Jinge Wu

Jinge Wu, Rowena Smith, Honghan Wu

Adverse Childhood Experiences (ACEs) are defined as a collection of highly stressful, and potentially traumatic, events or circumstances that occur throughout childhood and/or adolescence. They have been shown to be associated with increased risks of mental health diseases or other abnormal behaviours in later lives. However, the identification of ACEs from textual data with Natural Language Processing (NLP) is challenging because (a) there are no NLP ready ACE ontologies; (b) there are few resources available for machine learning, necessitating the data annotation from clinical experts; (c) costly annotations by domain experts and large number of documents for supporting large machine learning models. In this paper, we present an ontology-driven self-supervised approach (derive concept embeddings using an auto-encoder from baseline NLP results) for producing a publicly available resource that would support large-scale machine learning (e.g., training transformer based large language models) on social media corpus. This resource as well as the proposed approach are aimed to facilitate the community in training transferable NLP models for effectively surfacing ACEs in low-resource scenarios like NLP on clinical notes within Electronic Health Records. The resource including a list of ACE ontology terms, ACE concept embeddings and the NLP annotated corpus is available at https://github.com/knowlab/ACE-NLP.

Jinge Wu, Rowena Smith, Honghan Wu

Adverse Childhood Experiences (ACEs) are defined as a collection of highly stressful, and potentially traumatic, events or circumstances that occur throughout childhood and/or adolescence. They have been shown to be associated with increased risks of mental health diseases or other abnormal behaviours in later lives. However, the identification of ACEs from free-text Electronic Health Records (EHRs) with Natural Language Processing (NLP) is challenging because (a) there is no NLP ready ACE ontologies; (b) there are limited cases available for machine learning, necessitating the data annotation from clinical experts. We are currently developing a tool that would use NLP techniques to assist us in surfacing ACEs from clinical notes. This will enable us further research in identifying evidence of the relationship between ACEs and the subsequent developments of mental illness (e.g., addictions) in large-scale and longitudinal free-text EHRs, which has previously not been possible.

Jinge Wu, Yunsoo Kim, Eva C. Keller et al.

This paper proposes one of the first clinical applications of multimodal large language models (LLMs) as an assistant for radiologists to check errors in their reports. We created an evaluation dataset from real-world radiology datasets (including X-rays and CT scans). A subset of original reports was modified to contain synthetic errors by introducing three types of mistakes: "insert", "remove", and "substitute". The evaluation contained two difficulty levels: SIMPLE for binary error-checking and COMPLEX for identifying error types. At the SIMPLE level, our fine-tuned model significantly enhanced performance by 47.4% and 25.4% on MIMIC-CXR and IU X-ray data, respectively. This performance boost is also observed in unseen modality, CT scans, as the model performed 19.46% better than the baseline model. The model also surpassed the domain expert's accuracy in the MIMIC-CXR dataset by 1.67%. Notably, among the subsets (N=21) of the test set where a clinician did not achieve the correct conclusion, the LLaVA ensemble mode correctly identified 71.4% of these cases. However, all models performed poorly in identifying mistake types, underscoring the difficulty of the COMPLEX level. This study marks a promising step toward utilizing multimodal LLMs to enhance diagnostic accuracy in radiology. The ensemble model demonstrated comparable performance to clinicians, even capturing errors overlooked by humans.

Jinge Wu, Zhaolong Wu, Ruizhe Li et al.

The increasing complexity and workload of clinical radiology leads to inevitable oversights and mistakes in their use as diagnostic tools, causing delayed treatments and sometimes life-threatening harm to patients. While large language models (LLMs) have shown remarkable progress in many tasks, their utilities in detecting and correcting errors in radiology reporting are limited. This paper proposes a novel dual-knowledge infusion framework that enhances LLMs' capability for radiology report proofreading through systematic integration of medical expertise. Specifically, the knowledge infusion combines medical knowledge graph distillation (MKGD) with external knowledge retrieval (EXKR), enabling an effective automated approach in tackling mistakes in radiology reporting. By decomposing the complex proofreading task into three specialized stages of detection, localization, and correction, our method mirrors the systematic review process employed by expert radiologists, ensuring both precision and clinical interpretability. To perform a robust, clinically relevant evaluation, a comprehensive benchmark is also proposed using real-world radiology reports with real-world error patterns, including speech recognition confusions, terminology ambiguities, and template-related inconsistencies. Extensive evaluations across multiple LLM architectures demonstrate substantial improvements of our approach: up to 31.56% increase in error detection accuracy and 37.4% reduction in processing time. Human evaluation by radiologists confirms superior clinical relevance and factual consistency compared to existing approaches.

Abul Hasan, Jinge Wu, Quang Ngoc Nguyen et al.

This study introduces a novel knowledge enhanced tokenisation mechanism, K-Tokeniser, for clinical text processing. Technically, at initialisation stage, K-Tokeniser populates global representations of tokens based on semantic types of domain concepts (such as drugs or diseases) from either a domain ontology like Unified Medical Language System or the training data of the task related corpus. At training or inference stage, sentence level localised context will be utilised for choosing the optimal global token representation to realise the semantic-based tokenisation. To avoid pretraining using the new tokeniser, an embedding initialisation approach is proposed to generate representations for new tokens. Using three transformer-based language models, a comprehensive set of experiments are conducted on four real-world datasets for evaluating K-Tokeniser in a wide range of clinical text analytics tasks including clinical concept and relation extraction, automated clinical coding, clinical phenotype identification, and clinical research article classification. Overall, our models demonstrate consistent improvements over their counterparts in all tasks. In particular, substantial improvements are observed in the automated clinical coding task with 13\% increase on Micro $F_1$ score. Furthermore, K-Tokeniser also shows significant capacities in facilitating quicker converge of language models. Specifically, using K-Tokeniser, the language models would only require 50\% of the training data to achieve the best performance of the baseline tokeniser using all training data in the concept extraction task and less than 20\% of the data for the automated coding task. It is worth mentioning that all these improvements require no pre-training process, making the approach generalisable.

Zhaolong Wu, Abul Hasan, Jinge Wu et al.

This paper describes our submission to the MEDIQA-CORR 2024 shared task for automatically detecting and correcting medical errors in clinical notes. We report results for three methods of few-shot In-Context Learning (ICL) augmented with Chain-of-Thought (CoT) and reason prompts using a large language model (LLM). In the first method, we manually analyse a subset of train and validation dataset to infer three CoT prompts by examining error types in the clinical notes. In the second method, we utilise the training dataset to prompt the LLM to deduce reasons about their correctness or incorrectness. The constructed CoTs and reasons are then augmented with ICL examples to solve the tasks of error detection, span identification, and error correction. Finally, we combine the two methods using a rule-based ensemble method. Across the three sub-tasks, our ensemble method achieves a ranking of 3rd for both sub-task 1 and 2, while securing 7th place in sub-task 3 among all submissions.

Jinge Wu, Abul Hasan, Honghan Wu

Radiology report summarization is a crucial task that can help doctors quickly identify clinically significant findings without the need to review detailed sections of reports. This study proposes RadBARTsum, a domain-specific and ontology facilitated adaptation of the BART model for abstractive radiology report summarization. The approach involves two main steps: 1) re-training the BART model on a large corpus of radiology reports using a novel entity masking strategy to improving biomedical domain knowledge learning, and 2) fine-tuning the model for the summarization task using the Findings and Background sections to predict the Impression section. Experiments are conducted using different masking strategies. Results show that the re-training process with domain knowledge facilitated masking improves performances consistently across various settings. This work contributes a domain-specific generative language model for radiology report summarization and a method for utilising medical knowledge to realise entity masking language model. The proposed approach demonstrates a promising direction of enhancing the efficiency of language models by deepening its understanding of clinical knowledge in radiology reports.