Matching patients to clinical trials is a key unsolved challenge in bringing new drugs to market. Today, identifying patients who meet a trial's eligibility criteria is highly manual, taking up to 1 hour per patient. Automated screening is challenging, however, as it requires understanding unstructured clinical text. Large language models (LLMs) offer a promising solution. In this work, we explore their application to trial matching. First, we design an LLM-based system which, given a patient's medical history as unstructured clinical text, evaluates whether that patient meets a set of inclusion criteria (also specified as free text). Our zero-shot system achieves state-of-the-art scores on the n2c2 2018 cohort selection benchmark. Second, we improve the data and cost efficiency of our method by identifying a prompting strategy which matches patients an order of magnitude faster and more cheaply than the status quo, and develop a two-stage retrieval pipeline that reduces the number of tokens processed by up to a third while retaining high performance. Third, we evaluate the interpretability of our system by having clinicians evaluate the natural language justifications generated by the LLM for each eligibility decision, and show that it can output coherent explanations for 97% of its correct decisions and 75% of its incorrect ones. Our results establish the feasibility of using LLMs to accelerate clinical trial operations.
It is vital to learn effective policies that can be transferred to different domains with dynamics discrepancies in reinforcement learning (RL). In this paper, we consider dynamics adaptation settings where there exists dynamics mismatch between the source domain and the target domain, and one can get access to sufficient source domain data, while can only have limited interactions with the target domain. Existing methods address this problem by learning domain classifiers, performing data filtering from a value discrepancy perspective, etc. Instead, we tackle this challenge from a decoupled representation learning perspective. We perform representation learning only in the target domain and measure the representation deviations on the transitions from the source domain, which we show can be a signal of dynamics mismatch. We also show that representation deviation upper bounds performance difference of a given policy in the source domain and target domain, which motivates us to adopt representation deviation as a reward penalty. The produced representations are not involved in either policy or value function, but only serve as a reward penalizer. We conduct extensive experiments on environments with kinematic and morphology mismatch, and the results show that our method exhibits strong performance on many tasks. Our code is publicly available at //github.com/dmksjfl/PAR.
Acoustical knee health assessment has long promised an alternative to clinically available medical imaging tools, but this modality has yet to be adopted in medical practice. The field is currently led by machine learning models processing acoustical features, which have presented promising diagnostic performances. However, these methods overlook the intricate multi-source nature of audio signals and the underlying mechanisms at play. By addressing this critical gap, the present paper introduces a novel causal framework for validating knee acoustical features. We argue that current machine learning methodologies for acoustical knee diagnosis lack the required assurances and thus cannot be used to classify acoustic features as biomarkers. Our framework establishes a set of essential theoretical guarantees necessary to validate this claim. We apply our methodology to three real-world experiments investigating the effect of researchers' expectations, the experimental protocol and the wearable employed sensor. This investigation reveals latent issues such as underlying shortcut learning and performance inflation. This study is the first independent result reproduction study in the field of acoustical knee health evaluation. We conclude with actionable insights from our findings, offering valuable guidance to navigate these crucial limitations in future research.
Promoting healthy lifestyle behaviors remains a major public health concern, particularly due to their crucial role in preventing chronic conditions such as cancer, heart disease, and type 2 diabetes. Mobile health applications present a promising avenue for low-cost, scalable health behavior change promotion. Researchers are increasingly exploring adaptive algorithms that personalize interventions to each person's unique context. However, in empirical studies, mobile health applications often suffer from small effect sizes and low adherence rates, particularly in comparison to human coaching. Tailoring advice to a person's unique goals, preferences, and life circumstances is a critical component of health coaching that has been underutilized in adaptive algorithms for mobile health interventions. To address this, we introduce a new Thompson sampling algorithm that can accommodate personalized reward functions (i.e., goals, preferences, and constraints), while also leveraging data sharing across individuals to more quickly be able to provide effective recommendations. We prove that our modification incurs only a constant penalty on cumulative regret while preserving the sample complexity benefits of data sharing. We present empirical results on synthetic and semi-synthetic physical activity simulators, where in the latter we conducted an online survey to solicit preference data relating to physical activity, which we use to construct realistic reward models that leverages historical data from another study. Our algorithm achieves substantial performance improvements compared to baselines that do not share data or do not optimize for individualized rewards.
In the expanding field of language model applications, medical knowledge representation remains a significant challenge due to the specialized nature of the domain. Large language models, such as GPT-4, obtain reasonable scores on medical question answering tasks, but smaller models are far behind. In this work, we introduce a method to improve the proficiency of a small language model in the medical domain by employing a two-fold approach. We first fine-tune the model on a corpus of medical textbooks. Then, we use GPT-4 to generate questions similar to the downstream task, prompted with textbook knowledge, and use them to fine-tune the model. Additionally, we introduce ECN-QA, a novel medical question answering dataset containing ``progressive questions'' composed of related sequential questions. We show the benefits of our training strategy on this dataset. The study's findings highlight the potential of small language models in the medical domain when appropriately fine-tuned. The code and weights are available at //github.com/raidium-med/MQG.
The rapid development of collaborative robotics has provided a new possibility of helping the elderly who has difficulties in daily life, allowing robots to operate according to specific intentions. However, efficient human-robot cooperation requires natural, accurate and reliable intention recognition in shared environments. The current paramount challenge for this is reducing the uncertainty of multimodal fused intention to be recognized and reasoning adaptively a more reliable result despite current interactive condition. In this work we propose a novel learning-based multimodal fusion framework Batch Multimodal Confidence Learning for Opinion Pool (BMCLOP). Our approach combines Bayesian multimodal fusion method and batch confidence learning algorithm to improve accuracy, uncertainty reduction and success rate given the interactive condition. In particular, the generic and practical multimodal intention recognition framework can be easily extended further. Our desired assistive scenarios consider three modalities gestures, speech and gaze, all of which produce categorical distributions over all the finite intentions. The proposed method is validated with a six-DoF robot through extensive experiments and exhibits high performance compared to baselines.
Cybergrooming emerges as a growing threat to adolescent safety and mental health. One way to combat cybergrooming is to leverage predictive artificial intelligence (AI) to detect predatory behaviors in social media. However, these methods can encounter challenges like false positives and negative implications such as privacy concerns. Another complementary strategy involves using generative artificial intelligence to empower adolescents by educating them about predatory behaviors. To this end, we envision developing state-of-the-art conversational agents to simulate the conversations between adolescents and predators for educational purposes. Yet, one key challenge is the lack of a dataset to train such conversational agents. In this position paper, we present our motivation for empowering adolescents to cope with cybergrooming. We propose to develop large-scale, authentic datasets through an online survey targeting adolescents and parents. We discuss some initial background behind our motivation and proposed design of the survey, such as situating the participants in artificial cybergrooming scenarios, then allowing participants to respond to the survey to obtain their authentic responses. We also present several open questions related to our proposed approach and hope to discuss them with the workshop attendees.
Decision-making algorithms are being used in important decisions, such as who should be enrolled in health care programs and be hired. Even though these systems are currently deployed in high-stakes scenarios, many of them cannot explain their decisions. This limitation has prompted the Explainable Artificial Intelligence (XAI) initiative, which aims to make algorithms explainable to comply with legal requirements, promote trust, and maintain accountability. This paper questions whether and to what extent explainability can help solve the responsibility issues posed by autonomous AI systems. We suggest that XAI systems that provide post-hoc explanations could be seen as blameworthy agents, obscuring the responsibility of developers in the decision-making process. Furthermore, we argue that XAI could result in incorrect attributions of responsibility to vulnerable stakeholders, such as those who are subjected to algorithmic decisions (i.e., patients), due to a misguided perception that they have control over explainable algorithms. This conflict between explainability and accountability can be exacerbated if designers choose to use algorithms and patients as moral and legal scapegoats. We conclude with a set of recommendations for how to approach this tension in the socio-technical process of algorithmic decision-making and a defense of hard regulation to prevent designers from escaping responsibility.
It has been shown that deep neural networks are prone to overfitting on biased training data. Towards addressing this issue, meta-learning employs a meta model for correcting the training bias. Despite the promising performances, super slow training is currently the bottleneck in the meta learning approaches. In this paper, we introduce a novel Faster Meta Update Strategy (FaMUS) to replace the most expensive step in the meta gradient computation with a faster layer-wise approximation. We empirically find that FaMUS yields not only a reasonably accurate but also a low-variance approximation of the meta gradient. We conduct extensive experiments to verify the proposed method on two tasks. We show our method is able to save two-thirds of the training time while still maintaining the comparable or achieving even better generalization performance. In particular, our method achieves the state-of-the-art performance on both synthetic and realistic noisy labels, and obtains promising performance on long-tailed recognition on standard benchmarks.
Aspect based sentiment analysis (ABSA) can provide more detailed information than general sentiment analysis, because it aims to predict the sentiment polarities of the given aspects or entities in text. We summarize previous approaches into two subtasks: aspect-category sentiment analysis (ACSA) and aspect-term sentiment analysis (ATSA). Most previous approaches employ long short-term memory and attention mechanisms to predict the sentiment polarity of the concerned targets, which are often complicated and need more training time. We propose a model based on convolutional neural networks and gating mechanisms, which is more accurate and efficient. First, the novel Gated Tanh-ReLU Units can selectively output the sentiment features according to the given aspect or entity. The architecture is much simpler than attention layer used in the existing models. Second, the computations of our model could be easily parallelized during training, because convolutional layers do not have time dependency as in LSTM layers, and gating units also work independently. The experiments on SemEval datasets demonstrate the efficiency and effectiveness of our models.
Multi-relation Question Answering is a challenging task, due to the requirement of elaborated analysis on questions and reasoning over multiple fact triples in knowledge base. In this paper, we present a novel model called Interpretable Reasoning Network that employs an interpretable, hop-by-hop reasoning process for question answering. The model dynamically decides which part of an input question should be analyzed at each hop; predicts a relation that corresponds to the current parsed results; utilizes the predicted relation to update the question representation and the state of the reasoning process; and then drives the next-hop reasoning. Experiments show that our model yields state-of-the-art results on two datasets. More interestingly, the model can offer traceable and observable intermediate predictions for reasoning analysis and failure diagnosis.