Enhancing LLMs for Identifying and Prioritizing Important Medical Jargons from Electronic Health Record Notes Utilizing Data Augmentation

OpenNotes enables patients to access EHR notes, but medical jargon can hinder comprehension. To improve understanding, we evaluated closed- and open-source LLMs for extracting and prioritizing key medical terms using prompting, fine-tuning, and data augmentation. We assessed LLMs on 106 expert-annotated EHR notes, experimenting with (i) general vs. structured prompts, (ii) zero-shot vs. few-shot prompting, (iii) fine-tuning, and (iv) data augmentation. To enhance open-source models in low-resource settings, we used ChatGPT for data augmentation and applied ranking techniques. We incrementally increased the augmented dataset size (10 to 10,000) and conducted 5-fold cross-validation, reporting F1 score and Mean Reciprocal Rank (MRR). Our result show that fine-tuning and data augmentation improved performance over other strategies. GPT-4 Turbo achieved the highest F1 (0.433), while Mistral7B with data augmentation had the highest MRR (0.746). Open-source models, when fine-tuned or augmented, outperformed closed-source models. Notably, the best F1 and MRR scores did not always align. Few-shot prompting outperformed zero-shot in vanilla models, and structured prompts yielded different preferences across models. Fine-tuning improved zero-shot performance but sometimes degraded few-shot performance. Data augmentation performed comparably or better than other methods. Our evaluation highlights the effectiveness of prompting, fine-tuning, and data augmentation in improving model performance for medical jargon extraction in low-resource scenarios.

RARE: Retrieval-Augmented Reasoning Enhancement for Large Language Models

This work introduces RARE (Retrieval-Augmented Reasoning Enhancement), a versatile extension to the mutual reasoning framework (rStar), aimed at enhancing reasoning accuracy and factual integrity across large language models (LLMs) for complex, knowledge-intensive tasks such as commonsense and medical reasoning. RARE incorporates two innovative actions within the Monte Carlo Tree Search (MCTS) framework: A6, which generates search queries based on the initial problem statement, performs information retrieval using those queries, and augments reasoning with the retrieved data to formulate the final answer; and A7, which leverages information retrieval specifically for generated sub-questions and re-answers these sub-questions with the relevant contextual information. Additionally, a Retrieval-Augmented Factuality Scorer is proposed to replace the original discriminator, prioritizing reasoning paths that meet high standards of factuality. Experimental results with LLaMA 3.1 show that RARE enables open-source LLMs to achieve competitive performance with top open-source models like GPT-4 and GPT-4o. This research establishes RARE as a scalable solution for improving LLMs in domains where logical coherence and factual integrity are critical.

MCQG-SRefine: Multiple Choice Question Generation and Evaluation with Iterative Self-Critique, Correction, and Comparison Feedback

Automatic question generation (QG) is essential for AI and NLP, particularly in intelligent tutoring, dialogue systems, and fact verification. Generating multiple-choice questions (MCQG) for professional exams, like the United States Medical Licensing Examination (USMLE), is particularly challenging, requiring domain expertise and complex multi-hop reasoning for high-quality questions. However, current large language models (LLMs) like GPT-4 struggle with professional MCQG due to outdated knowledge, hallucination issues, and prompt sensitivity, resulting in unsatisfactory quality and difficulty. To address these challenges, we propose MCQG-SRefine, an LLM self-refine-based (Critique and Correction) framework for converting medical cases into high-quality USMLE-style questions. By integrating expert-driven prompt engineering with iterative self-critique and self-correction feedback, MCQG-SRefine significantly enhances human expert satisfaction regarding both the quality and difficulty of the questions. Furthermore, we introduce an LLM-as-Judge-based automatic metric to replace the complex and costly expert evaluation process, ensuring reliable and expert-aligned assessments.

RiTeK: A Dataset for Large Language Models Complex Reasoning over Textual Knowledge Graphs

Answering complex real-world questions often requires accurate retrieval from textual knowledge graphs (TKGs). The scarcity of annotated data, along with intricate topological structures, makes this task particularly challenging. As the nature of relational path information could enhance the inference ability of Large Language Models (LLMs), efficiently retrieving more complex relational path information from TKGs presents another key challenge. To tackle these challenges, we first develop a Dataset for LLMs Complex Reasoning over Textual Knowledge Graphs (RiTeK) with a broad topological structure coverage.We synthesize realistic user queries that integrate diverse topological structures, relational information, and complex textual descriptions. We conduct rigorous expert evaluation to validate the quality of our synthesized queries. And then, we introduce an enhanced Monte Carlo Tree Search (MCTS) method, Relational MCTS, to automatically extract relational path information from textual graphs for specific queries. Our dataset mainly covers the medical domain as the relation types and entity are complex and publicly available. Experimental results indicate that RiTeK poses significant challenges for current retrieval and LLM systems, while the proposed Relational MCTS method enhances LLM inference ability and achieves state-of-the-art performance on RiTeK.

Blocks Architecture (BloArk): Efficient, Cost-Effective, and Incremental Dataset Architecture for Wikipedia Revision History

Wikipedia (Wiki) is one of the most widely used and publicly available resources for natural language processing (NLP) applications. Wikipedia Revision History (WikiRevHist) shows the order in which edits were made to any Wiki page since its first modification. While the most up-to-date Wiki has been widely used as a training source, WikiRevHist can also be valuable resources for NLP applications. However, there are insufficient tools available to process WikiRevHist without having substantial computing resources, making additional customization, and spending extra time adapting others' works. Therefore, we report Blocks Architecture (BloArk), an efficiency-focused data processing architecture that reduces running time, computing resource requirements, and repeated works in processing WikiRevHist dataset. BloArk consists of three parts in its infrastructure: blocks, segments, and warehouses. On top of that, we build the core data processing pipeline: builder and modifier. The BloArk builder transforms the original WikiRevHist dataset from XML syntax into JSON Lines (JSONL) format for improving the concurrent and storage efficiency. The BloArk modifier takes previously-built warehouses to operate incremental modifications for improving the utilization of existing databases and reducing the cost of reusing others' works. In the end, BloArk can scale up easily in both processing Wikipedia Revision History and incrementally modifying existing dataset for downstream NLP use cases. The source code, documentations, and example usages are publicly available online and open-sourced under GPL-2.0 license.

CS4: Measuring the Creativity of Large Language Models Automatically by Controlling the Number of Story-Writing Constraints

Evaluating the creativity of large language models (LLMs) in story writing is difficult because LLM-generated stories could seemingly look creative but be very similar to some existing stories in their huge and proprietary training corpus. To overcome this challenge, we introduce a novel benchmark dataset with varying levels of prompt specificity: CS4 ($\mathbf{C}$omparing the $\mathbf{S}$kill of $\mathbf{C}$reating $\mathbf{S}$tories by $\mathbf{C}$ontrolling the $\mathbf{S}$ynthesized $\mathbf{C}$onstraint $\mathbf{S}$pecificity). By increasing the number of requirements/constraints in the prompt, we can increase the prompt specificity and hinder LLMs from retelling high-quality narratives in their training data. Consequently, CS4 empowers us to indirectly measure the LLMs' creativity without human annotations. Our experiments on LLaMA, Gemma, and Mistral not only highlight the creativity challenges LLMs face when dealing with highly specific prompts but also reveal that different LLMs perform very differently under different numbers of constraints and achieve different balances between the model's instruction-following ability and narrative coherence. Additionally, our experiments on OLMo suggest that Learning from Human Feedback (LHF) can help LLMs select better stories from their training data but has limited influence in boosting LLMs' ability to produce creative stories that are unseen in the training corpora. The benchmark is released at https://github.com/anirudhlakkaraju/cs4_benchmark.

MedQA-CS: Benchmarking Large Language Models Clinical Skills Using an AI-SCE Framework

Artificial intelligence (AI) and large language models (LLMs) in healthcare require advanced clinical skills (CS), yet current benchmarks fail to evaluate these comprehensively. We introduce MedQA-CS, an AI-SCE framework inspired by medical education's Objective Structured Clinical Examinations (OSCEs), to address this gap. MedQA-CS evaluates LLMs through two instruction-following tasks, LLM-as-medical-student and LLM-as-CS-examiner, designed to reflect real clinical scenarios. Our contributions include developing MedQA-CS, a comprehensive evaluation framework with publicly available data and expert annotations, and providing the quantitative and qualitative assessment of LLMs as reliable judges in CS evaluation. Our experiments show that MedQA-CS is a more challenging benchmark for evaluating clinical skills than traditional multiple-choice QA benchmarks (e.g., MedQA). Combined with existing benchmarks, MedQA-CS enables a more comprehensive evaluation of LLMs' clinical capabilities for both open- and closed-source LLMs.

Large Language Model-based Role-Playing for Personalized Medical Jargon Extraction

Previous studies reveal that Electronic Health Records (EHR), which have been widely adopted in the U.S. to allow patients to access their personal medical information, do not have high readability to patients due to the prevalence of medical jargon. Tailoring medical notes to individual comprehension by identifying jargon that is difficult for each person will enhance the utility of generative models. We present the first quantitative analysis to measure the impact of role-playing in LLM in medical term extraction. By comparing the results of Mechanical Turk workers over 20 sentences, our study demonstrates that LLM role-playing improves F1 scores in 95% of cases across 14 different socio-demographic backgrounds. Furthermore, applying role-playing with in-context learning outperformed the previous state-of-the-art models. Our research showed that ChatGPT can improve traditional medical term extraction systems by utilizing role-play to deliver personalized patient education, a potential that previous models had not achieved.

ReadCtrl: Personalizing text generation with readability-controlled instruction learning

Content generation conditioning on users's readability is an important application for personalization. In an era of large language models (LLMs), readability-controlled text generation based on LLMs has become increasingly important. This paper introduces a novel methodology called "Readability-Controlled Instruction Learning (ReadCtrl)," which aims to instruction-tune LLMs to tailor users' readability levels. Unlike the traditional methods, which primarily focused on categorical readability adjustments typically classified as high, medium, and low or expert and layperson levels with limited success, ReadCtrl introduces a dynamic framework that enables LLMs to generate content at various (near continuous level) complexity levels, thereby enhancing their versatility across different applications. Our results show that the ReadCtrl-Mistral-7B models significantly outperformed strong baseline models such as GPT-4 and Claude-3, with a win rate of 52.1%:35.7% against GPT-4 in human evaluations. Furthermore, Read-Ctrl has shown significant improvements in automatic evaluations, as evidenced by better readability metrics (e.g., FOG, FKGL) and generation quality metrics (e.g., BLEU, SARI, SummaC-Factuality, UniEval-Consistency and Coherence). These results underscore Read-Ctrl's effectiveness and tenacity in producing high-quality, contextually appropriate outputs that closely align with targeted readability levels, marking a significant advancement in personalized content generation using LLMs.

UMass-BioNLP at MEDIQA-M3G 2024: DermPrompt -- A Systematic Exploration of Prompt Engineering with GPT-4V for Dermatological Diagnosis

This paper presents our team's participation in the MEDIQA-ClinicalNLP2024 shared task B. We present a novel approach to diagnosing clinical dermatology cases by integrating large multimodal models, specifically leveraging the capabilities of GPT-4V under a retriever and a re-ranker framework. Our investigation reveals that GPT-4V, when used as a retrieval agent, can accurately retrieve the correct skin condition 85% of the time using dermatological images and brief patient histories. Additionally, we empirically show that Naive Chain-of-Thought (CoT) works well for retrieval while Medical Guidelines Grounded CoT is required for accurate dermatological diagnosis. Further, we introduce a Multi-Agent Conversation (MAC) framework and show its superior performance and potential over the best CoT strategy. The experiments suggest that using naive CoT for retrieval and multi-agent conversation for critique-based diagnosis, GPT-4V can lead to an early and accurate diagnosis of dermatological conditions. The implications of this work extend to improving diagnostic workflows, supporting dermatological education, and enhancing patient care by providing a scalable, accessible, and accurate diagnostic tool.