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Mar 14

Large Language Models to Identify Social Determinants of Health in Electronic Health Records

Social determinants of health (SDoH) have an important impact on patient outcomes but are incompletely collected from the electronic health records (EHR). This study researched the ability of large language models to extract SDoH from free text in EHRs, where they are most commonly documented, and explored the role of synthetic clinical text for improving the extraction of these scarcely documented, yet extremely valuable, clinical data. 800 patient notes were annotated for SDoH categories, and several transformer-based models were evaluated. The study also experimented with synthetic data generation and assessed for algorithmic bias. Our best-performing models were fine-tuned Flan-T5 XL (macro-F1 0.71) for any SDoH, and Flan-T5 XXL (macro-F1 0.70). The benefit of augmenting fine-tuning with synthetic data varied across model architecture and size, with smaller Flan-T5 models (base and large) showing the greatest improvements in performance (delta F1 +0.12 to +0.23). Model performance was similar on the in-hospital system dataset but worse on the MIMIC-III dataset. Our best-performing fine-tuned models outperformed zero- and few-shot performance of ChatGPT-family models for both tasks. These fine-tuned models were less likely than ChatGPT to change their prediction when race/ethnicity and gender descriptors were added to the text, suggesting less algorithmic bias (p<0.05). At the patient-level, our models identified 93.8% of patients with adverse SDoH, while ICD-10 codes captured 2.0%. Our method can effectively extracted SDoH information from clinic notes, performing better compare to GPT zero- and few-shot settings. These models could enhance real-world evidence on SDoH and aid in identifying patients needing social support.

Exploring Small Language Models with Prompt-Learning Paradigm for Efficient Domain-Specific Text Classification

Domain-specific text classification faces the challenge of scarce labeled data due to the high cost of manual labeling. Prompt-learning, known for its efficiency in few-shot scenarios, is proposed as an alternative to traditional fine-tuning methods. And besides, although large language models (LLMs) have gained prominence, small language models (SLMs, with under 1B parameters) offer significant customizability, adaptability, and cost-effectiveness for domain-specific tasks, given industry constraints. In this study, we investigate the potential of SLMs combined with prompt-learning paradigm for domain-specific text classification, specifically within customer-agent interactions in retail. Our evaluations show that, in few-shot settings when prompt-based model fine-tuning is possible, T5-base, a typical SLM with 220M parameters, achieve approximately 75% accuracy with limited labeled data (up to 15% of full data), which shows great potentials of SLMs with prompt-learning. Based on this, We further validate the effectiveness of active few-shot sampling and the ensemble strategy in the prompt-learning pipeline that contribute to a remarkable performance gain. Besides, in zero-shot settings with a fixed model, we underscore a pivotal observation that, although the GPT-3.5-turbo equipped with around 154B parameters garners an accuracy of 55.16%, the power of well designed prompts becomes evident when the FLAN-T5-large, a model with a mere 0.5% of GPT-3.5-turbo's parameters, achieves an accuracy exceeding 31% with the optimized prompt, a leap from its sub-18% performance with an unoptimized one. Our findings underscore the promise of prompt-learning in classification tasks with SLMs, emphasizing the benefits of active few-shot sampling, and ensemble strategies in few-shot settings, and the importance of prompt engineering in zero-shot settings.

Cappy: Outperforming and Boosting Large Multi-Task LMs with a Small Scorer

Large language models (LLMs) such as T0, FLAN, and OPT-IML, excel in multi-tasking under a unified instruction-following paradigm, where they also exhibit remarkable generalization abilities to unseen tasks. Despite their impressive performance, these LLMs, with sizes ranging from several billion to hundreds of billions of parameters, demand substantial computational resources, making their training and inference expensive and inefficient. Furthermore, adapting these models to downstream applications, particularly complex tasks, is often unfeasible due to the extensive hardware requirements for finetuning, even when utilizing parameter-efficient approaches such as prompt tuning. Additionally, the most powerful multi-task LLMs, such as OPT-IML-175B and FLAN-PaLM-540B, are not publicly accessible, severely limiting their customization potential. To address these challenges, we introduce a pretrained small scorer, Cappy, designed to enhance the performance and efficiency of multi-task LLMs. With merely 360 million parameters, Cappy functions either independently on classification tasks or serve as an auxiliary component for LLMs, boosting their performance. Moreover, Cappy enables efficiently integrating downstream supervision without requiring LLM finetuning nor the access to their parameters. Our experiments demonstrate that, when working independently on 11 language understanding tasks from PromptSource, Cappy outperforms LLMs that are several orders of magnitude larger. Besides, on 45 complex tasks from BIG-Bench, Cappy boosts the performance of the advanced multi-task LLM, FLAN-T5, by a large margin. Furthermore, Cappy is flexible to cooperate with other LLM adaptations, including finetuning and in-context learning, offering additional performance enhancement.

GPT-4V(ision) is a Generalist Web Agent, if Grounded

The recent development on large multimodal models (LMMs), especially GPT-4V(ision) and Gemini, has been quickly expanding the capability boundaries of multimodal models beyond traditional tasks like image captioning and visual question answering. In this work, we explore the potential of LMMs like GPT-4V as a generalist web agent that can follow natural language instructions to complete tasks on any given website. We propose SEEACT, a generalist web agent that harnesses the power of LMMs for integrated visual understanding and acting on the web. We evaluate on the recent MIND2WEB benchmark. In addition to standard offline evaluation on cached websites, we enable a new online evaluation setting by developing a tool that allows running web agents on live websites. We show that GPT-4V presents a great potential for web agents - it can successfully complete 50% of the tasks on live websites if we manually ground its textual plans into actions on the websites. This substantially outperforms text-only LLMs like GPT-4 or smaller models (FLAN-T5 and BLIP-2) specifically fine-tuned for web agents. However, grounding still remains a major challenge. Existing LMM grounding strategies like set-of-mark prompting turns out not effective for web agents, and the best grounding strategy we develop in this paper leverages both the HTML text and visuals. Yet, there is still a substantial gap with oracle grounding, leaving ample room for further improvement.

Automating Customer Service using LangChain: Building custom open-source GPT Chatbot for organizations

In the digital age, the dynamics of customer service are evolving, driven by technological advancements and the integration of Large Language Models (LLMs). This research paper introduces a groundbreaking approach to automating customer service using LangChain, a custom LLM tailored for organizations. The paper explores the obsolescence of traditional customer support techniques, particularly Frequently Asked Questions (FAQs), and proposes a paradigm shift towards responsive, context-aware, and personalized customer interactions. The heart of this innovation lies in the fusion of open-source methodologies, web scraping, fine-tuning, and the seamless integration of LangChain into customer service platforms. This open-source state-of-the-art framework, presented as "Sahaay," demonstrates the ability to scale across industries and organizations, offering real-time support and query resolution. Key elements of this research encompass data collection via web scraping, the role of embeddings, the utilization of Google's Flan T5 XXL, Base and Small language models for knowledge retrieval, and the integration of the chatbot into customer service platforms. The results section provides insights into their performance and use cases, here particularly within an educational institution. This research heralds a new era in customer service, where technology is harnessed to create efficient, personalized, and responsive interactions. Sahaay, powered by LangChain, redefines the customer-company relationship, elevating customer retention, value extraction, and brand image. As organizations embrace LLMs, customer service becomes a dynamic and customer-centric ecosystem.

DS6, Deformation-aware Semi-supervised Learning: Application to Small Vessel Segmentation with Noisy Training Data

Blood vessels of the brain provide the human brain with the required nutrients and oxygen. As a vulnerable part of the cerebral blood supply, pathology of small vessels can cause serious problems such as Cerebral Small Vessel Diseases (CSVD). It has also been shown that CSVD is related to neurodegeneration, such as Alzheimer's disease. With the advancement of 7 Tesla MRI systems, higher spatial image resolution can be achieved, enabling the depiction of very small vessels in the brain. Non-Deep Learning-based approaches for vessel segmentation, e.g., Frangi's vessel enhancement with subsequent thresholding, are capable of segmenting medium to large vessels but often fail to segment small vessels. The sensitivity of these methods to small vessels can be increased by extensive parameter tuning or by manual corrections, albeit making them time-consuming, laborious, and not feasible for larger datasets. This paper proposes a deep learning architecture to automatically segment small vessels in 7 Tesla 3D Time-of-Flight (ToF) Magnetic Resonance Angiography (MRA) data. The algorithm was trained and evaluated on a small imperfect semi-automatically segmented dataset of only 11 subjects; using six for training, two for validation, and three for testing. The deep learning model based on U-Net Multi-Scale Supervision was trained using the training subset and was made equivariant to elastic deformations in a self-supervised manner using deformation-aware learning to improve the generalisation performance. The proposed technique was evaluated quantitatively and qualitatively against the test set and achieved a Dice score of 80.44 pm 0.83. Furthermore, the result of the proposed method was compared against a selected manually segmented region (62.07 resultant Dice) and has shown a considerable improvement (18.98\%) with deformation-aware learning.