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May 12

Serialisation Strategy Matters: How FHIR Data Format Affects LLM Medication Reconciliation

Medication reconciliation at clinical handoffs is a high-stakes, error-prone process. Large language models are increasingly proposed to assist with this task using FHIR-structured patient records, but a fundamental and largely unstudied variable is how the FHIR data is serialised before being passed to the model. We present the first systematic comparison of four FHIR serialisation strategies (Raw JSON, Markdown Table, Clinical Narrative, and Chronological Timeline) across five open-weight models (Phi-3.5-mini, Mistral-7B, BioMistral-7B, Llama-3.1-8B, Llama-3.3-70B) on a controlled benchmark of 200 synthetic patients, totalling 4,000 inference runs. We find that serialisation strategy has a large, statistically significant effect on performance for models up to 8B parameters: Clinical Narrative outperforms Raw JSON by up to 19 F1 points for Mistral-7B (r = 0.617, p < 10^{-10}). This advantage reverses at 70B, where Raw JSON achieves the best mean F1 of 0.9956. In all 20 model and strategy combinations, mean precision exceeds mean recall: omission is the dominant failure mode, with models more often missing an active medication than fabricating one, which changes how clinical safety auditing priorities should be set. Smaller models plateau at roughly 7-10 concurrent active medications, leaving polypharmacy patients, the patients most at risk from reconciliation errors, systematically underserved. BioMistral-7B, a domain-pretrained model without instruction tuning, produces zero usable output in all conditions, showing that domain pretraining alone is not sufficient for structured extraction. These results offer practical, evidence-based format recommendations for clinical LLM deployment: Clinical Narrative for models up to 8B, Raw JSON for 70B and above. The complete pipeline is reproducible on open-source tools running on an AWS g6e.xlarge instance (NVIDIA L40S, 48 GB VRAM).

  • 1 authors
·
Apr 21

ChroKnowledge: Unveiling Chronological Knowledge of Language Models in Multiple Domains

Large language models (LLMs) have significantly impacted many aspects of our lives. However, assessing and ensuring their chronological knowledge remains challenging. Existing approaches fall short in addressing the accumulative nature of knowledge, often relying on a single time stamp. To overcome this, we introduce ChroKnowBench, a benchmark dataset designed to evaluate chronologically accumulated knowledge across three key aspects: multiple domains, time dependency, temporal state. Our benchmark distinguishes between knowledge that evolves (e.g., scientific discoveries, amended laws) and knowledge that remain constant (e.g., mathematical truths, commonsense facts). Building on this benchmark, we present ChroKnowledge (Chronological Categorization of Knowledge), a novel sampling-based framework for evaluating and updating LLMs' non-parametric chronological knowledge. Our evaluation shows: (1) The ability of eliciting temporal knowledge varies depending on the data format that model was trained on. (2) LLMs partially recall knowledge or show a cut-off at temporal boundaries rather than recalling all aspects of knowledge correctly. Thus, we apply our ChroKnowPrompt, an in-depth prompting to elicit chronological knowledge by traversing step-by-step through the surrounding time spans. We observe that our framework successfully updates the overall knowledge across the entire timeline in both the biomedical domain (+11.9%) and the general domain (+2.8%), demonstrating its effectiveness in refining temporal knowledge. This non-parametric approach also enables knowledge updates not only in open-source models but also in proprietary LLMs, ensuring comprehensive applicability across model types. We perform a comprehensive analysis based on temporal characteristics of ChroKnowPrompt and validate the potential of various models to elicit intrinsic temporal knowledge through our method.

  • 6 authors
·
Oct 13, 2024 3

Chronologically Accurate Retrieval for Temporal Grounding of Motion-Language Models

With the release of large-scale motion datasets with textual annotations, the task of establishing a robust latent space for language and 3D human motion has recently witnessed a surge of interest. Methods have been proposed to convert human motion and texts into features to achieve accurate correspondence between them. Despite these efforts to align language and motion representations, we claim that the temporal element is often overlooked, especially for compound actions, resulting in chronological inaccuracies. To shed light on the temporal alignment in motion-language latent spaces, we propose Chronologically Accurate Retrieval (CAR) to evaluate the chronological understanding of the models. We decompose textual descriptions into events, and prepare negative text samples by shuffling the order of events in compound action descriptions. We then design a simple task for motion-language models to retrieve the more likely text from the ground truth and its chronologically shuffled version. CAR reveals many cases where current motion-language models fail to distinguish the event chronology of human motion, despite their impressive performance in terms of conventional evaluation metrics. To achieve better temporal alignment between text and motion, we further propose to use these texts with shuffled sequence of events as negative samples during training to reinforce the motion-language models. We conduct experiments on text-motion retrieval and text-to-motion generation using the reinforced motion-language models, which demonstrate improved performance over conventional approaches, indicating the necessity to consider temporal elements in motion-language alignment.

  • 3 authors
·
Jul 22, 2024