Daily Papers

Mental health disorders are one of the most serious diseases in the world. Most people with such a disease lack access to adequate care, which highlights the importance of training models for the diagnosis and treatment of mental health disorders. However, in the mental health domain, privacy concerns limit the accessibility of personalized treatment data, making it challenging to build powerful models. In this paper, we introduce MentalArena, a self-play framework to train language models by generating domain-specific personalized data, where we obtain a better model capable of making a personalized diagnosis and treatment (as a therapist) and providing information (as a patient). To accurately model human-like mental health patients, we devise Symptom Encoder, which simulates a real patient from both cognition and behavior perspectives. To address intent bias during patient-therapist interactions, we propose Symptom Decoder to compare diagnosed symptoms with encoded symptoms, and dynamically manage the dialogue between patient and therapist according to the identified deviations. We evaluated MentalArena against 6 benchmarks, including biomedicalQA and mental health tasks, compared to 6 advanced models. Our models, fine-tuned on both GPT-3.5 and Llama-3-8b, significantly outperform their counterparts, including GPT-4o. We hope that our work can inspire future research on personalized care. Code is available in https://github.com/Scarelette/MentalArena/tree/main

Users of social platforms often perceive these sites as supportive spaces to post about their mental health issues. Those conversations contain important traces about individuals' health risks. Recently, researchers have exploited this online information to construct mental health detection models, which aim to identify users at risk on platforms like Twitter, Reddit or Facebook. Most of these models are centred on achieving good classification results, ignoring the explainability and interpretability of the decisions. Recent research has pointed out the importance of using clinical markers, such as the use of symptoms, to improve trust in the computational models by health professionals. In this paper, we propose using transformer-based architectures to detect and explain the appearance of depressive symptom markers in the users' writings. We present two approaches: i) train a model to classify, and another one to explain the classifier's decision separately and ii) unify the two tasks simultaneously using a single model. Additionally, for this latter manner, we also investigated the performance of recent conversational LLMs when using in-context learning. Our natural language explanations enable clinicians to interpret the models' decisions based on validated symptoms, enhancing trust in the automated process. We evaluate our approach using recent symptom-based datasets, employing both offline and expert-in-the-loop metrics to assess the quality of the explanations generated by our models. The experimental results show that it is possible to achieve good classification results while generating interpretable symptom-based explanations.

There has been a rapidly growing interest in Automatic Symptom Detection (ASD) and Automatic Diagnosis (AD) systems in the machine learning research literature, aiming to assist doctors in telemedicine services. These systems are designed to interact with patients, collect evidence about their symptoms and relevant antecedents, and possibly make predictions about the underlying diseases. Doctors would review the interactions, including the evidence and the predictions, collect if necessary additional information from patients, before deciding on next steps. Despite recent progress in this area, an important piece of doctors' interactions with patients is missing in the design of these systems, namely the differential diagnosis. Its absence is largely due to the lack of datasets that include such information for models to train on. In this work, we present a large-scale synthetic dataset of roughly 1.3 million patients that includes a differential diagnosis, along with the ground truth pathology, symptoms and antecedents for each patient. Unlike existing datasets which only contain binary symptoms and antecedents, this dataset also contains categorical and multi-choice symptoms and antecedents useful for efficient data collection. Moreover, some symptoms are organized in a hierarchy, making it possible to design systems able to interact with patients in a logical way. As a proof-of-concept, we extend two existing AD and ASD systems to incorporate the differential diagnosis, and provide empirical evidence that using differentials as training signals is essential for the efficiency of such systems or for helping doctors better understand the reasoning of those systems.

Depression is a pervasive mental health condition that affects hundreds of millions of individuals worldwide, yet many cases remain undiagnosed due to barriers in traditional clinical access and pervasive stigma. Social media platforms, and Reddit in particular, offer rich, user-generated narratives that can reveal early signs of depressive symptomatology. However, existing computational approaches often label entire posts simply as depressed or not depressed, without linking language to specific criteria from the DSM-5, the standard clinical framework for diagnosing depression. This limits both clinical relevance and interpretability. To address this gap, we introduce ReDSM5, a novel Reddit corpus comprising 1484 long-form posts, each exhaustively annotated at the sentence level by a licensed psychologist for the nine DSM-5 depression symptoms. For each label, the annotator also provides a concise clinical rationale grounded in DSM-5 methodology. We conduct an exploratory analysis of the collection, examining lexical, syntactic, and emotional patterns that characterize symptom expression in social media narratives. Compared to prior resources, ReDSM5 uniquely combines symptom-specific supervision with expert explanations, facilitating the development of models that not only detect depression but also generate human-interpretable reasoning. We establish baseline benchmarks for both multi-label symptom classification and explanation generation, providing reference results for future research on detection and interpretability.

We address a challenging and practical task of labeling questions in speech in real time during telephone calls to emergency medical services in English, which embeds within a broader decision support system for emergency call-takers. We propose a novel multimodal approach to real-time sequence labeling in speech. Our model treats speech and its own textual representation as two separate modalities or views, as it jointly learns from streamed audio and its noisy transcription into text via automatic speech recognition. Our results show significant gains of jointly learning from the two modalities when compared to text or audio only, under adverse noise and limited volume of training data. The results generalize to medical symptoms detection where we observe a similar pattern of improvements with multimodal learning.

Automatic medical report generation (MRG) is of great research value as it has the potential to relieve radiologists from the heavy burden of report writing. Despite recent advancements, accurate MRG remains challenging due to the need for precise clinical understanding and the identification of clinical findings. Moreover, the imbalanced distribution of diseases makes the challenge even more pronounced, as rare diseases are underrepresented in training data, making their diagnostic performance unreliable. To address these challenges, we propose diagnosis-driven prompts for medical report generation (PromptMRG), a novel framework that aims to improve the diagnostic accuracy of MRG with the guidance of diagnosis-aware prompts. Specifically, PromptMRG is based on encoder-decoder architecture with an extra disease classification branch. When generating reports, the diagnostic results from the classification branch are converted into token prompts to explicitly guide the generation process. To further improve the diagnostic accuracy, we design cross-modal feature enhancement, which retrieves similar reports from the database to assist the diagnosis of a query image by leveraging the knowledge from a pre-trained CLIP. Moreover, the disease imbalanced issue is addressed by applying an adaptive logit-adjusted loss to the classification branch based on the individual learning status of each disease, which overcomes the barrier of text decoder's inability to manipulate disease distributions. Experiments on two MRG benchmarks show the effectiveness of the proposed method, where it obtains state-of-the-art clinical efficacy performance on both datasets.

Decoding language from brain activity is a long-awaited goal in both healthcare and neuroscience. Major milestones have recently been reached thanks to intracranial devices: subject-specific pipelines trained on invasive brain responses to basic language tasks now start to efficiently decode interpretable features (e.g. letters, words, spectrograms). However, scaling this approach to natural speech and non-invasive brain recordings remains a major challenge. Here, we propose a single end-to-end architecture trained with contrastive learning across a large cohort of individuals to predict self-supervised representations of natural speech. We evaluate our model on four public datasets, encompassing 169 volunteers recorded with magneto- or electro-encephalography (M/EEG), while they listened to natural speech. The results show that our model can identify, from 3s of MEG signals, the corresponding speech segment with up to 72.5% top-10 accuracy out of 1,594 distinct segments (and 44% top-1 accuracy), and up to 19.1% out of 2,604 segments for EEG recordings -- hence allowing the decoding of phrases absent from the training set. Model comparison and ablation analyses show that these performances directly benefit from our original design choices, namely the use of (i) a contrastive objective, (ii) pretrained representations of speech and (iii) a common convolutional architecture simultaneously trained across several participants. Together, these results delineate a promising path to decode natural language processing in real time from non-invasive recordings of brain activity.

The automated generation of imaging reports proves invaluable in alleviating the workload of radiologists. A clinically applicable reports generation algorithm should demonstrate its effectiveness in producing reports that accurately describe radiology findings and attend to patient-specific indications. In this paper, we introduce a novel method, Structural Entities extraction and patient indications Incorporation (SEI) for chest X-ray report generation. Specifically, we employ a structural entities extraction (SEE) approach to eliminate presentation-style vocabulary in reports and improve the quality of factual entity sequences. This reduces the noise in the following cross-modal alignment module by aligning X-ray images with factual entity sequences in reports, thereby enhancing the precision of cross-modal alignment and further aiding the model in gradient-free retrieval of similar historical cases. Subsequently, we propose a cross-modal fusion network to integrate information from X-ray images, similar historical cases, and patient-specific indications. This process allows the text decoder to attend to discriminative features of X-ray images, assimilate historical diagnostic information from similar cases, and understand the examination intention of patients. This, in turn, assists in triggering the text decoder to produce high-quality reports. Experiments conducted on MIMIC-CXR validate the superiority of SEI over state-of-the-art approaches on both natural language generation and clinical efficacy metrics.

Intent is defined for understanding spoken language in existing works. Both textual features and acoustic features involved in medical speech contain intent, which is important for symptomatic diagnosis. In this paper, we propose a medical speech classification model named DRSC that automatically learns to disentangle intent and content representations from textual-acoustic data for classification. The intent representations of the text domain and the Mel-spectrogram domain are extracted via intent encoders, and then the reconstructed text feature and the Mel-spectrogram feature are obtained through two exchanges. After combining the intent from two domains into a joint representation, the integrated intent representation is fed into a decision layer for classification. Experimental results show that our model obtains an average accuracy rate of 95% in detecting 25 different medical symptoms.

While large language models have demonstrated exceptional performance across a wide range of tasks, they remain susceptible to hallucinations -- generating plausible yet factually incorrect contents. Existing methods to mitigating such risk often rely on sampling multiple full-length generations, which introduces significant response latency and becomes ineffective when the model consistently produces hallucinated outputs with high confidence. To address these limitations, we introduce Monitoring Decoding (MD), a novel framework that dynamically monitors the generation process and selectively applies in-process interventions, focusing on revising crucial tokens responsible for hallucinations. Instead of waiting until completion of multiple full-length generations, we identify hallucination-prone tokens during generation using a monitor function, and further refine these tokens through a tree-based decoding strategy. This approach ensures an enhanced factual accuracy and coherence in the generated output while maintaining efficiency. Experimental results demonstrate that MD consistently outperforms self-consistency-based approaches in both effectiveness and efficiency, achieving higher factual accuracy while significantly reducing computational overhead.

Speculative decoding (SPD) aims to accelerate the auto-regressive token generation process of a target Large Language Model (LLM). Some approaches employ a draft model with multiple heads to predict a sequence of future tokens, where each head handles a token in the sequence. The target LLM verifies the predicted sequence and accepts aligned tokens, enabling efficient multi-token generation. However, existing methods assume that all tokens within a sequence are equally important, employing identical head structures and relying on a single-generation paradigm, either serial or parallel. To this end, we theoretically demonstrate that initial tokens in the draft sequence are more important than later ones. Building on this insight, we propose Gumiho, a hybrid model combining serial and parallel heads. Specifically, given the critical importance of early tokens, we employ a sophisticated Transformer architecture for the early draft heads in a serial configuration to improve accuracy. For later tokens, we utilize multiple lightweight MLP heads operating in parallel to enhance efficiency. By allocating more advanced model structures and longer running times to the early heads, Gumiho achieves improved overall performance. The experimental results demonstrate that our method outperforms existing approaches, fully validating its effectiveness.

COVID-19 (coronavirus disease 2019) pandemic caused by SARS-CoV-2 has led to a treacherous and devastating catastrophe for humanity. At the time of writing, no specific antivirus drugs or vaccines are recommended to control infection transmission and spread. The current diagnosis of COVID-19 is done by Reverse-Transcription Polymer Chain Reaction (RT-PCR) testing. However, this method is expensive, time-consuming, and not easily available in straitened regions. An interpretable and COVID-19 diagnosis AI framework is devised and developed based on the cough sounds features and symptoms metadata to overcome these limitations. The proposed framework's performance was evaluated using a medical dataset containing Symptoms and Demographic data of 30000 audio segments, 328 cough sounds from 150 patients with four cough classes ( COVID-19, Asthma, Bronchitis, and Healthy). Experiments' results show that the model captures the better and robust feature embedding to distinguish between COVID-19 patient coughs and several types of non-COVID-19 coughs with higher specificity and accuracy of 95.04 pm 0.18% and 96.83pm 0.18% respectively, all the while maintaining interpretability.

In this paper, we introduce an improved approach of speculative decoding aimed at enhancing the efficiency of serving large language models. Our method capitalizes on the strengths of two established techniques: the classic two-model speculative decoding approach, and the more recent single-model approach, Medusa. Drawing inspiration from Medusa, our approach adopts a single-model strategy for speculative decoding. However, our method distinguishes itself by employing a single, lightweight draft head with a recurrent dependency design, akin in essence to the small, draft model uses in classic speculative decoding, but without the complexities of the full transformer architecture. And because of the recurrent dependency, we can use beam search to swiftly filter out undesired candidates with the draft head. The outcome is a method that combines the simplicity of single-model design and avoids the need to create a data-dependent tree attention structure only for inference in Medusa. We empirically demonstrate the effectiveness of the proposed method on several popular open source language models, along with a comprehensive analysis of the trade-offs involved in adopting this approach.

Depression, a prevalent mental health disorder impacting millions globally, demands reliable assessment systems. Unlike previous studies that focus solely on either detecting depression or predicting its severity, our work identifies individual symptoms of depression while also predicting its severity using speech input. We leverage self-supervised learning (SSL)-based speech models to better utilize the small-sized datasets that are frequently encountered in this task. Our study demonstrates notable performance improvements by utilizing SSL embeddings compared to conventional speech features. We compare various types of SSL pretrained models to elucidate the type of speech information (semantic, speaker, or prosodic) that contributes the most in identifying different symptoms. Additionally, we evaluate the impact of combining multiple SSL embeddings on performance. Furthermore, we show the significance of multi-task learning for identifying depressive symptoms effectively.

Foodborne gastrointestinal (GI) illness is a common cause of ill health in the UK. However, many cases do not interact with the healthcare system, posing significant challenges for traditional surveillance methods. The growth of publicly available online restaurant reviews and advancements in large language models (LLMs) present potential opportunities to extend disease surveillance by identifying public reports of GI illness. In this study, we introduce a novel annotation schema, developed with experts in GI illness, applied to the Yelp Open Dataset of reviews. Our annotations extend beyond binary disease detection, to include detailed extraction of information on symptoms and foods. We evaluate the performance of open-weight LLMs across these three tasks: GI illness detection, symptom extraction, and food extraction. We compare this performance to RoBERTa-based classification models fine-tuned specifically for these tasks. Our results show that using prompt-based approaches, LLMs achieve micro-F1 scores of over 90% for all three of our tasks. Using prompting alone, we achieve micro-F1 scores that exceed those of smaller fine-tuned models. We further demonstrate the robustness of LLMs in GI illness detection across three bias-focused experiments. Our results suggest that publicly available review text and LLMs offer substantial potential for public health surveillance of GI illness by enabling highly effective extraction of key information. While LLMs appear to exhibit minimal bias in processing, the inherent limitations of restaurant review data highlight the need for cautious interpretation of results.

Chronic Obstructive Pulmonary Disease (COPD), a major chronic respiratory disease with persistent airflow limitation, is a leading global cause of disability and mortality. Respiratory spirogram time series, routinely collected during pulmonary function tests (PFTs), play a critical role in the early detection of repsiratory diseases and in monitoring lung function over time. However, most current AI models for COPD diagnosis are limited to outputting classification results without providing a rationale for their diagnostic process, while current Large Language Models (LLMs) cannot understand spirograms yet, which severely limits their clinical trust and adoption. To tackle this challenge, we leverage a cohort of 234,028 individuals from the UK Biobank (UKB) to propose SpiroLLM, the first multimodal large language model that can understand spirogram. The model extracts morphological features from respiratory curves via a SpiroEncoder and aligns them with PFT numerical values in a unified latent space using a SpiroProjector, ultimately empowering a large language model to generate a comprehensive diagnostic report. Experimental results confirm that SpiroLLM achieved a diagnostic AUROC of 0.8980 (95% CI: 0.8820-0.9132). In a robustness test with missing core data, it maintained a 100% valid response rate, far surpassing the 13.4% of a text-only model and showcasing the superiority of its multimodal design. This work demonstrates the substantial potential of deeply fusing physiological signals with large language models, establishing a new paradigm for the next generation of interpretable and reliable clinical decision support tools.

A recently introduced classifier, called SS3, has shown to be well suited to deal with early risk detection (ERD) problems on text streams. It obtained state-of-the-art performance on early depression and anorexia detection on Reddit in the CLEF's eRisk open tasks. SS3 was created to deal with ERD problems naturally since: it supports incremental training and classification over text streams, and it can visually explain its rationale. However, SS3 processes the input using a bag-of-word model lacking the ability to recognize important word sequences. This aspect could negatively affect the classification performance and also reduces the descriptiveness of visual explanations. In the standard document classification field, it is very common to use word n-grams to try to overcome some of these limitations. Unfortunately, when working with text streams, using n-grams is not trivial since the system must learn and recognize which n-grams are important "on the fly". This paper introduces t-SS3, an extension of SS3 that allows it to recognize useful patterns over text streams dynamically. We evaluated our model in the eRisk 2017 and 2018 tasks on early depression and anorexia detection. Experimental results suggest that t-SS3 is able to improve both current results and the richness of visual explanations.

Automated interpretation of electrocardiograms (ECG) has garnered significant attention with the advancements in machine learning methodologies. Despite the growing interest, most current studies focus solely on classification or regression tasks, which overlook a crucial aspect of clinical cardio-disease diagnosis: the diagnostic report generated by experienced human clinicians. In this paper, we introduce a novel approach to ECG interpretation, leveraging recent breakthroughs in Large Language Models (LLMs) and Vision-Transformer (ViT) models. Rather than treating ECG diagnosis as a classification or regression task, we propose an alternative method of automatically identifying the most similar clinical cases based on the input ECG data. Also, since interpreting ECG as images is more affordable and accessible, we process ECG as encoded images and adopt a vision-language learning paradigm to jointly learn vision-language alignment between encoded ECG images and ECG diagnosis reports. Encoding ECG into images can result in an efficient ECG retrieval system, which will be highly practical and useful in clinical applications. More importantly, our findings could serve as a crucial resource for providing diagnostic services in underdeveloped regions.

Depression has proven to be a significant public health issue, profoundly affecting the psychological well-being of individuals. If it remains undiagnosed, depression can lead to severe health issues, which can manifest physically and even lead to suicide. Generally, Diagnosing depression or any other mental disorder involves conducting semi-structured interviews alongside supplementary questionnaires, including variants of the Patient Health Questionnaire (PHQ) by Clinicians and mental health professionals. This approach places significant reliance on the experience and judgment of trained physicians, making the diagnosis susceptible to personal biases. Given that the underlying mechanisms causing depression are still being actively researched, physicians often face challenges in diagnosing and treating the condition, particularly in its early stages of clinical presentation. Recently, significant strides have been made in Artificial neural computing to solve problems involving text, image, and speech in various domains. Our analysis has aimed to leverage these state-of-the-art (SOTA) models in our experiments to achieve optimal outcomes leveraging multiple modalities. The experiments were performed on the Extended Distress Analysis Interview Corpus Wizard of Oz dataset (E-DAIC) corpus presented in the Audio/Visual Emotion Challenge (AVEC) 2019 Challenge. The proposed solutions demonstrate better results achieved by Proprietary and Open-source Large Language Models (LLMs), which achieved a Root Mean Square Error (RMSE) score of 3.98 on Textual Modality, beating the AVEC 2019 challenge baseline results and current SOTA regression analysis architectures. Additionally, the proposed solution achieved an accuracy of 71.43% in the classification task. The paper also includes a novel audio-visual multi-modal network that predicts PHQ-8 scores with an RMSE of 6.51.

Accurate diagnostic coding of medical notes is crucial for enhancing patient care, medical research, and error-free billing in healthcare organizations. Manual coding is a time-consuming task for providers, and diagnostic codes often exhibit low sensitivity and specificity, whereas the free text in medical notes can be a more precise description of a patients status. Thus, accurate automated diagnostic coding of medical notes has become critical for a learning healthcare system. Recent developments in long-document transformer architectures have enabled attention-based deep-learning models to adjudicate medical notes. In addition, contrastive loss functions have been used to jointly pre-train large language and image models with noisy labels. To further improve the automated adjudication of medical notes, we developed an approach based on i) models for ICD-10 diagnostic code sequences using a large real-world data set, ii) large language models for medical notes, and iii) contrastive pre-training to build an integrated model of both ICD-10 diagnostic codes and corresponding medical text. We demonstrate that a contrastive approach for pre-training improves performance over prior state-of-the-art models for the MIMIC-III-50, MIMIC-III-rare50, and MIMIC-III-full diagnostic coding tasks.

Depression is a common mental disorder. Automatic depression detection tools using speech, enabled by machine learning, help early screening of depression. This paper addresses two limitations that may hinder the clinical implementations of such tools: noise resulting from segment-level labelling and a lack of model interpretability. We propose a bi-modal speech-level transformer to avoid segment-level labelling and introduce a hierarchical interpretation approach to provide both speech-level and sentence-level interpretations, based on gradient-weighted attention maps derived from all attention layers to track interactions between input features. We show that the proposed model outperforms a model that learns at a segment level (p=0.854, r=0.947, F1=0.947 compared to p=0.732, r=0.808, F1=0.768). For model interpretation, using one true positive sample, we show which sentences within a given speech are most relevant to depression detection; and which text tokens and Mel-spectrogram regions within these sentences are most relevant to depression detection. These interpretations allow clinicians to verify the validity of predictions made by depression detection tools, promoting their clinical implementations.

When trained on large, unfiltered crawls from the internet, language models pick up and reproduce all kinds of undesirable biases that can be found in the data: they often generate racist, sexist, violent or otherwise toxic language. As large models require millions of training examples to achieve good performance, it is difficult to completely prevent them from being exposed to such content. In this paper, we first demonstrate a surprising finding: pretrained language models recognize, to a considerable degree, their undesirable biases and the toxicity of the content they produce. We refer to this capability as self-diagnosis. Based on this finding, we then propose a decoding algorithm that, given only a textual description of the undesired behavior, reduces the probability of a language model producing problematic text. We refer to this approach as self-debiasing. Self-debiasing does not rely on manually curated word lists, nor does it require any training data or changes to the model's parameters. While we by no means eliminate the issue of language models generating biased text, we believe our approach to be an important step in this direction.

The limited availability of psychologists necessitates efficient identification of individuals requiring urgent mental healthcare. This study explores the use of Natural Language Processing (NLP) pipelines to analyze text data from online mental health forums used for consultations. By analyzing forum posts, these pipelines can flag users who may require immediate professional attention. A crucial challenge in this domain is data privacy and scarcity. To address this, we propose utilizing readily available curricular texts used in institutes specializing in mental health for pre-training the NLP pipelines. This helps us mimic the training process of a psychologist. Our work presents CASE-BERT that flags potential mental health disorders based on forum text. CASE-BERT demonstrates superior performance compared to existing methods, achieving an f1 score of 0.91 for Depression and 0.88 for Anxiety, two of the most commonly reported mental health disorders. Our code is publicly available.

Codification of free-text clinical narratives have long been recognised to be beneficial for secondary uses such as funding, insurance claim processing and research. The current scenario of assigning codes is a manual process which is very expensive, time-consuming and error prone. In recent years, many researchers have studied the use of Natural Language Processing (NLP), related Machine Learning (ML) and Deep Learning (DL) methods and techniques to resolve the problem of manual coding of clinical narratives and to assist human coders to assign clinical codes more accurately and efficiently. This systematic literature review provides a comprehensive overview of automated clinical coding systems that utilises appropriate NLP, ML and DL methods and techniques to assign ICD codes to discharge summaries. We have followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses(PRISMA) guidelines and conducted a comprehensive search of publications from January, 2010 to December 2020 in four academic databases- PubMed, ScienceDirect, Association for Computing Machinery(ACM) Digital Library, and the Association for Computational Linguistics(ACL) Anthology. We reviewed 7,556 publications; 38 met the inclusion criteria. This review identified: datasets having discharge summaries; NLP techniques along with some other data extraction processes, different feature extraction and embedding techniques. To measure the performance of classification methods, different evaluation metrics are used. Lastly, future research directions are provided to scholars who are interested in automated ICD code assignment. Efforts are still required to improve ICD code prediction accuracy, availability of large-scale de-identified clinical corpora with the latest version of the classification system. This can be a platform to guide and share knowledge with the less experienced coders and researchers.

Despite extensive standardization, diagnostic interviews for mental health disorders encompass substantial subjective judgment. Previous studies have demonstrated that EEG-based neural measures can function as reliable objective correlates of depression, or even predictors of depression and its course. However, their clinical utility has not been fully realized because of 1) the lack of automated ways to deal with the inherent noise associated with EEG data at scale, and 2) the lack of knowledge of which aspects of the EEG signal may be markers of a clinical disorder. Here we adapt an unsupervised pipeline from the recent deep representation learning literature to address these problems by 1) learning a disentangled representation using beta-VAE to denoise the signal, and 2) extracting interpretable features associated with a sparse set of clinical labels using a Symbol-Concept Association Network (SCAN). We demonstrate that our method is able to outperform the canonical hand-engineered baseline classification method on a number of factors, including participant age and depression diagnosis. Furthermore, our method recovers a representation that can be used to automatically extract denoised Event Related Potentials (ERPs) from novel, single EEG trajectories, and supports fast supervised re-mapping to various clinical labels, allowing clinicians to re-use a single EEG representation regardless of updates to the standardized diagnostic system. Finally, single factors of the learned disentangled representations often correspond to meaningful markers of clinical factors, as automatically detected by SCAN, allowing for human interpretability and post-hoc expert analysis of the recommendations made by the model.

Decoding methods play an indispensable role in converting language models from next-token predictors into practical task solvers. Prior research on decoding methods, primarily focusing on task-specific models, may not extend to the current era of general-purpose large language models (LLMs). Moreover, the recent influx of decoding strategies has further complicated this landscape. This paper provides a comprehensive and multifaceted analysis of various decoding methods within the context of LLMs, evaluating their performance, robustness to hyperparameter changes, and decoding speeds across a wide range of tasks, models, and deployment environments. Our findings reveal that decoding method performance is notably task-dependent and influenced by factors such as alignment, model size, and quantization. Intriguingly, sensitivity analysis exposes that certain methods achieve superior performance at the cost of extensive hyperparameter tuning, highlighting the trade-off between attaining optimal results and the practicality of implementation in varying contexts.

We present PanGu-Coder, a pretrained decoder-only language model adopting the PanGu-Alpha architecture for text-to-code generation, i.e. the synthesis of programming language solutions given a natural language problem description. We train PanGu-Coder using a two-stage strategy: the first stage employs Causal Language Modelling (CLM) to pre-train on raw programming language data, while the second stage uses a combination of Causal Language Modelling and Masked Language Modelling (MLM) training objectives that focus on the downstream task of text-to-code generation and train on loosely curated pairs of natural language program definitions and code functions. Finally, we discuss PanGu-Coder-FT, which is fine-tuned on a combination of competitive programming problems and code with continuous integration tests. We evaluate PanGu-Coder with a focus on whether it generates functionally correct programs and demonstrate that it achieves equivalent or better performance than similarly sized models, such as CodeX, while attending a smaller context window and training on less data.

This paper presents the development of a prototype Automatic Speech Recognition (ASR) system specifically designed for Bengali biomedical data. Recent advancements in Bengali ASR are encouraging, but a lack of domain-specific data limits the creation of practical healthcare ASR models. This project bridges this gap by developing an ASR system tailored for Bengali medical terms like symptoms, severity levels, and diseases, encompassing two major dialects: Bengali and Sylheti. We train and evaluate two popular ASR frameworks on a comprehensive 46-hour Bengali medical corpus. Our core objective is to create deployable health-domain ASR systems for digital health applications, ultimately increasing accessibility for non-technical users in the healthcare sector.

The proliferation of online toxic speech is a pertinent problem posing threats to demographic groups. While explicit toxic speech contains offensive lexical signals, implicit one consists of coded or indirect language. Therefore, it is crucial for models not only to detect implicit toxic speech but also to explain its toxicity. This draws a unique need for unified frameworks that can effectively detect and explain implicit toxic speech. Prior works mainly formulated the task of toxic speech detection and explanation as a text generation problem. Nonetheless, models trained using this strategy can be prone to suffer from the consequent error propagation problem. Moreover, our experiments reveal that the detection results of such models are much lower than those that focus only on the detection task. To bridge these gaps, we introduce ToXCL, a unified framework for the detection and explanation of implicit toxic speech. Our model consists of three modules: a (i) Target Group Generator to generate the targeted demographic group(s) of a given post; an (ii) Encoder-Decoder Model in which the encoder focuses on detecting implicit toxic speech and is boosted by a (iii) Teacher Classifier via knowledge distillation, and the decoder generates the necessary explanation. ToXCL achieves new state-of-the-art effectiveness, and outperforms baselines significantly.

This paper introduces Multimodal Speculative Decoding (MSD) to accelerate Multimodal Large Language Models (MLLMs) inference. Speculative decoding has been shown to accelerate Large Language Models (LLMs) without sacrificing accuracy. However, current speculative decoding methods for MLLMs fail to achieve the same speedup as they do for LLMs. To address this, we reimagine speculative decoding specifically for MLLMs. Our analysis of MLLM characteristics reveals two key design principles for MSD: (1) Text and visual tokens have fundamentally different characteristics and need to be processed separately during drafting. (2) Both language modeling ability and visual perception capability are crucial for the draft model. For the first principle, MSD decouples text and visual tokens in the draft model, allowing each to be handled based on its own characteristics. For the second principle, MSD uses a two-stage training strategy: In stage one, the draft model is trained on text-only instruction-tuning datasets to improve its language modeling ability. In stage two, MSD gradually introduces multimodal data to enhance the visual perception capability of the draft model. Experiments show that MSD boosts inference speed by up to 2.29times for LLaVA-1.5-7B and up to 2.46times for LLaVA-1.5-13B on multimodal benchmarks, demonstrating its effectiveness. Our code is available at https://github.com/Lyn-Lucy/MSD.

While speculative decoding has recently appeared as a promising direction for accelerating the inference of large language models (LLMs), the speedup and scalability are strongly bounded by the token acceptance rate. Prevalent methods usually organize predicted tokens as independent chains or fixed token trees, which fails to generalize to diverse query distributions. In this paper, we propose DySpec, a faster speculative decoding algorithm with a novel dynamic token tree structure. We begin by bridging the draft distribution and acceptance rate from intuitive and empirical clues, and successfully show that the two variables are strongly correlated. Based on this, we employ a greedy strategy to dynamically expand the token tree at run time. Theoretically, we show that our method can achieve optimal results under mild assumptions. Empirically, DySpec yields a higher acceptance rate and speedup than fixed trees. DySpec can drastically improve the throughput and reduce the latency of token generation across various data distribution and model sizes, which significantly outperforms strong competitors, including Specinfer and Sequoia. Under low temperature setting, DySpec can improve the throughput up to 9.1times and reduce the latency up to 9.4times on Llama2-70B. Under high temperature setting, DySpec can also improve the throughput up to 6.21times, despite the increasing difficulty of speculating more than one token per step for draft model.

Transducer and Attention based Encoder-Decoder (AED) are two widely used frameworks for speech-to-text tasks. They are designed for different purposes and each has its own benefits and drawbacks for speech-to-text tasks. In order to leverage strengths of both modeling methods, we propose a solution by combining Transducer and Attention based Encoder-Decoder (TAED) for speech-to-text tasks. The new method leverages AED's strength in non-monotonic sequence to sequence learning while retaining Transducer's streaming property. In the proposed framework, Transducer and AED share the same speech encoder. The predictor in Transducer is replaced by the decoder in the AED model, and the outputs of the decoder are conditioned on the speech inputs instead of outputs from an unconditioned language model. The proposed solution ensures that the model is optimized by covering all possible read/write scenarios and creates a matched environment for streaming applications. We evaluate the proposed approach on the MuST-C dataset and the findings demonstrate that TAED performs significantly better than Transducer for offline automatic speech recognition (ASR) and speech-to-text translation (ST) tasks. In the streaming case, TAED outperforms Transducer in the ASR task and one ST direction while comparable results are achieved in another translation direction.

Depression poses significant challenges to patients and healthcare organizations, necessitating efficient assessment methods. Existing paradigms typically focus on a patient-doctor way that overlooks multi-role interactions, such as family involvement in the evaluation and caregiving process. Moreover, current automatic depression detection (ADD) methods usually model depression detection as a classification or regression task, lacking interpretability for the decision-making process. To address these issues, we developed InterMind, a doctor-patient-family interactive depression assessment system empowered by large language models (LLMs). Our system enables patients and families to contribute descriptions, generates assistive diagnostic reports for doctors, and provides actionable insights, improving diagnostic precision and efficiency. To enhance LLMs' performance in psychological counseling and diagnostic interpretability, we integrate retrieval-augmented generation (RAG) and chain-of-thoughts (CoT) techniques for data augmentation, which mitigates the hallucination issue of LLMs in specific scenarios after instruction fine-tuning. Quantitative experiments and professional assessments by clinicians validate the effectiveness of our system.

Speech brain-computer interfaces aim to decipher what a person is trying to say from neural activity alone, restoring communication to people with paralysis who have lost the ability to speak intelligibly. The Brain-to-Text Benchmark '24 and associated competition was created to foster the advancement of decoding algorithms that convert neural activity to text. Here, we summarize the lessons learned from the competition ending on June 1, 2024 (the top 4 entrants also presented their experiences in a recorded webinar). The largest improvements in accuracy were achieved using an ensembling approach, where the output of multiple independent decoders was merged using a fine-tuned large language model (an approach used by all 3 top entrants). Performance gains were also found by improving how the baseline recurrent neural network (RNN) model was trained, including by optimizing learning rate scheduling and by using a diphone training objective. Improving upon the model architecture itself proved more difficult, however, with attempts to use deep state space models or transformers not yet appearing to offer a benefit over the RNN baseline. The benchmark will remain open indefinitely to support further work towards increasing the accuracy of brain-to-text algorithms.

The COVID-19 pandemic swept across the world rapidly, infecting millions of people. An efficient tool that can accurately recognize important clinical concepts of COVID-19 from free text in electronic health records (EHRs) will be valuable to accelerate COVID-19 clinical research. To this end, this study aims at adapting the existing CLAMP natural language processing tool to quickly build COVID-19 SignSym, which can extract COVID-19 signs/symptoms and their 8 attributes (body location, severity, temporal expression, subject, condition, uncertainty, negation, and course) from clinical text. The extracted information is also mapped to standard concepts in the Observational Medical Outcomes Partnership common data model. A hybrid approach of combining deep learning-based models, curated lexicons, and pattern-based rules was applied to quickly build the COVID-19 SignSym from CLAMP, with optimized performance. Our extensive evaluation using 3 external sites with clinical notes of COVID-19 patients, as well as the online medical dialogues of COVID-19, shows COVID-19 Sign-Sym can achieve high performance across data sources. The workflow used for this study can be generalized to other use cases, where existing clinical natural language processing tools need to be customized for specific information needs within a short time. COVID-19 SignSym is freely accessible to the research community as a downloadable package (https://clamp.uth.edu/covid/nlp.php) and has been used by 16 healthcare organizations to support clinical research of COVID-19.

Speculative decoding is a relatively new decoding framework that leverages small and efficient draft models to reduce the latency of LLMs. In this study, we introduce GliDe and CaPE, two low-hassle modifications to vanilla speculative decoding to further improve the decoding speed of a frozen LLM. Specifically, GliDe is a modified draft model architecture that reuses the cached keys and values from the target LLM, while CaPE is a proposal expansion method that uses the draft model's confidence scores to help select additional candidate tokens for verification. Extensive experiments on different benchmarks demonstrate that our proposed GliDe draft model significantly reduces the expected decoding latency. Additional evaluation using walltime reveals that GliDe can accelerate Vicuna models up to 2.17x and further extend the improvement to 2.61x with CaPE. We will release our code, data, and the trained draft models.

Given the dominance of dense retrievers that do not generalize well beyond their training dataset distributions, domain-specific test sets are essential in evaluating retrieval. There are few test datasets for retrieval systems intended for use by healthcare providers in a point-of-care setting. To fill this gap we have collaborated with medical professionals to create CURE, an ad-hoc retrieval test dataset for passage ranking with 2000 queries spanning 10 medical domains with a monolingual (English) and two cross-lingual (French/Spanish -> English) conditions. In this paper, we describe how CURE was constructed and provide baseline results to showcase its effectiveness as an evaluation tool. CURE is published with a Creative Commons Attribution Non Commercial 4.0 license and can be accessed on Hugging Face.

While the general machine learning (ML) community has benefited from public datasets, tasks, and models, the progress of ML in healthcare has been hampered by a lack of such shared assets. The success of foundation models creates new challenges for healthcare ML by requiring access to shared pretrained models to validate performance benefits. We help address these challenges through three contributions. First, we publish a new dataset, EHRSHOT, which contains deidentified structured data from the electronic health records (EHRs) of 6,739 patients from Stanford Medicine. Unlike MIMIC-III/IV and other popular EHR datasets, EHRSHOT is longitudinal and not restricted to ICU/ED patients. Second, we publish the weights of CLMBR-T-base, a 141M parameter clinical foundation model pretrained on the structured EHR data of 2.57M patients. We are one of the first to fully release such a model for coded EHR data; in contrast, most prior models released for clinical data (e.g. GatorTron, ClinicalBERT) only work with unstructured text and cannot process the rich, structured data within an EHR. We provide an end-to-end pipeline for the community to validate and build upon its performance. Third, we define 15 few-shot clinical prediction tasks, enabling evaluation of foundation models on benefits such as sample efficiency and task adaptation. Our model and dataset are available via a research data use agreement from the Stanford AIMI Center. Code to reproduce our results are available at our Github repo: https://github.com/som-shahlab/ehrshot-benchmark

Learning to represent free text is a core task in many clinical machine learning (ML) applications, as clinical text contains observations and plans not otherwise available for inference. State-of-the-art methods use large language models developed with immense computational resources and training data; however, applying these models is challenging because of the highly varying syntax and vocabulary in clinical free text. Structured information such as International Classification of Disease (ICD) codes often succinctly abstracts the most important facts of a clinical encounter and yields good performance, but is often not as available as clinical text in real-world scenarios. We propose a multi-view learning framework that jointly learns from codes and text to combine the availability and forward-looking nature of text and better performance of ICD codes. The learned text embeddings can be used as inputs to predictive algorithms independent of the ICD codes during inference. Our approach uses a Graph Neural Network (GNN) to process ICD codes, and Bi-LSTM to process text. We apply Deep Canonical Correlation Analysis (DCCA) to enforce the two views to learn a similar representation of each patient. In experiments using planned surgical procedure text, our model outperforms BERT models fine-tuned to clinical data, and in experiments using diverse text in MIMIC-III, our model is competitive to a fine-tuned BERT at a tiny fraction of its computational effort.

Interpreting electrocardiograms (ECGs) and generating comprehensive reports remain challenging tasks in cardiology, often requiring specialized expertise and significant time investment. To address these critical issues, we propose ECG-ReGen, a retrieval-based approach for ECG-to-text report generation and question answering. Our method leverages a self-supervised learning for the ECG encoder, enabling efficient similarity searches and report retrieval. By combining pre-training with dynamic retrieval and Large Language Model (LLM)-based refinement, ECG-ReGen effectively analyzes ECG data and answers related queries, with the potential of improving patient care. Experiments conducted on the PTB-XL and MIMIC-IV-ECG datasets demonstrate superior performance in both in-domain and cross-domain scenarios for report generation. Furthermore, our approach exhibits competitive performance on ECG-QA dataset compared to fully supervised methods when utilizing off-the-shelf LLMs for zero-shot question answering. This approach, effectively combining self-supervised encoder and LLMs, offers a scalable and efficient solution for accurate ECG interpretation, holding significant potential to enhance clinical decision-making.

Speculative Decoding (SD) is a technique to accelerate the inference of Large Language Models (LLMs) by using a lower complexity draft model to propose candidate tokens verified by a larger target model. To further improve efficiency, Multi-Candidate Speculative Decoding (MCSD) improves upon this by sampling multiple candidate tokens from the draft model at each step and verifying them in parallel, thus increasing the chances of accepting a token and reducing generation time. Existing MCSD methods rely on the draft model to initialize the multi-candidate sequences and use static length and tree attention structure for draft generation. However, such an approach suffers from the draft and target model's output distribution differences, especially in dynamic generation context. In this work, we introduce an improved version of MCSD that includes a target model initialized multi-candidate process, dynamic sliced topology-aware causal mask for dynamic length adjustment, and decision models to optimize early stopping. Our framework improves the acceptance rate, defined as the ratio of the longest draft sequence length accepted by the target model over the maximum draft sequence length, by a maximum of 164% and gains a maximum of 75% generation speed up over the MCSD baseline. We also conduct an ablation study to evaluate the impact of the decision model.

Medical coding is essential for standardizing clinical data and communication but is often time-consuming and prone to errors. Traditional Natural Language Processing (NLP) methods struggle with automating coding due to the large label space, lengthy text inputs, and the absence of supporting evidence annotations that justify code selection. Recent advancements in Generative Artificial Intelligence (AI) offer promising solutions to these challenges. In this work, we introduce MedCodER, a Generative AI framework for automatic medical coding that leverages extraction, retrieval, and re-ranking techniques as core components. MedCodER achieves a micro-F1 score of 0.60 on International Classification of Diseases (ICD) code prediction, significantly outperforming state-of-the-art methods. Additionally, we present a new dataset containing medical records annotated with disease diagnoses, ICD codes, and supporting evidence texts (https://doi.org/10.5281/zenodo.13308316). Ablation tests confirm that MedCodER's performance depends on the integration of each of its aforementioned components, as performance declines when these components are evaluated in isolation.

Clinical diagnosis prediction models, when provided with a patient's medical history, aim to detect potential diseases early, facilitating timely intervention and improving prognostic outcomes. However, the inherent scarcity of patient data and large disease candidate space often pose challenges in developing satisfactory models for this intricate task. The exploration of leveraging Large Language Models (LLMs) for encapsulating clinical decision processes has been limited. We introduce MERA, a clinical diagnosis prediction model that bridges pertaining natural language knowledge with medical practice. We apply hierarchical contrastive learning on a disease candidate ranking list to alleviate the large decision space issue. With concept memorization through fine-tuning, we bridge the natural language clinical knowledge with medical codes. Experimental results on MIMIC-III and IV datasets show that MERA achieves the state-of-the-art diagnosis prediction performance and dramatically elevates the diagnosis prediction capabilities of generative LMs.

Background: Electronic Health Records hold detailed longitudinal information about each patient's health status and general clinical history, a large portion of which is stored within the unstructured text. Existing approaches focus mostly on structured data and a subset of single-domain outcomes. We explore how temporal modelling of patients from free text and structured data, using deep generative transformers can be used to forecast a wide range of future disorders, substances, procedures or findings. Methods: We present Foresight, a novel transformer-based pipeline that uses named entity recognition and linking tools to convert document text into structured, coded concepts, followed by providing probabilistic forecasts for future medical events such as disorders, substances, procedures and findings. We processed the entire free-text portion from three different hospital datasets totalling 811336 patients covering both physical and mental health. Findings: On tests in two UK hospitals (King's College Hospital, South London and Maudsley) and the US MIMIC-III dataset precision@10 0.68, 0.76 and 0.88 was achieved for forecasting the next disorder in a patient timeline, while precision@10 of 0.80, 0.81 and 0.91 was achieved for forecasting the next biomedical concept. Foresight was also validated on 34 synthetic patient timelines by five clinicians and achieved relevancy of 97% for the top forecasted candidate disorder. As a generative model, it can forecast follow-on biomedical concepts for as many steps as required. Interpretation: Foresight is a general-purpose model for biomedical concept modelling that can be used for real-world risk forecasting, virtual trials and clinical research to study the progression of disorders, simulate interventions and counterfactuals, and educational purposes.

Millions of users share their experiences on social media sites, such as Twitter, which in turn generate valuable data for public health monitoring, digital epidemiology, and other analyses of population health at global scale. The first, critical, task for these applications is classifying whether a personal health event was mentioned, which we call the (PHM) problem. This task is challenging for many reasons, including typically short length of social media posts, inventive spelling and lexicons, and figurative language, including hyperbole using diseases like "heart attack" or "cancer" for emphasis, and not as a health self-report. This problem is even more challenging for rarely reported, or frequent but ambiguously expressed conditions, such as "stroke". To address this problem, we propose a general, robust method for detecting PHMs in social media, which we call WESPAD, that combines lexical, syntactic, word embedding-based, and context-based features. WESPAD is able to generalize from few examples by automatically distorting the word embedding space to most effectively detect the true health mentions. Unlike previously proposed state-of-the-art supervised and deep-learning techniques, WESPAD requires relatively little training data, which makes it possible to adapt, with minimal effort, to each new disease and condition. We evaluate WESPAD on both an established publicly available Flu detection benchmark, and on a new dataset that we have constructed with mentions of multiple health conditions. Our experiments show that WESPAD outperforms the baselines and state-of-the-art methods, especially in cases when the number and proportion of true health mentions in the training data is small.

In the era of Large Language Models (LLMs), given their remarkable text understanding and generation abilities, there is an unprecedented opportunity to develop new, LLM-based methods for trustworthy medical knowledge synthesis, extraction and summarization. This paper focuses on the problem of Pharmacovigilance (PhV), where the significance and challenges lie in identifying Adverse Drug Events (ADEs) from diverse text sources, such as medical literature, clinical notes, and drug labels. Unfortunately, this task is hindered by factors including variations in the terminologies of drugs and outcomes, and ADE descriptions often being buried in large amounts of narrative text. We present MALADE, the first effective collaborative multi-agent system powered by LLM with Retrieval Augmented Generation for ADE extraction from drug label data. This technique involves augmenting a query to an LLM with relevant information extracted from text resources, and instructing the LLM to compose a response consistent with the augmented data. MALADE is a general LLM-agnostic architecture, and its unique capabilities are: (1) leveraging a variety of external sources, such as medical literature, drug labels, and FDA tools (e.g., OpenFDA drug information API), (2) extracting drug-outcome association in a structured format along with the strength of the association, and (3) providing explanations for established associations. Instantiated with GPT-4 Turbo or GPT-4o, and FDA drug label data, MALADE demonstrates its efficacy with an Area Under ROC Curve of 0.90 against the OMOP Ground Truth table of ADEs. Our implementation leverages the Langroid multi-agent LLM framework and can be found at https://github.com/jihyechoi77/malade.

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.

To mitigate the high inference latency stemming from autoregressive decoding in Large Language Models (LLMs), Speculative Decoding has emerged as a novel decoding paradigm for LLM inference. In each decoding step, this method first efficiently drafts several future tokens and then verifies them in parallel. Unlike autoregressive decoding, Speculative Decoding facilitates the simultaneous decoding of multiple tokens per step, thereby accelerating inference. This paper presents a comprehensive overview and analysis of this promising decoding paradigm. We begin by providing a formal definition and formulation of Speculative Decoding. Then, we organize in-depth discussions on its key facets, including current leading techniques, the challenges faced, and potential future directions in this field. We aim for this work to serve as a catalyst for further research on Speculative Decoding, ultimately contributing to more efficient LLM inference.

Speech patterns have been identified as potential diagnostic markers for neuropsychiatric conditions. However, most studies only compare a single clinical group to healthy controls, whereas clinical practice often requires differentiating between multiple potential diagnoses (multiclass settings). To address this, we assembled a dataset of repeated recordings from 420 participants (67 with major depressive disorder, 106 with schizophrenia and 46 with autism, as well as matched controls), and tested the performance of a range of conventional machine learning models and advanced Transformer models on both binary and multiclass classification, based on voice and text features. While binary models performed comparably to previous research (F1 scores between 0.54-0.75 for autism spectrum disorder, ASD; 0.67-0.92 for major depressive disorder, MDD; and 0.71-0.83 for schizophrenia); when differentiating between multiple diagnostic groups performance decreased markedly (F1 scores between 0.35-0.44 for ASD, 0.57-0.75 for MDD, 0.15-0.66 for schizophrenia, and 0.38-0.52 macro F1). Combining voice and text-based models yielded increased performance, suggesting that they capture complementary diagnostic information. Our results indicate that models trained on binary classification may learn to rely on markers of generic differences between clinical and non-clinical populations, or markers of clinical features that overlap across conditions, rather than identifying markers specific to individual conditions. We provide recommendations for future research in the field, suggesting increased focus on developing larger transdiagnostic datasets that include more fine-grained clinical features, and that can support the development of models that better capture the complexity of neuropsychiatric conditions and naturalistic diagnostic assessment.

Chest X-Ray (CXR) report generation is a promising approach to improving the efficiency of CXR interpretation. However, a significant increase in diagnostic accuracy is required before that can be realised. Motivated by this, we propose a framework that is more inline with a radiologist's workflow by considering longitudinal data. Here, the decoder is additionally conditioned on the report from the subject's previous imaging study via a prompt. We also propose a new reward for reinforcement learning based on CXR-BERT, which computes the similarity between reports. We conduct experiments on the MIMIC-CXR dataset. The results indicate that longitudinal data improves CXR report generation. CXR-BERT is also shown to be a promising alternative to the current state-of-the-art reward based on RadGraph. This investigation indicates that longitudinal CXR report generation can offer a substantial increase in diagnostic accuracy. Our Hugging Face model is available at: https://huggingface.co/aehrc/cxrmate and code is available at: https://github.com/aehrc/cxrmate.

We demonstrate that carefully adjusting the tokenizer of the Whisper speech recognition model significantly improves the precision of word-level timestamps when applying dynamic time warping to the decoder's cross-attention scores. We fine-tune the model to produce more verbatim speech transcriptions and employ several techniques to increase robustness against multiple speakers and background noise. These adjustments achieve state-of-the-art performance on benchmarks for verbatim speech transcription, word segmentation, and the timed detection of filler events, and can further mitigate transcription hallucinations. The code is available open https://github.com/nyrahealth/CrisperWhisper.

The sequence-to-sequence (seq2seq) task aims at generating the target sequence based on the given input source sequence. Traditionally, most of the seq2seq task is resolved by the Encoder-Decoder framework which requires an encoder to encode the source sequence and a decoder to generate the target text. Recently, a bunch of new approaches have emerged that apply decoder-only language models directly to the seq2seq task. Despite the significant advancements in applying language models to the seq2seq task, there is still a lack of thorough analysis on the effectiveness of the decoder-only language model architecture. This paper aims to address this gap by conducting a detailed comparison between the encoder-decoder architecture and the decoder-only language model framework through the analysis of a regularized encoder-decoder structure. This structure is designed to replicate all behaviors in the classical decoder-only language model but has an encoder and a decoder making it easier to be compared with the classical encoder-decoder structure. Based on the analysis, we unveil the attention degeneration problem in the language model, namely, as the generation step number grows, less and less attention is focused on the source sequence. To give a quantitative understanding of this problem, we conduct a theoretical sensitivity analysis of the attention output with respect to the source input. Grounded on our analysis, we propose a novel partial attention language model to solve the attention degeneration problem. Experimental results on machine translation, summarization, and data-to-text generation tasks support our analysis and demonstrate the effectiveness of our proposed model.

Automatically summarizing patients' main problems from daily progress notes using natural language processing methods helps to battle against information and cognitive overload in hospital settings and potentially assists providers with computerized diagnostic decision support. Problem list summarization requires a model to understand, abstract, and generate clinical documentation. In this work, we propose a new NLP task that aims to generate a list of problems in a patient's daily care plan using input from the provider's progress notes during hospitalization. We investigate the performance of T5 and BART, two state-of-the-art seq2seq transformer architectures, in solving this problem. We provide a corpus built on top of progress notes from publicly available electronic health record progress notes in the Medical Information Mart for Intensive Care (MIMIC)-III. T5 and BART are trained on general domain text, and we experiment with a data augmentation method and a domain adaptation pre-training method to increase exposure to medical vocabulary and knowledge. Evaluation methods include ROUGE, BERTScore, cosine similarity on sentence embedding, and F-score on medical concepts. Results show that T5 with domain adaptive pre-training achieves significant performance gains compared to a rule-based system and general domain pre-trained language models, indicating a promising direction for tackling the problem summarization task.

Automatic coding of International Classification of Diseases (ICD) is a multi-label text categorization task that involves extracting disease or procedure codes from clinical notes. Despite the application of state-of-the-art natural language processing (NLP) techniques, there are still challenges including limited availability of data due to privacy constraints and the high variability of clinical notes caused by different writing habits of medical professionals and various pathological features of patients. In this work, we investigate the semi-structured nature of clinical notes and propose an automatic algorithm to segment them into sections. To address the variability issues in existing ICD coding models with limited data, we introduce a contrastive pre-training approach on sections using a soft multi-label similarity metric based on tree edit distance. Additionally, we design a masked section training strategy to enable ICD coding models to locate sections related to ICD codes. Extensive experimental results demonstrate that our proposed training strategies effectively enhance the performance of existing ICD coding methods.

There has been a recent explosion of computer vision models which perform many tasks and are composed of an image encoder (usually a ViT) and an autoregressive decoder (usually a Transformer). However, most of this work simply presents one system and its results, leaving many questions regarding design decisions and trade-offs of such systems unanswered. In this work, we aim to provide such answers. We take a close look at autoregressive decoders for multi-task learning in multimodal computer vision, including classification, captioning, visual question answering, and optical character recognition. Through extensive systematic experiments, we study the effects of task and data mixture, training and regularization hyperparameters, conditioning type and specificity, modality combination, and more. Importantly, we compare these to well-tuned single-task baselines to highlight the cost incurred by multi-tasking. A key finding is that a small decoder learned on top of a frozen pretrained encoder works surprisingly well. We call this setup locked-image tuning with decoder (LiT-decoder). It can be seen as teaching a decoder to interact with a pretrained vision model via natural language.

This paper is dedicated to the design and evaluation of the first AMR parser tailored for clinical notes. Our objective was to facilitate the precise transformation of the clinical notes into structured AMR expressions, thereby enhancing the interpretability and usability of clinical text data at scale. Leveraging the colon cancer dataset from the Temporal Histories of Your Medical Events (THYME) corpus, we adapted a state-of-the-art AMR parser utilizing continuous training. Our approach incorporates data augmentation techniques to enhance the accuracy of AMR structure predictions. Notably, through this learning strategy, our parser achieved an impressive F1 score of 88% on the THYME corpus's colon cancer dataset. Moreover, our research delved into the efficacy of data required for domain adaptation within the realm of clinical notes, presenting domain adaptation data requirements for AMR parsing. This exploration not only underscores the parser's robust performance but also highlights its potential in facilitating a deeper understanding of clinical narratives through structured semantic representations.

Case definitions are essential for effectively communicating public health threats. However, the absence of a standardized, machine-readable format poses significant challenges to interoperability, epidemiological research, the exchange of qualitative data, and the effective application of computational analysis methods, including artificial intelligence (AI). This complicates comparisons and collaborations across organizations and regions, limits data integration, and hinders technological innovation in public health. To address these issues, we propose the first open, machine-readable format for representing case and syndrome definitions. Additionally, we introduce the first comprehensive dataset of standardized case definitions and tools to convert existing human-readable definitions into machine-readable formats. We also provide an accessible online platform for browsing, analyzing, and contributing new definitions, available at https://opensyndrome.org. The Open Syndrome Definition format enables consistent, scalable use of case definitions across systems, unlocking AI's potential to strengthen public health preparedness and response. The source code for the format can be found at https://github.com/OpenSyndrome/schema under the MIT license.

Autoregressive decoding limits the efficiency of transformers for Machine Translation (MT). The community proposed specific network architectures and learning-based methods to solve this issue, which are expensive and require changes to the MT model, trading inference speed at the cost of the translation quality. In this paper, we propose to address the problem from the point of view of decoding algorithms, as a less explored but rather compelling direction. We propose to reframe the standard greedy autoregressive decoding of MT with a parallel formulation leveraging Jacobi and Gauss-Seidel fixed-point iteration methods for fast inference. This formulation allows to speed up existing models without training or modifications while retaining translation quality. We present three parallel decoding algorithms and test them on different languages and models showing how the parallelization introduces a speedup up to 38% w.r.t. the standard autoregressive decoding and nearly 2x when scaling the method on parallel resources. Finally, we introduce a decoding dependency graph visualizer (DDGviz) that let us see how the model has learned the conditional dependence between tokens and inspect the decoding procedure.

We propose Speculative Decoding (SpecDec), for the first time ever, to formally study exploiting the idea of speculative execution to accelerate autoregressive (AR) decoding. Speculative Decoding has two innovations: Spec-Drafter -- an independent model specially optimized for efficient and accurate drafting -- and Spec-Verification -- a reliable method for verifying the drafted tokens efficiently in the decoding paradigm. Experimental results on various seq2seq tasks including machine translation and abstractive summarization show our approach can achieve around 5times speedup for the popular Transformer architectures with comparable generation quality to beam search decoding, refreshing the impression that the draft-then-verify paradigm introduces only 1.4timessim2times speedup. In addition to the remarkable speedup, we also demonstrate 3 additional advantages of SpecDec, revealing its practical value for accelerating generative models in real-world applications. Our models and codes are available at https://github.com/hemingkx/SpecDec.

Depression is a global burden and one of the most challenging mental health conditions to control. Experts can detect its severity early using the Beck Depression Inventory (BDI) questionnaire, administer appropriate medication to patients, and impede its progression. Due to the fear of potential stigmatization, many patients turn to social media platforms like Reddit for advice and assistance at various stages of their journey. This research extracts text from Reddit to facilitate the diagnostic process. It employs a proposed labeling approach to categorize the text and subsequently fine-tunes the Longformer model. The model's performance is compared against baseline models, including Naive Bayes, Random Forest, Support Vector Machines, and Gradient Boosting. Our findings reveal that the Longformer model outperforms the baseline models in both English (48%) and Luganda (45%) languages on a custom-made dataset.

When asked to summarize articles or answer questions given a passage, large language models (LLMs) can hallucinate details and respond with unsubstantiated answers that are inaccurate with respect to the input context. This paper describes a simple approach for detecting such contextual hallucinations. We hypothesize that contextual hallucinations are related to the extent to which an LLM attends to information in the provided context versus its own generations. Based on this intuition, we propose a simple hallucination detection model whose input features are given by the ratio of attention weights on the context versus newly generated tokens (for each attention head). We find that a linear classifier based on these lookback ratio features is as effective as a richer detector that utilizes the entire hidden states of an LLM or a text-based entailment model. The lookback ratio-based detector -- Lookback Lens -- is found to transfer across tasks and even models, allowing a detector that is trained on a 7B model to be applied (without retraining) to a larger 13B model. We further apply this detector to mitigate contextual hallucinations, and find that a simple classifier-guided decoding approach is able to reduce the amount of hallucination, for example by 9.6% in the XSum summarization task.

A user-generated text on social media enables health workers to keep track of information, identify possible outbreaks, forecast disease trends, monitor emergency cases, and ascertain disease awareness and response to official health correspondence. This exchange of health information on social media has been regarded as an attempt to enhance public health surveillance (PHS). Despite its potential, the technology is still in its early stages and is not ready for widespread application. Advancements in pretrained language models (PLMs) have facilitated the development of several domain-specific PLMs and a variety of downstream applications. However, there are no PLMs for social media tasks involving PHS. We present and release PHS-BERT, a transformer-based PLM, to identify tasks related to public health surveillance on social media. We compared and benchmarked the performance of PHS-BERT on 25 datasets from different social medial platforms related to 7 different PHS tasks. Compared with existing PLMs that are mainly evaluated on limited tasks, PHS-BERT achieved state-of-the-art performance on all 25 tested datasets, showing that our PLM is robust and generalizable in the common PHS tasks. By making PHS-BERT available, we aim to facilitate the community to reduce the computational cost and introduce new baselines for future works across various PHS-related tasks.

The electrocardiogram (ECG) is an essential non-invasive diagnostic tool for assessing cardiac conditions. Existing automatic interpretation methods suffer from limited generalizability, focusing on a narrow range of cardiac conditions, and typically depend on raw physiological signals, which may not be readily available in resource-limited settings where only printed or digital ECG images are accessible. Recent advancements in multimodal large language models (MLLMs) present promising opportunities for addressing these challenges. However, the application of MLLMs to ECG image interpretation remains challenging due to the lack of instruction tuning datasets and well-established ECG image benchmarks for quantitative evaluation. To address these challenges, we introduce ECGInstruct, a comprehensive ECG image instruction tuning dataset of over one million samples, covering a wide range of ECG-related tasks from diverse data sources. Using ECGInstruct, we develop PULSE, an MLLM tailored for ECG image comprehension. In addition, we curate ECGBench, a new evaluation benchmark covering four key ECG image interpretation tasks across nine different datasets. Our experiments show that PULSE sets a new state-of-the-art, outperforming general MLLMs with an average accuracy improvement of 15% to 30%. This work highlights the potential of PULSE to enhance ECG interpretation in clinical practice.

The medical domain is vast and diverse, with many existing embedding models focused on general healthcare applications. However, these models often struggle to capture a deep understanding of diseases due to their broad generalization across the entire medical field. To address this gap, I present DisEmbed, a disease-focused embedding model. DisEmbed is trained on a synthetic dataset specifically curated to include disease descriptions, symptoms, and disease-related Q\&A pairs, making it uniquely suited for disease-related tasks. For evaluation, I benchmarked DisEmbed against existing medical models using disease-specific datasets and the triplet evaluation method. My results demonstrate that DisEmbed outperforms other models, particularly in identifying disease-related contexts and distinguishing between similar diseases. This makes DisEmbed highly valuable for disease-specific use cases, including retrieval-augmented generation (RAG) tasks, where its performance is particularly robust.

Depression and post traumatic stress disorder (PTSD) often co-occur with connected symptoms, complicating automated assessment, which is often binary and disorder specific. Clinically useful diagnosis needs severity aware cross disorder estimates and decision support explanations. Our unified tri modal affective severity framework synchronizes and fuses interview text with sentence level transformer embeddings, audio with log Mel statistics with deltas, and facial signals with action units, gaze, head and pose descriptors to output graded severities for diagnosing both depression (PHQ-8; 5 classes) and PTSD (3 classes). Standardized features are fused via a calibrated late fusion classifier, yielding per disorder probabilities and feature-level attributions. This severity aware tri-modal affective fusion approach is demoed on multi disorder concurrent depression and PTSD assessment. Stratified cross validation on DAIC derived corpora outperforms unimodal/ablation baselines. The fused model matches the strongest unimodal baseline on accuracy and weighted F1, while improving decision curve utility and robustness under noisy or missing modalities. For PTSD specifically, fusion reduces regression error and improves class concordance. Errors cluster between adjacent severities; extreme classes are identified reliably. Ablations show text contributes most to depression severity, audio and facial cues are critical for PTSD, whereas attributions align with linguistic and behavioral markers. Our approach offers reproducible evaluation and clinician in the loop support for affective clinical decision making.

Large language models (LLMs) excel at text generation, but their ability to handle clinical classification tasks involving structured data, such as time series, remains underexplored. In this work, we adapt instruction-tuned LLMs using DSPy-based prompt optimization to process clinical notes and structured EHR inputs jointly. Our results show that this approach achieves performance on par with specialized multimodal systems while requiring less complexity and offering greater adaptability across tasks.

We present X-Decoder, a generalized decoding model that can predict pixel-level segmentation and language tokens seamlessly. X-Decodert takes as input two types of queries: (i) generic non-semantic queries and (ii) semantic queries induced from text inputs, to decode different pixel-level and token-level outputs in the same semantic space. With such a novel design, X-Decoder is the first work that provides a unified way to support all types of image segmentation and a variety of vision-language (VL) tasks. Further, our design enables seamless interactions across tasks at different granularities and brings mutual benefits by learning a common and rich pixel-level visual-semantic understanding space, without any pseudo-labeling. After pretraining on a mixed set of a limited amount of segmentation data and millions of image-text pairs, X-Decoder exhibits strong transferability to a wide range of downstream tasks in both zero-shot and finetuning settings. Notably, it achieves (1) state-of-the-art results on open-vocabulary segmentation and referring segmentation on eight datasets; (2) better or competitive finetuned performance to other generalist and specialist models on segmentation and VL tasks; and (3) flexibility for efficient finetuning and novel task composition (e.g., referring captioning and image editing). Code, demo, video, and visualization are available at https://x-decoder-vl.github.io.

Automatic Speech Recognition (ASR) has seen remarkable progress, with models like OpenAI Whisper and NVIDIA Canary achieving state-of-the-art (SOTA) performance in offline transcription. However, these models are not designed for streaming (online or real-time) transcription, due to limitations in their architecture and training methodology. We propose a method to turn the transformer encoder-decoder model into a low-latency streaming model that is careless about future context. We present an analysis explaining why it is not straightforward to convert an encoder-decoder transformer to a low-latency streaming model. Our proposed method modifies the existing (non-causal) encoder to a causal encoder by fine-tuning both the encoder and decoder using Low-Rank Adaptation (LoRA) and a weakly aligned dataset. We then propose an updated inference mechanism that utilizes the fine-tune causal encoder and decoder to yield greedy and beam-search decoding, and is shown to be locally optimal. Experiments on low-latency chunk sizes (less than 300 msec) show that our fine-tuned model outperforms existing non-fine-tuned streaming approaches in most cases, while using a lower complexity. Additionally, we observe that our training process yields better alignment, enabling a simple method for extracting word-level timestamps. We release our training and inference code, along with the fine-tuned models, to support further research and development in streaming ASR.

Speculative decoding (SD) has emerged as a powerful method for accelerating autoregressive generation in large language models (LLMs), yet its integration into vision-language models (VLMs) remains underexplored. We introduce DREAM, a novel speculative decoding framework tailored for VLMs that combines three key innovations: (1) a cross-attention-based mechanism to inject intermediate features from the target model into the draft model for improved alignment, (2) adaptive intermediate feature selection based on attention entropy to guide efficient draft model training, and (3) visual token compression to reduce draft model latency. DREAM enables efficient, accurate, and parallel multimodal decoding with significant throughput improvement. Experiments across a diverse set of recent popular VLMs, including LLaVA, Pixtral, SmolVLM and Gemma3, demonstrate up to 3.6x speedup over conventional decoding and significantly outperform prior SD baselines in both inference throughput and speculative draft acceptance length across a broad range of multimodal benchmarks. The code is publicly available at: https://github.com/SAI-Lab-NYU/DREAM.git

We introduce a frustratingly simple, super efficient and surprisingly effective decoding method, which we call Frustratingly Simple Decoding (FSD), for neural text generation. The idea behind FSD is straightforward: we build an anti-LM based on previously generated text and use this anti-LM to penalize future generation of what has been generated. The anti-LM can be implemented as simple as an n-gram language model or a vectorized variant. In this way, FSD introduces no extra model parameters and negligible computational overhead (FSD can be as fast as greedy search). Despite the simplicity, FSD is surprisingly effective; Experiments show that FSD can outperform the canonical methods to date (i.e., nucleus sampling) as well as several strong baselines that were proposed recently.

Segmenting biomarkers in medical images is crucial for various biotech applications. Despite advances, Transformer and CNN based methods often struggle with variations in staining and morphology, limiting feature extraction. In medical image segmentation, where datasets often have limited sample availability, recent state-of-the-art (SOTA) methods achieve higher accuracy by leveraging pre-trained encoders, whereas end-to-end methods tend to underperform. This is due to challenges in effectively transferring rich multiscale features from encoders to decoders, as well as limitations in decoder efficiency. To address these issues, we propose an architecture that captures multi-scale local and global contextual information and a novel decoder design, which effectively integrates features from the encoder, emphasizes important channels and regions, and reconstructs spatial dimensions to enhance segmentation accuracy. Our method, compatible with various encoders, outperforms SOTA methods, as demonstrated by experiments on four datasets and ablation studies. Specifically, our method achieves absolute performance gains of 2.76% on MoNuSeg, 3.12% on DSB, 2.87% on Electron Microscopy, and 4.03% on TNBC datasets compared to existing SOTA methods. Code: https://github.com/saadwazir/MCADS-Decoder

Speculative Decoding is a widely used technique to speed up inference for Large Language Models (LLMs) without sacrificing quality. When performing inference, speculative decoding uses a smaller draft model to generate speculative tokens and then uses the target LLM to verify those draft tokens. The speedup provided by speculative decoding heavily depends on the choice of the draft model. In this work, we perform a detailed study comprising over 350 experiments with LLaMA-65B and OPT-66B using speculative decoding and delineate the factors that affect the performance gain provided by speculative decoding. Our experiments indicate that the performance of speculative decoding depends heavily on the latency of the draft model, and the draft model's capability in language modeling does not correlate strongly with its performance in speculative decoding. Based on these insights we explore a new design space for draft models and design hardware-efficient draft models for speculative decoding. Our newly designed draft model for LLaMA-65B can provide 60% higher throughput than existing draft models and can generalize further to the LLaMA-2 model family and supervised fine-tuned models.

Electrocardiogram (ECG) interpretation requires specialized expertise, often involving synthesizing insights from ECG signals with complex clinical queries posed in natural language. The scarcity of labeled ECG data coupled with the diverse nature of clinical inquiries presents a significant challenge for developing robust and adaptable ECG diagnostic systems. This work introduces a novel multimodal meta-learning method for few-shot ECG question answering, addressing the challenge of limited labeled data while leveraging the rich knowledge encoded within large language models (LLMs). Our LLM-agnostic approach integrates a pre-trained ECG encoder with a frozen LLM (e.g., LLaMA and Gemma) via a trainable fusion module, enabling the language model to reason about ECG data and generate clinically meaningful answers. Extensive experiments demonstrate superior generalization to unseen diagnostic tasks compared to supervised baselines, achieving notable performance even with limited ECG leads. For instance, in a 5-way 5-shot setting, our method using LLaMA-3.1-8B achieves accuracy of 84.6%, 77.3%, and 69.6% on single verify, choose and query question types, respectively. These results highlight the potential of our method to enhance clinical ECG interpretation by combining signal processing with the nuanced language understanding capabilities of LLMs, particularly in data-constrained scenarios.

Sleep is an essential component of human physiology, contributing significantly to overall health and quality of life. Accurate sleep staging and disorder detection are crucial for assessing sleep quality. Studies in the literature have proposed PSG-based approaches and machine-learning methods utilizing single-modality signals. However, existing methods often lack multimodal, multilabel frameworks and address sleep stages and disorders classification separately. In this paper, we propose a 1D-Vision Transformer for simultaneous classification of sleep stages and sleep disorders. Our method exploits the sleep disorders' correlation with specific sleep stage patterns and performs a simultaneous identification of a sleep stage and sleep disorder. The model is trained and tested using multimodal-multilabel sensory data (including photoplethysmogram, respiratory flow, and respiratory effort signals). The proposed method shows an overall accuracy (cohen's Kappa) of 78% (0.66) for five-stage sleep classification and 74% (0.58) for sleep apnea classification. Moreover, we analyzed the encoder attention weights to clarify our models' predictions and investigate the influence different features have on the models' outputs. The result shows that identified patterns, such as respiratory troughs and peaks, make a higher contribution to the final classification process.

Automatic program repair (APR) is crucial to improve software reliability. Recently, neural machine translation (NMT) techniques have been used to fix software bugs automatically. While promising, these approaches have two major limitations. Their search space often does not contain the correct fix, and their search strategy ignores software knowledge such as strict code syntax. Due to these limitations, existing NMT-based techniques underperform the best template-based approaches. We propose CURE, a new NMT-based APR technique with three major novelties. First, CURE pre-trains a programming language (PL) model on a large software codebase to learn developer-like source code before the APR task. Second, CURE designs a new code-aware search strategy that finds more correct fixes by focusing on compilable patches and patches that are close in length to the buggy code. Finally, CURE uses a subword tokenization technique to generate a smaller search space that contains more correct fixes. Our evaluation on two widely-used benchmarks shows that CURE correctly fixes 57 Defects4J bugs and 26 QuixBugs bugs, outperforming all existing APR techniques on both benchmarks.

Medical Visual Language Models have shown great potential in various healthcare applications, including medical image captioning and diagnostic assistance. However, most existing models rely on text-based instructions, limiting their usability in real-world clinical environments especially in scenarios such as surgery, text-based interaction is often impractical for physicians. In addition, current medical image analysis models typically lack comprehensive reasoning behind their predictions, which reduces their reliability for clinical decision-making. Given that medical diagnosis errors can have life-changing consequences, there is a critical need for interpretable and rational medical assistance. To address these challenges, we introduce an end-to-end speech-driven medical VLM, SilVar-Med, a multimodal medical image assistant that integrates speech interaction with VLMs, pioneering the task of voice-based communication for medical image analysis. In addition, we focus on the interpretation of the reasoning behind each prediction of medical abnormalities with a proposed reasoning dataset. Through extensive experiments, we demonstrate a proof-of-concept study for reasoning-driven medical image interpretation with end-to-end speech interaction. We believe this work will advance the field of medical AI by fostering more transparent, interactive, and clinically viable diagnostic support systems. Our code and dataset are publicly available at SiVar-Med.

In recent years, there is strong emphasis on mining medical data using machine learning techniques. A common problem is to obtain a noiseless set of textual documents, with a relevant content for the research question, and developing a Question Answering (QA) model for a specific medical field. The purpose of this paper is to present a new methodology for building a medical dataset and obtain a QA model for analysis of symptoms and impact on daily life for a specific disease domain. The ``Mental Health'' forum was used, a forum dedicated to people suffering from schizophrenia and different mental disorders. Relevant posts of active users, who regularly participate, were extrapolated providing a new method of obtaining low-bias content and without privacy issues. Furthermore, it is shown how to pre-process the dataset to convert it into a QA dataset. The Bidirectional Encoder Representations from Transformers (BERT), DistilBERT, RoBERTa, and BioBERT models were fine-tuned and evaluated via F1-Score, Exact Match, Precision and Recall. Accurate empirical experiments demonstrated the effectiveness of the proposed method for obtaining an accurate dataset for QA model implementation. By fine-tuning the BioBERT QA model, we achieved an F1 score of 0.885, showing a considerable improvement and outperforming the state-of-the-art model for mental disorders domain.

This technical report introduces a Named Clinical Entity Recognition Benchmark for evaluating language models in healthcare, addressing the crucial natural language processing (NLP) task of extracting structured information from clinical narratives to support applications like automated coding, clinical trial cohort identification, and clinical decision support. The leaderboard provides a standardized platform for assessing diverse language models, including encoder and decoder architectures, on their ability to identify and classify clinical entities across multiple medical domains. A curated collection of openly available clinical datasets is utilized, encompassing entities such as diseases, symptoms, medications, procedures, and laboratory measurements. Importantly, these entities are standardized according to the Observational Medical Outcomes Partnership (OMOP) Common Data Model, ensuring consistency and interoperability across different healthcare systems and datasets, and a comprehensive evaluation of model performance. Performance of models is primarily assessed using the F1-score, and it is complemented by various assessment modes to provide comprehensive insights into model performance. The report also includes a brief analysis of models evaluated to date, highlighting observed trends and limitations. By establishing this benchmarking framework, the leaderboard aims to promote transparency, facilitate comparative analyses, and drive innovation in clinical entity recognition tasks, addressing the need for robust evaluation methods in healthcare NLP.

Following each patient visit, physicians draft long semi-structured clinical summaries called SOAP notes. While invaluable to clinicians and researchers, creating digital SOAP notes is burdensome, contributing to physician burnout. In this paper, we introduce the first complete pipelines to leverage deep summarization models to generate these notes based on transcripts of conversations between physicians and patients. After exploring a spectrum of methods across the extractive-abstractive spectrum, we propose Cluster2Sent, an algorithm that (i) extracts important utterances relevant to each summary section; (ii) clusters together related utterances; and then (iii) generates one summary sentence per cluster. Cluster2Sent outperforms its purely abstractive counterpart by 8 ROUGE-1 points, and produces significantly more factual and coherent sentences as assessed by expert human evaluators. For reproducibility, we demonstrate similar benefits on the publicly available AMI dataset. Our results speak to the benefits of structuring summaries into sections and annotating supporting evidence when constructing summarization corpora.

Multimodal large language models (MLLMs) have recently achieved remarkable progress in radiology by integrating visual perception with natural language understanding. However, they often generate clinically unsupported descriptions, known as medical hallucinations, which pose serious risks in medical applications that demand accuracy and image-grounded outputs. Through empirical analysis, we find that prompt-induced hallucinations remain prevalent in radiology MLLMs, largely due to over-sensitivity to clinical sections. To address this, we introduce Clinical Contrastive Cecoding (CCD), a training-free and retrieval-free inference framework that integrates structured clinical signals from task-specific radiology expert models. CCD introduces a dual-stage contrastive mechanism to refine token-level logits during generation, thereby enhancing clinical fidelity without modifying the base MLLM. Experiments on three datasets and multiple models demonstrate that CCD consistently improves overall performance on radiology report generation (RRG). On the MIMIC-CXR dataset, it yields up to a 17% improvement in RadGraph-F1 when applied to state-of-the-art RRG models. Our approach provides a lightweight and generalisable solution for mitigating medical hallucinations, effectively bridging expert models and MLLMs in radiology.

Deployment of autoregressive large language models (LLMs) is costly, and as these models increase in size, the associated costs will become even more considerable. Consequently, different methods have been proposed to accelerate the token generation process and reduce costs. Speculative decoding (SD) is among the most promising approaches to speed up the LLM decoding process by verifying multiple tokens in parallel and using an auxiliary smaller draft model to generate the possible tokens. In SD, usually, one draft model is used to serve a specific target model; however, in practice, LLMs are diverse, and we might need to deal with many target models or more than one target model simultaneously. In this scenario, it is not clear which draft model should be used for which target model, and searching among different draft models or training customized draft models can further increase deployment costs. In this paper, we first introduce a novel multi-target scenario for the deployment of draft models for faster inference. Then, we present a novel, more efficient sorted speculative decoding mechanism that outperforms regular baselines in multi-target settings. We evaluated our method on Spec-Bench in different settings, including base models such as Vicuna 7B, 13B, and LLama Chat 70B. Our results suggest that our draft models perform better than baselines for multiple target models at the same time.

In today's interconnected globe, moving abroad is more and more prevalent, whether it's for employment, refugee resettlement, or other causes. Language difficulties between natives and immigrants present a common issue on a daily basis, especially in medical domain. This can make it difficult for patients and doctors to communicate during anamnesis or in the emergency room, which compromises patient care. The goal of the HYKIST Project is to develop a speech translation system to support patient-doctor communication with ASR and MT. ASR systems have recently displayed astounding performance on particular tasks for which enough quantities of training data are available, such as LibriSpeech. Building a good model is still difficult due to a variety of speaking styles, acoustic and recording settings, and a lack of in-domain training data. In this thesis, we describe our efforts to construct ASR systems for a conversational telephone speech recognition task in the medical domain for Vietnamese language to assist emergency room contact between doctors and patients across linguistic barriers. In order to enhance the system's performance, we investigate various training schedules and data combining strategies. We also examine how best to make use of the little data that is available. The use of publicly accessible models like XLSR-53 is compared to the use of customized pre-trained models, and both supervised and unsupervised approaches are utilized using wav2vec 2.0 as architecture.

Language models trained on large amounts of data require careful tuning to be safely deployed in real world. We revisit the guided decoding paradigm, where the goal is to augment the logits of the base language model using the scores from a task-specific reward model. We propose a simple but efficient parameterization of the autoregressive reward model enabling fast and effective guided decoding. On detoxification and sentiment control tasks, we show that our efficient parameterization performs on par with RAD, a strong but less efficient guided decoding approach.

Objective: Data unavailability has been one of the biggest barriers in clinical natural language processing. This paper is aimed at providing a large-scale and publicly available patient note dataset, named PMC-Patients, with relevant articles and similar patients annotations. The ultimate goal of PMC-Patients is to facilitate the development of retrieval-based clinical decision support systems. Materials and Methods: To collect PMC-Patients, we extract patient notes from case reports in PubMed Central by recognizing certain section patterns. Patient-article relevance and patient-patient similarity are annotated by citation relationships in PubMed. In addition, we perform three tasks with PMC-Patients to demonstrate its utility in providing clinical decision support for a given patient, including (1) classifying whether another patient is similar, (2) retrieving similar patients in PMC-Patients, and (3) retrieving relevant articles in PubMed. Results: We collect and release PMC-Patients under the CC BY-NC-SA license, which becomes the largest publicly available patient note dataset so far. PMC-Patients contains 167k patient notes that are annotated with 3.1M relevant articles and 293k similar patients. Qualitative and quantitative analyses reveal the high quality and richness of our dataset. Experiments show that classifying the similarity of patient pairs is relatively easy, but it is hard to retrieve similar patients or relevant articles for a given patient from a large set of candidates. Conclusion: We present PMC-Patients, a large-scale dataset of patient notes with high quality, easy access, diverse conditions, and rich annotations. The proposed dataset can also serve as a hard benchmark for evaluating retrieval-based clinical decision support systems.

Accurate and interpretable multi-disease diagnosis remains a critical challenge in medical research, particularly when leveraging heterogeneous multimodal medical data. Current approaches often rely on single-modal data, limiting their ability to comprehensively understand complex diseases. To address this, we propose MedTVT-R1, a novel Multimodal Large Language Model (MLLM) framework designed to integrate clinical multimodal data for reasoning and diagnosing multiple diseases. We construct MedTVT-QA, a curated instruction dataset that provides question-answer pairs for physiological-level interpretations and disease-level diagnoses with a Chain of Evidence approach. MedTVT-R1 incorporates a modality perception layer to capture inter-modal dependencies and adaptively weight modality contributions. Additionally, we employ Group Relative Policy Optimization (GRPO)-based Reinforcement Fine-Tuning with a Jaccard Reward function to enhance diagnostic reasoning. Experimental results demonstrate MedTVT-R1's superiority in multimodal feature utilization and multi-disease diagnosis, offering significant potential for clinical applications such as diagnostic report generation and comorbidity reasoning. The dataset and code are available at https://github.com/keke-nice/MedTVT-R1.

Recruiting patients to participate in clinical trials can be challenging and time-consuming. Usually, participation in a clinical trial is initiated by a healthcare professional and proposed to the patient. Promoting clinical trials directly to patients via online recruitment might help to reach them more efficiently. In this study, we address the case where a patient is initiating their own recruitment process and wants to determine whether they are eligible for a given clinical trial, using their own language to describe their medical profile. To study whether this creates difficulties in the patient trial matching process, we design a new dataset and task, Natural Language Inference for Patient Recruitment (NLI4PR), in which patient language profiles must be matched to clinical trials. We create it by adapting the TREC 2022 Clinical Trial Track dataset, which provides patients' medical profiles, and rephrasing them manually using patient language. We also use the associated clinical trial reports where the patients are either eligible or excluded. We prompt several open-source Large Language Models on our task and achieve from 56.5 to 71.8 of F1 score using patient language, against 64.7 to 73.1 for the same task using medical language. When using patient language, we observe only a small loss in performance for the best model, suggesting that having the patient as a starting point could be adopted to help recruit patients for clinical trials. The corpus and code bases are all freely available on our Github and HuggingFace repositories.

In this paper, we propose a novel neural network model called RNN Encoder-Decoder that consists of two recurrent neural networks (RNN). One RNN encodes a sequence of symbols into a fixed-length vector representation, and the other decodes the representation into another sequence of symbols. The encoder and decoder of the proposed model are jointly trained to maximize the conditional probability of a target sequence given a source sequence. The performance of a statistical machine translation system is empirically found to improve by using the conditional probabilities of phrase pairs computed by the RNN Encoder-Decoder as an additional feature in the existing log-linear model. Qualitatively, we show that the proposed model learns a semantically and syntactically meaningful representation of linguistic phrases.

Speculative decoding is a widely adopted technique for accelerating inference in large language models (LLMs), but its performance degrades on long inputs due to increased attention cost and reduced draft accuracy. We introduce SpecExtend, a drop-in enhancement that improves the performance of speculative decoding on long sequences without any additional training. SpecExtend integrates efficient attention mechanisms such as FlashAttention and Hybrid Tree Attention into both the draft and target models, reducing latency across all stages. To improve draft accuracy and speed, we propose Cross-model Retrieval, a novel KV cache update strategy that uses the target model's attention scores to dynamically select relevant context for the draft model. Extensive evaluations on three long-context understanding datasets show that SpecExtend accelerates standard tree-based speculative decoding by up to 2.22x for inputs up to 16K tokens, providing an effective solution for speculative decoding of long sequences. The code is available at https://github.com/jycha98/SpecExtend .

Prototype-based neural networks offer interpretable predictions by comparing inputs to learned, representative signal patterns anchored in training data. While such models have shown promise in the classification of physiological data, it remains unclear whether their prototypes capture an underlying structure that aligns with broader clinical phenotypes. We use a prototype-based deep learning model trained for multi-label ECG classification using the PTB-XL dataset. Then without modification we performed inference on the MIMIC-IV clinical database. We assess whether individual prototypes, trained solely for classification, are associated with hospital discharge diagnoses in the form of phecodes in this external population. Individual prototypes demonstrate significantly stronger and more specific associations with clinical outcomes compared to the classifier's class predictions, NLP-extracted concepts, or broader prototype classes across all phecode categories. Prototype classes with mixed significance patterns exhibit significantly greater intra-class distances (p < 0.0001), indicating the model learned to differentiate clinically meaningful variations within diagnostic categories. The prototypes achieve strong predictive performance across diverse conditions, with AUCs ranging from 0.89 for atrial fibrillation to 0.91 for heart failure, while also showing substantial signal for non-cardiac conditions such as sepsis and renal disease. These findings suggest that prototype-based models can support interpretable digital phenotyping from physiologic time-series data, providing transferable intermediate phenotypes that capture clinically meaningful physiologic signatures beyond their original training objectives.

This study aims to explore the implementation of Natural Language Processing (NLP) and machine learning (ML) techniques to automate the coding of medical letters with visualised explainability and light-weighted local computer settings. Currently in clinical settings, coding is a manual process that involves assigning codes to each condition, procedure, and medication in a patient's paperwork (e.g., 56265001 heart disease using SNOMED CT code). There are preliminary research on automatic coding in this field using state-of-the-art ML models; however, due to the complexity and size of the models, the real-world deployment is not achieved. To further facilitate the possibility of automatic coding practice, we explore some solutions in a local computer setting; in addition, we explore the function of explainability for transparency of AI models. We used the publicly available MIMIC-III database and the HAN/HLAN network models for ICD code prediction purposes. We also experimented with the mapping between ICD and SNOMED CT knowledge bases. In our experiments, the models provided useful information for 97.98\% of codes. The result of this investigation can shed some light on implementing automatic clinical coding in practice, such as in hospital settings, on the local computers used by clinicians , project page https://github.com/Glenj01/Medical-Coding.

In recent years, many interpretability methods have been proposed to help interpret the internal states of Transformer-models, at different levels of precision and complexity. Here, to analyze encoder-decoder Transformers, we propose a simple, new method: DecoderLens. Inspired by the LogitLens (for decoder-only Transformers), this method involves allowing the decoder to cross-attend representations of intermediate encoder layers instead of using the final encoder output, as is normally done in encoder-decoder models. The method thus maps previously uninterpretable vector representations to human-interpretable sequences of words or symbols. We report results from the DecoderLens applied to models trained on question answering, logical reasoning, speech recognition and machine translation. The DecoderLens reveals several specific subtasks that are solved at low or intermediate layers, shedding new light on the information flow inside the encoder component of this important class of models.

Linking clinical narratives to standardized vocabularies and coding systems is a key component of unlocking the information in medical text for analysis. However, many domains of medical concepts lack well-developed terminologies that can support effective coding of medical text. We present a framework for developing natural language processing (NLP) technologies for automated coding of under-studied types of medical information, and demonstrate its applicability via a case study on physical mobility function. Mobility is a component of many health measures, from post-acute care and surgical outcomes to chronic frailty and disability, and is coded in the International Classification of Functioning, Disability, and Health (ICF). However, mobility and other types of functional activity remain under-studied in medical informatics, and neither the ICF nor commonly-used medical terminologies capture functional status terminology in practice. We investigated two data-driven paradigms, classification and candidate selection, to link narrative observations of mobility to standardized ICF codes, using a dataset of clinical narratives from physical therapy encounters. Recent advances in language modeling and word embedding were used as features for established machine learning models and a novel deep learning approach, achieving a macro F-1 score of 84% on linking mobility activity reports to ICF codes. Both classification and candidate selection approaches present distinct strengths for automated coding in under-studied domains, and we highlight that the combination of (i) a small annotated data set; (ii) expert definitions of codes of interest; and (iii) a representative text corpus is sufficient to produce high-performing automated coding systems. This study has implications for the ongoing growth of NLP tools for a variety of specialized applications in clinical care and research.

This paper presents a novel multimodal framework to distinguish between different symptom classes of subjects in the schizophrenia spectrum and healthy controls using audio, video, and text modalities. We implemented Convolution Neural Network and Long Short Term Memory based unimodal models and experimented on various multimodal fusion approaches to come up with the proposed framework. We utilized a minimal Gated multimodal unit (mGMU) to obtain a bi-modal intermediate fusion of the features extracted from the input modalities before finally fusing the outputs of the bimodal fusions to perform subject-wise classifications. The use of mGMU units in the multimodal framework improved the performance in both weighted f1-score and weighted AUC-ROC scores.

Automatic depression detection from conversational data has gained significant interest in recent years. The DAIC-WOZ dataset, interviews conducted by a human-controlled virtual agent, has been widely used for this task. Recent studies have reported enhanced performance when incorporating interviewer's prompts into the model. In this work, we hypothesize that this improvement might be mainly due to a bias present in these prompts, rather than the proposed architectures and methods. Through ablation experiments and qualitative analysis, we discover that models using interviewer's prompts learn to focus on a specific region of the interviews, where questions about past experiences with mental health issues are asked, and use them as discriminative shortcuts to detect depressed participants. In contrast, models using participant responses gather evidence from across the entire interview. Finally, to highlight the magnitude of this bias, we achieve a 0.90 F1 score by intentionally exploiting it, the highest result reported to date on this dataset using only textual information. Our findings underline the need for caution when incorporating interviewers' prompts into models, as they may inadvertently learn to exploit targeted prompts, rather than learning to characterize the language and behavior that are genuinely indicative of the patient's mental health condition.

Speculative decoding (SD) accelerates large language model inference by using a smaller draft model to predict multiple tokens, which are then verified in parallel by the larger target model. However, the limited capacity of the draft model often necessitates tree-based sampling to improve prediction accuracy, where multiple candidates are generated at each step. We identify a key limitation in this approach: the candidates at the same step are derived from the same representation, limiting diversity and reducing overall effectiveness. To address this, we propose Jakiro, leveraging Mixture of Experts (MoE), where independent experts generate diverse predictions, effectively decoupling correlations among candidates. Furthermore, we introduce a hybrid inference strategy, combining autoregressive decoding for initial tokens with parallel decoding for subsequent stages, and enhance the latter with contrastive mechanism in features to improve accuracy. Our method significantly boosts prediction accuracy and achieves higher inference speedups. Extensive experiments across diverse models validate the effectiveness and robustness of our approach, establishing a new SOTA in speculative decoding. Our codes are available at https://github.com/haiduo/Jakiro.

Electrocardiograms (ECGs) are non-invasive diagnostic tools crucial for detecting cardiac arrhythmic diseases in clinical practice. While ECG Self-supervised Learning (eSSL) methods show promise in representation learning from unannotated ECG data, they often overlook the clinical knowledge that can be found in reports. This oversight and the requirement for annotated samples for downstream tasks limit eSSL's versatility. In this work, we address these issues with the Multimodal ECG Representation Learning (MERL}) framework. Through multimodal learning on ECG records and associated reports, MERL is capable of performing zero-shot ECG classification with text prompts, eliminating the need for training data in downstream tasks. At test time, we propose the Clinical Knowledge Enhanced Prompt Engineering (CKEPE) approach, which uses Large Language Models (LLMs) to exploit external expert-verified clinical knowledge databases, generating more descriptive prompts and reducing hallucinations in LLM-generated content to boost zero-shot classification. Based on MERL, we perform the first benchmark across six public ECG datasets, showing the superior performance of MERL compared against eSSL methods. Notably, MERL achieves an average AUC score of 75.2% in zero-shot classification (without training data), 3.2% higher than linear probed eSSL methods with 10\% annotated training data, averaged across all six datasets. Code and models are available at https://github.com/cheliu-computation/MERL

Background:Speech patterns have emerged as potential diagnostic markers for conditions with varying etiologies. Machine learning (ML) presents an opportunity to harness these patterns for accurate disease diagnosis. Objective: This review synthesized findings from studies exploring ML's capability in leveraging speech for the diagnosis of neurological, laryngeal and mental disorders. Methods: A systematic examination of 564 articles was conducted with 91 articles included in the study, which encompassed a wide spectrum of conditions, ranging from voice pathologies to mental and neurological disorders. Methods for speech classifications were assessed based on the relevant studies and scored between 0-10 based on the reported diagnostic accuracy of their ML models. Results: High diagnostic accuracies were consistently observed for laryngeal disorders, dysarthria, and changes related to speech in Parkinsons disease. These findings indicate the robust potential of speech as a diagnostic tool. Disorders like depression, schizophrenia, mild cognitive impairment and Alzheimers dementia also demonstrated high accuracies, albeit with some variability across studies. Meanwhile, disorders like OCD and autism highlighted the need for more extensive research to ascertain the relationship between speech patterns and the respective conditions. Conclusion: ML models utilizing speech patterns demonstrate promising potential in diagnosing a range of mental, laryngeal, and neurological disorders. However, the efficacy varies across conditions, and further research is needed. The integration of these models into clinical practice could potentially revolutionize the evaluation and diagnosis of a number of different medical conditions.

The field of medical diagnosis has undergone a significant transformation with the advent of large language models (LLMs), yet the challenges of interpretability within these models remain largely unaddressed. This study introduces Chain-of-Diagnosis (CoD) to enhance the interpretability of LLM-based medical diagnostics. CoD transforms the diagnostic process into a diagnostic chain that mirrors a physician's thought process, providing a transparent reasoning pathway. Additionally, CoD outputs the disease confidence distribution to ensure transparency in decision-making. This interpretability makes model diagnostics controllable and aids in identifying critical symptoms for inquiry through the entropy reduction of confidences. With CoD, we developed DiagnosisGPT, capable of diagnosing 9604 diseases. Experimental results demonstrate that DiagnosisGPT outperforms other LLMs on diagnostic benchmarks. Moreover, DiagnosisGPT provides interpretability while ensuring controllability in diagnostic rigor.

The primary goal of drug safety researchers and regulators is to promptly identify adverse drug reactions. Doing so may in turn prevent or reduce the harm to patients and ultimately improve public health. Evaluating and monitoring drug safety (i.e., pharmacovigilance) involves analyzing an ever growing collection of spontaneous reports from health professionals, physicians, and pharmacists, and information voluntarily submitted by patients. In this scenario, facilitating analysis of such reports via automation has the potential to rapidly identify safety signals. Unfortunately, public resources for developing natural language models for this task are scant. We present PHEE, a novel dataset for pharmacovigilance comprising over 5000 annotated events from medical case reports and biomedical literature, making it the largest such public dataset to date. We describe the hierarchical event schema designed to provide coarse and fine-grained information about patients' demographics, treatments and (side) effects. Along with the discussion of the dataset, we present a thorough experimental evaluation of current state-of-the-art approaches for biomedical event extraction, point out their limitations, and highlight open challenges to foster future research in this area.

Clinical diagnosis is critical in medical practice, typically requiring a continuous and evolving process that includes primary diagnosis, differential diagnosis, and final diagnosis. However, most existing clinical diagnostic tasks are single-step processes, which does not align with the complex multi-step diagnostic procedures found in real-world clinical settings. In this paper, we propose a multi-step diagnostic task and annotate a clinical diagnostic dataset (MSDiagnosis). This dataset includes primary diagnosis, differential diagnosis, and final diagnosis questions. Additionally, we propose a novel and effective framework. This framework combines forward inference, backward inference, reflection, and refinement, enabling the LLM to self-evaluate and adjust its diagnostic results. To assess the effectiveness of our proposed method, we design and conduct extensive experiments. The experimental results demonstrate the effectiveness of the proposed method. We also provide a comprehensive experimental analysis and suggest future research directions for this task.

Current medical question answering systems have difficulty processing long, detailed and informally worded questions submitted by patients, called Consumer Health Questions (CHQs). To address this issue, we introduce a medical question understanding and answering system with knowledge grounding and semantic self-supervision. Our system is a pipeline that first summarizes a long, medical, user-written question, using a supervised summarization loss. Then, our system performs a two-step retrieval to return answers. The system first matches the summarized user question with an FAQ from a trusted medical knowledge base, and then retrieves a fixed number of relevant sentences from the corresponding answer document. In the absence of labels for question matching or answer relevance, we design 3 novel, self-supervised and semantically-guided losses. We evaluate our model against two strong retrieval-based question answering baselines. Evaluators ask their own questions and rate the answers retrieved by our baselines and own system according to their relevance. They find that our system retrieves more relevant answers, while achieving speeds 20 times faster. Our self-supervised losses also help the summarizer achieve higher scores in ROUGE, as well as in human evaluation metrics. We release our code to encourage further research.

Large language models (LLMs) offer a promising pre-screening tool, improving early disease detection and providing enhanced healthcare access for underprivileged communities. The early diagnosis of various diseases continues to be a significant challenge in healthcare, primarily due to the nonspecific nature of early symptoms, the shortage of expert medical practitioners, and the need for prolonged clinical evaluations, all of which can delay treatment and adversely affect patient outcomes. With impressive accuracy in prediction across a range of diseases, LLMs have the potential to revolutionize clinical pre-screening and decision-making for various medical conditions. In this work, we study the diagnostic capability of LLMs for Rheumatoid Arthritis (RA) with real world patients data. Patient data was collected alongside diagnoses from medical experts, and the performance of LLMs was evaluated in comparison to expert diagnoses for RA disease prediction. We notice an interesting pattern in disease diagnosis and find an unexpected misalignment between prediction and explanation. We conduct a series of multi-round analyses using different LLM agents. The best-performing model accurately predicts rheumatoid arthritis (RA) diseases approximately 95\% of the time. However, when medical experts evaluated the reasoning generated by the model, they found that nearly 68\% of the reasoning was incorrect. This study highlights a clear misalignment between LLMs high prediction accuracy and its flawed reasoning, raising important questions about relying on LLM explanations in clinical settings. LLMs provide incorrect reasoning to arrive at the correct answer for RA disease diagnosis.

As the field of artificial intelligence progresses, assistive technologies are becoming more widely used across all industries. The healthcare industry is no different, with numerous studies being done to develop assistive tools for healthcare professionals. Automatic diagnostic systems are one such beneficial tool that can assist with a variety of tasks, including collecting patient information, analyzing test results, and diagnosing patients. However, the idea of developing systems that can provide a differential diagnosis has been largely overlooked in most of these research studies. In this study, we propose a transformer-based approach for providing differential diagnoses based on a patient's age, sex, medical history, and symptoms. We use the DDXPlus dataset, which provides differential diagnosis information for patients based on 49 disease types. Firstly, we propose a method to process the tabular patient data from the dataset and engineer them into patient reports to make them suitable for our research. In addition, we introduce two data modification modules to diversify the training data and consequently improve the robustness of the models. We approach the task as a multi-label classification problem and conduct extensive experiments using four transformer models. All the models displayed promising results by achieving over 97% F1 score on the held-out test set. Moreover, we design additional behavioral tests to get a broader understanding of the models. In particular, for one of our test cases, we prepared a custom test set of 100 samples with the assistance of a doctor. The results on the custom set showed that our proposed data modification modules improved the model's generalization capabilities. We hope our findings will provide future researchers with valuable insights and inspire them to develop reliable systems for automatic differential diagnosis.

Prompt tuning for pre-trained masked language models (MLM) has shown promising performance in natural language processing tasks with few labeled examples. It tunes a prompt for the downstream task, and a verbalizer is used to bridge the predicted token and label prediction. Due to the limited training data, prompt initialization is crucial for prompt tuning. Recently, MetaPrompting (Hou et al., 2022) uses meta-learning to learn a shared initialization for all task-specific prompts. However, a single initialization is insufficient to obtain good prompts for all tasks and samples when the tasks are complex. Moreover, MetaPrompting requires tuning the whole MLM, causing a heavy burden on computation and memory as the MLM is usually large. To address these issues, we use a prompt pool to extract more task knowledge and construct instance-dependent prompts via attention. We further propose a novel soft verbalizer (RepVerb) which constructs label embedding from feature embeddings directly. Combining meta-learning the prompt pool and RepVerb, we propose MetaPrompter for effective structured prompting. MetaPrompter is parameter-efficient as only the pool is required to be tuned. Experimental results demonstrate that MetaPrompter performs better than the recent state-of-the-arts and RepVerb outperforms existing soft verbalizers.

The increasing use of tools and solutions based on Large Language Models (LLMs) for various tasks in the medical domain has become a prominent trend. Their use in this highly critical and sensitive domain has thus raised important questions about their robustness, especially in response to variations in input, and the reliability of the generated outputs. This study addresses these questions by constructing a textual dataset based on the ICD-10-CM code descriptions, widely used in US hospitals and containing many clinical terms, and their easily reproducible rephrasing. We then benchmarked existing embedding models, either generalist or specialized in the clinical domain, in a semantic search task where the goal was to correctly match the rephrased text to the original description. Our results showed that generalist models performed better than clinical models, suggesting that existing clinical specialized models are more sensitive to small changes in input that confuse them. The highlighted problem of specialized models may be due to the fact that they have not been trained on sufficient data, and in particular on datasets that are not diverse enough to have a reliable global language understanding, which is still necessary for accurate handling of medical documents.

To build a French national electronic injury surveillance system based on emergency room visits, we aim to develop a coding system to classify their causes from clinical notes in free-text. Supervised learning techniques have shown good results in this area but require a large amount of expert annotated dataset which is time consuming and costly to obtain. We hypothesize that the Natural Language Processing Transformer model incorporating a generative self-supervised pre-training step can significantly reduce the required number of annotated samples for supervised fine-tuning. In this preliminary study, we test our hypothesis in the simplified problem of predicting whether a visit is the consequence of a traumatic event or not from free-text clinical notes. Using fully re-trained GPT-2 models (without OpenAI pre-trained weights), we assess the gain of applying a self-supervised pre-training phase with unlabeled notes prior to the supervised learning task. Results show that the number of data required to achieve a ginve level of performance (AUC>0.95) was reduced by a factor of 10 when applying pre-training. Namely, for 16 times more data, the fully-supervised model achieved an improvement <1% in AUC. To conclude, it is possible to adapt a multi-purpose neural language model such as the GPT-2 to create a powerful tool for classification of free-text notes with only a small number of labeled samples.

We present a unified, promptable model capable of simultaneously segmenting, recognizing, and captioning anything. Unlike SAM, we aim to build a versatile region representation in the wild via visual prompting. To achieve this, we train a generalizable model with massive segmentation masks, e.g., SA-1B masks, and semantic priors from a pre-trained CLIP model with 5 billion parameters. Specifically, we construct a promptable image decoder by adding a semantic token to each mask token. The semantic token is responsible for learning the semantic priors in a predefined concept space. Through joint optimization of segmentation on mask tokens and concept prediction on semantic tokens, our model exhibits strong regional recognition and localization capabilities. For example, an additional 38M-parameter causal text decoder trained from scratch sets a new record with a CIDEr score of 150.7 on the Visual Genome region captioning task. We believe this model can be a versatile region-level image tokenizer, capable of encoding general-purpose region context for a broad range of perception tasks. Code and models are available at https://github.com/baaivision/tokenize-anything.

Speculative decoding is an inference-acceleration method for large language models (LLMs) where a small language model generates a draft-token sequence which is further verified by the target LLM in parallel. Recent works have advanced this method by establishing a draft-token tree, achieving superior performance over a single-sequence speculative decoding. However, those works independently generate tokens at each level of the tree, not leveraging the tree's entire diversifiability. Besides, their empirical superiority has been shown for fixed length of sequences, implicitly granting more computational resource to LLM for the tree-based methods. None of the existing works has conducted empirical studies with fixed target computational budgets despite its importance to resource-bounded devices. We present Recursive Speculative Decoding (RSD), a novel tree-based method that samples draft tokens without replacement and maximizes the diversity of the tree. During RSD's drafting, the tree is built by either Gumbel-Top-k trick that draws tokens without replacement in parallel or Stochastic Beam Search that samples sequences without replacement while early-truncating unlikely draft sequences and reducing the computational cost of LLM. We empirically evaluate RSD with Llama 2 and OPT models, showing that RSD outperforms the baseline methods, consistently for fixed draft sequence length and in most cases for fixed computational budgets at LLM.

How to decode human vision through neural signals has attracted a long-standing interest in neuroscience and machine learning. Modern contrastive learning and generative models improved the performance of fMRI-based visual decoding and reconstruction. However, the high cost and low temporal resolution of fMRI limit their applications in brain-computer interfaces (BCIs), prompting a high need for EEG-based visual reconstruction. In this study, we present an EEG-based visual reconstruction framework. It consists of a plug-and-play EEG encoder called the Adaptive Thinking Mapper (ATM), which is aligned with image embeddings, and a two-stage EEG guidance image generator that first transforms EEG features into image priors and then reconstructs the visual stimuli with a pre-trained image generator. Our approach allows EEG embeddings to achieve superior performance in image classification and retrieval tasks. Our two-stage image generation strategy vividly reconstructs images seen by humans. Furthermore, we analyzed the impact of signals from different time windows and brain regions on decoding and reconstruction. The versatility of our framework is demonstrated in the magnetoencephalogram (MEG) data modality. We report that EEG-based visual decoding achieves SOTA performance, highlighting the portability, low cost, and high temporal resolution of EEG, enabling a wide range of BCI applications. The code of ATM is available at https://github.com/dongyangli-del/EEG_Image_decode.

The use of deep neural models for diagnosis prediction from clinical text has shown promising results. However, in clinical practice such models must not only be accurate, but provide doctors with interpretable and helpful results. We introduce ProtoPatient, a novel method based on prototypical networks and label-wise attention with both of these abilities. ProtoPatient makes predictions based on parts of the text that are similar to prototypical patients - providing justifications that doctors understand. We evaluate the model on two publicly available clinical datasets and show that it outperforms existing baselines. Quantitative and qualitative evaluations with medical doctors further demonstrate that the model provides valuable explanations for clinical decision support.

The inference process in Large Language Models (LLMs) is often limited due to the absence of parallelism in the auto-regressive decoding process, resulting in most operations being restricted by the memory bandwidth of accelerators. While methods such as speculative decoding have been suggested to address this issue, their implementation is impeded by the challenges associated with acquiring and maintaining a separate draft model. In this paper, we present Medusa, an efficient method that augments LLM inference by adding extra decoding heads to predict multiple subsequent tokens in parallel. Using a tree-based attention mechanism, Medusa constructs multiple candidate continuations and verifies them simultaneously in each decoding step. By leveraging parallel processing, Medusa introduces only minimal overhead in terms of single-step latency while substantially reducing the number of decoding steps required. We present two levels of fine-tuning procedures for Medusa to meet the needs of different use cases: Medusa-1: Medusa is directly fine-tuned on top of a frozen backbone LLM, enabling lossless inference acceleration. Medusa-2: Medusa is fine-tuned together with the backbone LLM, enabling better prediction accuracy of Medusa heads and higher speedup but needing a special training recipe that preserves the backbone model's capabilities. Moreover, we propose several extensions that improve or expand the utility of Medusa, including a self-distillation to handle situations where no training data is available and a typical acceptance scheme to boost the acceptance rate while maintaining generation quality. We evaluate Medusa on models of various sizes and training procedures. Our experiments demonstrate that Medusa-1 can achieve over 2.2x speedup without compromising generation quality, while Medusa-2 further improves the speedup to 2.3-3.6x.

Background: Social media platforms have become a viable source of medical information, with patients and healthcare professionals using them to share health-related information and track diseases. Similarly, YouTube, the largest video-sharing platform in the world contains vlogs where individuals talk about their illnesses. The aim of our study was to investigate the use of Natural Language Processing (NLP) to identify the spoken content of YouTube vlogs related to the diagnosis of Coronavirus disease of 2019 (COVID-19) for public health screening. Methods: COVID-19 videos on YouTube were searched using relevant keywords. A total of 1000 videos being spoken in English were downloaded out of which 791 were classified as vlogs, 192 were non-vlogs, and 17 were deleted by the channel. The videos were converted into a textual format using Microsoft Streams. The textual data was preprocessed using basic and advanced preprocessing methods. A lexicon of 200 words was created which contained words related to COVID-19. The data was analyzed using topic modeling, word clouds, and lexicon matching. Results: The word cloud results revealed discussions about COVID-19 symptoms like "fever", along with generic terms such as "mask" and "isolation". Lexical analysis demonstrated that in 96.46% of videos, patients discussed generic terms, and in 95.45% of videos, people talked about COVID-19 symptoms. LDA Topic Modeling results also generated topics that successfully captured key themes and content related to our investigation of COVID-19 diagnoses in YouTube vlogs. Conclusion: By leveraging NLP techniques on YouTube vlogs public health practitioners can enhance their ability to mitigate the effects of pandemics and effectively respond to public health challenges.

Deep Learning based models are currently dominating most state-of-the-art solutions for disease prediction. Existing works employ RNNs along with multiple levels of attention mechanisms to provide interpretability. These deep learning models, with trainable parameters running into millions, require huge amounts of compute and data to train and deploy. These requirements are sometimes so huge that they render usage of such models as unfeasible. We address these challenges by developing a simpler yet interpretable non-deep learning based model for application to EHR data. We model and showcase our work's results on the task of predicting first occurrence of a diagnosis, often overlooked in existing works. We push the capabilities of a tree based model and come up with a strong baseline for more sophisticated models. Its performance shows an improvement over deep learning based solutions (both, with and without the first-occurrence constraint) all the while maintaining interpretability.

The current state of adoption of well-structured electronic health records and integration of digital methods for storing medical patient data in structured formats can often considered as inferior compared to the use of traditional, unstructured text based patient data documentation. Data mining in the field of medical data analysis often needs to rely solely on processing of unstructured data to retrieve relevant data. In natural language processing (NLP), statistical models have been shown successful in various tasks like part-of-speech tagging, relation extraction (RE) and named entity recognition (NER). In this work, we present GERNERMED, the first open, neural NLP model for NER tasks dedicated to detect medical entity types in German text data. Here, we avoid the conflicting goals of protection of sensitive patient data from training data extraction and the publication of the statistical model weights by training our model on a custom dataset that was translated from publicly available datasets in foreign language by a pretrained neural machine translation model. The sample code and the statistical model is available at: https://github.com/frankkramer-lab/GERNERMED

We introduce Reward-Guided Speculative Decoding (RSD), a novel framework aimed at improving the efficiency of inference in large language models (LLMs). RSD synergistically combines a lightweight draft model with a more powerful target model, incorporating a controlled bias to prioritize high-reward outputs, in contrast to existing speculative decoding methods that enforce strict unbiasedness. RSD employs a process reward model to evaluate intermediate decoding steps and dynamically decide whether to invoke the target model, optimizing the trade-off between computational cost and output quality. We theoretically demonstrate that a threshold-based mixture strategy achieves an optimal balance between resource utilization and performance. Extensive evaluations on challenging reasoning benchmarks, including Olympiad-level tasks, show that RSD delivers significant efficiency gains against decoding with the target model only (up to 4.4x fewer FLOPs), while achieving significant better accuracy than parallel decoding method on average (up to +3.5). These results highlight RSD as a robust and cost-effective approach for deploying LLMs in resource-intensive scenarios.

Language models of code (LMs) work well when the surrounding code in the vicinity of generation provides sufficient context. This is not true when it becomes necessary to use types or functionality defined in another module or library, especially those not seen during training. LMs suffer from limited awareness of such global context and end up hallucinating, e.g., using types defined in other files incorrectly. Recent work tries to overcome this issue by retrieving global information to augment the local context. However, this bloats the prompt or requires architecture modifications and additional training. Integrated development environments (IDEs) assist developers by bringing the global context at their fingertips using static analysis. We extend this assistance, enjoyed by developers, to the LMs. We propose a notion of monitors that use static analysis in the background to guide the decoding. Unlike a priori retrieval, static analysis is invoked iteratively during the entire decoding process, providing the most relevant suggestions on demand. We demonstrate the usefulness of our proposal by monitoring for type-consistent use of identifiers whenever an LM generates code for object dereference. To evaluate our approach, we curate PragmaticCode, a dataset of open-source projects with their development environments. On models of varying parameter scale, we show that monitor-guided decoding consistently improves the ability of an LM to not only generate identifiers that match the ground truth but also improves compilation rates and agreement with ground truth. We find that LMs with fewer parameters, when guided with our monitor, can outperform larger LMs. With monitor-guided decoding, SantaCoder-1.1B achieves better compilation rate and next-identifier match than the much larger text-davinci-003 model. The datasets and code will be released at https://aka.ms/monitors4codegen .

The COVID-19 pandemic presents global challenges transcending boundaries of country, race, religion, and economy. The current gold standard method for COVID-19 detection is the reverse transcription polymerase chain reaction (RT-PCR) testing. However, this method is expensive, time-consuming, and violates social distancing. Also, as the pandemic is expected to stay for a while, there is a need for an alternate diagnosis tool which overcomes these limitations, and is deployable at a large scale. The prominent symptoms of COVID-19 include cough and breathing difficulties. We foresee that respiratory sounds, when analyzed using machine learning techniques, can provide useful insights, enabling the design of a diagnostic tool. Towards this, the paper presents an early effort in creating (and analyzing) a database, called Coswara, of respiratory sounds, namely, cough, breath, and voice. The sound samples are collected via worldwide crowdsourcing using a website application. The curated dataset is released as open access. As the pandemic is evolving, the data collection and analysis is a work in progress. We believe that insights from analysis of Coswara can be effective in enabling sound based technology solutions for point-of-care diagnosis of respiratory infection, and in the near future this can help to diagnose COVID-19.

Transformers-based models, such as BERT, have dramatically improved the performance for various natural language processing tasks. The clinical knowledge enriched model, namely ClinicalBERT, also achieved state-of-the-art results when performed on clinical named entity recognition and natural language inference tasks. One of the core limitations of these transformers is the substantial memory consumption due to their full self-attention mechanism. To overcome this, long sequence transformer models, e.g. Longformer and BigBird, were proposed with the idea of sparse attention mechanism to reduce the memory usage from quadratic to the sequence length to a linear scale. These models extended the maximum input sequence length from 512 to 4096, which enhanced the ability of modeling long-term dependency and consequently achieved optimal results in a variety of tasks. Inspired by the success of these long sequence transformer models, we introduce two domain enriched language models, namely Clinical-Longformer and Clinical-BigBird, which are pre-trained from large-scale clinical corpora. We evaluate both pre-trained models using 10 baseline tasks including named entity recognition, question answering, and document classification tasks. The results demonstrate that Clinical-Longformer and Clinical-BigBird consistently and significantly outperform ClinicalBERT as well as other short-sequence transformers in all downstream tasks. We have made our source code available at [https://github.com/luoyuanlab/Clinical-Longformer] the pre-trained models available for public download at: [https://huggingface.co/yikuan8/Clinical-Longformer].

International Classification of Disease (ICD) coding procedure which refers to tagging medical notes with diagnosis codes has been shown to be effective and crucial to the billing system in medical sector. Currently, ICD codes are assigned to a clinical note manually which is likely to cause many errors. Moreover, training skilled coders also requires time and human resources. Therefore, automating the ICD code determination process is an important task. With the advancement of artificial intelligence theory and computational hardware, machine learning approach has emerged as a suitable solution to automate this process. In this project, we apply a transformer-based architecture to capture the interdependence among the tokens of a document and then use a code-wise attention mechanism to learn code-specific representations of the entire document. Finally, they are fed to separate dense layers for corresponding code prediction. Furthermore, to handle the imbalance in the code frequency of clinical datasets, we employ a label distribution aware margin (LDAM) loss function. The experimental results on the MIMIC-III dataset show that our proposed model outperforms other baselines by a significant margin. In particular, our best setting achieves a micro-AUC score of 0.923 compared to 0.868 of bidirectional recurrent neural networks. We also show that by using the code-wise attention mechanism, the model can provide more insights about its prediction, and thus it can support clinicians to make reliable decisions. Our code is available online (https://github.com/biplob1ly/TransICD)

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.

Speculative decoding is a prominent technique to speed up the inference of a large target language model based on predictions of an auxiliary draft model. While effective, in application-specific settings, it often involves fine-tuning both draft and target models to achieve high acceptance rates. As the number of downstream tasks grows, these draft models add significant complexity to inference systems. We propose Speculative Streaming, a single-model speculative decoding method that fuses drafting into the target model by changing the fine-tuning objective from next token prediction to future n-gram prediction. Speculative Streaming speeds up decoding by 1.8 - 3.1X in a diverse set of tasks, such as Summarization, Structured Queries, and Meaning Representation, without sacrificing generation quality. Additionally, Speculative Streaming is parameter-efficient. It achieves on-par/higher speed-ups than Medusa-style architectures while using ~10000X fewer extra parameters, making it well-suited for resource-constrained devices.

Even with various regulations in place across countries and social media platforms (Government of India, 2021; European Parliament and Council of the European Union, 2022, digital abusive speech remains a significant issue. One potential approach to address this challenge is automatic text detoxification, a text style transfer (TST) approach that transforms toxic language into a more neutral or non-toxic form. To date, the availability of parallel corpora for the text detoxification task (Logachevavet al., 2022; Atwell et al., 2022; Dementievavet al., 2024a) has proven to be crucial for state-of-the-art approaches. With this work, we extend parallel text detoxification corpus to new languages -- German, Chinese, Arabic, Hindi, and Amharic -- testing in the extensive multilingual setup TST baselines. Next, we conduct the first of its kind an automated, explainable analysis of the descriptive features of both toxic and non-toxic sentences, diving deeply into the nuances, similarities, and differences of toxicity and detoxification across 9 languages. Finally, based on the obtained insights, we experiment with a novel text detoxification method inspired by the Chain-of-Thoughts reasoning approach, enhancing the prompting process through clustering on relevant descriptive attributes.

In this work, we present MedImageInsight, an open-source medical imaging embedding model. MedImageInsight is trained on medical images with associated text and labels across a diverse collection of domains, including X-Ray, CT, MRI, dermoscopy, OCT, fundus photography, ultrasound, histopathology, and mammography. Rigorous evaluations demonstrate MedImageInsight's ability to achieve state-of-the-art (SOTA) or human expert level performance across classification, image-image search, and fine-tuning tasks. Specifically, on public datasets, MedImageInsight achieves SOTA in CT 3D medical image retrieval, as well as SOTA in disease classification and search for chest X-ray, dermatology, and OCT imaging. Furthermore, MedImageInsight achieves human expert performance in bone age estimation (on both public and partner data), as well as AUC above 0.9 in most other domains. When paired with a text decoder, MedImageInsight achieves near SOTA level single image report findings generation with less than 10\% the parameters of other models. Compared to fine-tuning GPT-4o with only MIMIC-CXR data for the same task, MedImageInsight outperforms in clinical metrics, but underperforms on lexical metrics where GPT-4o sets a new SOTA. Importantly for regulatory purposes, MedImageInsight can generate ROC curves, adjust sensitivity and specificity based on clinical need, and provide evidence-based decision support through image-image search (which can also enable retrieval augmented generation). In an independent clinical evaluation of image-image search in chest X-ray, MedImageInsight outperformed every other publicly available foundation model evaluated by large margins (over 6 points AUC), and significantly outperformed other models in terms of AI fairness (across age and gender). We hope releasing MedImageInsight will help enhance collective progress in medical imaging AI research and development.

Scene text recognition (STR) methods have struggled to attain high accuracy and fast inference speed. Autoregressive (AR)-based models implement the recognition in a character-by-character manner, showing superiority in accuracy but with slow inference speed. Alternatively, parallel decoding (PD)-based models infer all characters in a single decoding pass, offering faster inference speed but generally worse accuracy. We first present an empirical study of AR decoding in STR, and discover that the AR decoder not only models linguistic context, but also provides guidance on visual context perception. Consequently, we propose Context Perception Parallel Decoder (CPPD) to predict the character sequence in a PD pass. CPPD devises a character counting module to infer the occurrence count of each character, and a character ordering module to deduce the content-free reading order and placeholders. Meanwhile, the character prediction task associates the placeholders with characters. They together build a comprehensive recognition context. We construct a series of CPPD models and also plug the proposed modules into existing STR decoders. Experiments on both English and Chinese benchmarks demonstrate that the CPPD models achieve highly competitive accuracy while running approximately 8x faster than their AR-based counterparts. Moreover, the plugged models achieve significant accuracy improvements. Code is at https://github.com/PaddlePaddle/PaddleOCR/blob/dygraph/doc/doc_en/algorithm_rec_cppd_en.md{this https URL}.

We present Dream-Coder 7B, an open-source discrete diffusion language model for code generation that exhibits emergent any-order generation capabilities. Unlike traditional autoregressive (AR) models that decode strictly left-to-right, Dream-Coder 7B adaptively determines its decoding strategy based on the coding task: sketch-first generation for complex algorithms, left-to-right generation for straightforward completions, and interleaved reasoning generation for code understanding tasks. We adapt a pretrained AR checkpoint to a discrete diffusion frameworks with a continuous-time weighted cross-entropy objective. Our post-training recipe comprises (i) supervised fine-tuning, where we mitigate padding pathologies via random truncation and a padding penalty to improve sample efficiency and stabilize generation; and (ii) reinforcement learning with verifiable rewards over a curated high-quality prompt set drawn from open-source datasets, using a tailored reinforcement learning recipe for diffusion language models. The resulting Dream-Coder 7B Instruct attains 21.4\% pass@1 on LiveCodeBench (2410--2505) and demonstrates competitive performance on HumanEval, MBPP, BigCodeBench, and CRUXEval. We release Dream-Coder-7B and Dream-Coder-7B-Instruct checkpoints, training recipes, preprocessing pipelines, and inference code to facilitate reproducibility and further research.

Accelerating the inference of large language models (LLMs) is a critical challenge in generative AI. Speculative decoding (SD) methods offer substantial efficiency gains by generating multiple tokens using a single target forward pass. However, existing SD approaches require the drafter and target models to share the same vocabulary, thus limiting the pool of possible drafters, often necessitating the training of a drafter from scratch. We present three new SD methods that remove this shared-vocabulary constraint. All three methods preserve the target distribution (i.e., they are lossless) and work with off-the-shelf models without requiring additional training or modifications. Empirically, on summarization, programming, and long-context tasks, our algorithms achieve significant speedups over standard autoregressive decoding. By enabling any off-the-shelf model to serve as drafter and requiring no retraining, this work substantially broadens the applicability of the SD framework in practice.

Pre-trained models for programming languages have recently demonstrated great success on code intelligence. To support both code-related understanding and generation tasks, recent works attempt to pre-train unified encoder-decoder models. However, such encoder-decoder framework is sub-optimal for auto-regressive tasks, especially code completion that requires a decoder-only manner for efficient inference. In this paper, we present UniXcoder, a unified cross-modal pre-trained model for programming language. The model utilizes mask attention matrices with prefix adapters to control the behavior of the model and leverages cross-modal contents like AST and code comment to enhance code representation. To encode AST that is represented as a tree in parallel, we propose a one-to-one mapping method to transform AST in a sequence structure that retains all structural information from the tree. Furthermore, we propose to utilize multi-modal contents to learn representation of code fragment with contrastive learning, and then align representations among programming languages using a cross-modal generation task. We evaluate UniXcoder on five code-related tasks over nine datasets. To further evaluate the performance of code fragment representation, we also construct a dataset for a new task, called zero-shot code-to-code search. Results show that our model achieves state-of-the-art performance on most tasks and analysis reveals that comment and AST can both enhance UniXcoder.

Objective: fMRI and derived measures such as functional connectivity (FC) have been used to predict brain age, general fluid intelligence, psychiatric disease status, and preclinical neurodegenerative disease. However, it is not always clear that all demographic confounds, such as age, sex, and race, have been removed from fMRI data. Additionally, many fMRI datasets are restricted to authorized researchers, making dissemination of these valuable data sources challenging. Methods: We create a variational autoencoder (VAE)-based model, DemoVAE, to decorrelate fMRI features from demographics and generate high-quality synthetic fMRI data based on user-supplied demographics. We train and validate our model using two large, widely used datasets, the Philadelphia Neurodevelopmental Cohort (PNC) and Bipolar and Schizophrenia Network for Intermediate Phenotypes (BSNIP). Results: We find that DemoVAE recapitulates group differences in fMRI data while capturing the full breadth of individual variations. Significantly, we also find that most clinical and computerized battery fields that are correlated with fMRI data are not correlated with DemoVAE latents. An exception are several fields related to schizophrenia medication and symptom severity. Conclusion: Our model generates fMRI data that captures the full distribution of FC better than traditional VAE or GAN models. We also find that most prediction using fMRI data is dependent on correlation with, and prediction of, demographics. Significance: Our DemoVAE model allows for generation of high quality synthetic data conditioned on subject demographics as well as the removal of the confounding effects of demographics. We identify that FC-based prediction tasks are highly influenced by demographic confounds.

Clinical trials are fundamental in developing new drugs, medical devices, and treatments. However, they are often time-consuming and have low success rates. Although there have been initial attempts to create large language models (LLMs) for clinical trial design and patient-trial matching, these models remain task-specific and not adaptable to diverse clinical trial tasks. To address this challenge, we propose a clinical trial foundation model named Panacea, designed to handle multiple tasks, including trial search, trial summarization, trial design, and patient-trial matching. We also assemble a large-scale dataset, named TrialAlign, of 793,279 trial documents and 1,113,207 trial-related scientific papers, to infuse clinical knowledge into the model by pre-training. We further curate TrialInstruct, which has 200,866 of instruction data for fine-tuning. These resources enable Panacea to be widely applicable for a range of clinical trial tasks based on user requirements. We evaluated Panacea on a new benchmark, named TrialPanorama, which covers eight clinical trial tasks. Our method performed the best on seven of the eight tasks compared to six cutting-edge generic or medicine-specific LLMs. Specifically, Panacea showed great potential to collaborate with human experts in crafting the design of eligibility criteria, study arms, and outcome measures, in multi-round conversations. In addition, Panacea achieved 14.42% improvement in patient-trial matching, 41.78% to 52.02% improvement in trial search, and consistently ranked at the top for five aspects of trial summarization. Our approach demonstrates the effectiveness of Panacea in clinical trials and establishes a comprehensive resource, including training data, model, and benchmark, for developing clinical trial foundation models, paving the path for AI-based clinical trial development.

Foundation models are reshaping EEG analysis, yet an important problem of EEG tokenization remains a challenge. This paper presents TFM-Tokenizer, a novel tokenization framework that learns a vocabulary of time-frequency motifs from single-channel EEG signals and encodes them into discrete tokens. We propose a dual-path architecture with time-frequency masking to capture robust motif representations, and it is model-agnostic, supporting both lightweight transformers and existing foundation models for downstream tasks. Our study demonstrates three key benefits: Accuracy: Experiments on four diverse EEG benchmarks demonstrate consistent performance gains across both single- and multi-dataset pretraining settings, achieving up to 17% improvement in Cohen's Kappa over strong baselines. Generalization: Moreover, as a plug-and-play component, it consistently boosts the performance of diverse foundation models, including BIOT and LaBraM. Scalability: By operating at the single-channel level rather than relying on the strict 10-20 EEG system, our method has the potential to be device-agnostic. Experiments on ear-EEG sleep staging, which differs from the pretraining data in signal format, channel configuration, recording device, and task, show that our tokenizer outperforms baselines by 14%. A comprehensive token analysis reveals strong class-discriminative, frequency-aware, and consistent structure, enabling improved representation quality and interpretability. Code is available at https://github.com/Jathurshan0330/TFM-Tokenizer.

Medical coding is the task of assigning medical codes to clinical free-text documentation. Healthcare professionals manually assign such codes to track patient diagnoses and treatments. Automated medical coding can considerably alleviate this administrative burden. In this paper, we reproduce, compare, and analyze state-of-the-art automated medical coding machine learning models. We show that several models underperform due to weak configurations, poorly sampled train-test splits, and insufficient evaluation. In previous work, the macro F1 score has been calculated sub-optimally, and our correction doubles it. We contribute a revised model comparison using stratified sampling and identical experimental setups, including hyperparameters and decision boundary tuning. We analyze prediction errors to validate and falsify assumptions of previous works. The analysis confirms that all models struggle with rare codes, while long documents only have a negligible impact. Finally, we present the first comprehensive results on the newly released MIMIC-IV dataset using the reproduced models. We release our code, model parameters, and new MIMIC-III and MIMIC-IV training and evaluation pipelines to accommodate fair future comparisons.

Named entity recognition (NER) is a widely applicable natural language processing task and building block of question answering, topic modeling, information retrieval, etc. In the medical domain, NER plays a crucial role by extracting meaningful chunks from clinical notes and reports, which are then fed to downstream tasks like assertion status detection, entity resolution, relation extraction, and de-identification. Reimplementing a Bi-LSTM-CNN-Char deep learning architecture on top of Apache Spark, we present a single trainable NER model that obtains new state-of-the-art results on seven public biomedical benchmarks without using heavy contextual embeddings like BERT. This includes improving BC4CHEMD to 93.72% (4.1% gain), Species800 to 80.91% (4.6% gain), and JNLPBA to 81.29% (5.2% gain). In addition, this model is freely available within a production-grade code base as part of the open-source Spark NLP library; can scale up for training and inference in any Spark cluster; has GPU support and libraries for popular programming languages such as Python, R, Scala and Java; and can be extended to support other human languages with no code changes.

We present a statistical model for German medical natural language processing trained for named entity recognition (NER) as an open, publicly available model. The work serves as a refined successor to our first GERNERMED model which is substantially outperformed by our work. We demonstrate the effectiveness of combining multiple techniques in order to achieve strong results in entity recognition performance by the means of transfer-learning on pretrained deep language models (LM), word-alignment and neural machine translation. Due to the sparse situation on open, public medical entity recognition models for German texts, this work offers benefits to the German research community on medical NLP as a baseline model. Since our model is based on public English data, its weights are provided without legal restrictions on usage and distribution. The sample code and the statistical model is available at: https://github.com/frankkramer-lab/GERNERMED-pp

Background: Natural Language Processing (NLP) is widely used to extract clinical insights from Electronic Health Records (EHRs). However, the lack of annotated data, automated tools, and other challenges hinder the full utilisation of NLP for EHRs. Various Machine Learning (ML), Deep Learning (DL) and NLP techniques are studied and compared to understand the limitations and opportunities in this space comprehensively. Methodology: After screening 261 articles from 11 databases, we included 127 papers for full-text review covering seven categories of articles: 1) medical note classification, 2) clinical entity recognition, 3) text summarisation, 4) deep learning (DL) and transfer learning architecture, 5) information extraction, 6) Medical language translation and 7) other NLP applications. This study follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Result and Discussion: EHR was the most commonly used data type among the selected articles, and the datasets were primarily unstructured. Various ML and DL methods were used, with prediction or classification being the most common application of ML or DL. The most common use cases were: the International Classification of Diseases, Ninth Revision (ICD-9) classification, clinical note analysis, and named entity recognition (NER) for clinical descriptions and research on psychiatric disorders. Conclusion: We find that the adopted ML models were not adequately assessed. In addition, the data imbalance problem is quite important, yet we must find techniques to address this underlining problem. Future studies should address key limitations in studies, primarily identifying Lupus Nephritis, Suicide Attempts, perinatal self-harmed and ICD-9 classification.

Pre-trained language models (PLMs), such as BERT and GPT, have revolutionized the field of NLP, not only in the general domain but also in the biomedical domain. Most prior efforts in building biomedical PLMs have resorted simply to domain adaptation and focused mainly on English. In this work we introduce eHealth, a Chinese biomedical PLM built from scratch with a new pre-training framework. This new framework pre-trains eHealth as a discriminator through both token- and sequence-level discrimination. The former is to detect input tokens corrupted by a generator and recover their original identities from plausible candidates, while the latter is to further distinguish corruptions of a same original sequence from those of others. As such, eHealth can learn language semantics at both token and sequence levels. Extensive experiments on 11 Chinese biomedical language understanding tasks of various forms verify the effectiveness and superiority of our approach. We release the pre-trained model at https://github.com/PaddlePaddle/Research/tree/master/KG/eHealth and will also release the code later.

Automatically classifying electronic health records (EHRs) into diagnostic codes has been challenging to the NLP community. State-of-the-art methods treated this problem as a multilabel classification problem and proposed various architectures to model this problem. However, these systems did not leverage the superb performance of pretrained language models, which achieved superb performance on natural language understanding tasks. Prior work has shown that pretrained language models underperformed on this task with the regular finetuning scheme. Therefore, this paper aims at analyzing the causes of the underperformance and developing a framework for automatic ICD coding with pretrained language models. We spotted three main issues through the experiments: 1) large label space, 2) long input sequences, and 3) domain mismatch between pretraining and fine-tuning. We propose PLMICD, a framework that tackles the challenges with various strategies. The experimental results show that our proposed framework can overcome the challenges and achieves state-of-the-art performance in terms of multiple metrics on the benchmark MIMIC data. The source code is available at https://github.com/MiuLab/PLM-ICD

Large Language Models (LLMs) fine-tuned to align with human values often exhibit alignment drift, producing unsafe or policy-violating completions when exposed to adversarial prompts, decoding perturbations, or paraphrased jailbreaks. While prior work has behaviorally characterized alignment failure, little is known about the training-time belief sources underlying these failures. We introduce TraceAlign, a unified framework for tracing unsafe completions back to their root causes in the model's training corpus. Central to our approach is the Belief Conflict Index (BCI), which quantifies semantic inconsistency between generated spans and aligned policies, based on retrieved training documents using suffix-array matching. We propose three complementary interventions: (i) TraceShield, an inference-time safety filter that refuses completions with high-BCI spans, (ii) Contrastive Belief Deconfliction Loss, a contrastive fine-tuning objective penalizing high-BCI continuations during DPO, and (iii) Prov-Decode, a provenance-aware decoding strategy that vetoes beam expansions predicted to yield high-BCI spans. Together, these defenses reduce alignment drift by up to 85% on our curated Alignment Drift Benchmark (ADB) while preserving utility on standard tasks, with delta less than 0.2 and improved refusal quality. We further derive a theoretical upper bound on drift likelihood via suffix-array span statistics, linking memorization frequency and length to adversarial reactivation risk. TraceAlign thus provides the first scalable, traceable, and grounded toolkit for understanding and mitigating alignment failures at source. To encourage further exploration and development, we open-source our implementation at: https://anonymous.4open.science/r/tracealign-2DA7

Speculative decoding is a pivotal technique to accelerate the inference of large language models (LLMs) by employing a smaller draft model to predict the target model's outputs. However, its efficacy can be limited due to the low predictive accuracy of the draft model, particularly when faced with diverse text inputs and a significant capability gap between the draft and target models. We introduce online speculative decoding (OSD) to address this challenge. The main idea is to continually update (multiple) draft model(s) on observed user query data using the abundant excess computational power in an LLM serving cluster. Given that LLM inference is memory-bounded, the surplus computational power in a typical LLM serving cluster can be repurposed for online retraining of draft models, thereby making the training cost-neutral. Since the query distribution of an LLM service is relatively simple, retraining on query distribution enables the draft model to more accurately predict the target model's outputs, particularly on data originating from query distributions. As the draft model evolves online, it aligns with the query distribution in real time, mitigating distribution shifts. We develop a prototype of online speculative decoding based on online knowledge distillation and evaluate it using both synthetic and real query data on several popular LLMs. The results show a substantial increase in the token acceptance rate by 0.1 to 0.65, which translates into 1.22x to 3.06x latency reduction.

Skin carcinoma is the most prevalent form of cancer globally, accounting for over $8 billion in annual healthcare expenditures. In clinical settings, physicians document patient visits using detailed SOAP (Subjective, Objective, Assessment, and Plan) notes. However, manually generating these notes is labor-intensive and contributes to clinician burnout. In this work, we propose a weakly supervised multimodal framework to generate clinically structured SOAP notes from limited inputs, including lesion images and sparse clinical text. Our approach reduces reliance on manual annotations, enabling scalable, clinically grounded documentation while alleviating clinician burden and reducing the need for large annotated data. Our method achieves performance comparable to GPT-4o, Claude, and DeepSeek Janus Pro across key clinical relevance metrics. To evaluate clinical quality, we introduce two novel metrics MedConceptEval and Clinical Coherence Score (CCS) which assess semantic alignment with expert medical concepts and input features, respectively.

Recent studies have revealed a number of pathologies of neural machine translation (NMT) systems. Hypotheses explaining these mostly suggest there is something fundamentally wrong with NMT as a model or its training algorithm, maximum likelihood estimation (MLE). Most of this evidence was gathered using maximum a posteriori (MAP) decoding, a decision rule aimed at identifying the highest-scoring translation, i.e. the mode. We argue that the evidence corroborates the inadequacy of MAP decoding more than casts doubt on the model and its training algorithm. In this work, we show that translation distributions do reproduce various statistics of the data well, but that beam search strays from such statistics. We show that some of the known pathologies and biases of NMT are due to MAP decoding and not to NMT's statistical assumptions nor MLE. In particular, we show that the most likely translations under the model accumulate so little probability mass that the mode can be considered essentially arbitrary. We therefore advocate for the use of decision rules that take into account the translation distribution holistically. We show that an approximation to minimum Bayes risk decoding gives competitive results confirming that NMT models do capture important aspects of translation well in expectation.

This study is dedicated to exploring the application of prompt learning methods to advance Named Entity Recognition (NER) within the medical domain. In recent years, the emergence of large-scale models has driven significant progress in NER tasks, particularly with the introduction of the BioBERT language model, which has greatly enhanced NER capabilities in medical texts. Our research introduces the Prompt-bioMRC model, which integrates both hard template and soft prompt designs aimed at refining the precision and efficiency of medical entity recognition. Through extensive experimentation across diverse medical datasets, our findings consistently demonstrate that our approach surpasses traditional models. This enhancement not only validates the efficacy of our methodology but also highlights its potential to provide reliable technological support for applications like intelligent diagnosis systems. By leveraging advanced NER techniques, this study contributes to advancing automated medical data processing, facilitating more accurate medical information extraction, and supporting efficient healthcare decision-making processes.

Autism spectrum disorder (ASD) is a prevalent psychiatric condition characterized by atypical cognitive, emotional, and social patterns. Timely and accurate diagnosis is crucial for effective interventions and improved outcomes in individuals with ASD. In this study, we propose a novel Multi-Atlas Enhanced Transformer framework, METAFormer, ASD classification. Our framework utilizes resting-state functional magnetic resonance imaging data from the ABIDE I dataset, comprising 406 ASD and 476 typical control (TC) subjects. METAFormer employs a multi-atlas approach, where flattened connectivity matrices from the AAL, CC200, and DOS160 atlases serve as input to the transformer encoder. Notably, we demonstrate that self-supervised pretraining, involving the reconstruction of masked values from the input, significantly enhances classification performance without the need for additional or separate training data. Through stratified cross-validation, we evaluate the proposed framework and show that it surpasses state-of-the-art performance on the ABIDE I dataset, with an average accuracy of 83.7% and an AUC-score of 0.832. The code for our framework is available at https://github.com/Lugges991/METAFormer

Brain decoding, a pivotal field in neuroscience, aims to reconstruct stimuli from acquired brain signals, primarily utilizing functional magnetic resonance imaging (fMRI). Currently, brain decoding is confined to a per-subject-per-model paradigm, limiting its applicability to the same individual for whom the decoding model is trained. This constraint stems from three key challenges: 1) the inherent variability in input dimensions across subjects due to differences in brain size; 2) the unique intrinsic neural patterns, influencing how different individuals perceive and process sensory information; 3) limited data availability for new subjects in real-world scenarios hampers the performance of decoding models. In this paper, we present a novel approach, MindBridge, that achieves cross-subject brain decoding by employing only one model. Our proposed framework establishes a generic paradigm capable of addressing these challenges by introducing biological-inspired aggregation function and novel cyclic fMRI reconstruction mechanism for subject-invariant representation learning. Notably, by cycle reconstruction of fMRI, MindBridge can enable novel fMRI synthesis, which also can serve as pseudo data augmentation. Within the framework, we also devise a novel reset-tuning method for adapting a pretrained model to a new subject. Experimental results demonstrate MindBridge's ability to reconstruct images for multiple subjects, which is competitive with dedicated subject-specific models. Furthermore, with limited data for a new subject, we achieve a high level of decoding accuracy, surpassing that of subject-specific models. This advancement in cross-subject brain decoding suggests promising directions for wider applications in neuroscience and indicates potential for more efficient utilization of limited fMRI data in real-world scenarios. Project page: https://littlepure2333.github.io/MindBridge

Large language models (LLMs) such as GPT-4o and o1 have demonstrated strong performance on clinical natural language processing (NLP) tasks across multiple medical benchmarks. Nonetheless, two high-impact NLP tasks - structured tabular reporting from nurse dictations and medical order extraction from doctor-patient consultations - remain underexplored due to data scarcity and sensitivity, despite active industry efforts. Practical solutions to these real-world clinical tasks can significantly reduce the documentation burden on healthcare providers, allowing greater focus on patient care. In this paper, we investigate these two challenging tasks using private and open-source clinical datasets, evaluating the performance of both open- and closed-weight LLMs, and analyzing their respective strengths and limitations. Furthermore, we propose an agentic pipeline for generating realistic, non-sensitive nurse dictations, enabling structured extraction of clinical observations. To support further research in both areas, we release SYNUR and SIMORD, the first open-source datasets for nurse observation extraction and medical order extraction.

Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder that often emerges in early childhood. ASD assessment typically involves an observation protocol including note-taking and ratings of child's social behavior conducted by a trained clinician. A robust machine learning (ML) model that is capable of labeling adult and child audio has the potential to save significant time and labor in manual coding children's behaviors. This may assist clinicians capture events of interest, better communicate events with parents, and educate new clinicians. In this study, we leverage the self-supervised learning model, Wav2Vec 2.0 (W2V2), pretrained on 4300h of home recordings of children under 5 years old, to build a unified system that performs both speaker diarization (SD) and vocalization classification (VC) tasks. We apply this system to two-channel audio recordings of brief 3-5 minute clinician-child interactions using the Rapid-ABC corpus. We propose a novel technique by introducing auxiliary features extracted from W2V2-based automatic speech recognition (ASR) system for children under 4 years old to improve children's VC task. We test our proposed method of improving children's VC task on two corpora (Rapid-ABC and BabbleCor) and observe consistent improvements. Furthermore, we reach, or perhaps outperform, the state-of-the-art performance of BabbleCor.

Advances in large language models (LLMs) provide new opportunities in healthcare for improved patient care, clinical decision-making, and enhancement of physician and administrator workflows. However, the potential of these models importantly depends on their ability to generalize effectively across clinical environments and populations, a challenge often underestimated in early development. To better understand reasons for these challenges and inform mitigation approaches, we evaluated ClinicLLM, an LLM trained on [HOSPITAL]'s clinical notes, analyzing its performance on 30-day all-cause readmission prediction focusing on variability across hospitals and patient characteristics. We found poorer generalization particularly in hospitals with fewer samples, among patients with government and unspecified insurance, the elderly, and those with high comorbidities. To understand reasons for lack of generalization, we investigated sample sizes for fine-tuning, note content (number of words per note), patient characteristics (comorbidity level, age, insurance type, borough), and health system aspects (hospital, all-cause 30-day readmission, and mortality rates). We used descriptive statistics and supervised classification to identify features. We found that, along with sample size, patient age, number of comorbidities, and the number of words in notes are all important factors related to generalization. Finally, we compared local fine-tuning (hospital specific), instance-based augmented fine-tuning and cluster-based fine-tuning for improving generalization. Among these, local fine-tuning proved most effective, increasing AUC by 0.25% to 11.74% (most helpful in settings with limited data). Overall, this study provides new insights for enhancing the deployment of large language models in the societally important domain of healthcare, and improving their performance for broader populations.

Speculative decoding (SD), where an extra draft model is employed to provide multiple draft tokens first and then the original target model verifies these tokens in parallel, has shown great power for LLM inference acceleration. However, existing SD methods suffer from the mutual waiting problem, i.e., the target model gets stuck when the draft model is guessing tokens, and vice versa. This problem is directly incurred by the asynchronous execution of the draft model and the target model, and is exacerbated due to the fixed draft length in speculative decoding. To address these challenges, we propose a conceptually simple, flexible, and general framework to boost speculative decoding, namely Parallel spEculative decoding with Adaptive dRaft Length (PEARL). Specifically, PEARL proposes pre-verify to verify the first draft token in advance during the drafting phase, and post-verify to generate more draft tokens during the verification phase. PEARL parallels the drafting phase and the verification phase via applying the two strategies, and achieves adaptive draft length for different scenarios, which effectively alleviates the mutual waiting problem. Moreover, we theoretically demonstrate that the mean accepted tokens of PEARL is more than existing draft-then-verify works. Experiments on various text generation benchmarks demonstrate the effectiveness of our \name, leading to a superior speedup performance up to 3.79times and 1.52times, compared to auto-regressive decoding and vanilla speculative decoding, respectively.

Pain is a complex and pervasive condition that affects a significant portion of the population. Accurate and consistent assessment is essential for individuals suffering from pain, as well as for developing effective management strategies in a healthcare system. Automatic pain assessment systems enable continuous monitoring, support clinical decision-making, and help minimize patient distress while mitigating the risk of functional deterioration. Leveraging physiological signals offers objective and precise insights into a person's state, and their integration in a multimodal framework can further enhance system performance. This study has been submitted to the Second Multimodal Sensing Grand Challenge for Next-Gen Pain Assessment (AI4PAIN). The proposed approach introduces Tiny-BioMoE, a lightweight pretrained embedding model for biosignal analysis. Trained on 4.4 million biosignal image representations and consisting of only 7.3 million parameters, it serves as an effective tool for extracting high-quality embeddings for downstream tasks. Extensive experiments involving electrodermal activity, blood volume pulse, respiratory signals, peripheral oxygen saturation, and their combinations highlight the model's effectiveness across diverse modalities in automatic pain recognition tasks. The model's architecture (code) and weights are available at https://github.com/GkikasStefanos/Tiny-BioMoE.

Databases of electronic health records (EHRs) are increasingly used to inform clinical decisions. Machine learning methods can find patterns in EHRs that are predictive of future adverse outcomes. However, statistical models may be built upon patterns of health-seeking behavior that vary across patient subpopulations, leading to poor predictive performance when training on one patient population and predicting on another. This note proposes two tests to better measure and understand model generalization. We use these tests to compare models derived from two data sources: (i) historical medical records, and (ii) electrocardiogram (EKG) waveforms. In a predictive task, we show that EKG-based models can be more stable than EHR-based models across different patient populations.

Biomedical literature often uses complex language and inaccessible professional terminologies. That is why simplification plays an important role in improving public health literacy. Applying Natural Language Processing (NLP) models to automate such tasks allows for quick and direct accessibility for lay readers. In this work, we investigate the ability of state-of-the-art large language models (LLMs) on the task of biomedical abstract simplification, using the publicly available dataset for plain language adaptation of biomedical abstracts (PLABA). The methods applied include domain fine-tuning and prompt-based learning (PBL) on: 1) Encoder-decoder models (T5, SciFive, and BART), 2) Decoder-only GPT models (GPT-3.5 and GPT-4) from OpenAI and BioGPT, and 3) Control-token mechanisms on BART-based models. We used a range of automatic evaluation metrics, including BLEU, ROUGE, SARI, and BERTscore, and also conducted human evaluations. BART-Large with Control Token (BART-L-w-CT) mechanisms reported the highest SARI score of 46.54 and T5-base reported the highest BERTscore 72.62. In human evaluation, BART-L-w-CTs achieved a better simplicity score over T5-Base (2.9 vs. 2.2), while T5-Base achieved a better meaning preservation score over BART-L-w-CTs (3.1 vs. 2.6). We also categorised the system outputs with examples, hoping this will shed some light for future research on this task. Our code, fine-tuned models, and data splits are available at https://github.com/HECTA-UoM/PLABA-MU

Existing speculative decoding methods typically require additional model structure and training processes to assist the model for draft token generation. This makes the migration of acceleration methods to the new model more costly and more demanding on device memory. To address this problem, we propose the Make Some Noise (MSN) training framework as a replacement for the supervised fine-tuning stage of the large language model. The training method simply introduces some noise at the input for the model to learn the denoising task. It significantly enhances the parallel decoding capability of the model without affecting the original task capability. In addition, we propose a tree-based retrieval-augmented Jacobi (TR-Jacobi) decoding strategy to further improve the inference speed of MSN models. Experiments in both the general and code domains have shown that MSN can improve inference speed by 2.3-2.7x times without compromising model performance. The MSN model also achieves comparable acceleration ratios to the SOTA model with additional model structure on Spec-Bench.

Pre-trained language models like ChatGPT have significantly improved code generation. As these models scale up, there is an increasing need for the output to handle more intricate tasks. Moreover, in bioinformatics, generating functional programs poses additional notable challenges due to the amount of domain knowledge, the need for complicated data operations, and intricate functional dependencies between the operations. Here, we present BioCoder, a benchmark developed to evaluate existing pre-trained models in generating bioinformatics code. In relation to function-code generation, BioCoder covers potential package dependencies, class declarations, and global variables. It incorporates 1026 functions and 1243 methods in Python and Java from GitHub and 253 examples from the Rosalind Project. BioCoder incorporates a fuzz-testing framework for evaluation, and we have applied it to evaluate many models including InCoder, CodeGen, CodeGen2, SantaCoder, StarCoder, StarCoder+, InstructCodeT5+, and ChatGPT. Our detailed analysis of these models emphasizes the importance of domain knowledge, pragmatic code generation, and contextual understanding. Our dataset, benchmark, Docker images, and scripts required for testing are all available at https://github.com/gersteinlab/biocoder.

Mental health is a significant and growing public health concern. As language usage can be leveraged to obtain crucial insights into mental health conditions, there is a need for large-scale, labeled, mental health-related datasets of users who have been diagnosed with one or more of such conditions. In this paper, we investigate the creation of high-precision patterns to identify self-reported diagnoses of nine different mental health conditions, and obtain high-quality labeled data without the need for manual labelling. We introduce the SMHD (Self-reported Mental Health Diagnoses) dataset and make it available. SMHD is a novel large dataset of social media posts from users with one or multiple mental health conditions along with matched control users. We examine distinctions in users' language, as measured by linguistic and psychological variables. We further explore text classification methods to identify individuals with mental conditions through their language.

The growth in the number of parameters of Large Language Models (LLMs) has led to a significant surge in computational requirements, making them challenging and costly to deploy. Speculative decoding (SD) leverages smaller models to efficiently propose future tokens, which are then verified by the LLM in parallel. Small models that utilise activations from the LLM currently achieve the fastest decoding speeds. However, we identify several limitations of SD models including the lack of on-policyness during training and partial observability. To address these shortcomings, we propose a more grounded architecture for small models by introducing a Mixture of Attentions for SD. Our novel architecture can be applied in two scenarios: a conventional single device deployment and a novel client-server deployment where the small model is hosted on a consumer device and the LLM on a server. In a single-device scenario, we demonstrate state-of-the-art speedups improving EAGLE-2 by 9.5% and its acceptance length by 25%. In a client-server setting, our experiments demonstrate: 1) state-of-the-art latencies with minimal calls to the server for different network conditions, and 2) in the event of a complete disconnection, our approach can maintain higher accuracy compared to other SD methods and demonstrates advantages over API calls to LLMs, which would otherwise be unable to continue the generation process.

Large Language Models (LLMs) have revolutionized natural language processing by unifying tasks into text generation, yet their large parameter sizes and autoregressive nature limit inference speed. SAM-Decoding addresses this by introducing a novel retrieval-based speculative decoding method that uses a suffix automaton for efficient and accurate draft generation. Unlike n-gram matching used by the existing method, SAM-Decoding finds the longest suffix match in generating text and text corpuss, achieving an average time complexity of O(1) per generation step. SAM-Decoding constructs static and dynamic suffix automatons for the text corpus and input prompts, respectively, enabling fast and precise draft generation. Meanwhile, it is designed as an approach that can be combined with existing methods, allowing SAM-Decoding to adaptively select a draft generation strategy based on the matching length, thus increasing the inference speed of the LLM. When combined with Token Recycling, evaluations show SAM-Decoding outperforms existing model-free methods, achieving a speedup of 2.27times over autoregressive decoding on Spec-Bench. When combined with EAGLE2, it reaches a speedup of 2.49times, surpassing all current approaches. Our code is available at https://github.com/hyx1999/SAM-Decoding.

Text generation with beam search has proven successful in a wide range of applications. The commonly-used implementation of beam decoding follows a first come, first served heuristic: it keeps a set of already completed sequences over time steps and stops when the size of this set reaches the beam size. We introduce a patience factor, a simple modification to this decoding algorithm, that generalizes the stopping criterion and provides flexibility to the depth of search. Extensive empirical results demonstrate that the patience factor improves decoding performance of strong pretrained models on news text summarization and machine translation over diverse language pairs, with a negligible inference slowdown. Our approach only modifies one line of code and can be thus readily incorporated in any implementation.

Speculative Decoding (SD) is a widely used approach to accelerate the inference of large language models (LLMs) without reducing generation quality. It operates by first using a compact model to draft multiple tokens efficiently, followed by parallel verification using the target LLM. This approach leads to faster inference compared to auto-regressive decoding. While there are multiple approaches to create a draft model, one promising approach is to use early-exit methods. These methods draft candidate tokens by using a subset of layers of the primary model and applying the remaining layers for verification, allowing a single model to handle both drafting and verification. While this technique reduces memory usage and computational cost, its performance relies on the choice of the exit layer for drafting and the number of tokens drafted (speculation length) in each SD round. Prior works use hyperparameter exploration to statically select these values. However, our evaluations show that these hyperparameter values are task-specific, and even within a task they are dependent on the current sequence context. We introduce DEL, a plug-and-play method that adaptively selects the exit layer and speculation length during inference. DEL dynamically tracks the token acceptance rate if the tokens are drafted at each layer of an LLM and uses that knowledge to heuristically select the optimal exit layer and speculation length. Our experiments across a broad range of models and downstream tasks show that DEL achieves overall speedups of 2.16timessim2.50times over vanilla auto-regressive decoding and improves upon the state-of-the-art SD methods by up to 0.27times.

Mental distress like depression and anxiety contribute to the largest proportion of the global burden of diseases. Automated diagnosis systems of such disorders, empowered by recent innovations in Artificial Intelligence, can pave the way to reduce the sufferings of the affected individuals. Development of such systems requires information-rich and balanced corpora. In this work, we introduce a novel mental distress analysis audio dataset DEPAC, labeled based on established thresholds on depression and anxiety standard screening tools. This large dataset comprises multiple speech tasks per individual, as well as relevant demographic information. Alongside, we present a feature set consisting of hand-curated acoustic and linguistic features, which were found effective in identifying signs of mental illnesses in human speech. Finally, we justify the quality and effectiveness of our proposed audio corpus and feature set in predicting depression severity by comparing the performance of baseline machine learning models built on this dataset with baseline models trained on other well-known depression corpora.

Pretrained generative models have opened new frontiers in brain decoding by enabling the synthesis of realistic texts and images from non-invasive brain recordings. However, the reliability of such outputs remains questionable--whether they truly reflect semantic activation in the brain, or are merely hallucinated by the powerful generative models. In this paper, we focus on EEG-to-text decoding and address its hallucination issue through the lens of posterior collapse. Acknowledging the underlying mismatch in information capacity between EEG and text, we reframe the decoding task as semantic summarization of core meanings rather than previously verbatim reconstruction of stimulus texts. To this end, we propose the Generative Language Inspection Model (GLIM), which emphasizes learning informative and interpretable EEG representations to improve semantic grounding under heterogeneous and small-scale data conditions. Experiments on the public ZuCo dataset demonstrate that GLIM consistently generates fluent, EEG-grounded sentences without teacher forcing. Moreover, it supports more robust evaluation beyond text similarity, through EEG-text retrieval and zero-shot semantic classification across sentiment categories, relation types, and corpus topics. Together, our architecture and evaluation protocols lay the foundation for reliable and scalable benchmarking in generative brain decoding.

Large language model (LLM) decoding involves generating a sequence of tokens based on a given context, where each token is predicted one at a time using the model's learned probabilities. The typical autoregressive decoding method requires a separate forward pass through the model for each token generated, which is computationally inefficient and poses challenges for deploying LLMs in latency-sensitive scenarios. The main limitations of current decoding methods stem from their inefficiencies and resource demands. Existing approaches either necessitate fine-tuning smaller models, which is resource-intensive, or rely on fixed retrieval schemes to construct drafts for the next tokens, which lack adaptability and fail to generalize across different models and contexts. To address these issues, we introduce a novel methodology called ADED, which accelerates LLM decoding without requiring fine-tuning. Our approach involves an adaptive draft-verification process that evolves over time to improve efficiency. We utilize a tri-gram matrix-based LLM representation to dynamically approximate the output distribution of the LLM, allowing the model to adjust to changing token probabilities during the decoding process. Additionally, we implement a draft construction mechanism that effectively balances exploration and exploitation, ensuring that the drafts generated are both diverse and close to the true output distribution of the LLM. The importance of this design lies in its ability to optimize the draft distribution adaptively, leading to faster and more accurate decoding. Through extensive experiments on various benchmark datasets and LLM architectures, we demonstrate that ADED significantly accelerates the decoding process while maintaining high accuracy, making it suitable for deployment in a wide range of practical applications.

Depressive and anxiety disorders are widespread, necessitating timely identification and management. Recent advances in Large Language Models (LLMs) offer potential solutions, yet high costs and ethical concerns about training data remain challenges. This paper introduces a pipeline for synthesizing clinical interviews, resulting in 1,157 interactive dialogues (PsyInterview), and presents EmoScan, an LLM-based emotional disorder screening system. EmoScan distinguishes between coarse (e.g., anxiety or depressive disorders) and fine disorders (e.g., major depressive disorders) and conducts high-quality interviews. Evaluations showed that EmoScan exceeded the performance of base models and other LLMs like GPT-4 in screening emotional disorders (F1-score=0.7467). It also delivers superior explanations (BERTScore=0.9408) and demonstrates robust generalizability (F1-score of 0.67 on an external dataset). Furthermore, EmoScan outperforms baselines in interviewing skills, as validated by automated ratings and human evaluations. This work highlights the importance of scalable data-generative pipelines for developing effective mental health LLM tools.

Electrocardiography plays a central role in cardiovascular diagnostics, yet existing automated approaches often struggle to generalize across clinical tasks and offer limited support for open-ended reasoning. We present DiagECG, a novel framework that integrates time-series and language modeling by enabling large language models to process 12-lead ECG signals for clinical text generation tasks. Our approach discretizes continuous ECG embeddings into symbolic tokens using a lead-independent encoder and quantization module. These tokens are then used to extend the vocabulary of LLM, allowing the model to handle both ECG and natural language inputs in a unified manner. To bridge the modality gap, we pretrain the model on an autoregressive ECG forecasting task, enabling the LLM to model temporal dynamics using its native language modeling capabilities. Finally, we perform instruction tuning on both ECG question answering and diagnostic report generation. Without modifying the core model, DiagECG achieves strong performance across tasks while maintaining generalization to out-of-distribution settings. Extensive experiments demonstrate the effectiveness of each component and highlight the potential of integrating symbolic ECG representations into LLMs for medical reasoning.

Inference-time optimization scales computation to derive deliberate reasoning steps for effective performance. While previous search-based strategies address the short-sightedness of auto-regressive generation, the vast search space leads to excessive exploration and insufficient exploitation. To strike an efficient balance to derive the optimal step, we frame the decoding strategy as foresight sampling, leveraging simulated future steps to obtain globally optimal step estimation. Built on it, we propose a novel decoding strategy, named phi-Decoding. To provide a precise and expressive estimation of step value, phi-Decoding approximates two distributions via foresight and clustering. Sampling from the joint distribution, the optimal steps can be selected for exploitation. To support adaptive computation allocation, we propose in-width and in-depth pruning strategies, featuring a light-weight solution to achieve inference efficiency. Extensive experiments across seven benchmarks show phi-Decoding outperforms strong baselines in both performance and efficiency. Additional analysis demonstrates its generalization across various LLMs and scalability across a wide range of computing budgets. The code will be released at https://github.com/xufangzhi/phi-Decoding, and the open-source PyPI package is coming soon.

Objective To solve major clinical natural language processing (NLP) tasks using a unified text-to-text learning architecture based on a generative large language model (LLM) via prompt tuning. Methods We formulated 7 key clinical NLP tasks as text-to-text learning and solved them using one unified generative clinical LLM, GatorTronGPT, developed using GPT-3 architecture and trained with up to 20 billion parameters. We adopted soft prompts (i.e., trainable vectors) with frozen LLM, where the LLM parameters were not updated (i.e., frozen) and only the vectors of soft prompts were updated, known as prompt tuning. We added additional soft prompts as a prefix to the input layer, which were optimized during the prompt tuning. We evaluated the proposed method using 7 clinical NLP tasks and compared them with previous task-specific solutions based on Transformer models. Results and Conclusion The proposed approach achieved state-of-the-art performance for 5 out of 7 major clinical NLP tasks using one unified generative LLM. Our approach outperformed previous task-specific transformer models by ~3% for concept extraction and 7% for relation extraction applied to social determinants of health, 3.4% for clinical concept normalization, 3.4~10% for clinical abbreviation disambiguation, and 5.5~9% for natural language inference. Our approach also outperformed a previously developed prompt-based machine reading comprehension (MRC) model, GatorTron-MRC, for clinical concept and relation extraction. The proposed approach can deliver the ``one model for all`` promise from training to deployment using a unified generative LLM.

In this paper, we consider enhancing medical visual-language pre-training (VLP) with domain-specific knowledge, by exploiting the paired image-text reports from the radiological daily practice. In particular, we make the following contributions: First, unlike existing works that directly process the raw reports, we adopt a novel triplet extraction module to extract the medical-related information, avoiding unnecessary complexity from language grammar and enhancing the supervision signals; Second, we propose a novel triplet encoding module with entity translation by querying a knowledge base, to exploit the rich domain knowledge in medical field, and implicitly build relationships between medical entities in the language embedding space; Third, we propose to use a Transformer-based fusion model for spatially aligning the entity description with visual signals at the image patch level, enabling the ability for medical diagnosis; Fourth, we conduct thorough experiments to validate the effectiveness of our architecture, and benchmark on numerous public benchmarks, e.g., ChestX-ray14, RSNA Pneumonia, SIIM-ACR Pneumothorax, COVIDx CXR-2, COVID Rural, and EdemaSeverity. In both zero-shot and fine-tuning settings, our model has demonstrated strong performance compared with the former methods on disease classification and grounding.

Personal sensing, leveraging data passively and near-continuously collected with wearables from patients in their ecological environment, is a promising paradigm to monitor mood disorders (MDs), a major determinant of worldwide disease burden. However, collecting and annotating wearable data is very resource-intensive. Studies of this kind can thus typically afford to recruit only a couple dozens of patients. This constitutes one of the major obstacles to applying modern supervised machine learning techniques to MDs detection. In this paper, we overcome this data bottleneck and advance the detection of MDs acute episode vs stable state from wearables data on the back of recent advances in self-supervised learning (SSL). This leverages unlabelled data to learn representations during pre-training, subsequently exploited for a supervised task. First, we collected open-access datasets recording with an Empatica E4 spanning different, unrelated to MD monitoring, personal sensing tasks -- from emotion recognition in Super Mario players to stress detection in undergraduates -- and devised a pre-processing pipeline performing on-/off-body detection, sleep-wake detection, segmentation, and (optionally) feature extraction. With 161 E4-recorded subjects, we introduce E4SelfLearning, the largest to date open access collection, and its pre-processing pipeline. Second, we show that SSL confidently outperforms fully-supervised pipelines using either our novel E4-tailored Transformer architecture (E4mer) or classical baseline XGBoost: 81.23% against 75.35% (E4mer) and 72.02% (XGBoost) correctly classified recording segments from 64 (half acute, half stable) patients. Lastly, we illustrate that SSL performance is strongly associated with the specific surrogate task employed for pre-training as well as with unlabelled data availability.

The advancement in healthcare has shifted focus toward patient-centric approaches, particularly in self-care and patient education, facilitated by access to Electronic Health Records (EHR). However, medical jargon in EHRs poses significant challenges in patient comprehension. To address this, we introduce a new task of automatically generating lay definitions, aiming to simplify complex medical terms into patient-friendly lay language. We first created the README dataset, an extensive collection of over 50,000 unique (medical term, lay definition) pairs and 300,000 mentions, each offering context-aware lay definitions manually annotated by domain experts. We have also engineered a data-centric Human-AI pipeline that synergizes data filtering, augmentation, and selection to improve data quality. We then used README as the training data for models and leveraged a Retrieval-Augmented Generation method to reduce hallucinations and improve the quality of model outputs. Our extensive automatic and human evaluations demonstrate that open-source mobile-friendly models, when fine-tuned with high-quality data, are capable of matching or even surpassing the performance of state-of-the-art closed-source large language models like ChatGPT. This research represents a significant stride in closing the knowledge gap in patient education and advancing patient-centric healthcare solutions.

Radiology reports are critical for clinical decision-making but often lack a standardized format, limiting both human interpretability and machine learning (ML) applications. While large language models (LLMs) have shown strong capabilities in reformatting clinical text, their high computational requirements, lack of transparency, and data privacy concerns hinder practical deployment. To address these challenges, we explore lightweight encoder-decoder models (<300M parameters)-specifically T5 and BERT2BERT-for structuring radiology reports from the MIMIC-CXR and CheXpert Plus datasets. We benchmark these models against eight open-source LLMs (1B-70B), adapted using prefix prompting, in-context learning (ICL), and low-rank adaptation (LoRA) finetuning. Our best-performing lightweight model outperforms all LLMs adapted using prompt-based techniques on a human-annotated test set. While some LoRA-finetuned LLMs achieve modest gains over the lightweight model on the Findings section (BLEU 6.4%, ROUGE-L 4.8%, BERTScore 3.6%, F1-RadGraph 1.1%, GREEN 3.6%, and F1-SRR-BERT 4.3%), these improvements come at the cost of substantially greater computational resources. For example, LLaMA-3-70B incurred more than 400 times the inference time, cost, and carbon emissions compared to the lightweight model. These results underscore the potential of lightweight, task-specific models as sustainable and privacy-preserving solutions for structuring clinical text in resource-constrained healthcare settings.

Next token prediction paradigm has been prevailing for autoregressive models in the era of LLMs. The current default sampling choice for popular LLMs is temperature scaling together with nucleus sampling to balance diversity and coherence. Nevertheless, such approach leads to inferior performance in various NLP tasks when the model is not certain about testing questions. To this end, we propose a brand new training-free decoding strategy, dubbed as Cautious Next Token Prediction (CNTP). In the decoding process, if the model has comparatively high prediction entropy at a certain step, we sample multiple trials starting from the step independently and stop when encountering any punctuation. Then we select the trial with the lowest perplexity score viewed as the most probable and reliable trial path given the model's capacity. The trial number is negatively correlated with the prediction confidence, i.e., the less confident the model is, the more trials it should sample. This is consistent with human beings' behaviour: when feeling uncertain or unconfident, one tends to think more creatively, exploring multiple thinking paths, to cautiously select the path one feels most confident about. Extensive experiments on both LLMs and MLLMs show that our proposed CNTP approach outperforms existing standard decoding strategies consistently by a clear margin. Moreover, the integration of CNTP with self consistency can further improve over vanilla self consistency. We believe our proposed CNTP has the potential to become one of the default choices for LLM decoding. Code is available at https://github.com/wyzjack/CNTP.

Inference from large autoregressive models like Transformers is slow - decoding K tokens takes K serial runs of the model. In this work we introduce speculative decoding - an algorithm to sample from autoregressive models faster without any changes to the outputs, by computing several tokens in parallel. At the heart of our approach lie the observations that (1) hard language-modeling tasks often include easier subtasks that can be approximated well by more efficient models, and (2) using speculative execution and a novel sampling method, we can make exact decoding from the large models faster, by running them in parallel on the outputs of the approximation models, potentially generating several tokens concurrently, and without changing the distribution. Our method can accelerate existing off-the-shelf models without retraining or architecture changes. We demonstrate it on T5-XXL and show a 2X-3X acceleration compared to the standard T5X implementation, with identical outputs.

Handwritten Mathematical Expression Recognition (HMER) has wide applications in human-machine interaction scenarios, such as digitized education and automated offices. Recently, sequence-based models with encoder-decoder architectures have been commonly adopted to address this task by directly predicting LaTeX sequences of expression images. However, these methods only implicitly learn the syntax rules provided by LaTeX, which may fail to describe the position and hierarchical relationship between symbols due to complex structural relations and diverse handwriting styles. To overcome this challenge, we propose a position forest transformer (PosFormer) for HMER, which jointly optimizes two tasks: expression recognition and position recognition, to explicitly enable position-aware symbol feature representation learning. Specifically, we first design a position forest that models the mathematical expression as a forest structure and parses the relative position relationships between symbols. Without requiring extra annotations, each symbol is assigned a position identifier in the forest to denote its relative spatial position. Second, we propose an implicit attention correction module to accurately capture attention for HMER in the sequence-based decoder architecture. Extensive experiments validate the superiority of PosFormer, which consistently outperforms the state-of-the-art methods 2.03%/1.22%/2.00%, 1.83%, and 4.62% gains on the single-line CROHME 2014/2016/2019, multi-line M2E, and complex MNE datasets, respectively, with no additional latency or computational cost. Code is available at https://github.com/SJTU-DeepVisionLab/PosFormer.

Pre-trained models for Natural Languages (NL) like BERT and GPT have been recently shown to transfer well to Programming Languages (PL) and largely benefit a broad set of code-related tasks. Despite their success, most current methods either rely on an encoder-only (or decoder-only) pre-training that is suboptimal for generation (resp. understanding) tasks or process the code snippet in the same way as NL, neglecting the special characteristics of PL such as token types. We present CodeT5, a unified pre-trained encoder-decoder Transformer model that better leverages the code semantics conveyed from the developer-assigned identifiers. Our model employs a unified framework to seamlessly support both code understanding and generation tasks and allows for multi-task learning. Besides, we propose a novel identifier-aware pre-training task that enables the model to distinguish which code tokens are identifiers and to recover them when they are masked. Furthermore, we propose to exploit the user-written code comments with a bimodal dual generation task for better NL-PL alignment. Comprehensive experiments show that CodeT5 significantly outperforms prior methods on understanding tasks such as code defect detection and clone detection, and generation tasks across various directions including PL-NL, NL-PL, and PL-PL. Further analysis reveals that our model can better capture semantic information from code. Our code and pre-trained models are released at https: //github.com/salesforce/CodeT5 .

While recent multimodal large language models (MLLMs) have advanced automated ECG interpretation, they still face two key limitations: (1) insufficient multimodal synergy between time series signals and visual ECG representations, and (2) limited explainability in linking diagnoses to granular waveform evidence. We introduce GEM, the first MLLM unifying ECG time series, 12-lead ECG images and text for grounded and clinician-aligned ECG interpretation. GEM enables feature-grounded analysis, evidence-driven reasoning, and a clinician-like diagnostic process through three core innovations: a dual-encoder framework extracting complementary time series and image features, cross-modal alignment for effective multimodal understanding, and knowledge-guided instruction generation for generating high-granularity grounding data (ECG-Grounding) linking diagnoses to measurable parameters (e.g., QRS/PR Intervals). Additionally, we propose the Grounded ECG Understanding task, a clinically motivated benchmark designed to comprehensively assess the MLLM's capability in grounded ECG understanding. Experimental results on both existing and our proposed benchmarks show GEM significantly improves predictive performance (CSN 7.4% uparrow), explainability (22.7% uparrow), and grounding (24.8% uparrow), making it more suitable for real-world clinical applications. GitHub repository: https://github.com/lanxiang1017/GEM.git

In recent years, the application of Large Language Models (LLMs) in healthcare has shown significant promise in improving the accessibility and dissemination of medical knowledge. This paper presents a detailed study of various LLMs trained on the MedQuAD medical question-answering dataset, with a focus on identifying the most effective model for providing accurate medical information. Among the models tested, the Sentence-t5 combined with Mistral 7B demonstrated superior performance, achieving a precision score of 0.762. This model's enhanced capabilities are attributed to its advanced pretraining techniques, robust architecture, and effective prompt construction methodologies. By leveraging these strengths, the Sentence-t5 + Mistral 7B model excels in understanding and generating precise medical answers. Our findings highlight the potential of integrating sophisticated LLMs in medical contexts to facilitate efficient and accurate medical knowledge retrieval, thus significantly enhancing patient education and support.

Query-focused summarization (QFS) aims to provide a summary of a single document/multi documents that can satisfy the information needs of a given query. It is useful for various real-world applications, such as abstractive snippet generation or more recent retrieval augmented generation (RAG). A prototypical QFS pipeline consists of a retriever (sparse or dense retrieval) and a generator (usually a large language model). However, applying large language models (LLM) potentially leads to hallucinations, especially when the evidence contradicts the prior belief of LLMs. There has been growing interest in developing new decoding methods to improve generation quality and reduce hallucination. In this work, we conduct a large-scale reproducibility study on one recently proposed decoding method -- Context-aware Decoding (CAD). In addition to replicating CAD's experiments on news summarization datasets, we include experiments on QFS datasets, and conduct more rigorous analysis on computational complexity and hyperparameter sensitivity. Experiments with eight different language models show that performance-wise, CAD improves QFS quality by (1) reducing factuality errors/hallucinations while (2) mostly retaining the match of lexical patterns, measured by ROUGE scores, while also at a cost of increased inference-time FLOPs and reduced decoding speed. The code implementation based on Huggingface Library is made available https://github.com/zhichaoxu-shufe/context-aware-decoding-qfs

Speculative Decoding (SD) has emerged as a widely used paradigm to accelerate the inference of large language models (LLMs) without compromising generation quality. It works by efficiently drafting multiple tokens using a compact model and then verifying them in parallel using the target LLM. Notably, Self-Speculative Decoding proposes skipping certain layers to construct the draft model, which eliminates the need for additional parameters or training. Despite its strengths, we observe in this work that drafting with layer skipping exhibits significant sensitivity to domain shifts, leading to a substantial drop in acceleration performance. To enhance the domain generalizability of this paradigm, we introduce KNN-SSD, an algorithm that leverages K-Nearest Neighbor (KNN) search to match different skipped layers with various domain inputs. We evaluated our algorithm in various models and multiple tasks, observing that its application leads to 1.3x-1.6x speedup in LLM inference.

Substance use disorders (SUDs) are a growing concern globally, necessitating enhanced understanding of the problem and its trends through data-driven research. Social media are unique and important sources of information about SUDs, particularly since the data in such sources are often generated by people with lived experiences. In this paper, we introduce Reddit-Impacts, a challenging Named Entity Recognition (NER) dataset curated from subreddits dedicated to discussions on prescription and illicit opioids, as well as medications for opioid use disorder. The dataset specifically concentrates on the lesser-studied, yet critically important, aspects of substance use--its clinical and social impacts. We collected data from chosen subreddits using the publicly available Application Programming Interface for Reddit. We manually annotated text spans representing clinical and social impacts reported by people who also reported personal nonmedical use of substances including but not limited to opioids, stimulants and benzodiazepines. Our objective is to create a resource that can enable the development of systems that can automatically detect clinical and social impacts of substance use from text-based social media data. The successful development of such systems may enable us to better understand how nonmedical use of substances affects individual health and societal dynamics, aiding the development of effective public health strategies. In addition to creating the annotated data set, we applied several machine learning models to establish baseline performances. Specifically, we experimented with transformer models like BERT, and RoBERTa, one few-shot learning model DANN by leveraging the full training dataset, and GPT-3.5 by using one-shot learning, for automatic NER of clinical and social impacts. The dataset has been made available through the 2024 SMM4H shared tasks.

Hope Speech Detection, a task of recognizing positive expressions, has made significant strides recently. However, much of the current works focus on model development without considering the issue of inherent imbalance in the data. Our work revisits this issue in hope-speech detection by introducing focal loss, data augmentation, and pre-processing strategies. Accordingly, we find that introducing focal loss as part of Multilingual-BERT's (M-BERT) training process mitigates the effect of class imbalance and improves overall F1-Macro by 0.11. At the same time, contextual and back-translation-based word augmentation with M-BERT improves results by 0.10 over baseline despite imbalance. Finally, we show that overlapping word removal based on pre-processing, though simple, improves F1-Macro by 0.28. In due process, we present detailed studies depicting various behaviors of each of these strategies and summarize key findings from our empirical results for those interested in getting the most out of M-BERT for hope speech detection under real-world conditions of data imbalance.

A crucial step within secondary analysis of electronic health records (EHRs) is to identify the patient cohort under investigation. While EHRs contain medical billing codes that aim to represent the conditions and treatments patients may have, much of the information is only present in the patient notes. Therefore, it is critical to develop robust algorithms to infer patients' conditions and treatments from their written notes. In this paper, we introduce a dataset for patient phenotyping, a task that is defined as the identification of whether a patient has a given medical condition (also referred to as clinical indication or phenotype) based on their patient note. Nursing Progress Notes and Discharge Summaries from the Intensive Care Unit of a large tertiary care hospital were manually annotated for the presence of several high-context phenotypes relevant to treatment and risk of re-hospitalization. This dataset contains 1102 Discharge Summaries and 1000 Nursing Progress Notes. Each Discharge Summary and Progress Note has been annotated by at least two expert human annotators (one clinical researcher and one resident physician). Annotated phenotypes include treatment non-adherence, chronic pain, advanced/metastatic cancer, as well as 10 other phenotypes. This dataset can be utilized for academic and industrial research in medicine and computer science, particularly within the field of medical natural language processing.

Contextual word embedding models such as ELMo (Peters et al., 2018) and BERT (Devlin et al., 2018) have dramatically improved performance for many natural language processing (NLP) tasks in recent months. However, these models have been minimally explored on specialty corpora, such as clinical text; moreover, in the clinical domain, no publicly-available pre-trained BERT models yet exist. In this work, we address this need by exploring and releasing BERT models for clinical text: one for generic clinical text and another for discharge summaries specifically. We demonstrate that using a domain-specific model yields performance improvements on three common clinical NLP tasks as compared to nonspecific embeddings. These domain-specific models are not as performant on two clinical de-identification tasks, and argue that this is a natural consequence of the differences between de-identified source text and synthetically non de-identified task text.

In this paper, we introduce a simple training-free technique to improve the performance of drafter-based speculative decoding (SpD) methods that incorporates language modeling head (LM head) during drafting process. A drafter-based speculative decoding leverages one or more smaller language models, a.k.a. drafters or draft models, to sample a draft sequence or tree consisting of multiple tokens, followed by verification by a base LLM, a target model, accepting a subset as its valid generation. As it is usually considered that the speculative decoding requires one-to-one mapping between vocabularies of the target model and the draft model, it has been natural to share the vocabulary between them, or even share the LM head as in EAGLE or Medusa. We first identify that this draft token sampling scheme inherently contains an unnecessary inference overhead in drafting, especially for some target LLMs with very large vocabularies. Then, we propose a simple technique, VocabTrim, to mitigate the drafting overhead to improve the generation speed in memory-bound environment. VocabTrim reconstructs the drafter LM head to contain only a limited set of tokens, selected by the most frequently sampled from the vocabulary of the target model. While limiting the vocabulary in drafting slightly degrades the acceptance rate, it significantly reduces the drafting latency in memory-bound process which is often the case on edge devices, resulting in higher memory-bound speed up (MBSU). We show that our method can boost the memory-bound speed-up for Llama-3 models on Spec-Bench, specifically by 16% for Llama-3.2-3B-Instruct.

Specialised pre-trained language models are becoming more frequent in NLP since they can potentially outperform models trained on generic texts. BioBERT and BioClinicalBERT are two examples of such models that have shown promise in medical NLP tasks. Many of these models are overparametrised and resource-intensive, but thanks to techniques like Knowledge Distillation (KD), it is possible to create smaller versions that perform almost as well as their larger counterparts. In this work, we specifically focus on development of compact language models for processing clinical texts (i.e. progress notes, discharge summaries etc). We developed a number of efficient lightweight clinical transformers using knowledge distillation and continual learning, with the number of parameters ranging from 15 million to 65 million. These models performed comparably to larger models such as BioBERT and ClinicalBioBERT and significantly outperformed other compact models trained on general or biomedical data. Our extensive evaluation was done across several standard datasets and covered a wide range of clinical text-mining tasks, including Natural Language Inference, Relation Extraction, Named Entity Recognition, and Sequence Classification. To our knowledge, this is the first comprehensive study specifically focused on creating efficient and compact transformers for clinical NLP tasks. The models and code used in this study can be found on our Huggingface profile at https://huggingface.co/nlpie and Github page at https://github.com/nlpie-research/Lightweight-Clinical-Transformers, respectively, promoting reproducibility of our results.