With the advancement of large language models, many dialogue systems are now capable of providing reasonable and informative responses to patients’ medical conditions. However, when patients consult their doctor, they may experience negative emotions due to the severity and urgency of their situation. If the model can provide appropriate comfort and empathy based on the patient’s negative emotions while answering medical questions, it will likely offer a more reassuring experience during the medical consultation process. To address this issue, our paper explores the balance between knowledge sharing and emotional support in the healthcare dialogue process. We utilize a large language model to rewrite a real-world interactive medical dialogue dataset, generating patient queries with negative emotions and corresponding medical responses aimed at soothing the patient’s emotions while addressing their concerns. The modified data serves to refine the latest large language models with various fine-tuning methods, enabling them to accurately provide sentences with both emotional reassurance and constructive suggestions in response to patients’ questions. Compared to the original LLM model, our experimental results demonstrate that our methodology significantly enhances the model’s ability to generate emotional responses while maintaining its original capability to provide accurate knowledge-based answers.

Automatically classifying electronic health records (EHRs) into diagnostic codes has been challenging to the NLP community. State-of-the-art methods treated this problem as a multi-label classification problem and proposed various architectures to model this problem. However, these systems did not leverage the superb performance of pretrained language models, which achieved superb performance on natural language understanding tasks. Prior work has shown that pretrained language models underperformed on this task with the regular fine-tuning scheme. Therefore, this paper aims at analyzing the causes of the underperformance and developing a framework for automatic ICD coding with pretrained language models. We spotted three main issues through the experiments: 1) large label space, 2) long input sequences, and 3) domain mismatch between pretraining and fine-tuning. We propose PLM-ICD, a framework that tackles the challenges with various strategies. The experimental results show that our proposed framework can overcome the challenges and achieves state-of-the-art performance in terms of multiple metrics on the benchmark MIMIC data. Our source code is available at https://github.com/MiuLab/PLM-ICD.

Given the clinical notes written in electronic health records (EHRs), it is challenging to predict the diagnostic codes which is formulated as a multi-label classification task. The large set of labels, the hierarchical dependency, and the imbalanced data make this prediction task extremely hard. Most existing work built a binary prediction for each label independently, ignoring the dependencies between labels. To address this problem, we propose a two-stage framework to improve automatic ICD coding by capturing the label correlation. Specifically, we train a label set distribution estimator to rescore the probability of each label set candidate generated by a base predictor. This paper is the first attempt at learning the label set distribution as a reranking module for ICD coding. In the experiments, our proposed framework is able to improve upon best-performing predictors for medical code prediction on the benchmark MIMIC datasets.

Clinical notes are essential medical documents to record each patient’s symptoms. Each record is typically annotated with medical diagnostic codes, which means diagnosis and treatment. This paper focuses on predicting diagnostic codes given the descriptive present illness in electronic health records by leveraging domain knowledge. We investigate various losses in a convolutional model to utilize hierarchical category knowledge of diagnostic codes in order to allow the model to share semantics across different labels under the same category. The proposed model not only considers the external domain knowledge but also addresses the issue about data imbalance. The MIMIC3 benchmark experiments show that the proposed methods can effectively utilize category knowledge and provide informative cues to improve the performance in terms of the top-ranked diagnostic codes which is better than the prior state-of-the-art. The investigation and discussion express the potential of integrating the domain knowledge in the current machine learning based models and guiding future research directions.