Recent developments in natural language generation have tremendous implications for healthcare. For instance, state-of-the-art systems could automate the generation of sections in clinical reports to alleviate physician workload and streamline hospital documentation. To explore these applications, we present a shared task consisting of two subtasks: (1) Radiology Report Generation (RRG24) and (2) Discharge Summary Generation (“Discharge Me!”). RRG24 involves generating the ‘Findings’ and ‘Impression’ sections of radiology reports given chest X-rays. “Discharge Me!” involves generating the ‘Brief Hospital Course’ and '‘Discharge Instructions’ sections of discharge summaries for patients admitted through the emergency department. “Discharge Me!” submissions were subsequently reviewed by a team of clinicians. Both tasks emphasize the goal of reducing clinician burnout and repetitive workloads by generating documentation. We received 201 submissions from across 8 teams for RRG24, and 211 submissions from across 16 teams for “Discharge Me!”.

In order to enable extraction of structured clinical data from unstructured radiology reports, we introduce RadGraph-XL, a large-scale, expert-annotated dataset for clinical entity and relation extraction. RadGraph-XL consists of 2,300 radiology reports, which are annotated with over 410,000 entities and relations by board-certified radiologists. Whereas previous approaches focus solely on chest X-rays, RadGraph-XL includes data from four anatomy-modality pairs - chest CT, abdomen/pelvis CT, brain MR, and chest X-rays. Then, in order to automate structured information extraction, we use RadGraph-XL to train transformer-based models for clinical entity and relation extraction. Our evaluations include comprehensive ablation studies as well as an expert reader study that evaluates trained models on out-of-domain data. Results demonstrate that our model surpasses the performance of previous methods by up to 52% and notably outperforms GPT-4 in this domain. We release RadGraph-XL as well as our trained model to foster further innovation and research in structured clinical information extraction.

Motivated by the scarcity of high-quality labeled biomedical text, as well as the success of data programming, we introduce KRISS-Search. By leveraging the Unified Medical Language Systems (UMLS) ontology, KRISS-Search addresses an interactive few-shot span recommendation task that we propose. We first introduce unsupervised KRISS-Search and show that our method outperforms existing methods in identifying spans that are semantically similar to a given span of interest, with >50% AUPRC improvement relative to PubMedBERT. We then introduce supervised KRISS-Search, which leverages human interaction to improve the notion of similarity used by unsupervised KRISS-Search. Through simulated human feedback, we demonstrate an enhanced F1 score of 0.68 in classifying spans as semantically similar or different in the low-label setting, outperforming PubMedBERT by 2 F1 points. Finally, supervised KRISS-Search demonstrates competitive or superior performance compared to PubMedBERT in few-shot biomedical named entity recognition (NER) across five benchmark datasets, with an average improvement of 5.6 F1 points. We envision KRISS-Search increasing the efficiency of programmatic data labeling and also providing broader utility as an interactive biomedical search engine.

Electronic phenotyping entails using electronic health records (EHRs) to identify patients with specific health outcomes and determine when those outcomes occurred. Unstructured clinical notes, which contain a vast amount of information, are a valuable resource for electronic phenotyping. However, traditional methods, such as rule-based labeling functions or neural networks, require significant manual effort to tune and may not generalize well to multiple indications. To address these challenges, we propose HyDE (hybrid diagnosis extractor). HyDE is a simple framework for electronic phenotyping that integrates labeling functions and a disease-agnostic neural network to assign diagnoses to patients. By training HyDE’s model to correct predictions made by labeling functions, we are able to disambiguate hypertension true positives and false positives with a supervised area under the precision-recall curve (AUPRC) of 0.85. We extend this hypertension-trained model to zero-shot evaluation of four other diseases, generating AUPRC values ranging from 0.82 - 0.95 and outperforming a labeling function baseline by 44 points in F1 score and a Word2Vec baseline by 24 points in F1 score on average. Furthermore, we demonstrate a speedup of >4x by pruning the length of inputs into our language model to ~2.3% of the full clinical notes, with negligible impact to the AUPRC. HyDE has the potential to improve the efficiency and efficacy of interpreting large-scale unstructured clinical notes for accurate EHR phenotyping.