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.
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Given a document in a source language, cross-lingual summarization (CLS) aims to generate a summary in a different target language. Recently, the emergence of Large Language Models (LLMs), such as GPT-3.5, ChatGPT and GPT-4, has attracted wide attention from the computational linguistics community. However, it is not yet known the performance of LLMs on CLS. In this report, we empirically use various prompts to guide LLMs to perform zero-shot CLS from different paradigms (i.e., end-to-end and pipeline), and provide a preliminary evaluation on the generated summaries. We find that ChatGPT and GPT-4 originally prefer to produce lengthy summaries with detailed information. These two LLMs can further balance informativeness and conciseness with the help of an interactive prompt, significantly improving their CLS performance. Experimental results on three widely-used CLS datasets show that GPT-4 achieves state-of-the-art zero-shot CLS performance, and performs competitively compared with the fine-tuned mBART-50. Moreover, we also find some multi-lingual and bilingual LLMs (i.e., BLOOMZ, ChatGLM-6B, Vicuna-13B and ChatYuan) have limited zero-shot CLS ability. Due to the composite nature of CLS, which requires models to perform summarization and translation simultaneously, accomplishing this task in a zero-shot manner is even a challenge for LLMs. Therefore, we sincerely hope and recommend future LLM research could use CLS as a testbed.
Ranking documents using Large Language Models (LLMs) by directly feeding the query and candidate documents into the prompt is an interesting and practical problem. However, there has been limited success so far, as researchers have found it difficult to outperform fine-tuned baseline rankers on benchmark datasets. We analyze pointwise and listwise ranking prompts used by existing methods and argue that off-the-shelf LLMs do not fully understand these ranking formulations, possibly due to the nature of how LLMs are trained. In this paper, we propose to significantly reduce the burden on LLMs by using a new technique called Pairwise Ranking Prompting (PRP). Our results are the first in the literature to achieve state-of-the-art ranking performance on standard benchmarks using moderate-sized open-sourced LLMs. On TREC-DL2020, PRP based on the Flan-UL2 model with 20B parameters outperforms the previous best approach in the literature, which is based on the blackbox commercial GPT-4 that has 50x (estimated) model size, by over 5% at NDCG@1. On TREC-DL2019, PRP is only inferior to the GPT-4 solution on the NDCG@5 and NDCG@10 metrics, while outperforming other existing solutions, such as InstructGPT which has 175B parameters, by over 10% for nearly all ranking metrics. Furthermore, we propose several variants of PRP to improve efficiency and show that it is possible to achieve competitive results even with linear complexity. We also discuss other benefits of PRP, such as supporting both generation and scoring LLM APIs, as well as being insensitive to input ordering.
Medical dialogue summarization is challenging due to the unstructured nature of medical conversations, the use of medical terminology in gold summaries, and the need to identify key information across multiple symptom sets. We present a novel system for the Dialogue2Note Medical Summarization tasks in the MEDIQA 2023 Shared Task. Our approach for section-wise summarization (Task A) is a two-stage process of selecting semantically similar dialogues and using the top-k similar dialogues as in-context examples for GPT-4. For full-note summarization (Task B), we use a similar solution with k=1. We achieved 3rd place in Task A (2nd among all teams), 4th place in Task B Division Wise Summarization (2nd among all teams), 15th place in Task A Section Header Classification (9th among all teams), and 8th place among all teams in Task B. Our results highlight the effectiveness of few-shot prompting for this task, though we also identify several weaknesses of prompting-based approaches. We compare GPT-4 performance with several finetuned baselines. We find that GPT-4 summaries are more abstractive and shorter. We make our code publicly available.
When trying to answer complex questions, people often rely on multiple sources of information, such as visual, textual, and tabular data. Previous approaches to this problem have focused on designing input features or model structure in the multi-modal space, which is inflexible for cross-modal reasoning or data-efficient training. In this paper, we call for an alternative paradigm, which transforms the images and tables into unified language representations, so that we can simplify the task into a simpler textual QA problem that can be solved using three steps: retrieval, ranking, and generation, all within a language space. This idea takes advantage of the power of pre-trained language models and is implemented in a framework called Solar. Our experimental results show that Solar outperforms all existing methods by 10.6-32.3 pts on two datasets, MultimodalQA and MMCoQA, across ten different metrics. Additionally, Solar achieves the best performance on the WebQA leaderboard
We study visual question answering in a setting where the answer has to be mined from a pool of relevant and irrelevant images given as a context. For such a setting, a model must first retrieve relevant images from the pool and answer the question from these retrieved images. We refer to this problem as retrieval-based visual question answering (or RETVQA in short). The RETVQA is distinctively different and more challenging than the traditionally-studied Visual Question Answering (VQA), where a given question has to be answered with a single relevant image in context. Towards solving the RETVQA task, we propose a unified Multi Image BART (MI-BART) that takes a question and retrieved images using our relevance encoder for free-form fluent answer generation. Further, we introduce the largest dataset in this space, namely RETVQA, which has the following salient features: multi-image and retrieval requirement for VQA, metadata-independent questions over a pool of heterogeneous images, expecting a mix of classification-oriented and open-ended generative answers. Our proposed framework achieves an accuracy of 76.5% and a fluency of 79.3% on the proposed dataset, namely RETVQA and also outperforms state-of-the-art methods by 4.9% and 11.8% on the image segment of the publicly available WebQA dataset on the accuracy and fluency metrics, respectively.
Reasoning is a fundamental aspect of human intelligence that plays a crucial role in activities such as problem solving, decision making, and critical thinking. In recent years, large language models (LLMs) have made significant progress in natural language processing, and there is observation that these models may exhibit reasoning abilities when they are sufficiently large. However, it is not yet clear to what extent LLMs are capable of reasoning. This paper provides a comprehensive overview of the current state of knowledge on reasoning in LLMs, including techniques for improving and eliciting reasoning in these models, methods and benchmarks for evaluating reasoning abilities, findings and implications of previous research in this field, and suggestions on future directions. Our aim is to provide a detailed and up-to-date review of this topic and stimulate meaningful discussion and future work.
Following unprecedented success on the natural language tasks, Transformers have been successfully applied to several computer vision problems, achieving state-of-the-art results and prompting researchers to reconsider the supremacy of convolutional neural networks (CNNs) as {de facto} operators. Capitalizing on these advances in computer vision, the medical imaging field has also witnessed growing interest for Transformers that can capture global context compared to CNNs with local receptive fields. Inspired from this transition, in this survey, we attempt to provide a comprehensive review of the applications of Transformers in medical imaging covering various aspects, ranging from recently proposed architectural designs to unsolved issues. Specifically, we survey the use of Transformers in medical image segmentation, detection, classification, reconstruction, synthesis, registration, clinical report generation, and other tasks. In particular, for each of these applications, we develop taxonomy, identify application-specific challenges as well as provide insights to solve them, and highlight recent trends. Further, we provide a critical discussion of the field's current state as a whole, including the identification of key challenges, open problems, and outlining promising future directions. We hope this survey will ignite further interest in the community and provide researchers with an up-to-date reference regarding applications of Transformer models in medical imaging. Finally, to cope with the rapid development in this field, we intend to regularly update the relevant latest papers and their open-source implementations at \url{//github.com/fahadshamshad/awesome-transformers-in-medical-imaging}.
Medical Visual Question Answering (VQA) is a combination of medical artificial intelligence and popular VQA challenges. Given a medical image and a clinically relevant question in natural language, the medical VQA system is expected to predict a plausible and convincing answer. Although the general-domain VQA has been extensively studied, the medical VQA still needs specific investigation and exploration due to its task features. In the first part of this survey, we cover and discuss the publicly available medical VQA datasets up to date about the data source, data quantity, and task feature. In the second part, we review the approaches used in medical VQA tasks. In the last part, we analyze some medical-specific challenges for the field and discuss future research directions.
Knowledge enhanced pre-trained language models (K-PLMs) are shown to be effective for many public tasks in the literature but few of them have been successfully applied in practice. To address this problem, we propose K-AID, a systematic approach that includes a low-cost knowledge acquisition process for acquiring domain knowledge, an effective knowledge infusion module for improving model performance, and a knowledge distillation component for reducing the model size and deploying K-PLMs on resource-restricted devices (e.g., CPU) for real-world application. Importantly, instead of capturing entity knowledge like the majority of existing K-PLMs, our approach captures relational knowledge, which contributes to better-improving sentence-level text classification and text matching tasks that play a key role in question answering (QA). We conducted a set of experiments on five text classification tasks and three text matching tasks from three domains, namely E-commerce, Government, and Film&TV, and performed online A/B tests in E-commerce. Experimental results show that our approach is able to achieve substantial improvement on sentence-level question answering tasks and bring beneficial business value in industrial settings.
The problem of answering questions using knowledge from pre-trained language models (LMs) and knowledge graphs (KGs) presents two challenges: given a QA context (question and answer choice), methods need to (i) identify relevant knowledge from large KGs, and (ii) perform joint reasoning over the QA context and KG. In this work, we propose a new model, QA-GNN, which addresses the above challenges through two key innovations: (i) relevance scoring, where we use LMs to estimate the importance of KG nodes relative to the given QA context, and (ii) joint reasoning, where we connect the QA context and KG to form a joint graph, and mutually update their representations through graph neural networks. We evaluate QA-GNN on the CommonsenseQA and OpenBookQA datasets, and show its improvement over existing LM and LM+KG models, as well as its capability to perform interpretable and structured reasoning, e.g., correctly handling negation in questions.
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