Multidisciplinary tumor boards (MTBs) bring specialists together to identify therapies for complex cancer cases, but preparing for them is time-intensive. Clinicians must extract key details from extensive records and evaluate treatment options. While large language models (LLMs) show promise in medicine for basic tasks like summarizing notes, little is known about their role in high-stakes tasks like MTB preparation. We conducted a mixed-methods study with 16 oncologists using two AI systems to prepare patient cases for MTB: an off-the-shelf assistant (Copilot) and a task-specific multi-agent system (Healthcare Agent Orchestrator, HAO). We analyzed oncologist prompts, AI responses, and oncologists’ perception of AI. Participants showed greater willingness to adopt HAO but were often overconfident in AI summaries and skeptical of AI-recommended therapies. Trust calibration strategies, such as source links and agent-trajectories, failed to align trust with system capabilities. We conclude with how AI systems should be built to support clinicians in high-stakes tasks.

Yiqing Xie, Sheng Zhang, Hao Cheng, Pengfei Liu, Zelalem Gero, Cliff Wong, Tristan Naumann, Hoifung Poon, Carolyn Rose. Proceedings of the 62nd Annual Meeting of the Association for Computational Linguistics (Volume 1: Long Papers). 2024.

Conversational generative AI has demonstrated remarkable promise for empowering biomedical practitioners, but current investigations focus on unimodal text. Multimodal conversational AI has seen rapid progress by leveraging billions of image-text pairs from the public web, but such general-domain vision-language models still lack sophistication in understanding and conversing about biomedical images. In this paper, we propose a cost-efficient approach for training a vision-language conversational assistant that can answer open-ended research questions of biomedical images. The key idea is to leverage a large-scale, broad-coverage biomedical figure-caption dataset extracted from PubMed Central, use GPT-4 to self-instruct open-ended instruction-following data from the captions, and then fine-tune a large general-domain vision-language model using a novel curriculum learning method. Specifically, the model first learns to align biomedical vocabulary using the figure-caption pairs as is, then learns to master open-ended conversational semantics using GPT-4 generated instruction-following data, broadly mimicking how a layperson gradually acquires biomedical knowledge. This enables us to train a Large Language and Vision Assistant for BioMedicine (LLaVA-Med) in less than 15 hours (with eight A100s). LLaVA-Med exhibits excellent multimodal conversational capability and can follow open-ended instruction to assist with inquiries about a biomedical image. On three standard biomedical visual question answering datasets, LLaVA-Med outperforms previous supervised state-of-the-art on certain metrics. To facilitate biomedical multimodal research, we will release our instruction-following data and the LLaVA-Med model.

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 taskspecific 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.

Information overload is a prevalent challenge in many high-value domains. A prominent case in point is the explosion of the biomedical literature on COVID-19, which swelled to hundreds of thousands of papers in a matter of months. In general, biomedical literature expands by two papers every minute, totalling over a million new papers every year. Search in the biomedical realm, and many other vertical domains is challenging due to the scarcity of direct supervision from click logs. Self-supervised learning has emerged as a promising direction to overcome the annotation bottleneck. We propose a general approach for vertical search based on domain-specific pretraining and present a case study for the biomedical domain. Despite being substantially simpler and not using any relevance labels for training or development, our method performs comparably or better than the best systems in the official TREC-COVID evaluation, a COVID-related biomedical search competition. Using distributed computing in modern cloud infrastructure, our system can scale to tens of millions of articles on PubMed and has been deployed as Microsoft Biomedical Search, a new search experience for biomedical literature: https://aka.ms/biomedsearch.