Joakim Edin, Andreas Geert Motzfeldt, Casper L. Christensen, Tuukka Ruotsalo, Lars Maaløe, Maria Maistro. Proceedings of the 63rd Annual Meeting of the Association for Computational Linguistics (Volume 1: Long Papers). 2025.

Electronic healthcare records are vital for patient safety as they document conditions, plans, and procedures in both free text and medical codes.Language models have significantly enhanced the processing of such records, streamlining workflows and reducing manual data entry, thereby saving healthcare providers significant resources.However, the black-box nature of these models often leaves healthcare professionals hesitant to trust them.State-ofthe-art explainability methods increase model transparency but rely on human-annotated evidence spans, which are costly.In this study, we propose an approach to produce plausible and faithful explanations without needing such annotations.We demonstrate on the automated medical coding task that adversarial robustness training improves explanation plausibility and introduce AttInGrad, a new explanation method superior to previous ones.By combining both contributions in a fully unsupervised setup, we produce explanations of comparable quality, or better, to that of a supervised approach.We release our code and model weights. 1

Medical coding is the task of assigning medical codes to clinical free-text documentation. Healthcare professionals manually assign such codes to track patient diagnoses and treatments. Automated medical coding can considerably alleviate this administrative burden. In this paper, we reproduce, compare, and analyze state-of-the-art automated medical coding machine learning models. We show that several models underperform due to weak configurations, poorly sampled train-test splits, and insufficient evaluation. In previous work, the macro F1 score has been calculated sub-optimally, and our correction doubles it. We contribute a revised model comparison using stratified sampling and identical experimental setups, including hyperparameters and decision boundary tuning. We analyze prediction errors to validate and falsify assumptions of previous works. The analysis confirms that all models struggle with rare codes, while long documents only have a negligible impact. Finally, we present the first comprehensive results on the newly released MIMIC-IV dataset using the reproduced models. We release our code, model parameters, and new MIMIC-III and MIMIC-IV training and evaluation pipelines to accommodate fair future comparisons.

We present simple methods for out-of-distribution detection using a trained generative model. These techniques, based on classical statistical tests, are model-agnostic in the sense that they can be applied to any differentiable generative model. The idea is to combine a classical parametric test (Rao’s score test) with the recently introduced typicality test. These two test statistics are both theoretically well-founded and exploit different sources of information based on the likelihood for the typicality test and its gradient for the score test. We show that combining them using Fisher’s method overall leads to a more accurate out-of-distribution test. We also discuss the benefits of casting out-of-distribution detection as a statistical testing problem, noting in particular that false positive rate control can be valuable for practical out-of-distribution detection. Despite their simplicity and generality, these methods can be competitive with model-specific out-of-distribution detection algorithms without any assumptions on the out-distribution.

Recent advances in self-supervised learning through contrastive training have shown that it is possible to learn a competitive speech recognition system with as little as 10 minutes of labeled data. However, these systems are computationally expensive since they require pre-training followed by fine-tuning in a large parameter space. We explore the performance of such systems without fine-tuning by training a state-of-the-art speech recognizer on the fixed representations from the computationally demanding wav2vec 2.0 framework. We find performance to decrease without fine-tuning and, in the extreme low-resource setting, wav2vec 2.0 is inferior to its predecessor. In addition, we find that wav2vec 2.0 representations live in a low dimensional subspace and that decorrelating the features of the representations can stabilize training of the automatic speech recognizer. Finally, we propose a bidirectional extension to the original wav2vec framework that consistently improves performance.

Deep generative models have been demonstrated as state-of-the-art density estimators. Yet, recent work has found that they often assign a higher likelihood to data from outside the training distribution. This seemingly paradoxical behavior has caused concerns over the quality of the attained density estimates. In the context of hierarchical variational autoencoders, we provide evidence to explain this behavior by out-of-distribution data having in-distribution low-level features. We argue that this is both expected and desirable behavior. With this insight in hand, we develop a fast, scalable and fully unsupervised likelihood-ratio score for OOD detection that requires data to be in-distribution across all feature-levels. We benchmark the method on a vast set of data and model combinations and achieve state-of-the-art results on out-of-distribution detection.

Jakob D. Havtorn, Jan Latko, Joakim Edin, Lars Maaløe, Lasse Borgholt, Lorenzo Belgrano, Nicolai Jacobsen, Regitze Sdun, Željko Agić. Proceedings of the 58th Annual Meeting of the Association for Computational Linguistics. 2020.

The two most common paradigms for end-to-end speech recognition are connectionist temporal classification (CTC) and attention-based encoder-decoder (AED) models. It has been argued that the latter is better suited for learning an implicit language model. We test this hypothesis by measuring temporal context sensitivity and evaluate how the models perform when we constrain the amount of contextual information in the audio input. We find that the AED model is indeed more context sensitive, but that the gap can be closed by adding self-attention to the CTC model. Furthermore, the two models perform similarly when contextual information is constrained. Finally, in contrast to previous research, our results show that the CTC model is highly competitive on WSJ and LibriSpeech without the help of an external language model.

With the introduction of the variational autoencoder (VAE), probabilistic latent variable models have received renewed attention as powerful generative models. However, their performance in terms of test likelihood and quality of generated samples has been surpassed by autoregressive models without stochastic units. Furthermore, flow-based models have recently been shown to be an attractive alternative that scales well to high-dimensional data. In this paper we close the performance gap by constructing VAE models that can effectively utilize a deep hierarchy of stochastic variables and model complex covariance structures. We introduce the Bidirectional-Inference Variational Autoencoder (BIVA), characterized by a skip-connected generative model and an inference network formed by a bidirectional stochastic inference path. We show that BIVA reaches state-of-the-art test likelihoods, generates sharp and coherent natural images, and uses the hierarchy of latent variables to capture different aspects of the data distribution. We observe that BIVA, in contrast to recent results, can be used for anomaly detection. We attribute this to the hierarchy of latent variables which is able to extract high-level semantic features. Finally, we extend BIVA to semi-supervised classification tasks and show that it performs comparably to state-of-the-art results by generative adversarial networks.

Deep generative models parameterized by neural networks have recently achieved state-of-the-art performance in unsupervised and semi-supervised learning. We extend deep generative models with auxiliary variables which improves the variational approximation. The auxiliary variables leave the generative model unchanged but make the variational distribution more expressive. Inspired by the structure of the auxiliary variable we also propose a model with two stochastic layers and skip connections. Our findings suggest that more expressive and properly specified deep generative models converge faster with better results. We show state-of-the-art performance within semi-supervised learning on MNIST, SVHN and NORB datasets.

Variational autoencoders are powerful models for unsupervised learning. However deep models with several layers of dependent stochastic variables are difficult to train which limits the improvements obtained using these highly expressive models. We propose a new inference model, the Ladder Variational Autoencoder, that recursively corrects the generative distribution by a data dependent approximate likelihood in a process resembling the recently proposed Ladder Network. We show that this model provides state of the art predictive log-likelihood and tighter log-likelihood lower bound compared to the purely bottom-up inference in layered Variational Autoencoders and other generative models. We provide a detailed analysis of the learned hierarchical latent representation and show that our new inference model is qualitatively different and utilizes a deeper more distributed hierarchy of latent variables. Finally, we observe that batch-normalization and deterministic warm-up (gradually turning on the KL-term) are crucial for training variational models with many stochastic layers.