Huixue Zhou

Pengshan Cai, Zonghai Yao, Fei Liu et al.

Patient portal allows discharged patients to access their personalized discharge instructions in electronic health records (EHRs). However, many patients have difficulty understanding or memorizing their discharge instructions. In this paper, we present PaniniQA, a patient-centric interactive question answering system designed to help patients understand their discharge instructions. PaniniQA first identifies important clinical content from patients' discharge instructions and then formulates patient-specific educational questions. In addition, PaniniQA is also equipped with answer verification functionality to provide timely feedback to correct patients' misunderstandings. Our comprehensive automatic and human evaluation results demonstrate our PaniniQA is capable of improving patients' mastery of their medical instructions through effective interactions

Junda Wang, Zonghai Yao, Zhichao Yang et al.

We introduce NoteChat, a novel cooperative multi-agent framework leveraging Large Language Models (LLMs) to generate patient-physician dialogues. NoteChat embodies the principle that an ensemble of role-specific LLMs, through structured role-play and strategic prompting, can perform their assigned roles more effectively. The synergy among these role-playing LLMs results in a cohesive and efficient dialogue generation. Evaluation on MTS-dialogue, a benchmark dataset for patient-physician dialogues-note pairs, shows that models trained with the augmented synthetic patient-physician dialogues by NoteChat outperforms other state-of-the-art models for generating clinical notes. Our comprehensive automatic and human evaluation demonstrates that NoteChat substantially surpasses state-of-the-art models like ChatGPT and GPT-4 up to 22.78% by domain experts in generating superior synthetic patient-physician dialogues based on clinical notes. NoteChat has the potential to engage patients directly and help clinical documentation, a leading cause of physician burnout.

Zihao Zhang, Zonghai Yao, Huixue Zhou et al.

Large language models have shown success as a tutor in education in various fields. Educating patients about their clinical visits plays a pivotal role in patients' adherence to their treatment plans post-discharge. This paper presents EHRTutor, an innovative multi-component framework leveraging the Large Language Model (LLM) for patient education through conversational question-answering. EHRTutor first formulates questions pertaining to the electronic health record discharge instructions. It then educates the patient through conversation by administering each question as a test. Finally, it generates a summary at the end of the conversation. Evaluation results using LLMs and domain experts have shown a clear preference for EHRTutor over the baseline. Moreover, EHRTutor also offers a framework for generating synthetic patient education dialogues that can be used for future in-house system training.

Zonghai Yao, Aditya Parashar, Huixue Zhou et al.

Automatic question generation (QG) is essential for AI and NLP, particularly in intelligent tutoring, dialogue systems, and fact verification. Generating multiple-choice questions (MCQG) for professional exams, like the United States Medical Licensing Examination (USMLE), is particularly challenging, requiring domain expertise and complex multi-hop reasoning for high-quality questions. However, current large language models (LLMs) like GPT-4 struggle with professional MCQG due to outdated knowledge, hallucination issues, and prompt sensitivity, resulting in unsatisfactory quality and difficulty. To address these challenges, we propose MCQG-SRefine, an LLM self-refine-based (Critique and Correction) framework for converting medical cases into high-quality USMLE-style questions. By integrating expert-driven prompt engineering with iterative self-critique and self-correction feedback, MCQG-SRefine significantly enhances human expert satisfaction regarding both the quality and difficulty of the questions. Furthermore, we introduce an LLM-as-Judge-based automatic metric to replace the complex and costly expert evaluation process, ensuring reliable and expert-aligned assessments.

Tiejin Chen, Longchao Da, Huixue Zhou et al.

The privacy concerns associated with the use of Large Language Models (LLMs) have grown recently with the development of LLMs such as ChatGPT. Differential Privacy (DP) techniques are explored in existing work to mitigate their privacy risks at the cost of generalization degradation. Our paper reveals that the flatness of DP-trained models' loss landscape plays an essential role in the trade-off between their privacy and generalization. We further propose a holistic framework to enforce appropriate weight flatness, which substantially improves model generalization with competitive privacy preservation. It innovates from three coarse-to-grained levels, including perturbation-aware min-max optimization on model weights within a layer, flatness-guided sparse prefix-tuning on weights across layers, and weight knowledge distillation between DP \& non-DP weights copies. Comprehensive experiments of both black-box and white-box scenarios are conducted to demonstrate the effectiveness of our proposal in enhancing generalization and maintaining DP characteristics. For instance, on text classification dataset QNLI, DP-Flat achieves similar performance with non-private full fine-tuning but with DP guarantee under privacy budget $ε=3$, and even better performance given higher privacy budgets. Codes are provided in the supplement.

Zaifu Zhan, Shuang Zhou, Huixue Zhou et al.

Foundation models, including language models, e.g., GPT, and vision models, e.g., CLIP, have significantly advanced numerous biomedical tasks. Despite these advancements, the high inference latency and the "overthinking" issues in model inference impair the efficiency and effectiveness of foundation models, thus limiting their application in real-time clinical settings. To address these challenges, we proposed EPEE (Entropy- and Patience-based Early Exiting), a novel hybrid strategy designed to improve the inference efficiency of foundation models. The core idea was to leverage the strengths of entropy-based and patience-based early exiting methods to overcome their respective weaknesses. To evaluate EPEE, we conducted experiments on three core biomedical tasks-classification, relation extraction, and event extraction-using four foundation models (BERT, ALBERT, GPT-2, and ViT) across twelve datasets, including clinical notes and medical images. The results showed that EPEE significantly reduced inference time while maintaining or improving accuracy, demonstrating its adaptability to diverse datasets and tasks. EPEE addressed critical barriers to deploying foundation models in healthcare by balancing efficiency and effectiveness. It potentially provided a practical solution for real-time clinical decision-making with foundation models, supporting reliable and efficient workflows.

Xuchen Li, Hengrui Gu, Mohan Zhang et al.

Text-prompted foundation models for medical image segmentation offer an intuitive way to delineate anatomical structures from natural language queries, but their predictions often lack spatial precision and degrade under domain shift. In contrast, visual-prompted models achieve strong segmentation performance across diverse modalities by leveraging spatial cues of precise bounding-box (bbox) prompts to guide the segmentation of target lesions. However, it is costly and challenging to obtain the precise visual prompts in clinical practice. We propose PPBoost (Progressive Prompt-Boosting), a framework that bridges these limitations by transforming weak text-derived signals into strong, spatially grounded visual prompts, operating under a strict zero-shot regime with no image- or pixel-level segmentation labels. PPBoost first uses a vision-language model to produce initial pseudo-bboxes conditioned on the textual object descriptions and applies an uncertainty-aware criterion to filter unreliable predictions. The retained image-bboxes pairs are then leveraged to train a pseudo-labeled detector, producing the high-quality bboxes for the query images. During inference, PPBoost further refines the generated bboxes by appropriately expanding them to tightly cover the target anatomical structures. The enhanced spatially-grounding bbox prompts guide existing segmentation models to generate final dense masks, effectively amplifying weak text cues into strong spatial guidance. Across three datasets spanning diverse modalities and anatomies, PPBoost consistently improves Dice and Normalized Surface Distance over text- and visual-prompted baselines and, notably, surpasses few-shot segmentation models without using labeled data. PPBoost can generalize to multiple typical visual segmentation model backbones.

Yongkang Xiao, Sinian Zhang, Yi Dai et al.

Knowledge graph completion (KGC) aims to predict missing triples in knowledge graphs (KGs) by leveraging existing triples and textual information. Recently, generative large language models (LLMs) have been increasingly employed for graph tasks. However, current approaches typically encode graph context in textual form, which fails to fully exploit the potential of LLMs for perceiving and reasoning about graph structures. To address this limitation, we propose DrKGC (Dynamic Subgraph Retrieval-Augmented LLMs for Knowledge Graph Completion). DrKGC employs a flexible lightweight model training strategy to learn structural embeddings and logical rules within the KG. It then leverages a novel bottom-up graph retrieval method to extract a subgraph for each query guided by the learned rules. Finally, a graph convolutional network (GCN) adapter uses the retrieved subgraph to enhance the structural embeddings, which are then integrated into the prompt for effective LLM fine-tuning. Experimental results on two general domain benchmark datasets and two biomedical datasets demonstrate the superior performance of DrKGC. Furthermore, a realistic case study in the biomedical domain highlights its interpretability and practical utility.