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Dec 9

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.

  • 14 authors
·
Aug 11, 2023

Flacuna: Unleashing the Problem Solving Power of Vicuna using FLAN Fine-Tuning

Recently, the release of INSTRUCTEVAL has provided valuable insights into the performance of large language models (LLMs) that utilize encoder-decoder or decoder-only architecture. Interestingly, despite being introduced four years ago, T5-based LLMs, such as FLAN-T5, continue to outperform the latest decoder-based LLMs, such as LLAMA and VICUNA, on tasks that require general problem-solving skills. This performance discrepancy can be attributed to three key factors: (1) Pre-training data, (2) Backbone architecture, and (3) Instruction dataset. In this technical report, our main focus is on investigating the impact of the third factor by leveraging VICUNA, a large language model based on LLAMA, which has undergone fine-tuning on ChatGPT conversations. To achieve this objective, we fine-tuned VICUNA using a customized instruction dataset collection called FLANMINI. This collection includes a subset of the large-scale instruction dataset known as FLAN, as well as various code-related datasets and conversational datasets derived from ChatGPT/GPT-4. This dataset comprises a large number of tasks that demand problem-solving skills. Our experimental findings strongly indicate that the enhanced problem-solving abilities of our model, FLACUNA, are obtained through fine-tuning VICUNA on the FLAN dataset, leading to significant improvements across numerous benchmark datasets in INSTRUCTEVAL. FLACUNA is publicly available at https://huggingface.co/declare-lab/flacuna-13b-v1.0.

  • 4 authors
·
Jul 5, 2023 1

UL2: Unifying Language Learning Paradigms

Existing pre-trained models are generally geared towards a particular class of problems. To date, there seems to be still no consensus on what the right architecture and pre-training setup should be. This paper presents a unified framework for pre-training models that are universally effective across datasets and setups. We begin by disentangling architectural archetypes with pre-training objectives -- two concepts that are commonly conflated. Next, we present a generalized & unified perspective for self-supervision in NLP and show how different pre-training objectives can be cast as one another and how interpolating between different objectives can be effective. We then propose Mixture-of-Denoisers (MoD), a pre-training objective that combines diverse pre-training paradigms together. We furthermore introduce a notion of mode switching, wherein downstream fine-tuning is associated with specific pre-training schemes. We conduct extensive ablative experiments to compare multiple pre-training objectives and find that our method pushes the Pareto-frontier by outperforming T5 & GPT-like models across multiple diverse setups. By scaling our model up to 20B parameters, we achieve SOTA performance on 50 well-established supervised finetuning based NLP tasks. Our model also achieve strong results at in-context learning, outperforming 175B GPT-3 on zero-shot SuperGLUE and tripling the performance of T5-XXL on one-shot summarization. On 0-shot MMLU, UL2 20B outperforms T0 and T5 models. UL2 20B also works well with chain-of-thought prompting and reasoning, making it an appealing choice for research into reasoning at a small to medium scale of 20B parameters. Finally, we apply FLAN instruction tuning to the UL2 20B model, achieving MMLU and Big-Bench scores competitive to FLAN-PaLM 62B. We release Flax-based T5X checkpoints for the UL2 20B & Flan-UL2 20B.

  • 14 authors
·
May 10, 2022