Search arXiv⌕ Search

arXiv subjects

Timothy Miller

Publications and source records attributed to Timothy Miller.

At least 19 recordsLinked to original sources
arXiv2025

Robust AI-ECG for Predicting Left Ventricular Systolic Dysfunction in Pediatric Congenital Heart Disease

Artificial intelligence-enhanced electrocardiogram (AI-ECG) has shown promise as an inexpensive, ubiquitous, and non-invasive screening tool to detect left ventricular systolic dysfunction in pediatric congenital heart disease. However, current approaches rely heavily on large-scale labeled datasets, which poses a major obstacle to the democratization of AI in hospitals where only limited pediatric ECG data are available. In this work, we propose a robust training framework to improve AI-ECG performance under low-resource conditions. Specifically, we introduce an on-manifold adversarial perturbation strategy for pediatric ECGs to generate synthetic noise samples that better reflect real-world signal variations. Building on this, we develop an uncertainty-aware adversarial training algorithm that is architecture-agnostic and enhances model robustness. Evaluation on the real-world pediatric dataset demonstrates that our method enables low-cost and reliable detection of left ventricular systolic dysfunction, highlighting its potential for deployment in resource-limited clinical settings.

cs.CE↗
arXiv2025

The Spectroscopic Stage-5 Experiment

The existence, properties, and dynamics of the dark sectors of our universe pose fundamental challenges to our current model of physics, and large-scale astronomical surveys may be our only hope to unravel these long-standing mysteries. In this white paper, we describe the science motivation, instrumentation, and survey plan for the next-generation spectroscopic observatory, the Stage-5 Spectroscopic Experiment (Spec-S5). Spec-S5 is a new all-sky spectroscopic instrument optimized to efficiently carry out cosmological surveys of unprecedented scale and precision. The baseline plan for Spec-S5 involves upgrading two existing 4-m telescopes to new 6-m wide-field facilities, each with a highly multiplexed spectroscopic instrument capable of simultaneously measuring the spectra of 13,000 astronomical targets. Spec-S5, which builds and improves on the hardware used for previous cosmology experiments, represents a cost-effective and rapid approach to realizing a more than 10$\times$ gain in spectroscopic capability compared to the current state-of-the-art represented by the Dark Energy Spectroscopic Instrument project (DESI). Spec-S5 will provide a critical scientific capability in the post-Rubin and post-DESI era for advancing cosmology, fundamental physics, and astrophysics in the 2030s.

astro-ph.CO↗
arXiv2025

Aspect-Oriented Summarization for Psychiatric Short-Term Readmission Prediction

Recent progress in large language models (LLMs) has enabled the automated processing of lengthy documents even without supervised training on a task-specific dataset. Yet, their zero-shot performance in complex tasks as opposed to straightforward information extraction tasks remains suboptimal. One feasible approach for tasks with lengthy, complex input is to first summarize the document and then apply supervised fine-tuning to the summary. However, the summarization process inevitably results in some loss of information. In this study we present a method for processing the summaries of long documents aimed to capture different important aspects of the original document. We hypothesize that LLM summaries generated with different aspect-oriented prompts contain different information signals, and we propose methods to measure these differences. We introduce approaches to effectively integrate signals from these different summaries for supervised training of transformer models. We validate our hypotheses on a high-impact task -- 30-day readmission prediction from a psychiatric discharge -- using real-world data from four hospitals, and show that our proposed method increases the prediction performance for the complex task of predicting patient outcome.

cs.CL↗
arXiv2024

Identifying Task Groupings for Multi-Task Learning Using Pointwise V-Usable Information

The success of multi-task learning can depend heavily on which tasks are grouped together. Naively grouping all tasks or a random set of tasks can result in negative transfer, with the multi-task models performing worse than single-task models. Though many efforts have been made to identify task groupings and to measure the relatedness among different tasks, it remains a challenging research topic to define a metric to identify the best task grouping out of a pool of many potential task combinations. We propose a metric of task relatedness based on task difficulty measured by pointwise V-usable information (PVI). PVI is a recently proposed metric to estimate how much usable information a dataset contains given a model. We hypothesize that tasks with not statistically different PVI estimates are similar enough to benefit from the joint learning process. We conduct comprehensive experiments to evaluate the feasibility of this metric for task grouping on 15 NLP datasets in the general, biomedical, and clinical domains. We compare the results of the joint learners against single learners, existing baseline methods, and recent large language models, including Llama 2 and GPT-4. The results show that by grouping tasks with similar PVI estimates, the joint learners yielded competitive results with fewer total parameters, with consistent performance across domains.

cs.CL↗
arXiv2023

The impact of responding to patient messages with large language model assistance

Documentation burden is a major contributor to clinician burnout, which is rising nationally and is an urgent threat to our ability to care for patients. Artificial intelligence (AI) chatbots, such as ChatGPT, could reduce clinician burden by assisting with documentation. Although many hospitals are actively integrating such systems into electronic medical record systems, AI chatbots utility and impact on clinical decision-making have not been studied for this intended use. We are the first to examine the utility of large language models in assisting clinicians draft responses to patient questions. In our two-stage cross-sectional study, 6 oncologists responded to 100 realistic synthetic cancer patient scenarios and portal messages developed to reflect common medical situations, first manually, then with AI assistance. We find AI-assisted responses were longer, less readable, but provided acceptable drafts without edits 58% of time. AI assistance improved efficiency 77% of time, with low harm risk (82% safe). However, 7.7% unedited AI responses could severely harm. In 31% cases, physicians thought AI drafts were human-written. AI assistance led to more patient education recommendations, fewer clinical actions than manual responses. Results show promise for AI to improve clinician efficiency and patient care through assisting documentation, if used judiciously. Monitoring model outputs and human-AI interaction remains crucial for safe implementation.

cs.CL↗
arXiv2023

Leveraging Medical Knowledge Graphs Into Large Language Models for Diagnosis Prediction: Design and Application Study

Electronic Health Records (EHRs) and routine documentation practices play a vital role in patients' daily care, providing a holistic record of health, diagnoses, and treatment. However, complex and verbose EHR narratives overload healthcare providers, risking diagnostic inaccuracies. While Large Language Models (LLMs) have showcased their potential in diverse language tasks, their application in the healthcare arena needs to ensure the minimization of diagnostic errors and the prevention of patient harm. In this paper, we outline an innovative approach for augmenting the proficiency of LLMs in the realm of automated diagnosis generation, achieved through the incorporation of a medical knowledge graph (KG) and a novel graph model: Dr.Knows, inspired by the clinical diagnostic reasoning process. We derive the KG from the National Library of Medicine's Unified Medical Language System (UMLS), a robust repository of biomedical knowledge. Our method negates the need for pre-training and instead leverages the KG as an auxiliary instrument aiding in the interpretation and summarization of complex medical concepts. Using real-world hospital datasets, our experimental results demonstrate that the proposed approach of combining LLMs with KG has the potential to improve the accuracy of automated diagnosis generation. More importantly, our approach offers an explainable diagnostic pathway, edging us closer to the realization of AI-augmented diagnostic decision support systems.

cs.CL↗
arXiv2023

Overview of the Problem List Summarization (ProbSum) 2023 Shared Task on Summarizing Patients' Active Diagnoses and Problems from Electronic Health Record Progress Notes

The BioNLP Workshop 2023 initiated the launch of a shared task on Problem List Summarization (ProbSum) in January 2023. The aim of this shared task is to attract future research efforts in building NLP models for real-world diagnostic decision support applications, where a system generating relevant and accurate diagnoses will augment the healthcare providers decision-making process and improve the quality of care for patients. The goal for participants is to develop models that generated a list of diagnoses and problems using input from the daily care notes collected from the hospitalization of critically ill patients. Eight teams submitted their final systems to the shared task leaderboard. In this paper, we describe the tasks, datasets, evaluation metrics, and baseline systems. Additionally, the techniques and results of the evaluation of the different approaches tried by the participating teams are summarized.

cs.CL↗
arXiv2023

Multi-Task Training with In-Domain Language Models for Diagnostic Reasoning

Generative artificial intelligence (AI) is a promising direction for augmenting clinical diagnostic decision support and reducing diagnostic errors, a leading contributor to medical errors. To further the development of clinical AI systems, the Diagnostic Reasoning Benchmark (DR.BENCH) was introduced as a comprehensive generative AI framework, comprised of six tasks representing key components in clinical reasoning. We present a comparative analysis of in-domain versus out-of-domain language models as well as multi-task versus single task training with a focus on the problem summarization task in DR.BENCH (Gao et al., 2023). We demonstrate that a multi-task, clinically trained language model outperforms its general domain counterpart by a large margin, establishing a new state-of-the-art performance, with a ROUGE-L score of 28.55. This research underscores the value of domain-specific training for optimizing clinical diagnostic reasoning tasks.

cs.CL↗
arXiv2023

Progress Note Understanding -- Assessment and Plan Reasoning: Overview of the 2022 N2C2 Track 3 Shared Task

Daily progress notes are common types in the electronic health record (EHR) where healthcare providers document the patient's daily progress and treatment plans. The EHR is designed to document all the care provided to patients, but it also enables note bloat with extraneous information that distracts from the diagnoses and treatment plans. Applications of natural language processing (NLP) in the EHR is a growing field with the majority of methods in information extraction. Few tasks use NLP methods for downstream diagnostic decision support. We introduced the 2022 National NLP Clinical Challenge (N2C2) Track 3: Progress Note Understanding - Assessment and Plan Reasoning as one step towards a new suite of tasks. The Assessment and Plan Reasoning task focuses on the most critical components of progress notes, Assessment and Plan subsections where health problems and diagnoses are contained. The goal of the task was to develop and evaluate NLP systems that automatically predict causal relations between the overall status of the patient contained in the Assessment section and its relation to each component of the Plan section which contains the diagnoses and treatment plans. The goal of the task was to identify and prioritize diagnoses as the first steps in diagnostic decision support to find the most relevant information in long documents like daily progress notes. We present the results of 2022 n2c2 Track 3 and provide a description of the data, evaluation, participation and system performance.

cs.AI↗
arXiv2022

DR.BENCH: Diagnostic Reasoning Benchmark for Clinical Natural Language Processing

The meaningful use of electronic health records (EHR) continues to progress in the digital era with clinical decision support systems augmented by artificial intelligence. A priority in improving provider experience is to overcome information overload and reduce the cognitive burden so fewer medical errors and cognitive biases are introduced during patient care. One major type of medical error is diagnostic error due to systematic or predictable errors in judgment that rely on heuristics. The potential for clinical natural language processing (cNLP) to model diagnostic reasoning in humans with forward reasoning from data to diagnosis and potentially reduce the cognitive burden and medical error has not been investigated. Existing tasks to advance the science in cNLP have largely focused on information extraction and named entity recognition through classification tasks. We introduce a novel suite of tasks coined as Diagnostic Reasoning Benchmarks, DR.BENCH, as a new benchmark for developing and evaluating cNLP models with clinical diagnostic reasoning ability. The suite includes six tasks from ten publicly available datasets addressing clinical text understanding, medical knowledge reasoning, and diagnosis generation. DR.BENCH is the first clinical suite of tasks designed to be a natural language generation framework to evaluate pre-trained language models. Experiments with state-of-the-art pre-trained generative language models using large general domain models and models that were continually trained on a medical corpus demonstrate opportunities for improvement when evaluated in DR. BENCH. We share DR. BENCH as a publicly available GitLab repository with a systematic approach to load and evaluate models for the cNLP community.

cs.CL↗
arXiv2022

Summarizing Patients Problems from Hospital Progress Notes Using Pre-trained Sequence-to-Sequence Models

Automatically summarizing patients' main problems from daily progress notes using natural language processing methods helps to battle against information and cognitive overload in hospital settings and potentially assists providers with computerized diagnostic decision support. Problem list summarization requires a model to understand, abstract, and generate clinical documentation. In this work, we propose a new NLP task that aims to generate a list of problems in a patient's daily care plan using input from the provider's progress notes during hospitalization. We investigate the performance of T5 and BART, two state-of-the-art seq2seq transformer architectures, in solving this problem. We provide a corpus built on top of progress notes from publicly available electronic health record progress notes in the Medical Information Mart for Intensive Care (MIMIC)-III. T5 and BART are trained on general domain text, and we experiment with a data augmentation method and a domain adaptation pre-training method to increase exposure to medical vocabulary and knowledge. Evaluation methods include ROUGE, BERTScore, cosine similarity on sentence embedding, and F-score on medical concepts. Results show that T5 with domain adaptive pre-training achieves significant performance gains compared to a rule-based system and general domain pre-trained language models, indicating a promising direction for tackling the problem summarization task.

cs.CL↗
arXiv2022

Hierarchical Annotation for Building A Suite of Clinical Natural Language Processing Tasks: Progress Note Understanding

Applying methods in natural language processing on electronic health records (EHR) data is a growing field. Existing corpus and annotation focus on modeling textual features and relation prediction. However, there is a paucity of annotated corpus built to model clinical diagnostic thinking, a process involving text understanding, domain knowledge abstraction and reasoning. This work introduces a hierarchical annotation schema with three stages to address clinical text understanding, clinical reasoning, and summarization. We created an annotated corpus based on an extensive collection of publicly available daily progress notes, a type of EHR documentation that is collected in time series in a problem-oriented format. The conventional format for a progress note follows a Subjective, Objective, Assessment and Plan heading (SOAP). We also define a new suite of tasks, Progress Note Understanding, with three tasks utilizing the three annotation stages. The novel suite of tasks was designed to train and evaluate future NLP models for clinical text understanding, clinical knowledge representation, inference, and summarization.

cs.CL↗
arXiv2021

A Scoping Review of Publicly Available Language Tasks in Clinical Natural Language Processing

Objective: to provide a scoping review of papers on clinical natural language processing (NLP) tasks that use publicly available electronic health record data from a cohort of patients. Materials and Methods: We searched six databases, including biomedical research and computer science literature database. A round of title/abstract screening and full-text screening were conducted by two reviewers. Our method followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Results: A total of 35 papers with 47 clinical NLP tasks met inclusion criteria between 2007 and 2021. We categorized the tasks by the type of NLP problems, including name entity recognition, summarization, and other NLP tasks. Some tasks were introduced with a topic of clinical decision support applications, such as substance abuse, phenotyping, cohort selection for clinical trial. We summarized the tasks by publication and dataset information. Discussion: The breadth of clinical NLP tasks keeps growing as the field of NLP evolves with advancements in language systems. However, gaps exist in divergent interests between general domain NLP community and clinical informatics community, and in generalizability of the data sources. We also identified issues in data selection and preparation including the lack of time-sensitive data, and invalidity of problem size and evaluation. Conclusions: The existing clinical NLP tasks cover a wide range of topics and the field will continue to grow and attract more attention from both general domain NLP and clinical informatics community. We encourage future work to incorporate multi-disciplinary collaboration, reporting transparency, and standardization in data preparation.

cs.CL↗
arXiv2021

BCH-NLP at BioCreative VII Track 3: medications detection in tweets using transformer networks and multi-task learning

In this paper, we present our work participating in the BioCreative VII Track 3 - automatic extraction of medication names in tweets, where we implemented a multi-task learning model that is jointly trained on text classification and sequence labelling. Our best system run achieved a strict F1 of 80.4, ranking first and more than 10 points higher than the average score of all participants. Our analyses show that the ensemble technique, multi-task learning, and data augmentation are all beneficial for medication detection in tweets.

cs.CL↗
arXiv2021

Classifying Long Clinical Documents with Pre-trained Transformers

Automatic phenotyping is a task of identifying cohorts of patients that match a predefined set of criteria. Phenotyping typically involves classifying long clinical documents that contain thousands of tokens. At the same time, recent state-of-art transformer-based pre-trained language models limit the input to a few hundred tokens (e.g. 512 tokens for BERT). We evaluate several strategies for incorporating pre-trained sentence encoders into document-level representations of clinical text, and find that hierarchical transformers without pre-training are competitive with task pre-trained models.

cs.CL↗
arXiv2020

Deep Representation Learning of Patient Data from Electronic Health Records (EHR): A Systematic Review

Patient representation learning refers to learning a dense mathematical representation of a patient that encodes meaningful information from Electronic Health Records (EHRs). This is generally performed using advanced deep learning methods. This study presents a systematic review of this field and provides both qualitative and quantitative analyses from a methodological perspective. We identified studies developing patient representations from EHRs with deep learning methods from MEDLINE, EMBASE, Scopus, the Association for Computing Machinery (ACM) Digital Library, and Institute of Electrical and Electronics Engineers (IEEE) Xplore Digital Library. After screening 363 articles, 49 papers were included for a comprehensive data collection. We noticed a typical workflow starting with feeding raw data, applying deep learning models, and ending with clinical outcome predictions as evaluations of the learned representations. Specifically, learning representations from structured EHR data was dominant (37 out of 49 studies). Recurrent Neural Networks were widely applied as the deep learning architecture (LSTM: 13 studies, GRU: 11 studies). Disease prediction was the most common application and evaluation (31 studies). Benchmark datasets were mostly unavailable (28 studies) due to privacy concerns of EHR data, and code availability was assured in 20 studies. We show the importance and feasibility of learning comprehensive representations of patient EHR data through a systematic review. Advances in patient representation learning techniques will be essential for powering patient-level EHR analyses. Future work will still be devoted to leveraging the richness and potential of available EHR data. Knowledge distillation and advanced learning techniques will be exploited to assist the capability of learning patient representation further.

cs.LG↗
arXiv2020

HST/COS Observations of Quasar Outflows in the 500 -- 1050 \AA\ Rest Frame: IV. The Largest Broad Absorption Line Acceleration

We present an analysis of the broad absorption line (BAL) velocity shift that appeared in one of the outflow systems in quasar SDSS J1042+1646. Observations were taken by the Hubble Space Telescope/Cosmic Origin Spectrograph in 2011 and 2017 in the 500 -- 1050 $\r{A}$ rest frame. The outflow's velocity centroid shifted by $\sim$ --1550 km s$^{-1}$ from --19,500 km s$^{-1}$ to --21,050 km s$^{-1}$ over a rest-frame time of 3.2 yr. The velocity shift signatures are most apparent in the absorption features from the Ne VIII $\lambda\lambda$ 770.41, 780.32 doublet and are supported by the absorption troughs from OV $\lambda$ 629.73 and the Mg X $\lambda\lambda$ 609.79, 624.94 doublet. This is the first time where a quasar outflow velocity shift is observed in troughs from more than one ion and in distinct troughs from a doublet transition (Ne VIII). We attribute the velocity shift to an acceleration of an existing outflow as we are able to exclude photoionization changes and motion of material into and out of the line of sight as alternate explanations. This leads to an average acceleration of 480 km s$^{-1}$ yr$^{-1}$ (1.52 cm s$^{-2}$) in the quasar rest frame. Both the acceleration and the absolute velocity shift are the largest reported for a quasar outflow to date. Based on the absorption troughs of the O V* multiplet, we derive a range for the distance of the outflow ($R$) from the central source, 0.05 pc $<$ $R$ $<$ 54.3 pc. This outflow shows similarities with the fast X-ray outflow detected in quasar PG 1211+143. We use the acceleration and velocity shift to constrain radiatively accelerated active galactic nucleus disk-wind models and use them to make predictions for future observations.

astro-ph.GA↗