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Probabilistic Imputation for Time-series Classification with Missing Data

Multivariate time series data for real-world applications typically contain a significant amount of missing values. The dominant approach for classification with such missing values is to impute them heuristically with specific values (zero, mean, values of adjacent time-steps) or learnable parameters. However, these simple strategies do not take the data generative process into account, and more importantly, do not effectively capture the uncertainty in prediction due to the multiple possibilities for the missing values. In this paper, we propose a novel probabilistic framework for classification with multivariate time series data with missing values. Our model consists of two parts; a deep generative model for missing value imputation and a classifier. Extending the existing deep generative models to better capture structures of time-series data, our deep generative model part is trained to impute the missing values in multiple plausible ways, effectively modeling the uncertainty of the imputation. The classifier part takes the time series data along with the imputed missing values and classifies signals, and is trained to capture the predictive uncertainty due to the multiple possibilities of imputations. Importantly, we show that na\"ively combining the generative model and the classifier could result in trivial solutions where the generative model does not produce meaningful imputations. To resolve this, we present a novel regularization technique that can promote the model to produce useful imputation values that help classification. Through extensive experiments on real-world time series data with missing values, we demonstrate the effectiveness of our method.

Awareness in Practice: Tensions in Access to Sensitive Attribute Data for Antidiscrimination

Organizations cannot address demographic disparities that they cannot see. Recent research on machine learning and fairness has emphasized that awareness of sensitive attributes, such as race and sex, is critical to the development of interventions. However, on the ground, the existence of these data cannot be taken for granted. This paper uses the domains of employment, credit, and healthcare in the United States to surface conditions that have shaped the availability of sensitive attribute data. For each domain, we describe how and when private companies collect or infer sensitive attribute data for antidiscrimination purposes. An inconsistent story emerges: Some companies are required by law to collect sensitive attribute data, while others are prohibited from doing so. Still others, in the absence of legal mandates, have determined that collection and imputation of these data are appropriate to address disparities. This story has important implications for fairness research and its future applications. If companies that mediate access to life opportunities are unable or hesitant to collect or infer sensitive attribute data, then proposed techniques to detect and mitigate bias in machine learning models might never be implemented outside the lab. We conclude that today's legal requirements and corporate practices, while highly inconsistent across domains, offer lessons for how to approach the collection and inference of sensitive data in appropriate circumstances. We urge stakeholders, including machine learning practitioners, to actively help chart a path forward that takes both policy goals and technical needs into account.

Gene Regulatory Network Inference in the Presence of Dropouts: a Causal View

Gene regulatory network inference (GRNI) is a challenging problem, particularly owing to the presence of zeros in single-cell RNA sequencing data: some are biological zeros representing no gene expression, while some others are technical zeros arising from the sequencing procedure (aka dropouts), which may bias GRNI by distorting the joint distribution of the measured gene expressions. Existing approaches typically handle dropout error via imputation, which may introduce spurious relations as the true joint distribution is generally unidentifiable. To tackle this issue, we introduce a causal graphical model to characterize the dropout mechanism, namely, Causal Dropout Model. We provide a simple yet effective theoretical result: interestingly, the conditional independence (CI) relations in the data with dropouts, after deleting the samples with zero values (regardless if technical or not) for the conditioned variables, are asymptotically identical to the CI relations in the original data without dropouts. This particular test-wise deletion procedure, in which we perform CI tests on the samples without zeros for the conditioned variables, can be seamlessly integrated with existing structure learning approaches including constraint-based and greedy score-based methods, thus giving rise to a principled framework for GRNI in the presence of dropouts. We further show that the causal dropout model can be validated from data, and many existing statistical models to handle dropouts fit into our model as specific parametric instances. Empirical evaluation on synthetic, curated, and real-world experimental transcriptomic data comprehensively demonstrate the efficacy of our method.

Multi-resolution Networks For Flexible Irregular Time Series Modeling (Multi-FIT)

Missing values, irregularly collected samples, and multi-resolution signals commonly occur in multivariate time series data, making predictive tasks difficult. These challenges are especially prevalent in the healthcare domain, where patients' vital signs and electronic records are collected at different frequencies and have occasionally missing information due to the imperfections in equipment or patient circumstances. Researchers have handled each of these issues differently, often handling missing data through mean value imputation and then using sequence models over the multivariate signals while ignoring the different resolution of signals. We propose a unified model named Multi-resolution Flexible Irregular Time series Network (Multi-FIT). The building block for Multi-FIT is the FIT network. The FIT network creates an informative dense representation at each time step using signal information such as last observed value, time difference since the last observed time stamp and overall mean for the signal. Vertical FIT (FIT-V) is a variant of FIT which also models the relationship between different temporal signals while creating the informative dense representations for the signal. The multi-FIT model uses multiple FIT networks for sets of signals with different resolutions, further facilitating the construction of flexible representations. Our model has three main contributions: a.) it does not impute values but rather creates informative representations to provide flexibility to the model for creating task-specific representations b.) it models the relationship between different signals in the form of support signals c.) it models different resolutions in parallel before merging them for the final prediction task. The FIT, FIT-V and Multi-FIT networks improve upon the state-of-the-art models for three predictive tasks, including the forecasting of patient survival.

Investigating Data Contamination in Modern Benchmarks for Large Language Models

Recent observations have underscored a disparity between the inflated benchmark scores and the actual performance of LLMs, raising concerns about potential contamination of evaluation benchmarks. This issue is especially critical for closed-source models and certain open-source models where training data transparency is lacking. In this paper we study data contamination by proposing two methods tailored for both open-source and proprietary LLMs. We first introduce a retrieval-based system to explore potential overlaps between evaluation benchmarks and pretraining corpora. We further present a novel investigation protocol named Testset Slot Guessing (TS-Guessing), applicable to both open and proprietary models. This approach entails masking a wrong answer in a multiple-choice question and prompting the model to fill in the gap. Additionally, it involves obscuring an unlikely word in an evaluation example and asking the model to produce it. We find that certain commercial LLMs could surprisingly guess the missing option in various test sets. Specifically, in the TruthfulQA benchmark, we find that LLMs exhibit notable performance improvement when provided with additional metadata in the benchmark. Further, in the MMLU benchmark, ChatGPT and GPT-4 demonstrated an exact match rate of 52\% and 57\%, respectively, in guessing the missing options in benchmark test data. We hope these results underscore the need for more robust evaluation methodologies and benchmarks in the field.

A Toolbox for Surfacing Health Equity Harms and Biases in Large Language Models

Large language models (LLMs) hold immense promise to serve complex health information needs but also have the potential to introduce harm and exacerbate health disparities. Reliably evaluating equity-related model failures is a critical step toward developing systems that promote health equity. In this work, we present resources and methodologies for surfacing biases with potential to precipitate equity-related harms in long-form, LLM-generated answers to medical questions and then conduct an empirical case study with Med-PaLM 2, resulting in the largest human evaluation study in this area to date. Our contributions include a multifactorial framework for human assessment of LLM-generated answers for biases, and EquityMedQA, a collection of seven newly-released datasets comprising both manually-curated and LLM-generated questions enriched for adversarial queries. Both our human assessment framework and dataset design process are grounded in an iterative participatory approach and review of possible biases in Med-PaLM 2 answers to adversarial queries. Through our empirical study, we find that the use of a collection of datasets curated through a variety of methodologies, coupled with a thorough evaluation protocol that leverages multiple assessment rubric designs and diverse rater groups, surfaces biases that may be missed via narrower evaluation approaches. Our experience underscores the importance of using diverse assessment methodologies and involving raters of varying backgrounds and expertise. We emphasize that while our framework can identify specific forms of bias, it is not sufficient to holistically assess whether the deployment of an AI system promotes equitable health outcomes. We hope the broader community leverages and builds on these tools and methods towards realizing a shared goal of LLMs that promote accessible and equitable healthcare for all.

The Dataset Nutrition Label: A Framework To Drive Higher Data Quality Standards

Artificial intelligence (AI) systems built on incomplete or biased data will often exhibit problematic outcomes. Current methods of data analysis, particularly before model development, are costly and not standardized. The Dataset Nutrition Label (the Label) is a diagnostic framework that lowers the barrier to standardized data analysis by providing a distilled yet comprehensive overview of dataset "ingredients" before AI model development. Building a Label that can be applied across domains and data types requires that the framework itself be flexible and adaptable; as such, the Label is comprised of diverse qualitative and quantitative modules generated through multiple statistical and probabilistic modelling backends, but displayed in a standardized format. To demonstrate and advance this concept, we generated and published an open source prototype with seven sample modules on the ProPublica Dollars for Docs dataset. The benefits of the Label are manyfold. For data specialists, the Label will drive more robust data analysis practices, provide an efficient way to select the best dataset for their purposes, and increase the overall quality of AI models as a result of more robust training datasets and the ability to check for issues at the time of model development. For those building and publishing datasets, the Label creates an expectation of explanation, which will drive better data collection practices. We also explore the limitations of the Label, including the challenges of generalizing across diverse datasets, and the risk of using "ground truth" data as a comparison dataset. We discuss ways to move forward given the limitations identified. Lastly, we lay out future directions for the Dataset Nutrition Label project, including research and public policy agendas to further advance consideration of the concept.

Selective Machine Learning of the Average Treatment Effect with an Invalid Instrumental Variable

Instrumental variable methods have been widely used to identify causal effects in the presence of unmeasured confounding. A key identification condition known as the exclusion restriction states that the instrument cannot have a direct effect on the outcome which is not mediated by the exposure in view. In the health and social sciences, such an assumption is often not credible. To address this concern, we consider identification conditions of the population average treatment effect with an invalid instrumental variable which does not satisfy the exclusion restriction, and derive the efficient influence function targeting the identifying functional under a nonparametric observed data model. We propose a novel multiply robust locally efficient estimator of the average treatment effect that is consistent in the union of multiple parametric nuisance models, as well as a multiply debiased machine learning estimator for which the nuisance parameters are estimated using generic machine learning methods, that effectively exploit various forms of linear or nonlinear structured sparsity in the nuisance parameter space. When one cannot be confident that any of these machine learners is consistent at sufficiently fast rates to ensure n-consistency for the average treatment effect, we introduce a new criteria for selective machine learning which leverages the multiple robustness property in order to ensure small bias. The proposed methods are illustrated through extensive simulations and a data analysis evaluating the causal effect of 401(k) participation on savings.

Adaptive Sampling Strategies to Construct Equitable Training Datasets

In domains ranging from computer vision to natural language processing, machine learning models have been shown to exhibit stark disparities, often performing worse for members of traditionally underserved groups. One factor contributing to these performance gaps is a lack of representation in the data the models are trained on. It is often unclear, however, how to operationalize representativeness in specific applications. Here we formalize the problem of creating equitable training datasets, and propose a statistical framework for addressing this problem. We consider a setting where a model builder must decide how to allocate a fixed data collection budget to gather training data from different subgroups. We then frame dataset creation as a constrained optimization problem, in which one maximizes a function of group-specific performance metrics based on (estimated) group-specific learning rates and costs per sample. This flexible approach incorporates preferences of model-builders and other stakeholders, as well as the statistical properties of the learning task. When data collection decisions are made sequentially, we show that under certain conditions this optimization problem can be efficiently solved even without prior knowledge of the learning rates. To illustrate our approach, we conduct a simulation study of polygenic risk scores on synthetic genomic data -- an application domain that often suffers from non-representative data collection. We find that our adaptive sampling strategy outperforms several common data collection heuristics, including equal and proportional sampling, demonstrating the value of strategic dataset design for building equitable models.

Integrating Earth Observation Data into Causal Inference: Challenges and Opportunities

Observational studies require adjustment for confounding factors that are correlated with both the treatment and outcome. In the setting where the observed variables are tabular quantities such as average income in a neighborhood, tools have been developed for addressing such confounding. However, in many parts of the developing world, features about local communities may be scarce. In this context, satellite imagery can play an important role, serving as a proxy for the confounding variables otherwise unobserved. In this paper, we study confounder adjustment in this non-tabular setting, where patterns or objects found in satellite images contribute to the confounder bias. Using the evaluation of anti-poverty aid programs in Africa as our running example, we formalize the challenge of performing causal adjustment with such unstructured data -- what conditions are sufficient to identify causal effects, how to perform estimation, and how to quantify the ways in which certain aspects of the unstructured image object are most predictive of the treatment decision. Via simulation, we also explore the sensitivity of satellite image-based observational inference to image resolution and to misspecification of the image-associated confounder. Finally, we apply these tools in estimating the effect of anti-poverty interventions in African communities from satellite imagery.

Machine Learning Workflow to Explain Black-box Models for Early Alzheimer's Disease Classification Evaluated for Multiple Datasets

Purpose: Hard-to-interpret Black-box Machine Learning (ML) were often used for early Alzheimer's Disease (AD) detection. Methods: To interpret eXtreme Gradient Boosting (XGBoost), Random Forest (RF), and Support Vector Machine (SVM) black-box models a workflow based on Shapley values was developed. All models were trained on the Alzheimer's Disease Neuroimaging Initiative (ADNI) dataset and evaluated for an independent ADNI test set, as well as the external Australian Imaging and Lifestyle flagship study of Ageing (AIBL), and Open Access Series of Imaging Studies (OASIS) datasets. Shapley values were compared to intuitively interpretable Decision Trees (DTs), and Logistic Regression (LR), as well as natural and permutation feature importances. To avoid the reduction of the explanation validity caused by correlated features, forward selection and aspect consolidation were implemented. Results: Some black-box models outperformed DTs and LR. The forward-selected features correspond to brain areas previously associated with AD. Shapley values identified biologically plausible associations with moderate to strong correlations with feature importances. The most important RF features to predict AD conversion were the volume of the amygdalae, and a cognitive test score. Good cognitive test performances and large brain volumes decreased the AD risk. The models trained using cognitive test scores significantly outperformed brain volumetric models (p<0.05). Cognitive Normal (CN) vs. AD models were successfully transferred to external datasets. Conclusion: In comparison to previous work, improved performances for ADNI and AIBL were achieved for CN vs. Mild Cognitive Impairment (MCI) classification using brain volumes. The Shapley values and the feature importances showed moderate to strong correlations.

Large Language Model Distilling Medication Recommendation Model

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.

DDXPlus: A New Dataset For Automatic Medical Diagnosis

There has been a rapidly growing interest in Automatic Symptom Detection (ASD) and Automatic Diagnosis (AD) systems in the machine learning research literature, aiming to assist doctors in telemedicine services. These systems are designed to interact with patients, collect evidence about their symptoms and relevant antecedents, and possibly make predictions about the underlying diseases. Doctors would review the interactions, including the evidence and the predictions, collect if necessary additional information from patients, before deciding on next steps. Despite recent progress in this area, an important piece of doctors' interactions with patients is missing in the design of these systems, namely the differential diagnosis. Its absence is largely due to the lack of datasets that include such information for models to train on. In this work, we present a large-scale synthetic dataset of roughly 1.3 million patients that includes a differential diagnosis, along with the ground truth pathology, symptoms and antecedents for each patient. Unlike existing datasets which only contain binary symptoms and antecedents, this dataset also contains categorical and multi-choice symptoms and antecedents useful for efficient data collection. Moreover, some symptoms are organized in a hierarchy, making it possible to design systems able to interact with patients in a logical way. As a proof-of-concept, we extend two existing AD and ASD systems to incorporate the differential diagnosis, and provide empirical evidence that using differentials as training signals is essential for the efficiency of such systems or for helping doctors better understand the reasoning of those systems.

Understanding Disparities in Post Hoc Machine Learning Explanation

Previous work has highlighted that existing post-hoc explanation methods exhibit disparities in explanation fidelity (across 'race' and 'gender' as sensitive attributes), and while a large body of work focuses on mitigating these issues at the explanation metric level, the role of the data generating process and black box model in relation to explanation disparities remains largely unexplored. Accordingly, through both simulations as well as experiments on a real-world dataset, we specifically assess challenges to explanation disparities that originate from properties of the data: limited sample size, covariate shift, concept shift, omitted variable bias, and challenges based on model properties: inclusion of the sensitive attribute and appropriate functional form. Through controlled simulation analyses, our study demonstrates that increased covariate shift, concept shift, and omission of covariates increase explanation disparities, with the effect pronounced higher for neural network models that are better able to capture the underlying functional form in comparison to linear models. We also observe consistent findings regarding the effect of concept shift and omitted variable bias on explanation disparities in the Adult income dataset. Overall, results indicate that disparities in model explanations can also depend on data and model properties. Based on this systematic investigation, we provide recommendations for the design of explanation methods that mitigate undesirable disparities.

Weak Proxies are Sufficient and Preferable for Fairness with Missing Sensitive Attributes

Evaluating fairness can be challenging in practice because the sensitive attributes of data are often inaccessible due to privacy constraints. The go-to approach that the industry frequently adopts is using off-the-shelf proxy models to predict the missing sensitive attributes, e.g. Meta [Alao et al., 2021] and Twitter [Belli et al., 2022]. Despite its popularity, there are three important questions unanswered: (1) Is directly using proxies efficacious in measuring fairness? (2) If not, is it possible to accurately evaluate fairness using proxies only? (3) Given the ethical controversy over inferring user private information, is it possible to only use weak (i.e. inaccurate) proxies in order to protect privacy? Our theoretical analyses show that directly using proxy models can give a false sense of (un)fairness. Second, we develop an algorithm that is able to measure fairness (provably) accurately with only three properly identified proxies. Third, we show that our algorithm allows the use of only weak proxies (e.g. with only 68.85%accuracy on COMPAS), adding an extra layer of protection on user privacy. Experiments validate our theoretical analyses and show our algorithm can effectively measure and mitigate bias. Our results imply a set of practical guidelines for practitioners on how to use proxies properly. Code is available at github.com/UCSC-REAL/fair-eval.

PRISM: Patient Records Interpretation for Semantic Clinical Trial Matching using Large Language Models

Clinical trial matching is the task of identifying trials for which patients may be potentially eligible. Typically, this task is labor-intensive and requires detailed verification of patient electronic health records (EHRs) against the stringent inclusion and exclusion criteria of clinical trials. This process is manual, time-intensive, and challenging to scale up, resulting in many patients missing out on potential therapeutic options. Recent advancements in Large Language Models (LLMs) have made automating patient-trial matching possible, as shown in multiple concurrent research studies. However, the current approaches are confined to constrained, often synthetic datasets that do not adequately mirror the complexities encountered in real-world medical data. In this study, we present the first, end-to-end large-scale empirical evaluation of clinical trial matching using real-world EHRs. Our study showcases the capability of LLMs to accurately match patients with appropriate clinical trials. We perform experiments with proprietary LLMs, including GPT-4 and GPT-3.5, as well as our custom fine-tuned model called OncoLLM and show that OncoLLM, despite its significantly smaller size, not only outperforms GPT-3.5 but also matches the performance of qualified medical doctors. All experiments were carried out on real-world EHRs that include clinical notes and available clinical trials from a single cancer center in the United States.

Inference Scaling scriptsizeFLaws: The Limits of LLM Resampling with Imperfect Verifiers

Recent research has generated hope that inference scaling could allow weaker language models to match or exceed the accuracy of stronger models, such as by repeatedly sampling solutions to a coding problem until it passes unit tests. The central thesis of this paper is that there is no free lunch for inference scaling: indefinite accuracy improvement through resampling can only be realized if the "verifier" (in this case, a set of unit tests) is perfect. When the verifier is imperfect, as it almost always is in domains such as reasoning or coding (for example, unit tests have imperfect coverage), there is a nonzero probability of false positives: incorrect solutions that pass the verifier. Resampling cannot decrease this probability, so it imposes an upper bound to the accuracy of resampling-based inference scaling even with an infinite compute budget. We find that there is a very strong correlation between the model's single-sample accuracy (i.e. accuracy without unit tests) and its false positive rate on coding benchmarks HumanEval and MBPP, whose unit tests have limited coverage. Therefore, no amount of inference scaling of weaker models can enable them to match the single-sample accuracy of a sufficiently strong model (Fig. 1a). When we consider that false positives have a negative utility compared to abstaining from producing a solution, it bends the inference scaling curve further downward. Empirically, we find that the optimal number of samples can be less than 10 under realistic assumptions (Fig. 1b). Finally, we show that beyond accuracy, false positives may have other undesirable qualities, such as poor adherence to coding style conventions.

Question-Answering Model for Schizophrenia Symptoms and Their Impact on Daily Life using Mental Health Forums Data

In recent years, there is strong emphasis on mining medical data using machine learning techniques. A common problem is to obtain a noiseless set of textual documents, with a relevant content for the research question, and developing a Question Answering (QA) model for a specific medical field. The purpose of this paper is to present a new methodology for building a medical dataset and obtain a QA model for analysis of symptoms and impact on daily life for a specific disease domain. The ``Mental Health'' forum was used, a forum dedicated to people suffering from schizophrenia and different mental disorders. Relevant posts of active users, who regularly participate, were extrapolated providing a new method of obtaining low-bias content and without privacy issues. Furthermore, it is shown how to pre-process the dataset to convert it into a QA dataset. The Bidirectional Encoder Representations from Transformers (BERT), DistilBERT, RoBERTa, and BioBERT models were fine-tuned and evaluated via F1-Score, Exact Match, Precision and Recall. Accurate empirical experiments demonstrated the effectiveness of the proposed method for obtaining an accurate dataset for QA model implementation. By fine-tuning the BioBERT QA model, we achieved an F1 score of 0.885, showing a considerable improvement and outperforming the state-of-the-art model for mental disorders domain.

The Impossible Test: A 2024 Unsolvable Dataset and A Chance for an AGI Quiz

This research introduces a novel evaluation framework designed to assess large language models' (LLMs) ability to acknowledge uncertainty on 675 fundamentally unsolvable problems. Using a curated dataset of graduate-level grand challenge questions with intentionally unknowable answers, we evaluated twelve state-of-the-art LLMs, including both open and closed-source models, on their propensity to admit ignorance rather than generate plausible but incorrect responses. The best models scored in 62-68% accuracy ranges for admitting the problem solution was unknown in fields ranging from biology to philosophy and mathematics. We observed an inverse relationship between problem difficulty and model accuracy, with GPT-4 demonstrating higher rates of uncertainty acknowledgment on more challenging problems (35.8%) compared to simpler ones (20.0%). This pattern indicates that models may be more prone to generate speculative answers when problems appear more tractable. The study also revealed significant variations across problem categories, with models showing difficulty in acknowledging uncertainty in invention and NP-hard problems while performing relatively better on philosophical and psychological challenges. These results contribute to the growing body of research on artificial general intelligence (AGI) assessment by highlighting the importance of uncertainty recognition as a critical component of future machine intelligence evaluation. This impossibility test thus extends previous theoretical frameworks for universal intelligence testing by providing empirical evidence of current limitations in LLMs' ability to recognize their own knowledge boundaries, suggesting new directions for improving model training architectures and evaluation approaches.

The ELEVATE-AI LLMs Framework: An Evaluation Framework for Use of Large Language Models in HEOR: an ISPOR Working Group Report

Introduction. Generative Artificial Intelligence, particularly large language models (LLMs), offers transformative potential for Health Economics and Outcomes Research (HEOR). However, evaluating the quality, transparency, and rigor of LLM-assisted research lacks standardized guidance. This article introduces the ELEVATE AI LLMs framework and checklist, designed to support researchers and reviewers in assessing LLM use in HEOR. Methods. The ELEVATE AI LLMs framework was developed through a targeted review of existing guidelines and evaluation frameworks. The framework comprises ten evaluation domains, including model characteristics, accuracy, comprehensiveness, and fairness. The accompanying checklist operationalizes the framework. To validate the framework, we applied it to two published studies, demonstrating its usability across different HEOR tasks. Results. The ELEVATE AI LLMs framework provides a comprehensive structure for evaluating LLM-assisted research, while the checklist facilitates practical application. Validation of the framework and checklist on studies of systematic literature reviews and health economic modeling highlighted their ability to identify strengths and gaps in reporting. Limitations. While the ELEVATE AI LLMs framework provides robust guidance, its broader generalizability and applicability to diverse HEOR tasks require further empirical testing. Additionally, several metrics adapted from computer science need further validation in HEOR contexts. Conclusion. The ELEVATE AI LLMs framework and checklist fill a critical gap in HEOR by offering structured guidance for evaluating LLM-assisted research. By promoting transparency, accuracy, and reproducibility, they aim to standardize and improve the integration of LLMs into HEOR, ensuring their outputs meet the field's rigorous standards.

Questioning the Survey Responses of Large Language Models

As large language models increase in capability, researchers have started to conduct surveys of all kinds on these models with varying scientific motivations. In this work, we examine what we can learn from a model's survey responses on the basis of the well-established American Community Survey (ACS) by the U.S. Census Bureau. Evaluating more than a dozen different models, varying in size from a few hundred million to ten billion parameters, hundreds of thousands of times each on questions from the ACS, we systematically establish two dominant patterns. First, smaller models have a significant position and labeling bias, for example, towards survey responses labeled with the letter "A". This A-bias diminishes, albeit slowly, as model size increases. Second, when adjusting for this labeling bias through randomized answer ordering, models still do not trend toward US population statistics or those of any cognizable population. Rather, models across the board trend toward uniformly random aggregate statistics over survey responses. This pattern is robust to various different ways of prompting the model, including what is the de-facto standard. Our findings demonstrate that aggregate statistics of a language model's survey responses lack the signals found in human populations. This absence of statistical signal cautions about the use of survey responses from large language models at present time.

KITAB: Evaluating LLMs on Constraint Satisfaction for Information Retrieval

We study the ability of state-of-the art models to answer constraint satisfaction queries for information retrieval (e.g., 'a list of ice cream shops in San Diego'). In the past, such queries were considered to be tasks that could only be solved via web-search or knowledge bases. More recently, large language models (LLMs) have demonstrated initial emergent abilities in this task. However, many current retrieval benchmarks are either saturated or do not measure constraint satisfaction. Motivated by rising concerns around factual incorrectness and hallucinations of LLMs, we present KITAB, a new dataset for measuring constraint satisfaction abilities of language models. KITAB consists of book-related data across more than 600 authors and 13,000 queries, and also offers an associated dynamic data collection and constraint verification approach for acquiring similar test data for other authors. Our extended experiments on GPT4 and GPT3.5 characterize and decouple common failure modes across dimensions such as information popularity, constraint types, and context availability. Results show that in the absence of context, models exhibit severe limitations as measured by irrelevant information, factual errors, and incompleteness, many of which exacerbate as information popularity decreases. While context availability mitigates irrelevant information, it is not helpful for satisfying constraints, identifying fundamental barriers to constraint satisfaction. We open source our contributions to foster further research on improving constraint satisfaction abilities of future models.

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

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

LongHealth: A Question Answering Benchmark with Long Clinical Documents

Background: Recent advancements in large language models (LLMs) offer potential benefits in healthcare, particularly in processing extensive patient records. However, existing benchmarks do not fully assess LLMs' capability in handling real-world, lengthy clinical data. Methods: We present the LongHealth benchmark, comprising 20 detailed fictional patient cases across various diseases, with each case containing 5,090 to 6,754 words. The benchmark challenges LLMs with 400 multiple-choice questions in three categories: information extraction, negation, and sorting, challenging LLMs to extract and interpret information from large clinical documents. Results: We evaluated nine open-source LLMs with a minimum of 16,000 tokens and also included OpenAI's proprietary and cost-efficient GPT-3.5 Turbo for comparison. The highest accuracy was observed for Mixtral-8x7B-Instruct-v0.1, particularly in tasks focused on information retrieval from single and multiple patient documents. However, all models struggled significantly in tasks requiring the identification of missing information, highlighting a critical area for improvement in clinical data interpretation. Conclusion: While LLMs show considerable potential for processing long clinical documents, their current accuracy levels are insufficient for reliable clinical use, especially in scenarios requiring the identification of missing information. The LongHealth benchmark provides a more realistic assessment of LLMs in a healthcare setting and highlights the need for further model refinement for safe and effective clinical application. We make the benchmark and evaluation code publicly available.

Mental-LLM: Leveraging Large Language Models for Mental Health Prediction via Online Text Data

Advances in large language models (LLMs) have empowered a variety of applications. However, there is still a significant gap in research when it comes to understanding and enhancing the capabilities of LLMs in the field of mental health. In this work, we present the first comprehensive evaluation of multiple LLMs, including Alpaca, Alpaca-LoRA, FLAN-T5, GPT-3.5, and GPT-4, on various mental health prediction tasks via online text data. We conduct a broad range of experiments, covering zero-shot prompting, few-shot prompting, and instruction fine-tuning. The results indicate a promising yet limited performance of LLMs with zero-shot and few-shot prompt designs for the mental health tasks. More importantly, our experiments show that instruction finetuning can significantly boost the performance of LLMs for all tasks simultaneously. Our best-finetuned models, Mental-Alpaca and Mental-FLAN-T5, outperform the best prompt design of GPT-3.5 (25 and 15 times bigger) by 10.9% on balanced accuracy and the best of GPT-4 (250 and 150 times bigger) by 4.8%. They further perform on par with the state-of-the-art task-specific language model. We also conduct an exploratory case study on LLMs' capability on the mental health reasoning tasks, illustrating the promising capability of certain models such as GPT-4. We summarize our findings into a set of action guidelines for potential methods to enhance LLMs' capability for mental health tasks. Meanwhile, we also emphasize the important limitations before achieving deployability in real-world mental health settings, such as known racial and gender bias. We highlight the important ethical risks accompanying this line of research.

Towards Bridging the Gaps between the Right to Explanation and the Right to be Forgotten

The Right to Explanation and the Right to be Forgotten are two important principles outlined to regulate algorithmic decision making and data usage in real-world applications. While the right to explanation allows individuals to request an actionable explanation for an algorithmic decision, the right to be forgotten grants them the right to ask for their data to be deleted from all the databases and models of an organization. Intuitively, enforcing the right to be forgotten may trigger model updates which in turn invalidate previously provided explanations, thus violating the right to explanation. In this work, we investigate the technical implications arising due to the interference between the two aforementioned regulatory principles, and propose the first algorithmic framework to resolve the tension between them. To this end, we formulate a novel optimization problem to generate explanations that are robust to model updates due to the removal of training data instances by data deletion requests. We then derive an efficient approximation algorithm to handle the combinatorial complexity of this optimization problem. We theoretically demonstrate that our method generates explanations that are provably robust to worst-case data deletion requests with bounded costs in case of linear models and certain classes of non-linear models. Extensive experimentation with real-world datasets demonstrates the efficacy of the proposed framework.

FairLay-ML: Intuitive Remedies for Unfairness in Data-Driven Social-Critical Algorithms

This thesis explores open-sourced machine learning (ML) model explanation tools to understand whether these tools can allow a layman to visualize, understand, and suggest intuitive remedies to unfairness in ML-based decision-support systems. Machine learning models trained on datasets biased against minority groups are increasingly used to guide life-altering social decisions, prompting the urgent need to study their logic for unfairness. Due to this problem's impact on vast populations of the general public, it is critical for the layperson -- not just subject matter experts in social justice or machine learning experts -- to understand the nature of unfairness within these algorithms and the potential trade-offs. Existing research on fairness in machine learning focuses mostly on the mathematical definitions and tools to understand and remedy unfair models, with some directly citing user-interactive tools as necessary for future work. This thesis presents FairLay-ML, a proof-of-concept GUI integrating some of the most promising tools to provide intuitive explanations for unfair logic in ML models by integrating existing research tools (e.g. Local Interpretable Model-Agnostic Explanations) with existing ML-focused GUI (e.g. Python Streamlit). We test FairLay-ML using models of various accuracy and fairness generated by an unfairness detector tool, Parfait-ML, and validate our results using Themis. Our study finds that the technology stack used for FairLay-ML makes it easy to install and provides real-time black-box explanations of pre-trained models to users. Furthermore, the explanations provided translate to actionable remedies.

Generalization in Healthcare AI: Evaluation of a Clinical Large Language Model

Advances in large language models (LLMs) provide new opportunities in healthcare for improved patient care, clinical decision-making, and enhancement of physician and administrator workflows. However, the potential of these models importantly depends on their ability to generalize effectively across clinical environments and populations, a challenge often underestimated in early development. To better understand reasons for these challenges and inform mitigation approaches, we evaluated ClinicLLM, an LLM trained on [HOSPITAL]'s clinical notes, analyzing its performance on 30-day all-cause readmission prediction focusing on variability across hospitals and patient characteristics. We found poorer generalization particularly in hospitals with fewer samples, among patients with government and unspecified insurance, the elderly, and those with high comorbidities. To understand reasons for lack of generalization, we investigated sample sizes for fine-tuning, note content (number of words per note), patient characteristics (comorbidity level, age, insurance type, borough), and health system aspects (hospital, all-cause 30-day readmission, and mortality rates). We used descriptive statistics and supervised classification to identify features. We found that, along with sample size, patient age, number of comorbidities, and the number of words in notes are all important factors related to generalization. Finally, we compared local fine-tuning (hospital specific), instance-based augmented fine-tuning and cluster-based fine-tuning for improving generalization. Among these, local fine-tuning proved most effective, increasing AUC by 0.25% to 11.74% (most helpful in settings with limited data). Overall, this study provides new insights for enhancing the deployment of large language models in the societally important domain of healthcare, and improving their performance for broader populations.

PMC-Patients: A Large-scale Dataset of Patient Notes and Relations Extracted from Case Reports in PubMed Central

Objective: Data unavailability has been one of the biggest barriers in clinical natural language processing. This paper is aimed at providing a large-scale and publicly available patient note dataset, named PMC-Patients, with relevant articles and similar patients annotations. The ultimate goal of PMC-Patients is to facilitate the development of retrieval-based clinical decision support systems. Materials and Methods: To collect PMC-Patients, we extract patient notes from case reports in PubMed Central by recognizing certain section patterns. Patient-article relevance and patient-patient similarity are annotated by citation relationships in PubMed. In addition, we perform three tasks with PMC-Patients to demonstrate its utility in providing clinical decision support for a given patient, including (1) classifying whether another patient is similar, (2) retrieving similar patients in PMC-Patients, and (3) retrieving relevant articles in PubMed. Results: We collect and release PMC-Patients under the CC BY-NC-SA license, which becomes the largest publicly available patient note dataset so far. PMC-Patients contains 167k patient notes that are annotated with 3.1M relevant articles and 293k similar patients. Qualitative and quantitative analyses reveal the high quality and richness of our dataset. Experiments show that classifying the similarity of patient pairs is relatively easy, but it is hard to retrieve similar patients or relevant articles for a given patient from a large set of candidates. Conclusion: We present PMC-Patients, a large-scale dataset of patient notes with high quality, easy access, diverse conditions, and rich annotations. The proposed dataset can also serve as a hard benchmark for evaluating retrieval-based clinical decision support systems.

Advancing Model Pruning via Bi-level Optimization

The deployment constraints in practical applications necessitate the pruning of large-scale deep learning models, i.e., promoting their weight sparsity. As illustrated by the Lottery Ticket Hypothesis (LTH), pruning also has the potential of improving their generalization ability. At the core of LTH, iterative magnitude pruning (IMP) is the predominant pruning method to successfully find 'winning tickets'. Yet, the computation cost of IMP grows prohibitively as the targeted pruning ratio increases. To reduce the computation overhead, various efficient 'one-shot' pruning methods have been developed, but these schemes are usually unable to find winning tickets as good as IMP. This raises the question of how to close the gap between pruning accuracy and pruning efficiency? To tackle it, we pursue the algorithmic advancement of model pruning. Specifically, we formulate the pruning problem from a fresh and novel viewpoint, bi-level optimization (BLO). We show that the BLO interpretation provides a technically-grounded optimization base for an efficient implementation of the pruning-retraining learning paradigm used in IMP. We also show that the proposed bi-level optimization-oriented pruning method (termed BiP) is a special class of BLO problems with a bi-linear problem structure. By leveraging such bi-linearity, we theoretically show that BiP can be solved as easily as first-order optimization, thus inheriting the computation efficiency. Through extensive experiments on both structured and unstructured pruning with 5 model architectures and 4 data sets, we demonstrate that BiP can find better winning tickets than IMP in most cases, and is computationally as efficient as the one-shot pruning schemes, demonstrating 2-7 times speedup over IMP for the same level of model accuracy and sparsity.

Domain constraints improve risk prediction when outcome data is missing

Machine learning models are often trained to predict the outcome resulting from a human decision. For example, if a doctor decides to test a patient for disease, will the patient test positive? A challenge is that historical decision-making determines whether the outcome is observed: we only observe test outcomes for patients doctors historically tested. Untested patients, for whom outcomes are unobserved, may differ from tested patients along observed and unobserved dimensions. We propose a Bayesian model class which captures this setting. The purpose of the model is to accurately estimate risk for both tested and untested patients. Estimating this model is challenging due to the wide range of possibilities for untested patients. To address this, we propose two domain constraints which are plausible in health settings: a prevalence constraint, where the overall disease prevalence is known, and an expertise constraint, where the human decision-maker deviates from purely risk-based decision-making only along a constrained feature set. We show theoretically and on synthetic data that domain constraints improve parameter inference. We apply our model to a case study of cancer risk prediction, showing that the model's inferred risk predicts cancer diagnoses, its inferred testing policy captures known public health policies, and it can identify suboptimalities in test allocation. Though our case study is in healthcare, our analysis reveals a general class of domain constraints which can improve model estimation in many settings.

MEDIC: Towards a Comprehensive Framework for Evaluating LLMs in Clinical Applications

The rapid development of Large Language Models (LLMs) for healthcare applications has spurred calls for holistic evaluation beyond frequently-cited benchmarks like USMLE, to better reflect real-world performance. While real-world assessments are valuable indicators of utility, they often lag behind the pace of LLM evolution, likely rendering findings obsolete upon deployment. This temporal disconnect necessitates a comprehensive upfront evaluation that can guide model selection for specific clinical applications. We introduce MEDIC, a framework assessing LLMs across five critical dimensions of clinical competence: medical reasoning, ethics and bias, data and language understanding, in-context learning, and clinical safety. MEDIC features a novel cross-examination framework quantifying LLM performance across areas like coverage and hallucination detection, without requiring reference outputs. We apply MEDIC to evaluate LLMs on medical question-answering, safety, summarization, note generation, and other tasks. Our results show performance disparities across model sizes, baseline vs medically finetuned models, and have implications on model selection for applications requiring specific model strengths, such as low hallucination or lower cost of inference. MEDIC's multifaceted evaluation reveals these performance trade-offs, bridging the gap between theoretical capabilities and practical implementation in healthcare settings, ensuring that the most promising models are identified and adapted for diverse healthcare applications.

Primary and Secondary Factor Consistency as Domain Knowledge to Guide Happiness Computing in Online Assessment

Happiness computing based on large-scale online web data and machine learning methods is an emerging research topic that underpins a range of issues, from personal growth to social stability. Many advanced Machine Learning (ML) models with explanations are used to compute the happiness online assessment while maintaining high accuracy of results. However, domain knowledge constraints, such as the primary and secondary relations of happiness factors, are absent from these models, which limits the association between computing results and the right reasons for why they occurred. This article attempts to provide new insights into the explanation consistency from an empirical study perspective. Then we study how to represent and introduce domain knowledge constraints to make ML models more trustworthy. We achieve this through: (1) proving that multiple prediction models with additive factor attributions will have the desirable property of primary and secondary relations consistency, and (2) showing that factor relations with quantity can be represented as an importance distribution for encoding domain knowledge. Factor explanation difference is penalized by the Kullback-Leibler divergence-based loss among computing models. Experimental results using two online web datasets show that domain knowledge of stable factor relations exists. Using this knowledge not only improves happiness computing accuracy but also reveals more significative happiness factors for assisting decisions well.

VLUCI: Variational Learning of Unobserved Confounders for Counterfactual Inference

Causal inference plays a vital role in diverse domains like epidemiology, healthcare, and economics. De-confounding and counterfactual prediction in observational data has emerged as a prominent concern in causal inference research. While existing models tackle observed confounders, the presence of unobserved confounders remains a significant challenge, distorting causal inference and impacting counterfactual outcome accuracy. To address this, we propose a novel variational learning model of unobserved confounders for counterfactual inference (VLUCI), which generates the posterior distribution of unobserved confounders. VLUCI relaxes the unconfoundedness assumption often overlooked by most causal inference methods. By disentangling observed and unobserved confounders, VLUCI constructs a doubly variational inference model to approximate the distribution of unobserved confounders, which are used for inferring more accurate counterfactual outcomes. Extensive experiments on synthetic and semi-synthetic datasets demonstrate VLUCI's superior performance in inferring unobserved confounders. It is compatible with state-of-the-art counterfactual inference models, significantly improving inference accuracy at both group and individual levels. Additionally, VLUCI provides confidence intervals for counterfactual outcomes, aiding decision-making in risk-sensitive domains. We further clarify the considerations when applying VLUCI to cases where unobserved confounders don't strictly conform to our model assumptions using the public IHDP dataset as an example, highlighting the practical advantages of VLUCI.

Yet Another ICU Benchmark: A Flexible Multi-Center Framework for Clinical ML

Medical applications of machine learning (ML) have experienced a surge in popularity in recent years. The intensive care unit (ICU) is a natural habitat for ML given the abundance of available data from electronic health records. Models have been proposed to address numerous ICU prediction tasks like the early detection of complications. While authors frequently report state-of-the-art performance, it is challenging to verify claims of superiority. Datasets and code are not always published, and cohort definitions, preprocessing pipelines, and training setups are difficult to reproduce. This work introduces Yet Another ICU Benchmark (YAIB), a modular framework that allows researchers to define reproducible and comparable clinical ML experiments; we offer an end-to-end solution from cohort definition to model evaluation. The framework natively supports most open-access ICU datasets (MIMIC III/IV, eICU, HiRID, AUMCdb) and is easily adaptable to future ICU datasets. Combined with a transparent preprocessing pipeline and extensible training code for multiple ML and deep learning models, YAIB enables unified model development. Our benchmark comes with five predefined established prediction tasks (mortality, acute kidney injury, sepsis, kidney function, and length of stay) developed in collaboration with clinicians. Adding further tasks is straightforward by design. Using YAIB, we demonstrate that the choice of dataset, cohort definition, and preprocessing have a major impact on the prediction performance - often more so than model class - indicating an urgent need for YAIB as a holistic benchmarking tool. We provide our work to the clinical ML community to accelerate method development and enable real-world clinical implementations. Software Repository: https://github.com/rvandewater/YAIB.

Toward Stable and Consistent Evaluation Results: A New Methodology for Base Model Evaluation

This paper poses two critical issues in evaluating base models (without post-training): (1) Unstable evaluation during training: in the early stages of pre-training, the models lack the capability to answer questions as required, leading to unstable evaluation results. This instability makes it difficult to provide solid conclusions to guide the training, especially for key experiments such as data ablation and scaling law. (2) Inconsistency between base and instruct models: base models generally exhibit poorer evaluation performance compared to corresponding instruct models. This gap poses a challenge for assessing whether a base model with better evaluation can truly lead to a better instruct model. To address these issues, we propose Base model Oriented Systematic Evaluation (BOSE), a method specifically designed to optimize the evaluation of base models. Specifically, BOSE introduces two key innovations: In-Context Light-instruction Prompt (ICLiP) for open-ended tasks and Blank-ppl for multi-choice tasks with candidate options, which transforms the standard perplexity (ppl) metric into a fill-in-the-blank format to mitigate early-stage evaluation fluctuations. Furthermore, we are the first to propose Kendall's rank correlation to quantitatively measure the evaluation stability and consistency. Experimental results demonstrate that BOSE significantly enhances both the stability of evaluations during pre-training and the consistency between base and instruct models, thereby providing more reliable guidance for the LLMs' training.

RareBench: Can LLMs Serve as Rare Diseases Specialists?

Generalist Large Language Models (LLMs), such as GPT-4, have shown considerable promise in various domains, including medical diagnosis. Rare diseases, affecting approximately 300 million people worldwide, often have unsatisfactory clinical diagnosis rates primarily due to a lack of experienced physicians and the complexity of differentiating among many rare diseases. In this context, recent news such as "ChatGPT correctly diagnosed a 4-year-old's rare disease after 17 doctors failed" underscore LLMs' potential, yet underexplored, role in clinically diagnosing rare diseases. To bridge this research gap, we introduce RareBench, a pioneering benchmark designed to systematically evaluate the capabilities of LLMs on 4 critical dimensions within the realm of rare diseases. Meanwhile, we have compiled the largest open-source dataset on rare disease patients, establishing a benchmark for future studies in this domain. To facilitate differential diagnosis of rare diseases, we develop a dynamic few-shot prompt methodology, leveraging a comprehensive rare disease knowledge graph synthesized from multiple knowledge bases, significantly enhancing LLMs' diagnostic performance. Moreover, we present an exhaustive comparative study of GPT-4's diagnostic capabilities against those of specialist physicians. Our experimental findings underscore the promising potential of integrating LLMs into the clinical diagnostic process for rare diseases. This paves the way for exciting possibilities in future advancements in this field.

MMAU: A Holistic Benchmark of Agent Capabilities Across Diverse Domains

Recent advances in large language models (LLMs) have increased the demand for comprehensive benchmarks to evaluate their capabilities as human-like agents. Existing benchmarks, while useful, often focus on specific application scenarios, emphasizing task completion but failing to dissect the underlying skills that drive these outcomes. This lack of granularity makes it difficult to deeply discern where failures stem from. Additionally, setting up these environments requires considerable effort, and issues of unreliability and reproducibility sometimes arise, especially in interactive tasks. To address these limitations, we introduce the Massive Multitask Agent Understanding (MMAU) benchmark, featuring comprehensive offline tasks that eliminate the need for complex environment setups. It evaluates models across five domains, including teal{Tool-use}, teal{Directed Acyclic Graph (DAG) QA}, teal{Data Science and Machine Learning coding}, teal{Contest-level programming} and teal{Mathematics}, and covers five essential capabilities: orange{Understanding}, orange{Reasoning}, orange{Planning}, orange{Problem-solving}, and orange{Self-correction}. With a total of 20 meticulously designed tasks encompassing over 3K distinct prompts, MMAU provides a comprehensive framework for evaluating the strengths and limitations of LLM agents. By testing 18 representative models on MMAU, we provide deep and insightful analyses. Ultimately, MMAU not only sheds light on the capabilities and limitations of LLM agents but also enhances the interpretability of their performance. Datasets and evaluation scripts of MMAU are released at https://github.com/apple/axlearn/docs/research/mmau.

DAIC-WOZ: On the Validity of Using the Therapist's prompts in Automatic Depression Detection from Clinical Interviews

Automatic depression detection from conversational data has gained significant interest in recent years. The DAIC-WOZ dataset, interviews conducted by a human-controlled virtual agent, has been widely used for this task. Recent studies have reported enhanced performance when incorporating interviewer's prompts into the model. In this work, we hypothesize that this improvement might be mainly due to a bias present in these prompts, rather than the proposed architectures and methods. Through ablation experiments and qualitative analysis, we discover that models using interviewer's prompts learn to focus on a specific region of the interviews, where questions about past experiences with mental health issues are asked, and use them as discriminative shortcuts to detect depressed participants. In contrast, models using participant responses gather evidence from across the entire interview. Finally, to highlight the magnitude of this bias, we achieve a 0.90 F1 score by intentionally exploiting it, the highest result reported to date on this dataset using only textual information. Our findings underline the need for caution when incorporating interviewers' prompts into models, as they may inadvertently learn to exploit targeted prompts, rather than learning to characterize the language and behavior that are genuinely indicative of the patient's mental health condition.

MEDEC: A Benchmark for Medical Error Detection and Correction in Clinical Notes

Several studies showed that Large Language Models (LLMs) can answer medical questions correctly, even outperforming the average human score in some medical exams. However, to our knowledge, no study has been conducted to assess the ability of language models to validate existing or generated medical text for correctness and consistency. In this paper, we introduce MEDEC (https://github.com/abachaa/MEDEC), the first publicly available benchmark for medical error detection and correction in clinical notes, covering five types of errors (Diagnosis, Management, Treatment, Pharmacotherapy, and Causal Organism). MEDEC consists of 3,848 clinical texts, including 488 clinical notes from three US hospital systems that were not previously seen by any LLM. The dataset has been used for the MEDIQA-CORR shared task to evaluate seventeen participating systems [Ben Abacha et al., 2024]. In this paper, we describe the data creation methods and we evaluate recent LLMs (e.g., o1-preview, GPT-4, Claude 3.5 Sonnet, and Gemini 2.0 Flash) for the tasks of detecting and correcting medical errors requiring both medical knowledge and reasoning capabilities. We also conducted a comparative study where two medical doctors performed the same task on the MEDEC test set. The results showed that MEDEC is a sufficiently challenging benchmark to assess the ability of models to validate existing or generated notes and to correct medical errors. We also found that although recent LLMs have a good performance in error detection and correction, they are still outperformed by medical doctors in these tasks. We discuss the potential factors behind this gap, the insights from our experiments, the limitations of current evaluation metrics, and share potential pointers for future research.

Eye Fairness: A Large-Scale 3D Imaging Dataset for Equitable Eye Diseases Screening and Fair Identity Scaling

Fairness or equity in machine learning is profoundly important for societal well-being, but limited public datasets hinder its progress, especially in the area of medicine. It is undeniable that fairness in medicine is one of the most important areas for fairness learning's applications. Currently, no large-scale public medical datasets with 3D imaging data for fairness learning are available, while 3D imaging data in modern clinics are standard tests for disease diagnosis. In addition, existing medical fairness datasets are actually repurposed datasets, and therefore they typically have limited demographic identity attributes with at most three identity attributes of age, gender, and race for fairness modeling. To address this gap, we introduce our Eye Fairness dataset with 30,000 subjects (Harvard-EF) covering three major eye diseases including age-related macular degeneration, diabetic retinopathy, and glaucoma affecting 380 million patients globally. Our Harvard-EF dataset includes both 2D fundus photos and 3D optical coherence tomography scans with six demographic identity attributes including age, gender, race, ethnicity, preferred language, and marital status. We also propose a fair identity scaling (FIS) approach combining group and individual scaling together to improve model fairness. Our FIS approach is compared with various state-of-the-art fairness learning methods with superior performance in the racial, gender, and ethnicity fairness tasks with 2D and 3D imaging data, which demonstrate the utilities of our Harvard-EF dataset for fairness learning. To facilitate fairness comparisons between different models, we propose performance-scaled disparity measures, which can be used to compare model fairness accounting for overall performance levels. The dataset and code are publicly accessible via https://ophai.hms.harvard.edu/datasets/harvard-ef30k.

LLMAuditor: A Framework for Auditing Large Language Models Using Human-in-the-Loop

As Large Language Models (LLMs) become more pervasive across various users and scenarios, identifying potential issues when using these models becomes essential. Examples of such issues include: bias, inconsistencies, and hallucination. Although auditing the LLM for these problems is often warranted, such a process is neither easy nor accessible for most. An effective method is to probe the LLM using different versions of the same question. This could expose inconsistencies in its knowledge or operation, indicating potential for bias or hallucination. However, to operationalize this auditing method at scale, we need an approach to create those probes reliably and automatically. In this paper we propose the LLMAuditor framework which is an automatic, and scalable solution, where one uses a different LLM along with human-in-the-loop (HIL). This approach offers verifiability and transparency, while avoiding circular reliance on the same LLM, and increasing scientific rigor and generalizability. Specifically, LLMAuditor includes two phases of verification using humans: standardized evaluation criteria to verify responses, and a structured prompt template to generate desired probes. A case study using questions from the TruthfulQA dataset demonstrates that we can generate a reliable set of probes from one LLM that can be used to audit inconsistencies in a different LLM. This process is enhanced by our structured prompt template with HIL, which not only boosts the reliability of our approach in auditing but also yields the delivery of less hallucinated results. The novelty of our research stems from the development of a comprehensive, general-purpose framework that includes a HIL verified prompt template for auditing responses generated by LLMs.

Model Sparsity Can Simplify Machine Unlearning

In response to recent data regulation requirements, machine unlearning (MU) has emerged as a critical process to remove the influence of specific examples from a given model. Although exact unlearning can be achieved through complete model retraining using the remaining dataset, the associated computational costs have driven the development of efficient, approximate unlearning techniques. Moving beyond data-centric MU approaches, our study introduces a novel model-based perspective: model sparsification via weight pruning, which is capable of reducing the gap between exact unlearning and approximate unlearning. We show in both theory and practice that model sparsity can boost the multi-criteria unlearning performance of an approximate unlearner, closing the approximation gap, while continuing to be efficient. This leads to a new MU paradigm, termed prune first, then unlearn, which infuses a sparse model prior into the unlearning process. Building on this insight, we also develop a sparsity-aware unlearning method that utilizes sparsity regularization to enhance the training process of approximate unlearning. Extensive experiments show that our proposals consistently benefit MU in various unlearning scenarios. A notable highlight is the 77% unlearning efficacy gain of fine-tuning (one of the simplest unlearning methods) when using sparsity-aware unlearning. Furthermore, we demonstrate the practical impact of our proposed MU methods in addressing other machine learning challenges, such as defending against backdoor attacks and enhancing transfer learning. Codes are available at https://github.com/OPTML-Group/Unlearn-Sparse.

LLMRec: Large Language Models with Graph Augmentation for Recommendation

The problem of data sparsity has long been a challenge in recommendation systems, and previous studies have attempted to address this issue by incorporating side information. However, this approach often introduces side effects such as noise, availability issues, and low data quality, which in turn hinder the accurate modeling of user preferences and adversely impact recommendation performance. In light of the recent advancements in large language models (LLMs), which possess extensive knowledge bases and strong reasoning capabilities, we propose a novel framework called LLMRec that enhances recommender systems by employing three simple yet effective LLM-based graph augmentation strategies. Our approach leverages the rich content available within online platforms (e.g., Netflix, MovieLens) to augment the interaction graph in three ways: (i) reinforcing user-item interaction egde, (ii) enhancing the understanding of item node attributes, and (iii) conducting user node profiling, intuitively from the natural language perspective. By employing these strategies, we address the challenges posed by sparse implicit feedback and low-quality side information in recommenders. Besides, to ensure the quality of the augmentation, we develop a denoised data robustification mechanism that includes techniques of noisy implicit feedback pruning and MAE-based feature enhancement that help refine the augmented data and improve its reliability. Furthermore, we provide theoretical analysis to support the effectiveness of LLMRec and clarify the benefits of our method in facilitating model optimization. Experimental results on benchmark datasets demonstrate the superiority of our LLM-based augmentation approach over state-of-the-art techniques. To ensure reproducibility, we have made our code and augmented data publicly available at: https://github.com/HKUDS/LLMRec.git

Towards Exact Computation of Inductive Bias

Much research in machine learning involves finding appropriate inductive biases (e.g. convolutional neural networks, momentum-based optimizers, transformers) to promote generalization on tasks. However, quantification of the amount of inductive bias associated with these architectures and hyperparameters has been limited. We propose a novel method for efficiently computing the inductive bias required for generalization on a task with a fixed training data budget; formally, this corresponds to the amount of information required to specify well-generalizing models within a specific hypothesis space of models. Our approach involves modeling the loss distribution of random hypotheses drawn from a hypothesis space to estimate the required inductive bias for a task relative to these hypotheses. Unlike prior work, our method provides a direct estimate of inductive bias without using bounds and is applicable to diverse hypothesis spaces. Moreover, we derive approximation error bounds for our estimation approach in terms of the number of sampled hypotheses. Consistent with prior results, our empirical results demonstrate that higher dimensional tasks require greater inductive bias. We show that relative to other expressive model classes, neural networks as a model class encode large amounts of inductive bias. Furthermore, our measure quantifies the relative difference in inductive bias between different neural network architectures. Our proposed inductive bias metric provides an information-theoretic interpretation of the benefits of specific model architectures for certain tasks and provides a quantitative guide to developing tasks requiring greater inductive bias, thereby encouraging the development of more powerful inductive biases.

Unboxing Occupational Bias: Grounded Debiasing LLMs with U.S. Labor Data

Large Language Models (LLMs) are prone to inheriting and amplifying societal biases embedded within their training data, potentially reinforcing harmful stereotypes related to gender, occupation, and other sensitive categories. This issue becomes particularly problematic as biased LLMs can have far-reaching consequences, leading to unfair practices and exacerbating social inequalities across various domains, such as recruitment, online content moderation, or even the criminal justice system. Although prior research has focused on detecting bias in LLMs using specialized datasets designed to highlight intrinsic biases, there has been a notable lack of investigation into how these findings correlate with authoritative datasets, such as those from the U.S. National Bureau of Labor Statistics (NBLS). To address this gap, we conduct empirical research that evaluates LLMs in a ``bias-out-of-the-box" setting, analyzing how the generated outputs compare with the distributions found in NBLS data. Furthermore, we propose a straightforward yet effective debiasing mechanism that directly incorporates NBLS instances to mitigate bias within LLMs. Our study spans seven different LLMs, including instructable, base, and mixture-of-expert models, and reveals significant levels of bias that are often overlooked by existing bias detection techniques. Importantly, our debiasing method, which does not rely on external datasets, demonstrates a substantial reduction in bias scores, highlighting the efficacy of our approach in creating fairer and more reliable LLMs.

Image-based Treatment Effect Heterogeneity

Randomized controlled trials (RCTs) are considered the gold standard for estimating the average treatment effect (ATE) of interventions. One use of RCTs is to study the causes of global poverty -- a subject explicitly cited in the 2019 Nobel Memorial Prize awarded to Duflo, Banerjee, and Kremer "for their experimental approach to alleviating global poverty." Because the ATE is a population summary, anti-poverty experiments often seek to unpack the effect variation around the ATE by conditioning (CATE) on tabular variables such as age and ethnicity that were measured during the RCT data collection. Although such variables are key to unpacking CATE, using only such variables may fail to capture historical, geographical, or neighborhood-specific contributors to effect variation, as tabular RCT data are often only observed near the time of the experiment. In global poverty research, when the location of the experiment units is approximately known, satellite imagery can provide a window into such factors important for understanding heterogeneity. However, there is no method that specifically enables applied researchers to analyze CATE from images. In this paper, using a deep probabilistic modeling framework, we develop such a method that estimates latent clusters of images by identifying images with similar treatment effects distributions. Our interpretable image CATE model also includes a sensitivity factor that quantifies the importance of image segments contributing to the effect cluster prediction. We compare the proposed methods against alternatives in simulation; also, we show how the model works in an actual RCT, estimating the effects of an anti-poverty intervention in northern Uganda and obtaining a posterior predictive distribution over effects for the rest of the country where no experimental data was collected. We make all models available in open-source software.

Using Imperfect Surrogates for Downstream Inference: Design-based Supervised Learning for Social Science Applications of Large Language Models

In computational social science (CSS), researchers analyze documents to explain social and political phenomena. In most scenarios, CSS researchers first obtain labels for documents and then explain labels using interpretable regression analyses in the second step. One increasingly common way to annotate documents cheaply at scale is through large language models (LLMs). However, like other scalable ways of producing annotations, such surrogate labels are often imperfect and biased. We present a new algorithm for using imperfect annotation surrogates for downstream statistical analyses while guaranteeing statistical properties -- like asymptotic unbiasedness and proper uncertainty quantification -- which are fundamental to CSS research. We show that direct use of surrogate labels in downstream statistical analyses leads to substantial bias and invalid confidence intervals, even with high surrogate accuracy of 80-90%. To address this, we build on debiased machine learning to propose the design-based supervised learning (DSL) estimator. DSL employs a doubly-robust procedure to combine surrogate labels with a smaller number of high-quality, gold-standard labels. Our approach guarantees valid inference for downstream statistical analyses, even when surrogates are arbitrarily biased and without requiring stringent assumptions, by controlling the probability of sampling documents for gold-standard labeling. Both our theoretical analysis and experimental results show that DSL provides valid statistical inference while achieving root mean squared errors comparable to existing alternatives that focus only on prediction without inferential guarantees.

Partial Correlations in Compositional Data Analysis

Partial correlations quantify linear association between two variables adjusting for the influence of the remaining variables. They form the backbone for graphical models and are readily obtained from the inverse of the covariance matrix. For compositional data, the covariance structure is specified from log ratios of variables, so unless we try to "open" the data via a normalization, this implies changes in the definition and interpretation of partial correlations. In the present work, we elucidate how results derived by Aitchison (1986) lead to a natural definition of partial correlation that has a number of advantages over current measures of association. For this, we show that the residuals of log-ratios between a variable with a reference, when adjusting for all remaining variables including the reference, are reference-independent. Since the reference itself can be controlled for, correlations between residuals are defined for the variables directly without the necessity to recur to ratios except when specifying which variables are partialled out. Thus, perhaps surprisingly, partial correlations do not have the problems commonly found with measures of pairwise association on compositional data. They are well-defined between two variables, are properly scaled, and allow for negative association. By design, they are subcompositionally incoherent, but they share this property with conventional partial correlations (where results change when adjusting for the influence of fewer variables). We discuss the equivalence with normalization-based approaches whenever the normalizing variables are controlled for. We also discuss the partial variances and correlations we obtain from a previously studied data set of Roman glass cups.

Medical Concept Representation Learning from Electronic Health Records and its Application on Heart Failure Prediction

Objective: To transform heterogeneous clinical data from electronic health records into clinically meaningful constructed features using data driven method that rely, in part, on temporal relations among data. Materials and Methods: The clinically meaningful representations of medical concepts and patients are the key for health analytic applications. Most of existing approaches directly construct features mapped to raw data (e.g., ICD or CPT codes), or utilize some ontology mapping such as SNOMED codes. However, none of the existing approaches leverage EHR data directly for learning such concept representation. We propose a new way to represent heterogeneous medical concepts (e.g., diagnoses, medications and procedures) based on co-occurrence patterns in longitudinal electronic health records. The intuition behind the method is to map medical concepts that are co-occuring closely in time to similar concept vectors so that their distance will be small. We also derive a simple method to construct patient vectors from the related medical concept vectors. Results: For qualitative evaluation, we study similar medical concepts across diagnosis, medication and procedure. In quantitative evaluation, our proposed representation significantly improves the predictive modeling performance for onset of heart failure (HF), where classification methods (e.g. logistic regression, neural network, support vector machine and K-nearest neighbors) achieve up to 23% improvement in area under the ROC curve (AUC) using this proposed representation. Conclusion: We proposed an effective method for patient and medical concept representation learning. The resulting representation can map relevant concepts together and also improves predictive modeling performance.

LLM+Reasoning+Planning for supporting incomplete user queries in presence of APIs

Recent availability of Large Language Models (LLMs) has led to the development of numerous LLM-based approaches aimed at providing natural language interfaces for various end-user tasks. These end-user tasks in turn can typically be accomplished by orchestrating a given set of APIs. In practice, natural language task requests (user queries) are often incomplete, i.e., they may not contain all the information required by the APIs. While LLMs excel at natural language processing (NLP) tasks, they frequently hallucinate on missing information or struggle with orchestrating the APIs. The key idea behind our proposed approach is to leverage logical reasoning and classical AI planning along with an LLM for accurately answering user queries including identification and gathering of any missing information in these queries. Our approach uses an LLM and ASP (Answer Set Programming) solver to translate a user query to a representation in Planning Domain Definition Language (PDDL) via an intermediate representation in ASP. We introduce a special API "get_info_api" for gathering missing information. We model all the APIs as PDDL actions in a way that supports dataflow between the APIs. Our approach then uses a classical AI planner to generate an orchestration of API calls (including calls to get_info_api) to answer the user query. Our evaluation results show that our approach significantly outperforms a pure LLM based approach by achieving over 95\% success rate in most cases on a dataset containing complete and incomplete single goal and multi-goal queries where the multi-goal queries may or may not require dataflow among the APIs.

EHRSHOT: An EHR Benchmark for Few-Shot Evaluation of Foundation Models

While the general machine learning (ML) community has benefited from public datasets, tasks, and models, the progress of ML in healthcare has been hampered by a lack of such shared assets. The success of foundation models creates new challenges for healthcare ML by requiring access to shared pretrained models to validate performance benefits. We help address these challenges through three contributions. First, we publish a new dataset, EHRSHOT, which contains deidentified structured data from the electronic health records (EHRs) of 6,739 patients from Stanford Medicine. Unlike MIMIC-III/IV and other popular EHR datasets, EHRSHOT is longitudinal and not restricted to ICU/ED patients. Second, we publish the weights of CLMBR-T-base, a 141M parameter clinical foundation model pretrained on the structured EHR data of 2.57M patients. We are one of the first to fully release such a model for coded EHR data; in contrast, most prior models released for clinical data (e.g. GatorTron, ClinicalBERT) only work with unstructured text and cannot process the rich, structured data within an EHR. We provide an end-to-end pipeline for the community to validate and build upon its performance. Third, we define 15 few-shot clinical prediction tasks, enabling evaluation of foundation models on benefits such as sample efficiency and task adaptation. Our model and dataset are available via a research data use agreement from the Stanford AIMI Center. Code to reproduce our results are available at our Github repo: https://github.com/som-shahlab/ehrshot-benchmark

Evaluating Correctness and Faithfulness of Instruction-Following Models for Question Answering

Retriever-augmented instruction-following models are attractive alternatives to fine-tuned approaches for information-seeking tasks such as question answering (QA). By simply prepending retrieved documents in its input along with an instruction, these models can be adapted to various information domains and tasks without additional fine-tuning. While the model responses tend to be natural and fluent, the additional verbosity makes traditional QA evaluation metrics such as exact match (EM) and F1 unreliable for accurately quantifying model performance. In this work, we investigate the performance of instruction-following models across three information-seeking QA tasks. We use both automatic and human evaluation to evaluate these models along two dimensions: 1) how well they satisfy the user's information need (correctness), and 2) whether they produce a response based on the provided knowledge (faithfulness). Guided by human evaluation and analysis, we highlight the shortcomings of traditional metrics for both correctness and faithfulness. We then propose simple token-overlap based and model-based metrics that reflect the true performance of these models. Our analysis reveals that instruction-following models are competitive, and sometimes even outperform fine-tuned models for correctness. However, these models struggle to stick to the provided knowledge and often hallucinate in their responses. We hope our work encourages a more holistic evaluation of instruction-following models for QA. Our code and data is available at https://github.com/McGill-NLP/instruct-qa

What are the Desired Characteristics of Calibration Sets? Identifying Correlates on Long Form Scientific Summarization

Summarization models often generate text that is poorly calibrated to quality metrics because they are trained to maximize the likelihood of a single reference (MLE). To address this, recent work has added a calibration step, which exposes a model to its own ranked outputs to improve relevance or, in a separate line of work, contrasts positive and negative sets to improve faithfulness. While effective, much of this work has focused on how to generate and optimize these sets. Less is known about why one setup is more effective than another. In this work, we uncover the underlying characteristics of effective sets. For each training instance, we form a large, diverse pool of candidates and systematically vary the subsets used for calibration fine-tuning. Each selection strategy targets distinct aspects of the sets, such as lexical diversity or the size of the gap between positive and negatives. On three diverse scientific long-form summarization datasets (spanning biomedical, clinical, and chemical domains), we find, among others, that faithfulness calibration is optimal when the negative sets are extractive and more likely to be generated, whereas for relevance calibration, the metric margin between candidates should be maximized and surprise--the disagreement between model and metric defined candidate rankings--minimized. Code to create, select, and optimize calibration sets is available at https://github.com/griff4692/calibrating-summaries

HelpSteer2-Preference: Complementing Ratings with Preferences

Reward models are critical for aligning models to follow instructions, and are typically trained following one of two popular paradigms: Bradley-Terry style or Regression style. However, there is a lack of evidence that either approach is better than the other, when adequately matched for data. This is primarily because these approaches require data collected in different (but incompatible) formats, meaning that adequately matched data is not available in existing public datasets. To tackle this problem, we release preference annotations (designed for Bradley-Terry training) to complement existing ratings (designed for Regression style training) in the HelpSteer2 dataset. To improve data interpretability, preference annotations are accompanied with human-written justifications. Using this data, we conduct the first head-to-head comparison of Bradley-Terry and Regression models when adequately matched for data. Based on insights derived from such a comparison, we propose a novel approach to combine Bradley-Terry and Regression reward modeling. A Llama-3.1-70B-Instruct model tuned with this approach scores 94.1 on RewardBench, emerging top of more than 140 reward models as of 1 Oct 2024. We also demonstrate the effectiveness of this reward model at aligning models to follow instructions in RLHF. We open-source this dataset (CC-BY-4.0 license) at https://huggingface.co/datasets/nvidia/HelpSteer2 and openly release the trained Reward Model at https://huggingface.co/nvidia/Llama-3.1-Nemotron-70B-Reward

Extending Mixture of Experts Model to Investigate Heterogeneity of Trajectories: When, Where and How to Add Which Covariates

Researchers are usually interested in examining the impact of covariates when separating heterogeneous samples into latent classes that are more homogeneous. The majority of theoretical and empirical studies with such aims have focused on identifying covariates as predictors of class membership in the structural equation modeling framework. In other words, the covariates only indirectly affect the sample heterogeneity. However, the covariates' influence on between-individual differences can also be direct. This article presents a mixture model that investigates covariates to explain within-cluster and between-cluster heterogeneity simultaneously, known as a mixture-of-experts (MoE) model. This study aims to extend the MoE framework to investigate heterogeneity in nonlinear trajectories: to identify latent classes, covariates as predictors to clusters, and covariates that explain within-cluster differences in change patterns over time. Our simulation studies demonstrate that the proposed model generally estimates the parameters unbiasedly, precisely and exhibits appropriate empirical coverage for a nominal 95% confidence interval. This study also proposes implementing structural equation model forests to shrink the covariate space of the proposed mixture model. We illustrate how to select covariates and construct the proposed model with longitudinal mathematics achievement data. Additionally, we demonstrate that the proposed mixture model can be further extended in the structural equation modeling framework by allowing the covariates that have direct effects to be time-varying.

Beta-Rank: A Robust Convolutional Filter Pruning Method For Imbalanced Medical Image Analysis

As deep neural networks include a high number of parameters and operations, it can be a challenge to implement these models on devices with limited computational resources. Despite the development of novel pruning methods toward resource-efficient models, it has become evident that these models are not capable of handling "imbalanced" and "limited number of data points". We proposed a novel filter pruning method by considering the input and output of filters along with the values of the filters that deal with imbalanced datasets better than others. Our pruning method considers the fact that all information about the importance of a filter may not be reflected in the value of the filter. Instead, it is reflected in the changes made to the data after the filter is applied to it. In this work, three methods are compared with the same training conditions except for the ranking values of each method, and 14 methods are compared from other papers. We demonstrated that our model performed significantly better than other methods for imbalanced medical datasets. For example, when we removed up to 58% of FLOPs for the IDRID dataset and up to 45% for the ISIC dataset, our model was able to yield an equivalent (or even superior) result to the baseline model. To evaluate FLOP and parameter reduction using our model in real-world settings, we built a smartphone app, where we demonstrated a reduction of up to 79% in memory usage and 72% in prediction time. All codes and parameters for training different models are available at https://github.com/mohofar/Beta-Rank

An adapted large language model facilitates multiple medical tasks in diabetes care

Diabetes is a chronic disease that poses a significant global health burden, and optimizing diabetes management requires multi-stakeholder collaboration. Large language models (LLMs) have shown promise in various healthcare scenarios, but their effectiveness across a diverse range of diabetes tasks remains unproven. In this study, we introduced a framework to train and validate diabetes-specific LLMs. We first developed a comprehensive data processing pipeline that includes data collection, filtering, augmentation and refinement. This approach contributes to creating a high-quality, diabetes-specific dataset, and several evaluation benchmarks entirely from scratch. Utilizing the collected training dataset, we fine-tuned a diabetes-specific LLM family that demonstrated state-of-the-art proficiency in understanding and processing various diabetes tasks compared to other LLMs. Furthermore, clinical studies showed the potential applications of our models in diabetes care, including providing personalized healthcare, assisting medical education, and streamlining clinical tasks. In conclusion, our study introduced a framework to develop and evaluate a diabetes-specific LLM family, and highlighted its potential to enhance clinical practice and provide personalized, data-driven support for diabetes support when facing different end users. The code is provided via GitHub at https://github.com/waltonfuture/Diabetica.

Reproducibility of the Methods in Medical Imaging with Deep Learning

Concerns about the reproducibility of deep learning research are more prominent than ever, with no clear solution in sight. The relevance of machine learning research can only be improved if we also employ empirical rigor that incorporates reproducibility guidelines, especially so in the medical imaging field. The Medical Imaging with Deep Learning (MIDL) conference has made advancements in this direction by advocating open access, and recently also recommending authors to make their code public - both aspects being adopted by the majority of the conference submissions. This helps the reproducibility of the methods, however, there is currently little or no support for further evaluation of these supplementary material, making them vulnerable to poor quality, which affects the impact of the entire submission. We have evaluated all accepted full paper submissions to MIDL between 2018 and 2022 using established, but slightly adjusted guidelines on reproducibility and the quality of the public repositories. The evaluations show that publishing repositories and using public datasets are becoming more popular, which helps traceability, but the quality of the repositories has not improved over the years, leaving room for improvement in every aspect of designing repositories. Merely 22% of all submissions contain a repository that were deemed repeatable using our evaluations. From the commonly encountered issues during the evaluations, we propose a set of guidelines for machine learning-related research for medical imaging applications, adjusted specifically for future submissions to MIDL.

Multilingual Text-to-Image Generation Magnifies Gender Stereotypes and Prompt Engineering May Not Help You

Text-to-image generation models have recently achieved astonishing results in image quality, flexibility, and text alignment and are consequently employed in a fast-growing number of applications. Through improvements in multilingual abilities, a larger community now has access to this kind of technology. Yet, as we will show, multilingual models suffer similarly from (gender) biases as monolingual models. Furthermore, the natural expectation is that these models will provide similar results across languages, but this is not the case and there are important differences between languages. Thus, we propose a novel benchmark MAGBIG intending to foster research in multilingual models without gender bias. We investigate whether multilingual T2I models magnify gender bias with MAGBIG. To this end, we use multilingual prompts requesting portrait images of persons of a certain occupation or trait (using adjectives). Our results show not only that models deviate from the normative assumption that each gender should be equally likely to be generated, but that there are also big differences across languages. Furthermore, we investigate prompt engineering strategies, i.e. the use of indirect, neutral formulations, as a possible remedy for these biases. Unfortunately, they help only to a limited extent and result in worse text-to-image alignment. Consequently, this work calls for more research into diverse representations across languages in image generators.

Subset Selection Based On Multiple Rankings in the Presence of Bias: Effectiveness of Fairness Constraints for Multiwinner Voting Score Functions

We consider the problem of subset selection where one is given multiple rankings of items and the goal is to select the highest ``quality'' subset. Score functions from the multiwinner voting literature have been used to aggregate rankings into quality scores for subsets. We study this setting of subset selection problems when, in addition, rankings may contain systemic or unconscious biases toward a group of items. For a general model of input rankings and biases, we show that requiring the selected subset to satisfy group fairness constraints can improve the quality of the selection with respect to unbiased rankings. Importantly, we show that for fairness constraints to be effective, different multiwinner score functions may require a drastically different number of rankings: While for some functions, fairness constraints need an exponential number of rankings to recover a close-to-optimal solution, for others, this dependency is only polynomial. This result relies on a novel notion of ``smoothness'' of submodular functions in this setting that quantifies how well a function can ``correctly'' assess the quality of items in the presence of bias. The results in this paper can be used to guide the choice of multiwinner score functions for the subset selection setting considered here; we additionally provide a tool to empirically enable this.

"Kelly is a Warm Person, Joseph is a Role Model": Gender Biases in LLM-Generated Reference Letters

Large Language Models (LLMs) have recently emerged as an effective tool to assist individuals in writing various types of content, including professional documents such as recommendation letters. Though bringing convenience, this application also introduces unprecedented fairness concerns. Model-generated reference letters might be directly used by users in professional scenarios. If underlying biases exist in these model-constructed letters, using them without scrutinization could lead to direct societal harms, such as sabotaging application success rates for female applicants. In light of this pressing issue, it is imminent and necessary to comprehensively study fairness issues and associated harms in this real-world use case. In this paper, we critically examine gender biases in LLM-generated reference letters. Drawing inspiration from social science findings, we design evaluation methods to manifest biases through 2 dimensions: (1) biases in language style and (2) biases in lexical content. We further investigate the extent of bias propagation by analyzing the hallucination bias of models, a term that we define to be bias exacerbation in model-hallucinated contents. Through benchmarking evaluation on 2 popular LLMs- ChatGPT and Alpaca, we reveal significant gender biases in LLM-generated recommendation letters. Our findings not only warn against using LLMs for this application without scrutinization, but also illuminate the importance of thoroughly studying hidden biases and harms in LLM-generated professional documents.

Causal Inference by String Diagram Surgery

Extracting causal relationships from observed correlations is a growing area in probabilistic reasoning, originating with the seminal work of Pearl and others from the early 1990s. This paper develops a new, categorically oriented view based on a clear distinction between syntax (string diagrams) and semantics (stochastic matrices), connected via interpretations as structure-preserving functors. A key notion in the identification of causal effects is that of an intervention, whereby a variable is forcefully set to a particular value independent of any prior propensities. We represent the effect of such an intervention as an endofunctor which performs `string diagram surgery' within the syntactic category of string diagrams. This diagram surgery in turn yields a new, interventional distribution via the interpretation functor. While in general there is no way to compute interventional distributions purely from observed data, we show that this is possible in certain special cases using a calculational tool called comb disintegration. We demonstrate the use of this technique on a well-known toy example, where we predict the causal effect of smoking on cancer in the presence of a confounding common cause. After developing this specific example, we show this technique provides simple sufficient conditions for computing interventions which apply to a wide variety of situations considered in the causal inference literature.

Large Language Models are not Fair Evaluators

In this paper, we uncover a systematic bias in the evaluation paradigm of adopting large language models~(LLMs), e.g., GPT-4, as a referee to score and compare the quality of responses generated by candidate models. We find that the quality ranking of candidate responses can be easily hacked by simply altering their order of appearance in the context. This manipulation allows us to skew the evaluation result, making one model appear considerably superior to the other, e.g., Vicuna-13B could beat ChatGPT on 66 over 80 tested queries with ChatGPT as an evaluator. To address this issue, we propose a calibration framework with three simple yet effective strategies: 1) Multiple Evidence Calibration, which requires the evaluator model to generate multiple evaluation evidence before assigning ratings; 2) Balanced Position Calibration, which aggregates results across various orders to determine the final score; 3) Human-in-the-Loop Calibration, which introduces a balanced position diversity entropy to measure the difficulty of each example and seeks human assistance when needed. We also manually annotate the "win/tie/lose" outcomes of responses from ChatGPT and Vicuna-13B in the Vicuna Benchmark's question prompt, and extensive experiments demonstrate that our approach successfully mitigates evaluation bias, resulting in closer alignment with human judgments. We release our code and human annotation at https://github.com/i-Eval/FairEval to facilitate future research.

Which Invariance Should We Transfer? A Causal Minimax Learning Approach

A major barrier to deploying current machine learning models lies in their non-reliability to dataset shifts. To resolve this problem, most existing studies attempted to transfer stable information to unseen environments. Particularly, independent causal mechanisms-based methods proposed to remove mutable causal mechanisms via the do-operator. Compared to previous methods, the obtained stable predictors are more effective in identifying stable information. However, a key question remains: which subset of this whole stable information should the model transfer, in order to achieve optimal generalization ability? To answer this question, we present a comprehensive minimax analysis from a causal perspective. Specifically, we first provide a graphical condition for the whole stable set to be optimal. When this condition fails, we surprisingly find with an example that this whole stable set, although can fully exploit stable information, is not the optimal one to transfer. To identify the optimal subset under this case, we propose to estimate the worst-case risk with a novel optimization scheme over the intervention functions on mutable causal mechanisms. We then propose an efficient algorithm to search for the subset with minimal worst-case risk, based on a newly defined equivalence relation between stable subsets. Compared to the exponential cost of exhaustively searching over all subsets, our searching strategy enjoys a polynomial complexity. The effectiveness and efficiency of our methods are demonstrated on synthetic data and the diagnosis of Alzheimer's disease.

De-identification of Patient Notes with Recurrent Neural Networks

Objective: Patient notes in electronic health records (EHRs) may contain critical information for medical investigations. However, the vast majority of medical investigators can only access de-identified notes, in order to protect the confidentiality of patients. In the United States, the Health Insurance Portability and Accountability Act (HIPAA) defines 18 types of protected health information (PHI) that needs to be removed to de-identify patient notes. Manual de-identification is impractical given the size of EHR databases, the limited number of researchers with access to the non-de-identified notes, and the frequent mistakes of human annotators. A reliable automated de-identification system would consequently be of high value. Materials and Methods: We introduce the first de-identification system based on artificial neural networks (ANNs), which requires no handcrafted features or rules, unlike existing systems. We compare the performance of the system with state-of-the-art systems on two datasets: the i2b2 2014 de-identification challenge dataset, which is the largest publicly available de-identification dataset, and the MIMIC de-identification dataset, which we assembled and is twice as large as the i2b2 2014 dataset. Results: Our ANN model outperforms the state-of-the-art systems. It yields an F1-score of 97.85 on the i2b2 2014 dataset, with a recall 97.38 and a precision of 97.32, and an F1-score of 99.23 on the MIMIC de-identification dataset, with a recall 99.25 and a precision of 99.06. Conclusion: Our findings support the use of ANNs for de-identification of patient notes, as they show better performance than previously published systems while requiring no feature engineering.

ONEBench to Test Them All: Sample-Level Benchmarking Over Open-Ended Capabilities

Traditional fixed test sets fall short in evaluating open-ended capabilities of foundation models. To address this, we propose ONEBench(OpeN-Ended Benchmarking), a new testing paradigm that consolidates individual evaluation datasets into a unified, ever-expanding sample pool. ONEBench allows users to generate custom, open-ended evaluation benchmarks from this pool, corresponding to specific capabilities of interest. By aggregating samples across test sets, ONEBench enables the assessment of diverse capabilities beyond those covered by the original test sets, while mitigating overfitting and dataset bias. Most importantly, it frames model evaluation as a collective process of selecting and aggregating sample-level tests. The shift from task-specific benchmarks to ONEBench introduces two challenges: (1)heterogeneity and (2)incompleteness. Heterogeneity refers to the aggregation over diverse metrics, while incompleteness describes comparing models evaluated on different data subsets. To address these challenges, we explore algorithms to aggregate sparse measurements into reliable model scores. Our aggregation algorithm ensures identifiability(asymptotically recovering ground-truth scores) and rapid convergence, enabling accurate model ranking with less data. On homogenous datasets, we show our aggregation algorithm provides rankings that highly correlate with those produced by average scores. We also demonstrate robustness to ~95% of measurements missing, reducing evaluation cost by up to 20x with little-to-no change in model rankings. We introduce ONEBench-LLM for language models and ONEBench-LMM for vision-language models, unifying evaluations across these domains. Overall, we present a technique for open-ended evaluation, which can aggregate over incomplete, heterogeneous sample-level measurements to continually grow a benchmark alongside the rapidly developing foundation models.

Comparing the Efficacy of GPT-4 and Chat-GPT in Mental Health Care: A Blind Assessment of Large Language Models for Psychological Support

Background: Rapid advancements in natural language processing have led to the development of large language models with the potential to revolutionize mental health care. These models have shown promise in assisting clinicians and providing support to individuals experiencing various psychological challenges. Objective: This study aims to compare the performance of two large language models, GPT-4 and Chat-GPT, in responding to a set of 18 psychological prompts, to assess their potential applicability in mental health care settings. Methods: A blind methodology was employed, with a clinical psychologist evaluating the models' responses without knowledge of their origins. The prompts encompassed a diverse range of mental health topics, including depression, anxiety, and trauma, to ensure a comprehensive assessment. Results: The results demonstrated a significant difference in performance between the two models (p > 0.05). GPT-4 achieved an average rating of 8.29 out of 10, while Chat-GPT received an average rating of 6.52. The clinical psychologist's evaluation suggested that GPT-4 was more effective at generating clinically relevant and empathetic responses, thereby providing better support and guidance to potential users. Conclusions: This study contributes to the growing body of literature on the applicability of large language models in mental health care settings. The findings underscore the importance of continued research and development in the field to optimize these models for clinical use. Further investigation is necessary to understand the specific factors underlying the performance differences between the two models and to explore their generalizability across various populations and mental health conditions.

Under the Surface: Tracking the Artifactuality of LLM-Generated Data

This work delves into the expanding role of large language models (LLMs) in generating artificial data. LLMs are increasingly employed to create a variety of outputs, including annotations, preferences, instruction prompts, simulated dialogues, and free text. As these forms of LLM-generated data often intersect in their application, they exert mutual influence on each other and raise significant concerns about the quality and diversity of the artificial data incorporated into training cycles, leading to an artificial data ecosystem. To the best of our knowledge, this is the first study to aggregate various types of LLM-generated text data, from more tightly constrained data like "task labels" to more lightly constrained "free-form text". We then stress test the quality and implications of LLM-generated artificial data, comparing it with human data across various existing benchmarks. Despite artificial data's capability to match human performance, this paper reveals significant hidden disparities, especially in complex tasks where LLMs often miss the nuanced understanding of intrinsic human-generated content. This study critically examines diverse LLM-generated data and emphasizes the need for ethical practices in data creation and when using LLMs. It highlights the LLMs' shortcomings in replicating human traits and behaviors, underscoring the importance of addressing biases and artifacts produced in LLM-generated content for future research and development. All data and code are available on our project page.

Can Generalist Foundation Models Outcompete Special-Purpose Tuning? Case Study in Medicine

Generalist foundation models such as GPT-4 have displayed surprising capabilities in a wide variety of domains and tasks. Yet, there is a prevalent assumption that they cannot match specialist capabilities of fine-tuned models. For example, most explorations to date on medical competency benchmarks have leveraged domain-specific training, as exemplified by efforts on BioGPT and Med-PaLM. We build on a prior study of GPT-4's capabilities on medical challenge benchmarks in the absence of special training. Rather than using simple prompting to highlight the model's out-of-the-box capabilities, we perform a systematic exploration of prompt engineering. We find that prompting innovation can unlock deeper specialist capabilities and show that GPT-4 easily tops prior leading results for medical benchmarks. The prompting methods we explore are general purpose, and make no specific use of domain expertise, removing the need for expert-curated content. Our experimental design carefully controls for overfitting during the prompt engineering process. We introduce Medprompt, based on a composition of several prompting strategies. With Medprompt, GPT-4 achieves state-of-the-art results on all nine of the benchmark datasets in the MultiMedQA suite. The method outperforms leading specialist models such as Med-PaLM 2 by a significant margin with an order of magnitude fewer calls to the model. Steering GPT-4 with Medprompt achieves a 27% reduction in error rate on the MedQA dataset over the best methods to date achieved with specialist models and surpasses a score of 90% for the first time. Beyond medical problems, we show the power of Medprompt to generalize to other domains and provide evidence for the broad applicability of the approach via studies of the strategy on exams in electrical engineering, machine learning, philosophy, accounting, law, nursing, and clinical psychology.

BEE: Metric-Adapted Explanations via Baseline Exploration-Exploitation

Two prominent challenges in explainability research involve 1) the nuanced evaluation of explanations and 2) the modeling of missing information through baseline representations. The existing literature introduces diverse evaluation metrics, each scrutinizing the quality of explanations through distinct lenses. Additionally, various baseline representations have been proposed, each modeling the notion of missingness differently. Yet, a consensus on the ultimate evaluation metric and baseline representation remains elusive. This work acknowledges the diversity in explanation metrics and baselines, demonstrating that different metrics exhibit preferences for distinct explanation maps resulting from the utilization of different baseline representations and distributions. To address the diversity in metrics and accommodate the variety of baseline representations in a unified manner, we propose Baseline Exploration-Exploitation (BEE) - a path-integration method that introduces randomness to the integration process by modeling the baseline as a learned random tensor. This tensor follows a learned mixture of baseline distributions optimized through a contextual exploration-exploitation procedure to enhance performance on the specific metric of interest. By resampling the baseline from the learned distribution, BEE generates a comprehensive set of explanation maps, facilitating the selection of the best-performing explanation map in this broad set for the given metric. Extensive evaluations across various model architectures showcase the superior performance of BEE in comparison to state-of-the-art explanation methods on a variety of objective evaluation metrics.

Can open source large language models be used for tumor documentation in Germany? -- An evaluation on urological doctors' notes

Tumor documentation in Germany is largely done manually, requiring reading patient records and entering data into structured databases. Large language models (LLMs) could potentially enhance this process by improving efficiency and reliability. This evaluation tests eleven different open source LLMs with sizes ranging from 1-70 billion model parameters on three basic tasks of the tumor documentation process: identifying tumor diagnoses, assigning ICD-10 codes, and extracting the date of first diagnosis. For evaluating the LLMs on these tasks, a dataset of annotated text snippets based on anonymized doctors' notes from urology was prepared. Different prompting strategies were used to investigate the effect of the number of examples in few-shot prompting and to explore the capabilities of the LLMs in general. The models Llama 3.1 8B, Mistral 7B, and Mistral NeMo 12 B performed comparably well in the tasks. Models with less extensive training data or having fewer than 7 billion parameters showed notably lower performance, while larger models did not display performance gains. Examples from a different medical domain than urology could also improve the outcome in few-shot prompting, which demonstrates the ability of LLMs to handle tasks needed for tumor documentation. Open source LLMs show a strong potential for automating tumor documentation. Models from 7-12 billion parameters could offer an optimal balance between performance and resource efficiency. With tailored fine-tuning and well-designed prompting, these models might become important tools for clinical documentation in the future. The code for the evaluation is available from https://github.com/stefan-m-lenz/UroLlmEval. We also release the dataset as a new valuable resource that addresses the shortage of authentic and easily accessible benchmarks in German-language medical NLP.