Gyubok Lee

Gyubok Lee, Hyeonji Hwang, Seongsu Bae et al.

We present a new text-to-SQL dataset for electronic health records (EHRs). The utterances were collected from 222 hospital staff members, including physicians, nurses, and insurance review and health records teams. To construct the QA dataset on structured EHR data, we conducted a poll at a university hospital and used the responses to create seed questions. We then manually linked these questions to two open-source EHR databases, MIMIC-III and eICU, and included various time expressions and held-out unanswerable questions in the dataset, which were also collected from the poll. Our dataset poses a unique set of challenges: the model needs to 1) generate SQL queries that reflect a wide range of needs in the hospital, including simple retrieval and complex operations such as calculating survival rate, 2) understand various time expressions to answer time-sensitive questions in healthcare, and 3) distinguish whether a given question is answerable or unanswerable. We believe our dataset, EHRSQL, can serve as a practical benchmark for developing and assessing QA models on structured EHR data and take a step further towards bridging the gap between text-to-SQL research and its real-life deployment in healthcare. EHRSQL is available at https://github.com/glee4810/EHRSQL.

Jungwoo Oh, Gyubok Lee, Seongsu Bae et al.

Question answering (QA) in the field of healthcare has received much attention due to significant advancements in natural language processing. However, existing healthcare QA datasets primarily focus on medical images, clinical notes, or structured electronic health record tables. This leaves the vast potential of combining electrocardiogram (ECG) data with these systems largely untapped. To address this gap, we present ECG-QA, the first QA dataset specifically designed for ECG analysis. The dataset comprises a total of 70 question templates that cover a wide range of clinically relevant ECG topics, each validated by an ECG expert to ensure their clinical utility. As a result, our dataset includes diverse ECG interpretation questions, including those that require a comparative analysis of two different ECGs. In addition, we have conducted numerous experiments to provide valuable insights for future research directions. We believe that ECG-QA will serve as a valuable resource for the development of intelligent QA systems capable of assisting clinicians in ECG interpretations. Dataset URL: https://github.com/Jwoo5/ecg-qa

Seongsu Bae, Daeun Kyung, Jaehee Ryu et al.

Electronic Health Records (EHRs), which contain patients' medical histories in various multi-modal formats, often overlook the potential for joint reasoning across imaging and table modalities underexplored in current EHR Question Answering (QA) systems. In this paper, we introduce EHRXQA, a novel multi-modal question answering dataset combining structured EHRs and chest X-ray images. To develop our dataset, we first construct two uni-modal resources: 1) The MIMIC-CXR-VQA dataset, our newly created medical visual question answering (VQA) benchmark, specifically designed to augment the imaging modality in EHR QA, and 2) EHRSQL (MIMIC-IV), a refashioned version of a previously established table-based EHR QA dataset. By integrating these two uni-modal resources, we successfully construct a multi-modal EHR QA dataset that necessitates both uni-modal and cross-modal reasoning. To address the unique challenges of multi-modal questions within EHRs, we propose a NeuralSQL-based strategy equipped with an external VQA API. This pioneering endeavor enhances engagement with multi-modal EHR sources and we believe that our dataset can catalyze advances in real-world medical scenarios such as clinical decision-making and research. EHRXQA is available at https://github.com/baeseongsu/ehrxqa.

Jaehee Ryu, Seonhee Cho, Gyubok Lee et al.

In this paper, we introduce EHR-SeqSQL, a novel sequential text-to-SQL dataset for Electronic Health Record (EHR) databases. EHR-SeqSQL is designed to address critical yet underexplored aspects in text-to-SQL parsing: interactivity, compositionality, and efficiency. To the best of our knowledge, EHR-SeqSQL is not only the largest but also the first medical text-to-SQL dataset benchmark to include sequential and contextual questions. We provide a data split and the new test set designed to assess compositional generalization ability. Our experiments demonstrate the superiority of a multi-turn approach over a single-turn approach in learning compositionality. Additionally, our dataset integrates specially crafted tokens into SQL queries to improve execution efficiency. With EHR-SeqSQL, we aim to bridge the gap between practical needs and academic research in the text-to-SQL domain. EHR-SeqSQL is available at https://github.com/seonhee99/EHR-SeqSQL.

Gyubok Lee, Woosog Chay, Seonhee Cho et al.

Text-to-SQL enables users to interact with databases using natural language, simplifying the retrieval and synthesis of information. Despite the remarkable success of large language models (LLMs) in translating natural language questions into SQL queries, widespread deployment remains limited due to two primary challenges. First, the effective use of text-to-SQL models depends on users' understanding of the model's capabilities-the scope of questions the model can correctly answer. Second, the absence of abstention mechanisms can lead to incorrect SQL generation going unnoticed, thereby undermining trust in the model's output. To enable wider deployment, it is crucial to address these challenges in model design and enhance model evaluation to build trust in the model's output. To this end, we introduce TrustSQL, a novel comprehensive benchmark designed to evaluate text-to-SQL reliability-defined as a model's ability to correctly handle any type of input question by generating correct SQL queries for feasible questions and abstaining from generating infeasible ones (e.g., due to schema incompatibility or functionalities beyond SQL). We evaluate existing methods using a novel penalty-based scoring metric with two modeling approaches: (1) pipeline-based methods combining SQL generators with infeasible question detectors and SQL error detectors for abstention; and (2) unified methods using a single model for the entire task. Our experimental results reveal that achieving high scores under severe penalties requires significant effort and provide a new perspective on developing text-to-SQL models for safer deployment. TrustSQL is available at https://github.com/glee4810/TrustSQL.

Gyubok Lee, Elea Bach, Eric Yang et al.

The recent shift toward the Health Level Seven Fast Healthcare Interoperability Resources (HL7 FHIR) standard opens a new frontier for clinical AI, demanding LLM agents to navigate complex, resource-based data models instead of conventional structured health data. However, existing benchmarks have lagged behind this transition, lacking the realism needed to evaluate recent LLMs on interoperable clinical data. To bridge this gap, we introduce FHIR-AgentBench, a benchmark that grounds 2,931 real-world clinical questions in the HL7 FHIR standard. Using this benchmark, we systematically evaluate agentic frameworks, comparing different data retrieval strategies (direct FHIR API calls vs. specialized tools), interaction patterns (single-turn vs. multi-turn), and reasoning strategies (natural language vs. code generation). Our experiments highlight the practical challenges of retrieving data from intricate FHIR resources and the difficulty of reasoning over them, both of which critically affect question answering performance. We publicly release the FHIR-AgentBench dataset and evaluation suite (https://github.com/glee4810/FHIR-AgentBench) to promote reproducible research and the development of robust, reliable LLM agents for clinical applications.

Yeonsu Kwon, Jiho Kim, Gyubok Lee et al.

Electronic Health Records (EHRs) are integral for storing comprehensive patient medical records, combining structured data (e.g., medications) with detailed clinical notes (e.g., physician notes). These elements are essential for straightforward data retrieval and provide deep, contextual insights into patient care. However, they often suffer from discrepancies due to unintuitive EHR system designs and human errors, posing serious risks to patient safety. To address this, we developed EHRCon, a new dataset and task specifically designed to ensure data consistency between structured tables and unstructured notes in EHRs. EHRCon was crafted in collaboration with healthcare professionals using the MIMIC-III EHR dataset, and includes manual annotations of 4,101 entities across 105 clinical notes checked against database entries for consistency. EHRCon has two versions, one using the original MIMIC-III schema, and another using the OMOP CDM schema, in order to increase its applicability and generalizability. Furthermore, leveraging the capabilities of large language models, we introduce CheckEHR, a novel framework for verifying the consistency between clinical notes and database tables. CheckEHR utilizes an eight-stage process and shows promising results in both few-shot and zero-shot settings. The code is available at https://github.com/dustn1259/EHRCon.

Sunjun Kweon, Junu Kim, Jiyoun Kim et al.

The development of large language models tailored for handling patients' clinical notes is often hindered by the limited accessibility and usability of these notes due to strict privacy regulations. To address these challenges, we first create synthetic large-scale clinical notes using publicly available case reports extracted from biomedical literature. We then use these synthetic notes to train our specialized clinical large language model, Asclepius. While Asclepius is trained on synthetic data, we assess its potential performance in real-world applications by evaluating it using real clinical notes. We benchmark Asclepius against several other large language models, including GPT-3.5-turbo and other open-source alternatives. To further validate our approach using synthetic notes, we also compare Asclepius with its variants trained on real clinical notes. Our findings convincingly demonstrate that synthetic clinical notes can serve as viable substitutes for real ones when constructing high-performing clinical language models. This conclusion is supported by detailed evaluations conducted by both GPT-4 and medical professionals. All resources including weights, codes, and data used in the development of Asclepius are made publicly accessible for future research. (https://github.com/starmpcc/Asclepius)

Seong Hyeon Park, Gyubok Lee, Manoj Bhat et al.

Multi-agent trajectory forecasting in autonomous driving requires an agent to accurately anticipate the behaviors of the surrounding vehicles and pedestrians, for safe and reliable decision-making. Due to partial observability in these dynamical scenes, directly obtaining the posterior distribution over future agent trajectories remains a challenging problem. In realistic embodied environments, each agent's future trajectories should be both diverse since multiple plausible sequences of actions can be used to reach its intended goals, and admissible since they must obey physical constraints and stay in drivable areas. In this paper, we propose a model that synthesizes multiple input signals from the multimodal world|the environment's scene context and interactions between multiple surrounding agents|to best model all diverse and admissible trajectories. We compare our model with strong baselines and ablations across two public datasets and show a significant performance improvement over previous state-of-the-art methods. Lastly, we offer new metrics incorporating admissibility criteria to further study and evaluate the diversity of predictions. Codes are at: https://github.com/kami93/CMU-DATF.

Gyubok Lee, Sunjun Kweon, Seongsu Bae et al.

Electronic Health Records (EHRs) are relational databases that store the entire medical histories of patients within hospitals. They record numerous aspects of patients' medical care, from hospital admission and diagnosis to treatment and discharge. While EHRs are vital sources of clinical data, exploring them beyond a predefined set of queries requires skills in query languages like SQL. To make information retrieval more accessible, one strategy is to build a question-answering system, possibly leveraging text-to-SQL models that can automatically translate natural language questions into corresponding SQL queries and use these queries to retrieve the answers. The EHRSQL 2024 shared task aims to advance and promote research in developing a question-answering system for EHRs using text-to-SQL modeling, capable of reliably providing requested answers to various healthcare professionals to improve their clinical work processes and satisfy their needs. Among more than 100 participants who applied to the shared task, eight teams were formed and completed the entire shared task requirement and demonstrated a wide range of methods to effectively solve this task. In this paper, we describe the task of reliable text-to-SQL modeling, the dataset, and the methods and results of the participants. We hope this shared task will spur further research and insights into developing reliable question-answering systems for EHRs.

Yongjin Yang, Sihyeon Kim, SangMook Kim et al.

Incorporating unanswerable questions into EHR QA systems is crucial for testing the trustworthiness of a system, as providing non-existent responses can mislead doctors in their diagnoses. The EHRSQL dataset stands out as a promising benchmark because it is the only dataset that incorporates unanswerable questions in the EHR QA system alongside practical questions. However, in this work, we identify a data bias in these unanswerable questions; they can often be discerned simply by filtering with specific N-gram patterns. Such biases jeopardize the authenticity and reliability of QA system evaluations. To tackle this problem, we propose a simple debiasing method of adjusting the split between the validation and test sets to neutralize the undue influence of N-gram filtering. By experimenting on the MIMIC-III dataset, we demonstrate both the existing data bias in EHRSQL and the effectiveness of our data split strategy in mitigating this bias.

Gyubok Lee, Woosog Chay, Heeyoung Kwak et al.

Despite the impressive performance of LLM-powered agents, their adoption for Electronic Health Record (EHR) data access remains limited by the absence of benchmarks that adequately capture real-world clinical data access flows. In practice, two core challenges hinder deployment: query ambiguity from vague user questions and value mismatch between user terminology and database entries. To address this, we introduce EHR-ChatQA an interactive database question answering benchmark that evaluates the end-to-end workflow of database agents: clarifying user questions, using tools to resolve value mismatches, and generating correct SQL to deliver accurate answers. To cover diverse patterns of query ambiguity and value mismatch, EHR-ChatQA assesses agents in a simulated environment with an LLM-based user across two interaction flows: Incremental Query Refinement (IncreQA), where users add constraints to existing queries, and Adaptive Query Refinement (AdaptQA), where users adjust their search goals mid-conversation. Experiments with state-of-the-art LLMs (e.g., o4-mini and Gemini-2.5-Flash) over five i.i.d. trials show that while agents achieve high Pass@5 of 90-95% (at least one of five trials) on IncreQA and 60-80% on AdaptQA, their Pass^5 (consistent success across all five trials) is substantially lower by 35-60%. These results underscore the need to build agents that are not only performant but also robust for the safety-critical EHR domain. Finally, we provide diagnostic insights into common failure modes to guide future agent development.

Woncheol Shin, Gyubok Lee, Jiyoung Lee et al.

This is an exploratory study that discovers the current image quantization (vector quantization) do not satisfy translation equivariance in the quantized space due to aliasing. Instead of focusing on anti-aliasing, we propose a simple yet effective way to achieve translation-equivariant image quantization by enforcing orthogonality among the codebook embeddings. To explore the advantages of translation-equivariant image quantization, we conduct three proof-of-concept experiments with a carefully controlled dataset: (1) text-to-image generation, where the quantized image indices are the target to predict, (2) image-to-text generation, where the quantized image indices are given as a condition, (3) using a smaller training set to analyze sample efficiency. From the strictly controlled experiments, we empirically verify that the translation-equivariant image quantizer improves not only sample efficiency but also the accuracy over VQGAN up to +11.9% in text-to-image generation and +3.9% in image-to-text generation.

Gyubok Lee, Seongjun Yang, Edward Choi

Accurate terminology translation is crucial for ensuring the practicality and reliability of neural machine translation (NMT) systems. To address this, lexically constrained NMT explores various methods to ensure pre-specified words and phrases appear in the translation output. However, in many cases, those methods are studied on general domain corpora, where the terms are mostly uni- and bi-grams (>98%). In this paper, we instead tackle a more challenging setup consisting of domain-specific corpora with much longer n-gram and highly specialized terms. Inspired by the recent success of masked span prediction models, we propose a simple and effective training strategy that achieves consistent improvements on both terminology and sentence-level translation for three domain-specific corpora in two language pairs.