Adapting pretrained language models to novel domains, such as clinical applications, traditionally involves retraining their entire set of parameters. Parameter-Efficient Fine-Tuning (PEFT) techniques for fine-tuning language models significantly reduce computational requirements by selectively fine-tuning small subsets of parameters. In this study, we propose a two-step PEFT framework and evaluate it in the clinical domain. Our approach combines a specialised PEFT adapter layer designed for clinical domain adaptation with another adapter specialised for downstream tasks. We evaluate the framework on multiple clinical outcome prediction datasets, comparing it to clinically trained language models. Our framework achieves a better AUROC score averaged across all clinical downstream tasks compared to clinical language models. In particular, we observe large improvements of 4-5% AUROC in large-scale multilabel classification tasks, such as diagnoses and procedures classification. To our knowledge, this study is the first to provide an extensive empirical analysis of the interplay between PEFT techniques and domain adaptation in an important real-world domain of clinical applications.

The MEDIQA-CORR 2024 shared task aims to assess the ability of Large Language Models (LLMs) to identify and correct medical errors in clinical notes. In this study, we evaluate the capability of general LLMs, specifically GPT-3.5 and GPT-4, to identify and correct medical errors with multiple prompting strategies. Recognising the limitation of LLMs in generating accurate corrections only via prompting strategies, we propose incorporating error-span predictions from a smaller, fine-tuned model in two ways: 1) by presenting it as a hint in the prompt and 2) by framing it as multiple-choice questions from which the LLM can choose the best correction. We found that our proposed prompting strategies significantly improve the LLM’s ability to generate corrections. Our best-performing solution with 8-shot + CoT + hints ranked sixth in the shared task leaderboard. Additionally, our comprehensive analyses show the impact of the location of the error sentence, the prompted role, and the position of the multiple-choice option on the accuracy of the LLM. This prompts further questions about the readiness of LLM to be implemented in real-world clinical settings.

The NLI4CT task assesses Natural Language Inference systems in predicting whether hypotheses entail or contradict evidence from Clinical Trial Reports. In this study, we evaluate various Large Language Models (LLMs) with multiple strategies, including Chain-of-Thought, In-Context Learning, and Parameter-Efficient Fine-Tuning (PEFT). We propose a PEFT method to improve the consistency of LLMs by merging adapters that were fine-tuned separately using triplet and language modelling objectives. We found that merging the two PEFT adapters improves the F1 score (+0.0346) and consistency (+0.152) of the LLMs. However, our novel methods did not produce more accurate results than GPT-4 in terms of faithfulness and consistency. Averaging the three metrics, GPT-4 ranks joint-first in the competition with 0.8328. Finally, our contamination analysis with GPT-4 indicates that there was no test data leakage. Our code is available at https://github.com/EdinburghClinicalNLP/semeval_nli4ct.