Qiuhao Lu

Qiuhao Lu, Dejing Dou, Thien Huu Nguyen

Deep learning models have demonstrated superior performance in various healthcare applications. However, the major limitation of these deep models is usually the lack of high-quality training data due to the private and sensitive nature of this field. In this study, we propose a novel textual data augmentation method to generate artificial clinical notes in patients' Electronic Health Records (EHRs) that can be used as additional training data for patient outcomes prediction. Essentially, we fine-tune the generative language model GPT-2 to synthesize labeled text with the original training data. More specifically, We propose a teacher-student framework where we first pre-train a teacher model on the original data, and then train a student model on the GPT-augmented data under the guidance of the teacher. We evaluate our method on the most common patient outcome, i.e., the 30-day readmission rate. The experimental results show that deep models can improve their predictive performance with the augmented data, indicating the effectiveness of the proposed architecture.

Qiuhao Lu, Rui Li, Andrew Wen et al.

Large Language Models (LLMs) have revolutionized various sectors, including healthcare where they are employed in diverse applications. Their utility is particularly significant in the context of rare diseases, where data scarcity, complexity, and specificity pose considerable challenges. In the clinical domain, Named Entity Recognition (NER) stands out as an essential task and it plays a crucial role in extracting relevant information from clinical texts. Despite the promise of LLMs, current research mostly concentrates on document-level NER, identifying entities in a more general context across entire documents, without extracting their precise location. Additionally, efforts have been directed towards adapting ChatGPT for token-level NER. However, there is a significant research gap when it comes to employing token-level NER for clinical texts, especially with the use of local open-source LLMs. This study aims to bridge this gap by investigating the effectiveness of both proprietary and local LLMs in token-level clinical NER. Essentially, we delve into the capabilities of these models through a series of experiments involving zero-shot prompting, few-shot prompting, retrieval-augmented generation (RAG), and instruction-fine-tuning. Our exploration reveals the inherent challenges LLMs face in token-level NER, particularly in the context of rare diseases, and suggests possible improvements for their application in healthcare. This research contributes to narrowing a significant gap in healthcare informatics and offers insights that could lead to a more refined application of LLMs in the healthcare sector.

Fali Wang, Zhiwei Zhang, Xianren Zhang et al.

Large language models (LLMs) have demonstrated emergent abilities in text generation, question answering, and reasoning, facilitating various tasks and domains. Despite their proficiency in various tasks, LLMs like PaLM 540B and Llama-3.1 405B face limitations due to large parameter sizes and computational demands, often requiring cloud API use which raises privacy concerns, limits real-time applications on edge devices, and increases fine-tuning costs. Additionally, LLMs often underperform in specialized domains such as healthcare and law due to insufficient domain-specific knowledge, necessitating specialized models. Therefore, Small Language Models (SLMs) are increasingly favored for their low inference latency, cost-effectiveness, efficient development, and easy customization and adaptability. These models are particularly well-suited for resource-limited environments and domain knowledge acquisition, addressing LLMs' challenges and proving ideal for applications that require localized data handling for privacy, minimal inference latency for efficiency, and domain knowledge acquisition through lightweight fine-tuning. The rising demand for SLMs has spurred extensive research and development. However, a comprehensive survey investigating issues related to the definition, acquisition, application, enhancement, and reliability of SLM remains lacking, prompting us to conduct a detailed survey on these topics. The definition of SLMs varies widely, thus to standardize, we propose defining SLMs by their capability to perform specialized tasks and suitability for resource-constrained settings, setting boundaries based on the minimal size for emergent abilities and the maximum size sustainable under resource constraints. For other aspects, we provide a taxonomy of relevant models/methods and develop general frameworks for each category to enhance and utilize SLMs effectively.

Kurt Miller, Qiuhao Lu, William Hersh et al.

Clinical document metadata, such as document type, structure, author role, medical specialty, and encounter setting, is essential for accurate interpretation of information captured in clinical documents. However, vast documentation heterogeneity and drift over time challenge harmonization of document metadata. Automated extraction methods have emerged to coalesce metadata from disparate practices into target schema. This scoping review aims to catalog research on clinical document metadata extraction, identify methodological trends and applications, and highlight gaps. We followed the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) guidelines to identify articles that perform clinical document metadata extraction. We initially found and screened 266 articles published between January 2011 and August 2025, then comprehensively reviewed 67 we deemed relevant to our study. Among the articles included, 45 were methodological, 17 used document metadata as features in a downstream application, and 5 analyzed document metadata composition. We observe myriad purposes for methodological study and application types. Available labelled public data remains sparse except for structural section datasets. Methods for extracting document metadata have progressed from largely rule-based and traditional machine learning with ample feature engineering to transformer-based architectures with minimal feature engineering. The emergence of large language models has enabled broader exploration of generalizability across tasks and datasets, allowing the possibility of advanced clinical text processing systems. We anticipate that research will continue to expand into richer document metadata representations and integrate further into clinical applications and workflows.

Qiuhao Lu, Thien Huu Nguyen, Dejing Dou

Unplanned intensive care unit (ICU) readmission rate is an important metric for evaluating the quality of hospital care. Efficient and accurate prediction of ICU readmission risk can not only help prevent patients from inappropriate discharge and potential dangers, but also reduce associated costs of healthcare. In this paper, we propose a new method that uses medical text of Electronic Health Records (EHRs) for prediction, which provides an alternative perspective to previous studies that heavily depend on numerical and time-series features of patients. More specifically, we extract discharge summaries of patients from their EHRs, and represent them with multiview graphs enhanced by an external knowledge graph. Graph convolutional networks are then used for representation learning. Experimental results prove the effectiveness of our method, yielding state-of-the-art performance for this task.

Hang Jiang, Sairam Gurajada, Qiuhao Lu et al.

Entity linking (EL), the task of disambiguating mentions in text by linking them to entities in a knowledge graph, is crucial for text understanding, question answering or conversational systems. Entity linking on short text (e.g., single sentence or question) poses particular challenges due to limited context. While prior approaches use either heuristics or black-box neural methods, here we propose LNN-EL, a neuro-symbolic approach that combines the advantages of using interpretable rules based on first-order logic with the performance of neural learning. Even though constrained to using rules, LNN-EL performs competitively against SotA black-box neural approaches, with the added benefits of extensibility and transferability. In particular, we show that we can easily blend existing rule templates given by a human expert, with multiple types of features (priors, BERT encodings, box embeddings, etc), and even scores resulting from previous EL methods, thus improving on such methods. For instance, on the LC-QuAD-1.0 dataset, we show more than $4$\% increase in F1 score over previous SotA. Finally, we show that the inductive bias offered by using logic results in learned rules that transfer well across datasets, even without fine tuning, while maintaining high accuracy.