Benjamin C. Warner

Hanyang Liu, Sunny S. Lou, Benjamin C. Warner et al.

Burnout is a significant public health concern affecting nearly half of the healthcare workforce. This paper presents the first end-to-end deep learning framework for predicting physician burnout based on electronic health record (EHR) activity logs, digital traces of physician work activities that are available in any EHR system. In contrast to prior approaches that exclusively relied on surveys for burnout measurement, our framework directly learns deep representations of physician behaviors from large-scale clinician activity logs to predict burnout. We propose the Hierarchical burnout Prediction based on Activity Logs (HiPAL), featuring a pre-trained time-dependent activity embedding mechanism tailored for activity logs and a hierarchical predictive model, which mirrors the natural hierarchical structure of clinician activity logs and captures physicians' evolving burnout risk at both short-term and long-term levels. To utilize the large amount of unlabeled activity logs, we propose a semi-supervised framework that learns to transfer knowledge extracted from unlabeled clinician activities to the HiPAL-based prediction model. The experiment on over 15 million clinician activity logs collected from the EHR at a large academic medical center demonstrates the advantages of our proposed framework in predictive performance of physician burnout and training efficiency over state-of-the-art approaches.

Benjamin C. Warner, Ziqi Xu, Simon Haroutounian et al.

Survey data can contain a high number of features while having a comparatively low quantity of examples. Machine learning models that attempt to predict outcomes from survey data under these conditions can overfit and result in poor generalizability. One remedy to this issue is feature selection, which attempts to select an optimal subset of features to learn upon. A relatively unexplored source of information in the feature selection process is the usage of textual names of features, which may be semantically indicative of which features are relevant to a target outcome. The relationships between feature names and target names can be evaluated using language models (LMs) to produce semantic textual similarity (STS) scores, which can then be used to select features. We examine the performance using STS to select features directly and in the minimal-redundancy-maximal-relevance (mRMR) algorithm. The performance of STS as a feature selection metric is evaluated against preliminary survey data collected as a part of a clinical study on persistent post-surgical pain (PPSP). The results suggest that features selected with STS can result in higher performance models compared to traditional feature selection algorithms.

Benjamin C. Warner, Thomas Kannampallil, Seunghwan Kim

EHR audit logs are a highly granular stream of events that capture clinician activities, and is a significant area of interest for research in characterizing clinician workflow on the electronic health record (EHR). Existing techniques to measure the complexity of workflow through EHR audit logs (audit logs) involve time- or frequency-based cross-sectional aggregations that are unable to capture the full complexity of a EHR session. We briefly evaluate the usage of transformer-based tabular language model (tabular LM) in measuring the entropy or disorderedness of action sequences within workflow and release the evaluated models publicly.

Benjamin Clavié, Nathan Cooper, Benjamin Warner

While encoder-only models such as BERT and ModernBERT are ubiquitous in real-world NLP applications, their conventional reliance on task-specific classification heads can limit their applicability compared to decoder-based large language models (LLMs). In this work, we introduce ModernBERT-Large-Instruct, a 0.4B-parameter encoder model that leverages its masked language modelling (MLM) head for generative classification. Our approach employs an intentionally simple training loop and inference mechanism that requires no heavy pre-processing, heavily engineered prompting, or architectural modifications. ModernBERT-Large-Instruct exhibits strong zero-shot performance on both classification and knowledge-based tasks, outperforming similarly sized LLMs on MMLU and achieving 93% of Llama3-1B's MMLU performance with 60% less parameters. We also demonstrate that, when fine-tuned, the generative approach using the MLM head matches or even surpasses traditional classification-head methods across diverse NLU tasks.This capability emerges specifically in models trained on contemporary, diverse data mixes, with models trained on lower volume, less-diverse data yielding considerably weaker performance. Although preliminary, these results demonstrate the potential of using the original generative masked language modelling head over traditional task-specific heads for downstream tasks. Our work suggests that further exploration into this area is warranted, highlighting many avenues for future improvements.