Xiaohan Li

Zheng Liu, Xiaohan Li, Philip Yu

The fairness issue of clinical data modeling, especially on Electronic Health Records (EHRs), is of utmost importance due to EHR's complex latent structure and potential selection bias. It is frequently necessary to mitigate health disparity while keeping the model's overall accuracy in practice. However, traditional methods often encounter the trade-off between accuracy and fairness, as they fail to capture the underlying factors beyond observed data. To tackle this challenge, we propose a novel model called Fair Longitudinal Medical Deconfounder (FLMD) that aims to achieve both fairness and accuracy in longitudinal Electronic Health Records (EHR) modeling. Drawing inspiration from the deconfounder theory, FLMD employs a two-stage training process. In the first stage, FLMD captures unobserved confounders for each encounter, which effectively represents underlying medical factors beyond observed EHR, such as patient genotypes and lifestyle habits. This unobserved confounder is crucial for addressing the accuracy/fairness dilemma. In the second stage, FLMD combines the learned latent representation with other relevant features to make predictions. By incorporating appropriate fairness criteria, such as counterfactual fairness, FLMD ensures that it maintains high prediction accuracy while simultaneously minimizing health disparities. We conducted comprehensive experiments on two real-world EHR datasets to demonstrate the effectiveness of FLMD. Apart from the comparison of baseline methods and FLMD variants in terms of fairness and accuracy, we assessed the performance of all models on disturbed/imbalanced and synthetic datasets to showcase the superiority of FLMD across different settings and provide valuable insights into its capabilities.

Mengxian Lyu, Xiaohan Li, Ziyi Chen et al.

Natural language generation (NLG) is the key technology to achieve generative artificial intelligence (AI). With the breakthroughs in large language models (LLMs), NLG has been widely used in various medical applications, demonstrating the potential to enhance clinical workflows, support clinical decision-making, and improve clinical documentation. Heterogeneous and diverse medical data modalities, such as medical text, images, and knowledge bases, are utilized in NLG. Researchers have proposed many generative models and applied them in a number of healthcare applications. There is a need for a comprehensive review of NLG methods and applications in the medical domain. In this study, we systematically reviewed 113 scientific publications from a total of 3,988 NLG-related articles identified using a literature search, focusing on data modality, model architecture, clinical applications, and evaluation methods. Following PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) guidelines, we categorize key methods, identify clinical applications, and assess their capabilities, limitations, and emerging challenges. This timely review covers the key NLG technologies and medical applications and provides valuable insights for future studies to leverage NLG to transform medical discovery and healthcare.

Mengxian Lyu, Cheng Peng, Xiaohan Li et al.

Automatic text summarization (ATS) is an emerging technology to assist clinicians in providing continuous and coordinated care. This study presents an approach to summarize doctor-patient dialogues using generative large language models (LLMs). We developed prompt-tuning algorithms to instruct generative LLMs to summarize clinical text. We examined the prompt-tuning strategies, the size of soft prompts, and the few-short learning ability of GatorTronGPT, a generative clinical LLM developed using 277 billion clinical and general English words with up to 20 billion parameters. We compared GatorTronGPT with a previous solution based on fine-tuning of a widely used T5 model, using a clinical benchmark dataset MTS-DIALOG. The experimental results show that the GatorTronGPT- 20B model achieved the best performance on all evaluation metrics. The proposed solution has a low computing cost as the LLM parameters are not updated during prompt-tuning. This study demonstrates the efficiency of generative clinical LLMs for clinical ATS through prompt tuning.