode in diffusion models, which we term mode interpolation. Specifically, we find that diffusion models smoothly "interpolate" between nearby data modes in the training set, to generate samples that are completely outside the support of the original training distribution; this phenomenon leads diffusion models to generate artifacts that never existed in real data (i.e., hallucinations). We systematically study the reasons for, and the manifestation of this phenomenon. Through experiments on 1D and 2D Gaussians, we show how a discontinuous loss landscape in the diffusion model's decoder leads to a region where any smooth approximation will cause such hallucinations. Through experiments on artificial datasets with various shapes, we show how hallucination leads to the generation of combinations of shapes that never existed. Finally, we show that diffusion models in fact know when they go out of support and hallucinate. This is captured by the high variance in the trajectory of the generated sample towards the final few backward sampling process. Using a simple metric to capture this variance, we can remove over 95% of hallucinations at generation time while retaining 96% of in-support samples. We conclude our exploration by showing the implications of such hallucination (and its removal) on the collapse (and stabilization) of recursive training on synthetic data with experiments on MNIST and 2D Gaussians dataset. We release our code at https://github.com/locuslab/diffusion-model-hallucination.

Analyzing LLM Behavior in Dialogue Summarization: Unveiling Circumstantial Hallucination Trends

Recent advancements in large language models (LLMs) have considerably advanced the capabilities of summarization systems. However, they continue to face concerns about hallucinations. While prior work has evaluated LLMs extensively in news domains, most evaluation of dialogue summarization has focused on BART-based models, leaving a gap in our understanding of their faithfulness. Our work benchmarks the faithfulness of LLMs for dialogue summarization, using human annotations and focusing on identifying and categorizing span-level inconsistencies. Specifically, we focus on two prominent LLMs: GPT-4 and Alpaca-13B. Our evaluation reveals subtleties as to what constitutes a hallucination: LLMs often generate plausible inferences, supported by circumstantial evidence in the conversation, that lack direct evidence, a pattern that is less prevalent in older models. We propose a refined taxonomy of errors, coining the category of "Circumstantial Inference" to bucket these LLM behaviors and release the dataset. Using our taxonomy, we compare the behavioral differences between LLMs and older fine-tuned models. Additionally, we systematically assess the efficacy of automatic error detection methods on LLM summaries and find that they struggle to detect these nuanced errors. To address this, we introduce two prompt-based approaches for fine-grained error detection that outperform existing metrics, particularly for identifying "Circumstantial Inference."

Rethinking LLM Memorization through the Lens of Adversarial Compression

Large language models (LLMs) trained on web-scale datasets raise substantial concerns regarding permissible data usage. One major question is whether these models "memorize" all their training data or they integrate many data sources in some way more akin to how a human would learn and synthesize information. The answer hinges, to a large degree, on $\textit{how we define memorization}$. In this work, we propose the Adversarial Compression Ratio (ACR) as a metric for assessing memorization in LLMs -- a given string from the training data is considered memorized if it can be elicited by a prompt shorter than the string itself. In other words, these strings can be "compressed" with the model by computing adversarial prompts of fewer tokens. We outline the limitations of existing notions of memorization and show how the ACR overcomes these challenges by (i) offering an adversarial view to measuring memorization, especially for monitoring unlearning and compliance; and (ii) allowing for the flexibility to measure memorization for arbitrary strings at a reasonably low compute. Our definition serves as a valuable and practical tool for determining when model owners may be violating terms around data usage, providing a potential legal tool and a critical lens through which to address such scenarios. Project page: https://locuslab.github.io/acr-memorization.

Scaling Laws for Data Filtering -- Data Curation cannot be Compute Agnostic

Vision-language models (VLMs) are trained for thousands of GPU hours on carefully curated web datasets. In recent times, data curation has gained prominence with several works developing strategies to retain 'high-quality' subsets of 'raw' scraped data. For instance, the LAION public dataset retained only 10% of the total crawled data. However, these strategies are typically developed agnostic of the available compute for training. In this paper, we first demonstrate that making filtering decisions independent of training compute is often suboptimal: the limited high-quality data rapidly loses its utility when repeated, eventually requiring the inclusion of 'unseen' but 'lower-quality' data. To address this quality-quantity tradeoff ($\texttt{QQT}$), we introduce neural scaling laws that account for the non-homogeneous nature of web data, an angle ignored in existing literature. Our scaling laws (i) characterize the $\textit{differing}$ 'utility' of various quality subsets of web data; (ii) account for how utility diminishes for a data point at its 'nth' repetition; and (iii) formulate the mutual interaction of various data pools when combined, enabling the estimation of model performance on a combination of multiple data pools without ever jointly training on them. Our key message is that data curation $\textit{cannot}$ be agnostic of the total compute that a model will be trained for. Our scaling laws allow us to curate the best possible pool for achieving top performance on Datacomp at various compute budgets, carving out a pareto-frontier for data curation. Code is available at https://github.com/locuslab/scaling_laws_data_filtering.