Social determinants of health (SDoH) play a critical role in shaping health outcomes, particularly in pediatric populations where interventions can have long-term implications. SDoH are frequently studied in the Electronic Health Record (EHR), which provides a rich repository for diverse patient data. In this work, we present a novel annotated corpus, the Pediatric Social History Annotation Corpus (PedSHAC), and evaluate the automatic extraction of detailed SDoH representations using fine-tuned and in-context learning methods with Large Language Models (LLMs). PedSHAC comprises annotated social history sections from 1,260 clinical notes obtained from pediatric patients within the University of Washington (UW) hospital system. Employing an event-based annotation scheme, PedSHAC captures ten distinct health determinants to encompass living and economic stability, prior trauma, education access, substance use history, and mental health with an overall annotator agreement of 81.9 F1. Our proposed fine-tuning LLM-based extractors achieve high performance at 78.4 F1 for event arguments. In-context learning approaches with GPT-4 demonstrate promise for reliable SDoH extraction with limited annotated examples, with extraction performance at 82.3 F1 for event triggers.

Unpredictability, especially unpredictability with unknown error characteristics, is a highly undesirable trait, particularly in medical patient care applications. Although large pre-trained language models (LLM) have been applied to a variety of unseen tasks with highly competitive and successful results, their sensitivity to language inputs and resulting performance variability is not well-studied. In this work, we test state-of-the-art pre-trained language models from a variety of families to characterize their error generation and reliability in medical assessment ability. Particularly, we experiment with general medical assessment multiple choice tests, as well as their open-ended and true-false alternatives. We also profile model consistency, error agreements with each other and to humans; and finally, quantify their ability to recover and explain errors. The findings in this work can be used to give further information about medical models so that modelers can make better-informed decisions rather than relying on standalone performance metrics alone.

Remote patient care provides opportunities for expanding medical access, saving healthcare costs, and offering on-demand convenient services. In the MEDIQA-M3G 2024 Shared Task, researchers explored solutions for the specific task of dermatological consumer health visual question answering, where user generated queries and images are used as input and a free-text answer response is generated as output. In this novel challenge, eight teams with a total of 48 submissions were evaluated across three language test sets. In this work, we provide a summary of the dataset, as well as results and approaches. We hope that the insights learned here will inspire future research directions that can lead to technology that deburdens clinical workload and improves care.

Automatic detection and correction of medical errors enables a more rigorous validation of medical documentation as well as clinical notes generated by large language models. Such solutions can ensure the accuracy and medical coherence of clinical texts and enhance patient care and health outcomes. The MEDIQA-CORR 2024 shared task focused on detecting and correcting different types of medical errors in clinical texts. Seventeen teams participated in the shared task and experimented with a broad range of approaches and models. In this paper, we describe the MEDIQA-CORR task, datasets, and the participants’ results and methods.

Social determinants of health (SDOH) documented in the electronic health record through unstructured text are increasingly being studied to understand how SDOH impacts patient health outcomes. In this work, we utilize the Social History Annotation Corpus (SHAC), a multi-institutional corpus of de-identified social history sections annotated for SDOH, including substance use, employment, and living status information. We explore the automatic extraction of SDOH information with SHAC in both standoff and inline annotation formats using GPT-4 in a one-shot prompting setting. We compare GPT-4 extraction performance with a high-performing supervised approach and perform thorough error analyses. Our prompt-based GPT-4 method achieved an overall 0.652 F1 on the SHAC test set, similar to the 7th best-performing system among all teams in the n2c2 challenge with SHAC.