Correlation between Alignment-Uniformity and Performance of Dense Contrastive RepresentationsJong Hak Moon, Wonjae Kim, Edward Choi
Recently, dense contrastive learning has shown superior performance on dense prediction tasks compared to instance-level contrastive learning. Despite its supremacy, the properties of dense contrastive representations have not yet been carefully studied. Therefore, we analyze the theoretical ideas of dense contrastive learning using a standard CNN and straightforward feature matching scheme rather than propose a new complex method. Inspired by the analysis of the properties of instance-level contrastive representations through the lens of alignment and uniformity on the hypersphere, we employ and extend the same lens for the dense contrastive representations to analyze their underexplored properties. We discover the core principle in constructing a positive pair of dense features and empirically proved its validity. Also, we introduces a new scalar metric that summarizes the correlation between alignment-and-uniformity and downstream performance. Using this metric, we study various facets of densely learned contrastive representations such as how the correlation changes over single- and multi-object datasets or linear evaluation and dense prediction tasks. The source code is publicly available at: https://github.com/SuperSupermoon/DenseCL-analysis
Lunguage: A Benchmark for Structured and Sequential Chest X-ray InterpretationJong Hak Moon, Geon Choi, Paloma Rabaey et al.
Radiology reports convey detailed clinical observations and capture diagnostic reasoning that evolves over time. However, existing evaluation methods are limited to single-report settings and rely on coarse metrics that fail to capture fine-grained clinical semantics and temporal dependencies. We introduce LUNGUAGE,a benchmark dataset for structured radiology report generation that supports both single-report evaluation and longitudinal patient-level assessment across multiple studies. It contains 1,473 annotated chest X-ray reports, each reviewed by experts, and 80 of them contain longitudinal annotations to capture disease progression and inter-study intervals, also reviewed by experts. Using this benchmark, we develop a two-stage framework that transforms generated reports into fine-grained, schema-aligned structured representations, enabling longitudinal interpretation. We also propose LUNGUAGESCORE, an interpretable metric that compares structured outputs at the entity, relation, and attribute level while modeling temporal consistency across patient timelines. These contributions establish the first benchmark dataset, structuring framework, and evaluation metric for sequential radiology reporting, with empirical results demonstrating that LUNGUAGESCORE effectively supports structured report evaluation. The code is available at: https://github.com/SuperSupermoon/Lunguage
2.7CLSep 2, 2024
DiversityMedQA: Assessing Demographic Biases in Medical Diagnosis using Large Language ModelsRajat Rawat, Hudson McBride, Dhiyaan Nirmal et al.
As large language models (LLMs) gain traction in healthcare, concerns about their susceptibility to demographic biases are growing. We introduce {DiversityMedQA}, a novel benchmark designed to assess LLM responses to medical queries across diverse patient demographics, such as gender and ethnicity. By perturbing questions from the MedQA dataset, which comprises medical board exam questions, we created a benchmark that captures the nuanced differences in medical diagnosis across varying patient profiles. Our findings reveal notable discrepancies in model performance when tested against these demographic variations. Furthermore, to ensure the perturbations were accurate, we also propose a filtering strategy that validates each perturbation. By releasing DiversityMedQA, we provide a resource for evaluating and mitigating demographic bias in LLM medical diagnoses.
Publicly Shareable Clinical Large Language Model Built on Synthetic Clinical NotesSunjun Kweon, Junu Kim, Jiyoun Kim et al.
The development of large language models tailored for handling patients' clinical notes is often hindered by the limited accessibility and usability of these notes due to strict privacy regulations. To address these challenges, we first create synthetic large-scale clinical notes using publicly available case reports extracted from biomedical literature. We then use these synthetic notes to train our specialized clinical large language model, Asclepius. While Asclepius is trained on synthetic data, we assess its potential performance in real-world applications by evaluating it using real clinical notes. We benchmark Asclepius against several other large language models, including GPT-3.5-turbo and other open-source alternatives. To further validate our approach using synthetic notes, we also compare Asclepius with its variants trained on real clinical notes. Our findings convincingly demonstrate that synthetic clinical notes can serve as viable substitutes for real ones when constructing high-performing clinical language models. This conclusion is supported by detailed evaluations conducted by both GPT-4 and medical professionals. All resources including weights, codes, and data used in the development of Asclepius are made publicly accessible for future research. (https://github.com/starmpcc/Asclepius)
Multi-modal Understanding and Generation for Medical Images and Text via Vision-Language Pre-TrainingJong Hak Moon, Hyungyung Lee, Woncheol Shin et al.
Recently a number of studies demonstrated impressive performance on diverse vision-language multi-modal tasks such as image captioning and visual question answering by extending the BERT architecture with multi-modal pre-training objectives. In this work we explore a broad set of multi-modal representation learning tasks in the medical domain, specifically using radiology images and the unstructured report. We propose Medical Vision Language Learner (MedViLL), which adopts a BERT-based architecture combined with a novel multi-modal attention masking scheme to maximize generalization performance for both vision-language understanding tasks (diagnosis classification, medical image-report retrieval, medical visual question answering) and vision-language generation task (radiology report generation). By statistically and rigorously evaluating the proposed model on four downstream tasks with three radiographic image-report datasets (MIMIC-CXR, Open-I, and VQA-RAD), we empirically demonstrate the superior downstream task performance of MedViLL against various baselines, including task-specific architectures. The source code is publicly available at: https://github.com/SuperSupermoon/MedViLL
2.7CLNov 6, 2025
Modeling Clinical Uncertainty in Radiology Reports: from Explicit Uncertainty Markers to Implicit Reasoning PathwaysPaloma Rabaey, Jong Hak Moon, Jung-Oh Lee et al.
Radiology reports are invaluable for clinical decision-making and hold great potential for automated analysis when structured into machine-readable formats. These reports often contain uncertainty, which we categorize into two distinct types: (i) Explicit uncertainty reflects doubt about the presence or absence of findings, conveyed through hedging phrases. These vary in meaning depending on the context, making rule-based systems insufficient to quantify the level of uncertainty for specific findings; (ii) Implicit uncertainty arises when radiologists omit parts of their reasoning, recording only key findings or diagnoses. Here, it is often unclear whether omitted findings are truly absent or simply unmentioned for brevity. We address these challenges with a two-part framework. We quantify explicit uncertainty by creating an expert-validated, LLM-based reference ranking of common hedging phrases, and mapping each finding to a probability value based on this reference. In addition, we model implicit uncertainty through an expansion framework that systematically adds characteristic sub-findings derived from expert-defined diagnostic pathways for 14 common diagnoses. Using these methods, we release Lunguage++, an expanded, uncertainty-aware version of the Lunguage benchmark of fine-grained structured radiology reports. This enriched resource enables uncertainty-aware image classification, faithful diagnostic reasoning, and new investigations into the clinical impact of diagnostic uncertainty.
14.7CLJun 14
EHRNote-ChatQA: A Benchmark for Evidence-Grounded Multi-Turn Clinical Question Answering over Longitudinal Discharge SummariesJiyoun Kim, Muhan Yeo, Eunhye Jang et al.
Discharge summaries are crucial clinical documents containing the context of a patient's overall hospital stay, and are routinely reviewed by medical experts for patient readmission, ongoing care, and diagnostic decision-making. When reviewing them, medical experts often must iteratively synthesize information across multiple summaries while verifying the evidence supporting each answer. Although large language models (LLMs) are increasingly explored for clinical question answering, existing benchmarks do not sufficiently reflect this setting: they often evaluate exam-style medical knowledge or focus on single-turn question answering with limited evidence-grounding evaluation. We introduce EHRNote-ChatQA, the first benchmark for evidence-grounded multi-turn clinical question answering over patients' multiple discharge summaries. Built from de-identified MIMIC-IV discharge summaries, EHRNote-ChatQA contains 967 patient-level multi-turn samples spanning one to five notes and 16,072 medical-expert-verified QA pairs (8,036 content questions, each paired with an evidence-grounding question) across eight clinical categories. The benchmark is constructed through an expert-informed pipeline combining discharge-summary structuring schema, expert-curated multi-turn QA templates, and LLM-based generation, followed by review and revision of every single QA sample by 11 medical experts. Benchmarking 22 open- and closed-source LLMs reveals several challenges, including that LLMs struggle more with evidence grounding than content answering, multi-turn errors compound across turns, and single-turn clinical QA performance does not reliably transfer to this setting. These findings establish EHRNote-ChatQA as a rigorous and practical benchmark for evaluating clinical QA systems. The dataset will be made publicly available through PhysioNet credentialed access.