Hans Moen

Ya Gao, Hans Moen, Saila Koivusalo et al.

Nursing notes, an important part of Electronic Health Records (EHRs), track a patient's health during a care episode. Summarizing key information in nursing notes can help clinicians quickly understand patients' conditions. However, existing summarization methods in the clinical setting, especially abstractive methods, have overlooked nursing notes and require reference summaries for training. We introduce QGSumm, a novel query-guided self-supervised domain adaptation approach for abstractive nursing note summarization. The method uses patient-related clinical queries for guidance, and hence does not need reference summaries for training. Through automatic experiments and manual evaluation by an expert clinician, we study our approach and other state-of-the-art Large Language Models (LLMs) for nursing note summarization. Our experiments show: 1) GPT-4 is competitive in maintaining information in the original nursing notes, 2) QGSumm can generate high-quality summaries with a good balance between recall of the original content and hallucination rate lower than other top methods. Ultimately, our work offers a new perspective on conditional text summarization, tailored to clinical applications.

Hung Nguyen, Hans Moen, Pekka Marttinen

Extracting insights from Electronic Health Record (EHR) databases often requires SQL expertise, creating a barrier for clinical decision-making and research. A promising approach is to use Large Language Models (LLMs) to translate natural language questions into SQL through Retrieval-Augmented Generation (RAG), where relevant question-SQL examples are retrieved to generate new queries via few-shot learning. However, adapting this method to the medical domain is non-trivial, as effective retrieval requires examples that align with both the logical structure of the question and its referenced entities (e.g., drug names, procedure titles). Standard single-step RAG struggles to optimize both aspects simultaneously and often relies on near-exact matches to generalize effectively. This issue is especially severe in healthcare, as questions often contain noisy and inconsistent medical jargon. To address this, we present CBR-to-SQL, a framework inspired by Case-based Reasoning theory that decomposes RAG's single-step retrieval into two explicit stages: one that focuses on retrieving structurally relevant examples, and one that aligns entities with the target database schema. Evaluated on two clinical benchmarks, CBR-to-SQL achieves competitive accuracies compared to fine-tuned methods. More importantly, it demonstrates considerably higher sample efficiency and robustness than the standard RAG approach, particularly under data scarcity and retrieval perturbations.

Akseli Reunamo, Laura-Maria Peltonen, Hans Moen et al.

This paper reports on pretraining ModernBERT encoder models in six different sizes, ranging from 51M to 475M parameters, with a focus on limited multilingualism, emphasizing languages relevant to Finland. Our models are competitive with, or superior to, existing multilingual models. They outperform monolingual models on tasks that require a context longer than 512 tokens. We present empirical results on using different data in the final stage of training. The code and models are publicly released.

Hans Moen, Vishnu Raj, Andrius Vabalas et al.

Health registers contain rich information about individuals' health histories. Here our interest lies in understanding how individuals' health trajectories evolve in a nationwide longitudinal dataset with coded features, such as clinical codes, procedures, and drug purchases. We introduce a straightforward approach for training a Transformer-based deep learning model in a way that lets us analyze how individuals' trajectories change over time. This is achieved by modifying the training objective and by applying a causal attention mask. We focus here on a general task of predicting the onset of a range of common diseases in a given future forecast interval. However, instead of providing a single prediction about diagnoses that could occur in this forecast interval, our approach enable the model to provide continuous predictions at every time point up until, and conditioned on, the time of the forecast period. We find that this model performs comparably to other models, including a bi-directional transformer model, in terms of basic prediction performance while at the same time offering promising trajectory modeling properties. We explore a couple of ways to use this model for analyzing health trajectories and aiding in early detection of events that forecast possible later disease onsets. We hypothesize that this method may be helpful in continuous monitoring of peoples' health trajectories and enabling interventions in ongoing health trajectories, as well as being useful in retrospective analyses.