Joseph Daws

Asad Aali, Dave Van Veen, Yamin Ishraq Arefeen et al.

Brief hospital course (BHC) summaries are clinical documents that summarize a patient's hospital stay. While large language models (LLMs) depict remarkable capabilities in automating real-world tasks, their capabilities for healthcare applications such as synthesizing BHCs from clinical notes have not been shown. We introduce a novel pre-processed dataset, the MIMIC-IV-BHC, encapsulating clinical note and brief hospital course (BHC) pairs to adapt LLMs for BHC synthesis. Furthermore, we introduce a benchmark of the summarization performance of two general-purpose LLMs and three healthcare-adapted LLMs. Using clinical notes as input, we apply prompting-based (using in-context learning) and fine-tuning-based adaptation strategies to three open-source LLMs (Clinical-T5-Large, Llama2-13B, FLAN-UL2) and two proprietary LLMs (GPT-3.5, GPT-4). We evaluate these LLMs across multiple context-length inputs using natural language similarity metrics. We further conduct a clinical study with five clinicians, comparing clinician-written and LLM-generated BHCs across 30 samples, focusing on their potential to enhance clinical decision-making through improved summary quality. We observe that the Llama2-13B fine-tuned LLM outperforms other domain-adapted models given quantitative evaluation metrics of BLEU and BERT-Score. GPT-4 with in-context learning shows more robustness to increasing context lengths of clinical note inputs than fine-tuned Llama2-13B. Despite comparable quantitative metrics, the reader study depicts a significant preference for summaries generated by GPT-4 with in-context learning compared to both Llama2-13B fine-tuned summaries and the original summaries, highlighting the need for qualitative clinical evaluation.

Joseph Daws, Clayton Webster

We show the existence of a deep neural network capable of approximating a wide class of high-dimensional approximations. The construction of the proposed neural network is based on a quasi-optimal polynomial approximation. We show that this network achieves an error rate that is sub-exponential in the number of polynomial functions, $M$, used in the polynomial approximation. The complexity of the network which achieves this sub-exponential rate is shown to be algebraic in $M$.

Joseph Daws, Clayton G. Webster

In this effort we propose a novel approach for reconstructing multivariate functions from training data, by identifying both a suitable network architecture and an initialization using polynomial-based approximations. Training deep neural networks using gradient descent can be interpreted as moving the set of network parameters along the loss landscape in order to minimize the loss functional. The initialization of parameters is important for iterative training methods based on descent. Our procedure produces a network whose initial state is a polynomial representation of the training data. The major advantage of this technique is from this initialized state the network may be improved using standard training procedures. Since the network already approximates the data, training is more likely to produce a set of parameters associated with a desirable local minimum. We provide the details of the theory necessary for constructing such networks and also consider several numerical examples that reveal our approach ultimately produces networks which can be effectively trained from our initialized state to achieve an improved approximation for a large class of target functions.