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.

Despite the success of data augmentation in improving CLIP model, existing methods that utilize LLM or SAM to enrich the information in captions still suffer from several limitations, including insufficient detail and excessive hallucinations, ultimately resulting in compromised alignment and masking the true potential of dense information. This can lead to erroneous conclusions about CLIP’s ability to handle rich data, impeding the development of more effective models. To address the limitations of existing methods, we introduce a novel pipeline that generates highly detailed, factually accurate captions for images, which facilitates in-depth analysis of the potential for dense information in multimodal alignment. Contrary to previous findings, our investigation revealed that lengthening captions boosts performance across diverse benchmarks, even surpassing the effectiveness of meticulously crafted hard negative samples. Building on these insights, DELIP is introduced, demonstrably enhancing both foundational multimodal alignment and compositional reasoning abilities. Finally, we explore strategies to expand the context window of the text encoder, unlocking the potential of richer data for CLIP and paving the way for advancements in leveraging dense information for multimodal alignment.

Evaluating radiology reports is a challenging problem as factual correctness is extremely important due to its medical nature. Existing automatic evaluation metrics either suffer from failing to consider factual correctness (e.g., BLEU and ROUGE) or are limited in their interpretability (e.g., F1CheXpert and F1RadGraph). In this paper, we introduce GREEN (Generative Radiology Report Evaluation and Error Notation), a radiology report generation metric that leverages the natural language understanding of language models to identify and explain clinically significant errors in candidate reports, both quantitatively and qualitatively. Compared to current metrics, GREEN offers: 1) a score aligned with expert preferences, 2) human interpretable explanations of clinically significant errors, enabling feedback loops with end-users, and 3) a lightweight open-source method that reaches the performance of commercial counterparts. We validate our GREEN metric by comparing it to GPT-4, as well as to error counts of 6 experts and preferences of 2 experts. Our method demonstrates not only higher correlation with expert error counts, but simultaneously higher alignment with expert preferences when compared to previous approaches.

Large Language Models (LLMs) provide a possibility to make a great breakthrough in medicine. The establishment of a standardized medical benchmark becomes a fundamental cornerstone to measure progression. However, medical environments in different regions have their local characteristics, e.g., the ubiquity and significance of traditional Chinese medicine within China. Therefore, merely translating English-based medical evaluation may result in contextual incongruities to a local region. To solve the issue, we propose a localized medical benchmark called CMB, a Comprehensive Medical Benchmark in Chinese, designed and rooted entirely within the native Chinese linguistic and cultural framework. While traditional Chinese medicine is integral to this evaluation, it does not constitute its entirety. Using this benchmark, we have evaluated several prominent large-scale LLMs, including ChatGPT, GPT-4, dedicated Chinese LLMs, and LLMs specialized in the medical domain. We hope this benchmark provide first-hand experience in existing LLMs for medicine and also facilitate the widespread adoption and enhancement of medical LLMs within China. Our data and code are publicly available at https://github.com/FreedomIntelligence/CMB.

This paper is devoted to the development of a localized Large Language Model (LLM) specifically for Arabic, a language imbued with unique cultural characteristics inadequately addressed by current mainstream models. Significant concerns emerge when addressing cultural sensitivity and local values. To address this, the paper proposes a comprehensive solution that includes further pre-training with Arabic texts, Supervised Fine-Tuning (SFT) utilizing native Arabic instructions, and GPT-4 responses in Arabic, alongside Reinforcement Learning with AI Feedback (RLAIF) employing a reward model attuned to local culture and values. The goal is to cultivate culturally cognizant and value-aligned Arabic LLMs capable of accommodating the diverse, application-specific needs of Arabic-speaking communities. Comprehensive evaluations reveal that the resulting model, dubbed ‘AceGPT’, sets the state-of-the-art standard for open Arabic LLMs across various benchmarks. Codes, data, and models are in https://github.com/FreedomIntelligence/AceGPT.

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!”.

Radiology report summarization (RRS) is a growing area of research. Given the Findings section of a radiology report, the goal is to generate a summary (called an Impression section) that highlights the key observations and conclusions of the radiology study. However, RRS currently faces essential limitations. First, many prior studies conduct experiments on private datasets, preventing reproduction of results and fair comparisons across different systems and solutions. Second, most prior approaches are evaluated solely on chest X-rays. To address these limitations, we propose a dataset (MIMIC-RRS) involving three new modalities and seven new anatomies based on the MIMIC-III and MIMIC-CXR datasets. We then conduct extensive experiments to evaluate the performance of models both within and across modality-anatomy pairs in MIMIC-RRS. In addition, we evaluate their clinical efficacy via RadGraph, a factual correctness metric.

The impression is crucial for the referring physicians to grasp key information since it is concluded from the findings and reasoning of radiologists. To alleviate the workload of radiologists and reduce repetitive human labor in impression writing, many researchers have focused on automatic impression generation. However, recent works on this task mainly summarize the corresponding findings and pay less attention to the radiology images. In clinical, radiographs can provide more detailed valuable observations to enhance radiologists’ impression writing, especially for complicated cases. Besides, each sentence in findings usually focuses on single anatomy, such that they only need to be matched to corresponding anatomical regions instead of the whole image, which is beneficial for textual and visual features alignment. Therefore, we propose a novel anatomy-enhanced multimodal model to promote impression generation. In detail, we first construct a set of rules to extract anatomies and put these prompts into each sentence to highlight anatomy characteristics. Then, two separate encoders are applied to extract features from the radiograph and findings. Afterward, we utilize a contrastive learning module to align these two representations at the overall level and use a co-attention to fuse them at the sentence level with the help of anatomy-enhanced sentence representation. The experimental results on two benchmark datasets confirm the effectiveness of the proposed method, which achieves state-of-the-art results.

Masked language modeling (MLM) has been one of the most popular pretraining recipes in natural language processing, e.g., BERT, one of the representative models. Recently, contrastive language-image pretraining (CLIP) has also attracted attention, especially its vision models that achieve excellent performance on a broad range of vision tasks. However, few studies are dedicated to studying the text encoders learned by CLIP. In this paper, we analyze the difference between BERT-style and CLIP-style text encoders from three experiments: (i) general text understanding, (ii) vision-centric text understanding, and (iii) text-to-image generation. Experimental analyses show that although CLIP-style text encoders underperform BERT-style ones for general text understanding tasks, they are equipped with a unique ability, i.e., synesthesia, for the cross-modal association, which is more similar to the senses of humans.

In this paper, we present HuatuoGPT, a Large Language Model (LLM) for medical consultation. The core recipe of HuatuoGPT is to leverage both distilled data from **ChatGPT** and real-world data from **doctors** in the supervised fine-tuning stage. This is not only because purely using **ChatGPT**-distilled data might cause ‘model collapse’, but also because real-world data from **doctors** would be complementary to **ChatGPT**-distilled data. The responses from ChatGPT are usually detailed, well-presented, fluent, and instruction-followed, but it cannot perform like a doctor in many aspects, e.g. for interactive diagnosis. Therefore, the extra doctors’ data could tame a distilled language model to perform like doctors. To synergize the strengths of both data sources, we introduce RLMF (Reinforcement Learning from Mixed Feedback) where a reward model is trained to align the language model with the merits that both sources (ChatGPT and doctors) bring. Experimental results (in GPT-4 evaluation, human evaluation, and medical benchmark datasets) demonstrate that HuatuoGPT achieves state-of-the-art results in performing medical consultation among open-source LLMs. It is worth noting that by using additional real-world data and RLMF, the distilled language model (i.e., HuatuoGPT) outperforms its teacher model (i.e., ChatGPT) in most cases.

The impression section of a radiology report summarizes the most prominent observation from the findings section and is the most important section for radiologists to communicate to physicians. Summarizing findings is time-consuming and can be prone to error for inexperienced radiologists, and thus automatic impression generation has attracted substantial attention. With the encoder-decoder framework, most previous studies explore incorporating extra knowledge (e.g., static pre-defined clinical ontologies or extra background information). Yet, they encode such knowledge by a separate encoder to treat it as an extra input to their models, which is limited in leveraging their relations with the original findings. To address the limitation, we propose a unified framework for exploiting both extra knowledge and the original findings in an integrated way so that the critical information (i.e., key words and their relations) can be extracted in an appropriate way to facilitate impression generation. In detail, for each input findings, it is encoded by a text encoder and a graph is constructed through its entities and dependency tree. Then, a graph encoder (e.g., graph neural networks (GNNs)) is adopted to model relation information in the constructed graph. Finally, to emphasize the key words in the findings, contrastive learning is introduced to map positive samples (constructed by masking non-key words) closer and push apart negative ones (constructed by masking key words). The experimental results on two datasets, OpenI and MIMIC-CXR, confirm the effectiveness of our proposed method, where the state-of-the-art results are achieved.

Medical imaging plays a significant role in clinical practice of medical diagnosis, where the text reports of the images are essential in understanding them and facilitating later treatments. By generating the reports automatically, it is beneficial to help lighten the burden of radiologists and significantly promote clinical automation, which already attracts much attention in applying artificial intelligence to medical domain. Previous studies mainly follow the encoder-decoder paradigm and focus on the aspect of text generation, with few studies considering the importance of cross-modal mappings and explicitly exploit such mappings to facilitate radiology report generation. In this paper, we propose a cross-modal memory networks (CMN) to enhance the encoder-decoder framework for radiology report generation, where a shared memory is designed to record the alignment between images and texts so as to facilitate the interaction and generation across modalities. Experimental results illustrate the effectiveness of our proposed model, where state-of-the-art performance is achieved on two widely used benchmark datasets, i.e., IU X-Ray and MIMIC-CXR. Further analyses also prove that our model is able to better align information from radiology images and texts so as to help generating more accurate reports in terms of clinical indicators.

Medical imaging is frequently used in clinical practice and trials for diagnosis and treatment. Writing imaging reports is time-consuming and can be error-prone for inexperienced radiologists. Therefore, automatically generating radiology reports is highly desired to lighten the workload of radiologists and accordingly promote clinical automation, which is an essential task to apply artificial intelligence to the medical domain. In this paper, we propose to generate radiology reports with memory-driven Transformer, where a relational memory is designed to record key information of the generation process and a memory-driven conditional layer normalization is applied to incorporating the memory into the decoder of Transformer. Experimental results on two prevailing radiology report datasets, IU X-Ray and MIMIC-CXR, show that our proposed approach outperforms previous models with respect to both language generation metrics and clinical evaluations. Particularly, this is the first work reporting the generation results on MIMIC-CXR to the best of our knowledge. Further analyses also demonstrate that our approach is able to generate long reports with necessary medical terms as well as meaningful image-text attention mappings.