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Mar 11

OpenMedLM: Prompt engineering can out-perform fine-tuning in medical question-answering with open-source large language models

LLMs have become increasingly capable at accomplishing a range of specialized-tasks and can be utilized to expand equitable access to medical knowledge. Most medical LLMs have involved extensive fine-tuning, leveraging specialized medical data and significant, thus costly, amounts of computational power. Many of the top performing LLMs are proprietary and their access is limited to very few research groups. However, open-source (OS) models represent a key area of growth for medical LLMs due to significant improvements in performance and an inherent ability to provide the transparency and compliance required in healthcare. We present OpenMedLM, a prompting platform which delivers state-of-the-art (SOTA) performance for OS LLMs on medical benchmarks. We evaluated a range of OS foundation LLMs (7B-70B) on four medical benchmarks (MedQA, MedMCQA, PubMedQA, MMLU medical-subset). We employed a series of prompting strategies, including zero-shot, few-shot, chain-of-thought (random selection and kNN selection), and ensemble/self-consistency voting. We found that OpenMedLM delivers OS SOTA results on three common medical LLM benchmarks, surpassing the previous best performing OS models that leveraged computationally costly extensive fine-tuning. The model delivers a 72.6% accuracy on the MedQA benchmark, outperforming the previous SOTA by 2.4%, and achieves 81.7% accuracy on the MMLU medical-subset, establishing itself as the first OS LLM to surpass 80% accuracy on this benchmark. Our results highlight medical-specific emergent properties in OS LLMs which have not yet been documented to date elsewhere, and showcase the benefits of further leveraging prompt engineering to improve the performance of accessible LLMs for medical applications.

RegionBLIP: A Unified Multi-modal Pre-training Framework for Holistic and Regional Comprehension

In this work, we investigate extending the comprehension of Multi-modal Large Language Models (MLLMs) to regional objects. To this end, we propose to extract features corresponding to regional objects as soft prompts for LLM, which provides a straightforward and scalable approach and eliminates the need for LLM fine-tuning. To effectively extract regional features from regular image features and irregular point cloud features, we present a novel and unified position-assisted feature extraction module. Furthermore, training an MLLM from scratch is highly time-consuming. Thus, we propose incrementally extending existing pre-trained MLLMs to comprehend more modalities and the regional objects of those modalities. Specifically, we freeze the Q-Former from BLIP-2, an impressive MLLM, and optimize the modality-specific Lora parameters in Q-Former and LLM for each newly introduced modality. The freezing of the Q-Former eliminates the need for extensive pre-training on massive image-text data. The freezed Q-Former pre-trained from massive image-text data is also beneficial for the pre-training on image-region-text data. We name our framework RegionBLIP. We pre-train RegionBLIP on image-region-text, point-cloud-text, and point-cloud-region-text data. Experimental results verify that can preserve the image comprehension capability of BILP-2 and further gain a comprehension of the newly introduced point cloud modality and regional objects. The Data, Code, and Pre-trained models will be available at https://github.com/mightyzau/RegionBLIP.

The Open Source Advantage in Large Language Models (LLMs)

Large language models (LLMs) mark a key shift in natural language processing (NLP), having advanced text generation, translation, and domain-specific reasoning. Closed-source models like GPT-4, powered by proprietary datasets and extensive computational resources, lead with state-of-the-art performance today. However, they face criticism for their "black box" nature and for limiting accessibility in a manner that hinders reproducibility and equitable AI development. By contrast, open-source initiatives like LLaMA and BLOOM prioritize democratization through community-driven development and computational efficiency. These models have significantly reduced performance gaps, particularly in linguistic diversity and domain-specific applications, while providing accessible tools for global researchers and developers. Notably, both paradigms rely on foundational architectural innovations, such as the Transformer framework by Vaswani et al. (2017). Closed-source models excel by scaling effectively, while open-source models adapt to real-world applications in underrepresented languages and domains. Techniques like Low-Rank Adaptation (LoRA) and instruction-tuning datasets enable open-source models to achieve competitive results despite limited resources. To be sure, the tension between closed-source and open-source approaches underscores a broader debate on transparency versus proprietary control in AI. Ethical considerations further highlight this divide. Closed-source systems restrict external scrutiny, while open-source models promote reproducibility and collaboration but lack standardized auditing documentation frameworks to mitigate biases. Hybrid approaches that leverage the strengths of both paradigms are likely to shape the future of LLM innovation, ensuring accessibility, competitive technical performance, and ethical deployment.

WebRL: Training LLM Web Agents via Self-Evolving Online Curriculum Reinforcement Learning

Large language models (LLMs) have shown remarkable potential as autonomous agents, particularly in web-based tasks. However, existing LLM web agents heavily rely on expensive proprietary LLM APIs, while open LLMs lack the necessary decision-making capabilities. This paper introduces WebRL, a self-evolving online curriculum reinforcement learning framework designed to train high-performance web agents using open LLMs. WebRL addresses three key challenges in building LLM web agents, including the scarcity of training tasks, sparse feedback signals, and policy distribution drift in online learning. Specifically, WebRL incorporates 1) a self-evolving curriculum that generates new tasks from unsuccessful attempts, 2) a robust outcome-supervised reward model (ORM), and 3) adaptive reinforcement learning strategies to ensure consistent improvements. We apply WebRL to transform open Llama-3.1 and GLM-4 models into proficient web agents. On WebArena-Lite, WebRL improves the success rate of Llama-3.1-8B from 4.8% to 42.4%, and from 6.1% to 43% for GLM-4-9B. These open models significantly surpass the performance of GPT-4-Turbo (17.6%) and GPT-4o (13.9%) and outperform previous state-of-the-art web agents trained on open LLMs (AutoWebGLM, 18.2%). Our findings demonstrate WebRL's effectiveness in bridging the gap between open and proprietary LLM-based web agents, paving the way for more accessible and powerful autonomous web interaction systems.

On the Tool Manipulation Capability of Open-source Large Language Models

Recent studies on software tool manipulation with large language models (LLMs) mostly rely on closed model APIs. The industrial adoption of these models is substantially constrained due to the security and robustness risks in exposing information to closed LLM API services. In this paper, we ask can we enhance open-source LLMs to be competitive to leading closed LLM APIs in tool manipulation, with practical amount of human supervision. By analyzing common tool manipulation failures, we first demonstrate that open-source LLMs may require training with usage examples, in-context demonstration and generation style regulation to resolve failures. These insights motivate us to revisit classical methods in LLM literature, and demonstrate that we can adapt them as model alignment with programmatic data generation, system prompts and in-context demonstration retrievers to enhance open-source LLMs for tool manipulation. To evaluate these techniques, we create the ToolBench, a tool manipulation benchmark consisting of diverse software tools for real-world tasks. We demonstrate that our techniques can boost leading open-source LLMs by up to 90% success rate, showing capabilities competitive to OpenAI GPT-4 in 4 out of 8 ToolBench tasks. We show that such enhancement typically requires about one developer day to curate data for each tool, rendering a recipe with practical amount of human supervision.

Data-Juicer: A One-Stop Data Processing System for Large Language Models

The immense evolution in Large Language Models (LLMs) has underscored the importance of massive, diverse, and high-quality data. Despite this, existing open-source tools for LLM data processing remain limited and mostly tailored to specific datasets, with an emphasis on the reproducibility of released data over adaptability and usability, inhibiting potential applications. In response, we propose a one-stop, powerful yet flexible and user-friendly LLM data processing system named Data-Juicer. Our system offers over 50 built-in versatile operators and pluggable tools, which synergize modularity, composability, and extensibility dedicated to diverse LLM data processing needs. By incorporating visualized and automatic evaluation capabilities, Data-Juicer enables a timely feedback loop to accelerate data processing and gain data insights. To enhance usability, Data-Juicer provides out-of-the-box components for users with various backgrounds, and fruitful data recipes for LLM pre-training and post-tuning usages. Further, we employ multi-facet system optimization and seamlessly integrate Data-Juicer with both LLM and distributed computing ecosystems, to enable efficient and scalable data processing. Empirical validation of the generated data recipes reveals considerable improvements in LLaMA performance for various pre-training and post-tuning cases, demonstrating up to 7.45% relative improvement of averaged score across 16 LLM benchmarks and 16.25% higher win rate using pair-wise GPT-4 evaluation. The system's efficiency and scalability are also validated, supported by up to 88.7% reduction in single-machine processing time, 77.1% and 73.1% less memory and CPU usage respectively, and 7.91x processing acceleration when utilizing distributed computing ecosystems. Our system, data recipes, and multiple tutorial demos are released, calling for broader research centered on LLM data.

Multiple Choice Questions and Large Languages Models: A Case Study with Fictional Medical Data

Large Language Models (LLMs) like ChatGPT demonstrate significant potential in the medical field, often evaluated using multiple-choice questions (MCQs) similar to those found on the USMLE. Despite their prevalence in medical education, MCQs have limitations that might be exacerbated when assessing LLMs. To evaluate the effectiveness of MCQs in assessing the performance of LLMs, we developed a fictional medical benchmark focused on a non-existent gland, the Glianorex. This approach allowed us to isolate the knowledge of the LLM from its test-taking abilities. We used GPT-4 to generate a comprehensive textbook on the Glianorex in both English and French and developed corresponding multiple-choice questions in both languages. We evaluated various open-source, proprietary, and domain-specific LLMs using these questions in a zero-shot setting. The models achieved average scores around 67%, with minor performance differences between larger and smaller models. Performance was slightly higher in English than in French. Fine-tuned medical models showed some improvement over their base versions in English but not in French. The uniformly high performance across models suggests that traditional MCQ-based benchmarks may not accurately measure LLMs' clinical knowledge and reasoning abilities, instead highlighting their pattern recognition skills. This study underscores the need for more robust evaluation methods to better assess the true capabilities of LLMs in medical contexts.

Parrot: Efficient Serving of LLM-based Applications with Semantic Variable

The rise of large language models (LLMs) has enabled LLM-based applications (a.k.a. AI agents or co-pilots), a new software paradigm that combines the strength of LLM and conventional software. Diverse LLM applications from different tenants could design complex workflows using multiple LLM requests to accomplish one task. However, they have to use the over-simplified request-level API provided by today's public LLM services, losing essential application-level information. Public LLM services have to blindly optimize individual LLM requests, leading to sub-optimal end-to-end performance of LLM applications. This paper introduces Parrot, an LLM service system that focuses on the end-to-end experience of LLM-based applications. Parrot proposes Semantic Variable, a unified abstraction to expose application-level knowledge to public LLM services. A Semantic Variable annotates an input/output variable in the prompt of a request, and creates the data pipeline when connecting multiple LLM requests, providing a natural way to program LLM applications. Exposing Semantic Variables to the public LLM service allows it to perform conventional data flow analysis to uncover the correlation across multiple LLM requests. This correlation opens a brand-new optimization space for the end-to-end performance of LLM-based applications. Extensive evaluations demonstrate that Parrot can achieve up to an order-of-magnitude improvement for popular and practical use cases of LLM applications.

CollabStory: Multi-LLM Collaborative Story Generation and Authorship Analysis

The rise of unifying frameworks that enable seamless interoperability of Large Language Models (LLMs) has made LLM-LLM collaboration for open-ended tasks a possibility. Despite this, there have not been efforts to explore such collaborative writing. We take the next step beyond human-LLM collaboration to explore this multi-LLM scenario by generating the first exclusively LLM-generated collaborative stories dataset called CollabStory. We focus on single-author (N=1) to multi-author (up to N=5) scenarios, where multiple LLMs co-author stories. We generate over 32k stories using open-source instruction-tuned LLMs. Further, we take inspiration from the PAN tasks that have set the standard for human-human multi-author writing tasks and analysis. We extend their authorship-related tasks for multi-LLM settings and present baselines for LLM-LLM collaboration. We find that current baselines are not able to handle this emerging scenario. Thus, CollabStory is a resource that could help propel an understanding as well as the development of techniques to discern the use of multiple LLMs. This is crucial to study in the context of writing tasks since LLM-LLM collaboration could potentially overwhelm ongoing challenges related to plagiarism detection, credit assignment, maintaining academic integrity in educational settings, and addressing copyright infringement concerns. We make our dataset and code available at \url{https://github.com/saranya-venkatraman/multi_llm_story_writing}.

A Preliminary Study of o1 in Medicine: Are We Closer to an AI Doctor?

Large language models (LLMs) have exhibited remarkable capabilities across various domains and tasks, pushing the boundaries of our knowledge in learning and cognition. The latest model, OpenAI's o1, stands out as the first LLM with an internalized chain-of-thought technique using reinforcement learning strategies. While it has demonstrated surprisingly strong capabilities on various general language tasks, its performance in specialized fields such as medicine remains unknown. To this end, this report provides a comprehensive exploration of o1 on different medical scenarios, examining 3 key aspects: understanding, reasoning, and multilinguality. Specifically, our evaluation encompasses 6 tasks using data from 37 medical datasets, including two newly constructed and more challenging question-answering (QA) tasks based on professional medical quizzes from the New England Journal of Medicine (NEJM) and The Lancet. These datasets offer greater clinical relevance compared to standard medical QA benchmarks such as MedQA, translating more effectively into real-world clinical utility. Our analysis of o1 suggests that the enhanced reasoning ability of LLMs may (significantly) benefit their capability to understand various medical instructions and reason through complex clinical scenarios. Notably, o1 surpasses the previous GPT-4 in accuracy by an average of 6.2% and 6.6% across 19 datasets and two newly created complex QA scenarios. But meanwhile, we identify several weaknesses in both the model capability and the existing evaluation protocols, including hallucination, inconsistent multilingual ability, and discrepant metrics for evaluation. We release our raw data and model outputs at https://ucsc-vlaa.github.io/o1_medicine/ for future research.

BLADE: Enhancing Black-box Large Language Models with Small Domain-Specific Models

Large Language Models (LLMs) like ChatGPT and GPT-4 are versatile and capable of addressing a diverse range of tasks. However, general LLMs, which are developed on open-domain data, may lack the domain-specific knowledge essential for tasks in vertical domains, such as legal, medical, etc. To address this issue, previous approaches either conduct continuous pre-training with domain-specific data or employ retrieval augmentation to support general LLMs. Unfortunately, these strategies are either cost-intensive or unreliable in practical applications. To this end, we present a novel framework named BLADE, which enhances Black-box LArge language models with small Domain-spEcific models. BLADE consists of a black-box LLM and a small domain-specific LM. The small LM preserves domain-specific knowledge and offers specialized insights, while the general LLM contributes robust language comprehension and reasoning capabilities. Specifically, our method involves three steps: 1) pre-training the small LM with domain-specific data, 2) fine-tuning this model using knowledge instruction data, and 3) joint Bayesian optimization of the general LLM and the small LM. Extensive experiments conducted on public legal and medical benchmarks reveal that BLADE significantly outperforms existing approaches. This shows the potential of BLADE as an effective and cost-efficient solution in adapting general LLMs for vertical domains.

Hippocrates: An Open-Source Framework for Advancing Large Language Models in Healthcare

The integration of Large Language Models (LLMs) into healthcare promises to transform medical diagnostics, research, and patient care. Yet, the progression of medical LLMs faces obstacles such as complex training requirements, rigorous evaluation demands, and the dominance of proprietary models that restrict academic exploration. Transparent, comprehensive access to LLM resources is essential for advancing the field, fostering reproducibility, and encouraging innovation in healthcare AI. We present Hippocrates, an open-source LLM framework specifically developed for the medical domain. In stark contrast to previous efforts, it offers unrestricted access to its training datasets, codebase, checkpoints, and evaluation protocols. This open approach is designed to stimulate collaborative research, allowing the community to build upon, refine, and rigorously evaluate medical LLMs within a transparent ecosystem. Also, we introduce Hippo, a family of 7B models tailored for the medical domain, fine-tuned from Mistral and LLaMA2 through continual pre-training, instruction tuning, and reinforcement learning from human and AI feedback. Our models outperform existing open medical LLMs models by a large-margin, even surpassing models with 70B parameters. Through Hippocrates, we aspire to unlock the full potential of LLMs not just to advance medical knowledge and patient care but also to democratize the benefits of AI research in healthcare, making them available across the globe.

A Comparative Study of Open-Source Large Language Models, GPT-4 and Claude 2: Multiple-Choice Test Taking in Nephrology

In recent years, there have been significant breakthroughs in the field of natural language processing, particularly with the development of large language models (LLMs). These LLMs have showcased remarkable capabilities on various benchmarks. In the healthcare field, the exact role LLMs and other future AI models will play remains unclear. There is a potential for these models in the future to be used as part of adaptive physician training, medical co-pilot applications, and digital patient interaction scenarios. The ability of AI models to participate in medical training and patient care will depend in part on their mastery of the knowledge content of specific medical fields. This study investigated the medical knowledge capability of LLMs, specifically in the context of internal medicine subspecialty multiple-choice test-taking ability. We compared the performance of several open-source LLMs (Koala 7B, Falcon 7B, Stable-Vicuna 13B, and Orca Mini 13B), to GPT-4 and Claude 2 on multiple-choice questions in the field of Nephrology. Nephrology was chosen as an example of a particularly conceptually complex subspecialty field within internal medicine. The study was conducted to evaluate the ability of LLM models to provide correct answers to nephSAP (Nephrology Self-Assessment Program) multiple-choice questions. The overall success of open-sourced LLMs in answering the 858 nephSAP multiple-choice questions correctly was 17.1% - 25.5%. In contrast, Claude 2 answered 54.4% of the questions correctly, whereas GPT-4 achieved a score of 73.3%. We show that current widely used open-sourced LLMs do poorly in their ability for zero-shot reasoning when compared to GPT-4 and Claude 2. The findings of this study potentially have significant implications for the future of subspecialty medical training and patient care.

Interpretable Bilingual Multimodal Large Language Model for Diverse Biomedical Tasks

Several medical Multimodal Large Languange Models (MLLMs) have been developed to address tasks involving visual images with textual instructions across various medical modalities, achieving impressive results. Most current medical generalist models are region-agnostic, treating the entire image as a holistic representation. However, they struggle to identify which specific regions they are focusing on when generating a sentence. To mimic the behavior of doctors, who typically begin by reviewing the entire image before concentrating on specific regions for a thorough evaluation, we aim to enhance the capability of medical MLLMs in understanding anatomical regions within entire medical scans. To achieve it, we first formulate Region-Centric tasks and construct a large-scale dataset, MedRegInstruct, to incorporate regional information into training. Combining our collected dataset with other medical multimodal corpora for training, we propose a Region-Aware medical MLLM, MedRegA, which is the first bilingual generalist medical AI system to simultaneously handle image-level and region-level medical vision-language tasks across a broad range of modalities. Our MedRegA not only enables three region-centric tasks, but also achieves the best performance for visual question answering, report generation and medical image classification over 8 modalities, showcasing significant versatility. Experiments demonstrate that our model can not only accomplish powerful performance across various medical vision-language tasks in bilingual settings, but also recognize and detect structures in multimodal medical scans, boosting the interpretability and user interactivity of medical MLLMs. Our project page is https://medrega.github.io.

MAP-Neo: Highly Capable and Transparent Bilingual Large Language Model Series

Large Language Models (LLMs) have made great strides in recent years to achieve unprecedented performance across different tasks. However, due to commercial interest, the most competitive models like GPT, Gemini, and Claude have been gated behind proprietary interfaces without disclosing the training details. Recently, many institutions have open-sourced several strong LLMs like LLaMA-3, comparable to existing closed-source LLMs. However, only the model's weights are provided with most details (e.g., intermediate checkpoints, pre-training corpus, and training code, etc.) being undisclosed. To improve the transparency of LLMs, the research community has formed to open-source truly open LLMs (e.g., Pythia, Amber, OLMo), where more details (e.g., pre-training corpus and training code) are being provided. These models have greatly advanced the scientific study of these large models including their strengths, weaknesses, biases and risks. However, we observe that the existing truly open LLMs on reasoning, knowledge, and coding tasks are still inferior to existing state-of-the-art LLMs with similar model sizes. To this end, we open-source MAP-Neo, a highly capable and transparent bilingual language model with 7B parameters trained from scratch on 4.5T high-quality tokens. Our MAP-Neo is the first fully open-sourced bilingual LLM with comparable performance compared to existing state-of-the-art LLMs. Moreover, we open-source all details to reproduce our MAP-Neo, where the cleaned pre-training corpus, data cleaning pipeline, checkpoints, and well-optimized training/evaluation framework are provided. Finally, we hope our MAP-Neo will enhance and strengthen the open research community and inspire more innovations and creativities to facilitate the further improvements of LLMs.

LLM-Adapters: An Adapter Family for Parameter-Efficient Fine-Tuning of Large Language Models

The success of large language models (LLMs), like GPT-3 and ChatGPT, has led to the development of numerous cost-effective and accessible alternatives that are created by fine-tuning open-access LLMs with task-specific data (e.g., ChatDoctor) or instruction data (e.g., Alpaca). Among the various fine-tuning methods, adapter-based parameter-efficient fine-tuning (PEFT) is undoubtedly one of the most attractive topics, as it only requires fine-tuning a few external parameters instead of the entire LLMs while achieving comparable or even better performance. To enable further research on PEFT methods of LLMs, this paper presents LLM-Adapters, an easy-to-use framework that integrates various adapters into LLMs and can execute these adapter-based PEFT methods of LLMs for different tasks. The framework includes state-of-the-art open-access LLMs such as LLaMA, BLOOM, OPT, and GPT-J, as well as widely used adapters such as Series adapter, Parallel adapter, and LoRA. The framework is designed to be research-friendly, efficient, modular, and extendable, allowing the integration of new adapters and the evaluation of them with new and larger-scale LLMs. Furthermore, to evaluate the effectiveness of adapters in LLMs-Adapters, we conduct experiments on six math reasoning datasets. The results demonstrate that using adapter-based PEFT in smaller-scale LLMs (7B) with few extra trainable parameters yields comparable, and in some cases superior, performance to that of powerful LLMs (175B) in zero-shot inference on simple math reasoning datasets. Overall, we provide a promising framework for fine-tuning large LLMs on downstream tasks. We believe the proposed LLMs-Adapters will advance adapter-based PEFT research, facilitate the deployment of research pipelines, and enable practical applications to real-world systems.

LLM Inference Unveiled: Survey and Roofline Model Insights

The field of efficient Large Language Model (LLM) inference is rapidly evolving, presenting a unique blend of opportunities and challenges. Although the field has expanded and is vibrant, there hasn't been a concise framework that analyzes the various methods of LLM Inference to provide a clear understanding of this domain. Our survey stands out from traditional literature reviews by not only summarizing the current state of research but also by introducing a framework based on roofline model for systematic analysis of LLM inference techniques. This framework identifies the bottlenecks when deploying LLMs on hardware devices and provides a clear understanding of practical problems, such as why LLMs are memory-bound, how much memory and computation they need, and how to choose the right hardware. We systematically collate the latest advancements in efficient LLM inference, covering crucial areas such as model compression (e.g., Knowledge Distillation and Quantization), algorithm improvements (e.g., Early Exit and Mixture-of-Expert), and both hardware and system-level enhancements. Our survey stands out by analyzing these methods with roofline model, helping us understand their impact on memory access and computation. This distinctive approach not only showcases the current research landscape but also delivers valuable insights for practical implementation, positioning our work as an indispensable resource for researchers new to the field as well as for those seeking to deepen their understanding of efficient LLM deployment. The analyze tool, LLM-Viewer, is open-sourced.

Can Open-Source LLMs Compete with Commercial Models? Exploring the Few-Shot Performance of Current GPT Models in Biomedical Tasks

Commercial large language models (LLMs), like OpenAI's GPT-4 powering ChatGPT and Anthropic's Claude 3 Opus, have dominated natural language processing (NLP) benchmarks across different domains. New competing Open-Source alternatives like Mixtral 8x7B or Llama 3 have emerged and seem to be closing the gap while often offering higher throughput and being less costly to use. Open-Source LLMs can also be self-hosted, which makes them interesting for enterprise and clinical use cases where sensitive data should not be processed by third parties. We participated in the 12th BioASQ challenge, which is a retrieval augmented generation (RAG) setting, and explored the performance of current GPT models Claude 3 Opus, GPT-3.5-turbo and Mixtral 8x7b with in-context learning (zero-shot, few-shot) and QLoRa fine-tuning. We also explored how additional relevant knowledge from Wikipedia added to the context-window of the LLM might improve their performance. Mixtral 8x7b was competitive in the 10-shot setting, both with and without fine-tuning, but failed to produce usable results in the zero-shot setting. QLoRa fine-tuning and Wikipedia context did not lead to measurable performance gains. Our results indicate that the performance gap between commercial and open-source models in RAG setups exists mainly in the zero-shot setting and can be closed by simply collecting few-shot examples for domain-specific use cases. The code needed to rerun these experiments is available through GitHub.

The Potential of LLMs in Medical Education: Generating Questions and Answers for Qualification Exams

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

Closing the gap between open-source and commercial large language models for medical evidence summarization

Large language models (LLMs) hold great promise in summarizing medical evidence. Most recent studies focus on the application of proprietary LLMs. Using proprietary LLMs introduces multiple risk factors, including a lack of transparency and vendor dependency. While open-source LLMs allow better transparency and customization, their performance falls short compared to proprietary ones. In this study, we investigated to what extent fine-tuning open-source LLMs can further improve their performance in summarizing medical evidence. Utilizing a benchmark dataset, MedReview, consisting of 8,161 pairs of systematic reviews and summaries, we fine-tuned three broadly-used, open-sourced LLMs, namely PRIMERA, LongT5, and Llama-2. Overall, the fine-tuned LLMs obtained an increase of 9.89 in ROUGE-L (95% confidence interval: 8.94-10.81), 13.21 in METEOR score (95% confidence interval: 12.05-14.37), and 15.82 in CHRF score (95% confidence interval: 13.89-16.44). The performance of fine-tuned LongT5 is close to GPT-3.5 with zero-shot settings. Furthermore, smaller fine-tuned models sometimes even demonstrated superior performance compared to larger zero-shot models. The above trends of improvement were also manifested in both human and GPT4-simulated evaluations. Our results can be applied to guide model selection for tasks demanding particular domain knowledge, such as medical evidence summarization.