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Jan 27

Medical Triage as Pairwise Ranking: A Benchmark for Urgency in Patient Portal Messages

Medical triage is the task of allocating medical resources and prioritizing patients based on medical need. This paper introduces the first large-scale public dataset for studying medical triage in the context of asynchronous outpatient portal messages. Our novel task formulation views patient message triage as a pairwise inference problem, where we train LLMs to choose `"which message is more medically urgent" in a head-to-head tournament-style re-sort of a physician's inbox. Our novel benchmark PMR-Bench contains 1569 unique messages and 2,000+ high-quality test pairs for pairwise medical urgency assessment alongside a scalable training data generation pipeline. PMR-Bench includes samples that contain both unstructured patient-written messages alongside real electronic health record (EHR) data, emulating a real-world medical triage scenario. We develop a novel automated data annotation strategy to provide LLMs with in-domain guidance on this task. The resulting data is used to train two model classes, UrgentReward and UrgentSFT, leveraging Bradley-Terry and next token prediction objective, respectively to perform pairwise urgency classification. We find that UrgentSFT achieves top performance on PMR-Bench, with UrgentReward showing distinct advantages in low-resource settings. For example, UrgentSFT-8B and UrgentReward-8B provide a 15- and 16-point boost, respectively, on inbox sorting metrics over off-the-shelf 8B models. Paper resources can be found at https://tinyurl.com/Patient-Message-Triage

  • 7 authors
·
Jan 19

In-Context Pretraining: Language Modeling Beyond Document Boundaries

Large language models (LMs) are currently trained to predict tokens given document prefixes, enabling them to directly perform long-form generation and prompting-style tasks which can be reduced to document completion. Existing pretraining pipelines train LMs by concatenating random sets of short documents to create input contexts but the prior documents provide no signal for predicting the next document. We instead present In-Context Pretraining, a new approach where language models are pretrained on a sequence of related documents, thereby explicitly encouraging them to read and reason across document boundaries. We can do In-Context Pretraining by simply changing the document ordering so that each context contains related documents, and directly applying existing pretraining pipelines. However, this document sorting problem is challenging. There are billions of documents and we would like the sort to maximize contextual similarity for every document without repeating any data. To do this, we introduce approximate algorithms for finding related documents with efficient nearest neighbor search and constructing coherent input contexts with a graph traversal algorithm. Our experiments show In-Context Pretraining offers a simple and scalable approach to significantly enhance LMs'performance: we see notable improvements in tasks that require more complex contextual reasoning, including in-context learning (+8%), reading comprehension (+15%), faithfulness to previous contexts (+16%), long-context reasoning (+5%), and retrieval augmentation (+9%).

  • 10 authors
·
Oct 16, 2023 3

Assessing Episodic Memory in LLMs with Sequence Order Recall Tasks

Current LLM benchmarks focus on evaluating models' memory of facts and semantic relations, primarily assessing semantic aspects of long-term memory. However, in humans, long-term memory also includes episodic memory, which links memories to their contexts, such as the time and place they occurred. The ability to contextualize memories is crucial for many cognitive tasks and everyday functions. This form of memory has not been evaluated in LLMs with existing benchmarks. To address the gap in evaluating memory in LLMs, we introduce Sequence Order Recall Tasks (SORT), which we adapt from tasks used to study episodic memory in cognitive psychology. SORT requires LLMs to recall the correct order of text segments, and provides a general framework that is both easily extendable and does not require any additional annotations. We present an initial evaluation dataset, Book-SORT, comprising 36k pairs of segments extracted from 9 books recently added to the public domain. Based on a human experiment with 155 participants, we show that humans can recall sequence order based on long-term memory of a book. We find that models can perform the task with high accuracy when relevant text is given in-context during the SORT evaluation. However, when presented with the book text only during training, LLMs' performance on SORT falls short. By allowing to evaluate more aspects of memory, we believe that SORT will aid in the emerging development of memory-augmented models.

  • 10 authors
·
Oct 10, 2024

The Impact of Element Ordering on LM Agent Performance

There has been a surge of interest in language model agents that can navigate virtual environments such as the web or desktop. To navigate such environments, agents benefit from information on the various elements (e.g., buttons, text, or images) present. It remains unclear which element attributes have the greatest impact on agent performance, especially in environments that only provide a graphical representation (i.e., pixels). Here we find that the ordering in which elements are presented to the language model is surprisingly impactful--randomizing element ordering in a webpage degrades agent performance comparably to removing all visible text from an agent's state representation. While a webpage provides a hierarchical ordering of elements, there is no such ordering when parsing elements directly from pixels. Moreover, as tasks become more challenging and models more sophisticated, our experiments suggest that the impact of ordering increases. Finding an effective ordering is non-trivial. We investigate the impact of various element ordering methods in web and desktop environments. We find that dimensionality reduction provides a viable ordering for pixel-only environments. We train a UI element detection model to derive elements from pixels and apply our findings to an agent benchmark--OmniACT--where we only have access to pixels. Our method completes more than two times as many tasks on average relative to the previous state-of-the-art.

  • 3 authors
·
Sep 18, 2024