Zhengyun Zhao

Huaiyuan Ying, Zhengyun Zhao, Yang Zhao et al.

Objective: Biomedical Knowledge Graphs play a pivotal role in various biomedical research domains. Concurrently, term clustering emerges as a crucial step in constructing these knowledge graphs, aiming to identify synonymous terms. Due to a lack of knowledge, previous contrastive learning models trained with Unified Medical Language System (UMLS) synonyms struggle at clustering difficult terms and do not generalize well beyond UMLS terms. In this work, we leverage the world knowledge from Large Language Models (LLMs) and propose Contrastive Learning for Representing Terms via Explanations (CoRTEx) to enhance term representation and significantly improves term clustering. Materials and Methods: The model training involves generating explanations for a cleaned subset of UMLS terms using ChatGPT. We employ contrastive learning, considering term and explanation embeddings simultaneously, and progressively introduce hard negative samples. Additionally, a ChatGPT-assisted BIRCH algorithm is designed for efficient clustering of a new ontology. Results: We established a clustering test set and a hard negative test set, where our model consistently achieves the highest F1 score. With CoRTEx embeddings and the modified BIRCH algorithm, we grouped 35,580,932 terms from the Biomedical Informatics Ontology System (BIOS) into 22,104,559 clusters with O(N) queries to ChatGPT. Case studies highlight the model's efficacy in handling challenging samples, aided by information from explanations. Conclusion: By aligning terms to their explanations, CoRTEx demonstrates superior accuracy over benchmark models and robustness beyond its training set, and it is suitable for clustering terms for large-scale biomedical ontologies.

Huaiyuan Ying, Hongyi Yuan, Jinsen Lu et al.

Electronic Health Records (EHRs) hold immense potential for advancing healthcare, offering rich, longitudinal data that combines structured information with valuable insights from unstructured clinical notes. However, the unstructured nature of clinical text poses significant challenges for secondary applications. Traditional methods for structuring EHR free-text data, such as rule-based systems and multi-stage pipelines, are often limited by their time-consuming configurations and inability to adapt across clinical notes from diverse healthcare settings. Few systems provide a comprehensive attribute extraction for terminologies. While giant large language models (LLMs) like GPT-4 and LLaMA 405B excel at structuring tasks, they are slow, costly, and impractical for large-scale use. To overcome these limitations, we introduce GENIE, a Generative Note Information Extraction system that leverages LLMs to streamline the structuring of unstructured clinical text into usable data with standardized format. GENIE processes entire paragraphs in a single pass, extracting entities, assertion statuses, locations, modifiers, values, and purposes with high accuracy. Its unified, end-to-end approach simplifies workflows, reduces errors, and eliminates the need for extensive manual intervention. Using a robust data preparation pipeline and fine-tuned small scale LLMs, GENIE achieves competitive performance across multiple information extraction tasks, outperforming traditional tools like cTAKES and MetaMap and can handle extra attributes to be extracted. GENIE strongly enhances real-world applicability and scalability in healthcare systems. By open-sourcing the model and test data, we aim to encourage collaboration and drive further advancements in EHR structurization.

Zecheng Wang, Deyuan Liu, Chunshan Li et al.

Standard negative log-likelihood (NLL) for Supervised Fine-Tuning (SFT) applies uniform token-level weighting. This rigidity creates a two-fold failure mode: (i) overemphasizing low-probability targets can amplify gradients on noisy supervision and disrupt robust priors, and (ii) uniform weighting provides weak sharpening when the model is already confident. Existing methods fail to resolve the resulting plasticity--stability dilemma, often suppressing necessary learning signals alongside harmful ones. To address this issue, we unify token-level SFT objectives within a generalized deformed-log family and expose a universal gate $\times$ error gradient structure, where the gate controls how much the model trusts its current prediction. By employing the Cayley transform, we map the model's continuously evolving uncertainty onto a continuous focus trajectory, which enables seamless interpolation between scenarios involving uncertain novel concepts and those involving well-established knowledge. We then introduce Dynamic Entropy Fine-Tuning (DEFT), a parameter-free objective that modulates the trust gate using distribution concentration (Rényi-2 entropy) as a practical proxy for the model's predictive state. Extensive experiments and analyses demonstrate that DEFT achieves a better balance between exploration and exploitation, leading to improved overall performance.

Zhengyun Zhao, Huaiyuan Ying, Yue Zhong et al.

Electronic Health Records (EHRs) are pivotal in clinical practices, yet their retrieval remains a challenge mainly due to semantic gap issues. Recent advancements in dense retrieval offer promising solutions but existing models, both general-domain and biomedical-domain, fall short due to insufficient medical knowledge or mismatched training corpora. This paper introduces \texttt{DR.EHR}, a series of dense retrieval models specifically tailored for EHR retrieval. We propose a two-stage training pipeline utilizing MIMIC-IV discharge summaries to address the need for extensive medical knowledge and large-scale training data. The first stage involves medical entity extraction and knowledge injection from a biomedical knowledge graph, while the second stage employs large language models to generate diverse training data. We train two variants of \texttt{DR.EHR}, with 110M and 7B parameters, respectively. Evaluated on the CliniQ benchmark, our models significantly outperforms all existing dense retrievers, achieving state-of-the-art results. Detailed analyses confirm our models' superiority across various match and query types, particularly in challenging semantic matches like implication and abbreviation. Ablation studies validate the effectiveness of each pipeline component, and supplementary experiments on EHR QA datasets demonstrate the models' generalizability on natural language questions, including complex ones with multiple entities. This work significantly advances EHR retrieval, offering a robust solution for clinical applications.

Zhengyun Zhao, Qiao Jin, Fangyuan Chen et al.

Objective: Retrieval-based Clinical Decision Support (ReCDS) can aid clinical workflow by providing relevant literature and similar patients for a given patient. However, the development of ReCDS systems has been severely obstructed by the lack of diverse patient collections and publicly available large-scale patient-level annotation datasets. In this paper, we aim to define and benchmark two ReCDS tasks: Patient-to-Article Retrieval (ReCDS-PAR) and Patient-to-Patient Retrieval (ReCDS-PPR) using a novel dataset called PMC-Patients. Methods: We extract patient summaries from PubMed Central articles using simple heuristics and utilize the PubMed citation graph to define patient-article relevance and patient-patient similarity. We also implement and evaluate several ReCDS systems on the PMC-Patients benchmarks, including sparse retrievers, dense retrievers, and nearest neighbor retrievers. We conduct several case studies to show the clinical utility of PMC-Patients. Results: PMC-Patients contains 167k patient summaries with 3.1M patient-article relevance annotations and 293k patient-patient similarity annotations, which is the largest-scale resource for ReCDS and also one of the largest patient collections. Human evaluation and analysis show that PMC-Patients is a diverse dataset with high-quality annotations. The evaluation of various ReCDS systems shows that the PMC-Patients benchmark is challenging and calls for further research. Conclusion: We present PMC-Patients, a large-scale, diverse, and publicly available patient summary dataset with the largest-scale patient-level relation annotations. Based on PMC-Patients, we formally define two benchmark tasks for ReCDS systems and evaluate various existing retrieval methods. PMC-Patients can largely facilitate methodology research on ReCDS systems and shows real-world clinical utility.