Mexico

In this paper, we report our effort to tackle the challenge of extracting chemotimelines from EHR notes across a dataset of three cancer types. We focus on the two subtasks: 1) detection and classification of temporal relations given the annotated chemotherapy events and time expressions and 2) directly extracting patient chemotherapy timelines from EHR notes. We address both subtasks using Large Language Models. Our best-performing methods in both subtasks use Flan-T5, an instruction-tuned language model. Our proposed system achieves the highest average score in both subtasks. Our results underscore the effectiveness of finetuning general-domain large language models in domain-specific and unseen tasks.

NAACL 2024

LAILab at Chemotimelines 2024: Finetuning sequence-to-sequence language models for temporal relation extraction towards cancer patient undergoing chemotherapy treatment

cancer informatics

temporal relation extraction

deep learning

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 
*You can read the full Welcome message in the [Conference Handbook (downloadable)](https://drive.google.com/file/d/1H1NvW0VASQjkSCYgw3mr-3l4yYDSxz6B/view?usp=sharing)*

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2024 Annual Conference of the North American Chapter of the Association for Computational Linguistics

The automatic identification of medical errors in clinical notes is crucial for improving the quality of healthcare services.LLMs emerge as a powerful artificial intelligence tool for automating this task. However, LLMs present vulnerabilities, high costs, and sometimes a lack of transparency. This article addresses the detection of medical errors through the fine-tuning approach, conducting a comprehensive comparison between various models and exploring in depth the components of the machine learning pipeline. The results obtained with the fine-tuned ClinicalBert and Gated recurrent units (Gru) models show an accuracy of 0.56 and 0.55, respectively. This approach not only mitigates the problems associated with the use of LLMs but also demonstrates how exhaustive iteration in critical phases of the pipeline, especially in feature selection, can facilitate the automation of clinical record analysis.

VerbaNexAI at MEDIQA-CORR: Efficacy of GRU with BioWordVec and ClinicalBERT in Error Correction in Clinical Notes

The 2024 Shared Task on Chemotherapy Treatment Timeline Extraction aims to advance the state of the art of clinical event timeline extraction from the Electronic Health Records (EHRs). Specifically, this edition focuses on chemotherapy event timelines from EHRs of patients with breast, ovarian and skin cancers. These patient-level timelines present a novel challenge which involves tasks such as the extraction of relevant events, time expressions and temporal relations from each document and then summarizing over the documents. De-identified EHRs for 57,530 patients with breast and ovarian cancer spanning 2004-2020, and approximately 15,946 patients with melanoma spanning 2010-2020 were made available to participants after executing a Data Use Agreement. A subset of patients is annotated for gold entities, time expressions, temporal relations and patient-level timelines. The rest is considered unlabeled data. In Subtask1, gold chemotherapy event mentions and time expressions are provided (along with the EHR notes). Participants are asked to build the patient-level timelines using gold annotations as input. Thus, the subtask seeks to explore the topics of temporal relations extraction and timeline creation if event and time expression input is perfect. In Subtask2, which is the realistic real-world setting, only EHR notes are provided. Thus, the subtask aims at developing an end-to-end system for chemotherapy treatment timeline extraction from patient's EHR notes. There were 18 submissions for Subtask 1 and 9 submissions for Subtask 2. The organizers provided a baseline system. The teams employed a variety of methods including Logistic Regression, TF-IDF, n-grams, transformer models, zero-shot prompting with Large Language Models (LLMs), and instruction tuning. The gap in performance between prompting LLMs and finetuning smaller-sized LMs indicates that for a challenging task such as patient-level chemotherapy timeline extraction, more sophisticated LLMs or prompting techniques are necessary in order to achieve optimal results as finetuing smaller-sized LMs outperforms by a wide margin.

Overview of the 2024 Shared Task on Chemotherapy Treatment Timeline Extraction

In natural language processing applied to the clinical domain, utilizing large language models has emerged as a promising avenue for error detection and correction on clinical notes, a knowledge-intensive task for which annotated data is scarce. This paper presents MedReAct'N'MedReFlex, which leverages a suite of four LLM-based medical agents. The MedReAct agent initiates the process by observing, analyzing, and taking action, generating trajectories to guide the search to target a potential error in the clinical notes. Subsequently, the MedEval agent employs five evaluators to assess the targeted error and the proposed correction. In cases where MedReAct's actions prove insufficient, the MedReFlex agent intervenes, engaging in reflective analysis and proposing alternative strategies. Finally, the MedFinalParser agent formats the final output, preserving the original style while ensuring the integrity of the error correction process. One core component of our method is our RAG pipeline based on our ClinicalCorp corpora. Among other well-known sources containing clinical guidelines and information, we preprocess and release the open-source MedWiki dataset for clinical RAG application. Our results demonstrate the central role of our RAG approach with ClinicalCorp leveraged through the MedReAct'N'MedReFlex framework. It achieved the ninth rank on the MEDIQA-CORR 2024 final leaderboard.

IryoNLP at MEDIQA-CORR 2024: Tackling the Medical Error Detection & Correction Task on the Shoulders of Medical Agents

This paper presents our approach for the 2024 ChemoTimelines shared task. Specifically, we explored using Large Language Models (LLMs) for temporal relation extraction. We evaluate multiple model variations based on how the training data is used. For instance, we transform the task into a question-answering problem and use QA pairs to extract chemo-related events and their temporal relations. Next, we add all the documents to each question-answer pair as examples in our training dataset. Finally, we explore adding unlabeled data for continued pretraining. Each addition is done iteratively. Our results show that adding the document helps, but unlabeled data does not yield performance improvements, possibly because we used only 1\% of the available data. Moreover, we find that instruction-tuned models still substantially underperform more traditional systems (e.g., EntityBERT).

UTSA-NLP at ChemoTimelines 2024: Evaluating Instruction-Tuned Language Models for Temporal Relation Extraction

This paper outlines our submission to the MEDIQA2024 Multilingual and Multimodal Medical Answer Generation (M3G) shared task. We report results for two standalone solutions under the English category of the task, the first involving two consecutive API calls to the Claude 3 Opus API and the second involving training an image-disease label joint embedding in the style of CLIP for image classification. These two solutions scored 1st and 2nd place respectively on the competition leaderboard, substantially outperforming the next best solution. Additionally, we discuss insights gained from post-competition experiments. While the performance of these two described solutions have significant room for improvement due to the difficulty of the shared task and the challenging nature of medical visual question answering in general, we identify the multi-stage LLM approach and the CLIP image classification approach as promising avenues for further investigation.

WangLab at MEDIQA-M3G 2024: Multimodal Medical Answer Generation using Large Language Models

Electronic Health Records (EHRs) are relational databases that store the entire medical histories of patients within hospitals. They record numerous aspects of patients' medical care, from hospital admission and diagnosis to treatment and discharge. While EHRs are vital sources of clinical data, exploring them beyond a predefined set of queries requires skills in query languages like SQL. To make information retrieval more accessible, one strategy is to build a question-answering system, possibly leveraging text-to-SQL models that can automatically translate natural language questions into corresponding SQL queries and use these queries to retrieve the answers. The EHRSQL 2024 shared task aims to advance and promote research in developing a question-answering system for EHRs using text-to-SQL modeling, capable of reliably providing requested answers to various healthcare professionals to improve their clinical work processes and satisfy their needs. Among more than 100 participants who applied to the shared task, eight teams completed the entire shared task processes and demonstrated a wide range of methods to effectively solve this task. In this paper, we describe the task of reliable text-to-SQL modeling, the dataset, and the methods and results of the participants. We hope this shared task will spur further research and insights into developing reliable question-answering systems for EHRs.

Overview of the EHRSQL 2024 Shared Task on Reliable Text-to-SQL Modeling on Electronic Health Records

The EHRSQL task aims to develop a dependable text-to-SQL model for Electronic Health Records (EHR) databases, which are crucial sources of clinical data that store patients' medical histories in hospitals. Large language models (LLM) have been proven to exhibit state-of-the-art performance for text-to-SQL tasks across various domains. To this end, we have developed a framework, SQL Generation through Classification Answer Selector by LLM (SCAS), which comprises two modules. The CAS module determines the answerability of the question, while the SG model generates the SQL query exclusively for answerable questions. Our system ranked 7th on the leaderboard with a Reliability Score of 53.21 on the official test set.

Saama Technologies at EHRSQL 2024: SQL Generation through Classification Answer Selector by LLM

Recently, deep learning-based language models have significantly enhanced text-to-SQL tasks, with promising applications in retrieving patient records within the medical domain. One notable challenge in such applications is discerning unanswerable queries. Through fine-tuning model, we demonstrate the feasibility of converting medical record inquiries into SQL queries. Additionally, we introduce an entropy-based method to identify and filter out unanswerable results. We further enhance result quality by filtering low-confidence SQL through log probability-based distribution, while grammatical and schema errors are mitigated by executing queries on the actual database.
We experimentally verified that our method can filter unanswerable questions, which can be widely utilized even when the parameters of the model are not accessible, and that it can be effectively utilized in practice.

ProbGate at EHRSQL 2024: Enhancing SQL Query Generation Accuracy through Probabilistic Threshold Filtering and Error Handling

Perturbation-based explanation methods such as LIME and SHAP are commonly applied to text classification. This work focuses on their extension to generative language models. To address the challenges of text as output and long text inputs, we propose a general framework called MExGen that can be instantiated with different attribution algorithms. To handle text output, we introduce the notion of scalarizers for mapping text to real numbers and investigate multiple possibilities. To handle long inputs, we take a multi-level approach, proceeding from coarser levels of granularity to finer ones, and focus on algorithms with linear scaling in model queries. We conduct a systematic evaluation, both automated and human, of perturbation-based attribution methods for summarization and context-grounded question answering. The results show that our framework can provide more locally faithful explanations of generated output.

Multi-Level Explanations for Generative Language Models

As the media landscape evolves, the study of news framing, key to shaping public opinion, has expanded. Our study presents a methodology for framing analysis in Spanish media using NLP to uncover the cultural and political factors shaping narratives. This method enhances linguistic inclusivity in framing studies and highlights Spanish media's role in public opinion, showing NLP's utility in diverse linguistic contexts and contributing to a more comprehensive global media analysis.

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VerbaNexAI at MEDIQA-CORR: Efficacy of GRU with BioWordVec and ClinicalBERT in Error Correction in Clinical Notes

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