Fine-tuning pretrained models for automatically summarizing doctor-patient conversation transcripts presents many challenges: limited training data, significant domain shift, long and noisy transcripts, and high target summary variability. In this paper, we explore the feasibility of using pretrained transformer models for automatically summarizing doctor-patient conversations directly from transcripts. We show that fluent and adequate summaries can be generated with limited training data by fine-tuning BART on a specially constructed dataset. The resulting models greatly surpass the performance of an average human annotator and the quality of previous published work for the task. We evaluate multiple methods for handling long conversations, comparing them to the obvious baseline of truncating the conversation to fit the pretrained model length limit. We introduce a multistage approach that tackles the task by learning two fine-tuned models: one for summarizing conversation chunks into partial summaries, followed by one for rewriting the collection of partial summaries into a complete summary. Using a carefully chosen fine-tuning dataset, this method is shown to be effective at handling longer conversations, improving the quality of generated summaries. We conduct both an automatic evaluation (through ROUGE and two concept-based metrics focusing on medical findings) and a human evaluation (through qualitative examples from literature, assessing hallucination, generalization, fluency, and general quality of the generated summaries).
Multi-label document classification (MLDC) problems can be challenging, especially for long documents with a large label set and a long-tail distribution over labels. In this paper, we present an effective convolutional attention network for the MLDC problem with a focus on medical code prediction from clinical documents. Our innovations are three-fold: (1) we utilize a deep convolution-based encoder with the squeeze-and-excitation networks and residual networks to aggregate the information across the document and learn meaningful document representations that cover different ranges of texts; (2) we explore multi-layer and sum-pooling attention to extract the most informative features from these multi-scale representations; (3) we combine binary cross entropy loss and focal loss to improve performance for rare labels. We focus our evaluation study on MIMIC-III, a widely used dataset in the medical domain. Our models outperform prior work on medical coding and achieve new state-of-the-art results on multiple metrics. We also demonstrate the language independent nature of our approach by applying it to two non-English datasets. Our model outperforms prior best model and a multilingual Transformer model by a substantial margin.
Most classification models work by first predicting a posterior probability distribution over all classes and then selecting that class with the largest estimated probability. In many settings however, the quality of posterior probability itself (e.g., 65% chance having diabetes), gives more reliable information than the final predicted class alone. When these methods are shown to be poorly calibrated, most fixes to date have relied on posterior calibration, which rescales the predicted probabilities but often has little impact on final classifications. Here we propose an end-to-end training procedure called posterior calibrated (PosCal) training that directly optimizes the objective while minimizing the difference between the predicted and empirical posterior probabilities.We show that PosCal not only helps reduce the calibration error but also improve task performance by penalizing drops in performance of both objectives. Our PosCal achieves about 2.5% of task performance gain and 16.1% of calibration error reduction on GLUE (Wang et al., 2018) compared to the baseline. We achieved the comparable task performance with 13.2% calibration error reduction on xSLUE (Kang and Hovy, 2019), but not outperforming the two-stage calibration baseline. PosCal training can be easily extendable to any types of classification tasks as a form of regularization term. Also, PosCal has the advantage that it incrementally tracks needed statistics for the calibration objective during the training process, making efficient use of large training sets.