Medical text generation aims to assist with administrative work and highlight salient information to support decision-making.To reflect the specific requirements of medical text, in this paper, we propose a set of metrics to evaluate the completeness, conciseness, and attribution of the generated text at a fine-grained level. The metrics can be computed by various types of evaluators including instruction-following (both proprietary and open-source) and supervised entailment models. We demonstrate the effectiveness of the resulting framework, DocLens, with three evaluators on three tasks: clinical note generation, radiology report summarization, and patient question summarization. A comprehensive human study shows that DocLens exhibits substantially higher agreement with the judgments of medical experts than existing metrics. The results also highlight the need to improve open-source evaluators and suggest potential directions. We released the code at https://github.com/yiqingxyq/DocLens.

Summarization models often generate text that is poorly calibrated to quality metrics because they are trained to maximize the likelihood of a single reference (MLE). To address this, recent work has added a calibration step, which exposes a model to its own ranked outputs to improve relevance or, in a separate line of work, contrasts positive and negative sets to improve faithfulness. While effective, much of this work has focused on how to generate and optimize these sets. Less is known about why one setup is more effective than another. In this work, we uncover the underlying characteristics of effective sets. For each training instance, we form a large, diverse pool of candidates and systematically vary the subsets used for calibration fine-tuning. Each selection strategy targets distinct aspects of the sets, such as lexical diversity or the size of the gap between positive and negatives. On three diverse scientific long-form summarization datasets (spanning biomedical, clinical, and chemical domains), we find, among others, that faithfulness calibration is optimal when the negative sets are extractive and more likely to be generated, whereas for relevance calibration, the metric margin between candidates should be maximized and surprise–the disagreement between model and metric defined candidate rankings–minimized.

Relation extraction (RE), which has relied on structurally annotated corpora for model training, has been particularly challenging in low-resource scenarios and domains. Recent literature has tackled low-resource RE by self-supervised learning, where the solution involves pretraining the entity pair embedding by RE-based objective and finetuning on labeled data by classification-based objective. However, a critical challenge to this approach is the gap in objectives, which prevents the RE model from fully utilizing the knowledge in pretrained representations. In this paper, we aim at bridging the gap and propose to pretrain and finetune the RE model using consistent objectives of contrastive learning. Since in this kind of representation learning paradigm, one relation may easily form multiple clusters in the representation space, we further propose a multi-center contrastive loss that allows one relation to form multiple clusters to better align with pretraining. Experiments on two document-level RE datasets, BioRED and Re-DocRED, demonstrate the effectiveness of our method. Particularly, when using 1% end-task training data, our method outperforms PLM-based RE classifier by 10.5% and 6.1% on the two datasets, respectively.

Prompt tuning offers an efficient approach to domain adaptation for pretrained language models, which predominantly focus on masked language modeling or generative objectives. However, the potential of discriminative language models in biomedical tasks remains underexplored.To bridge this gap, we develop BioDLM, a method tailored for biomedical domain adaptation of discriminative language models that incorporates prompt-based continual pretraining and prompt tuning for downstream tasks. BioDLM aims to maximize the potential of discriminative language models in low-resource scenarios by reformulating these tasks as span-level corruption detection, thereby enhancing performance on domain-specific tasks and improving the efficiency of continual pertaining. In this way, BioDLM provides a data-efficient domain adaptation method for discriminative language models, effectively enhancing performance on discriminative tasks within the biomedical domain.

Label scarcity is a bottleneck for improving task performance in specialized domains. We propose a novel compositional transfer learning framework (DoT51) for zero-shot domain transfer. Without access to in-domain labels, DoT5 jointly learns domain knowledge (from masked language modelling of unlabelled in-domain free text) and task knowledge (from task training on more readily available general-domain data) in a multi-task manner. To improve the transferability of task training, we design a strategy named NLGU: We simultaneously train natural language generation (NLG) for in-domain label-to-data generation, which enables data augmentation for self-finetuning and natural language understanding (NLU) for label prediction. We evaluate DoT5 on the biomedical domain and the resource-lean subdomain of radiology, focusing on natural language inference, text summarization, and embedding learning. DoT5 demonstrates the effectiveness of compositional transfer learning through multi-task learning. In particular, DoT5 outperforms the current state-of-the-art in zero-shot transfer by over 7 absolute points in accuracy on RadNLI. We validate DoT5 with ablations and a case study demonstrating its ability to solve challenging NLI examples requiring in-domain expertise.

Entity linking faces significant challenges such as prolific variations and prevalent ambiguities, especially in high-value domains with myriad entities. Standard classification approaches suffer from the annotation bottleneck and cannot effectively handle unseen entities. Zero-shot entity linking has emerged as a promising direction for generalizing to new entities, but it still requires example gold entity mentions during training and canonical descriptions for all entities, both of which are rarely available outside of Wikipedia. In this paper, we explore Knowledge-RIch Self-Supervision (KRISS) for biomedical entity linking, by leveraging readily available domain knowledge. In training, it generates self-supervised mention examples on unlabeled text using a domain ontology and trains a contextual encoder using contrastive learning. For inference, it samples self-supervised mentions as prototypes for each entity and conducts linking by mapping the test mention to the most similar prototype. Our approach can easily incorporate entity descriptions and gold mention labels if available. We conducted extensive experiments on seven standard datasets spanning biomedical literature and clinical notes. Without using any labeled information, our method produces KRISSBERT, a universal entity linker for four million UMLS entities that attains new state of the art, outperforming prior self-supervised methods by as much as 20 absolute points in accuracy. We released KRISSBERT at https://aka.ms/krissbert.

Extracting relations across large text spans has been relatively underexplored in NLP, but it is particularly important for high-value domains such as biomedicine, where obtaining high recall of the latest findings is crucial for practical applications. Compared to conventional information extraction confined to short text spans, document-level relation extraction faces additional challenges in both inference and learning. Given longer text spans, state-of-the-art neural architectures are less effective and task-specific self-supervision such as distant supervision becomes very noisy. In this paper, we propose decomposing document-level relation extraction into relation detection and argument resolution, taking inspiration from Davidsonian semantics. This enables us to incorporate explicit discourse modeling and leverage modular self-supervision for each sub-problem, which is less noise-prone and can be further refined end-to-end via variational EM. We conduct a thorough evaluation in biomedical machine reading for precision oncology, where cross-paragraph relation mentions are prevalent. Our method outperforms prior state of the art, such as multi-scale learning and graph neural networks, by over 20 absolute F1 points. The gain is particularly pronounced among the most challenging relation instances whose arguments never co-occur in a paragraph.

Contextual word embedding models such as ELMo and BERT have dramatically improved performance for many natural language processing (NLP) tasks in recent months. However, these models have been minimally explored on specialty corpora, such as clinical text; moreover, in the clinical domain, no publicly-available pre-trained BERT models yet exist. In this work, we address this need by exploring and releasing BERT models for clinical text: one for generic clinical text and another for discharge summaries specifically. We demonstrate that using a domain-specific model yields performance improvements on 3/5 clinical NLP tasks, establishing a new state-of-the-art on the MedNLI dataset. We find that these domain-specific models are not as performant on 2 clinical de-identification tasks, and argue that this is a natural consequence of the differences between de-identified source text and synthetically non de-identified task text.