Many diagnostic errors occur because clinicians cannot easily access relevant information in patient Electronic Health Records (EHRs). In this work we propose a method to use LLMs to identify pieces of evidence in patient EHR data that indicate increased or decreased risk of specific diagnoses; our ultimate aim is to increase access to evidence and reduce diagnostic errors. In particular, we propose a Neural Additive Model to make predictions backed by evidence with individualized risk estimates at time-points where clinicians are still uncertain, aiming to specifically mitigate delays in diagnosis and errors stemming from an incomplete differential. To train such a model, it is necessary to infer temporally fine-grained retrospective labels of eventual "true" diagnoses. We do so with LLMs, to ensure that the input text is from before a confident diagnosis can be made. We use an LLM to retrieve an initial pool of evidence, but then refine this set of evidence according to correlations learned by the model. We conduct an in-depth evaluation of the usefulness of our approach by simulating how it might be used by a clinician to decide between a pre-defined list of differential diagnoses.
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Recent artificial intelligence (AI) systems have reached milestones in "grand challenges" ranging from Go to protein-folding. The capability to retrieve medical knowledge, reason over it, and answer medical questions comparably to physicians has long been viewed as one such grand challenge. Large language models (LLMs) have catalyzed significant progress in medical question answering; Med-PaLM was the first model to exceed a "passing" score in US Medical Licensing Examination (USMLE) style questions with a score of 67.2% on the MedQA dataset. However, this and other prior work suggested significant room for improvement, especially when models' answers were compared to clinicians' answers. Here we present Med-PaLM 2, which bridges these gaps by leveraging a combination of base LLM improvements (PaLM 2), medical domain finetuning, and prompting strategies including a novel ensemble refinement approach. Med-PaLM 2 scored up to 86.5% on the MedQA dataset, improving upon Med-PaLM by over 19% and setting a new state-of-the-art. We also observed performance approaching or exceeding state-of-the-art across MedMCQA, PubMedQA, and MMLU clinical topics datasets. We performed detailed human evaluations on long-form questions along multiple axes relevant to clinical applications. In pairwise comparative ranking of 1066 consumer medical questions, physicians preferred Med-PaLM 2 answers to those produced by physicians on eight of nine axes pertaining to clinical utility (p < 0.001). We also observed significant improvements compared to Med-PaLM on every evaluation axis (p < 0.001) on newly introduced datasets of 240 long-form "adversarial" questions to probe LLM limitations. While further studies are necessary to validate the efficacy of these models in real-world settings, these results highlight rapid progress towards physician-level performance in medical question answering.
Large Language Models (LLMs) have significantly advanced natural language processing (NLP) with their impressive language understanding and generation capabilities. However, their performance may be suboptimal for long-tail or domain-specific tasks due to limited exposure to domain-specific knowledge and vocabulary. Additionally, the lack of transparency of most state-of-the-art (SOTA) LLMs, which can only be accessed via APIs, impedes further fine-tuning with custom data. Moreover, data privacy is a significant concern. To address these challenges, we propose the novel Parametric Knowledge Guiding (PKG) framework, which equips LLMs with a knowledge-guiding module to access relevant knowledge at runtime without altering the LLMs' parameters. Our PKG is based on open-source "white-box" small language models, allowing offline storage of any knowledge that LLMs require. We demonstrate that our PKG framework can enhance the performance of "black-box" LLMs on a range of long-tail and domain-specific downstream tasks requiring factual, tabular, medical, and multimodal knowledge.
The real-world data tends to be heavily imbalanced and severely skew the data-driven deep neural networks, which makes Long-Tailed Recognition (LTR) a massive challenging task. Existing LTR methods seldom train Vision Transformers (ViTs) with Long-Tailed (LT) data, while the off-the-shelf pretrain weight of ViTs always leads to unfair comparisons. In this paper, we systematically investigate the ViTs' performance in LTR and propose LiVT to train ViTs from scratch only with LT data. With the observation that ViTs suffer more severe LTR problems, we conduct Masked Generative Pretraining (MGP) to learn generalized features. With ample and solid evidence, we show that MGP is more robust than supervised manners. In addition, Binary Cross Entropy (BCE) loss, which shows conspicuous performance with ViTs, encounters predicaments in LTR. We further propose the balanced BCE to ameliorate it with strong theoretical groundings. Specially, we derive the unbiased extension of Sigmoid and compensate extra logit margins to deploy it. Our Bal-BCE contributes to the quick convergence of ViTs in just a few epochs. Extensive experiments demonstrate that with MGP and Bal-BCE, LiVT successfully trains ViTs well without any additional data and outperforms comparable state-of-the-art methods significantly, e.g., our ViT-B achieves 81.0% Top-1 accuracy in iNaturalist 2018 without bells and whistles. Code is available at //github.com/XuZhengzhuo/LiVT.
Graph Neural Networks (GNNs) have shown promising results on a broad spectrum of applications. Most empirical studies of GNNs directly take the observed graph as input, assuming the observed structure perfectly depicts the accurate and complete relations between nodes. However, graphs in the real world are inevitably noisy or incomplete, which could even exacerbate the quality of graph representations. In this work, we propose a novel Variational Information Bottleneck guided Graph Structure Learning framework, namely VIB-GSL, in the perspective of information theory. VIB-GSL advances the Information Bottleneck (IB) principle for graph structure learning, providing a more elegant and universal framework for mining underlying task-relevant relations. VIB-GSL learns an informative and compressive graph structure to distill the actionable information for specific downstream tasks. VIB-GSL deduces a variational approximation for irregular graph data to form a tractable IB objective function, which facilitates training stability. Extensive experimental results demonstrate that the superior effectiveness and robustness of VIB-GSL.
Recent contrastive representation learning methods rely on estimating mutual information (MI) between multiple views of an underlying context. E.g., we can derive multiple views of a given image by applying data augmentation, or we can split a sequence into views comprising the past and future of some step in the sequence. Contrastive lower bounds on MI are easy to optimize, but have a strong underestimation bias when estimating large amounts of MI. We propose decomposing the full MI estimation problem into a sum of smaller estimation problems by splitting one of the views into progressively more informed subviews and by applying the chain rule on MI between the decomposed views. This expression contains a sum of unconditional and conditional MI terms, each measuring modest chunks of the total MI, which facilitates approximation via contrastive bounds. To maximize the sum, we formulate a contrastive lower bound on the conditional MI which can be approximated efficiently. We refer to our general approach as Decomposed Estimation of Mutual Information (DEMI). We show that DEMI can capture a larger amount of MI than standard non-decomposed contrastive bounds in a synthetic setting, and learns better representations in a vision domain and for dialogue generation.
When learning tasks over time, artificial neural networks suffer from a problem known as Catastrophic Forgetting (CF). This happens when the weights of a network are overwritten during the training of a new task causing forgetting of old information. To address this issue, we propose MetA Reusable Knowledge or MARK, a new method that fosters weight reusability instead of overwriting when learning a new task. Specifically, MARK keeps a set of shared weights among tasks. We envision these shared weights as a common Knowledge Base (KB) that is not only used to learn new tasks, but also enriched with new knowledge as the model learns new tasks. Key components behind MARK are two-fold. On the one hand, a metalearning approach provides the key mechanism to incrementally enrich the KB with new knowledge and to foster weight reusability among tasks. On the other hand, a set of trainable masks provides the key mechanism to selectively choose from the KB relevant weights to solve each task. By using MARK, we achieve state of the art results in several popular benchmarks, surpassing the best performing methods in terms of average accuracy by over 10% on the 20-Split-MiniImageNet dataset, while achieving almost zero forgetfulness using 55% of the number of parameters. Furthermore, an ablation study provides evidence that, indeed, MARK is learning reusable knowledge that is selectively used by each task.
Graph Neural Networks (GNNs) have proven to be useful for many different practical applications. However, many existing GNN models have implicitly assumed homophily among the nodes connected in the graph, and therefore have largely overlooked the important setting of heterophily, where most connected nodes are from different classes. In this work, we propose a novel framework called CPGNN that generalizes GNNs for graphs with either homophily or heterophily. The proposed framework incorporates an interpretable compatibility matrix for modeling the heterophily or homophily level in the graph, which can be learned in an end-to-end fashion, enabling it to go beyond the assumption of strong homophily. Theoretically, we show that replacing the compatibility matrix in our framework with the identity (which represents pure homophily) reduces to GCN. Our extensive experiments demonstrate the effectiveness of our approach in more realistic and challenging experimental settings with significantly less training data compared to previous works: CPGNN variants achieve state-of-the-art results in heterophily settings with or without contextual node features, while maintaining comparable performance in homophily settings.
Weakly supervised phrase grounding aims at learning region-phrase correspondences using only image-sentence pairs. A major challenge thus lies in the missing links between image regions and sentence phrases during training. To address this challenge, we leverage a generic object detector at training time, and propose a contrastive learning framework that accounts for both region-phrase and image-sentence matching. Our core innovation is the learning of a region-phrase score function, based on which an image-sentence score function is further constructed. Importantly, our region-phrase score function is learned by distilling from soft matching scores between the detected object class names and candidate phrases within an image-sentence pair, while the image-sentence score function is supervised by ground-truth image-sentence pairs. The design of such score functions removes the need of object detection at test time, thereby significantly reducing the inference cost. Without bells and whistles, our approach achieves state-of-the-art results on the task of visual phrase grounding, surpassing previous methods that require expensive object detectors at test time.
Reasoning with knowledge expressed in natural language and Knowledge Bases (KBs) is a major challenge for Artificial Intelligence, with applications in machine reading, dialogue, and question answering. General neural architectures that jointly learn representations and transformations of text are very data-inefficient, and it is hard to analyse their reasoning process. These issues are addressed by end-to-end differentiable reasoning systems such as Neural Theorem Provers (NTPs), although they can only be used with small-scale symbolic KBs. In this paper we first propose Greedy NTPs (GNTPs), an extension to NTPs addressing their complexity and scalability limitations, thus making them applicable to real-world datasets. This result is achieved by dynamically constructing the computation graph of NTPs and including only the most promising proof paths during inference, thus obtaining orders of magnitude more efficient models. Then, we propose a novel approach for jointly reasoning over KBs and textual mentions, by embedding logic facts and natural language sentences in a shared embedding space. We show that GNTPs perform on par with NTPs at a fraction of their cost while achieving competitive link prediction results on large datasets, providing explanations for predictions, and inducing interpretable models. Source code, datasets, and supplementary material are available online at //github.com/uclnlp/gntp.
Graph Neural Networks (GNNs), which generalize deep neural networks to graph-structured data, have drawn considerable attention and achieved state-of-the-art performance in numerous graph related tasks. However, existing GNN models mainly focus on designing graph convolution operations. The graph pooling (or downsampling) operations, that play an important role in learning hierarchical representations, are usually overlooked. In this paper, we propose a novel graph pooling operator, called Hierarchical Graph Pooling with Structure Learning (HGP-SL), which can be integrated into various graph neural network architectures. HGP-SL incorporates graph pooling and structure learning into a unified module to generate hierarchical representations of graphs. More specifically, the graph pooling operation adaptively selects a subset of nodes to form an induced subgraph for the subsequent layers. To preserve the integrity of graph's topological information, we further introduce a structure learning mechanism to learn a refined graph structure for the pooled graph at each layer. By combining HGP-SL operator with graph neural networks, we perform graph level representation learning with focus on graph classification task. Experimental results on six widely used benchmarks demonstrate the effectiveness of our proposed model.
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