Aokun Chen

Amin Dada, Aokun Chen, Cheng Peng et al.

Traditionally, large language models have been either trained on general web crawls or domain-specific data. However, recent successes of generative large language models, have shed light on the benefits of cross-domain datasets. To examine the significance of prioritizing data diversity over quality, we present a German dataset comprising texts from five domains, along with another dataset aimed at containing high-quality data. Through training a series of models ranging between 122M and 750M parameters on both datasets, we conduct a comprehensive benchmark on multiple downstream tasks. Our findings demonstrate that the models trained on the cross-domain dataset outperform those trained on quality data alone, leading to improvements up to $4.45\%$ over the previous state-of-the-art. The models are available at https://huggingface.co/ikim-uk-essen

Aokun Chen, Zehao Yu, Xi Yang et al.

Objective: To develop a natural language processing (NLP) system to extract medications and contextual information that help understand drug changes. This project is part of the 2022 n2c2 challenge. Materials and methods: We developed NLP systems for medication mention extraction, event classification (indicating medication changes discussed or not), and context classification to classify medication changes context into 5 orthogonal dimensions related to drug changes. We explored 6 state-of-the-art pretrained transformer models for the three subtasks, including GatorTron, a large language model pretrained using >90 billion words of text (including >80 billion words from >290 million clinical notes identified at the University of Florida Health). We evaluated our NLP systems using annotated data and evaluation scripts provided by the 2022 n2c2 organizers. Results:Our GatorTron models achieved the best F1-scores of 0.9828 for medication extraction (ranked 3rd), 0.9379 for event classification (ranked 2nd), and the best micro-average accuracy of 0.9126 for context classification. GatorTron outperformed existing transformer models pretrained using smaller general English text and clinical text corpora, indicating the advantage of large language models. Conclusion: This study demonstrated the advantage of using large transformer models for contextual medication information extraction from clinical narratives.

Cheng Peng, Xi Yang, Kaleb E Smith et al.

Objective To develop soft prompt-based learning algorithms for large language models (LLMs), examine the shape of prompts, prompt-tuning using frozen/unfrozen LLMs, transfer learning, and few-shot learning abilities. Methods We developed a soft prompt-based LLM model and compared 4 training strategies including (1) fine-tuning without prompts; (2) hard-prompt with unfrozen LLMs; (3) soft-prompt with unfrozen LLMs; and (4) soft-prompt with frozen LLMs. We evaluated 7 pretrained LLMs using the 4 training strategies for clinical concept and relation extraction on two benchmark datasets. We evaluated the transfer learning ability of the prompt-based learning algorithms in a cross-institution setting. We also assessed the few-shot learning ability. Results and Conclusion When LLMs are unfrozen, GatorTron-3.9B with soft prompting achieves the best strict F1-scores of 0.9118 and 0.8604 for concept extraction, outperforming the traditional fine-tuning and hard prompt-based models by 0.6~3.1% and 1.2~2.9%, respectively; GatorTron-345M with soft prompting achieves the best F1-scores of 0.8332 and 0.7488 for end-to-end relation extraction, outperforming the other two models by 0.2~2% and 0.6~11.7%, respectively. When LLMs are frozen, small (i.e., 345 million parameters) LLMs have a big gap to be competitive with unfrozen models; scaling LLMs up to billions of parameters makes frozen LLMs competitive with unfrozen LLMs. For cross-institute evaluation, soft prompting with a frozen GatorTron-8.9B model achieved the best performance. This study demonstrates that (1) machines can learn soft prompts better than humans, (2) frozen LLMs have better few-shot learning ability and transfer learning ability to facilitate muti-institution applications, and (3) frozen LLMs require large models.

Mengxian Lyu, Cheng Peng, Daniel Paredes et al.

Automatic generation of discharge summaries presents significant challenges due to the length of clinical documentation, the dispersed nature of patient information, and the diverse terminology used in healthcare. This paper presents a hybrid solution for generating discharge summary sections as part of our participation in the "Discharge Me!" Challenge at the BioNLP 2024 Shared Task. We developed a two-stage generation method using both extractive and abstractive techniques, in which we first apply name entity recognition (NER) to extract key clinical concepts, which are then used as input for a prompt-tuning-based GatorTronGPT model to generate coherent text for two important sections including "Brief Hospital Course" and "Discharge Instructions". Our system was ranked 5th in this challenge, achieving an overall score of 0.284. The results demonstrate the effectiveness of our hybrid solution in improving the quality of automated discharge section generation.

Aokun Chen, Daniel Paredes, Zehao Yu et al.

Delirium is an acute decline or fluctuation in attention, awareness, or other cognitive function that can lead to serious adverse outcomes. Despite the severe outcomes, delirium is frequently unrecognized and uncoded in patients' electronic health records (EHRs) due to its transient and diverse nature. Natural language processing (NLP), a key technology that extracts medical concepts from clinical narratives, has shown great potential in studies of delirium outcomes and symptoms. To assist in the diagnosis and phenotyping of delirium, we formed an expert panel to categorize diverse delirium symptoms, composed annotation guidelines, created a delirium corpus with diverse delirium symptoms, and developed NLP methods to extract delirium symptoms from clinical notes. We compared 5 state-of-the-art transformer models including 2 models (BERT and RoBERTa) from the general domain and 3 models (BERT_MIMIC, RoBERTa_MIMIC, and GatorTron) from the clinical domain. GatorTron achieved the best strict and lenient F1 scores of 0.8055 and 0.8759, respectively. We conducted an error analysis to identify challenges in annotating delirium symptoms and developing NLP systems. To the best of our knowledge, this is the first large language model-based delirium symptom extraction system. Our study lays the foundation for the future development of computable phenotypes and diagnosis methods for delirium.

Qianqian Xie, Qingyu Chen, Aokun Chen et al.

Recent advancements in large language models (LLMs) like ChatGPT and LLaMA show promise in medical applications, yet challenges remain in medical language comprehension. This study presents Me-LLaMA, a new medical LLM family based on open-source LLaMA models, optimized for medical text analysis and diagnosis by leveraging large-scale, domain-specific datasets. The Me-LLaMA family, including foundation models Me-LLaMA 13/70B and their chat-enhanced versions, was developed through continued pre-training and instruction tuning with 129B tokens and 214K samples from biomedical and clinical sources. Training the 70B models required over 100,000 A100 GPU hours. Me-LLaMA's performance was evaluated across six medical text analysis tasks using 12 benchmark datasets and complex clinical case diagnosis, with automatic and human evaluations. Results indicate Me-LLaMA outperforms LLaMA and other open-source medical LLMs in zero-shot and supervised settings. Task-specific tuning further boosts performance, surpassing ChatGPT on 7 of 8 datasets and GPT-4 on 5 of 8. For complex clinical cases, Me-LLaMA achieves performance comparable to ChatGPT and GPT-4. This work underscores the importance of domain-specific data in developing medical LLMs and addresses the high computational costs involved in training, highlighting a balance between pre-training and fine-tuning strategies. Me-LLaMA models are now accessible under user agreements, providing a valuable resource for advancing medical AI.

Cheng Peng, Xi Yang, Aokun Chen et al.

Objective To solve major clinical natural language processing (NLP) tasks using a unified text-to-text learning architecture based on a generative large language model (LLM) via prompt tuning. Methods We formulated 7 key clinical NLP tasks as text-to-text learning and solved them using one unified generative clinical LLM, GatorTronGPT, developed using GPT-3 architecture and trained with up to 20 billion parameters. We adopted soft prompts (i.e., trainable vectors) with frozen LLM, where the LLM parameters were not updated (i.e., frozen) and only the vectors of soft prompts were updated, known as prompt tuning. We added additional soft prompts as a prefix to the input layer, which were optimized during the prompt tuning. We evaluated the proposed method using 7 clinical NLP tasks and compared them with previous task-specific solutions based on Transformer models. Results and Conclusion The proposed approach achieved state-of-the-art performance for 5 out of 7 major clinical NLP tasks using one unified generative LLM. Our approach outperformed previous task-specific transformer models by ~3% for concept extraction and 7% for relation extraction applied to social determinants of health, 3.4% for clinical concept normalization, 3.4~10% for clinical abbreviation disambiguation, and 5.5~9% for natural language inference. Our approach also outperformed a previously developed prompt-based machine reading comprehension (MRC) model, GatorTron-MRC, for clinical concept and relation extraction. The proposed approach can deliver the ``one model for all`` promise from training to deployment using a unified generative LLM.

Aokun Chen, Qian Li, Yu Huang et al.

A comprehensive view of factors associated with AD/ADRD will significantly aid in studies to develop new treatments for AD/ADRD and identify high-risk populations and patients for prevention efforts. In our study, we summarized the risk factors for AD/ADRD by reviewing existing meta-analyses and review articles on risk and preventive factors for AD/ADRD. In total, we extracted 477 risk factors in 10 categories from 537 studies. We constructed an interactive knowledge map to disseminate our study results. Most of the risk factors are accessible from structured Electronic Health Records (EHRs), and clinical narratives show promise as information sources. However, evaluating genomic risk factors using RWD remains a challenge, as genetic testing for AD/ADRD is still not a common practice and is poorly documented in both structured and unstructured EHRs. Considering the constantly evolving research on AD/ADRD risk factors, literature mining via NLP methods offers a solution to automatically update our knowledge map.

Cheng Peng, Xi Yang, Aokun Chen et al.

There is enormous enthusiasm and concerns in using large language models (LLMs) in healthcare, yet current assumptions are all based on general-purpose LLMs such as ChatGPT. This study develops a clinical generative LLM, GatorTronGPT, using 277 billion words of mixed clinical and English text with a GPT-3 architecture of 20 billion parameters. GatorTronGPT improves biomedical natural language processing for medical research. Synthetic NLP models trained using GatorTronGPT generated text outperform NLP models trained using real-world clinical text. Physicians Turing test using 1 (worst) to 9 (best) scale shows that there is no significant difference in linguistic readability (p = 0.22; 6.57 of GatorTronGPT compared with 6.93 of human) and clinical relevance (p = 0.91; 7.0 of GatorTronGPT compared with 6.97 of human) and that physicians cannot differentiate them (p < 0.001). This study provides insights on the opportunities and challenges of LLMs for medical research and healthcare.

Xi Yang, Aokun Chen, Nima PourNejatian et al.

There is an increasing interest in developing artificial intelligence (AI) systems to process and interpret electronic health records (EHRs). Natural language processing (NLP) powered by pretrained language models is the key technology for medical AI systems utilizing clinical narratives. However, there are few clinical language models, the largest of which trained in the clinical domain is comparatively small at 110 million parameters (compared with billions of parameters in the general domain). It is not clear how large clinical language models with billions of parameters can help medical AI systems utilize unstructured EHRs. In this study, we develop from scratch a large clinical language model - GatorTron - using >90 billion words of text (including >82 billion words of de-identified clinical text) and systematically evaluate it on 5 clinical NLP tasks including clinical concept extraction, medical relation extraction, semantic textual similarity, natural language inference (NLI), and medical question answering (MQA). We examine how (1) scaling up the number of parameters and (2) scaling up the size of the training data could benefit these NLP tasks. GatorTron models scale up the clinical language model from 110 million to 8.9 billion parameters and improve 5 clinical NLP tasks (e.g., 9.6% and 9.5% improvement in accuracy for NLI and MQA), which can be applied to medical AI systems to improve healthcare delivery. The GatorTron models are publicly available at: https://catalog.ngc.nvidia.com/orgs/nvidia/teams/clara/models/gatortron_og.

Luiz Giovanini, Fabrício Ceschin, Mirela Silva et al.

This paper investigates whether computer usage profiles comprised of process-, network-, mouse-, and keystroke-related events are unique and consistent over time in a naturalistic setting, discussing challenges and opportunities of using such profiles in applications of continuous authentication. We collected ecologically-valid computer usage profiles from 31 MS Windows 10 computer users over 8 weeks and submitted this data to comprehensive machine learning analysis involving a diverse set of online and offline classifiers. We found that: (i) profiles were mostly consistent over the 8-week data collection period, with most (83.9%) repeating computer usage habits on a daily basis; (ii) computer usage profiling has the potential to uniquely characterize computer users (with a maximum F-score of 99.90%); (iii) network-related events were the most relevant features to accurately recognize profiles (95.69% of the top features distinguishing users were network-related); and (iv) binary models were the most well-suited for profile recognition, with better results achieved in the online setting compared to the offline setting (maximum F-score of 99.90% vs. 95.50%).

Ruimin Sun, Xiaoyong Yuan, Pan He et al.

Existing malware detectors on safety-critical devices have difficulties in runtime detection due to the performance overhead. In this paper, we introduce PROPEDEUTICA, a framework for efficient and effective real-time malware detection, leveraging the best of conventional machine learning (ML) and deep learning (DL) techniques. In PROPEDEUTICA, all software start execution are considered as benign and monitored by a conventional ML classifier for fast detection. If the software receives a borderline classification from the ML detector (e.g. the software is 50% likely to be benign and 50% likely to be malicious), the software will be transferred to a more accurate, yet performance demanding DL detector. To address spatial-temporal dynamics and software execution heterogeneity, we introduce a novel DL architecture (DEEPMALWARE) for PROPEDEUTICA with multi-stream inputs. We evaluated PROPEDEUTICA with 9,115 malware samples and 1,338 benign software from various categories for the Windows OS. With a borderline interval of [30%-70%], PROPEDEUTICA achieves an accuracy of 94.34% and a false-positive rate of 8.75%, with 41.45% of the samples moved for DEEPMALWARE analysis. Even using only CPU, PROPEDEUTICA can detect malware within less than 0.1 seconds.