The prevalence of vision-threatening eye diseases is a significant global burden, with many cases remaining undiagnosed or diagnosed too late for effective treatment. Large vision-language models (LVLMs) have the potential to assist in understanding anatomical information, diagnosing eye diseases, and drafting interpretations and follow-up plans, thereby reducing the burden on clinicians and improving access to eye care. However, limited benchmarks are available to assess LVLMs’ performance in ophthalmology-specific applications. In this study, we introduce LMOD, a large-scale multimodal ophthalmology benchmark consisting of 21,993 instances across (1) five ophthalmic imaging modalities: optical coherence tomography, color fundus photographs, scanning laser ophthalmoscopy, lens photographs, and surgical scenes; (2) free-text, demographic, and disease biomarker information; and (3) primary ophthalmology-specific applications such as anatomical information understanding, disease diagnosis, and subgroup analysis. In addition, we benchmarked 13 state-of-the-art LVLM representatives from closed-source, open-source, and medical domains. The results demonstrate a significant performance drop for LVLMs in ophthalmology compared to other domains. Systematic error analysis further identified six major failure modes: misclassification, failure to abstain, inconsistent reasoning, hallucination, assertions without justification, and lack of domain-specific knowledge. In contrast, supervised neural networks specifically trained on these tasks as baselines demonstrated high accuracy. These findings underscore the pressing need for benchmarks in the development and validation of ophthalmology-specific LVLMs.

Large Language Models (LLMs) have significantly advanced healthcare innovation on generation capabilities. However, their application in real clinical settings is challenging due to potential deviations from medical facts and inherent biases. In this work, we develop an augmented LLM framework, KG-Rank, which leverages a medical knowledge graph (KG) with ranking and re-ranking techniques, aiming to improve free-text question-answering (QA) in the medical domain. Specifically, upon receiving a question, we initially retrieve triplets from a medical KG to gather factual information. Subsequently, we innovatively apply ranking methods to refine the ordering of these triplets, aiming to yield more precise answers. To the best of our knowledge, KG-Rank is the first application of ranking models combined with KG in medical QA specifically for generating long answers. Evaluation of four selected medical QA datasets shows that KG-Rank achieves an improvement of over 18% in the ROUGE-L score. Moreover, we extend KG-Rank to open domains, where it realizes a 14% improvement in ROUGE-L, showing the effectiveness and potential of KG-Rank.

In this work, we propose our top-ranking (2nd place) pipeline for the generation of discharge summary subsections as a part of the BioNLP 2024 Shared Task 2: “Discharge Me!”. We evaluate both encoder-decoder and state-of-the-art decoder-only language models on the generation of two key sections of the discharge summary. To evaluate the ability of NLP methods to further alleviate the documentation burden on physicians, we also design a novel pipeline to generate the brief hospital course directly from structured information found in the EHR. Finally, we evaluate a constrained beam search approach to inject external knowledge about relevant patient problems into the text generation process. We find that a BioBART model fine-tuned on a larger fraction of the data without constrained beam search outperforms all other models.

The integration of large language model (LLM) techniques in the field of medical analysis has brought about significant advancements, yet the scarcity of large, diverse, and well-annotated datasets remains a major challenge. Medical data and tasks, which vary in format, size, and other parameters, require extensive preprocessing and standardization for effective use in training LLMs. To address these challenges, we introduce MedINST, the Meta Dataset of Biomedical Instructions, a novel multi-domain, multi-task instructional meta-dataset. MedINST comprises 133 biomedical NLP tasks and over 7 million training samples, making it the most comprehensive biomedical instruction dataset to date. Using MedINST as the meta dataset, we curate MedINST32, a challenging benchmark with different task difficulties aiming to evaluate LLMs’ generalization ability. We fine-tune several LLMs on MedINST and evaluate on MedINST32, showcasing enhanced cross-task generalization.

Multi-task learning (MTL) has achieved remarkable success in natural language processing applications. In this work, we study a multi-task learning model with multiple decoders on varieties of biomedical and clinical natural language processing tasks such as text similarity, relation extraction, named entity recognition, and text inference. Our empirical results demonstrate that the MTL fine-tuned models outperform state-of-the-art transformer models (e.g., BERT and its variants) by 2.0% and 1.3% in biomedical and clinical domain adaptation, respectively. Pairwise MTL further demonstrates more details about which tasks can improve or decrease others. This is particularly helpful in the context that researchers are in the hassle of choosing a suitable model for new problems. The code and models are publicly available at https://github.com/ncbi-nlp/bluebert.

Lymph node status plays a pivotal role in the treatment of cancer. The extraction of lymph nodes from radiology text reports enables large-scale training of lymph node detection on MRI. In this work, we first propose an ontology of 41 types of abdominal lymph nodes with a hierarchical relationship. We then introduce an end-to-end approach based on the combination of rules and transformer-based methods to detect these abdominal lymph node mentions and classify their types from the MRI radiology reports. We demonstrate the superior performance of a model fine-tuned on MRI reports using BlueBERT, called MriBERT. We find that MriBERT outperforms the rule-based labeler (0.957 vs 0.644 in micro weighted F1-score) as well as other BERT-based variations (0.913 - 0.928). We make the code and MriBERT publicly available at https://github.com/ncbi-nlp/bluebert, with the hope that this method can facilitate the development of medical report annotators to produce labels from scratch at scale.