Mexico

Clinical Decision Support Systems assist medical professionals in providing optimal care for patients.
A prominent data source used for creating tasks for such systems is the Medical Information Mart for Intensive Care (MIMIC).
MIMIC contains electronic health records (EHR) gathered in a tertiary hospital in the United States.
The majority of past work is based on the third version of MIMIC, although the fourth is the most recent version.
This new version, not only introduces more data into MIMIC, but also increases the variety of patients.
While MIMIC-III is limited to intensive care units, MIMIC-IV also offers EHRs from the emergency department.
In this work, we investigate how to adapt previous work to update clinical outcome prediction for MIMIC-IV.
We revisit several established tasks, including prediction of diagnoses, procedures, length-of-stay, and also introduce a novel task: patient routing prediction.
Furthermore, we quantitatively and qualitatively evaluate all tasks on several bio-medical transformer encoder models.
Finally, we provide narratives for future research directions in the clinical outcome prediction domain.
We make our source code publicly available to reproduce our experiments, data, and tasks.

NAACL 2024

Revisiting Clinical Outcome Prediction for MIMIC-IV

mimic-iv

datasets & tasks

clinical outcome prediction

encoders

classification

benchmark

workshop paper

## Welcome to 2024 Annual Conference of the North American Chapter of the Association for Computational Linguistics!
This year, the conference is in Mexico City. NAACL was actually already planned for Mexico City in 2021, but due to the pandemic the entire conference was moved online. This year, finally, we get to go! So it is my sincere pleasure to welcome you to Mexico City, whether in person or virtually. Having the conference in Mexico City is a good opportunity to emphasize that NAACL is our flagship conference for ACL members not only in North America but also in Central and South America, even though NAACL has been bearing “North” in its name. At this year’s conference, we have a theme to match, with a theme track on the Languages of Latin America to showcase the linguistic diversity of the region.
 
The opportunity to present at NAACL should not depend on a researcher’s travel budget, or their family status. This is why it is so important to make virtual participation at NAACL as good an experience as possible – but we want to also provide a good experience for in-person participants. As a community, we are still working out the best way to do that. This year at NAACL, we are trying out a big virtual poster session ahead of the conference, with the hope that this will make make for a lively and interactive experience. At the same time, we are reducing virtual oral presentations, which seem to be particularly tricky to make to work well. A big thanks to the NAACL program chairs and to Luciana Benotti for all their ideas and work to improve the virtual experience. And participants, virtual as well as in-person: Please let us know what worked for you and what didn’t, so we can continue to improve hybrid conferences. 
 
I have been lucky to work with many amazing people. Without their insight, dedication and patience, and without the many hours of work they put in, NAACL would not have been possible. A huge thank you to the program chairs Helena Gomez, Kevin Duh, and Steve Bethard – you are the best! 
 
Finally, I would like to thank all authors, invited speakers and panelists, area chairs and reviewers, the volunteers organizing and chairing sessions, and all attendees, in-person and virtual. Thank you for helping us make NAACL 2024 come to life. 
 
Welcome and hope you all enjoy the conference! 
Katrin Erk 
The University of Texas at Austin 
NAACL-2024 General Chair 
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2024 Annual Conference of the North American Chapter of the Association for Computational Linguistics

We explore the potential of Large Language Models (LLMs) to assist and potentially correct physicians in medical decision-making tasks. We evaluate several LLMs, including Meditron, Llama2, and Mistral, to analyze the ability of these models to interact effectively with physicians across different scenarios. We consider questions from PubMedQA and several tasks, ranging from binary (yes/no) responses to long answer generation, where the answer of the model is produced after an interaction with a physician. Our findings suggest that prompt design significantly influences the downstream accuracy of LLMs and that LLMs can provide valuable feedback to physicians, challenging incorrect diagnoses and contributing to more accurate decision-making. For example, when the physician is accurate 38% of the time, Mistral can produce the correct answer, improving accuracy up to 74% depending on the prompt being used, while Llama2 and Meditron models exhibit greater sensitivity to prompt choice. Our analysis also uncovers the challenges of ensuring that LLM-generated suggestions are pertinent and useful, emphasizing the need for further research in this area.

Can LLMs Correct Physicians, Yet? Investigating Effective Interaction Methods in the Medical Domain

We explore the utility of pre-trained Large Language Models (LLMs) in detecting the presence, subtypes, and severity of aphasia across English and Mandarin Chinese speakers. Our investigation suggests that even without fine-tuning or domain-specific training, pre-trained LLMs can offer some insights on language disorders, regardless of speakers' first language. Our analysis also reveals noticeable differences between English and Chinese LLMs. While the English LLMs exhibit near-chance level accuracy in subtyping aphasia, the Chinese counterparts demonstrate less than satisfactory performance in distinguishing between individuals with and without aphasia. This research advocates for the importance of linguistically tailored and specified approaches in leveraging LLMs for clinical applications, especially in the context of multilingual populations.

Leveraging pre-trained large language models for aphasia detection in English and Chinese speakers

Vision-language models, while effective in general domains and showing strong performance in diverse multi-modal applications like visual question-answering (VQA), struggle to maintain the same level of effectiveness in more specialized domains, e.g., medical. We propose a medical vision-language model that integrates large vision and language models adapted for the medical domain. This model goes through three stages of parameter-efficient training using three separate biomedical and radiology multi-modal visual and text datasets. The proposed model achieves state-of-the-art performance on the SLAKE 1.0 medical VQA (MedVQA) dataset with an overall accuracy of 87.5% and demonstrates strong performance on another MedVQA dataset, VQA-RAD, achieving an overall accuracy of 73.2%.

Fusion of Domain-Adapted Vision and Language Models for Medical Visual Question Answering

This paper is dedicated to the design and evaluation of the first AMR parser tailored for clinical notes. Our objective was to facilitate the precise transformation of the clinical notes into structured AMR expressions, thereby enhancing the interpretability and usability of clinical text data at scale. Leveraging the colon cancer dataset from the Temporal Histories of Your Medical Events (THYME) corpus, we adapted a state-of-the-art AMR parser utilizing continuous training. Our approach incorporates data augmentation techniques to enhance the accuracy of AMR structure predictions. Notably, through this learning strategy, our parser achieved an impressive F1 score of 88\% on the THYME corpus's colon cancer dataset. Moreover, our research delved into the efficacy of data required for domain adaptation within the realm of clinical notes, presenting domain adaptation data requirements for AMR parsing. This exploration not only underscores the parser's robust performance but also highlights its potential in facilitating a deeper understanding of clinical narratives through structured semantic representations.

Adapting Abstract Meaning Representation Parsing to the Clinical Narrative – the SPRING THYME parser

Radiology Report Generation (R2Gen) demonstrates how Multi-modal Large Language Models (MLLMs) can automate the creation of accurate and coherent radiological reports. Existing methods often hallucinate details in text-based reports that don’t accurately reflect the image content. To mitigate this, we introduce a novel strategy, SERPENT-VLM (SElf Refining Radiology RePort GENeraTion using Vision Language Models), which improves the R2Gen task by integrating a self-refining mechanism into the MLLM framework. We employ a unique self-supervised loss that leverages similarity between pooled image representations and the contextual representations of the generated radiological text, alongside the standard Causal Language Modeling objective, to refine image-text representations. This allows the model to scrutinize and align the generated text through dynamic interaction between a given image and the generated text, therefore reducing hallucination and continuously enhancing nuanced report generation. SERPENT-VLM outperforms existing baselines such as LlaVA-Med, BiomedGPT, etc., achieving SoTA performance on the IU X-ray and Radiology Objects in COntext (ROCO) datasets, and also proves to be robust against noisy images. A qualitative case study emphasizes the significant advancements towards more sophisticated MLLM frameworks for R2Gen, opening paths for further research into self-supervised refinement in the medical imaging domain.

SERPENT-VLM : Self-Refining Radiology Report Generation Using Vision Language Models

This paper explores the impact of incorporating sentiment, emotion, and domain-specific lexicons into a transformer-based model for depression symptom estimation. Lexicon information is added by marking the words in the input transcripts of patient-therapist conversations as well as in social media posts. Overall results show that the introduction of external knowledge within pre-trained language models can be beneficial for prediction performance, while different lexicons show distinct behaviours depending on the targeted task. Additionally, new state-of-the-art results are obtained for the estimation of depression level over patient-therapist interviews.

Evaluating Lexicon Incorporation for Depression Symptom Estimation

This paper describes our submission to the MEDIQA-CORR 2024 shared task for automatically detecting and correcting medical errors in clinical notes. We report results for three methods of few-shot In-Context Learning (ICL) augmented with Chain-of-Thought (CoT) and reason prompts using a large language model (LLM). In the first method, we manually analyse a subset of train and validation dataset to infer three CoT prompts by examining error types in the clinical notes. In the second method, we utilise the training dataset to prompt the LLM to deduce reasons about their correctness or incorrectness. The constructed CoTs and reasons are then augmented with ICL examples to solve the tasks of error detection, span identification, and error correction. Finally, we combine the two methods using a rule-based ensemble method. Across the three sub-tasks, our ensemble method achieves a ranking of 3rd for both sub-task 1 and 2, while securing 7th place in sub-task 3 among all submissions.

KnowLab_AIMed at MEDIQA-CORR 2024: Chain-of-Though (CoT) prompting strategies for medical error detection and correction

As generative dialog models become ubiquitous in real-world applications, it is paramount to ensure a harmless generation. There are two major challenges when enforcing safety to open-domain chatbots (ODC). Firstly, it is impractical to provide training data reflecting the desired response to all emerging forms of toxicity (generalisation challenge). Secondly, implementing safety features may compromise the quality of the conversation (trade-off challenge). To tackle the challenges, this paper introduces a regularized fine-tuning approach called safeGD. By employing a safety-tailored loss, we translate better optimization to more safety. To ensure better convergence, safeGD penalizes sharp minima. Experimental results on datasets of "BAD" and "prosocial dialog" demonstrate that our model outperforms the current baselines \ignore{state-of-the-art methods} in reducing toxicity while preserving the conversation quality. Moreover, compared to other baselines, safeGD can better generalize to unseen toxicity.

Flatness-Aware Gradient Descent for Safe Conversational AI

GPT-4V has attracted considerable attention due to its extraordinary capacity for integrating and processing multimodal information. At the same time, its ability of face recognition raises new safety concerns of privacy leakage. Despite researchers' efforts in safety alignment through RLHF or preprocessing filters, vulnerabilities might still be exploited. In our study, we introduce \textbf{AutoRec}, an innovative automatic jailbreak technique inspired by prompt optimization. We leverage Large Language Models (LLMs) for red-teaming to refine the jailbreak prompt and employ weak-to-strong in-context learning prompts to boost efficiency. Furthermore, we present an effective search method that incorporates early stopping to minimize optimization time and token expenditure. Our experiments demonstrate that \textbf{AutoRec} significantly surpasses conventional methods, achieving an Attack Success Rate (ASR) exceeding 95.3\%. This research sheds light on strengthening GPT-4V security, underscoring the potential for LLMs to be exploited in compromising GPT-4V integrity.

Big Brother is Watching You: Automatically Jailbreak GPT-4V for Facial Recognition

Prior work on selective prediction minimizes incorrect predictions from vision-language models (VLMs) by allowing them to abstain from answering when uncertain. However, when deploying a vision-language system with low tolerance for inaccurate predictions, selective prediction may be over-cautious and abstain too frequently, even on many correct predictions. We introduce ReCoVERR, an inference-time algorithm to reduce the over-abstention of a selective vision-language system without decreasing prediction accuracy. When the VLM makes a low-confidence prediction, instead of abstaining, ReCoVERR tries to find relevant clues in the image that provide additional evidence for the prediction. ReCoVERR uses an LLM to pose related questions to the VLM, collects high-confidence evidences, and if enough evidence confirms the prediction, the system makes a prediction instead of abstaining. ReCoVERR enables two VLMs, BLIP2 and InstructBLIP, to answer up to 20% more questions on the A-OKVQA task than vanilla selective prediction without decreasing system accuracy, thus improving overall system reliability.

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Can LLMs Correct Physicians, Yet? Investigating Effective Interaction Methods in the Medical Domain

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