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Mar 11

Diagnosis extraction from unstructured Dutch echocardiogram reports using span- and document-level characteristic classification

Clinical machine learning research and AI driven clinical decision support models rely on clinically accurate labels. Manually extracting these labels with the help of clinical specialists is often time-consuming and expensive. This study tests the feasibility of automatic span- and document-level diagnosis extraction from unstructured Dutch echocardiogram reports. We included 115,692 unstructured echocardiogram reports from the UMCU a large university hospital in the Netherlands. A randomly selected subset was manually annotated for the occurrence and severity of eleven commonly described cardiac characteristics. We developed and tested several automatic labelling techniques at both span and document levels, using weighted and macro F1-score, precision, and recall for performance evaluation. We compared the performance of span labelling against document labelling methods, which included both direct document classifiers and indirect document classifiers that rely on span classification results. The SpanCategorizer and MedRoBERTa.nl models outperformed all other span and document classifiers, respectively. The weighted F1-score varied between characteristics, ranging from 0.60 to 0.93 in SpanCategorizer and 0.96 to 0.98 in MedRoBERTa.nl. Direct document classification was superior to indirect document classification using span classifiers. SetFit achieved competitive document classification performance using only 10\% of the training data. Utilizing a reduced label set yielded near-perfect document classification results. We recommend using our published SpanCategorizer and MedRoBERTa.nl models for span- and document-level diagnosis extraction from Dutch echocardiography reports. For settings with limited training data, SetFit may be a promising alternative for document classification.

High-resolution Piano Transcription with Pedals by Regressing Onset and Offset Times

Automatic music transcription (AMT) is the task of transcribing audio recordings into symbolic representations. Recently, neural network-based methods have been applied to AMT, and have achieved state-of-the-art results. However, many previous systems only detect the onset and offset of notes frame-wise, so the transcription resolution is limited to the frame hop size. There is a lack of research on using different strategies to encode onset and offset targets for training. In addition, previous AMT systems are sensitive to the misaligned onset and offset labels of audio recordings. Furthermore, there are limited researches on sustain pedal transcription on large-scale datasets. In this article, we propose a high-resolution AMT system trained by regressing precise onset and offset times of piano notes. At inference, we propose an algorithm to analytically calculate the precise onset and offset times of piano notes and pedal events. We show that our AMT system is robust to the misaligned onset and offset labels compared to previous systems. Our proposed system achieves an onset F1 of 96.72% on the MAESTRO dataset, outperforming previous onsets and frames system of 94.80%. Our system achieves a pedal onset F1 score of 91.86\%, which is the first benchmark result on the MAESTRO dataset. We have released the source code and checkpoints of our work at https://github.com/bytedance/piano_transcription.

Comparing Rule-Based and Deep Learning Models for Patient Phenotyping

Objective: We investigate whether deep learning techniques for natural language processing (NLP) can be used efficiently for patient phenotyping. Patient phenotyping is a classification task for determining whether a patient has a medical condition, and is a crucial part of secondary analysis of healthcare data. We assess the performance of deep learning algorithms and compare them with classical NLP approaches. Materials and Methods: We compare convolutional neural networks (CNNs), n-gram models, and approaches based on cTAKES that extract pre-defined medical concepts from clinical notes and use them to predict patient phenotypes. The performance is tested on 10 different phenotyping tasks using 1,610 discharge summaries extracted from the MIMIC-III database. Results: CNNs outperform other phenotyping algorithms in all 10 tasks. The average F1-score of our model is 76 (PPV of 83, and sensitivity of 71) with our model having an F1-score up to 37 points higher than alternative approaches. We additionally assess the interpretability of our model by presenting a method that extracts the most salient phrases for a particular prediction. Conclusion: We show that NLP methods based on deep learning improve the performance of patient phenotyping. Our CNN-based algorithm automatically learns the phrases associated with each patient phenotype. As such, it reduces the annotation complexity for clinical domain experts, who are normally required to develop task-specific annotation rules and identify relevant phrases. Our method performs well in terms of both performance and interpretability, which indicates that deep learning is an effective approach to patient phenotyping based on clinicians' notes.

A Lightweight Instrument-Agnostic Model for Polyphonic Note Transcription and Multipitch Estimation

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

CXR-LLaVA: Multimodal Large Language Model for Interpreting Chest X-ray Images

Purpose: Recent advancements in large language models (LLMs) have expanded their capabilities in a multimodal fashion, potentially replicating the image interpretation of human radiologists. This study aimed to develop open-source multimodal large language model for interpreting chest X-ray images (CXR-LLaVA). We also examined the effect of prompt engineering and model parameters such as temperature and nucleus sampling. Materials and Methods: For training, we collected 659,287 publicly available CXRs: 417,336 CXRs had labels for certain radiographic abnormalities (dataset 1); 241,951 CXRs provided free-text radiology reports (dataset 2). After pre-training the Resnet50 as an image encoder, the contrastive language-image pre-training was used to align CXRs and corresponding radiographic abnormalities. Then, the Large Language Model Meta AI-2 was fine-tuned using dataset 2, which were refined using GPT-4, with generating various question answering scenarios. The code can be found at https://github.com/ECOFRI/CXR_LLaVA. Results: In the test set, we observed that the model's performance fluctuated based on its parameters. On average, it achieved F1 score of 0.34 for five pathologic findings (atelectasis, cardiomegaly, consolidation, edema, and pleural effusion), which was improved to 0.46 through prompt engineering. In the independent set, the model achieved an average F1 score of 0.30 for the same pathologic findings. Notably, for the pediatric chest radiograph dataset, which was unseen during training, the model differentiated abnormal radiographs with an F1 score ranging from 0.84 to 0.85. Conclusion: CXR-LLaVA demonstrates promising potential in CXR interpretation. Both prompt engineering and model parameter adjustments can play pivotal roles in interpreting CXRs.

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.

MusicScore: A Dataset for Music Score Modeling and Generation

Music scores are written representations of music and contain rich information about musical components. The visual information on music scores includes notes, rests, staff lines, clefs, dynamics, and articulations. This visual information in music scores contains more semantic information than audio and symbolic representations of music. Previous music score datasets have limited sizes and are mainly designed for optical music recognition (OMR). There is a lack of research on creating a large-scale benchmark dataset for music modeling and generation. In this work, we propose MusicScore, a large-scale music score dataset collected and processed from the International Music Score Library Project (IMSLP). MusicScore consists of image-text pairs, where the image is a page of a music score and the text is the metadata of the music. The metadata of MusicScore is extracted from the general information section of the IMSLP pages. The metadata includes rich information about the composer, instrument, piece style, and genre of the music pieces. MusicScore is curated into small, medium, and large scales of 400, 14k, and 200k image-text pairs with varying diversity, respectively. We build a score generation system based on a UNet diffusion model to generate visually readable music scores conditioned on text descriptions to benchmark the MusicScore dataset for music score generation. MusicScore is released to the public at https://huggingface.co/datasets/ZheqiDAI/MusicScore.

ModernBERT is More Efficient than Conventional BERT for Chest CT Findings Classification in Japanese Radiology Reports

Objective: This study aims to evaluate and compare the performance of two Japanese language models-conventional Bidirectional Encoder Representations from Transformers (BERT) and the newer ModernBERT-in classifying findings from chest CT reports, with a focus on tokenization efficiency, processing time, and classification performance. Methods: We conducted a retrospective study using the CT-RATE-JPN dataset containing 22,778 training reports and 150 test reports. Both models were fine-tuned for multi-label classification of 18 common chest CT conditions. The training data was split in 18,222:4,556 for training and validation. Performance was evaluated using F1 scores for each condition and exact match accuracy across all 18 labels. Results: ModernBERT demonstrated superior tokenization efficiency, requiring 24.0% fewer tokens per document (258.1 vs. 339.6) compared to BERT Base. This translated to significant performance improvements, with ModernBERT completing training in 1877.67 seconds versus BERT's 3090.54 seconds (39% reduction). ModernBERT processed 38.82 samples per second during training (1.65x faster) and 139.90 samples per second during inference (1.66x faster). Despite these efficiency gains, classification performance remained comparable, with ModernBERT achieving superior F1 scores in 8 conditions, while BERT performed better in 4 conditions. Overall exact match accuracy was slightly higher for ModernBERT (74.67% vs. 72.67%), though this difference was not statistically significant (p=0.6291). Conclusion: ModernBERT offers substantial improvements in tokenization efficiency and training speed without sacrificing classification performance. These results suggest that ModernBERT is a promising candidate for clinical applications in Japanese radiology reports analysis.

Application of LLM Agents in Recruitment: A Novel Framework for Resume Screening

The automation of resume screening is a crucial aspect of the recruitment process in organizations. Automated resume screening systems often encompass a range of natural language processing (NLP) tasks. The advent of Large Language Models (LLMs) has notably enhanced the efficacy of these systems, showcasing their robust generalization abilities across diverse language-related tasks. Accompanying these developments are various agents based on LLMs, which facilitate their application in practical scenarios. This paper introduces a novel LLM-based agent framework for resume screening, aimed at enhancing efficiency and time management in recruitment processes. Our framework is distinct in its ability to efficiently summarize and grade each resume from a large dataset. Moreover, it utilizes LLM agents for decision-making, determining which candidates receive job offers, or which ones to bring in for interviews. To evaluate our framework, we constructed a dataset from actual resumes and conducted simulate a resume screening process. Subsequently, the outcomes of the simulation experiment were compared and subjected to detailed analysis. The results demonstrate that our automated resume screening framework is 11 times faster than traditional manual methods. Furthermore, by fine-tuning the LLMs, we observed a significant improvement in the F1 score, reaching 87.73\%, during the resume sentence classification phase. In the resume summarization and grading phase, our fine-tuned model surpassed the baseline performance of the GPT-3.5 model. Analysis of the decision-making efficacy of the LLM agents in the final offer stage further underscores the potential of LLM agents in transforming resume screening processes.

SubjECTive-QA: Measuring Subjectivity in Earnings Call Transcripts' QA Through Six-Dimensional Feature Analysis

Fact-checking is extensively studied in the context of misinformation and disinformation, addressing objective inaccuracies. However, a softer form of misinformation involves responses that are factually correct but lack certain features such as clarity and relevance. This challenge is prevalent in formal Question-Answer (QA) settings such as press conferences in finance, politics, sports, and other domains, where subjective answers can obscure transparency. Despite this, there is a lack of manually annotated datasets for subjective features across multiple dimensions. To address this gap, we introduce SubjECTive-QA, a human annotated dataset on Earnings Call Transcripts' (ECTs) QA sessions as the answers given by company representatives are often open to subjective interpretations and scrutiny. The dataset includes 49,446 annotations for long-form QA pairs across six features: Assertive, Cautious, Optimistic, Specific, Clear, and Relevant. These features are carefully selected to encompass the key attributes that reflect the tone of the answers provided during QA sessions across different domain. Our findings are that the best-performing Pre-trained Language Model (PLM), RoBERTa-base, has similar weighted F1 scores to Llama-3-70b-Chat on features with lower subjectivity, such as Relevant and Clear, with a mean difference of 2.17% in their weighted F1 scores. The models perform significantly better on features with higher subjectivity, such as Specific and Assertive, with a mean difference of 10.01% in their weighted F1 scores. Furthermore, testing SubjECTive-QA's generalizability using QAs from White House Press Briefings and Gaggles yields an average weighted F1 score of 65.97% using our best models for each feature, demonstrating broader applicability beyond the financial domain. SubjECTive-QA is publicly available under the CC BY 4.0 license

NOTE: Notable generation Of patient Text summaries through Efficient approach based on direct preference optimization

The discharge summary is a one of critical documents in the patient journey, encompassing all events experienced during hospitalization, including multiple visits, medications, tests, surgery/procedures, and admissions/discharge. Providing a summary of the patient's progress is crucial, as it significantly influences future care and planning. Consequently, clinicians face the laborious and resource-intensive task of manually collecting, organizing, and combining all the necessary data for a discharge summary. Therefore, we propose "NOTE", which stands for "Notable generation Of patient Text summaries through an Efficient approach based on direct preference optimization". NOTE is based on Medical Information Mart for Intensive Care- III dataset and summarizes a single hospitalization of a patient. Patient events are sequentially combined and used to generate a discharge summary for each hospitalization. In the present circumstances, large language models' application programming interfaces (LLMs' APIs) are widely available, but importing and exporting medical data presents significant challenges due to privacy protection policies in healthcare institutions. Moreover, to ensure optimal performance, it is essential to implement a lightweight model for internal server or program within the hospital. Therefore, we utilized DPO and parameter efficient fine tuning (PEFT) techniques to apply a fine-tuning method that guarantees superior performance. To demonstrate the practical application of the developed NOTE, we provide a webpage-based demonstration software. In the future, we will aim to deploy the software available for actual use by clinicians in hospital. NOTE can be utilized to generate various summaries not only discharge summaries but also throughout a patient's journey, thereby alleviating the labor-intensive workload of clinicians and aiming for increased efficiency.

The Critique of Critique

Critique, as a natural language description for assessing the quality of model-generated content, has been proven to play an essential role in the training, evaluation, and refinement of Large Language Models (LLMs). However, there is a lack of principled understanding in evaluating the quality of the critique itself. In this paper, we pioneer the critique of critique, termed MetaCritique, which is a framework to evaluate the critique from two aspects, i.e., factuality as precision score and comprehensiveness as recall score. We calculate the harmonic mean of precision and recall as the overall rating called F1 score. To obtain a reliable evaluation outcome, we propose Atomic Information Units (AIUs), which describe the critique in a more fine-grained manner. MetaCritique takes each AIU into account and aggregates each AIU's judgment for the overall score. Moreover, given the evaluation process involves intricate reasoning, our MetaCritique provides a natural language rationale to support each judgment. We construct a meta-evaluation dataset containing 300 critiques (2653 AIUs) across four tasks (question answering, reasoning, entailment, and summarization), and we conduct a comparative study to demonstrate the feasibility and effectiveness. Experiments also show superior critique judged by MetaCritique leads to better refinement, indicating generative artificial intelligence indeed has the potential to be significantly advanced with our MetaCritique. We will release relevant code and meta-evaluation datasets at https://github.com/GAIR-NLP/MetaCritique.

TabSim: A Siamese Neural Network for Accurate Estimation of Table Similarity

Tables are a popular and efficient means of presenting structured information. They are used extensively in various kinds of documents including web pages. Tables display information as a two-dimensional matrix, the semantics of which is conveyed by a mixture of structure (rows, columns), headers, caption, and content. Recent research has started to consider tables as first class objects, not just as an addendum to texts, yielding interesting results for problems like table matching, table completion, or value imputation. All of these problems inherently rely on an accurate measure for the semantic similarity of two tables. We present TabSim, a novel method to compute table similarity scores using deep neural networks. Conceptually, TabSim represents a table as a learned concatenation of embeddings of its caption, its content, and its structure. Given two tables in this representation, a Siamese neural network is trained to compute a score correlating with the tables' semantic similarity. To train and evaluate our method, we created a gold standard corpus consisting of 1500 table pairs extracted from biomedical articles and manually scored regarding their degree of similarity, and adopted two other corpora originally developed for a different yet similar task. Our evaluation shows that TabSim outperforms other table similarity measures on average by app. 7% pp F1-score in a binary similarity classification setting and by app. 1.5% pp in a ranking scenario.

Boosting EfficientNets Ensemble Performance via Pseudo-Labels and Synthetic Images by pix2pixHD for Infection and Ischaemia Classification in Diabetic Foot Ulcers

Diabetic foot ulcers are a common manifestation of lesions on the diabetic foot, a syndrome acquired as a long-term complication of diabetes mellitus. Accompanying neuropathy and vascular damage promote acquisition of pressure injuries and tissue death due to ischaemia. Affected areas are prone to infections, hindering the healing progress. The research at hand investigates an approach on classification of infection and ischaemia, conducted as part of the Diabetic Foot Ulcer Challenge (DFUC) 2021. Different models of the EfficientNet family are utilized in ensembles. An extension strategy for the training data is applied, involving pseudo-labeling for unlabeled images, and extensive generation of synthetic images via pix2pixHD to cope with severe class imbalances. The resulting extended training dataset features 8.68 times the size of the baseline and shows a real to synthetic image ratio of 1:3. Performances of models and ensembles trained on the baseline and extended training dataset are compared. Synthetic images featured a broad qualitative variety. Results show that models trained on the extended training dataset as well as their ensemble benefit from the large extension. F1-Scores for rare classes receive outstanding boosts, while those for common classes are either not harmed or boosted moderately. A critical discussion concretizes benefits and identifies limitations, suggesting improvements. The work concludes that classification performance of individual models as well as that of ensembles can be boosted utilizing synthetic images. Especially performance for rare classes benefits notably.