arXiv subjects

Zonghai Yao

Publications and source records attributed to Zonghai Yao.

At least 37 records · Page 2Linked to original sources

arXiv2025

DischargeSim: A Simulation Benchmark for Educational Doctor-Patient Communication at Discharge

Discharge communication is a critical yet underexplored component of patient care, where the goal shifts from diagnosis to education. While recent large language model (LLM) benchmarks emphasize in-visit diagnostic reasoning, they fail to evaluate models' ability to support patients after the visit. We introduce DischargeSim, a novel benchmark that evaluates LLMs on their ability to act as personalized discharge educators. DischargeSim simulates post-visit, multi-turn conversations between LLM-driven DoctorAgents and PatientAgents with diverse psychosocial profiles (e.g., health literacy, education, emotion). Interactions are structured across six clinically grounded discharge topics and assessed along three axes: (1) dialogue quality via automatic and LLM-as-judge evaluation, (2) personalized document generation including free-text summaries and structured AHRQ checklists, and (3) patient comprehension through a downstream multiple-choice exam. Experiments across 18 LLMs reveal significant gaps in discharge education capability, with performance varying widely across patient profiles. Notably, model size does not always yield better education outcomes, highlighting trade-offs in strategy use and content prioritization. DischargeSim offers a first step toward benchmarking LLMs in post-visit clinical education and promoting equitable, personalized patient support.

cs.CL↗

arXiv2025

MedReadCtrl: Personalizing medical text generation with readability-controlled instruction learning

Generative AI has demonstrated strong potential in healthcare, from clinical decision support to patient-facing chatbots that improve outcomes. A critical challenge for deployment is effective human-AI communication, where content must be both personalized and understandable. We introduce MedReadCtrl, a readability-controlled instruction tuning framework that enables LLMs to adjust output complexity without compromising meaning. Evaluations of nine datasets and three tasks across medical and general domains show that MedReadCtrl achieves significantly lower readability instruction-following errors than GPT-4 (e.g., 1.39 vs. 1.59 on ReadMe, p<0.001) and delivers substantial gains on unseen clinical tasks (e.g., +14.7 ROUGE-L, +6.18 SARI on MTSamples). Experts consistently preferred MedReadCtrl (71.7% vs. 23.3%), especially at low literacy levels. These gains reflect MedReadCtrl's ability to restructure clinical content into accessible, readability-aligned language while preserving medical intent, offering a scalable solution to support patient education and expand equitable access to AI-enabled care.

cs.CL↗

arXiv2025

SynthEHR-Eviction: Enhancing Eviction SDoH Detection with LLM-Augmented Synthetic EHR Data

Eviction is a significant yet understudied social determinants of health (SDoH), linked to housing instability, unemployment, and mental health. While eviction appears in unstructured electronic health records (EHRs), it is rarely coded in structured fields, limiting downstream applications. We introduce SynthEHR-Eviction, a scalable pipeline combining LLMs, human-in-the-loop annotation, and automated prompt optimization (APO) to extract eviction statuses from clinical notes. Using this pipeline, we created the largest public eviction-related SDoH dataset to date, comprising 14 fine-grained categories. Fine-tuned LLMs (e.g., Qwen2.5, LLaMA3) trained on SynthEHR-Eviction achieved Macro-F1 scores of 88.8% (eviction) and 90.3% (other SDoH) on human validated data, outperforming GPT-4o-APO (87.8%, 87.3%), GPT-4o-mini-APO (69.1%, 78.1%), and BioBERT (60.7%, 68.3%), while enabling cost-effective deployment across various model sizes. The pipeline reduces annotation effort by over 80%, accelerates dataset creation, enables scalable eviction detection, and generalizes to other information extraction tasks.

cs.CL↗

arXiv2025

RARE: Retrieval-Augmented Reasoning Enhancement for Large Language Models

This work introduces RARE (Retrieval-Augmented Reasoning Enhancement), a versatile extension to the mutual reasoning framework (rStar), aimed at enhancing reasoning accuracy and factual integrity across large language models (LLMs) for complex, knowledge-intensive tasks such as commonsense and medical reasoning. RARE incorporates two innovative actions within the Monte Carlo Tree Search (MCTS) framework: A6, which generates search queries based on the initial problem statement, performs information retrieval using those queries, and augments reasoning with the retrieved data to formulate the final answer; and A7, which leverages information retrieval specifically for generated sub-questions and re-answers these sub-questions with the relevant contextual information. Additionally, a Retrieval-Augmented Factuality Scorer is proposed to replace the original discriminator, prioritizing reasoning paths that meet high standards of factuality. Experimental results with LLaMA 3.1 show that RARE enables open-source LLMs to achieve competitive performance with top open-source models like GPT-4 and GPT-4o. This research establishes RARE as a scalable solution for improving LLMs in domains where logical coherence and factual integrity are critical.

cs.CL↗

arXiv2025

MCQG-SRefine: Multiple Choice Question Generation and Evaluation with Iterative Self-Critique, Correction, and Comparison Feedback

Automatic question generation (QG) is essential for AI and NLP, particularly in intelligent tutoring, dialogue systems, and fact verification. Generating multiple-choice questions (MCQG) for professional exams, like the United States Medical Licensing Examination (USMLE), is particularly challenging, requiring domain expertise and complex multi-hop reasoning for high-quality questions. However, current large language models (LLMs) like GPT-4 struggle with professional MCQG due to outdated knowledge, hallucination issues, and prompt sensitivity, resulting in unsatisfactory quality and difficulty. To address these challenges, we propose MCQG-SRefine, an LLM self-refine-based (Critique and Correction) framework for converting medical cases into high-quality USMLE-style questions. By integrating expert-driven prompt engineering with iterative self-critique and self-correction feedback, MCQG-SRefine significantly enhances human expert satisfaction regarding both the quality and difficulty of the questions. Furthermore, we introduce an LLM-as-Judge-based automatic metric to replace the complex and costly expert evaluation process, ensuring reliable and expert-aligned assessments.

cs.CL↗

arXiv2025

Improving Summarization with Human Edits

Recent work has shown the promise of learning with human feedback paradigms to produce human-determined high-quality text. Existing works use human feedback to train large language models (LLMs) in general domain abstractive summarization and have obtained summary quality exceeding traditional likelihood training. In this paper, we focus on a less explored form of human feedback -- Human Edits. We propose Sequence Alignment (un)Likelihood Training (SALT), a novel technique to use both the human-edited and model-generated data together in the training loop. In addition, we demonstrate simulating Human Edits with ground truth summaries coming from existing training data -- Imitation edits, along with the model-generated summaries obtained after the training, to reduce the need for expensive human-edit data. In our experiments, we extend human feedback exploration from general domain summarization to medical domain summarization. Our results demonstrate the effectiveness of SALT in improving the summary quality with Human and Imitation Edits. Through additional experiments, we show that SALT outperforms the conventional RLHF method (designed for human preferences) -- DPO, when applied to human-edit data. We hope the evidence in our paper prompts researchers to explore, collect, and better use different human feedback approaches scalably.

cs.CL↗

arXiv2024

README: Bridging Medical Jargon and Lay Understanding for Patient Education through Data-Centric NLP

The advancement in healthcare has shifted focus toward patient-centric approaches, particularly in self-care and patient education, facilitated by access to Electronic Health Records (EHR). However, medical jargon in EHRs poses significant challenges in patient comprehension. To address this, we introduce a new task of automatically generating lay definitions, aiming to simplify complex medical terms into patient-friendly lay language. We first created the README dataset, an extensive collection of over 50,000 unique (medical term, lay definition) pairs and 300,000 mentions, each offering context-aware lay definitions manually annotated by domain experts. We have also engineered a data-centric Human-AI pipeline that synergizes data filtering, augmentation, and selection to improve data quality. We then used README as the training data for models and leveraged a Retrieval-Augmented Generation method to reduce hallucinations and improve the quality of model outputs. Our extensive automatic and human evaluations demonstrate that open-source mobile-friendly models, when fine-tuned with high-quality data, are capable of matching or even surpassing the performance of state-of-the-art closed-source large language models like ChatGPT. This research represents a significant stride in closing the knowledge gap in patient education and advancing patient-centric healthcare solutions.

cs.CL↗

arXiv2024

Blocks Architecture (BloArk): Efficient, Cost-Effective, and Incremental Dataset Architecture for Wikipedia Revision History

Wikipedia (Wiki) is one of the most widely used and publicly available resources for natural language processing (NLP) applications. Wikipedia Revision History (WikiRevHist) shows the order in which edits were made to any Wiki page since its first modification. While the most up-to-date Wiki has been widely used as a training source, WikiRevHist can also be valuable resources for NLP applications. However, there are insufficient tools available to process WikiRevHist without having substantial computing resources, making additional customization, and spending extra time adapting others' works. Therefore, we report Blocks Architecture (BloArk), an efficiency-focused data processing architecture that reduces running time, computing resource requirements, and repeated works in processing WikiRevHist dataset. BloArk consists of three parts in its infrastructure: blocks, segments, and warehouses. On top of that, we build the core data processing pipeline: builder and modifier. The BloArk builder transforms the original WikiRevHist dataset from XML syntax into JSON Lines (JSONL) format for improving the concurrent and storage efficiency. The BloArk modifier takes previously-built warehouses to operate incremental modifications for improving the utilization of existing databases and reducing the cost of reusing others' works. In the end, BloArk can scale up easily in both processing Wikipedia Revision History and incrementally modifying existing dataset for downstream NLP use cases. The source code, documentations, and example usages are publicly available online and open-sourced under GPL-2.0 license.

cs.CL↗

arXiv2024

CS4: Measuring the Creativity of Large Language Models Automatically by Controlling the Number of Story-Writing Constraints

Evaluating the creativity of large language models (LLMs) in story writing is difficult because LLM-generated stories could seemingly look creative but be very similar to some existing stories in their huge and proprietary training corpus. To overcome this challenge, we introduce a novel benchmark dataset with varying levels of prompt specificity: CS4 ($\mathbf{C}$omparing the $\mathbf{S}$kill of $\mathbf{C}$reating $\mathbf{S}$tories by $\mathbf{C}$ontrolling the $\mathbf{S}$ynthesized $\mathbf{C}$onstraint $\mathbf{S}$pecificity). By increasing the number of requirements/constraints in the prompt, we can increase the prompt specificity and hinder LLMs from retelling high-quality narratives in their training data. Consequently, CS4 empowers us to indirectly measure the LLMs' creativity without human annotations. Our experiments on LLaMA, Gemma, and Mistral not only highlight the creativity challenges LLMs face when dealing with highly specific prompts but also reveal that different LLMs perform very differently under different numbers of constraints and achieve different balances between the model's instruction-following ability and narrative coherence. Additionally, our experiments on OLMo suggest that Learning from Human Feedback (LHF) can help LLMs select better stories from their training data but has limited influence in boosting LLMs' ability to produce creative stories that are unseen in the training corpora. The benchmark is released at https://github.com/anirudhlakkaraju/cs4_benchmark.

cs.CL↗

arXiv2024

Large Language Models are In-context Teachers for Knowledge Reasoning

In this work, we study in-context teaching (ICT), where a teacher provides in-context example rationales to teach a student to reason over unseen cases. Human teachers are usually required to craft in-context demonstrations, which are costly and have high variance. We ask whether a large language model (LLM) can serve as a more effective in-context teacher for itself or other LLMs, compared to humans. Inspired by the Encoding Specificity Hypothesis from human episodic memory, we hypothesize that in-context exemplars crafted by the teacher should match the training data of the student. This hypothesis motivates us to propose Self-Explain where an LLM's self-elicited explanations are used as in-context demonstrations for prompting it as they are generalized from the model's training examples. Self-Explain is shown to significantly outperform using human-crafted exemplars and other baselines. Furthermore, we reveal that for ICT, rationales from different teacher LLMs or human experts that more resemble the student LLM's self-explanations are better in-context demonstrations. This supports our encoding specificity hypothesis. We then propose Teach-Back that aligns a teacher LLM with the student to enhance the ICT performance. For example, Teach-Back enables a 7B model to teach the much larger GPT-3.5 in context, surpassing human teachers by around 5% in test accuracy on medical question answering.

cs.CL↗

arXiv2024

SYNFAC-EDIT: Synthetic Imitation Edit Feedback for Factual Alignment in Clinical Summarization

Large Language Models (LLMs) such as GPT & Llama have demonstrated significant achievements in summarization tasks but struggle with factual inaccuracies, a critical issue in clinical NLP applications where errors could lead to serious consequences. To counter the high costs and limited availability of expert-annotated data for factual alignment, this study introduces an innovative pipeline that utilizes >100B parameter GPT variants like GPT-3.5 & GPT-4 to act as synthetic experts to generate high-quality synthetics feedback aimed at enhancing factual consistency in clinical note summarization. Our research primarily focuses on edit feedback generated by these synthetic feedback experts without additional human annotations, mirroring and optimizing the practical scenario in which medical professionals refine AI system outputs. Although such 100B+ parameter GPT variants have proven to demonstrate expertise in various clinical NLP tasks, such as the Medical Licensing Examination, there is scant research on their capacity to act as synthetic feedback experts and deliver expert-level edit feedback for improving the generation quality of weaker (<10B parameter) LLMs like GPT-2 (1.5B) & Llama 2 (7B) in clinical domain. So in this work, we leverage 100B+ GPT variants to act as synthetic feedback experts offering expert-level edit feedback, that is used to reduce hallucinations and align weaker (<10B parameter) LLMs with medical facts using two distinct alignment algorithms (DPO & SALT), endeavoring to narrow the divide between AI-generated content and factual accuracy. This highlights the substantial potential of LLM-based synthetic edits in enhancing the alignment of clinical factuality.

cs.CL↗

arXiv2024

Large Language Model-based Role-Playing for Personalized Medical Jargon Extraction

Previous studies reveal that Electronic Health Records (EHR), which have been widely adopted in the U.S. to allow patients to access their personal medical information, do not have high readability to patients due to the prevalence of medical jargon. Tailoring medical notes to individual comprehension by identifying jargon that is difficult for each person will enhance the utility of generative models. We present the first quantitative analysis to measure the impact of role-playing in LLM in medical term extraction. By comparing the results of Mechanical Turk workers over 20 sentences, our study demonstrates that LLM role-playing improves F1 scores in 95% of cases across 14 different socio-demographic backgrounds. Furthermore, applying role-playing with in-context learning outperformed the previous state-of-the-art models. Our research showed that ChatGPT can improve traditional medical term extraction systems by utilizing role-play to deliver personalized patient education, a potential that previous models had not achieved.

cs.CL↗

arXiv2024

Do Physicians Know How to Prompt? The Need for Automatic Prompt Optimization Help in Clinical Note Generation

This study examines the effect of prompt engineering on the performance of Large Language Models (LLMs) in clinical note generation. We introduce an Automatic Prompt Optimization (APO) framework to refine initial prompts and compare the outputs of medical experts, non-medical experts, and APO-enhanced GPT3.5 and GPT4. Results highlight GPT4 APO's superior performance in standardizing prompt quality across clinical note sections. A human-in-the-loop approach shows that experts maintain content quality post-APO, with a preference for their own modifications, suggesting the value of expert customization. We recommend a two-phase optimization process, leveraging APO-GPT4 for consistency and expert input for personalization.

cs.CL↗

arXiv2024

JMLR: Joint Medical LLM and Retrieval Training for Enhancing Reasoning and Professional Question Answering Capability

Large Language Models (LLMs) have demonstrated a remarkable potential in medical knowledge acquisition and question-answering. However, LLMs can potentially hallucinate and yield factually incorrect outcomes, even with domain-specific pretraining. Previously, retrieval augmented generation (RAG) has limited success in addressing hallucinations. Unlike previous methods in RAG where the retrieval model was trained separately from the LLM, we introduce JMLR (for Jointly trains LLM and information Retrieval) during the fine-tuning phase. The synchronized training mechanism enhances JMLR's ability to retrieve clinical guidelines and leverage medical knowledge to reason and answer questions and reduces the demand for computational resources. We evaluated JMLR on the important medical question-answering application. Our experimental results demonstrate that JMLR-13B (70.5%) outperforms a previous state-of-the-art open-source model using conventional pre-training and fine-tuning Meditron-70B (68.9%) and Llama2-13B with RAG (67.7%) on a medical question-answering dataset. Comprehensive evaluations reveal JMLR-13B enhances reasoning quality and reduces hallucinations better than Claude3-Opus. Additionally, JMLR-13B (148 GPU hours) also trains much faster than Meditron-70B (42630 GPU hours). Through this work, we provide a new and efficient knowledge enhancement method for healthcare, demonstrating the potential of integrating retrieval and LLM training for medical question-answering systems.

cs.CL↗

arXiv2024

NoteChat: A Dataset of Synthetic Doctor-Patient Conversations Conditioned on Clinical Notes

We introduce NoteChat, a novel cooperative multi-agent framework leveraging Large Language Models (LLMs) to generate patient-physician dialogues. NoteChat embodies the principle that an ensemble of role-specific LLMs, through structured role-play and strategic prompting, can perform their assigned roles more effectively. The synergy among these role-playing LLMs results in a cohesive and efficient dialogue generation. Evaluation on MTS-dialogue, a benchmark dataset for patient-physician dialogues-note pairs, shows that models trained with the augmented synthetic patient-physician dialogues by NoteChat outperforms other state-of-the-art models for generating clinical notes. Our comprehensive automatic and human evaluation demonstrates that NoteChat substantially surpasses state-of-the-art models like ChatGPT and GPT-4 up to 22.78% by domain experts in generating superior synthetic patient-physician dialogues based on clinical notes. NoteChat has the potential to engage patients directly and help clinical documentation, a leading cause of physician burnout.

cs.CL↗

arXiv2024

ReadCtrl: Personalizing text generation with readability-controlled instruction learning

Content generation conditioning on users's readability is an important application for personalization. In an era of large language models (LLMs), readability-controlled text generation based on LLMs has become increasingly important. This paper introduces a novel methodology called "Readability-Controlled Instruction Learning (ReadCtrl)," which aims to instruction-tune LLMs to tailor users' readability levels. Unlike the traditional methods, which primarily focused on categorical readability adjustments typically classified as high, medium, and low or expert and layperson levels with limited success, ReadCtrl introduces a dynamic framework that enables LLMs to generate content at various (near continuous level) complexity levels, thereby enhancing their versatility across different applications. Our results show that the ReadCtrl-Mistral-7B models significantly outperformed strong baseline models such as GPT-4 and Claude-3, with a win rate of 52.1%:35.7% against GPT-4 in human evaluations. Furthermore, Read-Ctrl has shown significant improvements in automatic evaluations, as evidenced by better readability metrics (e.g., FOG, FKGL) and generation quality metrics (e.g., BLEU, SARI, SummaC-Factuality, UniEval-Consistency and Coherence). These results underscore Read-Ctrl's effectiveness and tenacity in producing high-quality, contextually appropriate outputs that closely align with targeted readability levels, marking a significant advancement in personalized content generation using LLMs.

cs.CL↗

arXiv2024

BioInstruct: Instruction Tuning of Large Language Models for Biomedical Natural Language Processing

To enhance the performance of large language models (LLMs) in biomedical natural language processing (BioNLP) by introducing a domain-specific instruction dataset and examining its impact when combined with multi-task learning principles. We created the BioInstruct, comprising 25,005 instructions to instruction-tune LLMs(LLaMA 1 & 2, 7B & 13B version). The instructions were created by prompting the GPT-4 language model with three-seed samples randomly drawn from an 80 human curated instructions. We employed Low-Rank Adaptation(LoRA) for parameter-efficient fine-tuning. We then evaluated these instruction-tuned LLMs on several BioNLP tasks, which can be grouped into three major categories: question answering(QA), information extraction(IE), and text generation(GEN). We also examined whether categories(e.g., QA, IE, and generation) of instructions impact model performance. Comparing with LLMs without instruction-tuned, our instruction-tuned LLMs demonstrated marked performance gains: 17.3% in QA, 5.7% in IE, and 96% in Generation tasks. Our 7B-parameter instruction-tuned LLaMA 1 model was competitive or even surpassed other LLMs in the biomedical domain that were also fine-tuned from LLaMA 1 with vast domain-specific data or a variety of tasks. Our results also show that the performance gain is significantly higher when instruction fine-tuning is conducted with closely related tasks. Our findings align with the observations of multi-task learning, suggesting the synergies between two tasks. The BioInstruct dataset serves as a valuable resource and instruction tuned LLMs lead to the best performing BioNLP applications.

cs.CL↗

arXiv2024

UMass-BioNLP at MEDIQA-M3G 2024: DermPrompt -- A Systematic Exploration of Prompt Engineering with GPT-4V for Dermatological Diagnosis

This paper presents our team's participation in the MEDIQA-ClinicalNLP2024 shared task B. We present a novel approach to diagnosing clinical dermatology cases by integrating large multimodal models, specifically leveraging the capabilities of GPT-4V under a retriever and a re-ranker framework. Our investigation reveals that GPT-4V, when used as a retrieval agent, can accurately retrieve the correct skin condition 85% of the time using dermatological images and brief patient histories. Additionally, we empirically show that Naive Chain-of-Thought (CoT) works well for retrieval while Medical Guidelines Grounded CoT is required for accurate dermatological diagnosis. Further, we introduce a Multi-Agent Conversation (MAC) framework and show its superior performance and potential over the best CoT strategy. The experiments suggest that using naive CoT for retrieval and multi-agent conversation for critique-based diagnosis, GPT-4V can lead to an early and accurate diagnosis of dermatological conditions. The implications of this work extend to improving diagnostic workflows, supporting dermatological education, and enhancing patient care by providing a scalable, accessible, and accurate diagnostic tool.

cs.AI↗