TOP-Training: Target-Oriented Pretraining for Medical Extractive Question Answering

Saptarshi Sengupta, Connor Heaton, Shreya Ghosh, Wenpeng Yin, Preslav Nakov, Suhang Wang


Abstract
We study extractive question-answering in the medical domain (Medical-EQA). This problem has two main challenges: (i) domain specificity, as most AI models lack necessary domain knowledge, and (ii) extraction-based answering style, which restricts most autoregressive LLMs due to potential hallucinations. To handle those challenges, we propose TOP-Training, a target-oriented pre-training paradigm that stands out among all domain adaptation techniques with two desirable features: (i) TOP-Training moves one step further than popular domain-oriented fine-tuning since it not only moves closer to the target domain, but also familiarizes itself with the target dataset, and (ii) it does not assume the existence of a large set of unlabeled instances from the target domain. Specifically, for a target Medical-EQA dataset, we extract its entities and leverage large language models (LLMs) to generate synthetic texts containing those entities; we then demonstrate that pretraining on this synthetic text data yields better performance on the target Medical-EQA benchmarks. Overall, our contributions are threefold: (i) TOP-Training, a new pretraining technique to effectively adapt LLMs to better solve a target problem, (ii) TOP-Training has a wide application scope because it does not require the target problem to have a large set of unlabeled data, and (iii) our experiments highlight the limitations of autoregressive LLMs, emphasizing TOP-Training as a means to unlock the true potential of bidirectional LLMs.
Anthology ID:
2025.coling-main.469
Volume:
Proceedings of the 31st International Conference on Computational Linguistics
Month:
January
Year:
2025
Address:
Abu Dhabi, UAE
Editors:
Owen Rambow, Leo Wanner, Marianna Apidianaki, Hend Al-Khalifa, Barbara Di Eugenio, Steven Schockaert
Venue:
COLING
SIG:
Publisher:
Association for Computational Linguistics
Note:
Pages:
7035–7054
Language:
URL:
https://aclanthology.org/2025.coling-main.469/
DOI:
Bibkey:
Cite (ACL):
Saptarshi Sengupta, Connor Heaton, Shreya Ghosh, Wenpeng Yin, Preslav Nakov, and Suhang Wang. 2025. TOP-Training: Target-Oriented Pretraining for Medical Extractive Question Answering. In Proceedings of the 31st International Conference on Computational Linguistics, pages 7035–7054, Abu Dhabi, UAE. Association for Computational Linguistics.
Cite (Informal):
TOP-Training: Target-Oriented Pretraining for Medical Extractive Question Answering (Sengupta et al., COLING 2025)
Copy Citation:
PDF:
https://aclanthology.org/2025.coling-main.469.pdf