This study aims to leverage state of the art language models to automate generating the “Brief Hospital Course” and “Discharge Instructions” sections of Discharge Summaries from the MIMIC-IV dataset, reducing clinicians’ administrative workload. We investigate how automation can improve documentation accuracy, alleviate clinician burnout, and enhance operational efficacy in healthcare facilities. This research was conducted within our participation in the Shared Task Discharge Me! at BioNLP @ ACL 2024. Various strategies were employed, including Few-Shot learning, instruction tuning, and Dynamic Expert Selection (DES), to develop models capable of generating the required text sections. Utilizing an additional clinical domain-specific dataset demonstrated substantial potential to enhance clinical language processing. The DES method, which optimizes the selection of text outputs from multiple predictions, proved to be especially effective. It achieved the highest overall score of 0.332 in the competition, surpassing single-model outputs. This finding suggests that advanced deep learning methods in combination with DES can effectively automate parts of electronic health record documentation. These advancements could enhance patient care by freeing clinician time for patient interactions. The integration of text selection strategies represents a promising avenue for further research.

This paper details the efforts of the WisPerMed team in the BioLaySumm2024 Shared Task on automatic lay summarization in the biomedical domain, aimed at making scientific publications accessible to non-specialists. Large language models (LLMs), specifically the BioMistral and Llama3 models, were fine-tuned and employed to create lay summaries from complex scientific texts. The summarization performance was enhanced through various approaches, including instruction tuning, few-shot learning, and prompt variations tailored to incorporate specific context information. The experiments demonstrated that fine-tuning generally led to the best performance across most evaluated metrics. Few-shot learning notably improved the models’ ability to generate relevant and factually accurate texts, particularly when using a well-crafted prompt. Additionally, a Dynamic Expert Selection (DES) mechanism to optimize the selection of text outputs based on readability and factuality metrics was developed. Out of 54 participants, the WisPerMed team reached the 4th place, measured by readability, factuality, and relevance. Determined by the overall score, our approach improved upon the baseline by approx. 5.5 percentage points and was only approx. 1.5 percentage points behind the first place.

Recent advances in natural language processing (NLP) can be largely attributed to the advent of pre-trained language models such as BERT and RoBERTa. While these models demonstrate remarkable performance on general datasets, they can struggle in specialized domains such as medicine, where unique domain-specific terminologies, domain-specific abbreviations, and varying document structures are common. This paper explores strategies for adapting these models to domain-specific requirements, primarily through continuous pre-training on domain-specific data. We pre-trained several German medical language models on 2.4B tokens derived from translated public English medical data and 3B tokens of German clinical data. The resulting models were evaluated on various German downstream tasks, including named entity recognition (NER), multi-label classification, and extractive question answering. Our results suggest that models augmented by clinical and translation-based pre-training typically outperform general domain models in medical contexts. We conclude that continuous pre-training has demonstrated the ability to match or even exceed the performance of clinical models trained from scratch. Furthermore, pre-training on clinical data or leveraging translated texts have proven to be reliable methods for domain adaptation in medical NLP tasks.

In this work, cross-linguistic span prediction based on contextualized word embedding models is used together with neural machine translation (NMT) to transfer and apply the state-of-the-art models in natural language processing (NLP) to a low-resource language clinical corpus. Two directions are evaluated: (a) English models can be applied to translated texts to subsequently transfer the predicted annotations to the source language and (b) existing high-quality annotations can be transferred beyond translation and then used to train NLP models in the target language. Effectiveness and loss of transmission is evaluated using the German Berlin-Tübingen-Oncology Corpus (BRONCO) dataset with transferred external data from NCBI disease, SemEval-2013 drug-drug interaction (DDI) and i2b2/VA 2010 data. The use of English models for translated clinical texts has always involved attempts to take full advantage of the benefits associated with them (large pre-trained biomedical word embeddings). To improve advances in this area, we provide a general-purpose pipeline to transfer any annotated BRAT or CoNLL format to various target languages. For the entity class medication, good results were obtained with 0.806 F1-score after re-alignment. Limited success occurred in the diagnosis and treatment class with results just below 0.5 F1-score due to differences in annotation guidelines.