A dataset and benchmark for hospital course summarization with adapted large language modelsAsad Aali, Dave Van Veen, Yamin Ishraq Arefeen et al.
Brief hospital course (BHC) summaries are clinical documents that summarize a patient's hospital stay. While large language models (LLMs) depict remarkable capabilities in automating real-world tasks, their capabilities for healthcare applications such as synthesizing BHCs from clinical notes have not been shown. We introduce a novel pre-processed dataset, the MIMIC-IV-BHC, encapsulating clinical note and brief hospital course (BHC) pairs to adapt LLMs for BHC synthesis. Furthermore, we introduce a benchmark of the summarization performance of two general-purpose LLMs and three healthcare-adapted LLMs. Using clinical notes as input, we apply prompting-based (using in-context learning) and fine-tuning-based adaptation strategies to three open-source LLMs (Clinical-T5-Large, Llama2-13B, FLAN-UL2) and two proprietary LLMs (GPT-3.5, GPT-4). We evaluate these LLMs across multiple context-length inputs using natural language similarity metrics. We further conduct a clinical study with five clinicians, comparing clinician-written and LLM-generated BHCs across 30 samples, focusing on their potential to enhance clinical decision-making through improved summary quality. We observe that the Llama2-13B fine-tuned LLM outperforms other domain-adapted models given quantitative evaluation metrics of BLEU and BERT-Score. GPT-4 with in-context learning shows more robustness to increasing context lengths of clinical note inputs than fine-tuned Llama2-13B. Despite comparable quantitative metrics, the reader study depicts a significant preference for summaries generated by GPT-4 with in-context learning compared to both Llama2-13B fine-tuned summaries and the original summaries, highlighting the need for qualitative clinical evaluation.
Offline Policy Comparison under Limited Historical Agent-Environment InteractionsAnton Dereventsov, Joseph D. Daws, Clayton Webster
We address the challenge of policy evaluation in real-world applications of reinforcement learning systems where the available historical data is limited due to ethical, practical, or security considerations. This constrained distribution of data samples often leads to biased policy evaluation estimates. To remedy this, we propose that instead of policy evaluation, one should perform policy comparison, i.e. to rank the policies of interest in terms of their value based on available historical data. In addition we present the Limited Data Estimator (LDE) as a simple method for evaluating and comparing policies from a small number of interactions with the environment. According to our theoretical analysis, the LDE is shown to be statistically reliable on policy comparison tasks under mild assumptions on the distribution of the historical data. Additionally, our numerical experiments compare the LDE to other policy evaluation methods on the task of policy ranking and demonstrate its advantage in various settings.
An adaptive stochastic gradient-free approach for high-dimensional blackbox optimizationAnton Dereventsov, Clayton G. Webster, Joseph D. Daws
In this work, we propose a novel adaptive stochastic gradient-free (ASGF) approach for solving high-dimensional nonconvex optimization problems based on function evaluations. We employ a directional Gaussian smoothing of the target function that generates a surrogate of the gradient and assists in avoiding bad local optima by utilizing nonlocal information of the loss landscape. Applying a deterministic quadrature scheme results in a massively scalable technique that is sample-efficient and achieves spectral accuracy. At each step we randomly generate the search directions while primarily following the surrogate of the smoothed gradient. This enables exploitation of the gradient direction while maintaining sufficient space exploration, and accelerates convergence towards the global extrema. In addition, we make use of a local approximation of the Lipschitz constant in order to adaptively adjust the values of all hyperparameters, thus removing the careful fine-tuning of current algorithms that is often necessary to be successful when applied to a large class of learning tasks. As such, the ASGF strategy offers significant improvements when solving high-dimensional nonconvex optimization problems when compared to other gradient-free methods (including the so called "evolutionary strategies") as well as iterative approaches that rely on the gradient information of the objective function. We illustrate the improved performance of this method by providing several comparative numerical studies on benchmark global optimization problems and reinforcement learning tasks.
8.0NADec 4, 2019
Analysis of Deep Neural Networks with Quasi-optimal polynomial approximation ratesJoseph Daws, Clayton Webster
We show the existence of a deep neural network capable of approximating a wide class of high-dimensional approximations. The construction of the proposed neural network is based on a quasi-optimal polynomial approximation. We show that this network achieves an error rate that is sub-exponential in the number of polynomial functions, $M$, used in the polynomial approximation. The complexity of the network which achieves this sub-exponential rate is shown to be algebraic in $M$.
6.0LGMay 24, 2019
A Polynomial-Based Approach for Architectural Design and Learning with Deep Neural NetworksJoseph Daws, Clayton G. Webster
In this effort we propose a novel approach for reconstructing multivariate functions from training data, by identifying both a suitable network architecture and an initialization using polynomial-based approximations. Training deep neural networks using gradient descent can be interpreted as moving the set of network parameters along the loss landscape in order to minimize the loss functional. The initialization of parameters is important for iterative training methods based on descent. Our procedure produces a network whose initial state is a polynomial representation of the training data. The major advantage of this technique is from this initialized state the network may be improved using standard training procedures. Since the network already approximates the data, training is more likely to produce a set of parameters associated with a desirable local minimum. We provide the details of the theory necessary for constructing such networks and also consider several numerical examples that reveal our approach ultimately produces networks which can be effectively trained from our initialized state to achieve an improved approximation for a large class of target functions.