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May 21

Comparing Rule-Based and Deep Learning Models for Patient Phenotyping

Objective: We investigate whether deep learning techniques for natural language processing (NLP) can be used efficiently for patient phenotyping. Patient phenotyping is a classification task for determining whether a patient has a medical condition, and is a crucial part of secondary analysis of healthcare data. We assess the performance of deep learning algorithms and compare them with classical NLP approaches. Materials and Methods: We compare convolutional neural networks (CNNs), n-gram models, and approaches based on cTAKES that extract pre-defined medical concepts from clinical notes and use them to predict patient phenotypes. The performance is tested on 10 different phenotyping tasks using 1,610 discharge summaries extracted from the MIMIC-III database. Results: CNNs outperform other phenotyping algorithms in all 10 tasks. The average F1-score of our model is 76 (PPV of 83, and sensitivity of 71) with our model having an F1-score up to 37 points higher than alternative approaches. We additionally assess the interpretability of our model by presenting a method that extracts the most salient phrases for a particular prediction. Conclusion: We show that NLP methods based on deep learning improve the performance of patient phenotyping. Our CNN-based algorithm automatically learns the phrases associated with each patient phenotype. As such, it reduces the annotation complexity for clinical domain experts, who are normally required to develop task-specific annotation rules and identify relevant phrases. Our method performs well in terms of both performance and interpretability, which indicates that deep learning is an effective approach to patient phenotyping based on clinicians' notes.

  • 11 authors
·
Mar 25, 2017

CXR-LLaVA: Multimodal Large Language Model for Interpreting Chest X-ray Images

Purpose: Recent advancements in large language models (LLMs) have expanded their capabilities in a multimodal fashion, potentially replicating the image interpretation of human radiologists. This study aimed to develop open-source multimodal large language model for interpreting chest X-ray images (CXR-LLaVA). We also examined the effect of prompt engineering and model parameters such as temperature and nucleus sampling. Materials and Methods: For training, we collected 659,287 publicly available CXRs: 417,336 CXRs had labels for certain radiographic abnormalities (dataset 1); 241,951 CXRs provided free-text radiology reports (dataset 2). After pre-training the Resnet50 as an image encoder, the contrastive language-image pre-training was used to align CXRs and corresponding radiographic abnormalities. Then, the Large Language Model Meta AI-2 was fine-tuned using dataset 2, which were refined using GPT-4, with generating various question answering scenarios. The code can be found at https://github.com/ECOFRI/CXR_LLaVA. Results: In the test set, we observed that the model's performance fluctuated based on its parameters. On average, it achieved F1 score of 0.34 for five pathologic findings (atelectasis, cardiomegaly, consolidation, edema, and pleural effusion), which was improved to 0.46 through prompt engineering. In the independent set, the model achieved an average F1 score of 0.30 for the same pathologic findings. Notably, for the pediatric chest radiograph dataset, which was unseen during training, the model differentiated abnormal radiographs with an F1 score ranging from 0.84 to 0.85. Conclusion: CXR-LLaVA demonstrates promising potential in CXR interpretation. Both prompt engineering and model parameter adjustments can play pivotal roles in interpreting CXRs.

  • 4 authors
·
Oct 22, 2023

ConfTuner: Training Large Language Models to Express Their Confidence Verbally

Large Language Models (LLMs) are increasingly deployed in high-stakes domains such as science, law, and healthcare, where accurate expressions of uncertainty are essential for reliability and trust. However, current LLMs are often observed to generate incorrect answers with high confidence, a phenomenon known as "overconfidence". Recent efforts have focused on calibrating LLMs' verbalized confidence: i.e., their expressions of confidence in text form, such as "I am 80% confident that...". Existing approaches either rely on prompt engineering or fine-tuning with heuristically generated uncertainty estimates, both of which have limited effectiveness and generalizability. Motivated by the notion of proper scoring rules for calibration in classical machine learning models, we introduce ConfTuner, a simple and efficient fine-tuning method that introduces minimal overhead and does not require ground-truth confidence scores or proxy confidence estimates. ConfTuner relies on a new loss function, tokenized Brier score, which we theoretically prove to be a proper scoring rule, intuitively meaning that it "correctly incentivizes the model to report its true probability of being correct". ConfTuner improves calibration across diverse reasoning tasks and generalizes to black-box models such as GPT-4o. Our results further show that better-calibrated confidence enables downstream gains in self-correction and model cascade, advancing the development of trustworthy LLM systems. The code is available at https://github.com/liushiliushi/ConfTuner.

  • 4 authors
·
Aug 26, 2025