Daily Papers

The increasing size of language models raises great research interests in parameter-efficient fine-tuning such as LoRA that freezes the pre-trained model, and injects small-scale trainable parameters for multiple downstream tasks (e.g., summarization, question answering and translation). To further enhance the efficiency of fine-tuning, we propose a framework that integrates LoRA and structured layer pruning. The integrated framework is validated on two created deidentified medical report summarization datasets based on MIMIC-IV-Note and two public medical dialogue datasets. By tuning 0.6% parameters of the original model and pruning over 30% Transformer-layers, our framework can reduce 50% of GPU memory usage and speed up 100% of the training phase, while preserving over 92% generation qualities on free-text sequence-to-sequence tasks.

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.

Predicting disease trajectories from electronic health records (EHRs) is a complex task due to major challenges such as data non-stationarity, high granularity of medical codes, and integration of multimodal data. EHRs contain both structured data, such as diagnostic codes, and unstructured data, such as clinical notes, which hold essential information often overlooked. Current models, primarily based on structured data, struggle to capture the complete medical context of patients, resulting in a loss of valuable information. To address this issue, we propose an approach that integrates unstructured clinical notes into transformer-based deep learning models for sequential disease prediction. This integration enriches the representation of patients' medical histories, thereby improving the accuracy of diagnosis predictions. Experiments on MIMIC-IV datasets demonstrate that the proposed approach outperforms traditional models relying solely on structured data.

Although recent advances in scaling large language models (LLMs) have resulted in improvements on many NLP tasks, it remains unclear whether these models trained primarily with general web text are the right tool in highly specialized, safety critical domains such as clinical text. Recent results have suggested that LLMs encode a surprising amount of medical knowledge. This raises an important question regarding the utility of smaller domain-specific language models. With the success of general-domain LLMs, is there still a need for specialized clinical models? To investigate this question, we conduct an extensive empirical analysis of 12 language models, ranging from 220M to 175B parameters, measuring their performance on 3 different clinical tasks that test their ability to parse and reason over electronic health records. As part of our experiments, we train T5-Base and T5-Large models from scratch on clinical notes from MIMIC III and IV to directly investigate the efficiency of clinical tokens. We show that relatively small specialized clinical models substantially outperform all in-context learning approaches, even when finetuned on limited annotated data. Further, we find that pretraining on clinical tokens allows for smaller, more parameter-efficient models that either match or outperform much larger language models trained on general text. We release the code and the models used under the PhysioNet Credentialed Health Data license and data use agreement.

Medical coding is the task of assigning medical codes to clinical free-text documentation. Healthcare professionals manually assign such codes to track patient diagnoses and treatments. Automated medical coding can considerably alleviate this administrative burden. In this paper, we reproduce, compare, and analyze state-of-the-art automated medical coding machine learning models. We show that several models underperform due to weak configurations, poorly sampled train-test splits, and insufficient evaluation. In previous work, the macro F1 score has been calculated sub-optimally, and our correction doubles it. We contribute a revised model comparison using stratified sampling and identical experimental setups, including hyperparameters and decision boundary tuning. We analyze prediction errors to validate and falsify assumptions of previous works. The analysis confirms that all models struggle with rare codes, while long documents only have a negligible impact. Finally, we present the first comprehensive results on the newly released MIMIC-IV dataset using the reproduced models. We release our code, model parameters, and new MIMIC-III and MIMIC-IV training and evaluation pipelines to accommodate fair future comparisons.

Video has become a popular media form for information sharing and consumption. However, taking notes while watching a video requires significant time and effort. To address this, we propose a novel interactive system, NoTeeline, for taking real-time, personalized notes. NoTeeline lets users quickly jot down keypoints (micronotes), which are automatically expanded into full-fledged notes that capture the content of the user's micronotes and are consistent with the user's writing style. In a within-subjects study (N=12), we found that NoTeeline helps users create high-quality notes that capture the essence of their micronotes with a higher factual correctness (93.2%) while accurately reflecting their writing style. While using NoTeeline, participants experienced significantly reduced mental effort, captured satisfactory notes while writing 47% less text, and completed notetaking with 43.9% less time compared to a manual notetaking baseline.

Automatic International Classification of Diseases (ICD) coding aims to assign multiple ICD codes to a medical note with average length of 3,000+ tokens. This task is challenging due to a high-dimensional space of multi-label assignment (tens of thousands of ICD codes) and the long-tail challenge: only a few codes (common diseases) are frequently assigned while most codes (rare diseases) are infrequently assigned. This study addresses the long-tail challenge by adapting a prompt-based fine-tuning technique with label semantics, which has been shown to be effective under few-shot setting. To further enhance the performance in medical domain, we propose a knowledge-enhanced longformer by injecting three domain-specific knowledge: hierarchy, synonym, and abbreviation with additional pretraining using contrastive learning. Experiments on MIMIC-III-full, a benchmark dataset of code assignment, show that our proposed method outperforms previous state-of-the-art method in 14.5% in marco F1 (from 10.3 to 11.8, P<0.001). To further test our model on few-shot setting, we created a new rare diseases coding dataset, MIMIC-III-rare50, on which our model improves marco F1 from 17.1 to 30.4 and micro F1 from 17.2 to 32.6 compared to previous method.

International Classification of Disease (ICD) coding procedure which refers to tagging medical notes with diagnosis codes has been shown to be effective and crucial to the billing system in medical sector. Currently, ICD codes are assigned to a clinical note manually which is likely to cause many errors. Moreover, training skilled coders also requires time and human resources. Therefore, automating the ICD code determination process is an important task. With the advancement of artificial intelligence theory and computational hardware, machine learning approach has emerged as a suitable solution to automate this process. In this project, we apply a transformer-based architecture to capture the interdependence among the tokens of a document and then use a code-wise attention mechanism to learn code-specific representations of the entire document. Finally, they are fed to separate dense layers for corresponding code prediction. Furthermore, to handle the imbalance in the code frequency of clinical datasets, we employ a label distribution aware margin (LDAM) loss function. The experimental results on the MIMIC-III dataset show that our proposed model outperforms other baselines by a significant margin. In particular, our best setting achieves a micro-AUC score of 0.923 compared to 0.868 of bidirectional recurrent neural networks. We also show that by using the code-wise attention mechanism, the model can provide more insights about its prediction, and thus it can support clinicians to make reliable decisions. Our code is available online (https://github.com/biplob1ly/TransICD)

The development of large language models tailored for handling patients' clinical notes is often hindered by the limited accessibility and usability of these notes due to strict privacy regulations. To address these challenges, we first create synthetic large-scale clinical notes using publicly available case reports extracted from biomedical literature. We then use these synthetic notes to train our specialized clinical large language model, Asclepius. While Asclepius is trained on synthetic data, we assess its potential performance in real-world applications by evaluating it using real clinical notes. We benchmark Asclepius against several other large language models, including GPT-3.5-turbo and other open-source alternatives. To further validate our approach using synthetic notes, we also compare Asclepius with its variants trained on real clinical notes. Our findings convincingly demonstrate that synthetic clinical notes can serve as viable substitutes for real ones when constructing high-performing clinical language models. This conclusion is supported by detailed evaluations conducted by both GPT-4 and medical professionals. All resources including weights, codes, and data used in the development of Asclepius are made publicly accessible for future research.

Generative models, particularly text-to-image (T2I) diffusion models, play a crucial role in medical image analysis. However, these models are prone to training data memorization, posing significant risks to patient privacy. Synthetic chest X-ray generation is one of the most common applications in medical image analysis with the MIMIC-CXR dataset serving as the primary data repository for this task. This study adopts a data-driven approach and presents the first systematic attempt to identify prompts and text tokens in MIMIC-CXR that contribute the most to training data memorization. Our analysis reveals an unexpected finding: prompts containing traces of de-identification procedures are among the most memorized, with de-identification markers contributing the most. Furthermore, we also find existing inference-time memorization mitigation strategies are ineffective and fail to sufficiently reduce the model's reliance on memorized text tokens highlighting a broader issue in T2I synthesis with MIMIC-CXR. On this front, we propose actionable strategies to enhance privacy and improve the reliability of generative models in medical imaging. Finally, our results provide a foundation for future work on developing and benchmarking memorization mitigation techniques for synthetic chest X-ray generation using the MIMIC-CXR dataset.

Innovations like protein diffusion have enabled significant progress in de novo protein design, which is a vital topic in life science. These methods typically depend on protein structure encoders to model residue backbone frames, where atoms do not exist. Most prior encoders rely on atom-wise features, such as angles and distances between atoms, which are not available in this context. Thus far, only several simple encoders, such as IPA, have been proposed for this scenario, exposing the frame modeling as a bottleneck. In this work, we proffer the Vector Field Network (VFN), which enables network layers to perform learnable vector computations between coordinates of frame-anchored virtual atoms, thus achieving a higher capability for modeling frames. The vector computation operates in a manner similar to a linear layer, with each input channel receiving 3D virtual atom coordinates instead of scalar values. The multiple feature vectors output by the vector computation are then used to update the residue representations and virtual atom coordinates via attention aggregation. Remarkably, VFN also excels in modeling both frames and atoms, as the real atoms can be treated as the virtual atoms for modeling, positioning VFN as a potential universal encoder. In protein diffusion (frame modeling), VFN exhibits an impressive performance advantage over IPA, excelling in terms of both designability (67.04% vs. 53.58%) and diversity (66.54% vs. 51.98%). In inverse folding (frame and atom modeling), VFN outperforms the previous SoTA model, PiFold (54.7% vs. 51.66%), on sequence recovery rate. We also propose a method of equipping VFN with the ESM model, which significantly surpasses the previous ESM-based SoTA (62.67% vs. 55.65%), LM-Design, by a substantial margin.

Text-to-image diffusion models have demonstrated remarkable capabilities in transforming textual prompts into coherent images, yet the computational cost of their inference remains a persistent challenge. To address this issue, we present UFOGen, a novel generative model designed for ultra-fast, one-step text-to-image synthesis. In contrast to conventional approaches that focus on improving samplers or employing distillation techniques for diffusion models, UFOGen adopts a hybrid methodology, integrating diffusion models with a GAN objective. Leveraging a newly introduced diffusion-GAN objective and initialization with pre-trained diffusion models, UFOGen excels in efficiently generating high-quality images conditioned on textual descriptions in a single step. Beyond traditional text-to-image generation, UFOGen showcases versatility in applications. Notably, UFOGen stands among the pioneering models enabling one-step text-to-image generation and diverse downstream tasks, presenting a significant advancement in the landscape of efficient generative models. \blfootnote{*Work done as a student researcher of Google, dagger indicates equal contribution.

Foundation models rely on large-scale web-crawled datasets, which frequently contain noisy data, biases, and irrelevant content. Existing data selection techniques typically use human heuristics, downstream evaluation datasets, or specialized scoring models, and can overlook samples' utility in the training process. Instead, we propose a new approach, Mimic Score, a data quality metric that uses a pretrained reference model as a guide to assess the usefulness of data samples for training a new model. It relies on the alignment between the gradient of the new model parameters and the vector pointing toward the reference model in weight space. Samples that misalign with this direction are considered low-value and can be filtered out. Motivated by the Mimic score, we develop Grad-Mimic, a data selection framework that identifies and prioritizes useful samples, automating the selection process to create effective filters. Empirically, using Mimic scores to guide model training results in consistent performance gains across six image datasets and enhances the performance of CLIP models. Moreover, Mimic scores and their associated filters improve upon existing filtering methods and offer accurate estimation of dataset quality.

Clinical predictive models often rely on patients' electronic health records (EHR), but integrating medical knowledge to enhance predictions and decision-making is challenging. This is because personalized predictions require personalized knowledge graphs (KGs), which are difficult to generate from patient EHR data. To address this, we propose GraphCare, an open-world framework that uses external KGs to improve EHR-based predictions. Our method extracts knowledge from large language models (LLMs) and external biomedical KGs to build patient-specific KGs, which are then used to train our proposed Bi-attention AugmenTed (BAT) graph neural network (GNN) for healthcare predictions. On two public datasets, MIMIC-III and MIMIC-IV, GraphCare surpasses baselines in four vital healthcare prediction tasks: mortality, readmission, length of stay (LOS), and drug recommendation. On MIMIC-III, it boosts AUROC by 17.6\% and 6.6\% for mortality and readmission, and F1-score by 7.9\% and 10.8\% for LOS and drug recommendation, respectively. Notably, GraphCare demonstrates a substantial edge in scenarios with limited data availability. Our findings highlight the potential of using external KGs in healthcare prediction tasks and demonstrate the promise of GraphCare in generating personalized KGs for promoting personalized medicine.

This paper proposes one of the first clinical applications of multimodal large language models (LLMs) as an assistant for radiologists to check errors in their reports. We created an evaluation dataset from two real-world radiology datasets (MIMIC-CXR and IU-Xray), with 1,000 subsampled reports each. A subset of original reports was modified to contain synthetic errors by introducing various type of mistakes. The evaluation contained two difficulty levels: SIMPLE for binary error-checking and COMPLEX for identifying error types. LLaVA (Large Language and Visual Assistant) variant models, including our instruction-tuned model, were used for the evaluation. Additionally, a domain expert evaluation was conducted on a small test set. At the SIMPLE level, the LLaVA v1.5 model outperformed other publicly available models. Instruction tuning significantly enhanced performance by 47.4% and 25.4% on MIMIC-CXR and IU-Xray data, respectively. The model also surpassed the domain experts accuracy in the MIMIC-CXR dataset by 1.67%. Notably, among the subsets (N=21) of the test set where a clinician did not achieve the correct conclusion, the LLaVA ensemble mode correctly identified 71.4% of these cases. This study marks a promising step toward utilizing multi-modal LLMs to enhance diagnostic accuracy in radiology. The ensemble model demonstrated comparable performance to clinicians, even capturing errors overlooked by humans. Nevertheless, future work is needed to improve the model ability to identify the types of inconsistency.

Recent years have witnessed significant progress in generative models for music, featuring diverse architectures that balance output quality, diversity, speed, and user control. This study explores a user-friendly graphical interface enabling the drawing of masked regions for inpainting by an Hourglass Diffusion Transformer (HDiT) model trained on MIDI piano roll images. To enhance note generation in specified areas, masked regions can be "repainted" with extra noise. The non-latent HDiTs linear scaling with pixel count allows efficient generation in pixel space, providing intuitive and interpretable controls such as masking throughout the network and removing the need to operate in compressed latent spaces such as those provided by pretrained autoencoders. We demonstrate that, in addition to inpainting of melodies, accompaniment, and continuations, the use of repainting can help increase note density yielding musical structures closely matching user specifications such as rising, falling, or diverging melody and/or accompaniment, even when these lie outside the typical training data distribution. We achieve performance on par with prior results while operating at longer context windows, with no autoencoder, and can enable complex geometries for inpainting masks, increasing the options for machine-assisted composers to control the generated music.

Traditional molecular string representations, such as SMILES, often pose challenges for AI-driven molecular design due to their non-sequential depiction of molecular substructures. To address this issue, we introduce Sequential Attachment-based Fragment Embedding (SAFE), a novel line notation for chemical structures. SAFE reimagines SMILES strings as an unordered sequence of interconnected fragment blocks while maintaining full compatibility with existing SMILES parsers. It streamlines complex generative tasks, including scaffold decoration, fragment linking, polymer generation, and scaffold hopping, while facilitating autoregressive generation for fragment-constrained design, thereby eliminating the need for intricate decoding or graph-based models. We demonstrate the effectiveness of SAFE by training an 87-million-parameter GPT2-like model on a dataset containing 1.1 billion SAFE representations. Through extensive experimentation, we show that our SAFE-GPT model exhibits versatile and robust optimization performance. SAFE opens up new avenues for the rapid exploration of chemical space under various constraints, promising breakthroughs in AI-driven molecular design.

This study investigates the integration of diverse patient data sources into multimodal language models for automated chest X-ray (CXR) report generation. Traditionally, CXR report generation relies solely on CXR images and limited radiology data, overlooking valuable information from patient health records, particularly from emergency departments. Utilising the MIMIC-CXR and MIMIC-IV-ED datasets, we incorporate detailed patient information such as aperiodic vital signs, medications, and clinical history to enhance diagnostic accuracy. We introduce a novel approach to transform these heterogeneous data sources into embeddings that prompt a multimodal language model, significantly enhancing the diagnostic accuracy of generated radiology reports. Our comprehensive evaluation demonstrates the benefits of using a broader set of patient data, underscoring the potential for enhanced diagnostic capabilities and better patient outcomes through the integration of multimodal data in CXR report generation.

In this paper, we propose a novel cross-modal distillation method, called TinyCLIP, for large-scale language-image pre-trained models. The method introduces two core techniques: affinity mimicking and weight inheritance. Affinity mimicking explores the interaction between modalities during distillation, enabling student models to mimic teachers' behavior of learning cross-modal feature alignment in a visual-linguistic affinity space. Weight inheritance transmits the pre-trained weights from the teacher models to their student counterparts to improve distillation efficiency. Moreover, we extend the method into a multi-stage progressive distillation to mitigate the loss of informative weights during extreme compression. Comprehensive experiments demonstrate the efficacy of TinyCLIP, showing that it can reduce the size of the pre-trained CLIP ViT-B/32 by 50%, while maintaining comparable zero-shot performance. While aiming for comparable performance, distillation with weight inheritance can speed up the training by 1.4 - 7.8 times compared to training from scratch. Moreover, our TinyCLIP ViT-8M/16, trained on YFCC-15M, achieves an impressive zero-shot top-1 accuracy of 41.1% on ImageNet, surpassing the original CLIP ViT-B/16 by 3.5% while utilizing only 8.9% parameters. Finally, we demonstrate the good transferability of TinyCLIP in various downstream tasks. Code and models will be open-sourced at https://aka.ms/tinyclip.

We introduce VampNet, a masked acoustic token modeling approach to music synthesis, compression, inpainting, and variation. We use a variable masking schedule during training which allows us to sample coherent music from the model by applying a variety of masking approaches (called prompts) during inference. VampNet is non-autoregressive, leveraging a bidirectional transformer architecture that attends to all tokens in a forward pass. With just 36 sampling passes, VampNet can generate coherent high-fidelity musical waveforms. We show that by prompting VampNet in various ways, we can apply it to tasks like music compression, inpainting, outpainting, continuation, and looping with variation (vamping). Appropriately prompted, VampNet is capable of maintaining style, genre, instrumentation, and other high-level aspects of the music. This flexible prompting capability makes VampNet a powerful music co-creation tool. Code and audio samples are available online.

Imitation learning from a large set of human demonstrations has proved to be an effective paradigm for building capable robot agents. However, the demonstrations can be extremely costly and time-consuming to collect. We introduce MimicGen, a system for automatically synthesizing large-scale, rich datasets from only a small number of human demonstrations by adapting them to new contexts. We use MimicGen to generate over 50K demonstrations across 18 tasks with diverse scene configurations, object instances, and robot arms from just ~200 human demonstrations. We show that robot agents can be effectively trained on this generated dataset by imitation learning to achieve strong performance in long-horizon and high-precision tasks, such as multi-part assembly and coffee preparation, across broad initial state distributions. We further demonstrate that the effectiveness and utility of MimicGen data compare favorably to collecting additional human demonstrations, making it a powerful and economical approach towards scaling up robot learning. Datasets, simulation environments, videos, and more at https://mimicgen.github.io .

Instruction following is crucial in contemporary LLM. However, when extended to multimodal setting, it often suffers from misalignment between specific textual instruction and targeted local region of an image. To achieve more accurate and nuanced multimodal instruction following, we introduce Instruction-guided Visual Masking (IVM), a new versatile visual grounding model that is compatible with diverse multimodal models, such as LMM and robot model. By constructing visual masks for instruction-irrelevant regions, IVM-enhanced multimodal models can effectively focus on task-relevant image regions to better align with complex instructions. Specifically, we design a visual masking data generation pipeline and create an IVM-Mix-1M dataset with 1 million image-instruction pairs. We further introduce a new learning technique, Discriminator Weighted Supervised Learning (DWSL) for preferential IVM training that prioritizes high-quality data samples. Experimental results on generic multimodal tasks such as VQA and embodied robotic control demonstrate the versatility of IVM, which as a plug-and-play tool, significantly boosts the performance of diverse multimodal models, yielding new state-of-the-art results across challenging multimodal benchmarks. Code is available at https://github.com/2toinf/IVM.

Automatic Music Transcription (AMT) has been recognized as a key enabling technology with a wide range of applications. Given the task's complexity, best results have typically been reported for systems focusing on specific settings, e.g. instrument-specific systems tend to yield improved results over instrument-agnostic methods. Similarly, higher accuracy can be obtained when only estimating frame-wise f_0 values and neglecting the harder note event detection. Despite their high accuracy, such specialized systems often cannot be deployed in the real-world. Storage and network constraints prohibit the use of multiple specialized models, while memory and run-time constraints limit their complexity. In this paper, we propose a lightweight neural network for musical instrument transcription, which supports polyphonic outputs and generalizes to a wide variety of instruments (including vocals). Our model is trained to jointly predict frame-wise onsets, multipitch and note activations, and we experimentally show that this multi-output structure improves the resulting frame-level note accuracy. Despite its simplicity, benchmark results show our system's note estimation to be substantially better than a comparable baseline, and its frame-level accuracy to be only marginally below those of specialized state-of-the-art AMT systems. With this work we hope to encourage the community to further investigate low-resource, instrument-agnostic AMT systems.

Chemical similarity searches are widely used in-silico methods for identifying new drug-like molecules. These methods have historically relied on structure-based comparisons to compute molecular similarity. Here, we use a chemical language model to create a vector-based chemical search. We extend implementations by creating a prompt engineering strategy that utilizes two different chemical string representation algorithms: one for the query and the other for the database. We explore this method by reviewing the search results from five drug-like query molecules (penicillin G, nirmatrelvir, zidovudine, lysergic acid diethylamide, and fentanyl) and three dye-like query molecules (acid blue 25, avobenzone, and 2-diphenylaminocarbazole). We find that this novel method identifies molecules that are functionally similar to the query, indicated by the associated patent literature, and that many of these molecules are structurally distinct from the query, making them unlikely to be found with traditional chemical similarity search methods. This method may aid in the discovery of novel structural classes of molecules that achieve target functionality.

The dynamic nature of proteins is crucial for determining their biological functions and properties, for which Monte Carlo (MC) and molecular dynamics (MD) simulations stand as predominant tools to study such phenomena. By utilizing empirically derived force fields, MC or MD simulations explore the conformational space through numerically evolving the system via Markov chain or Newtonian mechanics. However, the high-energy barrier of the force fields can hamper the exploration of both methods by the rare event, resulting in inadequately sampled ensemble without exhaustive running. Existing learning-based approaches perform direct sampling yet heavily rely on target-specific simulation data for training, which suffers from high data acquisition cost and poor generalizability. Inspired by simulated annealing, we propose Str2Str, a novel structure-to-structure translation framework capable of zero-shot conformation sampling with roto-translation equivariant property. Our method leverages an amortized denoising score matching objective trained on general crystal structures and has no reliance on simulation data during both training and inference. Experimental results across several benchmarking protein systems demonstrate that Str2Str outperforms previous state-of-the-art generative structure prediction models and can be orders of magnitude faster compared to long MD simulations. Our open-source implementation is available at https://github.com/lujiarui/Str2Str