Daily Papers

The detection of depression through non-verbal cues has gained significant attention. Previous research predominantly centred on identifying depression within the confines of controlled laboratory environments, often with the supervision of psychologists or counsellors. Unfortunately, datasets generated in such controlled settings may struggle to account for individual behaviours in real-life situations. In response to this limitation, we present the Extended D-vlog dataset, encompassing a collection of 1, 261 YouTube vlogs. Additionally, the emergence of large language models (LLMs) like GPT3.5, and GPT4 has sparked interest in their potential they can act like mental health professionals. Yet, the readiness of these LLM models to be used in real-life settings is still a concern as they can give wrong responses that can harm the users. We introduce a virtual agent serving as an initial contact for mental health patients, offering Cognitive Behavioral Therapy (CBT)-based responses. It comprises two core functions: 1. Identifying depression in individuals, and 2. Delivering CBT-based therapeutic responses. Our Mistral model achieved impressive scores of 70.1% and 30.9% for distortion assessment and classification, along with a Bert score of 88.7%. Moreover, utilizing the TVLT model on our Multimodal Extended D-vlog Dataset yielded outstanding results, with an impressive F1-score of 67.8%

There is a significant gap between patient needs and available mental health support today. In this paper, we aim to thoroughly examine the potential of using Large Language Models (LLMs) to assist professional psychotherapy. To this end, we propose a new benchmark, CBT-BENCH, for the systematic evaluation of cognitive behavioral therapy (CBT) assistance. We include three levels of tasks in CBT-BENCH: I: Basic CBT knowledge acquisition, with the task of multiple-choice questions; II: Cognitive model understanding, with the tasks of cognitive distortion classification, primary core belief classification, and fine-grained core belief classification; III: Therapeutic response generation, with the task of generating responses to patient speech in CBT therapy sessions. These tasks encompass key aspects of CBT that could potentially be enhanced through AI assistance, while also outlining a hierarchy of capability requirements, ranging from basic knowledge recitation to engaging in real therapeutic conversations. We evaluated representative LLMs on our benchmark. Experimental results indicate that while LLMs perform well in reciting CBT knowledge, they fall short in complex real-world scenarios requiring deep analysis of patients' cognitive structures and generating effective responses, suggesting potential future work.

As mental health issues globally escalate, there is a tremendous need for advanced digital support systems. We introduce MentalAgora, a novel framework employing large language models enhanced by interaction between multiple agents for tailored mental health support. This framework operates through three stages: strategic debating, tailored counselor creation, and response generation, enabling the dynamic customization of responses based on individual user preferences and therapeutic needs. We conduct experiments utilizing a high-quality evaluation dataset TherapyTalk crafted with mental health professionals, shwoing that MentalAgora generates expert-aligned and user preference-enhanced responses. Our evaluations, including experiments and user studies, demonstrate that MentalAgora aligns with professional standards and effectively meets user preferences, setting a new benchmark for digital mental health interventions.

Clinical Question Answering (QA) systems enable doctors to quickly access patient information from electronic health records (EHRs). However, training these systems requires significant annotated data, which is limited due to the expertise needed and the privacy concerns associated with clinical data. This paper explores generating Clinical QA data using large language models (LLMs) in a zero-shot setting. We find that naive prompting often results in easy questions that do not reflect the complexity of clinical scenarios. To address this, we propose two prompting strategies: 1) instructing the model to generate questions that do not overlap with the input context, and 2) summarizing the input record using a predefined schema to scaffold question generation. Experiments on two Clinical QA datasets demonstrate that our method generates more challenging questions, significantly improving fine-tuning performance over baselines. We compare synthetic and gold data and find a gap between their training efficacy resulting from the quality of synthetically generated answers.

Developing an efficient retriever to retrieve knowledge from a large-scale knowledge base (KB) is critical for task-oriented dialogue systems to effectively handle localized and specialized tasks. However, widely used generative models such as T5 and ChatGPT often struggle to differentiate subtle differences among the retrieved KB records when generating responses, resulting in suboptimal quality of generated responses. In this paper, we propose the application of maximal marginal likelihood to train a perceptive retriever by utilizing signals from response generation for supervision. In addition, our approach goes beyond considering solely retrieved entities and incorporates various meta knowledge to guide the generator, thus improving the utilization of knowledge. We evaluate our approach on three task-oriented dialogue datasets using T5 and ChatGPT as the backbone models. The results demonstrate that when combined with meta knowledge, the response generator can effectively leverage high-quality knowledge records from the retriever and enhance the quality of generated responses. The codes and models of this paper are available at https://github.com/shenwzh3/MK-TOD.

Medical open-domain question answering demands substantial access to specialized knowledge. Recent efforts have sought to decouple knowledge from model parameters, counteracting architectural scaling and allowing for training on common low-resource hardware. The retrieve-then-read paradigm has become ubiquitous, with model predictions grounded on relevant knowledge pieces from external repositories such as PubMed, textbooks, and UMLS. An alternative path, still under-explored but made possible by the advent of domain-specific large language models, entails constructing artificial contexts through prompting. As a result, "to generate or to retrieve" is the modern equivalent of Hamlet's dilemma. This paper presents MedGENIE, the first generate-then-read framework for multiple-choice question answering in medicine. We conduct extensive experiments on MedQA-USMLE, MedMCQA, and MMLU, incorporating a practical perspective by assuming a maximum of 24GB VRAM. MedGENIE sets a new state-of-the-art (SOTA) in the open-book setting of each testbed, even allowing a small-scale reader to outcompete zero-shot closed-book 175B baselines while using up to 706times fewer parameters. Overall, our findings reveal that generated passages are more effective than retrieved counterparts in attaining higher accuracy.

Clinical natural language processing requires methods that can address domain-specific challenges, such as complex medical terminology and clinical contexts. Recently, large language models (LLMs) have shown promise in this domain. Yet, their direct deployment can lead to privacy issues and are constrained by resources. To address this challenge, we delve into synthetic clinical text generation using LLMs for clinical NLP tasks. We propose an innovative, resource-efficient approach, ClinGen, which infuses knowledge into the process. Our model involves clinical knowledge extraction and context-informed LLM prompting. Both clinical topics and writing styles are drawn from external domain-specific knowledge graphs and LLMs to guide data generation. Our extensive empirical study across 7 clinical NLP tasks and 16 datasets reveals that ClinGen consistently enhances performance across various tasks, effectively aligning the distribution of real datasets and significantly enriching the diversity of generated training instances. We will publish our code and all the generated data in https://github.com/ritaranx/ClinGen.

To build a high-quality open-domain chatbot, we introduce the effective training process of PLATO-2 via curriculum learning. There are two stages involved in the learning process. In the first stage, a coarse-grained generation model is trained to learn response generation under the simplified framework of one-to-one mapping. In the second stage, a fine-grained generative model augmented with latent variables and an evaluation model are further trained to generate diverse responses and to select the best response, respectively. PLATO-2 was trained on both Chinese and English data, whose effectiveness and superiority are verified through comprehensive evaluations, achieving new state-of-the-art results.

Recent approaches to empathetic response generation incorporate emotion causalities to enhance comprehension of both the user's feelings and experiences. However, these approaches suffer from two critical issues. First, they only consider causalities between the user's emotion and the user's experiences, and ignore those between the user's experiences. Second, they neglect interdependence among causalities and reason them independently. To solve the above problems, we expect to reason all plausible causalities interdependently and simultaneously, given the user's emotion, dialogue history, and future dialogue content. Then, we infuse these causalities into response generation for empathetic responses. Specifically, we design a new model, i.e., the Conditional Variational Graph Auto-Encoder (CVGAE), for the causality reasoning, and adopt a multi-source attention mechanism in the decoder for the causality infusion. We name the whole framework as CARE, abbreviated for CAusality Reasoning for Empathetic conversation. Experimental results indicate that our method achieves state-of-the-art performance.

Large Language Models (LLMs) have demonstrated a powerful ability for text generation. However, achieving optimal results with a given prompt or instruction can be challenging, especially for billion-sized models. Additionally, undesired behaviors such as toxicity or hallucinations can manifest. While much larger models (e.g., ChatGPT) may demonstrate strength in mitigating these issues, there is still no guarantee of complete prevention. In this work, we propose formalizing text generation as a future-constrained generation problem to minimize undesirable behaviors and enforce faithfulness to instructions. The estimation of future constraint satisfaction, accomplished using LLMs, guides the text generation process. Our extensive experiments demonstrate the effectiveness of the proposed approach across three distinct text generation tasks: keyword-constrained generation (Lin et al., 2020), toxicity reduction (Gehman et al., 2020), and factual correctness in question-answering (Gao et al., 2023).

Motivation: The development of novel compounds targeting proteins of interest is one of the most important tasks in the pharmaceutical industry. Deep generative models have been applied to targeted molecular design and have shown promising results. Recently, target-specific molecule generation has been viewed as a translation between the protein language and the chemical language. However, such a model is limited by the availability of interacting protein-ligand pairs. On the other hand, large amounts of unlabeled protein sequences and chemical compounds are available and have been used to train language models that learn useful representations. In this study, we propose exploiting pretrained biochemical language models to initialize (i.e. warm start) targeted molecule generation models. We investigate two warm start strategies: (i) a one-stage strategy where the initialized model is trained on targeted molecule generation (ii) a two-stage strategy containing a pre-finetuning on molecular generation followed by target specific training. We also compare two decoding strategies to generate compounds: beam search and sampling. Results: The results show that the warm-started models perform better than a baseline model trained from scratch. The two proposed warm-start strategies achieve similar results to each other with respect to widely used metrics from benchmarks. However, docking evaluation of the generated compounds for a number of novel proteins suggests that the one-stage strategy generalizes better than the two-stage strategy. Additionally, we observe that beam search outperforms sampling in both docking evaluation and benchmark metrics for assessing compound quality. Availability and implementation: The source code is available at https://github.com/boun-tabi/biochemical-lms-for-drug-design and the materials are archived in Zenodo at https://doi.org/10.5281/zenodo.6832145

Large language models (LLMs) have shown promise for generative and knowledge-intensive tasks including question-answering (QA) tasks. However, the practical deployment still faces challenges, notably the issue of "hallucination", where models generate plausible-sounding but unfaithful or nonsensical information. This issue becomes particularly critical in the medical domain due to the uncommon professional concepts and potential social risks involved. This paper analyses the phenomenon of hallucination in medical generative QA systems using widely adopted LLMs and datasets. Our investigation centers on the identification and comprehension of common problematic answers, with a specific emphasis on hallucination. To tackle this challenge, we present an interactive self-reflection methodology that incorporates knowledge acquisition and answer generation. Through this feedback process, our approach steadily enhances the factuality, consistency, and entailment of the generated answers. Consequently, we harness the interactivity and multitasking ability of LLMs and produce progressively more precise and accurate answers. Experimental results on both automatic and human evaluation demonstrate the superiority of our approach in hallucination reduction compared to baselines.

Keyphrase generation is the task consisting in generating a set of words or phrases that highlight the main topics of a document. There are few datasets for keyphrase generation in the biomedical domain and they do not meet the expectations in terms of size for training generative models. In this paper, we introduce kp-biomed, the first large-scale biomedical keyphrase generation dataset with more than 5M documents collected from PubMed abstracts. We train and release several generative models and conduct a series of experiments showing that using large scale datasets improves significantly the performances for present and absent keyphrase generation. The dataset is available under CC-BY-NC v4.0 license at https://huggingface.co/ datasets/taln-ls2n/kpbiomed.

Large language models (LLMs) have recently become the leading source of answers for users' questions online. Despite their ability to offer eloquent answers, their accuracy and reliability can pose a significant challenge. This is especially true for sensitive domains such as biomedicine, where there is a higher need for factually correct answers. This paper introduces a biomedical retrieval-augmented generation (RAG) system designed to enhance the reliability of generated responses. The system is based on a fine-tuned LLM for the referenced question-answering, where retrieved relevant abstracts from PubMed are passed to LLM's context as input through a prompt. Its output is an answer based on PubMed abstracts, where each statement is referenced accordingly, allowing the users to verify the answer. Our retrieval system achieves an absolute improvement of 23% compared to the PubMed search engine. Based on the manual evaluation on a small sample, our fine-tuned LLM component achieves comparable results to GPT-4 Turbo in referencing relevant abstracts. We make the dataset used to fine-tune the models and the fine-tuned models based on Mistral-7B-instruct-v0.1 and v0.2 publicly available.

The way people respond to messaging from public health organizations on social media can provide insight into public perceptions on critical health issues, especially during a global crisis such as COVID-19. It could be valuable for high-impact organizations such as the US Centers for Disease Control and Prevention (CDC) or the World Health Organization (WHO) to understand how these perceptions impact reception of messaging on health policy recommendations. We collect two datasets of public health messages and their responses from Twitter relating to COVID-19 and Vaccines, and introduce a predictive method which can be used to explore the potential reception of such messages. Specifically, we harness a generative model (GPT-2) to directly predict probable future responses and demonstrate how it can be used to optimize expected reception of important health guidance. Finally, we introduce a novel evaluation scheme with extensive statistical testing which allows us to conclude that our models capture the semantics and sentiment found in actual public health responses.

Target-guided response generation enables dialogue systems to smoothly transition a conversation from a dialogue context toward a target sentence. Such control is useful for designing dialogue systems that direct a conversation toward specific goals, such as creating non-obtrusive recommendations or introducing new topics in the conversation. In this paper, we introduce a new technique for target-guided response generation, which first finds a bridging path of commonsense knowledge concepts between the source and the target, and then uses the identified bridging path to generate transition responses. Additionally, we propose techniques to re-purpose existing dialogue datasets for target-guided generation. Experiments reveal that the proposed techniques outperform various baselines on this task. Finally, we observe that the existing automated metrics for this task correlate poorly with human judgement ratings. We propose a novel evaluation metric that we demonstrate is more reliable for target-guided response evaluation. Our work generally enables dialogue system designers to exercise more control over the conversations that their systems produce.

Multimodal language models that process both text and speech have a potential for applications in spoken dialogue systems. However, current models face two major challenges in response generation latency: (1) generating a spoken response requires the prior generation of a written response, and (2) speech sequences are significantly longer than text sequences. This study addresses these issues by extending the input and output sequences of the language model to support the parallel generation of text and speech. Our experiments on spoken question answering tasks demonstrate that our approach improves latency while maintaining the quality of response content. Additionally, we show that latency can be further reduced by generating speech in multiple sequences. Demo samples are available at https://rinnakk.github.io/research/publications/PSLM.

Retrieval augmented generation (RAG) with large language models (LLMs) for Question Answering (QA) entails furnishing relevant context within the prompt to facilitate the LLM in answer generation. During the generation, inaccuracies or hallucinations frequently occur due to two primary factors: inadequate or distracting context in the prompts, and the inability of LLMs to effectively reason through the facts. In this paper, we investigate whether providing aligned context via a carefully selected passage sequence leads to better answer generation by the LLM for multi-hop QA. We introduce, "GenSco", a novel approach of selecting passages based on the predicted decomposition of the multi-hop questions}. The framework consists of two distinct LLMs: (i) Generator LLM, which is used for question decomposition and final answer generation; (ii) an auxiliary open-sourced LLM, used as the scorer, to semantically guide the Generator for passage selection. The generator is invoked only once for the answer generation, resulting in a cost-effective and efficient approach. We evaluate on three broadly established multi-hop question answering datasets: 2WikiMultiHop, Adversarial HotPotQA and MuSiQue and achieve an absolute gain of 15.1 and 5.9 points in Exact Match score with respect to the best performing baselines over MuSiQue and 2WikiMultiHop respectively.

A key trait of daily conversations between individuals is the ability to express empathy towards others, and exploring ways to implement empathy is a crucial step towards human-like dialogue systems. Previous approaches on this topic mainly focus on detecting and utilizing the user's emotion for generating empathetic responses. However, since empathy includes both aspects of affection and cognition, we argue that in addition to identifying the user's emotion, cognitive understanding of the user's situation should also be considered. To this end, we propose a novel approach for empathetic response generation, which leverages commonsense to draw more information about the user's situation and uses this additional information to further enhance the empathy expression in generated responses. We evaluate our approach on EmpatheticDialogues, which is a widely-used benchmark dataset for empathetic response generation. Empirical results demonstrate that our approach outperforms the baseline models in both automatic and human evaluations and can generate more informative and empathetic responses.

Recent advances in generative models, including large language models (LLMs), vision language models (VLMs), and diffusion models, have accelerated the field of natural language and image processing in medicine and marked a significant paradigm shift in how biomedical models can be developed and deployed. While these models are highly adaptable to new tasks, scaling and evaluating their usage presents new challenges not addressed in previous frameworks. In particular, the ability of these models to produce useful outputs with little to no specialized training data ("zero-" or "few-shot" approaches), as well as the open-ended nature of their outputs, necessitate the development of new guidelines for robust reporting of clinical generative model research. In response to gaps in standards and best practices for the development of clinical AI tools identified by US Executive Order 141103 and several emerging national networks for clinical AI evaluation, we begin to formalize some of these guidelines by building on the original MI-CLAIM checklist. The new checklist, MI-CLAIM-GEN (Table 1), aims to address differences in training, evaluation, interpretability, and reproducibility of new generative models compared to non-generative ("predictive") AI models. This MI-CLAIM-GEN checklist also seeks to clarify cohort selection reporting with unstructured clinical data and adds additional items on alignment with ethical standards for clinical AI research.

The sparsity of labelled data is an obstacle to the development of Relation Extraction models and the completion of databases in various biomedical areas. While being of high interest in drug-discovery, the natural-products literature, reporting the identification of potential bioactive compounds from organisms, is a concrete example of such an overlooked topic. To mark the start of this new task, we created the first curated evaluation dataset and extracted literature items from the LOTUS database to build training sets. To this end, we developed a new sampler inspired by diversity metrics in ecology, named Greedy Maximum Entropy sampler, or GME-sampler (https://github.com/idiap/gme-sampler). The strategic optimization of both balance and diversity of the selected items in the evaluation set is important given the resource-intensive nature of manual curation. After quantifying the noise in the training set, in the form of discrepancies between the input abstracts text and the expected output labels, we explored different strategies accordingly. Framing the task as an end-to-end Relation Extraction, we evaluated the performance of standard fine-tuning as a generative task and few-shot learning with open Large Language Models (LLaMA 7B-65B). In addition to their evaluation in few-shot settings, we explore the potential of open Large Language Models (Vicuna-13B) as synthetic data generator and propose a new workflow for this purpose. All evaluated models exhibited substantial improvements when fine-tuned on synthetic abstracts rather than the original noisy data. We provide our best performing (f1-score=59.0) BioGPT-Large model for end-to-end RE of natural-products relationships along with all the generated synthetic data and the evaluation dataset. See more details at https://github.com/idiap/abroad-re.

The proliferation of online misinformation has posed significant threats to public interest. While numerous online users actively participate in the combat against misinformation, many of such responses can be characterized by the lack of politeness and supporting facts. As a solution, text generation approaches are proposed to automatically produce counter-misinformation responses. Nevertheless, existing methods are often trained end-to-end without leveraging external knowledge, resulting in subpar text quality and excessively repetitive responses. In this paper, we propose retrieval augmented response generation for online misinformation (RARG), which collects supporting evidence from scientific sources and generates counter-misinformation responses based on the evidences. In particular, our RARG consists of two stages: (1) evidence collection, where we design a retrieval pipeline to retrieve and rerank evidence documents using a database comprising over 1M academic articles; (2) response generation, in which we align large language models (LLMs) to generate evidence-based responses via reinforcement learning from human feedback (RLHF). We propose a reward function to maximize the utilization of the retrieved evidence while maintaining the quality of the generated text, which yields polite and factual responses that clearly refutes misinformation. To demonstrate the effectiveness of our method, we study the case of COVID-19 and perform extensive experiments with both in- and cross-domain datasets, where RARG consistently outperforms baselines by generating high-quality counter-misinformation responses.

Accurate and efficient question-answering systems are essential for delivering high-quality patient care in the medical field. While Large Language Models (LLMs) have made remarkable strides across various domains, they continue to face significant challenges in medical question answering, particularly in understanding domain-specific terminologies and performing complex reasoning. These limitations undermine their effectiveness in critical medical applications. To address these issues, we propose a novel approach incorporating similar case generation within a multi-agent medical question-answering (MedQA) system. Specifically, we leverage the Llama3.1:70B model, a state-of-the-art LLM, in a multi-agent architecture to enhance performance on the MedQA dataset using zero-shot learning. Our method capitalizes on the model's inherent medical knowledge and reasoning capabilities, eliminating the need for additional training data. Experimental results show substantial performance gains over existing benchmark models, with improvements of 7% in both accuracy and F1-score across various medical QA tasks. Furthermore, we examine the model's interpretability and reliability in addressing complex medical queries. This research not only offers a robust solution for medical question answering but also establishes a foundation for broader applications of LLMs in the medical domain.

Large language models (LLMs), such as ChatGPT, are able to generate human-like, fluent responses for many downstream tasks, e.g., task-oriented dialog and question answering. However, applying LLMs to real-world, mission-critical applications remains challenging mainly due to their tendency to generate hallucinations and their inability to use external knowledge. This paper proposes a LLM-Augmenter system, which augments a black-box LLM with a set of plug-and-play modules. Our system makes the LLM generate responses grounded in external knowledge, e.g., stored in task-specific databases. It also iteratively revises LLM prompts to improve model responses using feedback generated by utility functions, e.g., the factuality score of a LLM-generated response. The effectiveness of LLM-Augmenter is empirically validated on two types of scenarios, task-oriented dialog and open-domain question answering. LLM-Augmenter significantly reduces ChatGPT's hallucinations without sacrificing the fluency and informativeness of its responses. We make the source code and models publicly available.

In this paper, we introduce a unified and generalist Biomedical Generative Pre-trained Transformer (BiomedGPT) model, which leverages self-supervision on large and diverse datasets to accept multi-modal inputs and perform a range of downstream tasks. Our experiments demonstrate that BiomedGPT delivers expansive and inclusive representations of biomedical data, outperforming the majority of preceding state-of-the-art models across five distinct tasks with 20 public datasets spanning over 15 unique biomedical modalities. Through the ablation study, we also showcase the efficacy of our multi-modal and multi-task pretraining approach in transferring knowledge to previously unseen data. Overall, our work presents a significant step forward in developing unified and generalist models for biomedicine, with far-reaching implications for improving healthcare outcomes.

Large language models (LLMs) have demonstrated remarkable performance by following natural language instructions without fine-tuning them on domain-specific tasks and data. However, leveraging LLMs for domain-specific question answering suffers from severe limitations. The generated answer tends to hallucinate due to the training data collection time (when using off-the-shelf), complex user utterance and wrong retrieval (in retrieval-augmented generation). Furthermore, due to the lack of awareness about the domain and expected output, such LLMs may generate unexpected and unsafe answers that are not tailored to the target domain. In this paper, we propose CarExpert, an in-car retrieval-augmented conversational question-answering system leveraging LLMs for different tasks. Specifically, CarExpert employs LLMs to control the input, provide domain-specific documents to the extractive and generative answering components, and controls the output to ensure safe and domain-specific answers. A comprehensive empirical evaluation exhibits that CarExpert outperforms state-of-the-art LLMs in generating natural, safe and car-specific answers.

Large Language Models (LLMs) has shown exceptional capabilities in many natual language understanding and generation tasks. However, the personalization issue still remains a much-coveted property, especially when it comes to the multiple sources involved in the dialogue system. To better plan and incorporate the use of multiple sources in generating personalized response, we firstly decompose it into three sub-tasks: Knowledge Source Selection, Knowledge Retrieval, and Response Generation. We then propose a novel Unified Multi-Source Retrieval-Augmented Generation system (UniMS-RAG) Specifically, we unify these three sub-tasks with different formulations into the same sequence-to-sequence paradigm during the training, to adaptively retrieve evidences and evaluate the relevance on-demand using special tokens, called acting tokens and evaluation tokens. Enabling language models to generate acting tokens facilitates interaction with various knowledge sources, allowing them to adapt their behavior to diverse task requirements. Meanwhile, evaluation tokens gauge the relevance score between the dialogue context and the retrieved evidence. In addition, we carefully design a self-refinement mechanism to iteratively refine the generated response considering 1) the consistency scores between the generated response and retrieved evidence; and 2) the relevance scores. Experiments on two personalized datasets (DuLeMon and KBP) show that UniMS-RAG achieves state-of-the-art performance on the knowledge source selection and response generation task with itself as a retriever in a unified manner. Extensive analyses and discussions are provided for shedding some new perspectives for personalized dialogue systems.

Recent immense breakthroughs in generative models such as in GPT4 have precipitated re-imagined ubiquitous usage of these models in all applications. One area that can benefit by improvements in artificial intelligence (AI) is healthcare. The note generation task from doctor-patient encounters, and its associated electronic medical record documentation, is one of the most arduous time-consuming tasks for physicians. It is also a natural prime potential beneficiary to advances in generative models. However with such advances, benchmarking is more critical than ever. Whether studying model weaknesses or developing new evaluation metrics, shared open datasets are an imperative part of understanding the current state-of-the-art. Unfortunately as clinic encounter conversations are not routinely recorded and are difficult to ethically share due to patient confidentiality, there are no sufficiently large clinic dialogue-note datasets to benchmark this task. Here we present the Ambient Clinical Intelligence Benchmark (ACI-BENCH) corpus, the largest dataset to date tackling the problem of AI-assisted note generation from visit dialogue. We also present the benchmark performances of several common state-of-the-art approaches.

Understanding the reason for emotional support response is crucial for establishing connections between users and emotional support dialogue systems. Previous works mostly focus on generating better responses but ignore interpretability, which is extremely important for constructing reliable dialogue systems. To empower the system with better interpretability, we propose an emotional support response generation scheme, named Emotion-Focused and Strategy-Driven Chain-of-Thought (ESCoT), mimicking the process of identifying, understanding, and regulating emotions. Specially, we construct a new dataset with ESCoT in two steps: (1) Dialogue Generation where we first generate diverse conversation situations, then enhance dialogue generation using richer emotional support strategies based on these situations; (2) Chain Supplement where we focus on supplementing selected dialogues with elements such as emotion, stimuli, appraisal, and strategy reason, forming the manually verified chains. Additionally, we further develop a model to generate dialogue responses with better interpretability. We also conduct extensive experiments and human evaluations to validate the effectiveness of the proposed ESCoT and generated dialogue responses. Our data and code are available at https://github.com/TeigenZhang/ESCoT{https://github.com/TeigenZhang/ESCoT}.

There is enormous enthusiasm and concerns in using large language models (LLMs) in healthcare, yet current assumptions are all based on general-purpose LLMs such as ChatGPT. This study develops a clinical generative LLM, GatorTronGPT, using 277 billion words of mixed clinical and English text with a GPT-3 architecture of 20 billion parameters. GatorTronGPT improves biomedical natural language processing for medical research. Synthetic NLP models trained using GatorTronGPT generated text outperform NLP models trained using real-world clinical text. Physicians Turing test using 1 (worst) to 9 (best) scale shows that there is no significant difference in linguistic readability (p = 0.22; 6.57 of GatorTronGPT compared with 6.93 of human) and clinical relevance (p = 0.91; 7.0 of GatorTronGPT compared with 6.97 of human) and that physicians cannot differentiate them (p < 0.001). This study provides insights on the opportunities and challenges of LLMs for medical research and healthcare.

Objective To solve major clinical natural language processing (NLP) tasks using a unified text-to-text learning architecture based on a generative large language model (LLM) via prompt tuning. Methods We formulated 7 key clinical NLP tasks as text-to-text learning and solved them using one unified generative clinical LLM, GatorTronGPT, developed using GPT-3 architecture and trained with up to 20 billion parameters. We adopted soft prompts (i.e., trainable vectors) with frozen LLM, where the LLM parameters were not updated (i.e., frozen) and only the vectors of soft prompts were updated, known as prompt tuning. We added additional soft prompts as a prefix to the input layer, which were optimized during the prompt tuning. We evaluated the proposed method using 7 clinical NLP tasks and compared them with previous task-specific solutions based on Transformer models. Results and Conclusion The proposed approach achieved state-of-the-art performance for 5 out of 7 major clinical NLP tasks using one unified generative LLM. Our approach outperformed previous task-specific transformer models by ~3% for concept extraction and 7% for relation extraction applied to social determinants of health, 3.4% for clinical concept normalization, 3.4~10% for clinical abbreviation disambiguation, and 5.5~9% for natural language inference. Our approach also outperformed a previously developed prompt-based machine reading comprehension (MRC) model, GatorTron-MRC, for clinical concept and relation extraction. The proposed approach can deliver the ``one model for all`` promise from training to deployment using a unified generative LLM.

Empathetic response generation is a desirable aspect of conversational agents, crucial for facilitating engaging and emotionally intelligent multi-turn conversations between humans and machines. Leveraging large language models for this task has shown promising results, yet challenges persist in ensuring both the empathetic quality of the responses and retention of the generalization performance of the models. We propose a novel approach where we construct theory-driven preference datasets based on emotion grounding and use them to align LLMs with preference optimization algorithms to address these challenges. To evaluate empathetic response generation, we employ the EmpatheticDialogues dataset, assessing empathy with the diff-Epitome and BERTscore metrics and with multi-dimensional human evaluation. Additionally, we measure diversity and emotional valence using feature-based methods. We also evaluate the impact of training on the generalization performance using the MMLU benchmark and tasks from the Open LLM Leaderboard. The results show that LLMs can be aligned for empathetic response generation by preference optimization while retaining their general performance and that emotion grounding can guide preference dataset creation. We make all datasets, source code, and models publicly available. https://github.com/justtherightsize/empo

Traditional drug design faces significant challenges due to inherent chemical and biological complexities, often resulting in high failure rates in clinical trials. Deep learning advancements, particularly generative models, offer potential solutions to these challenges. One promising algorithm is DrugGPT, a transformer-based model, that generates small molecules for input protein sequences. Although promising, it generates both chemically valid and invalid structures and does not incorporate the features of approved drugs, resulting in time-consuming and inefficient drug discovery. To address these issues, we introduce DrugGen, an enhanced model based on the DrugGPT structure. DrugGen is fine-tuned on approved drug-target interactions and optimized with proximal policy optimization. By giving reward feedback from protein-ligand binding affinity prediction using pre-trained transformers (PLAPT) and a customized invalid structure assessor, DrugGen significantly improves performance. Evaluation across multiple targets demonstrated that DrugGen achieves 100% valid structure generation compared to 95.5% with DrugGPT and produced molecules with higher predicted binding affinities (7.22 [6.30-8.07]) compared to DrugGPT (5.81 [4.97-6.63]) while maintaining diversity and novelty. Docking simulations further validate its ability to generate molecules targeting binding sites effectively. For example, in the case of fatty acid-binding protein 5 (FABP5), DrugGen generated molecules with superior docking scores (FABP5/11, -9.537 and FABP5/5, -8.399) compared to the reference molecule (Palmitic acid, -6.177). Beyond lead compound generation, DrugGen also shows potential for drug repositioning and creating novel pharmacophores for existing targets. By producing high-quality small molecules, DrugGen provides a high-performance medium for advancing pharmaceutical research and drug discovery.

Retrieval augmented generation (RAG) provides the capability to constrain generative model outputs, and mitigate the possibility of hallucination, by providing relevant in-context text. The number of tokens a generative large language model (LLM) can incorporate as context is finite, thus limiting the volume of knowledge from which to generate an answer. We propose a two-layer RAG framework for query-focused answer generation and evaluate a proof-of-concept for this framework in the context of query-focused summary generation from social media forums, focusing on emerging drug-related information. The evaluations demonstrate the effectiveness of the two-layer framework in resource constrained settings to enable researchers in obtaining near real-time data from users.

Drug discovery typically consists of multiple steps, including identifying a target protein key to a disease's etiology, validating that interacting with this target could prevent symptoms or cure the disease, discovering a small molecule or biologic therapeutic to interact with it, and optimizing the candidate molecule through a complex landscape of required properties. Drug discovery related tasks often involve prediction and generation while considering multiple entities that potentially interact, which poses a challenge for typical AI models. For this purpose we present MAMMAL - Molecular Aligned Multi-Modal Architecture and Language - a method that we applied to create a versatile multi-task foundation model ibm/biomed.omics.bl.sm.ma-ted-458m that learns from large-scale biological datasets (2 billion samples) across diverse modalities, including proteins, small molecules, and genes. We introduce a prompt syntax that supports a wide range of classification, regression, and generation tasks. It allows combining different modalities and entity types as inputs and/or outputs. Our model handles combinations of tokens and scalars and enables the generation of small molecules and proteins, property prediction, and transcriptomic lab test predictions. We evaluated the model on 11 diverse downstream tasks spanning different steps within a typical drug discovery pipeline, where it reaches new SOTA in 9 tasks and is comparable to SOTA in 2 tasks. This performance is achieved while using a unified architecture serving all tasks, in contrast to the original SOTA performance achieved using tailored architectures. The model code and pretrained weights are publicly available at https://github.com/BiomedSciAI/biomed-multi-alignment and https://huggingface.co/ibm/biomed.omics.bl.sm.ma-ted-458m.

Achieving true human-like ability to conduct a conversation remains an elusive goal for open-ended dialogue systems. We posit this is because extant approaches towards natural language generation (NLG) are typically construed as end-to-end architectures that do not adequately model human generation processes. To investigate, we decouple generation into two separate phases: planning and realization. In the planning phase, we train two planners to generate plans for response utterances. The realization phase uses response plans to produce an appropriate response. Through rigorous evaluations, both automated and human, we demonstrate that decoupling the process into planning and realization performs better than an end-to-end approach.

Great research interests have been attracted to devise AI services that are able to provide mental health support. However, the lack of corpora is a main obstacle to this research, particularly in Chinese language. In this paper, we propose PsyQA, a Chinese dataset of psychological health support in the form of question and answer pair. PsyQA is crawled from a Chinese mental health service platform, and contains 22K questions and 56K long and well-structured answers. Based on the psychological counseling theories, we annotate a portion of answer texts with typical strategies for providing support, and further present in-depth analysis of both lexical features and strategy patterns in the counseling answers. We also evaluate the performance of generating counseling answers with the generative pretrained models. Results show that utilizing strategies enhances the fluency and helpfulness of generated answers, but there is still a large space for future research.

Advancements in DNA sequencing technologies have significantly improved our ability to decode genomic sequences. However, the prediction and interpretation of these sequences remain challenging due to the intricate nature of genetic material. Large language models (LLMs) have introduced new opportunities for biological sequence analysis. Recent developments in genomic language models have underscored the potential of LLMs in deciphering DNA sequences. Nonetheless, existing models often face limitations in robustness and application scope, primarily due to constraints in model structure and training data scale. To address these limitations, we present GENERator, a generative genomic foundation model featuring a context length of 98k base pairs (bp) and 1.2B parameters. Trained on an expansive dataset comprising 386B bp of eukaryotic DNA, the GENERator demonstrates state-of-the-art performance across both established and newly proposed benchmarks. The model adheres to the central dogma of molecular biology, accurately generating protein-coding sequences that translate into proteins structurally analogous to known families. It also shows significant promise in sequence optimization, particularly through the prompt-responsive generation of promoter sequences with specific activity profiles. These capabilities position the GENERator as a pivotal tool for genomic research and biotechnological advancement, enhancing our ability to interpret and predict complex biological systems and enabling precise genomic interventions.

Current approaches to empathetic response generation view the set of emotions expressed in the input text as a flat structure, where all the emotions are treated uniformly. We argue that empathetic responses often mimic the emotion of the user to a varying degree, depending on its positivity or negativity and content. We show that the consideration of this polarity-based emotion clusters and emotional mimicry results in improved empathy and contextual relevance of the response as compared to the state-of-the-art. Also, we introduce stochasticity into the emotion mixture that yields emotionally more varied empathetic responses than the previous work. We demonstrate the importance of these factors to empathetic response generation using both automatic- and human-based evaluations. The implementation of MIME is publicly available at https://github.com/declare-lab/MIME.

Access to real-world medication prescriptions is essential for medical research and healthcare quality improvement. However, access to real medication prescriptions is often limited due to the sensitive nature of the information expressed. Additionally, manually labelling these instructions for training and fine-tuning Natural Language Processing (NLP) models can be tedious and expensive. We introduce a novel task-specific model architecture, Label-To-Text-Transformer (LT3), tailored to generate synthetic medication prescriptions based on provided labels, such as a vocabulary list of medications and their attributes. LT3 is trained on a set of around 2K lines of medication prescriptions extracted from the MIMIC-III database, allowing the model to produce valuable synthetic medication prescriptions. We evaluate LT3's performance by contrasting it with a state-of-the-art Pre-trained Language Model (PLM), T5, analysing the quality and diversity of generated texts. We deploy the generated synthetic data to train the SpacyNER model for the Named Entity Recognition (NER) task over the n2c2-2018 dataset. The experiments show that the model trained on synthetic data can achieve a 96-98\% F1 score at Label Recognition on Drug, Frequency, Route, Strength, and Form. LT3 codes and data will be shared at https://github.com/HECTA-UoM/Label-To-Text-Transformer

In the medical domain, numerous scenarios necessitate the long-form generation ability of large language models (LLMs). Specifically, when addressing patients' questions, it is essential that the model's response conveys factual claims, highlighting the need for an automated method to evaluate those claims. Thus, we introduce MedLFQA, a benchmark dataset reconstructed using long-form question-answering datasets related to the biomedical domain. We use MedLFQA to facilitate the automatic evaluations of factuality. We also propose OLAPH, a simple and novel framework that enables the improvement of factuality through automatic evaluations. The OLAPH framework iteratively trains LLMs to mitigate hallucinations using sampling predictions and preference optimization. In other words, we iteratively set the highest-scoring response as a preferred response derived from sampling predictions and train LLMs to align with the preferred response that improves factuality. We highlight that, even on evaluation metrics not used during training, LLMs trained with our OLAPH framework demonstrate significant performance improvement in factuality. Our findings reveal that a 7B LLM trained with our OLAPH framework can provide long answers comparable to the medical experts' answers in terms of factuality. We believe that our work could shed light on gauging the long-text generation ability of LLMs in the medical domain. Our code and datasets are available at https://github.com/dmis-lab/OLAPH}{https://github.com/dmis-lab/OLAPH.

The meaningful use of electronic health records (EHR) continues to progress in the digital era with clinical decision support systems augmented by artificial intelligence. A priority in improving provider experience is to overcome information overload and reduce the cognitive burden so fewer medical errors and cognitive biases are introduced during patient care. One major type of medical error is diagnostic error due to systematic or predictable errors in judgment that rely on heuristics. The potential for clinical natural language processing (cNLP) to model diagnostic reasoning in humans with forward reasoning from data to diagnosis and potentially reduce the cognitive burden and medical error has not been investigated. Existing tasks to advance the science in cNLP have largely focused on information extraction and named entity recognition through classification tasks. We introduce a novel suite of tasks coined as Diagnostic Reasoning Benchmarks, DR.BENCH, as a new benchmark for developing and evaluating cNLP models with clinical diagnostic reasoning ability. The suite includes six tasks from ten publicly available datasets addressing clinical text understanding, medical knowledge reasoning, and diagnosis generation. DR.BENCH is the first clinical suite of tasks designed to be a natural language generation framework to evaluate pre-trained language models. Experiments with state-of-the-art pre-trained generative language models using large general domain models and models that were continually trained on a medical corpus demonstrate opportunities for improvement when evaluated in DR. BENCH. We share DR. BENCH as a publicly available GitLab repository with a systematic approach to load and evaluate models for the cNLP community.

Retrieval-augmented generation (RAG) for language models significantly improves language understanding systems. The basic retrieval-then-read pipeline of response generation has evolved into a more extended process due to the integration of various components, sometimes even forming loop structures. Despite its advancements in improving response accuracy, challenges like poor retrieval quality for complex questions that require the search of multifaceted semantic information, inefficiencies in knowledge re-retrieval during long-term serving, and lack of personalized responses persist. Motivated by transcending these limitations, we introduce ERAGent, a cutting-edge framework that embodies an advancement in the RAG area. Our contribution is the introduction of the synergistically operated module: Enhanced Question Rewriter and Knowledge Filter, for better retrieval quality. Retrieval Trigger is incorporated to curtail extraneous external knowledge retrieval without sacrificing response quality. ERAGent also personalizes responses by incorporating a learned user profile. The efficiency and personalization characteristics of ERAGent are supported by the Experiential Learner module which makes the AI assistant being capable of expanding its knowledge and modeling user profile incrementally. Rigorous evaluations across six datasets and three question-answering tasks prove ERAGent's superior accuracy, efficiency, and personalization, emphasizing its potential to advance the RAG field and its applicability in practical systems.

Problem: Effective patient-centered communication is a core competency for physicians. However, both seasoned providers and medical trainees report decreased confidence in leading conversations on sensitive topics such as goals of care or end-of-life discussions. The significant administrative burden and the resources required to provide dedicated training in leading difficult conversations has been a long-standing problem in medical education. Approach: In this work, we present a novel educational tool designed to facilitate interactive, real-time simulations of difficult conversations in a video-based format through the use of multimodal generative artificial intelligence (AI). Leveraging recent advances in language modeling, computer vision, and generative audio, this tool creates realistic, interactive scenarios with avatars, or "synthetic patients." These synthetic patients interact with users throughout various stages of medical care using a custom-built video chat application, offering learners the chance to practice conversations with patients from diverse belief systems, personalities, and ethnic backgrounds. Outcomes: While the development of this platform demanded substantial upfront investment in labor, it offers a highly-realistic simulation experience with minimal financial investment. For medical trainees, this educational tool can be implemented within programs to simulate patient-provider conversations and can be incorporated into existing palliative care curriculum to provide a scalable, high-fidelity simulation environment for mastering difficult conversations. Next Steps: Future developments will explore enhancing the authenticity of these encounters by working with patients to incorporate their histories and personalities, as well as employing the use of AI-generated evaluations to offer immediate, constructive feedback to learners post-simulation.

Question generation is a conditioned language generation task that consists in generating a context-aware question given a context and the targeted answer. Train language modelling with a mere likelihood maximization has been widely used while suffering from exposure bias and the discordance between the training and the test metrics. In the way of addressing this issue, The presented work portrays a fully Transformer-based reinforcement learning generator-evaluation architecture for neural question generation. To edge the flexibility of the generation, a semantic-based reward score was externally infused during the training to drive the training of the language model. The global architecture is laid out in a generator-evaluator fashion optimized directly to n-gram and semantic-based metrics. Evaluation metrics for language modelling only based on n-gram overlapping do not consider semantic relations between reference and candidate sequences. To improve the evaluation step, a two-fold evaluation was carried out. On the one side, an n-gram overlapping evaluation using the BLEU score. On the other side, a semantic-based assessment using BERTScore and NUBIA. The results were corroborated by a binary human evaluation of the semantic relatedness of the generated question and the ground truth. The results obtained showed that use a semantic-based REINFORCE algorithm for the question generation syntactically reshapes the generated questions while preserving their underlying semantic meaning. Many downstream applications can be drawn from a successful question generation including the enlargement of question answering datasets, the improvement of conversational systems, the enhancement of autonomous educational assessment systems, and so forth.

In recent years, with the rapid advancements in large language models (LLMs), achieving excellent empathetic response capabilities has become a crucial prerequisite. Consequently, managing and understanding empathetic datasets have gained increasing significance. However, empathetic data are typically human-labeled, leading to insufficient datasets and wasted human labor. In this work, we present Synth-Empathy, an LLM-based data generation and quality and diversity selection pipeline that automatically generates high-quality empathetic data while discarding low-quality data. With the data generated from a low empathetic model, we are able to further improve empathetic response performance and achieve state-of-the-art (SoTA) results across multiple benchmarks. Moreover, our model achieves SoTA performance on various human evaluation benchmarks, demonstrating its effectiveness and robustness in real-world applications. Furthermore, we show the trade-off between data quantity and quality, providing insights into empathetic data generation and selection.

Recent proprietary large language models (LLMs), such as GPT-4, have achieved a milestone in tackling diverse challenges in the biomedical domain, ranging from multiple-choice questions to long-form generations. To address challenges that still cannot be handled with the encoded knowledge of LLMs, various retrieval-augmented generation (RAG) methods have been developed by searching documents from the knowledge corpus and appending them unconditionally or selectively to the input of LLMs for generation. However, when applying existing methods to different domain-specific problems, poor generalization becomes apparent, leading to fetching incorrect documents or making inaccurate judgments. In this paper, we introduce Self-BioRAG, a framework reliable for biomedical text that specializes in generating explanations, retrieving domain-specific documents, and self-reflecting generated responses. We utilize 84k filtered biomedical instruction sets to train Self-BioRAG that can assess its generated explanations with customized reflective tokens. Our work proves that domain-specific components, such as a retriever, domain-related document corpus, and instruction sets are necessary for adhering to domain-related instructions. Using three major medical question-answering benchmark datasets, experimental results of Self-BioRAG demonstrate significant performance gains by achieving a 7.2% absolute improvement on average over the state-of-the-art open-foundation model with a parameter size of 7B or less. Overall, we analyze that Self-BioRAG finds the clues in the question, retrieves relevant documents if needed, and understands how to answer with information from retrieved documents and encoded knowledge as a medical expert does. We release our data and code for training our framework components and model weights (7B and 13B) to enhance capabilities in biomedical and clinical domains.

This paper presents synthetic Preference Optimization (PO) datasets generated using multi-agent workflows and evaluates the effectiveness and potential of these workflows in the dataset generation process. PO dataset generation requires two modules: (1) response evaluation, and (2) response generation. In the response evaluation module, the responses from Large Language Models (LLMs) are evaluated and ranked - a task typically carried out by human annotators that we automate using LLMs. We assess the response evaluation module in a 2 step process. In step 1, we assess LLMs as evaluators using three distinct prompting strategies. In step 2, we apply the winning prompting strategy to compare the performance of LLM-as-a-Judge, LLMs-as-a-Jury, and LLM Debate. In each step, we use inter-rater agreement using Cohen's Kappa between human annotators and LLMs. For the response generation module, we compare different configurations for the LLM Feedback Loop using the identified LLM evaluator configuration. We use the win rate (the fraction of times a generation framework is selected as the best by an LLM evaluator) to determine the best multi-agent configuration for generation. After identifying the best configurations for both modules, we use models from the GPT, Gemma, and Llama families to generate our PO datasets using the above pipeline. We generate two types of PO datasets, one to improve the generation capabilities of individual LLM and the other to improve the multi-agent workflow. Our evaluation shows that GPT-4o-as-a-Judge is more consistent across datasets when the candidate responses do not include responses from the GPT family. Additionally, we find that the LLM Feedback Loop, with Llama as the generator and Gemma as the reviewer, achieves a notable 71.8% and 73.8% win rate over single-agent Llama and Gemma, respectively.

We introduce the StatCan Dialogue Dataset consisting of 19,379 conversation turns between agents working at Statistics Canada and online users looking for published data tables. The conversations stem from genuine intents, are held in English or French, and lead to agents retrieving one of over 5000 complex data tables. Based on this dataset, we propose two tasks: (1) automatic retrieval of relevant tables based on a on-going conversation, and (2) automatic generation of appropriate agent responses at each turn. We investigate the difficulty of each task by establishing strong baselines. Our experiments on a temporal data split reveal that all models struggle to generalize to future conversations, as we observe a significant drop in performance across both tasks when we move from the validation to the test set. In addition, we find that response generation models struggle to decide when to return a table. Considering that the tasks pose significant challenges to existing models, we encourage the community to develop models for our task, which can be directly used to help knowledge workers find relevant tables for live chat users.

The recent advancements in artificial intelligence highlight the potential of language models in psychological health support. While models trained on data from mental health service platform have achieved preliminary success, challenges persist in areas such as data scarcity, quality, and ensuring a solid foundation in psychological techniques. To address these challenges, this study introduces a novel approach to enhance the precision and efficacy of psychological support through large language models. Specifically, we design a specific prompt derived from principles of Cognitive Behavioral Therapy (CBT) and have generated the CBT QA dataset, specifically for Chinese psychological health Q&A based on CBT structured intervention strategies. Unlike previous methods, our dataset emphasizes professional and structured response. Utilizing this dataset, we fine-tuned the large language model, giving birth to CBT-LLM, the large-scale language model specifically designed for Cognitive Behavioral Therapy techniques. Empirical evaluations demonstrate that CBT-LLM excels in generating structured, professional, and highly relevant responses in psychological health support tasks, showcasing its practicality and quality. The model is available on Hugging Face: https://huggingface.co/Hongbin37/CBT-LLM.

Since the COVID-19 pandemic, clinicians have seen a large and sustained influx in patient portal messages, significantly contributing to clinician burnout. To the best of our knowledge, there are no large-scale public patient portal messages corpora researchers can use to build tools to optimize clinician portal workflows. Informed by our ongoing work with a regional hospital, this study introduces an LLM-powered framework for configurable and realistic patient portal message generation. Our approach leverages few-shot grounded text generation, requiring only a small number of de-identified patient portal messages to help LLMs better match the true style and tone of real data. Clinical experts in our team deem this framework as HIPAA-friendly, unlike existing privacy-preserving approaches to synthetic text generation which cannot guarantee all sensitive attributes will be protected. Through extensive quantitative and human evaluation, we show that our framework produces data of higher quality than comparable generation methods as well as all related datasets. We believe this work provides a path forward for (i) the release of large-scale synthetic patient message datasets that are stylistically similar to ground-truth samples and (ii) HIPAA-friendly data generation which requires minimal human de-identification efforts.

Textual response generation is an essential task for multimodal task-oriented dialog systems.Although existing studies have achieved fruitful progress, they still suffer from two critical limitations: 1) focusing on the attribute knowledge but ignoring the relation knowledge that can reveal the correlations between different entities and hence promote the response generation}, and 2) only conducting the cross-entropy loss based output-level supervision but lacking the representation-level regularization. To address these limitations, we devise a novel multimodal task-oriented dialog system (named MDS-S2). Specifically, MDS-S2 first simultaneously acquires the context related attribute and relation knowledge from the knowledge base, whereby the non-intuitive relation knowledge is extracted by the n-hop graph walk. Thereafter, considering that the attribute knowledge and relation knowledge can benefit the responding to different levels of questions, we design a multi-level knowledge composition module in MDS-S2 to obtain the latent composed response representation. Moreover, we devise a set of latent query variables to distill the semantic information from the composed response representation and the ground truth response representation, respectively, and thus conduct the representation-level semantic regularization. Extensive experiments on a public dataset have verified the superiority of our proposed MDS-S2. We have released the codes and parameters to facilitate the research community.

In this paper, we release a largest ever medical Question Answering (QA) dataset with 26 million QA pairs. We benchmark many existing approaches in our dataset in terms of both retrieval and generation. Experimental results show that the existing models perform far lower than expected and the released dataset is still challenging in the pre-trained language model era. Moreover, we also experimentally show the benefit of the proposed dataset in many aspects: (i) trained models for other QA datasets in a zero-shot fashion; and (ii) as external knowledge for retrieval-augmented generation (RAG); and (iii) improving existing pre-trained language models by using the QA pairs as a pre-training corpus in continued training manner. We believe that this dataset will not only contribute to medical research but also facilitate both the patients and clinical doctors. See https://github.com/FreedomIntelligence/Huatuo-26M.

Clinical question answering systems have the potential to provide clinicians with relevant and timely answers to their questions. Nonetheless, despite the advances that have been made, adoption of these systems in clinical settings has been slow. One issue is a lack of question-answering datasets which reflect the real-world needs of health professionals. In this work, we present RealMedQA, a dataset of realistic clinical questions generated by humans and an LLM. We describe the process for generating and verifying the QA pairs and assess several QA models on BioASQ and RealMedQA to assess the relative difficulty of matching answers to questions. We show that the LLM is more cost-efficient for generating "ideal" QA pairs. Additionally, we achieve a lower lexical similarity between questions and answers than BioASQ which provides an additional challenge to the top two QA models, as per the results. We release our code and our dataset publicly to encourage further research.

Artificial Intelligence (AI) advancement is heavily dependent on access to large-scale, high-quality training data. However, in specialized domains such as healthcare, data acquisition faces significant constraints due to privacy regulations, ethical considerations, and limited availability. While synthetic data generation offers a promising solution, conventional approaches typically require substantial real data for training generative models. The emergence of large-scale prompt-based models presents new opportunities for synthetic data generation without direct access to protected data. However, crafting effective prompts for domain-specific data generation remains challenging, and manual prompt engineering proves insufficient for achieving output with sufficient precision and authenticity. We review recent developments in automatic prompt optimization, following PRISMA guidelines. We analyze six peer-reviewed studies published between 2020 and 2024 that focus on automatic data-free prompt optimization methods. Our analysis reveals three approaches: feedback-driven, error-based, and control-theoretic. Although all approaches demonstrate promising capabilities in prompt refinement and adaptation, our findings suggest the need for an integrated framework that combines complementary optimization techniques to enhance synthetic data generation while minimizing manual intervention. We propose future research directions toward developing robust, iterative prompt optimization frameworks capable of improving the quality of synthetic data. This advancement can be particularly crucial for sensitive fields and in specialized domains where data access is restricted, potentially transforming how we approach synthetic data generation for AI development.

While holding great promise for improving and facilitating healthcare, large language models (LLMs) struggle to produce up-to-date responses on evolving topics due to outdated knowledge or hallucination. Retrieval-augmented generation (RAG) is a pivotal innovation that improves the accuracy and relevance of LLM responses by integrating LLMs with a search engine and external sources of knowledge. However, the quality of RAG responses can be largely impacted by the rank and density of key information in the retrieval results, such as the "lost-in-the-middle" problem. In this work, we aim to improve the robustness and reliability of the RAG workflow in the medical domain. Specifically, we propose a map-reduce strategy, BriefContext, to combat the "lost-in-the-middle" issue without modifying the model weights. We demonstrated the advantage of the workflow with various LLM backbones and on multiple QA datasets. This method promises to improve the safety and reliability of LLMs deployed in healthcare domains.

Language models trained on large-scale corpora can generate remarkably fluent results in open-domain dialogue. However, for the persona-based dialogue generation task, consistency and coherence are also key factors, which are great challenges for language models. Existing works mainly focus on valuable data filtering, model structure modifying, or objective function designing, while their improvements are limited and hard to generalize to all types of pre-trained language models. However, we find that language models can produce consistent and coherent responses if we consider enough generations. Thus, the problems lay in large-scale response generation and target response selection. In this work, a simple but effective two-stage SimOAP strategy is proposed, i.e., over-sampling and post-evaluation. The over-sampling stage takes large-scale responses from existing trained models efficiently via off-the-shelf distilling and compressing methods, and the post-evaluation stage selects a good response based on multiple well-designed evaluation metrics from large-scale candidates. Experimental results show that the proposed plug-in SimOAP strategy improves the backbone models and outperforms the baseline strategies in both automatic and human evaluations.

Large Language Models (LLMs) have demonstrated remarkable success in diverse natural language processing (NLP) tasks in general domains. However, LLMs sometimes generate responses with the hallucination about medical facts due to limited domain knowledge. Such shortcomings pose potential risks in the utilization of LLMs within medical contexts. To address this challenge, we propose knowledge-tuning, which leverages structured medical knowledge bases for the LLMs to grasp domain knowledge efficiently and facilitate reliable response generation. We also release cMedKnowQA, a Chinese medical knowledge question-answering dataset constructed from medical knowledge bases to assess the medical knowledge proficiency of LLMs. Experimental results show that the LLMs which are knowledge-tuned with cMedKnowQA, can exhibit higher levels of accuracy in response generation compared with vanilla instruction-tuning and offer a new reliable way for the domain adaptation of LLMs.

Program synthesis or code generation aims to generate a program that satisfies a problem specification. Recent approaches using large-scale pretrained language models (LMs) have shown promising results, yet they have some critical limitations. In particular, they often follow a standard supervised fine-tuning procedure to train a code generation model only from the pairs of natural-language problem descriptions and ground-truth programs. Such paradigm largely ignores some important but potentially useful signals in the problem specification such as unit tests, which thus often results in poor performance when solving complex unseen coding tasks. To address the limitations, we propose "CodeRL", a new framework for program synthesis tasks through pretrained LMs and deep reinforcement learning (RL). Specifically, during training, we treat the code-generating LM as an actor network, and introduce a critic network that is trained to predict the functional correctness of generated programs and provide dense feedback signals to the actor. During inference, we introduce a new generation procedure with a critical sampling strategy that allows a model to automatically regenerate programs based on feedback from example unit tests and critic scores. For the model backbones, we extended the encoder-decoder architecture of CodeT5 with enhanced learning objectives, larger model sizes, and better pretraining data. Our method not only achieves new SOTA results on the challenging APPS benchmark, but also shows strong zero-shot transfer capability with new SOTA results on the simpler MBPP benchmark.

We consider incorporating topic information into the sequence-to-sequence framework to generate informative and interesting responses for chatbots. To this end, we propose a topic aware sequence-to-sequence (TA-Seq2Seq) model. The model utilizes topics to simulate prior knowledge of human that guides them to form informative and interesting responses in conversation, and leverages the topic information in generation by a joint attention mechanism and a biased generation probability. The joint attention mechanism summarizes the hidden vectors of an input message as context vectors by message attention, synthesizes topic vectors by topic attention from the topic words of the message obtained from a pre-trained LDA model, and let these vectors jointly affect the generation of words in decoding. To increase the possibility of topic words appearing in responses, the model modifies the generation probability of topic words by adding an extra probability item to bias the overall distribution. Empirical study on both automatic evaluation metrics and human annotations shows that TA-Seq2Seq can generate more informative and interesting responses, and significantly outperform the-state-of-the-art response generation models.

The rapid growth of biomedical knowledge has outpaced our ability to efficiently extract insights and generate novel hypotheses. Large language models (LLMs) have emerged as a promising tool to revolutionize knowledge interaction and potentially accelerate biomedical discovery. In this paper, we present a comprehensive evaluation of LLMs as biomedical hypothesis generators. We construct a dataset of background-hypothesis pairs from biomedical literature, carefully partitioned into training, seen, and unseen test sets based on publication date to mitigate data contamination. Using this dataset, we assess the hypothesis generation capabilities of top-tier instructed models in zero-shot, few-shot, and fine-tuning settings. To enhance the exploration of uncertainty, a crucial aspect of scientific discovery, we incorporate tool use and multi-agent interactions in our evaluation framework. Furthermore, we propose four novel metrics grounded in extensive literature review to evaluate the quality of generated hypotheses, considering both LLM-based and human assessments. Our experiments yield two key findings: 1) LLMs can generate novel and validated hypotheses, even when tested on literature unseen during training, and 2) Increasing uncertainty through multi-agent interactions and tool use can facilitate diverse candidate generation and improve zero-shot hypothesis generation performance. However, we also observe that the integration of additional knowledge through few-shot learning and tool use may not always lead to performance gains, highlighting the need for careful consideration of the type and scope of external knowledge incorporated. These findings underscore the potential of LLMs as powerful aids in biomedical hypothesis generation and provide valuable insights to guide further research in this area.

Large-scale language models (LLMs) have achieved remarkable success across various language tasks but suffer from hallucinations and temporal misalignment. To mitigate these shortcomings, Retrieval-augmented generation (RAG) has been utilized to provide external knowledge to facilitate the answer generation. However, applying such models to the medical domain faces several challenges due to the lack of domain-specific knowledge and the intricacy of real-world scenarios. In this study, we explore LLMs with RAG framework for knowledge-intensive tasks in the medical field. To evaluate the capabilities of LLMs, we introduce MedicineQA, a multi-round dialogue benchmark that simulates the real-world medication consultation scenario and requires LLMs to answer with retrieved evidence from the medicine database. MedicineQA contains 300 multi-round question-answering pairs, each embedded within a detailed dialogue history, highlighting the challenge posed by this knowledge-intensive task to current LLMs. We further propose a new Distill-Retrieve-Read framework instead of the previous Retrieve-then-Read. Specifically, the distillation and retrieval process utilizes a tool calling mechanism to formulate search queries that emulate the keyword-based inquiries used by search engines. With experimental results, we show that our framework brings notable performance improvements and surpasses the previous counterparts in the evidence retrieval process in terms of evidence retrieval accuracy. This advancement sheds light on applying RAG to the medical domain.

Since the advent of chatbots in the commercial sector, they have been widely employed in the customer service department. Typically, these commercial chatbots are retrieval-based, so they are unable to respond to queries absent in the provided dataset. On the contrary, generative chatbots try to create the most appropriate response, but are mostly unable to create a smooth flow in the customer-bot dialog. Since the client has few options left for continuing after receiving a response, the dialog becomes short. Through our work, we try to maximize the intelligence of a simple conversational agent so it can answer unseen queries, and generate follow-up questions or remarks. We have built a chatbot for a jewelry shop that finds the underlying objective of the customer's query by finding similarity of the input to patterns in the corpus. Our system features an audio input interface for clients, so they may speak to it in natural language. After converting the audio to text, we trained the model to extract the intent of the query, to find an appropriate response and to speak to the client in a natural human voice. To gauge the system's performance, we used performance metrics such as Recall, Precision and F1 score.

Large language models (LLMs) have significantly benefited from training on diverse, high-quality task-specific data, leading to impressive performance across a range of downstream applications. Current methods often rely on human-annotated data or predefined task templates to direct powerful LLMs in synthesizing task-relevant data for effective model training. However, this dependence on manually designed components may constrain the scope of generated data, potentially overlooking critical edge cases or novel scenarios that could challenge the model. In this paper, we present a novel approach, ReverseGen, designed to automatically generate effective training samples that expose the weaknesses of LLMs. Specifically, we introduce a dedicated proposer trained to produce queries that lead target models to generate unsatisfactory responses. These failure-inducing queries are then used to construct training data, helping to address the models' shortcomings and improve overall performance. Our approach is flexible and can be applied to models of various scales (3B, 7B, and 8B). We evaluate ReverseGen on three key applications (safety, honesty, and math), demonstrating that our generated data is both highly effective and diverse. Models fine-tuned with ReverseGen-generated data consistently outperform those trained on human-annotated or general model-generated data, offering a new perspective on data synthesis for task-specific LLM enhancement.

Retrieval-augmented generation (RAG) techniques have proven to be effective in integrating up-to-date information, mitigating hallucinations, and enhancing response quality, particularly in specialized domains. While many RAG approaches have been proposed to enhance large language models through query-dependent retrievals, these approaches still suffer from their complex implementation and prolonged response times. Typically, a RAG workflow involves multiple processing steps, each of which can be executed in various ways. Here, we investigate existing RAG approaches and their potential combinations to identify optimal RAG practices. Through extensive experiments, we suggest several strategies for deploying RAG that balance both performance and efficiency. Moreover, we demonstrate that multimodal retrieval techniques can significantly enhance question-answering capabilities about visual inputs and accelerate the generation of multimodal content using a "retrieval as generation" strategy.

Pre-trained language models have attracted increasing attention in the biomedical domain, inspired by their great success in the general natural language domain. Among the two main branches of pre-trained language models in the general language domain, i.e., BERT (and its variants) and GPT (and its variants), the first one has been extensively studied in the biomedical domain, such as BioBERT and PubMedBERT. While they have achieved great success on a variety of discriminative downstream biomedical tasks, the lack of generation ability constrains their application scope. In this paper, we propose BioGPT, a domain-specific generative Transformer language model pre-trained on large scale biomedical literature. We evaluate BioGPT on six biomedical NLP tasks and demonstrate that our model outperforms previous models on most tasks. Especially, we get 44.98%, 38.42% and 40.76% F1 score on BC5CDR, KD-DTI and DDI end-to-end relation extraction tasks respectively, and 78.2% accuracy on PubMedQA, creating a new record. Our larger model BioGPT-Large achieves 81.0% on PubMedQA. Our case study on text generation further demonstrates the advantage of BioGPT on biomedical literature to generate fluent descriptions for biomedical terms. Code is available at https://github.com/microsoft/BioGPT.

Existing dialog datasets contain a sequence of utterances and responses without any explicit background knowledge associated with them. This has resulted in the development of models which treat conversation as a sequence-to-sequence generation task i.e, given a sequence of utterances generate the response sequence). This is not only an overly simplistic view of conversation but it is also emphatically different from the way humans converse by heavily relying on their background knowledge about the topic (as opposed to simply relying on the previous sequence of utterances). For example, it is common for humans to (involuntarily) produce utterances which are copied or suitably modified from background articles they have read about the topic. To facilitate the development of such natural conversation models which mimic the human process of conversing, we create a new dataset containing movie chats wherein each response is explicitly generated by copying and/or modifying sentences from unstructured background knowledge such as plots, comments and reviews about the movie. We establish baseline results on this dataset (90K utterances from 9K conversations) using three different models: (i) pure generation based models which ignore the background knowledge (ii) generation based models which learn to copy information from the background knowledge when required and (iii) span prediction based models which predict the appropriate response span in the background knowledge.

Foundation models (FMs) have exhibited remarkable performance across a wide range of downstream tasks in many domains. Nevertheless, general-purpose FMs often face challenges when confronted with domain-specific problems, due to their limited access to the proprietary training data in a particular domain. In biomedicine, there are various biological modalities, such as molecules, proteins, and cells, which are encoded by the language of life and exhibit significant modality gaps with human natural language. In this paper, we introduce BioMedGPT, an open multimodal generative pre-trained transformer (GPT) for biomedicine, to bridge the gap between the language of life and human natural language. BioMedGPT allows users to easily ``communicate'' with diverse biological modalities through free text, which is the first of its kind. BioMedGPT aligns different biological modalities with natural language via a large generative language model, namely, BioMedGPT-LM. We publish BioMedGPT-10B, which unifies the feature spaces of molecules, proteins, and natural language via encoding and alignment. Through fine-tuning, BioMedGPT-10B outperforms or is on par with human and significantly larger general-purpose foundation models on the biomedical QA task. It also demonstrates promising performance in the molecule QA and protein QA tasks, which could greatly accelerate the discovery of new drugs and therapeutic targets. In addition, BioMedGPT-LM-7B is the first large generative language model based on Llama2 in the biomedical domain, therefore is commercial friendly. Both BioMedGPT-10B and BioMedGPT-LM-7B are open-sourced to the research community. In addition, we publish the datasets that are meticulously curated for the alignment of multi-modalities, i.e., PubChemQA and UniProtQA. All the models, codes, and datasets are available at https://github.com/PharMolix/OpenBioMed.

Synthesizing clinical evidence largely relies on systematic reviews of clinical trials and retrospective analyses from medical literature. However, the rapid expansion of publications presents challenges in efficiently identifying, summarizing, and updating clinical evidence. Here, we introduce TrialMind, a generative artificial intelligence (AI) pipeline for facilitating human-AI collaboration in three crucial tasks for evidence synthesis: study search, screening, and data extraction. To assess its performance, we chose published systematic reviews to build the benchmark dataset, named TrialReviewBench, which contains 100 systematic reviews and the associated 2,220 clinical studies. Our results show that TrialMind excels across all three tasks. In study search, it generates diverse and comprehensive search queries to achieve high recall rates (Ours 0.711-0.834 v.s. Human baseline 0.138-0.232). For study screening, TrialMind surpasses traditional embedding-based methods by 30% to 160%. In data extraction, it outperforms a GPT-4 baseline by 29.6% to 61.5%. We further conducted user studies to confirm its practical utility. Compared to manual efforts, human-AI collaboration using TrialMind yielded a 71.4% recall lift and 44.2% time savings in study screening and a 23.5% accuracy lift and 63.4% time savings in data extraction. Additionally, when comparing synthesized clinical evidence presented in forest plots, medical experts favored TrialMind's outputs over GPT-4's outputs in 62.5% to 100% of cases. These findings show the promise of LLM-based approaches like TrialMind to accelerate clinical evidence synthesis via streamlining study search, screening, and data extraction from medical literature, with exceptional performance improvement when working with human experts.

Under the pandemic of COVID-19, people experiencing COVID19-related symptoms or exposed to risk factors have a pressing need to consult doctors. Due to hospital closure, a lot of consulting services have been moved online. Because of the shortage of medical professionals, many people cannot receive online consultations timely. To address this problem, we aim to develop a medical dialogue system that can provide COVID19-related consultations. We collected two dialogue datasets -- CovidDialog -- (in English and Chinese respectively) containing conversations between doctors and patients about COVID-19. On these two datasets, we train several dialogue generation models based on Transformer, GPT, and BERT-GPT. Since the two COVID-19 dialogue datasets are small in size, which bear high risk of overfitting, we leverage transfer learning to mitigate data deficiency. Specifically, we take the pretrained models of Transformer, GPT, and BERT-GPT on dialog datasets and other large-scale texts, then finetune them on our CovidDialog tasks. We perform both automatic and human evaluation of responses generated by these models. The results show that the generated responses are promising in being doctor-like, relevant to the conversation history, and clinically informative. The data and code are available at https://github.com/UCSD-AI4H/COVID-Dialogue.

Retrieving proper domain knowledge from an external database lies at the heart of end-to-end task-oriented dialog systems to generate informative responses. Most existing systems blend knowledge retrieval with response generation and optimize them with direct supervision from reference responses, leading to suboptimal retrieval performance when the knowledge base becomes large-scale. To address this, we propose to decouple knowledge retrieval from response generation and introduce a multi-grained knowledge retriever (MAKER) that includes an entity selector to search for relevant entities and an attribute selector to filter out irrelevant attributes. To train the retriever, we propose a novel distillation objective that derives supervision signals from the response generator. Experiments conducted on three standard benchmarks with both small and large-scale knowledge bases demonstrate that our retriever performs knowledge retrieval more effectively than existing methods. Our code has been made publicly available.https://github.com/18907305772/MAKER

Medical language models (MLMs) have become pivotal in advancing medical natural language processing. However, prior models that rely on pre-training or supervised fine-tuning often exhibit low data efficiency and limited practicality in real-world clinical applications. While OpenAIs O1 highlights test-time scaling in mathematics, attempts to replicate this approach in medicine typically distill responses from GPT-series models to open-source models, focusing primarily on multiple-choice tasks. This strategy, though straightforward, neglects critical concerns like data privacy and realistic deployment in clinical settings. In this work, we present a deployable, small-scale medical language model, \mone, designed for long-chain reasoning in clinical tasks using a self-evolution paradigm. Starting with a seed dataset of around 8,000 instances spanning five domains and 16 datasets, we prompt a base policy model to perform Monte Carlo Tree Search (MCTS) to construct verifiable reasoning chains. Each reasoning step is assigned an evolution rollout value, allowing verified trajectories to train the policy model and the reward model. During inference, the policy model generates multiple responses, and the reward model selects the one with the highest reward score. Experiments on eleven evaluation datasets demonstrate that \mone outperforms prior open-source models by 2 points, with the addition of the reward model further boosting performance (sim13 points), surpassing GPT-4o-mini. Code and data are available at https://github.com/pixas/MedSSS.

Large language models (LLMs) have shown success in generating high-quality responses. In order to achieve better alignment with LLMs with human preference, various works are proposed based on specific optimization process, which, however, is not suitable to Black-Box LLMs like GPT-4, due to inaccessible parameters. In Black-Box LLMs case, their performance is highly dependent on the quality of the provided prompts. Existing methods to enhance response quality often involve a prompt refinement model, yet these approaches potentially suffer from semantic inconsistencies between the refined and original prompts, and typically overlook the relationship between them. To address these challenges, we introduce a self-instructed in-context learning framework that empowers LLMs to deliver more effective responses by generating reliable derived prompts to construct informative contextual environments. Our approach incorporates a self-instructed reinforcement learning mechanism, enabling direct interaction with the response model during derived prompt generation for better alignment. We then formulate querying as an in-context learning task, using responses from LLMs combined with the derived prompts to establish a contextual demonstration for the original prompt. This strategy ensures alignment with the original query, reduces discrepancies from refined prompts, and maximizes the LLMs' in-context learning capability. Extensive experiments demonstrate that the proposed method not only generates more reliable derived prompts but also significantly enhances LLMs' ability to deliver more effective responses, including Black-Box models such as GPT-4.

Medicine is inherently multimodal, with rich data modalities spanning text, imaging, genomics, and more. Generalist biomedical artificial intelligence (AI) systems that flexibly encode, integrate, and interpret this data at scale can potentially enable impactful applications ranging from scientific discovery to care delivery. To enable the development of these models, we first curate MultiMedBench, a new multimodal biomedical benchmark. MultiMedBench encompasses 14 diverse tasks such as medical question answering, mammography and dermatology image interpretation, radiology report generation and summarization, and genomic variant calling. We then introduce Med-PaLM Multimodal (Med-PaLM M), our proof of concept for a generalist biomedical AI system. Med-PaLM M is a large multimodal generative model that flexibly encodes and interprets biomedical data including clinical language, imaging, and genomics with the same set of model weights. Med-PaLM M reaches performance competitive with or exceeding the state of the art on all MultiMedBench tasks, often surpassing specialist models by a wide margin. We also report examples of zero-shot generalization to novel medical concepts and tasks, positive transfer learning across tasks, and emergent zero-shot medical reasoning. To further probe the capabilities and limitations of Med-PaLM M, we conduct a radiologist evaluation of model-generated (and human) chest X-ray reports and observe encouraging performance across model scales. In a side-by-side ranking on 246 retrospective chest X-rays, clinicians express a pairwise preference for Med-PaLM M reports over those produced by radiologists in up to 40.50% of cases, suggesting potential clinical utility. While considerable work is needed to validate these models in real-world use cases, our results represent a milestone towards the development of generalist biomedical AI systems.

Recent text-to-image generative models have demonstrated an unparalleled ability to generate diverse and creative imagery guided by a target text prompt. While revolutionary, current state-of-the-art diffusion models may still fail in generating images that fully convey the semantics in the given text prompt. We analyze the publicly available Stable Diffusion model and assess the existence of catastrophic neglect, where the model fails to generate one or more of the subjects from the input prompt. Moreover, we find that in some cases the model also fails to correctly bind attributes (e.g., colors) to their corresponding subjects. To help mitigate these failure cases, we introduce the concept of Generative Semantic Nursing (GSN), where we seek to intervene in the generative process on the fly during inference time to improve the faithfulness of the generated images. Using an attention-based formulation of GSN, dubbed Attend-and-Excite, we guide the model to refine the cross-attention units to attend to all subject tokens in the text prompt and strengthen - or excite - their activations, encouraging the model to generate all subjects described in the text prompt. We compare our approach to alternative approaches and demonstrate that it conveys the desired concepts more faithfully across a range of text prompts.

Artificial intelligence (AI)-driven methods can vastly improve the historically costly drug design process, with various generative models already in widespread use. Generative models for de novo drug design, in particular, focus on the creation of novel biological compounds entirely from scratch, representing a promising future direction. Rapid development in the field, combined with the inherent complexity of the drug design process, creates a difficult landscape for new researchers to enter. In this survey, we organize de novo drug design into two overarching themes: small molecule and protein generation. Within each theme, we identify a variety of subtasks and applications, highlighting important datasets, benchmarks, and model architectures and comparing the performance of top models. We take a broad approach to AI-driven drug design, allowing for both micro-level comparisons of various methods within each subtask and macro-level observations across different fields. We discuss parallel challenges and approaches between the two applications and highlight future directions for AI-driven de novo drug design as a whole. An organized repository of all covered sources is available at https://github.com/gersteinlab/GenAI4Drug.

Humans often refer to personal narratives, life experiences, and events to make a conversation more engaging and rich. While persona-grounded dialog models are able to generate responses that follow a given persona, they often miss out on stating detailed experiences or events related to a persona, often leaving conversations shallow and dull. In this work, we equip dialog models with 'background stories' related to a persona by leveraging fictional narratives from existing story datasets (e.g. ROCStories). Since current dialog datasets do not contain such narratives as responses, we perform an unsupervised adaptation of a retrieved story for generating a dialog response using a gradient-based rewriting technique. Our proposed method encourages the generated response to be fluent (i.e., highly likely) with the dialog history, minimally different from the retrieved story to preserve event ordering and consistent with the original persona. We demonstrate that our method can generate responses that are more diverse, and are rated more engaging and human-like by human evaluators, compared to outputs from existing dialog models.

We introduce Synthetic Alignment data Generation for Safety Evaluation and Red Teaming (SAGE-RT or SAGE) a novel pipeline for generating synthetic alignment and red-teaming data. Existing methods fall short in creating nuanced and diverse datasets, providing necessary control over the data generation and validation processes, or require large amount of manually generated seed data. SAGE addresses these limitations by using a detailed taxonomy to produce safety-alignment and red-teaming data across a wide range of topics. We generated 51,000 diverse and in-depth prompt-response pairs, encompassing over 1,500 topics of harmfulness and covering variations of the most frequent types of jailbreaking prompts faced by large language models (LLMs). We show that the red-teaming data generated through SAGE jailbreaks state-of-the-art LLMs in more than 27 out of 32 sub-categories, and in more than 58 out of 279 leaf-categories (sub-sub categories). The attack success rate for GPT-4o, GPT-3.5-turbo is 100% over the sub-categories of harmfulness. Our approach avoids the pitfalls of synthetic safety-training data generation such as mode collapse and lack of nuance in the generation pipeline by ensuring a detailed coverage of harmful topics using iterative expansion of the topics and conditioning the outputs on the generated raw-text. This method can be used to generate red-teaming and alignment data for LLM Safety completely synthetically to make LLMs safer or for red-teaming the models over a diverse range of topics.

Millions of users come to online peer counseling platforms to seek support on diverse topics ranging from relationship stress to anxiety. However, studies show that online peer support groups are not always as effective as expected largely due to users' negative experiences with unhelpful counselors. Peer counselors are key to the success of online peer counseling platforms, but most of them often do not have systematic ways to receive guidelines or supervision. In this work, we introduce CARE: an interactive AI-based tool to empower peer counselors through automatic suggestion generation. During the practical training stage, CARE helps diagnose which specific counseling strategies are most suitable in the given context and provides tailored example responses as suggestions. Counselors can choose to select, modify, or ignore any suggestion before replying to the support seeker. Building upon the Motivational Interviewing framework, CARE utilizes large-scale counseling conversation data together with advanced natural language generation techniques to achieve these functionalities. We demonstrate the efficacy of CARE by performing both quantitative evaluations and qualitative user studies through simulated chats and semi-structured interviews. We also find that CARE especially helps novice counselors respond better in challenging situations.

The development of large language models (LLMs) has significantly enhanced the capabilities of multimodal LLMs (MLLMs) as general assistants. However, lack of user-specific knowledge still restricts their application in human's daily life. In this paper, we introduce the Retrieval Augmented Personalization (RAP) framework for MLLMs' personalization. Starting from a general MLLM, we turn it into a personalized assistant in three steps. (a) Remember: We design a key-value database to store user-related information, e.g., user's name, avatar and other attributes. (b) Retrieve: When the user initiates a conversation, RAP will retrieve relevant information from the database using a multimodal retriever. (c) Generate: The input query and retrieved concepts' information are fed into MLLMs to generate personalized, knowledge-augmented responses. Unlike previous methods, RAP allows real-time concept editing via updating the external database. To further improve generation quality and alignment with user-specific information, we design a pipeline for data collection and create a specialized dataset for personalized training of MLLMs. Based on the dataset, we train a series of MLLMs as personalized multimodal assistants. By pretraining on large-scale dataset, RAP-MLLMs can generalize to infinite visual concepts without additional finetuning. Our models demonstrate outstanding flexibility and generation quality across a variety of tasks, such as personalized image captioning, question answering and visual recognition. The code, data and models are available at https://github.com/Hoar012/RAP-MLLM.

Recent advancements in Retrieval-Augmented Generation (RAG) have shown remarkable performance in enhancing response accuracy and relevance by integrating external knowledge into generative models. However, existing RAG methods primarily focus on providing text-only answers, even in multimodal retrieval-augmented generation scenarios. In this work, we introduce the Multimodal Retrieval-Augmented Multimodal Generation (MRAMG) task, which aims to generate answers that combine both text and images, fully leveraging the multimodal data within a corpus. Despite the importance of this task, there is a notable absence of a comprehensive benchmark to effectively evaluate MRAMG performance. To bridge this gap, we introduce the MRAMG-Bench, a carefully curated, human-annotated dataset comprising 4,346 documents, 14,190 images, and 4,800 QA pairs, sourced from three categories: Web Data, Academic Papers, and Lifestyle. The dataset incorporates diverse difficulty levels and complex multi-image scenarios, providing a robust foundation for evaluating multimodal generation tasks. To facilitate rigorous evaluation, our MRAMG-Bench incorporates a comprehensive suite of both statistical and LLM-based metrics, enabling a thorough analysis of the performance of popular generative models in the MRAMG task. Besides, we propose an efficient multimodal answer generation framework that leverages both LLMs and MLLMs to generate multimodal responses. Our datasets are available at: https://huggingface.co/MRAMG.

Given the dominance of dense retrievers that do not generalize well beyond their training dataset distributions, domain-specific test sets are essential in evaluating retrieval. There are few test datasets for retrieval systems intended for use by healthcare providers in a point-of-care setting. To fill this gap we have collaborated with medical professionals to create CURE, an ad-hoc retrieval test dataset for passage ranking with 2000 queries spanning 10 medical domains with a monolingual (English) and two cross-lingual (French/Spanish -> English) conditions. In this paper, we describe how CURE was constructed and provide baseline results to showcase its effectiveness as an evaluation tool. CURE is published with a Creative Commons Attribution Non Commercial 4.0 license and can be accessed on Hugging Face.

Current pre-training works in natural language generation pay little attention to the problem of exposure bias on downstream tasks. To address this issue, we propose an enhanced multi-flow sequence to sequence pre-training and fine-tuning framework named ERNIE-GEN, which bridges the discrepancy between training and inference with an infilling generation mechanism and a noise-aware generation method. To make generation closer to human writing patterns, this framework introduces a span-by-span generation flow that trains the model to predict semantically-complete spans consecutively rather than predicting word by word. Unlike existing pre-training methods, ERNIE-GEN incorporates multi-granularity target sampling to construct pre-training data, which enhances the correlation between encoder and decoder. Experimental results demonstrate that ERNIE-GEN achieves state-of-the-art results with a much smaller amount of pre-training data and parameters on a range of language generation tasks, including abstractive summarization (Gigaword and CNN/DailyMail), question generation (SQuAD), dialogue generation (Persona-Chat) and generative question answering (CoQA).

Training on model-generated synthetic data is a promising approach for finetuning LLMs, but it remains unclear when it helps or hurts. In this paper, we investigate this question for math reasoning via an empirical study, followed by building a conceptual understanding of our observations. First, we find that while the typical approach of finetuning a model on synthetic correct or positive problem-solution pairs generated by capable models offers modest performance gains, sampling more correct solutions from the finetuned learner itself followed by subsequent fine-tuning on this self-generated data doubles the efficiency of the same synthetic problems. At the same time, training on model-generated positives can amplify various spurious correlations, resulting in flat or even inverse scaling trends as the amount of data increases. Surprisingly, we find that several of these issues can be addressed if we also utilize negative responses, i.e., model-generated responses that are deemed incorrect by a final answer verifier. Crucially, these negatives must be constructed such that the training can appropriately recover the utility or advantage of each intermediate step in the negative response. With this per-step scheme, we are able to attain consistent gains over only positive data, attaining performance similar to amplifying the amount of synthetic data by 8 times. We show that training on per-step negatives can help to unlearn spurious correlations in the positive data, and is equivalent to advantage-weighted reinforcement learning (RL), implying that it inherits robustness benefits of RL over imitating positive data alone.

Given the increasing use of synthetic data in language model (LM) post-training, an LM's ability to generate high-quality data has become nearly as crucial as its ability to solve problems directly. While prior works have focused on developing effective data generation methods, they lack systematic comparison of different LMs as data generators in a unified setting. To address this gap, we propose AgoraBench, a benchmark that provides standardized settings and metrics to evaluate LMs' data generation abilities. Through synthesizing 1.26 million training instances using 6 LMs and training 99 student models, we uncover key insights about LMs' data generation capabilities. First, we observe that LMs exhibit distinct strengths. For instance, GPT-4o excels at generating new problems, while Claude-3.5-Sonnet performs better at enhancing existing ones. Furthermore, our analysis reveals that an LM's data generation ability doesn't necessarily correlate with its problem-solving ability. Instead, multiple intrinsic features of data quality-including response quality, perplexity, and instruction difficulty-collectively serve as better indicators. Finally, we demonstrate that strategic choices in output format and cost-conscious model selection significantly impact data generation effectiveness.

Vision-Language Models (VLM) can support clinicians by analyzing medical images and engaging in natural language interactions to assist in diagnostic and treatment tasks. However, VLMs often exhibit "hallucinogenic" behavior, generating textual outputs not grounded in contextual multimodal information. This challenge is particularly pronounced in the medical domain, where we do not only require VLM outputs to be accurate in single interactions but also to be consistent with clinical reasoning and diagnostic pathways throughout multi-turn conversations. For this purpose, we propose a new alignment algorithm that uses symbolic representations of clinical reasoning to ground VLMs in medical knowledge. These representations are utilized to (i) generate GPT-4-guided visual instruction tuning data at scale, simulating clinician-VLM conversations with demonstrations of clinical reasoning, and (ii) create an automatic reward function that evaluates the clinical validity of VLM generations throughout clinician-VLM interactions. Our algorithm eliminates the need for human involvement in training data generation or reward model construction, reducing costs compared to standard reinforcement learning with human feedback (RLHF). We apply our alignment algorithm to develop Dr-LLaVA, a conversational VLM finetuned for analyzing bone marrow pathology slides, demonstrating strong performance in multi-turn medical conversations.

Combination therapies have become the standard of care for diseases such as cancer, tuberculosis, malaria and HIV. However, the combinatorial set of available multi-drug treatments creates a challenge in identifying effective combination therapies available in a situation. To assist medical professionals in identifying beneficial drug-combinations, we construct an expert-annotated dataset for extracting information about the efficacy of drug combinations from the scientific literature. Beyond its practical utility, the dataset also presents a unique NLP challenge, as the first relation extraction dataset consisting of variable-length relations. Furthermore, the relations in this dataset predominantly require language understanding beyond the sentence level, adding to the challenge of this task. We provide a promising baseline model and identify clear areas for further improvement. We release our dataset, code, and baseline models publicly to encourage the NLP community to participate in this task.

Synthetic medical data generation has opened up new possibilities in the healthcare domain, offering a powerful tool for simulating clinical scenarios, enhancing diagnostic and treatment quality, gaining granular medical knowledge, and accelerating the development of unbiased algorithms. In this context, we present a novel approach called ViewXGen, designed to overcome the limitations of existing methods that rely on general domain pipelines using only radiology reports to generate frontal-view chest X-rays. Our approach takes into consideration the diverse view positions found in the dataset, enabling the generation of chest X-rays with specific views, which marks a significant advancement in the field. To achieve this, we introduce a set of specially designed tokens for each view position, tailoring the generation process to the user's preferences. Furthermore, we leverage multi-view chest X-rays as input, incorporating valuable information from different views within the same study. This integration rectifies potential errors and contributes to faithfully capturing abnormal findings in chest X-ray generation. To validate the effectiveness of our approach, we conducted statistical analyses, evaluating its performance in a clinical efficacy metric on the MIMIC-CXR dataset. Also, human evaluation demonstrates the remarkable capabilities of ViewXGen, particularly in producing realistic view-specific X-rays that closely resemble the original images.

Instruction tuning-supervised fine-tuning using instruction-response pairs-is a foundational step in transitioning pre-trained Large Language Models (LLMs) into helpful and safe chat assistants. Our hypothesis is that establishing an adequate output space can enable such a transition given the capabilities inherent in pre-trained LLMs. To verify this, we propose Response Tuning (RT), which eliminates the instruction-conditioning step in instruction tuning and solely focuses on response space supervision. Our experiments demonstrate that RT models, trained only using responses, can effectively respond to a wide range of instructions and exhibit helpfulness comparable to that of their instruction-tuned counterparts. Furthermore, we observe that controlling the training response distribution can significantly improve their user preference or elicit target behaviors such as refusing assistance for unsafe queries. Our findings illuminate the role of establishing an adequate output space in alignment, highlighting the potential of the extensive inherent capabilities of pre-trained LLMs.

We introduce a novel method of generating synthetic question answering corpora by combining models of question generation and answer extraction, and by filtering the results to ensure roundtrip consistency. By pretraining on the resulting corpora we obtain significant improvements on SQuAD2 and NQ, establishing a new state-of-the-art on the latter. Our synthetic data generation models, for both question generation and answer extraction, can be fully reproduced by finetuning a publicly available BERT model on the extractive subsets of SQuAD2 and NQ. We also describe a more powerful variant that does full sequence-to-sequence pretraining for question generation, obtaining exact match and F1 at less than 0.1% and 0.4% from human performance on SQuAD2.

Assessing the capabilities and limitations of large language models (LLMs) has garnered significant interest, yet the evaluation of multiple models in real-world scenarios remains rare. Multilingual evaluation often relies on translated benchmarks, which typically do not capture linguistic and cultural nuances present in the source language. This study provides an extensive assessment of 24 LLMs on real world data collected from Indian patients interacting with a medical chatbot in Indian English and 4 other Indic languages. We employ a uniform Retrieval Augmented Generation framework to generate responses, which are evaluated using both automated techniques and human evaluators on four specific metrics relevant to our application. We find that models vary significantly in their performance and that instruction tuned Indic models do not always perform well on Indic language queries. Further, we empirically show that factual correctness is generally lower for responses to Indic queries compared to English queries. Finally, our qualitative work shows that code-mixed and culturally relevant queries in our dataset pose challenges to evaluated models.

Generative information retrieval, encompassing two major tasks of Generative Document Retrieval (GDR) and Grounded Answer Generation (GAR), has gained significant attention in the area of information retrieval and natural language processing. Existing methods for GDR and GAR rely on separate retrieval and reader modules, which hinder simultaneous optimization. To overcome this, we present UniGen, a Unified Generative framework for retrieval and question answering that integrates both tasks into a single generative model leveraging the capabilities of large language models. UniGen employs a shared encoder and two distinct decoders for generative retrieval and question answering. To facilitate the learning of both tasks, we introduce connectors, generated by large language models, to bridge the gaps between query inputs and generation targets, as well as between document identifiers and answers. Furthermore, we propose an iterative enhancement strategy that leverages generated answers and retrieved documents to iteratively improve both tasks. Through extensive experiments on the MS MARCO and NQ datasets, we demonstrate the effectiveness of UniGen, showcasing its superior performance in both the retrieval and the question answering tasks.

The lack of high-quality data for content-grounded generation tasks has been identified as a major obstacle to advancing these tasks. To address this gap, we propose Genie, a novel method for automatically generating high-quality content-grounded data. It consists of three stages: (a) Content Preparation, (b) Generation: creating task-specific examples from the content (e.g., question-answer pairs or summaries). (c) Filtering mechanism aiming to ensure the quality and faithfulness of the generated data. We showcase this methodology by generating three large-scale synthetic data, making wishes, for Long-Form Question-Answering (LFQA), summarization, and information extraction. In a human evaluation, our generated data was found to be natural and of high quality. Furthermore, we compare models trained on our data with models trained on human-written data -- ELI5 and ASQA for LFQA and CNN-DailyMail for Summarization. We show that our models are on par with or outperforming models trained on human-generated data and consistently outperforming them in faithfulness. Finally, we applied our method to create LFQA data within the medical domain and compared a model trained on it with models trained on other domains.

Discovering novel drug candidate molecules is one of the most fundamental and critical steps in drug development. Generative deep learning models, which create synthetic data given a probability distribution, have been developed with the purpose of picking completely new samples from a partially known space. Generative models offer high potential for designing de novo molecules; however, in order for them to be useful in real-life drug development pipelines, these models should be able to design target-specific molecules, which is the next step in this field. In this study, we propose DrugGEN, for the de novo design of drug candidate molecules that interact with selected target proteins. The proposed system represents compounds and protein structures as graphs and processes them via serially connected two generative adversarial networks comprising graph transformers. DrugGEN is trained using a large dataset of compounds from ChEMBL and target-specific bioactive molecules, to design effective and specific inhibitory molecules against the AKT1 protein, which has critical importance for developing treatments against various types of cancer. On fundamental benchmarks, DrugGEN models have either competitive or better performance against other methods. To assess the target-specific generation performance, we conducted further in silico analysis with molecular docking and deep learning-based bioactivity prediction. Results indicate that de novo molecules have high potential for interacting with the AKT1 protein structure in the level of its native ligand. DrugGEN can be used to design completely novel and effective target-specific drug candidate molecules for any druggable protein, given target features and a dataset of experimental bioactivities. Code base, datasets, results and trained models of DrugGEN are available at https://github.com/HUBioDataLab/DrugGEN

Many practical applications of dialogue technology require the generation of responses according to a particular developer-specified persona. While a variety of personas can be elicited from recent large language models, the opaqueness and unpredictability of these models make it desirable to be able to specify personas in an explicit form. In previous work, personas have typically been represented as sets of one-off pieces of self-knowledge that are retrieved by the dialogue system for use in generation. However, in realistic human conversations, personas are often revealed through story-like narratives that involve rich habitual knowledge -- knowledge about kinds of events that an agent often participates in (e.g., work activities, hobbies, sporting activities, favorite entertainments, etc.), including typical goals, sub-events, preconditions, and postconditions of those events. We capture such habitual knowledge using an explicit schema representation, and propose an approach to dialogue generation that retrieves relevant schemas to condition a large language model to generate persona-based responses. Furthermore, we demonstrate a method for bootstrapping the creation of such schemas by first generating generic passages from a set of simple facts, and then inducing schemas from the generated passages.

We study the problem of extrapolative controlled generation, i.e., generating sequences with attribute values beyond the range seen in training. This task is of significant importance in automated design, especially drug discovery, where the goal is to design novel proteins that are better (e.g., more stable) than existing sequences. Thus, by definition, the target sequences and their attribute values are out of the training distribution, posing challenges to existing methods that aim to directly generate the target sequence. Instead, in this work, we propose Iterative Controlled Extrapolation (ICE) which iteratively makes local edits to a sequence to enable extrapolation. We train the model on synthetically generated sequence pairs that demonstrate small improvement in the attribute value. Results on one natural language task (sentiment analysis) and two protein engineering tasks (ACE2 stability and AAV fitness) show that ICE considerably outperforms state-of-the-art approaches despite its simplicity. Our code and models are available at: https://github.com/vishakhpk/iter-extrapolation.

The widespread adoption of electronic health records and digital healthcare data has created a demand for data-driven insights to enhance patient outcomes, diagnostics, and treatments. However, using real patient data presents privacy and regulatory challenges, including compliance with HIPAA and GDPR. Synthetic data generation, using generative AI models like GANs and VAEs offers a promising solution to balance valuable data access and patient privacy protection. In this paper, we examine generative AI models for creating realistic, anonymized patient data for research and training, explore synthetic data applications in healthcare, and discuss its benefits, challenges, and future research directions. Synthetic data has the potential to revolutionize healthcare by providing anonymized patient data while preserving privacy and enabling versatile applications.

We study extractive question-answering in the medical domain (Medical-EQA). This problem has two main challenges: (i) domain specificity, as most AI models lack necessary domain knowledge, and (ii) extraction-based answering style, which restricts most autoregressive LLMs due to potential hallucinations. To handle those challenges, we propose TOP-Training, a target-oriented pre-training paradigm that stands out among all domain adaptation techniques with two desirable features: (i) TOP-Training moves one step further than popular domain-oriented fine-tuning since it not only moves closer to the target domain, but also familiarizes itself with the target dataset, and (ii) it does not assume the existence of a large set of unlabeled instances from the target domain. Specifically, for a target Medical-EQA dataset, we extract its entities and leverage large language models (LLMs) to generate synthetic texts containing those entities; we then demonstrate that pretraining on this synthetic text data yields better performance on the target Medical-EQA benchmarks. Overall, our contributions are threefold: (i) TOP-Training, a new pretraining technique to effectively adapt LLMs to better solve a target problem, (ii) TOP-Training has a wide application scope because it does not require the target problem to have a large set of unlabeled data, and (iii) our experiments highlight the limitations of autoregressive LLMs, emphasizing TOP-Training as a means to unlock the true potential of bidirectional LLMs.

This paper summarizes our work on the first track of the ninth Dialog System Technology Challenge (DSTC 9), "Beyond Domain APIs: Task-oriented Conversational Modeling with Unstructured Knowledge Access". The goal of the task is to generate responses to user turns in a task-oriented dialog that require knowledge from unstructured documents. The task is divided into three subtasks: detection, selection and generation. In order to be compute efficient, we formulate the selection problem in terms of hierarchical classification steps. We achieve our best results with this model. Alternatively, we employ siamese sequence embedding models, referred to as Dense Knowledge Retrieval, to retrieve relevant documents. This method further reduces the computation time by a factor of more than 100x at the cost of degradation in R@1 of 5-6% compared to the first model. Then for either approach, we use Retrieval Augmented Generation to generate responses based on multiple selected snippets and we show how the method can be used to fine-tune trained embeddings.

Recent Large Language Models (LLMs) have shown remarkable capabilities in mimicking fictional characters or real humans in conversational settings. However, the realism and consistency of these responses can be further enhanced by providing richer information of the agent being mimicked. In this paper, we propose a novel approach to generate more realistic and consistent responses from LLMs, leveraging five senses, attributes, emotional states, relationship with the interlocutor, and memories. By incorporating these factors, we aim to increase the LLM's capacity for generating natural and realistic reactions in conversational exchanges. Through our research, we expect to contribute to the development of LLMs that demonstrate improved capabilities in mimicking fictional characters. We release a new benchmark dataset and all our codes, prompts, and sample results on our Github: https://github.com/srafsasm/InfoRichBot

In this paper, we present the current progress of the project Verif.ai, an open-source scientific generative question-answering system with referenced and verified answers. The components of the system are (1) an information retrieval system combining semantic and lexical search techniques over scientific papers (PubMed), (2) a fine-tuned generative model (Mistral 7B) taking top answers and generating answers with references to the papers from which the claim was derived, and (3) a verification engine that cross-checks the generated claim and the abstract or paper from which the claim was derived, verifying whether there may have been any hallucinations in generating the claim. We are reinforcing the generative model by providing the abstract in context, but in addition, an independent set of methods and models are verifying the answer and checking for hallucinations. Therefore, we believe that by using our method, we can make scientists more productive, while building trust in the use of generative language models in scientific environments, where hallucinations and misinformation cannot be tolerated.

Realistic practice and tailored feedback are key processes for training peer counselors with clinical skills. However, existing mechanisms of providing feedback largely rely on human supervision. Peer counselors often lack mechanisms to receive detailed feedback from experienced mentors, making it difficult for them to support the large number of people with mental health issues who use peer counseling. Our work aims to leverage large language models to provide contextualized and multi-level feedback to empower peer counselors, especially novices, at scale. To achieve this, we co-design with a group of senior psychotherapy supervisors to develop a multi-level feedback taxonomy, and then construct a publicly available dataset with comprehensive feedback annotations of 400 emotional support conversations. We further design a self-improvement method on top of large language models to enhance the automatic generation of feedback. Via qualitative and quantitative evaluation with domain experts, we demonstrate that our method minimizes the risk of potentially harmful and low-quality feedback generation which is desirable in such high-stakes scenarios.

This paper introduces an innovative approach using Retrieval-Augmented Generation (RAG) pipelines with Large Language Models (LLMs) to enhance information retrieval and query response systems for university-related question answering. By systematically extracting data from the university official webpage and employing advanced prompt engineering techniques, we generate accurate, contextually relevant responses to user queries. We developed a comprehensive university benchmark, UniversityQuestionBench (UQB), to rigorously evaluate our system performance, based on common key metrics in the filed of RAG pipelines, assessing accuracy and reliability through various metrics and real-world scenarios. Our experimental results demonstrate significant improvements in the precision and relevance of generated responses, enhancing user experience and reducing the time required to obtain relevant answers. In summary, this paper presents a novel application of RAG pipelines and LLMs, supported by a meticulously prepared university benchmark, offering valuable insights into advanced AI techniques for academic data retrieval and setting the stage for future research in this domain.

We investigate the usefulness of generative Large Language Models (LLMs) in generating training data for cross-encoder re-rankers in a novel direction: generating synthetic documents instead of synthetic queries. We introduce a new dataset, ChatGPT-RetrievalQA, and compare the effectiveness of models fine-tuned on LLM-generated and human-generated data. Data generated with generative LLMs can be used to augment training data, especially in domains with smaller amounts of labeled data. We build ChatGPT-RetrievalQA based on an existing dataset, human ChatGPT Comparison Corpus (HC3), consisting of public question collections with human responses and answers from ChatGPT. We fine-tune a range of cross-encoder re-rankers on either human-generated or ChatGPT-generated data. Our evaluation on MS MARCO DEV, TREC DL'19, and TREC DL'20 demonstrates that cross-encoder re-ranking models trained on ChatGPT responses are statistically significantly more effective zero-shot re-rankers than those trained on human responses. In a supervised setting, the human-trained re-rankers outperform the LLM-trained re-rankers. Our novel findings suggest that generative LLMs have high potential in generating training data for neural retrieval models. Further work is needed to determine the effect of factually wrong information in the generated responses and test our findings' generalizability with open-source LLMs. We release our data, code, and cross-encoders checkpoints for future work.

Despite the potential of Large Language Models (LLMs) in medicine, they may generate responses lacking supporting evidence or based on hallucinated evidence. While Retrieval Augment Generation (RAG) is popular to address this issue, few studies implemented and evaluated RAG in downstream domain-specific applications. We developed a RAG pipeline with 70,000 ophthalmology-specific documents that retrieve relevant documents to augment LLMs during inference time. In a case study on long-form consumer health questions, we systematically evaluated the responses including over 500 references of LLMs with and without RAG on 100 questions with 10 healthcare professionals. The evaluation focuses on factuality of evidence, selection and ranking of evidence, attribution of evidence, and answer accuracy and completeness. LLMs without RAG provided 252 references in total. Of which, 45.3% hallucinated, 34.1% consisted of minor errors, and 20.6% were correct. In contrast, LLMs with RAG significantly improved accuracy (54.5% being correct) and reduced error rates (18.8% with minor hallucinations and 26.7% with errors). 62.5% of the top 10 documents retrieved by RAG were selected as the top references in the LLM response, with an average ranking of 4.9. The use of RAG also improved evidence attribution (increasing from 1.85 to 2.49 on a 5-point scale, P<0.001), albeit with slight decreases in accuracy (from 3.52 to 3.23, P=0.03) and completeness (from 3.47 to 3.27, P=0.17). The results demonstrate that LLMs frequently exhibited hallucinated and erroneous evidence in the responses, raising concerns for downstream applications in the medical domain. RAG substantially reduced the proportion of such evidence but encountered challenges.

Medicine, by its nature, is a multifaceted domain that requires the synthesis of information across various modalities. Medical generative vision-language models (VLMs) make a first step in this direction and promise many exciting clinical applications. However, existing models typically have to be fine-tuned on sizeable down-stream datasets, which poses a significant limitation as in many medical applications data is scarce, necessitating models that are capable of learning from few examples in real-time. Here we propose Med-Flamingo, a multimodal few-shot learner adapted to the medical domain. Based on OpenFlamingo-9B, we continue pre-training on paired and interleaved medical image-text data from publications and textbooks. Med-Flamingo unlocks few-shot generative medical visual question answering (VQA) abilities, which we evaluate on several datasets including a novel challenging open-ended VQA dataset of visual USMLE-style problems. Furthermore, we conduct the first human evaluation for generative medical VQA where physicians review the problems and blinded generations in an interactive app. Med-Flamingo improves performance in generative medical VQA by up to 20\% in clinician's rating and firstly enables multimodal medical few-shot adaptations, such as rationale generation. We release our model, code, and evaluation app under https://github.com/snap-stanford/med-flamingo.

The recommendation of medication is a vital aspect of intelligent healthcare systems, as it involves prescribing the most suitable drugs based on a patient's specific health needs. Unfortunately, many sophisticated models currently in use tend to overlook the nuanced semantics of medical data, while only relying heavily on identities. Furthermore, these models face significant challenges in handling cases involving patients who are visiting the hospital for the first time, as they lack prior prescription histories to draw upon. To tackle these issues, we harness the powerful semantic comprehension and input-agnostic characteristics of Large Language Models (LLMs). Our research aims to transform existing medication recommendation methodologies using LLMs. In this paper, we introduce a novel approach called Large Language Model Distilling Medication Recommendation (LEADER). We begin by creating appropriate prompt templates that enable LLMs to suggest medications effectively. However, the straightforward integration of LLMs into recommender systems leads to an out-of-corpus issue specific to drugs. We handle it by adapting the LLMs with a novel output layer and a refined tuning loss function. Although LLM-based models exhibit remarkable capabilities, they are plagued by high computational costs during inference, which is impractical for the healthcare sector. To mitigate this, we have developed a feature-level knowledge distillation technique, which transfers the LLM's proficiency to a more compact model. Extensive experiments conducted on two real-world datasets, MIMIC-III and MIMIC-IV, demonstrate that our proposed model not only delivers effective results but also is efficient. To ease the reproducibility of our experiments, we release the implementation code online.

Large language models (LLMs) are proficient in capturing factual knowledge across various domains. However, refining their capabilities on previously seen knowledge or integrating new knowledge from external sources remains a significant challenge. In this work, we propose a novel synthetic knowledge ingestion method called Ski, which leverages fine-grained synthesis, interleaved generation, and assemble augmentation strategies to construct high-quality data representations from raw knowledge sources. We then integrate Ski and its variations with three knowledge injection techniques: Retrieval Augmented Generation (RAG), Supervised Fine-tuning (SFT), and Continual Pre-training (CPT) to inject and refine knowledge in language models. Extensive empirical experiments are conducted on various question-answering tasks spanning finance, biomedicine, and open-generation domains to demonstrate that Ski significantly outperforms baseline methods by facilitating effective knowledge injection. We believe that our work is an important step towards enhancing the factual accuracy of LLM outputs by refining knowledge representation and injection capabilities.

Recent advances in large language model (LLM) training have highlighted the need for diverse, high-quality instruction data. Recently, many works are exploring synthetic data generation using LLMs. However, they primarily focus on prompt engineering with standard supervised instruction-finetuned models, which contains a fundamental limitation: these models are optimized for general question-answering/problem-solving rather than data generation. We propose a paradigm shift named NOMAD by investigating how to specifically train models for data generation, demonstrating that this task differs significantly from training a classical LM. We identify two key factors: no-prompt-masked training and proper training set size selection. Our method, NOMAD, shows substantial improvements over baselines, achieving >4\% gains in TriviaQA and >2\% in GSM8K with limited training data. Finally, we offer new insights by interpreting synthetic data through the lenses of "relevance" and "novelty".

Rationality and emotion are two fundamental elements of humans. Endowing agents with rationality and emotion has been one of the major milestones in AI. However, in the field of conversational AI, most existing models only specialize in one aspect and neglect the other, which often leads to dull or unrelated responses. In this paper, we hypothesize that combining rationality and emotion into conversational agents can improve response quality. To test the hypothesis, we focus on one fundamental aspect of rationality, i.e., commonsense, and propose CARE, a novel model for commonsense-aware emotional response generation. Specifically, we first propose a framework to learn and construct commonsense-aware emotional latent concepts of the response given an input message and a desired emotion. We then propose three methods to collaboratively incorporate the latent concepts into response generation. Experimental results on two large-scale datasets support our hypothesis and show that our model can produce more accurate and commonsense-aware emotional responses and achieve better human ratings than state-of-the-art models that only specialize in one aspect.

Large language models (LLMs) have demonstrated exceptional performance in planning the use of various functional tools, such as calculators and retrievers, particularly in question-answering tasks. In this paper, we expand the definition of these tools, centering on conceptual tools within the context of dialogue systems. A conceptual tool specifies a cognitive concept that aids systematic or investigative thought. These conceptual tools play important roles in practice, such as multiple psychological or tutoring strategies being dynamically applied in a single turn to compose helpful responses. To further enhance the reasoning and planning capability of LLMs with these conceptual tools, we introduce a multi-persona collaboration framework: Think-Plan-Execute (TPE). This framework decouples the response generation process into three distinct roles: Thinker, Planner, and Executor. Specifically, the Thinker analyzes the internal status exhibited in the dialogue context, such as user emotions and preferences, to formulate a global guideline. The Planner then generates executable plans to call different conceptual tools (e.g., sources or strategies), while the Executor compiles all intermediate results into a coherent response. This structured approach not only enhances the explainability and controllability of responses but also reduces token redundancy. We demonstrate the effectiveness of TPE across various dialogue response generation tasks, including multi-source (FoCus) and multi-strategy interactions (CIMA and PsyQA). This reveals its potential to handle real-world dialogue interactions that require more complicated tool learning beyond just functional tools. The full code and data will be released for reproduction.

Predicting how different interventions will causally affect a specific individual is important in a variety of domains such as personalized medicine, public policy, and online marketing. There are a large number of methods to predict the effect of an existing intervention based on historical data from individuals who received it. However, in many settings it is important to predict the effects of novel interventions (e.g., a newly invented drug), which these methods do not address. Here, we consider zero-shot causal learning: predicting the personalized effects of a novel intervention. We propose CaML, a causal meta-learning framework which formulates the personalized prediction of each intervention's effect as a task. CaML trains a single meta-model across thousands of tasks, each constructed by sampling an intervention, along with its recipients and nonrecipients. By leveraging both intervention information (e.g., a drug's attributes) and individual features~(e.g., a patient's history), CaML is able to predict the personalized effects of novel interventions that do not exist at the time of training. Experimental results on real world datasets in large-scale medical claims and cell-line perturbations demonstrate the effectiveness of our approach. Most strikingly, CaML's zero-shot predictions outperform even strong baselines trained directly on data from the test interventions.

Generating fluent and informative responses is of critical importance for task-oriented dialogue systems. Existing pipeline approaches generally predict multiple dialogue acts first and use them to assist response generation. There are at least two shortcomings with such approaches. First, the inherent structures of multi-domain dialogue acts are neglected. Second, the semantic associations between acts and responses are not taken into account for response generation. To address these issues, we propose a neural co-generation model that generates dialogue acts and responses concurrently. Unlike those pipeline approaches, our act generation module preserves the semantic structures of multi-domain dialogue acts and our response generation module dynamically attends to different acts as needed. We train the two modules jointly using an uncertainty loss to adjust their task weights adaptively. Extensive experiments are conducted on the large-scale MultiWOZ dataset and the results show that our model achieves very favorable improvement over several state-of-the-art models in both automatic and human evaluations.

Mental health disorders are one of the most serious diseases in the world. Most people with such a disease lack access to adequate care, which highlights the importance of training models for the diagnosis and treatment of mental health disorders. However, in the mental health domain, privacy concerns limit the accessibility of personalized treatment data, making it challenging to build powerful models. In this paper, we introduce MentalArena, a self-play framework to train language models by generating domain-specific personalized data, where we obtain a better model capable of making a personalized diagnosis and treatment (as a therapist) and providing information (as a patient). To accurately model human-like mental health patients, we devise Symptom Encoder, which simulates a real patient from both cognition and behavior perspectives. To address intent bias during patient-therapist interactions, we propose Symptom Decoder to compare diagnosed symptoms with encoded symptoms, and dynamically manage the dialogue between patient and therapist according to the identified deviations. We evaluated MentalArena against 6 benchmarks, including biomedicalQA and mental health tasks, compared to 6 advanced models. Our models, fine-tuned on both GPT-3.5 and Llama-3-8b, significantly outperform their counterparts, including GPT-4o. We hope that our work can inspire future research on personalized care. Code is available in https://github.com/Scarelette/MentalArena/tree/main

This paper contains what the Georgetown InfoSense group has done in regard to solving the challenges presented by TREC iKAT 2023. Our submitted runs outperform the median runs by a significant margin, exhibiting superior performance in nDCG across various cut numbers and in overall success rate. Our approach uses a Generate-Retrieve-Generate method, which we've found to greatly outpace Retrieve-Then-Generate approaches for the purposes of iKAT. Our solution involves the use of Large Language Models (LLMs) for initial answers, answer grounding by BM25, passage quality filtering by logistic regression, and answer generation by LLMs again. We leverage several purpose-built Language Models, including BERT, Chat-based, and text-to-transfer-based models, for text understanding, classification, generation, and summarization. The official results of the TREC evaluation contradict our initial self-evaluation, which may suggest that a decrease in the reliance on our retrieval and classification methods is better. Nonetheless, our findings suggest that the sequence of involving these different components matters, where we see an essentiality of using LLMs before using search engines.

End of semester student evaluations of teaching are the dominant mechanism for providing feedback to academics on their teaching practice. For large classes, however, the volume of feedback makes these tools impractical for this purpose. This paper explores the use of open-source generative AI to synthesise factual, actionable and appropriate summaries of student feedback from these survey responses. In our setup, we have 742 student responses ranging over 75 courses in a Computer Science department. For each course, we synthesise a summary of the course evaluations and actionable items for the instructor. Our results reveal a promising avenue for enhancing teaching practices in the classroom setting. Our contribution lies in demonstrating the feasibility of using generative AI to produce insightful feedback for teachers, thus providing a cost-effective means to support educators' development. Overall, our work highlights the possibility of using generative AI to produce factual, actionable, and appropriate feedback for teachers in the classroom setting.

The ability to ask questions is important in both human and machine intelligence. Learning to ask questions helps knowledge acquisition, improves question-answering and machine reading comprehension tasks, and helps a chatbot to keep the conversation flowing with a human. Existing question generation models are ineffective at generating a large amount of high-quality question-answer pairs from unstructured text, since given an answer and an input passage, question generation is inherently a one-to-many mapping. In this paper, we propose Answer-Clue-Style-aware Question Generation (ACS-QG), which aims at automatically generating high-quality and diverse question-answer pairs from unlabeled text corpus at scale by imitating the way a human asks questions. Our system consists of: i) an information extractor, which samples from the text multiple types of assistive information to guide question generation; ii) neural question generators, which generate diverse and controllable questions, leveraging the extracted assistive information; and iii) a neural quality controller, which removes low-quality generated data based on text entailment. We compare our question generation models with existing approaches and resort to voluntary human evaluation to assess the quality of the generated question-answer pairs. The evaluation results suggest that our system dramatically outperforms state-of-the-art neural question generation models in terms of the generation quality, while being scalable in the meantime. With models trained on a relatively smaller amount of data, we can generate 2.8 million quality-assured question-answer pairs from a million sentences found in Wikipedia.

Recent approaches to empathetic response generation try to incorporate commonsense knowledge or reasoning about the causes of emotions to better understand the user's experiences and feelings. However, these approaches mainly focus on understanding the causalities of context from the user's perspective, ignoring the system's perspective. In this paper, we propose a commonsense-based causality explanation approach for diverse empathetic response generation that considers both the user's perspective (user's desires and reactions) and the system's perspective (system's intentions and reactions). We enhance ChatGPT's ability to reason for the system's perspective by integrating in-context learning with commonsense knowledge. Then, we integrate the commonsense-based causality explanation with both ChatGPT and a T5-based model. Experimental evaluations demonstrate that our method outperforms other comparable methods on both automatic and human evaluations.

Documentation burden is a major contributor to clinician burnout, which is rising nationally and is an urgent threat to our ability to care for patients. Artificial intelligence (AI) chatbots, such as ChatGPT, could reduce clinician burden by assisting with documentation. Although many hospitals are actively integrating such systems into electronic medical record systems, AI chatbots utility and impact on clinical decision-making have not been studied for this intended use. We are the first to examine the utility of large language models in assisting clinicians draft responses to patient questions. In our two-stage cross-sectional study, 6 oncologists responded to 100 realistic synthetic cancer patient scenarios and portal messages developed to reflect common medical situations, first manually, then with AI assistance. We find AI-assisted responses were longer, less readable, but provided acceptable drafts without edits 58% of time. AI assistance improved efficiency 77% of time, with low harm risk (82% safe). However, 7.7% unedited AI responses could severely harm. In 31% cases, physicians thought AI drafts were human-written. AI assistance led to more patient education recommendations, fewer clinical actions than manual responses. Results show promise for AI to improve clinician efficiency and patient care through assisting documentation, if used judiciously. Monitoring model outputs and human-AI interaction remains crucial for safe implementation.

In the expanding field of language model applications, medical knowledge representation remains a significant challenge due to the specialized nature of the domain. Large language models, such as GPT-4, obtain reasonable scores on medical question answering tasks, but smaller models are far behind. In this work, we introduce a method to improve the proficiency of a small language model in the medical domain by employing a two-fold approach. We first fine-tune the model on a corpus of medical textbooks. Then, we use GPT-4 to generate questions similar to the downstream task, prompted with textbook knowledge, and use them to fine-tune the model. Additionally, we introduce ECN-QA, a novel medical question answering dataset containing ``progressive questions'' composed of related sequential questions. We show the benefits of our training strategy on this dataset. The study's findings highlight the potential of small language models in the medical domain when appropriately fine-tuned. The code and weights are available at https://github.com/raidium-med/MQG.

Virtual counselors powered by large language models (LLMs) aim to create interactive support systems that effectively assist clients struggling with mental health challenges. To replicate counselor-client conversations, researchers have built an online mental health platform that allows professional counselors to provide clients with text-based counseling services for about an hour per session. Notwithstanding its effectiveness, challenges exist as human annotation is time-consuming, cost-intensive, privacy-protected, and not scalable. To address this issue and investigate the applicability of LLMs in psychological counseling conversation simulation, we propose a framework that employs two LLMs via role-playing for simulating counselor-client interactions. Our framework involves two LLMs, one acting as a client equipped with a specific and real-life user profile and the other playing the role of an experienced counselor, generating professional responses using integrative therapy techniques. We implement both the counselor and the client by zero-shot prompting the GPT-4 model. In order to assess the effectiveness of LLMs in simulating counselor-client interactions and understand the disparities between LLM- and human-generated conversations, we evaluate the synthetic data from various perspectives. We begin by assessing the client's performance through automatic evaluations. Next, we analyze and compare the disparities between dialogues generated by the LLM and those generated by professional counselors. Furthermore, we conduct extensive experiments to thoroughly examine the performance of our LLM-based counselor trained with synthetic interactive dialogues by benchmarking against state-of-the-art models for mental health.

Synthetic data generation has the potential to impact applications and domains with scarce data. However, before such data is used for sensitive tasks such as mental health, we need an understanding of how different demographics are represented in it. In our paper, we analyze the potential of producing synthetic data using GPT-3 by exploring the various stressors it attributes to different race and gender combinations, to provide insight for future researchers looking into using LLMs for data generation. Using GPT-3, we develop HEADROOM, a synthetic dataset of 3,120 posts about depression-triggering stressors, by controlling for race, gender, and time frame (before and after COVID-19). Using this dataset, we conduct semantic and lexical analyses to (1) identify the predominant stressors for each demographic group; and (2) compare our synthetic data to a human-generated dataset. We present the procedures to generate queries to develop depression data using GPT-3, and conduct analyzes to uncover the types of stressors it assigns to demographic groups, which could be used to test the limitations of LLMs for synthetic data generation for depression data. Our findings show that synthetic data mimics some of the human-generated data distribution for the predominant depression stressors across diverse demographics.

Researchers and developers increasingly rely on toxicity scoring to moderate generative language model outputs, in settings such as customer service, information retrieval, and content generation. However, toxicity scoring may render pertinent information inaccessible, rigidify or "value-lock" cultural norms, and prevent language reclamation processes, particularly for marginalized people. In this work, we extend the concept of algorithmic recourse to generative language models: we provide users a novel mechanism to achieve their desired prediction by dynamically setting thresholds for toxicity filtering. Users thereby exercise increased agency relative to interactions with the baseline system. A pilot study (n = 30) supports the potential of our proposed recourse mechanism, indicating improvements in usability compared to fixed-threshold toxicity-filtering of model outputs. Future work should explore the intersection of toxicity scoring, model controllability, user agency, and language reclamation processes -- particularly with regard to the bias that many communities encounter when interacting with generative language models.

The increased capabilities of generative AI have dramatically expanded its possible use cases in medicine. We provide a comprehensive overview of generative AI use cases for clinicians, patients, clinical trial organizers, researchers, and trainees. We then discuss the many challenges -- including maintaining privacy and security, improving transparency and interpretability, upholding equity, and rigorously evaluating models -- which must be overcome to realize this potential, and the open research directions they give rise to.

Developing therapeutics is a lengthy and expensive process that requires the satisfaction of many different criteria, and AI models capable of expediting the process would be invaluable. However, the majority of current AI approaches address only a narrowly defined set of tasks, often circumscribed within a particular domain. To bridge this gap, we introduce Tx-LLM, a generalist large language model (LLM) fine-tuned from PaLM-2 which encodes knowledge about diverse therapeutic modalities. Tx-LLM is trained using a collection of 709 datasets that target 66 tasks spanning various stages of the drug discovery pipeline. Using a single set of weights, Tx-LLM simultaneously processes a wide variety of chemical or biological entities(small molecules, proteins, nucleic acids, cell lines, diseases) interleaved with free-text, allowing it to predict a broad range of associated properties, achieving competitive with state-of-the-art (SOTA) performance on 43 out of 66 tasks and exceeding SOTA on 22. Among these, Tx-LLM is particularly powerful and exceeds best-in-class performance on average for tasks combining molecular SMILES representations with text such as cell line names or disease names, likely due to context learned during pretraining. We observe evidence of positive transfer between tasks with diverse drug types (e.g.,tasks involving small molecules and tasks involving proteins), and we study the impact of model size, domain finetuning, and prompting strategies on performance. We believe Tx-LLM represents an important step towards LLMs encoding biochemical knowledge and could have a future role as an end-to-end tool across the drug discovery development pipeline.

Recent research on large language models (LLMs) has primarily focused on their adaptation and application in specialized domains. The application of LLMs in the medical field is mainly concentrated on tasks such as the automation of medical report generation, summarization, diagnostic reasoning, and question-and-answer interactions between doctors and patients. The challenge of becoming a good teacher is more formidable than that of becoming a good student, and this study pioneers the application of LLMs in the field of medical education. In this work, we investigate the extent to which LLMs can generate medical qualification exam questions and corresponding answers based on few-shot prompts. Utilizing a real-world Chinese dataset of elderly chronic diseases, we tasked the LLMs with generating open-ended questions and answers based on a subset of sampled admission reports across eight widely used LLMs, including ERNIE 4, ChatGLM 4, Doubao, Hunyuan, Spark 4, Qwen, Llama 3, and Mistral. Furthermore, we engaged medical experts to manually evaluate these open-ended questions and answers across multiple dimensions. The study found that LLMs, after using few-shot prompts, can effectively mimic real-world medical qualification exam questions, whereas there is room for improvement in the correctness, evidence-based statements, and professionalism of the generated answers. Moreover, LLMs also demonstrate a decent level of ability to correct and rectify reference answers. Given the immense potential of artificial intelligence in the medical field, the task of generating questions and answers for medical qualification exams aimed at medical students, interns and residents can be a significant focus of future research.

We propose DISC-MedLLM, a comprehensive solution that leverages Large Language Models (LLMs) to provide accurate and truthful medical response in end-to-end conversational healthcare services. To construct high-quality Supervised Fine-Tuning (SFT) datasets, we employ three strategies: utilizing medical knowledge-graphs, reconstructing real-world dialogues, and incorporating human-guided preference rephrasing. These datasets are instrumental in training DISC-MedLLM, surpassing existing medical LLMs in both single-turn and multi-turn consultation scenarios. Extensive experimental results demonstrate the effectiveness of the proposed model in bridging the gap between general language models and real-world medical consultation. Additionally, we release the constructed dataset and model weights to further contribute to research and development. Further details and resources can be found at https://github.com/FudanDISC/DISC-MedLLM

Recent advances in large-scale pre-training such as GPT-3 allow seemingly high quality text to be generated from a given prompt. However, such generation systems often suffer from problems of hallucinated facts, and are not inherently designed to incorporate useful external information. Grounded generation models appear to offer remedies, but their training typically relies on rarely-available parallel data where information-relevant documents are provided for context. We propose a framework that alleviates this data constraint by jointly training a grounded generator and document retriever on the language model signal. The model learns to reward retrieval of the documents with the highest utility in generation, and attentively combines them using a Mixture-of-Experts (MoE) ensemble to generate follow-on text. We demonstrate that both generator and retriever can take advantage of this joint training and work synergistically to produce more informative and relevant text in both prose and dialogue generation.

Most NLP tasks are modeled as supervised learning and thus require labeled training data to train effective models. However, manually producing such data at sufficient quality and quantity is known to be costly and time-intensive. Current research addresses this bottleneck by exploring a novel paradigm called zero-shot learning via dataset generation. Here, a powerful LLM is prompted with a task description to generate labeled data that can be used to train a downstream NLP model. For instance, an LLM might be prompted to "generate 500 movie reviews with positive overall sentiment, and another 500 with negative sentiment." The generated data could then be used to train a binary sentiment classifier, effectively leveraging an LLM as a teacher to a smaller student model. With this demo, we introduce Fabricator, an open-source Python toolkit for dataset generation. Fabricator implements common dataset generation workflows, supports a wide range of downstream NLP tasks (such as text classification, question answering, and entity recognition), and is integrated with well-known libraries to facilitate quick experimentation. With Fabricator, we aim to support researchers in conducting reproducible dataset generation experiments using LLMs and help practitioners apply this approach to train models for downstream tasks.

Customizable role-playing in large language models (LLMs), also known as character generalization, is gaining increasing attention for its versatility and cost-efficiency in developing and deploying role-playing dialogue agents. This study explores a large-scale data synthesis approach to equip LLMs with character generalization capabilities. We begin by synthesizing large-scale character profiles using personas from Persona Hub and then explore two strategies: response rewriting and response generation, to create character-aligned instructional responses. To validate the effectiveness of our synthetic instruction tuning data for character generalization, we perform supervised fine-tuning (SFT) using the LLaMA-3 8B model. Our best-performing model strengthens the original LLaMA-3 8B Instruct model and achieves performance comparable to GPT-4o models on role-playing dialogue. We release our synthetic characters and instruction-tuning dialogues to support public research.

Instruction Tuning (IT), the process of training large language models (LLMs) using instruction-response pairs, has emerged as the predominant method for transforming base pre-trained LLMs into open-domain conversational agents. While IT has achieved notable success and widespread adoption, its limitations and shortcomings remain underexplored. In this paper, through rigorous experiments and an in-depth analysis of the changes LLMs undergo through IT, we reveal various limitations of IT. In particular, we show that (1) IT fails to enhance knowledge or skills in LLMs. LoRA fine-tuning is limited to learning response initiation and style tokens, and full-parameter fine-tuning leads to knowledge degradation. (2) Copying response patterns from IT datasets derived from knowledgeable sources leads to a decline in response quality. (3) Full-parameter fine-tuning increases hallucination by inaccurately borrowing tokens from conceptually similar instances in the IT dataset for generating responses. (4) Popular methods to improve IT do not lead to performance improvements over a simple LoRA fine-tuned model. Our findings reveal that responses generated solely from pre-trained knowledge consistently outperform responses by models that learn any form of new knowledge from IT on open-source datasets. We hope the insights and challenges revealed inspire future work.

This paper presents the system description of our entry for the COLING 2025 RegNLP RIRAG (Regulatory Information Retrieval and Answer Generation) challenge, focusing on leveraging advanced information retrieval and answer generation techniques in regulatory domains. We experimented with a combination of embedding models, including Stella, BGE, CDE, and Mpnet, and leveraged fine-tuning and reranking for retrieving relevant documents in top ranks. We utilized a novel approach, LeSeR, which achieved competitive results with a recall@10 of 0.8201 and map@10 of 0.6655 for retrievals. This work highlights the transformative potential of natural language processing techniques in regulatory applications, offering insights into their capabilities for implementing a retrieval augmented generation system while identifying areas for future improvement in robustness and domain adaptation.

We present a design framework called Conversational Learning with Analytical Step-by-Step Strategies (CLASS) for developing high-performance Intelligent Tutoring Systems (ITS). The CLASS framework aims to empower ITS with with two critical capabilities: imparting tutor-like step-by-step guidance and enabling tutor-like conversations in natural language to effectively engage learners. To empower ITS with the aforementioned capabilities, the CLASS framework employs two carefully curated synthetic datasets. The first scaffolding dataset encompasses a variety of elements, including problems, their corresponding subproblems, hints, incorrect solutions, and tailored feedback. This dataset provides ITS with essential problem-solving strategies necessary for guiding students through each step of the conversation. The second conversational dataset contains simulated student-tutor conversations that involve the application of problem-solving strategies learned from the first dataset. In the second dataset, the tutoring system adheres to a pre-defined response template, which helps to maintain consistency and structure in ITS's responses during its interactions. This structured methodology facilitates seamless integration of user feedback and yields valuable insights into ITS's internal decision-making process, allowing for continuous refinement and improvement of the system. We also present a proof-of-concept ITS, referred to as SPOCK, trained using the CLASS framework with a focus on college level introductory biology content. A carefully constructed protocol was developed for SPOCK's preliminary evaluation, examining aspects such as the factual accuracy and relevance of its responses. Experts in the field of biology offered favorable remarks, particularly highlighting SPOCK's capability to break down questions into manageable subproblems and provide step-by-step guidance to students.

In recent years, the machine learning research community has benefited tremendously from the availability of openly accessible benchmark datasets. Clinical data are usually not openly available due to their highly confidential nature. This has hampered the development of reproducible and generalisable machine learning applications in health care. Here we introduce the Health Gym - a growing collection of highly realistic synthetic medical datasets that can be freely accessed to prototype, evaluate, and compare machine learning algorithms, with a specific focus on reinforcement learning. The three synthetic datasets described in this paper present patient cohorts with acute hypotension and sepsis in the intensive care unit, and people with human immunodeficiency virus (HIV) receiving antiretroviral therapy in ambulatory care. The datasets were created using a novel generative adversarial network (GAN). The distributions of variables, and correlations between variables and trends over time in the synthetic datasets mirror those in the real datasets. Furthermore, the risk of sensitive information disclosure associated with the public distribution of the synthetic datasets is estimated to be very low.

Large language models (LLMs) have demonstrated impressive capabilities in natural language understanding and generation, but the quality bar for medical and clinical applications is high. Today, attempts to assess models' clinical knowledge typically rely on automated evaluations on limited benchmarks. There is no standard to evaluate model predictions and reasoning across a breadth of tasks. To address this, we present MultiMedQA, a benchmark combining six existing open question answering datasets spanning professional medical exams, research, and consumer queries; and HealthSearchQA, a new free-response dataset of medical questions searched online. We propose a framework for human evaluation of model answers along multiple axes including factuality, precision, possible harm, and bias. In addition, we evaluate PaLM (a 540-billion parameter LLM) and its instruction-tuned variant, Flan-PaLM, on MultiMedQA. Using a combination of prompting strategies, Flan-PaLM achieves state-of-the-art accuracy on every MultiMedQA multiple-choice dataset (MedQA, MedMCQA, PubMedQA, MMLU clinical topics), including 67.6% accuracy on MedQA (US Medical License Exam questions), surpassing prior state-of-the-art by over 17%. However, human evaluation reveals key gaps in Flan-PaLM responses. To resolve this we introduce instruction prompt tuning, a parameter-efficient approach for aligning LLMs to new domains using a few exemplars. The resulting model, Med-PaLM, performs encouragingly, but remains inferior to clinicians. We show that comprehension, recall of knowledge, and medical reasoning improve with model scale and instruction prompt tuning, suggesting the potential utility of LLMs in medicine. Our human evaluations reveal important limitations of today's models, reinforcing the importance of both evaluation frameworks and method development in creating safe, helpful LLM models for clinical applications.

Large Language Models (LLMs) excel in data synthesis but can be inaccurate in domain-specific tasks, which retrieval-augmented generation (RAG) systems address by leveraging user-provided data. However, RAGs require optimization in both retrieval and generation stages, which can affect output quality. In this paper, we present LLM-Ref, a writing assistant tool that aids researchers in writing articles from multiple source documents with enhanced reference synthesis and handling capabilities. Unlike traditional RAG systems that use chunking and indexing, our tool retrieves and generates content directly from text paragraphs. This method facilitates direct reference extraction from the generated outputs, a feature unique to our tool. Additionally, our tool employs iterative response generation, effectively managing lengthy contexts within the language model's constraints. Compared to baseline RAG-based systems, our approach achieves a 3.25times to 6.26times increase in Ragas score, a comprehensive metric that provides a holistic view of a RAG system's ability to produce accurate, relevant, and contextually appropriate responses. This improvement shows our method enhances the accuracy and contextual relevance of writing assistance tools.

Generative language models often struggle with specialized or less-discussed knowledge. A potential solution is found in Retrieval-Augmented Generation (RAG) models which act like retrieving information before generating responses. In this study, we explore how the Atlas approach, a RAG model, decides between what it already knows (parametric) and what it retrieves (non-parametric). We use causal mediation analysis and controlled experiments to examine how internal representations influence information processing. Our findings disentangle the effects of parametric knowledge and the retrieved context. They indicate that in cases where the model can choose between both types of information (parametric and non-parametric), it relies more on the context than the parametric knowledge. Furthermore, the analysis investigates the computations involved in how the model uses the information from the context. We find that multiple mechanisms are active within the model and can be detected with mediation analysis: first, the decision of whether the context is relevant, and second, how the encoder computes output representations to support copying when relevant.

Retrieval-augmented generation (RAG) has emerged as a promising approach to enhance the performance of large language models (LLMs) in knowledge-intensive tasks such as those from medical domain. However, the sensitive nature of the medical domain necessitates a completely accurate and trustworthy system. While existing RAG benchmarks primarily focus on the standard retrieve-answer setting, they overlook many practical scenarios that measure crucial aspects of a reliable medical system. This paper addresses this gap by providing a comprehensive evaluation framework for medical question-answering (QA) systems in a RAG setting for these situations, including sufficiency, integration, and robustness. We introduce Medical Retrieval-Augmented Generation Benchmark (MedRGB) that provides various supplementary elements to four medical QA datasets for testing LLMs' ability to handle these specific scenarios. Utilizing MedRGB, we conduct extensive evaluations of both state-of-the-art commercial LLMs and open-source models across multiple retrieval conditions. Our experimental results reveals current models' limited ability to handle noise and misinformation in the retrieved documents. We further analyze the LLMs' reasoning processes to provides valuable insights and future directions for developing RAG systems in this critical medical domain.

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.

Caution: This paper includes offensive words that could potentially cause unpleasantness. The fast-paced evolution of generative language models such as GPT-4 has demonstrated outstanding results in various NLP generation tasks. However, due to the potential generation of offensive words related to race or gender, various Controllable Text Generation (CTG) methods have been proposed to mitigate the occurrence of harmful words. However, existing CTG methods not only reduce toxicity but also negatively impact several aspects of the language model's generation performance, including topic consistency, grammar, and perplexity. This paper explores the limitations of previous methods and introduces a novel solution in the form of a simple Gated Toxicity Avoidance (GTA) that can be applied to any CTG method. We also evaluate the effectiveness of the proposed GTA by comparing it with state-of-the-art CTG methods across various datasets. Our findings reveal that gated toxicity avoidance efficiently achieves comparable levels of toxicity reduction to the original CTG methods while preserving the generation performance of the language model.

High-quality conversational datasets are integral to the successful development of Intelligent Tutoring Systems (ITS) that employ a Large Language Model (LLM) backend. These datasets, when used to fine-tune the LLM backend, significantly enhance the quality of interactions between students and ITS. A common strategy for developing these datasets involves generating synthetic student-teacher dialogues using advanced GPT-4 models. However, challenges arise when these dialogues demand complex calculations, common in subjects like physics. Despite its advanced capabilities, GPT-4's performance falls short in reliably handling even simple multiplication tasks, marking a significant limitation in its utility for these subjects. To address these challenges, this paper introduces an innovative stateful prompt design. Our approach generates a mock conversation between a student and a tutorbot, both roles simulated by GPT-4. Each student response triggers a soliloquy (an inner monologue) in the GPT-tutorbot, which assesses whether its response would necessitate calculations. If so, it proceeds to script the required code in Python and then uses the resulting output to construct its response to the student. Our approach notably enhances the quality of synthetic conversation datasets, especially for subjects that are calculation-intensive. Our findings show that our Higgs model -- a LLaMA finetuned with datasets generated through our novel stateful prompt design -- proficiently utilizes Python for computations. Consequently, finetuning with our datasets enriched with code soliloquies enhances not just the accuracy but also the computational reliability of Higgs' responses.

Large language models (LLMs) have demonstrated remarkable capabilities in natural language understanding and generation across various domains, including medicine. We present a comprehensive evaluation of GPT-4, a state-of-the-art LLM, on medical competency examinations and benchmark datasets. GPT-4 is a general-purpose model that is not specialized for medical problems through training or engineered to solve clinical tasks. Our analysis covers two sets of official practice materials for the USMLE, a three-step examination program used to assess clinical competency and grant licensure in the United States. We also evaluate performance on the MultiMedQA suite of benchmark datasets. Beyond measuring model performance, experiments were conducted to investigate the influence of test questions containing both text and images on model performance, probe for memorization of content during training, and study probability calibration, which is of critical importance in high-stakes applications like medicine. Our results show that GPT-4, without any specialized prompt crafting, exceeds the passing score on USMLE by over 20 points and outperforms earlier general-purpose models (GPT-3.5) as well as models specifically fine-tuned on medical knowledge (Med-PaLM, a prompt-tuned version of Flan-PaLM 540B). In addition, GPT-4 is significantly better calibrated than GPT-3.5, demonstrating a much-improved ability to predict the likelihood that its answers are correct. We also explore the behavior of the model qualitatively through a case study that shows the ability of GPT-4 to explain medical reasoning, personalize explanations to students, and interactively craft new counterfactual scenarios around a medical case. Implications of the findings are discussed for potential uses of GPT-4 in medical education, assessment, and clinical practice, with appropriate attention to challenges of accuracy and safety.

Applying large language models (LLMs) to assist in psycho-counseling is an emerging and meaningful approach, driven by the significant gap between patient needs and the availability of mental health support. However, current LLMs struggle to consistently provide effective responses to client speeches, largely due to the lack of supervision from high-quality real psycho-counseling data, whose content is typically inaccessible due to client privacy concerns. Furthermore, the quality of therapists' responses in available sessions can vary significantly based on their professional training and experience. Assessing the quality of therapists' responses remains an open challenge. In this work, we address these challenges by first proposing a set of professional and comprehensive principles to evaluate therapists' responses to client speeches. Using these principles, we create a preference dataset, PsychoCounsel-Preference, which contains 36k high-quality preference comparison pairs. This dataset aligns with the preferences of professional psychotherapists, providing a robust foundation for evaluating and improving LLMs in psycho-counseling. Experiments on reward modeling and preference learning demonstrate that PsychoCounsel-Preference is an excellent resource for LLMs to acquire essential skills for responding to clients in a counseling session. Our best-aligned model, PsychoCounsel-Llama3-8B, achieves an impressive win rate of 87% against GPT-4o. We release PsychoCounsel-Preference, PsychoCounsel-Llama3-8B and the reward model PsychoCounsel Llama3-8B-Reward to facilitate the research of psycho-counseling with LLMs at: https://hf.co/Psychotherapy-LLM.

While large language models have demonstrated exceptional performance across a wide range of tasks, they remain susceptible to hallucinations -- generating plausible yet factually incorrect contents. Existing methods to mitigating such risk often rely on sampling multiple full-length generations, which introduces significant response latency and becomes ineffective when the model consistently produces hallucinated outputs with high confidence. To address these limitations, we introduce Monitoring Decoding (MD), a novel framework that dynamically monitors the generation process and selectively applies in-process interventions, focusing on revising crucial tokens responsible for hallucinations. Instead of waiting until completion of multiple full-length generations, we identify hallucination-prone tokens during generation using a monitor function, and further refine these tokens through a tree-based decoding strategy. This approach ensures an enhanced factual accuracy and coherence in the generated output while maintaining efficiency. Experimental results demonstrate that MD consistently outperforms self-consistency-based approaches in both effectiveness and efficiency, achieving higher factual accuracy while significantly reducing computational overhead.

Pretrained language models have served as important backbones for natural language processing. Recently, in-domain pretraining has been shown to benefit various domain-specific downstream tasks. In the biomedical domain, natural language generation (NLG) tasks are of critical importance, while understudied. Approaching natural language understanding (NLU) tasks as NLG achieves satisfying performance in the general domain through constrained language generation or language prompting. We emphasize the lack of in-domain generative language models and the unsystematic generative downstream benchmarks in the biomedical domain, hindering the development of the research community. In this work, we introduce the generative language model BioBART that adapts BART to the biomedical domain. We collate various biomedical language generation tasks including dialogue, summarization, entity linking, and named entity recognition. BioBART pretrained on PubMed abstracts has enhanced performance compared to BART and set strong baselines on several tasks. Furthermore, we conduct ablation studies on the pretraining tasks for BioBART and find that sentence permutation has negative effects on downstream tasks.

This project aims to investigate a novel sequence generation method inspired by the AlphaGo paradigm, adapting it for use with large language models (LLMs). The proposed approach involves creating search trees of different possible completions and evaluating these completions based on model confidence. By considering various paths in the search tree and scoring them according to the model's confidence in each completion, we can generate diverse and high-quality sequences. This research explores the implementation of this paradigm by using confidence as a proxy for response quality akin to beam search vijayakumar2016diverse. The primary goal of this paper is to outline the paradigm and demonstrate its potential, rather than focusing on achieving perfect results. The paper will outline the reasons why we believe this paradigm has the potential to improve LLMs in the following manners: 1) increase output quality, 2) decrease errors, 3) eliminate or reduce the compound error problems, 4) generate diverse and creative completions, 5) allow for iterative problem-solving, and 6) self-training. We expect this approach to yield a set of diverse and coherent sequences, offering insights into balancing exploration and exploitation in sequence generation. Potential applications include creative text generation tasks, such as storytelling and content creation, as well as other natural language processing domains, like machine translation and automated summarization. The goal is that the model will be far more effective as it will be able to consider many possible variations allowing it to find the ideal completion. This research aims to contribute to the understanding of effective search strategies in sequence generation and their impact on generating high-quality, varied textual outputs.

Radiotherapy (RT) planning is complex, subjective, and time-intensive. Advances in artificial intelligence (AI) promise to improve its precision, efficiency, and consistency, but progress is often limited by the scarcity of large, standardized datasets. To address this, we introduce the Automated Iterative RT Planning (AIRTP) system, a scalable solution for generating high-quality treatment plans. This scalable solution is designed to generate substantial volumes of consistently high-quality treatment plans, overcoming a key obstacle in the advancement of AI-driven RT planning. Our AIRTP pipeline adheres to clinical guidelines and automates essential steps, including organ-at-risk (OAR) contouring, helper structure creation, beam setup, optimization, and plan quality improvement, using AI integrated with RT planning software like Eclipse of Varian. Furthermore, a novel approach for determining optimization parameters to reproduce 3D dose distributions, i.e. a method to convert dose predictions to deliverable treatment plans constrained by machine limitations. A comparative analysis of plan quality reveals that our automated pipeline produces treatment plans of quality comparable to those generated manually, which traditionally require several hours of labor per plan. Committed to public research, the first data release of our AIRTP pipeline includes nine cohorts covering head-and-neck and lung cancer sites to support an AAPM 2025 challenge. This data set features more than 10 times the number of plans compared to the largest existing well-curated public data set to our best knowledge. Repo:{https://github.com/RiqiangGao/GDP-HMM_AAPMChallenge}

Large Language Models (LLMs) and multi-agent systems have shown impressive capabilities in natural language tasks but face challenges in clinical trial applications, primarily due to limited access to external knowledge. Recognizing the potential of advanced clinical trial tools that aggregate and predict based on the latest medical data, we propose an integrated solution to enhance their accessibility and utility. We introduce Clinical Agent System (ClinicalAgent), a clinical multi-agent system designed for clinical trial tasks, leveraging GPT-4, multi-agent architectures, LEAST-TO-MOST, and ReAct reasoning technology. This integration not only boosts LLM performance in clinical contexts but also introduces novel functionalities. The proposed method achieves competitive predictive performance in clinical trial outcome prediction (0.7908 PR-AUC), obtaining a 0.3326 improvement over the standard prompt Method. Publicly available code can be found at https://anonymous.4open.science/r/ClinicalAgent-6671.

As advances in large language models (LLMs) and multimodal techniques continue to mature, the development of general-purpose multimodal large language models (MLLMs) has surged, offering significant applications in interpreting natural images. However, the field of pathology has largely remained untapped, particularly in gathering high-quality data and designing comprehensive model frameworks. To bridge the gap in pathology MLLMs, we present PathAsst, a multimodal generative foundation AI assistant to revolutionize diagnostic and predictive analytics in pathology. The development of PathAsst involves three pivotal steps: data acquisition, CLIP model adaptation, and the training of PathAsst's multimodal generative capabilities. Firstly, we collect over 207K high-quality pathology image-text pairs from authoritative sources. Leveraging the advanced power of ChatGPT, we generate over 180K instruction-following samples. Furthermore, we devise additional instruction-following data specifically tailored for invoking eight pathology-specific sub-models we prepared, allowing the PathAsst to effectively collaborate with these models, enhancing its diagnostic ability. Secondly, by leveraging the collected data, we construct PathCLIP, a pathology-dedicated CLIP, to enhance PathAsst's capabilities in interpreting pathology images. Finally, we integrate PathCLIP with the Vicuna-13b and utilize pathology-specific instruction-tuning data to enhance the multimodal generation capacity of PathAsst and bolster its synergistic interactions with sub-models. The experimental results of PathAsst show the potential of harnessing AI-powered generative foundation model to improve pathology diagnosis and treatment processes.

We introduce a new dynamic vocabulary for language models. It can involve arbitrary text spans during generation. These text spans act as basic generation bricks, akin to tokens in the traditional static vocabularies. We show that, the ability to generate multi-tokens atomically improve both generation quality and efficiency (compared to the standard language model, the MAUVE metric is increased by 25%, the latency is decreased by 20%). The dynamic vocabulary can be deployed in a plug-and-play way, thus is attractive for various downstream applications. For example, we demonstrate that dynamic vocabulary can be applied to different domains in a training-free manner. It also helps to generate reliable citations in question answering tasks (substantially enhancing citation results without compromising answer accuracy).

Retrieval Augmented Generation (RAG) enriches the ability of language models to reason using external context to augment responses for a given user prompt. This approach has risen in popularity due to practical applications in various applications of language models in search, question/answering, and chat-bots. However, the exact nature of how this approach works isn't clearly understood. In this paper, we mechanistically examine the RAG pipeline to highlight that language models take shortcut and have a strong bias towards utilizing only the context information to answer the question, while relying minimally on their parametric memory. We probe this mechanistic behavior in language models with: (i) Causal Mediation Analysis to show that the parametric memory is minimally utilized when answering a question and (ii) Attention Contributions and Knockouts to show that the last token residual stream do not get enriched from the subject token in the question, but gets enriched from other informative tokens in the context. We find this pronounced shortcut behaviour true across both LLaMa and Phi family of models.

The rapid advancement of large language models (LLMs) has significantly impacted various domains, including healthcare and biomedicine. However, the phenomenon of hallucination, where LLMs generate outputs that deviate from factual accuracy or context, poses a critical challenge, especially in high-stakes domains. This paper conducts a scoping study of existing techniques for mitigating hallucinations in knowledge-based task in general and especially for medical domains. Key methods covered in the paper include Retrieval-Augmented Generation (RAG)-based techniques, iterative feedback loops, supervised fine-tuning, and prompt engineering. These techniques, while promising in general contexts, require further adaptation and optimization for the medical domain due to its unique demands for up-to-date, specialized knowledge and strict adherence to medical guidelines. Addressing these challenges is crucial for developing trustworthy AI systems that enhance clinical decision-making and patient safety as well as accuracy of biomedical scientific research.

Synthetic data is becoming increasingly important for accelerating the development of language models, both large and small. Despite several successful use cases, researchers also raised concerns around model collapse and drawbacks of imitating other models. This discrepancy can be attributed to the fact that synthetic data varies in quality and diversity. Effective use of synthetic data usually requires significant human effort in curating the data. We focus on using synthetic data for post-training, specifically creating data by powerful models to teach a new skill or behavior to another model, we refer to this setting as Generative Teaching. We introduce AgentInstruct, an extensible agentic framework for automatically creating large amounts of diverse and high-quality synthetic data. AgentInstruct can create both the prompts and responses, using only raw data sources like text documents and code files as seeds. We demonstrate the utility of AgentInstruct by creating a post training dataset of 25M pairs to teach language models different skills, such as text editing, creative writing, tool usage, coding, reading comprehension, etc. The dataset can be used for instruction tuning of any base model. We post-train Mistral-7b with the data. When comparing the resulting model Orca-3 to Mistral-7b-Instruct (which uses the same base model), we observe significant improvements across many benchmarks. For example, 40% improvement on AGIEval, 19% improvement on MMLU, 54% improvement on GSM8K, 38% improvement on BBH and 45% improvement on AlpacaEval. Additionally, it consistently outperforms other models such as LLAMA-8B-instruct and GPT-3.5-turbo.

Large Language Models (LLMs) have made significant strides in natural language processing but face challenges in terms of computational expense and inefficiency as they grow in size, especially in domain-specific tasks. Small Language Models (SLMs), on the other hand, often struggle in these tasks due to limited capacity and training data. In this paper, we introduce Dr. LLaMA, a method for improving SLMs through generative data augmentation using LLMs, focusing on medical question-answering tasks and the PubMedQA dataset. Our findings indicate that LLMs effectively refine and diversify existing question-answer pairs, resulting in improved performance of a much smaller model on domain-specific QA datasets after fine-tuning. This study highlights the challenges of using LLMs for domain-specific question answering and suggests potential research directions to address these limitations, ultimately aiming to create more efficient and capable models for specialized applications. We have also made our code available for interested researchers

Recent studies show that Question Answering (QA) based on Answer Sentence Selection (AS2) can be improved by generating an improved answer from the top-k ranked answer sentences (termed GenQA). This allows for synthesizing the information from multiple candidates into a concise, natural-sounding answer. However, creating large-scale supervised training data for GenQA models is very challenging. In this paper, we propose to train a GenQA model by transferring knowledge from a trained AS2 model, to overcome the aforementioned issue. First, we use an AS2 model to produce a ranking over answer candidates for a set of questions. Then, we use the top ranked candidate as the generation target, and the next k top ranked candidates as context for training a GenQA model. We also propose to use the AS2 model prediction scores for loss weighting and score-conditioned input/output shaping, to aid the knowledge transfer. Our evaluation on three public and one large industrial datasets demonstrates the superiority of our approach over the AS2 baseline, and GenQA trained using supervised data.

Recent advancements in generative modeling have made it possible to generate high-quality content from context information, but a key question remains: how to teach models to know when to generate content? To answer this question, this study proposes a novel event generative model that draws its statistical intuition from marked temporal point processes, and offers a clean, flexible, and computationally efficient solution for a wide range of applications involving multi-dimensional marks. We aim to capture the distribution of the point process without explicitly specifying the conditional intensity or probability density. Instead, we use a conditional generator that takes the history of events as input and generates the high-quality subsequent event that is likely to occur given the prior observations. The proposed framework offers a host of benefits, including exceptional efficiency in learning the model and generating samples, as well as considerable representational power to capture intricate dynamics in multi- or even high-dimensional event space. Our numerical results demonstrate superior performance compared to other state-of-the-art baselines.

Retrieval-augmented generation (RAG) techniques leverage the in-context learning capabilities of large language models (LLMs) to produce more accurate and relevant responses. Originating from the simple 'retrieve-then-read' approach, the RAG framework has evolved into a highly flexible and modular paradigm. A critical component, the Query Rewriter module, enhances knowledge retrieval by generating a search-friendly query. This method aligns input questions more closely with the knowledge base. Our research identifies opportunities to enhance the Query Rewriter module to Query Rewriter+ by generating multiple queries to overcome the Information Plateaus associated with a single query and by rewriting questions to eliminate Ambiguity, thereby clarifying the underlying intent. We also find that current RAG systems exhibit issues with Irrelevant Knowledge; to overcome this, we propose the Knowledge Filter. These two modules are both based on the instruction-tuned Gemma-2B model, which together enhance response quality. The final identified issue is Redundant Retrieval; we introduce the Memory Knowledge Reservoir and the Retriever Trigger to solve this. The former supports the dynamic expansion of the RAG system's knowledge base in a parameter-free manner, while the latter optimizes the cost for accessing external knowledge, thereby improving resource utilization and response efficiency. These four RAG modules synergistically improve the response quality and efficiency of the RAG system. The effectiveness of these modules has been validated through experiments and ablation studies across six common QA datasets. The source code can be accessed at https://github.com/Ancientshi/ERM4.

A common and fundamental limitation of Generative AI (GenAI) is its propensity to hallucinate. While large language models (LLM) have taken the world by storm, without eliminating or at least reducing hallucinations, real-world GenAI systems may face challenges in user adoption. In the process of deploying an enterprise application that produces workflows based on natural language requirements, we devised a system leveraging Retrieval Augmented Generation (RAG) to greatly improve the quality of the structured output that represents such workflows. Thanks to our implementation of RAG, our proposed system significantly reduces hallucinations in the output and improves the generalization of our LLM in out-of-domain settings. In addition, we show that using a small, well-trained retriever encoder can reduce the size of the accompanying LLM, thereby making deployments of LLM-based systems less resource-intensive.

In this paper, we describe our participation in the subtask 1 of CASE-2022, Event Causality Identification with Casual News Corpus. We address the Causal Relation Identification (CRI) task by exploiting a set of simple yet complementary techniques for fine-tuning language models (LMs) on a small number of annotated examples (i.e., a few-shot configuration). We follow a prompt-based prediction approach for fine-tuning LMs in which the CRI task is treated as a masked language modeling problem (MLM). This approach allows LMs natively pre-trained on MLM problems to directly generate textual responses to CRI-specific prompts. We compare the performance of this method against ensemble techniques trained on the entire dataset. Our best-performing submission was fine-tuned with only 256 instances per class, 15.7% of the all available data, and yet obtained the second-best precision (0.82), third-best accuracy (0.82), and an F1-score (0.85) very close to what was reported by the winner team (0.86).

Inspire therapy is an FDA-approved internal neurostimulation treatment for obstructive sleep apnea. However, not all patients respond to this therapy, posing a challenge even for experienced otolaryngologists to determine candidacy. This paper makes the first attempt to leverage both machine learning and deep learning techniques in discerning patient responsiveness to Inspire therapy using medical data and videos captured through Drug-Induced Sleep Endoscopy (DISE), an essential procedure for Inspire therapy. To achieve this, we gathered and annotated three datasets from 127 patients. Two of these datasets comprise endoscopic videos focused on the Base of the Tongue and Velopharynx. The third dataset composes the patient's clinical information. By utilizing these datasets, we benchmarked and compared the performance of six deep learning models and five classical machine learning algorithms. The results demonstrate the potential of employing machine learning and deep learning techniques to determine a patient's eligibility for Inspire therapy, paving the way for future advancements in this field.

Question answering (QA) models often rely on large-scale training datasets, which necessitates the development of a data generation framework to reduce the cost of manual annotations. Although several recent studies have aimed to generate synthetic questions with single-span answers, no study has been conducted on the creation of list questions with multiple, non-contiguous spans as answers. To address this gap, we propose LIQUID, an automated framework for generating list QA datasets from unlabeled corpora. We first convert a passage from Wikipedia or PubMed into a summary and extract named entities from the summarized text as candidate answers. This allows us to select answers that are semantically correlated in context and is, therefore, suitable for constructing list questions. We then create questions using an off-the-shelf question generator with the extracted entities and original passage. Finally, iterative filtering and answer expansion are performed to ensure the accuracy and completeness of the answers. Using our synthetic data, we significantly improve the performance of the previous best list QA models by exact-match F1 scores of 5.0 on MultiSpanQA, 1.9 on Quoref, and 2.8 averaged across three BioASQ benchmarks.

Recent researches of large language models(LLM), which is pre-trained on massive general-purpose corpora, have achieved breakthroughs in responding human queries. However, these methods face challenges including limited data insufficiency to support extensive pre-training and can not align responses with users' instructions. To address these issues, we introduce a medical instruction dataset, CMedINS, containing six medical instructions derived from actual medical tasks, which effectively fine-tunes LLM in conjunction with other data. Subsequently, We launch our medical model, IIMedGPT, employing an efficient preference alignment method, Direct preference Optimization(DPO). The results show that our final model outperforms existing medical models in medical dialogue.Datsets, Code and model checkpoints will be released upon acceptance.

Empathy is a complex cognitive ability based on the reasoning of others' affective states. In order to better understand others and express stronger empathy in dialogues, we argue that two issues must be tackled at the same time: (i) identifying which word is the cause for the other's emotion from his or her utterance and (ii) reflecting those specific words in the response generation. However, previous approaches for recognizing emotion cause words in text require sub-utterance level annotations, which can be demanding. Taking inspiration from social cognition, we leverage a generative estimator to infer emotion cause words from utterances with no word-level label. Also, we introduce a novel method based on pragmatics to make dialogue models focus on targeted words in the input during generation. Our method is applicable to any dialogue models with no additional training on the fly. We show our approach improves multiple best-performing dialogue agents on generating more focused empathetic responses in terms of both automatic and human evaluation.

Large Language Models (LLMs) generalize well across language tasks, but suffer from hallucinations and uninterpretability, making it difficult to assess their accuracy without ground-truth. Retrieval-Augmented Generation (RAG) models have been proposed to reduce hallucinations and provide provenance for how an answer was generated. Applying such models to the scientific literature may enable large-scale, systematic processing of scientific knowledge. We present PaperQA, a RAG agent for answering questions over the scientific literature. PaperQA is an agent that performs information retrieval across full-text scientific articles, assesses the relevance of sources and passages, and uses RAG to provide answers. Viewing this agent as a question answering model, we find it exceeds performance of existing LLMs and LLM agents on current science QA benchmarks. To push the field closer to how humans perform research on scientific literature, we also introduce LitQA, a more complex benchmark that requires retrieval and synthesis of information from full-text scientific papers across the literature. Finally, we demonstrate PaperQA's matches expert human researchers on LitQA.

Large Language Models (LLMs), such as GPT3.5, have exhibited remarkable proficiency in comprehending and generating natural language. However, their unpersonalized generation paradigm may result in suboptimal user-specific outcomes. Typically, users converse differently based on their knowledge and preferences. This necessitates the task of enhancing user-oriented LLM which remains unexplored. While one can fully train an LLM for this objective, the resource consumption is unaffordable. Prior research has explored memory-based methods to store and retrieve knowledge to enhance generation without retraining for new queries. However, we contend that a mere memory module is inadequate to comprehend a user's preference, and fully training an LLM can be excessively costly. In this study, we propose a novel computational bionic memory mechanism, equipped with a parameter-efficient fine-tuning schema, to personalize LLMs. Our extensive experimental results demonstrate the effectiveness and superiority of the proposed approach. To encourage further research into this area, we are releasing a new conversation dataset generated entirely by LLM based on an open-source medical corpus, as well as our implementation code.

Online medical consultation (OMC) restricts doctors to gathering patient information solely through inquiries, making the already complex sequential decision-making process of diagnosis even more challenging. Recently, the rapid advancement of large language models has demonstrated a significant potential to transform OMC. However, most studies have primarily focused on improving diagnostic accuracy under conditions of relatively sufficient information, while paying limited attention to the "inquiry" phase of the consultation process. This lack of focus has left the relationship between "inquiry" and "diagnosis" insufficiently explored. In this paper, we first extract real patient interaction strategies from authentic doctor-patient conversations and use these strategies to guide the training of a patient simulator that closely mirrors real-world behavior. By inputting medical records into our patient simulator to simulate patient responses, we conduct extensive experiments to explore the relationship between "inquiry" and "diagnosis" in the consultation process. Experimental results demonstrate that inquiry and diagnosis adhere to the Liebig's law: poor inquiry quality limits the effectiveness of diagnosis, regardless of diagnostic capability, and vice versa. Furthermore, the experiments reveal significant differences in the inquiry performance of various models. To investigate this phenomenon, we categorize the inquiry process into four types: (1) chief complaint inquiry; (2) specification of known symptoms; (3) inquiry about accompanying symptoms; and (4) gathering family or medical history. We analyze the distribution of inquiries across the four types for different models to explore the reasons behind their significant performance differences. We plan to open-source the weights and related code of our patient simulator at https://github.com/LIO-H-ZEN/PatientSimulator.

The common toxicity and societal bias in contents generated by large language models (LLMs) necessitate strategies to reduce harm. Present solutions often demand white-box access to the model or substantial training, which is impractical for cutting-edge commercial LLMs. Moreover, prevailing prompting methods depend on external tool feedback and fail to simultaneously lessen toxicity and bias. Motivated by social psychology principles, we propose a novel strategy named perspective-taking prompting (\textsc{PeT)} that inspires LLMs to integrate diverse human perspectives and self-regulate their responses. This self-correction mechanism can significantly diminish toxicity (up to 89%) and bias (up to 73%) in LLMs' responses. Rigorous evaluations and ablation studies are conducted on two commercial LLMs (ChatGPT and GLM) and three open-source LLMs, revealing PeT's superiority in producing less harmful responses, outperforming five strong baselines.

In response to the pressing need for advanced clinical problem-solving tools in healthcare, we introduce BooksMed, a novel framework based on a Large Language Model (LLM). BooksMed uniquely emulates human cognitive processes to deliver evidence-based and reliable responses, utilizing the GRADE (Grading of Recommendations, Assessment, Development, and Evaluations) framework to effectively quantify evidence strength. For clinical decision-making to be appropriately assessed, an evaluation metric that is clinically aligned and validated is required. As a solution, we present ExpertMedQA, a multispecialty clinical benchmark comprised of open-ended, expert-level clinical questions, and validated by a diverse group of medical professionals. By demanding an in-depth understanding and critical appraisal of up-to-date clinical literature, ExpertMedQA rigorously evaluates LLM performance. BooksMed outperforms existing state-of-the-art models Med-PaLM 2, Almanac, and ChatGPT in a variety of medical scenarios. Therefore, a framework that mimics human cognitive stages could be a useful tool for providing reliable and evidence-based responses to clinical inquiries.

Building high-quality datasets for specialized tasks is a time-consuming and resource-intensive process that often requires specialized domain knowledge. We propose Corpus Retrieval and Augmentation for Fine-Tuning (CRAFT), a method for generating synthetic datasets, given a small number of user-written few-shots that demonstrate the task to be performed. Given the few-shot examples, we use large-scale public web-crawled corpora and similarity-based document retrieval to find other relevant human-written documents. Lastly, instruction-tuned large language models (LLMs) augment the retrieved documents into custom-formatted task samples, which then can be used for fine-tuning. We demonstrate that CRAFT can efficiently generate large-scale task-specific training datasets for four diverse tasks: biology question-answering (QA), medicine QA and commonsense QA as well as summarization. Our experiments show that CRAFT-based models outperform or achieve comparable performance to general LLMs for QA tasks, while CRAFT-based summarization models outperform models trained on human-curated data by 46 preference points.

Recent text-to-image generative models have enabled us to transform our words into vibrant, captivating imagery. The surge of personalization techniques that has followed has also allowed us to imagine unique concepts in new scenes. However, an intriguing question remains: How can we generate a new, imaginary concept that has never been seen before? In this paper, we present the task of creative text-to-image generation, where we seek to generate new members of a broad category (e.g., generating a pet that differs from all existing pets). We leverage the under-studied Diffusion Prior models and show that the creative generation problem can be formulated as an optimization process over the output space of the diffusion prior, resulting in a set of "prior constraints". To keep our generated concept from converging into existing members, we incorporate a question-answering model that adaptively adds new constraints to the optimization problem, encouraging the model to discover increasingly more unique creations. Finally, we show that our prior constraints can also serve as a strong mixing mechanism allowing us to create hybrids between generated concepts, introducing even more flexibility into the creative process.

Recent Multi-Party Conversation (MPC) models typically rely on graph-based approaches to capture dialogue structures. However, these methods have limitations, such as information loss during the projection of utterances into structural embeddings and constraints in leveraging pre-trained language models directly. In this paper, we propose SS-MPC, a response generation model for MPC that eliminates the need for explicit graph structures. Unlike existing models that depend on graphs to analyze conversation structures, SS-MPC internally encodes the dialogue structure as a sequential input, enabling direct utilization of pre-trained language models. Experimental results show that SS-MPC achieves 15.60\% BLEU-1 and 12.44\% ROUGE-L score, outperforming the current state-of-the-art MPC response generation model by 3.91\%p in BLEU-1 and 0.62\%p in ROUGE-L. Additionally, human evaluation confirms that SS-MPC generates more fluent and accurate responses compared to existing MPC models.

Recently, large language model (LLM) based artificial intelligence (AI) systems have demonstrated remarkable capabilities in natural language understanding and generation. However, these models face a significant challenge when it comes to sensitive applications, such as reasoning over medical knowledge and answering medical questions in a physician-like manner. Prior studies attempted to overcome this challenge by increasing the model size (>100B) to learn more general medical knowledge, while there is still room for improvement in LLMs with smaller-scale model sizes (<100B). In this work, we start from a pre-trained general LLM model (AntGLM-10B) and fine-tune it from a medical beginner towards a medical expert (called AntGLM-Med-10B), which leverages a 3-stage optimization procedure, i.e., general medical knowledge injection, medical domain instruction tuning, and specific medical task adaptation. Our contributions are threefold: (1) We specifically investigate how to adapt a pre-trained general LLM in medical domain, especially for a specific medical task. (2) We collect and construct large-scale medical datasets for each stage of the optimization process. These datasets encompass various data types and tasks, such as question-answering, medical reasoning, multi-choice questions, and medical conversations. (3) Specifically for multi-choice questions in the medical domain, we propose a novel Verification-of-Choice approach for prompting engineering, which significantly enhances the reasoning ability of LLMs. Remarkably, by combining the above approaches, our AntGLM-Med-10B model can outperform the most of LLMs on PubMedQA, including both general and medical LLMs, even when these LLMs have larger model size.

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.

Large Language Models (LLMs) have shown the potential to significantly contribute to patient care, diagnostics, and administrative processes. Emerging biomedical LLMs address healthcare-specific challenges, including privacy demands and computational constraints. However, evaluation of these models has primarily been limited to non-clinical tasks, which do not reflect the complexity of practical clinical applications. Additionally, there has been no thorough comparison between biomedical and general-domain LLMs for clinical tasks. To fill this gap, we present the Clinical Language Understanding Evaluation (CLUE), a benchmark tailored to evaluate LLMs on real-world clinical tasks. CLUE includes two novel datasets derived from MIMIC IV discharge letters and four existing tasks designed to test the practical applicability of LLMs in healthcare settings. Our evaluation covers several biomedical and general domain LLMs, providing insights into their clinical performance and applicability. CLUE represents a step towards a standardized approach to evaluating and developing LLMs in healthcare to align future model development with the real-world needs of clinical application. We publish our evaluation and data generation scripts: https://github.com/dadaamin/CLUE

Large language models (LLMs) are versatile and can address many tasks, but for computational efficiency, it is often desirable to distill their capabilities into smaller student models. One way to do this for classification tasks is via dataset synthesis, which can be accomplished by generating examples of each label from the LLM. Prior approaches to synthesis use few-shot prompting, which relies on the LLM's parametric knowledge to generate usable examples. However, this leads to issues of repetition, bias towards popular entities, and stylistic differences from human text. In this work, we propose Synthesize by Retrieval and Refinement (SynthesizRR), which uses retrieval augmentation to introduce variety into the dataset synthesis process: as retrieved passages vary, the LLM is "seeded" with different content to generate its examples. We empirically study the synthesis of six datasets, covering topic classification, sentiment analysis, tone detection, and humor, requiring complex synthesis strategies. We find SynthesizRR greatly improves lexical and semantic diversity, similarity to human-written text, and distillation performance, when compared to standard 32-shot prompting and six baseline approaches.

Large language models (LLMs) are capable of processing lengthy dialogue histories during prolonged interaction with users without additional memory modules; however, their responses tend to overlook or incorrectly recall information from the past. In this paper, we revisit memory-augmented response generation in the era of LLMs. While prior work focuses on getting rid of outdated memories, we argue that such memories can provide contextual cues that help dialogue systems understand the development of past events and, therefore, benefit response generation. We present Theanine, a framework that augments LLMs' response generation with memory timelines -- series of memories that demonstrate the development and causality of relevant past events. Along with Theanine, we introduce TeaFarm, a counterfactual-driven question-answering pipeline addressing the limitation of G-Eval in long-term conversations. Supplementary videos of our methods and the TeaBag dataset for TeaFarm evaluation are in https://theanine-693b0.web.app/.

Large language models have exhibited exceptional performance on various Natural Language Processing (NLP) tasks, leveraging techniques such as the pre-training, and instruction fine-tuning. Despite these advances, their effectiveness in medical applications is limited, due to challenges such as factual inaccuracies, reasoning abilities, and lack grounding in real-world experience. In this study, we present ClinicalGPT, a language model explicitly designed and optimized for clinical scenarios. By incorporating extensive and diverse real-world data, such as medical records, domain-specific knowledge, and multi-round dialogue consultations in the training process, ClinicalGPT is better prepared to handle multiple clinical task. Furthermore, we introduce a comprehensive evaluation framework that includes medical knowledge question-answering, medical exams, patient consultations, and diagnostic analysis of medical records. Our results demonstrate that ClinicalGPT significantly outperforms other models in these tasks, highlighting the effectiveness of our approach in adapting large language models to the critical domain of healthcare.

Large Language Models (LLMs), such as the LLaMA model, have demonstrated their effectiveness in various general-domain natural language processing (NLP) tasks. Nevertheless, LLMs have not yet performed optimally in biomedical domain tasks due to the need for medical expertise in the responses. In response to this challenge, we propose HuaTuo, a LLaMA-based model that has been supervised-fine-tuned with generated QA (Question-Answer) instances. The experimental results demonstrate that HuaTuo generates responses that possess more reliable medical knowledge. Our proposed HuaTuo model is accessible at https://github.com/SCIR-HI/Huatuo-Llama-Med-Chinese.

This paper presents an experience report on the development of Retrieval Augmented Generation (RAG) systems using PDF documents as the primary data source. The RAG architecture combines generative capabilities of Large Language Models (LLMs) with the precision of information retrieval. This approach has the potential to redefine how we interact with and augment both structured and unstructured knowledge in generative models to enhance transparency, accuracy, and contextuality of responses. The paper details the end-to-end pipeline, from data collection, preprocessing, to retrieval indexing and response generation, highlighting technical challenges and practical solutions. We aim to offer insights to researchers and practitioners developing similar systems using two distinct approaches: OpenAI's Assistant API with GPT Series and Llama's open-source models. The practical implications of this research lie in enhancing the reliability of generative AI systems in various sectors where domain-specific knowledge and real-time information retrieval is important. The Python code used in this work is also available at: https://github.com/GPT-Laboratory/RAG-LLM-Development-Guidebook-from-PDFs.

Clinical trials are fundamental in developing new drugs, medical devices, and treatments. However, they are often time-consuming and have low success rates. Although there have been initial attempts to create large language models (LLMs) for clinical trial design and patient-trial matching, these models remain task-specific and not adaptable to diverse clinical trial tasks. To address this challenge, we propose a clinical trial foundation model named Panacea, designed to handle multiple tasks, including trial search, trial summarization, trial design, and patient-trial matching. We also assemble a large-scale dataset, named TrialAlign, of 793,279 trial documents and 1,113,207 trial-related scientific papers, to infuse clinical knowledge into the model by pre-training. We further curate TrialInstruct, which has 200,866 of instruction data for fine-tuning. These resources enable Panacea to be widely applicable for a range of clinical trial tasks based on user requirements. We evaluated Panacea on a new benchmark, named TrialPanorama, which covers eight clinical trial tasks. Our method performed the best on seven of the eight tasks compared to six cutting-edge generic or medicine-specific LLMs. Specifically, Panacea showed great potential to collaborate with human experts in crafting the design of eligibility criteria, study arms, and outcome measures, in multi-round conversations. In addition, Panacea achieved 14.42% improvement in patient-trial matching, 41.78% to 52.02% improvement in trial search, and consistently ranked at the top for five aspects of trial summarization. Our approach demonstrates the effectiveness of Panacea in clinical trials and establishes a comprehensive resource, including training data, model, and benchmark, for developing clinical trial foundation models, paving the path for AI-based clinical trial development.

Recent breakthroughs in large language models (LLMs) offer unprecedented natural language understanding and generation capabilities. However, existing surveys on LLMs in biomedicine often focus on specific applications or model architectures, lacking a comprehensive analysis that integrates the latest advancements across various biomedical domains. This review, based on an analysis of 484 publications sourced from databases including PubMed, Web of Science, and arXiv, provides an in-depth examination of the current landscape, applications, challenges, and prospects of LLMs in biomedicine, distinguishing itself by focusing on the practical implications of these models in real-world biomedical contexts. Firstly, we explore the capabilities of LLMs in zero-shot learning across a broad spectrum of biomedical tasks, including diagnostic assistance, drug discovery, and personalized medicine, among others, with insights drawn from 137 key studies. Then, we discuss adaptation strategies of LLMs, including fine-tuning methods for both uni-modal and multi-modal LLMs to enhance their performance in specialized biomedical contexts where zero-shot fails to achieve, such as medical question answering and efficient processing of biomedical literature. Finally, we discuss the challenges that LLMs face in the biomedicine domain including data privacy concerns, limited model interpretability, issues with dataset quality, and ethics due to the sensitive nature of biomedical data, the need for highly reliable model outputs, and the ethical implications of deploying AI in healthcare. To address these challenges, we also identify future research directions of LLM in biomedicine including federated learning methods to preserve data privacy and integrating explainable AI methodologies to enhance the transparency of LLMs.

Pre-trained Generative models such as BART, T5, etc. have gained prominence as a preferred method for text generation in various natural language processing tasks, including abstractive long-form question answering (QA) and summarization. However, the potential of generative models in extractive QA tasks, where discriminative models are commonly employed, remains largely unexplored. Discriminative models often encounter challenges associated with label sparsity, particularly when only a small portion of the context contains the answer. The challenge is more pronounced for multi-span answers. In this work, we introduce a novel approach that uses the power of pre-trained generative models to address extractive QA tasks by generating indexes corresponding to context tokens or sentences that form part of the answer. Through comprehensive evaluations on multiple extractive QA datasets, including MultiSpanQA, BioASQ, MASHQA, and WikiQA, we demonstrate the superior performance of our proposed approach compared to existing state-of-the-art models.

Mental illness remains one of the most critical public health issues. Despite its importance, many mental health professionals highlight a disconnect between their training and actual real-world patient practice. To help bridge this gap, we propose PATIENT-{\Psi}, a novel patient simulation framework for cognitive behavior therapy (CBT) training. To build PATIENT-{\Psi}, we construct diverse patient cognitive models based on CBT principles and use large language models (LLMs) programmed with these cognitive models to act as a simulated therapy patient. We propose an interactive training scheme, PATIENT-{\Psi}-TRAINER, for mental health trainees to practice a key skill in CBT -- formulating the cognitive model of the patient -- through role-playing a therapy session with PATIENT-{\Psi}. To evaluate PATIENT-{\Psi}, we conducted a comprehensive user study of 13 mental health trainees and 20 experts. The results demonstrate that practice using PATIENT-{\Psi}-TRAINER enhances the perceived skill acquisition and confidence of the trainees beyond existing forms of training such as textbooks, videos, and role-play with non-patients. Based on the experts' perceptions, PATIENT-{\Psi} is perceived to be closer to real patient interactions than GPT-4, and PATIENT-{\Psi}-TRAINER holds strong promise to improve trainee competencies. Our code and data are released at https://github.com/ruiyiw/patient-psi.

Simulating human clients in mental health counseling is crucial for training and evaluating counselors (both human or simulated) in a scalable manner. Nevertheless, past research on client simulation did not focus on complex conversation tasks such as mental health counseling. In these tasks, the challenge is to ensure that the client's actions (i.e., interactions with the counselor) are consistent with with its stipulated profiles and negative behavior settings. In this paper, we propose a novel framework that supports consistent client simulation for mental health counseling. Our framework tracks the mental state of a simulated client, controls its state transitions, and generates for each state behaviors consistent with the client's motivation, beliefs, preferred plan to change, and receptivity. By varying the client profile and receptivity, we demonstrate that consistent simulated clients for different counseling scenarios can be effectively created. Both our automatic and expert evaluations on the generated counseling sessions also show that our client simulation method achieves higher consistency than previous methods.

Large Language Models (LLMs) have demonstrated significant potential in transforming clinical applications. In this study, we investigate the efficacy of four techniques in adapting LLMs for clinical use-cases: continuous pretraining, instruct fine-tuning, NEFTune, and prompt engineering. We employ these methods on Mistral 7B and Mixtral 8x7B models, leveraging a large-scale clinical pretraining dataset of 50 billion tokens and an instruct fine-tuning dataset of 500 million tokens. Our evaluation across various clinical tasks reveals the impact of each technique. While continuous pretraining beyond 250 billion tokens yields marginal improvements on its own, it establishes a strong foundation for instruct fine-tuning. Notably, NEFTune, designed primarily to enhance generation quality, surprisingly demonstrates additional gains on our benchmark. Complex prompt engineering methods further enhance performance. These findings show the importance of tailoring fine-tuning strategies and exploring innovative techniques to optimize LLM performance in the clinical domain.

Generating clinical reports from raw recordings such as X-rays and electroencephalogram (EEG) is an essential and routine task for doctors. However, it is often time-consuming to write accurate and detailed reports. Most existing methods try to generate the whole reports from the raw input with limited success because 1) generated reports often contain errors that need manual review and correction, 2) it does not save time when doctors want to write additional information into the report, and 3) the generated reports are not customized based on individual doctors' preference. We propose {\it CL}inic{\it A}l {\it R}eport {\it A}uto-completion (CLARA), an interactive method that generates reports in a sentence by sentence fashion based on doctors' anchor words and partially completed sentences. CLARA searches for most relevant sentences from existing reports as the template for the current report. The retrieved sentences are sequentially modified by combining with the input feature representations to create the final report. In our experimental evaluation, CLARA achieved 0.393 CIDEr and 0.248 BLEU-4 on X-ray reports and 0.482 CIDEr and 0.491 BLEU-4 for EEG reports for sentence-level generation, which is up to 35% improvement over the best baseline. Also via our qualitative evaluation, CLARA is shown to produce reports which have a significantly higher level of approval by doctors in a user study (3.74 out of 5 for CLARA vs 2.52 out of 5 for the baseline).

Large Language Models (LLMs) such as GPT & Llama have demonstrated significant achievements in summarization tasks but struggle with factual inaccuracies, a critical issue in clinical NLP applications where errors could lead to serious consequences. To counter the high costs and limited availability of expert-annotated data for factual alignment, this study introduces an innovative pipeline that utilizes >100B parameter GPT variants like GPT-3.5 & GPT-4 to act as synthetic experts to generate high-quality synthetics feedback aimed at enhancing factual consistency in clinical note summarization. Our research primarily focuses on edit feedback generated by these synthetic feedback experts without additional human annotations, mirroring and optimizing the practical scenario in which medical professionals refine AI system outputs. Although such 100B+ parameter GPT variants have proven to demonstrate expertise in various clinical NLP tasks, such as the Medical Licensing Examination, there is scant research on their capacity to act as synthetic feedback experts and deliver expert-level edit feedback for improving the generation quality of weaker (<10B parameter) LLMs like GPT-2 (1.5B) & Llama 2 (7B) in clinical domain. So in this work, we leverage 100B+ GPT variants to act as synthetic feedback experts offering expert-level edit feedback, that is used to reduce hallucinations and align weaker (<10B parameter) LLMs with medical facts using two distinct alignment algorithms (DPO & SALT), endeavoring to narrow the divide between AI-generated content and factual accuracy. This highlights the substantial potential of LLM-based synthetic edits in enhancing the alignment of clinical factuality.

Large Language Models (LLMs) generate responses to questions; however, their effectiveness is often hindered by sub-optimal quality of answers and occasional failures to provide accurate responses to questions. To address these challenges, a fine-tuning process is employed, involving feedback and examples to refine models. The objective is to enhance AI models through continuous feedback loops, utilizing metrics such as cosine similarity, LLM evaluation and Rouge-L scores to evaluate the models. Leveraging LLMs like GPT-3.5, GPT4ALL, and LLaMA2, and Claude, this approach is benchmarked on financial datasets, including the FinanceBench and RAG Instruct Benchmark Tester Dataset, illustrating the necessity of fine-tuning. The results showcase the capability of fine-tuned models to surpass the accuracy of zero-shot LLMs, providing superior question and answering capabilities. Notably, the combination of fine-tuning the LLM with a process known as Retrieval Augmented Generation (RAG) proves to generate responses with improved accuracy.

Large language models (LLMs) represent a transformative class of AI tools capable of revolutionizing various aspects of healthcare by generating human-like responses across diverse contexts and adapting to novel tasks following human instructions. Their potential application spans a broad range of medical tasks, such as clinical documentation, matching patients to clinical trials, and answering medical questions. In this primer paper, we propose an actionable guideline to help healthcare professionals more efficiently utilize LLMs in their work, along with a set of best practices. This approach consists of several main phases, including formulating the task, choosing LLMs, prompt engineering, fine-tuning, and deployment. We start with the discussion of critical considerations in identifying healthcare tasks that align with the core capabilities of LLMs and selecting models based on the selected task and data, performance requirements, and model interface. We then review the strategies, such as prompt engineering and fine-tuning, to adapt standard LLMs to specialized medical tasks. Deployment considerations, including regulatory compliance, ethical guidelines, and continuous monitoring for fairness and bias, are also discussed. By providing a structured step-by-step methodology, this tutorial aims to equip healthcare professionals with the tools necessary to effectively integrate LLMs into clinical practice, ensuring that these powerful technologies are applied in a safe, reliable, and impactful manner.

Sequence generation applications require satisfying semantic constraints, such as ensuring that programs are correct, using certain keywords, or avoiding undesirable content. Language models, whether fine-tuned or prompted with few-shot demonstrations, frequently violate these constraints, and lack a mechanism to iteratively revise their outputs. Moreover, some powerful language models are of extreme scale or inaccessible, making it inefficient, if not infeasible, to update their parameters for task-specific adaptation. We present Self-Correction, an approach that decouples an imperfect base generator (an off-the-shelf language model or supervised sequence-to-sequence model) from a separate corrector that learns to iteratively correct imperfect generations. To train the corrector, we propose an online training procedure that can use either scalar or natural language feedback on intermediate imperfect generations. We show that Self-Correction improves upon the base generator in three diverse generation tasks - mathematical program synthesis, lexically-constrained generation, and toxicity control - even when the corrector is much smaller than the base generator.

We introduce a novel graph-based Retrieval-Augmented Generation (RAG) framework specifically designed for the medical domain, called MedGraphRAG, aimed at enhancing Large Language Model (LLM) capabilities and generating evidence-based results, thereby improving safety and reliability when handling private medical data. Our comprehensive pipeline begins with a hybrid static-semantic approach to document chunking, significantly improving context capture over traditional methods. Extracted entities are used to create a three-tier hierarchical graph structure, linking entities to foundational medical knowledge sourced from medical papers and dictionaries. These entities are then interconnected to form meta-graphs, which are merged based on semantic similarities to develop a comprehensive global graph. This structure supports precise information retrieval and response generation. The retrieval process employs a U-retrieve method to balance global awareness and indexing efficiency of the LLM. Our approach is validated through a comprehensive ablation study comparing various methods for document chunking, graph construction, and information retrieval. The results not only demonstrate that our hierarchical graph construction method consistently outperforms state-of-the-art models on multiple medical Q\&A benchmarks, but also confirms that the responses generated include source documentation, significantly enhancing the reliability of medical LLMs in practical applications. Code will be at: https://github.com/MedicineToken/Medical-Graph-RAG/tree/main

The rapid development of Large Language Models (LLMs) has substantially expanded the range of tasks they can address. In the field of Natural Language Processing (NLP), researchers have shifted their focus from conventional NLP tasks (e.g., sequence tagging and parsing) towards tasks that revolve around aligning with human needs (e.g., brainstorming and email writing). This shift in task distribution imposes new requirements on evaluating these aligned models regarding generality (i.e., assessing performance across diverse scenarios), flexibility (i.e., examining under different protocols), and interpretability (i.e., scrutinizing models with explanations). In this paper, we propose a generative judge with 13B parameters, Auto-J, designed to address these challenges. Our model is trained on user queries and LLM-generated responses under massive real-world scenarios and accommodates diverse evaluation protocols (e.g., pairwise response comparison and single-response evaluation) with well-structured natural language critiques. To demonstrate the efficacy of our approach, we construct a new testbed covering 58 different scenarios. Experimentally, Auto-J outperforms a series of strong competitors, including both open-source and closed-source models, by a large margin. We also provide detailed analysis and case studies to further reveal the potential of our method and make a variety of resources public at https://github.com/GAIR-NLP/auto-j.

This study explores the use of Large language models to analyze therapist remarks in a psychotherapeutic setting. The paper focuses on the application of BERTopic, a machine learning-based topic modeling tool, to the dialogue of two different groups of therapists (classical and modern), which makes it possible to identify and describe a set of topics that consistently emerge across these groups. The paper describes in detail the chosen algorithm for BERTopic, which included creating a vector space from a corpus of therapist remarks, reducing its dimensionality, clustering the space, and creating and optimizing topic representation. Along with the automatic topical modeling by the BERTopic, the research involved an expert assessment of the findings and manual topic structure optimization. The topic modeling results highlighted the most common and stable topics in therapists speech, offering insights into how language patterns in therapy develop and remain stable across different therapeutic styles. This work contributes to the growing field of machine learning in psychotherapy by demonstrating the potential of automated methods to improve both the practice and training of therapists. The study highlights the value of topic modeling as a tool for gaining a deeper understanding of therapeutic dialogue and offers new opportunities for improving therapeutic effectiveness and clinical supervision.

Human dialogue contains evolving concepts, and speakers naturally associate multiple concepts to compose a response. However, current dialogue models with the seq2seq framework lack the ability to effectively manage concept transitions and can hardly introduce multiple concepts to responses in a sequential decoding manner. To facilitate a controllable and coherent dialogue, in this work, we devise a concept-guided non-autoregressive model (CG-nAR) for open-domain dialogue generation. The proposed model comprises a multi-concept planning module that learns to identify multiple associated concepts from a concept graph and a customized Insertion Transformer that performs concept-guided non-autoregressive generation to complete a response. The experimental results on two public datasets show that CG-nAR can produce diverse and coherent responses, outperforming state-of-the-art baselines in both automatic and human evaluations with substantially faster inference speed.

Current approaches for controlling dialogue response generation are primarily focused on high-level attributes like style, sentiment, or topic. In this work, we focus on constrained long-term dialogue generation, which involves more fine-grained control and requires a given set of control words to appear in generated responses. This setting requires a model to not only consider the generation of these control words in the immediate context, but also produce utterances that will encourage the generation of the words at some time in the (possibly distant) future. We define the problem of constrained long-term control for dialogue generation, identify gaps in current methods for evaluation, and propose new metrics that better measure long-term control. We also propose a retrieval-augmented method that improves performance of long-term controlled generation via logit modification techniques. We show through experiments on three task-oriented dialogue datasets that our metrics better assess dialogue control relative to current alternatives and that our method outperforms state-of-the-art constrained generation baselines.

This study investigates the use of generative AI and multi-agent systems to provide automatic feedback in educational contexts, particularly for student constructed responses in science assessments. The research addresses a key gap in the field by exploring how multi-agent systems, called AutoFeedback, can improve the quality of GenAI-generated feedback, overcoming known issues such as over-praise and over-inference that are common in single-agent large language models (LLMs). The study developed a multi-agent system consisting of two AI agents: one for generating feedback and another for validating and refining it. The system was tested on a dataset of 240 student responses, and its performance was compared to that of a single-agent LLM. Results showed that AutoFeedback significantly reduced the occurrence of over-praise and over-inference errors, providing more accurate and pedagogically sound feedback. The findings suggest that multi-agent systems can offer a more reliable solution for generating automated feedback in educational settings, highlighting their potential for scalable and personalized learning support. These results have important implications for educators and researchers seeking to leverage AI in formative assessments, offering a pathway to more effective feedback mechanisms that enhance student learning outcomes.

The recent surge in research focused on generating synthetic data from large language models (LLMs), especially for scenarios with limited data availability, marks a notable shift in Generative Artificial Intelligence (AI). Their ability to perform comparably to real-world data positions this approach as a compelling solution to low-resource challenges. This paper delves into advanced technologies that leverage these gigantic LLMs for the generation of task-specific training data. We outline methodologies, evaluation techniques, and practical applications, discuss the current limitations, and suggest potential pathways for future research.

Automated Short Answer Scoring (ASAS) is a critical component in educational assessment. While traditional ASAS systems relied on rule-based algorithms or complex deep learning methods, recent advancements in Generative Language Models (GLMs) offer new opportunities for improvement. This study explores the application of GLMs to ASAS, leveraging their off-the-shelf capabilities and performance in various domains. We propose a novel pipeline that combines vector databases, transformer-based encoders, and GLMs to enhance short answer scoring accuracy. Our approach stores training responses in a vector database, retrieves semantically similar responses during inference, and employs a GLM to analyze these responses and determine appropriate scores. We further optimize the system through fine-tuned retrieval processes and prompt engineering. Evaluation on the SemEval 2013 dataset demonstrates a significant improvement on the SCIENTSBANK 3-way and 2-way tasks compared to existing methods, highlighting the potential of GLMs in advancing ASAS technology.

Memorizing and utilizing speakers' personas is a common practice for response generation in long-term conversations. Yet, human-authored datasets often provide uninformative persona sentences that hinder response quality. This paper presents a novel framework that leverages commonsense-based persona expansion to address such issues in long-term conversation. While prior work focuses on not producing personas that contradict others, we focus on transforming contradictory personas into sentences that contain rich speaker information, by refining them based on their contextual backgrounds with designed strategies. As the pioneer of persona expansion in multi-session settings, our framework facilitates better response generation via human-like persona refinement. The supplementary video of our work is available at https://caffeine-15bbf.web.app/.

Sequence-to-sequence neural network models for generation of conversational responses tend to generate safe, commonplace responses (e.g., "I don't know") regardless of the input. We suggest that the traditional objective function, i.e., the likelihood of output (response) given input (message) is unsuited to response generation tasks. Instead we propose using Maximum Mutual Information (MMI) as the objective function in neural models. Experimental results demonstrate that the proposed MMI models produce more diverse, interesting, and appropriate responses, yielding substantive gains in BLEU scores on two conversational datasets and in human evaluations.

Query-document relevance prediction is a critical problem in Information Retrieval systems. This problem has increasingly been tackled using (pretrained) transformer-based models which are finetuned using large collections of labeled data. However, in specialized domains such as e-commerce and healthcare, the viability of this approach is limited by the dearth of large in-domain data. To address this paucity, recent methods leverage these powerful models to generate high-quality task and domain-specific synthetic data. Prior work has largely explored synthetic data generation or query generation (QGen) for Question-Answering (QA) and binary (yes/no) relevance prediction, where for instance, the QGen models are given a document, and trained to generate a query relevant to that document. However in many problems, we have a more fine-grained notion of relevance than a simple yes/no label. Thus, in this work, we conduct a detailed study into how QGen approaches can be leveraged for nuanced relevance prediction. We demonstrate that -- contrary to claims from prior works -- current QGen approaches fall short of the more conventional cross-domain transfer-learning approaches. Via empirical studies spanning 3 public e-commerce benchmarks, we identify new shortcomings of existing QGen approaches -- including their inability to distinguish between different grades of relevance. To address this, we introduce label-conditioned QGen models which incorporates knowledge about the different relevance. While our experiments demonstrate that these modifications help improve performance of QGen techniques, we also find that QGen approaches struggle to capture the full nuance of the relevance label space and as a result the generated queries are not faithful to the desired relevance label.

The capability to generate responses with diversity and faithfulness using factual knowledge is paramount for creating a human-like, trustworthy dialogue system. Common strategies either adopt a two-step paradigm, which optimizes knowledge selection and response generation separately, and may overlook the inherent correlation between these two tasks, or leverage conditional variational method to jointly optimize knowledge selection and response generation by employing an inference network. In this paper, we present an end-to-end learning framework, termed Sequential Posterior Inference (SPI), capable of selecting knowledge and generating dialogues by approximately sampling from the posterior distribution. Unlike other methods, SPI does not require the inference network or assume a simple geometry of the posterior distribution. This straightforward and intuitive inference procedure of SPI directly queries the response generation model, allowing for accurate knowledge selection and generation of faithful responses. In addition to modeling contributions, our experimental results on two common dialogue datasets (Wizard of Wikipedia and Holl-E) demonstrate that SPI outperforms previous strong baselines according to both automatic and human evaluation metrics.

Question generation (QG) from a given context can enhance comprehension, engagement, assessment, and overall efficacy in learning or conversational environments. Despite recent advancements in QG, the challenge of enhancing or measuring the diversity of generated questions often remains unaddressed. In this paper, we introduce a multi-question generation model (mQG), which is capable of generating multiple, diverse, and answerable questions by focusing on context and questions. To validate the answerability of the generated questions, we employ a SQuAD2.0 fine-tuned question answering model, classifying the questions as answerable or not. We train and evaluate mQG on the FairytaleQA dataset, a well-structured QA dataset based on storybooks, with narrative questions. We further apply a zero-shot adaptation on the TellMeWhy and SQuAD1.1 datasets. mQG shows promising results across various evaluation metrics, among strong baselines.

Large language models (LLMs) have demonstrated remarkable performance in diverse tasks using zero-shot and few-shot prompting. Even though their capabilities of data synthesis have been studied well in recent years, the generated data suffers from a lack of diversity, less adherence to the prompt, and potential biases that creep into the data from the generator model. In this work, we tackle the challenge of generating datasets with high diversity, upon which a student model is trained for downstream tasks. Taking the route of decoding-time guidance-based approaches, we propose CorrSynth, which generates data that is more diverse and faithful to the input prompt using a correlated sampling strategy. Further, our method overcomes the complexity drawbacks of some other guidance-based techniques like classifier-based guidance. With extensive experiments, we show the effectiveness of our approach and substantiate our claims. In particular, we perform intrinsic evaluation to show the improvements in diversity. Our experiments show that CorrSynth improves both student metrics and intrinsic metrics upon competitive baselines across four datasets, showing the innate advantage of our method.

Brief hospital course (BHC) summaries are common clinical documents generated by summarizing clinical notes. While large language models (LLMs) depict remarkable capabilities in automating real-world tasks, their capabilities for healthcare applications such as BHC synthesis have not been shown. To enable the adaptation of LLMs for BHC synthesis, we introduce a novel benchmark consisting of a pre-processed dataset extracted from MIMIC-IV notes, encapsulating clinical note, and brief hospital course (BHC) pairs. We assess the performance of two general-purpose LLMs and three healthcare-adapted LLMs to improve BHC synthesis from clinical notes. Using clinical notes as input for generating BHCs, we apply prompting-based (using in-context learning) and fine-tuning-based adaptation strategies to three open-source LLMs (Clinical-T5-Large, Llama2-13B, FLAN-UL2) and two proprietary LLMs (GPT-3.5, GPT-4). We quantitatively evaluate the performance of these LLMs across varying context-length inputs using conventional natural language similarity metrics. We further perform a qualitative study where five diverse clinicians blindly compare clinician-written BHCs and two LLM-generated BHCs for 30 samples across metrics of comprehensiveness, conciseness, factual correctness, and fluency. Overall, we present a new benchmark and pre-processed dataset for using LLMs in BHC synthesis from clinical notes. We observe high-quality summarization performance for both in-context proprietary and fine-tuned open-source LLMs using both quantitative metrics and a qualitative clinical reader study. We propose our work as a benchmark to motivate future works to adapt and assess the performance of LLMs in BHC synthesis.

Recent AI-assistant agents, such as ChatGPT, predominantly rely on supervised fine-tuning (SFT) with human annotations and reinforcement learning from human feedback (RLHF) to align the output of large language models (LLMs) with human intentions, ensuring they are helpful, ethical, and reliable. However, this dependence can significantly constrain the true potential of AI-assistant agents due to the high cost of obtaining human supervision and the related issues on quality, reliability, diversity, self-consistency, and undesirable biases. To address these challenges, we propose a novel approach called SELF-ALIGN, which combines principle-driven reasoning and the generative power of LLMs for the self-alignment of AI agents with minimal human supervision. Our approach encompasses four stages: first, we use an LLM to generate synthetic prompts, and a topic-guided method to augment the prompt diversity; second, we use a small set of human-written principles for AI models to follow, and guide the LLM through in-context learning from demonstrations (of principles application) to produce helpful, ethical, and reliable responses to user's queries; third, we fine-tune the original LLM with the high-quality self-aligned responses so that the resulting model can generate desirable responses for each query directly without the principle set and the demonstrations anymore; and finally, we offer a refinement step to address the issues of overly-brief or indirect responses. Applying SELF-ALIGN to the LLaMA-65b base language model, we develop an AI assistant named Dromedary. With fewer than 300 lines of human annotations (including < 200 seed prompts, 16 generic principles, and 5 exemplars for in-context learning). Dromedary significantly surpasses the performance of several state-of-the-art AI systems, including Text-Davinci-003 and Alpaca, on benchmark datasets with various settings.

Objective: Using natural language processing (NLP) to find sentences that state treatment plans in a clinical note, would automate plan extraction and would further enable their use in tools that help providers and care managers. However, as in the most NLP tasks on clinical text, creating gold standard to train and test NLP models is tedious and expensive. Fortuitously, sometimes but not always clinical notes contain sections with a heading that identifies the section as a plan. Leveraging contents of such labeled sections as a noisy training data, we assessed accuracy of NLP models trained with the data. Methods: We used common variations of plan headings and rule-based heuristics to find plan sections with headings in clinical notes, and we extracted sentences from them and formed a noisy training data of plan sentences. We trained Support Vector Machine (SVM) and Convolutional Neural Network (CNN) models with the data. We measured accuracy of the trained models on the noisy dataset using ten-fold cross validation and separately on a set-aside manually annotated dataset. Results: About 13% of 117,730 clinical notes contained treatment plans sections with recognizable headings in the 1001 longitudinal patient records that were obtained from Cleveland Clinic under an IRB approval. We were able to extract and create a noisy training data of 13,492 plan sentences from the clinical notes. CNN achieved best F measures, 0.91 and 0.97 in the cross-validation and set-aside evaluation experiments respectively. SVM slightly underperformed with F measures of 0.89 and 0.96 in the same experiments. Conclusion: Our study showed that the training supervised learning models using noisy plan sentences was effective in identifying them in all clinical notes. More broadly, sections with informal headings in clinical notes can be a good source for generating effective training data.

Generating synthetic text addresses the challenge of data availability in privacy-sensitive domains such as healthcare. This study explores the applicability of synthetic data in real-world medical settings. We introduce MedSyn, a novel medical text generation framework that integrates large language models with a Medical Knowledge Graph (MKG). We use MKG to sample prior medical information for the prompt and generate synthetic clinical notes with GPT-4 and fine-tuned LLaMA models. We assess the benefit of synthetic data through application in the ICD code prediction task. Our research indicates that synthetic data can increase the classification accuracy of vital and challenging codes by up to 17.8% compared to settings without synthetic data. Furthermore, to provide new data for further research in the healthcare domain, we present the largest open-source synthetic dataset of clinical notes for the Russian language, comprising over 41k samples covering 219 ICD-10 codes.