Medical coding is the process by which standardized medical codes are assigned to patient health records. This is a complex and challenging task that typically requires an expert human coder to review health records and assign codes from a classification system based on a standard set of rules. Since health records typically consist of a large proportion of free-text documents, this problem has traditionally been approached as a natural language processing (NLP) task. While machine learning-based methods have seen recent popularity on this task, they tend to struggle with codes that are assigned less frequently, for which little or no training data exists. In this work we utilize the open-source NLP programming language, NLP++, to design and build an automated system to assign International Classification of Diseases (ICD) codes to discharge summaries that functions in the absence of labeled training data. We evaluate our system using the MIMIC-III dataset and find that for codes with little training data, our approach achieves competitive performance compared to state-of-the-art machine learning approaches.

This paper presents our system descriptions for SemEval 2023-Task 7: Multi-evidence Natural Language Inference for Clinical Trial Data sub-tasks one and two. Provided with a collection of Clinical Trial Reports (CTRs) and corresponding expert-annotated claim statements, sub-task one involves determining an inferential relationship between the statement and CTR premise: contradiction or entailment. Sub-task two involves retrieving evidence from the CTR which is necessary to determine the entailment in sub-task one. For sub-task two we employ a recent transformer-based language model pretrained on biomedical literature, which we domain-adapt on a set of clinical trial reports. For sub-task one, we take an ensemble approach in which we leverage the evidence retrieval model from sub-task two to extract relevant sections, which are then passed to a second model of equivalent architecture to determine entailment. Our system achieves a ranking of seventh on sub-task one with an F1-score of 0.705 and sixth on sub-task two with an F1-score of 0.806. In addition, we find that the high rate of success of language models on this dataset may be partially attributable to the existence of annotation artifacts.

As pretrained transformer language models continue to achieve state-of-the-art performance, the Natural Language Processing community has pushed for advances in model compression and efficient attention mechanisms to address high computational requirements and limited input sequence length. Despite these separate efforts, no investigation has been done into the intersection of these two fields. In this work, we provide an evaluation of model compression via knowledge distillation on efficient attention transformers. We provide cost-performance trade-offs for the compression of state-of-the-art efficient attention architectures and the gains made in performance in comparison to their full attention counterparts. Furthermore, we introduce a new long-context Named Entity Recognition dataset, GONERD, to train and test the performance of NER models on long sequences. We find that distilled efficient attention transformers can preserve a significant amount of original model performance, preserving up to 98.6% across short-context tasks (GLUE, SQUAD, CoNLL-2003), up to 94.6% across long-context Question-and-Answering tasks (HotpotQA, TriviaQA), and up to 98.8% on long-context Named Entity Recognition (GONERD), while decreasing inference times by up to 57.8%. We find that, for most models on most tasks, performing knowledge distillation is an effective method to yield high-performing efficient attention models with low costs.