Wen-wai Yim

Asma Ben Abacha, Wen-wai Yim, Yujuan Fu et al.

Several studies showed that Large Language Models (LLMs) can answer medical questions correctly, even outperforming the average human score in some medical exams. However, to our knowledge, no study has been conducted to assess the ability of language models to validate existing or generated medical text for correctness and consistency. In this paper, we introduce MEDEC (https://github.com/abachaa/MEDEC), the first publicly available benchmark for medical error detection and correction in clinical notes, covering five types of errors (Diagnosis, Management, Treatment, Pharmacotherapy, and Causal Organism). MEDEC consists of 3,848 clinical texts, including 488 clinical notes from three US hospital systems that were not previously seen by any LLM. The dataset has been used for the MEDIQA-CORR shared task to evaluate seventeen participating systems [Ben Abacha et al., 2024]. In this paper, we describe the data creation methods and we evaluate recent LLMs (e.g., o1-preview, GPT-4, Claude 3.5 Sonnet, and Gemini 2.0 Flash) for the tasks of detecting and correcting medical errors requiring both medical knowledge and reasoning capabilities. We also conducted a comparative study where two medical doctors performed the same task on the MEDEC test set. The results showed that MEDEC is a sufficiently challenging benchmark to assess the ability of models to validate existing or generated notes and to correct medical errors. We also found that although recent LLMs have a good performance in error detection and correction, they are still outperformed by medical doctors in these tasks. We discuss the potential factors behind this gap, the insights from our experiments, the limitations of current evaluation metrics, and share potential pointers for future research.

Xiaofeng Zhu, Thomas Lin, Vishal Anand et al.

The core challenge in numerous real-world applications is to match an inquiry to the best document from a mutable and finite set of candidates. Existing industry solutions, especially latency-constrained services, often rely on similarity algorithms that sacrifice quality for speed. In this paper we introduce a generic semantic learning-to-rank framework, Self-training Semantic Cross-attention Ranking (sRank). This transformer-based framework uses linear pairwise loss with mutable training batch sizes and achieves quality gains and high efficiency, and has been applied effectively to show gains on two industry tasks at Microsoft over real-world large-scale data sets: Smart Reply (SR) and Ambient Clinical Intelligence (ACI). In Smart Reply, sRank assists live customers with technical support by selecting the best reply from predefined solutions based on consumer and support agent messages. It achieves 11.7% gain in offline top-one accuracy on the SR task over the previous system, and has enabled 38.7% time reduction in composing messages in telemetry recorded since its general release in January 2021. In the ACI task, sRank selects relevant historical physician templates that serve as guidance for a text summarization model to generate higher quality medical notes. It achieves 35.5% top-one accuracy gain, along with 46% relative ROUGE-L gain in generated medical notes.

Juampablo E. Heras Rivera, Daniel K. Low, Xavier Xiong et al.

Accurate brain tumor typing requires integrating heterogeneous clinical evidence, including magnetic resonance imaging (MRI), histopathology, and pathology reports, which are often incomplete at the time of diagnosis. We introduce CoRe-BT, a cross-modal radiology-pathology-text benchmark for brain tumor typing, designed to study robust multimodal learning under missing modality conditions. The dataset comprises 310 patients with multi-sequence brain MRI (T1, T1c, T2, FLAIR), including 95 cases with paired H&E-stained whole-slide pathology images and pathology reports. All cases are annotated with tumor type and grade, and MRI volumes include expert-annotated tumor masks, enabling both region-aware modeling and auxiliary learning tasks. Tumors are categorized into six clinically relevant classes capturing the heterogeneity of common and rare glioma subtypes. We evaluate tumor typing under variable modality availability by comparing MRI-only models with multimodal approaches that incorporate pathology information when present. Baseline experiments demonstrate the feasibility of multimodal fusion and highlight complementary modality contributions across clinically relevant typing tasks. CoRe-BT provides a grounded testbed for advancing multimodal glioma typing and representation learning in realistic scenarios with incomplete clinical data.

Zhaoyi Sun, Wen-Wai Yim, Ozlem Uzuner et al.

Objective: This review aims to explore the potential and challenges of using Natural Language Processing (NLP) to detect, correct, and mitigate medically inaccurate information, including errors, misinformation, and hallucination. By unifying these concepts, the review emphasizes their shared methodological foundations and their distinct implications for healthcare. Our goal is to advance patient safety, improve public health communication, and support the development of more reliable and transparent NLP applications in healthcare. Methods: A scoping review was conducted following PRISMA guidelines, analyzing studies from 2020 to 2024 across five databases. Studies were selected based on their use of NLP to address medically inaccurate information and were categorized by topic, tasks, document types, datasets, models, and evaluation metrics. Results: NLP has shown potential in addressing medically inaccurate information on the following tasks: (1) error detection (2) error correction (3) misinformation detection (4) misinformation correction (5) hallucination detection (6) hallucination mitigation. However, challenges remain with data privacy, context dependency, and evaluation standards. Conclusion: This review highlights the advancements in applying NLP to tackle medically inaccurate information while underscoring the need to address persistent challenges. Future efforts should focus on developing real-world datasets, refining contextual methods, and improving hallucination management to ensure reliable and transparent healthcare applications.

Matthias Blondeel, Noel Codella, Sam Preston et al.

Molecular Tumor Boards (MTBs) are multidisciplinary forums where oncology specialists collaboratively assess complex patient cases to determine optimal treatment strategies. A central element of this process is the patient summary, typically compiled by a medical oncologist, radiation oncologist, or surgeon, or their trained medical assistant, who distills heterogeneous medical records into a concise narrative to facilitate discussion. This manual approach is often labor-intensive, subjective, and prone to omissions of critical information. To address these limitations, we introduce the Healthcare Agent Orchestrator (HAO), a Large Language Model (LLM)-driven AI agent that coordinates a multi-agent clinical workflow to generate accurate and comprehensive patient summaries for MTBs. Evaluating predicted patient summaries against ground truth presents additional challenges due to stylistic variation, ordering, synonym usage, and phrasing differences, which complicate the measurement of both succinctness and completeness. To overcome these evaluation hurdles, we propose TBFact, a ``model-as-a-judge'' framework designed to assess the comprehensiveness and succinctness of generated summaries. Using a benchmark dataset derived from de-identified tumor board discussions, we applied TBFact to evaluate our Patient History agent. Results show that the agent captured 94% of high-importance information (including partial entailments) and achieved a TBFact recall of 0.84 under strict entailment criteria. We further demonstrate that TBFact enables a data-free evaluation framework that institutions can deploy locally without sharing sensitive clinical data. Together, HAO and TBFact establish a robust foundation for delivering reliable and scalable support to MTBs.

Asma Ben Abacha, Wen-wai Yim, George Michalopoulos et al.

Recent studies on automatic note generation have shown that doctors can save significant amounts of time when using automatic clinical note generation (Knoll et al., 2022). Summarization models have been used for this task to generate clinical notes as summaries of doctor-patient conversations (Krishna et al., 2021; Cai et al., 2022). However, assessing which model would best serve clinicians in their daily practice is still a challenging task due to the large set of possible correct summaries, and the potential limitations of automatic evaluation metrics. In this paper, we study evaluation methods and metrics for the automatic generation of clinical notes from medical conversations. In particular, we propose new task-specific metrics and we compare them to SOTA evaluation metrics in text summarization and generation, including: (i) knowledge-graph embedding-based metrics, (ii) customized model-based metrics, (iii) domain-adapted/fine-tuned metrics, and (iv) ensemble metrics. To study the correlation between the automatic metrics and manual judgments, we evaluate automatic notes/summaries by comparing the system and reference facts and computing the factual correctness, and the hallucination and omission rates for critical medical facts. This study relied on seven datasets manually annotated by domain experts. Our experiments show that automatic evaluation metrics can have substantially different behaviors on different types of clinical notes datasets. However, the results highlight one stable subset of metrics as the most correlated with human judgments with a relevant aggregation of different evaluation criteria.