Linh Tran

Izhak Shafran, Nan Du, Linh Tran et al.

There is a growing interest in creating tools to assist in clinical note generation using the audio of provider-patient encounters. Motivated by this goal and with the help of providers and medical scribes, we developed an annotation scheme to extract relevant clinical concepts. We used this annotation scheme to label a corpus of about 6k clinical encounters. This was used to train a state-of-the-art tagging model. We report ontologies, labeling results, model performances, and detailed analyses of the results. Our results show that the entities related to medications can be extracted with a relatively high accuracy of 0.90 F-score, followed by symptoms at 0.72 F-score, and conditions at 0.57 F-score. In our task, we not only identify where the symptoms are mentioned but also map them to canonical forms as they appear in the clinical notes. Of the different types of errors, in about 19-38% of the cases, we find that the model output was correct, and about 17-32% of the errors do not impact the clinical note. Taken together, the models developed in this work are more useful than the F-scores reflect, making it a promising approach for practical applications.

Florian Wenzel, Kevin Roth, Bastiaan S. Veeling et al.

During the past five years the Bayesian deep learning community has developed increasingly accurate and efficient approximate inference procedures that allow for Bayesian inference in deep neural networks. However, despite this algorithmic progress and the promise of improved uncertainty quantification and sample efficiency there are---as of early 2020---no publicized deployments of Bayesian neural networks in industrial practice. In this work we cast doubt on the current understanding of Bayes posteriors in popular deep neural networks: we demonstrate through careful MCMC sampling that the posterior predictive induced by the Bayes posterior yields systematically worse predictions compared to simpler methods including point estimates obtained from SGD. Furthermore, we demonstrate that predictive performance is improved significantly through the use of a "cold posterior" that overcounts evidence. Such cold posteriors sharply deviate from the Bayesian paradigm but are commonly used as heuristic in Bayesian deep learning papers. We put forward several hypotheses that could explain cold posteriors and evaluate the hypotheses through experiments. Our work questions the goal of accurate posterior approximations in Bayesian deep learning: If the true Bayes posterior is poor, what is the use of more accurate approximations? Instead, we argue that it is timely to focus on understanding the origin of the improved performance of cold posteriors.

Nan Du, Mingqiu Wang, Linh Tran et al.

Recently we proposed the Span Attribute Tagging (SAT) Model (Du et al., 2019) to infer clinical entities (e.g., symptoms) and their properties (e.g., duration). It tackles the challenge of large label space and limited training data using a hierarchical two-stage approach that identifies the span of interest in a tagging step and assigns labels to the span in a classification step. We extend the SAT model to jointly infer not only entities and their properties but also relations between them. Most relation extraction models restrict inferring relations between tokens within a few neighboring sentences, mainly to avoid high computational complexity. In contrast, our proposed Relation-SAT (R-SAT) model is computationally efficient and can infer relations over the entire conversation, spanning an average duration of 10 minutes. We evaluate our model on a corpus of clinical conversations. When the entities are given, the R-SAT outperforms baselines in identifying relations between symptoms and their properties by about 32% (0.82 vs 0.62 F-score) and by about 50% (0.60 vs 0.41 F-score) on medications and their properties. On the more difficult task of jointly inferring entities and relations, the R-SAT model achieves a performance of 0.34 and 0.45 for symptoms and medications respectively, which is significantly better than 0.18 and 0.35 for the baseline model. The contributions of different components of the model are quantified using ablation analysis.

Nan Du, Kai Chen, Anjuli Kannan et al.

This paper describes novel models tailored for a new application, that of extracting the symptoms mentioned in clinical conversations along with their status. Lack of any publicly available corpus in this privacy-sensitive domain led us to develop our own corpus, consisting of about 3K conversations annotated by professional medical scribes. We propose two novel deep learning approaches to infer the symptom names and their status: (1) a new hierarchical span-attribute tagging (\SAT) model, trained using curriculum learning, and (2) a variant of sequence-to-sequence model which decodes the symptoms and their status from a few speaker turns within a sliding window over the conversation. This task stems from a realistic application of assisting medical providers in capturing symptoms mentioned by patients from their clinical conversations. To reflect this application, we define multiple metrics. From inter-rater agreement, we find that the task is inherently difficult. We conduct comprehensive evaluations on several contrasting conditions and observe that the performance of the models range from an F-score of 0.5 to 0.8 depending on the condition. Our analysis not only reveals the inherent challenges of the task, but also provides useful directions to improve the models.