The ability of large language models (LLMs) to follow natural language instructions with human-level fluency suggests many opportunities in healthcare to reduce administrative burden and improve quality of care. However, evaluating LLMs on realistic text generation tasks for healthcare remains challenging. Existing question answering datasets for electronic health record (EHR) data fail to capture the complexity of information needs and documentation burdens experienced by clinicians. To address these challenges, we introduce MedAlign, a benchmark dataset of 983 natural language instructions for EHR data. MedAlign is curated by 15 clinicians (7 specialities), includes clinician-written reference responses for 303 instructions, and provides 276 longitudinal EHRs for grounding instruction-response pairs. We used MedAlign to evaluate 6 general domain LLMs, having clinicians rank the accuracy and quality of each LLM response. We found high error rates, ranging from 35% (GPT-4) to 68% (MPT-7B-Instruct), and 8.3% drop in accuracy moving from 32k to 2k context lengths for GPT-4. Finally, we report correlations between clinician rankings and automated natural language generation metrics as a way to rank LLMs without human review. MedAlign is provided under a research data use agreement to enable LLM evaluations on tasks aligned with clinician needs and preferences.

Synthesizing information from various data sources plays a crucial role in the practice of modern medicine. Current applications of artificial intelligence in medicine often focus on single-modality data due to a lack of publicly available, multimodal medical datasets. To address this limitation, we introduce INSPECT, which contains de-identified longitudinal records from a large cohort of pulmonary embolism (PE) patients, along with ground truth labels for multiple outcomes. INSPECT contains data from 19,402 patients, including CT images, sections of radiology reports, and structured electronic health record (EHR) data (including demographics, diagnoses, procedures, and vitals). Using our provided dataset, we develop and release a benchmark for evaluating several baseline modeling approaches on a variety of important PE related tasks. We evaluate image-only, EHR-only, and fused models. Trained models and the de-identified dataset are made available for non-commercial use under a data use agreement. To the best our knowledge, INSPECT is the largest multimodal dataset for enabling reproducible research on strategies for integrating 3D medical imaging and EHR data.