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Mar 14

RareBench: Can LLMs Serve as Rare Diseases Specialists?

Generalist Large Language Models (LLMs), such as GPT-4, have shown considerable promise in various domains, including medical diagnosis. Rare diseases, affecting approximately 300 million people worldwide, often have unsatisfactory clinical diagnosis rates primarily due to a lack of experienced physicians and the complexity of differentiating among many rare diseases. In this context, recent news such as "ChatGPT correctly diagnosed a 4-year-old's rare disease after 17 doctors failed" underscore LLMs' potential, yet underexplored, role in clinically diagnosing rare diseases. To bridge this research gap, we introduce RareBench, a pioneering benchmark designed to systematically evaluate the capabilities of LLMs on 4 critical dimensions within the realm of rare diseases. Meanwhile, we have compiled the largest open-source dataset on rare disease patients, establishing a benchmark for future studies in this domain. To facilitate differential diagnosis of rare diseases, we develop a dynamic few-shot prompt methodology, leveraging a comprehensive rare disease knowledge graph synthesized from multiple knowledge bases, significantly enhancing LLMs' diagnostic performance. Moreover, we present an exhaustive comparative study of GPT-4's diagnostic capabilities against those of specialist physicians. Our experimental findings underscore the promising potential of integrating LLMs into the clinical diagnostic process for rare diseases. This paves the way for exciting possibilities in future advancements in this field.

ChatGPT is a Knowledgeable but Inexperienced Solver: An Investigation of Commonsense Problem in Large Language Models

Large language models (LLMs) such as ChatGPT and GPT-4 have made significant progress in NLP. However, their ability to memorize, represent, and leverage commonsense knowledge has been a well-known pain point for LLMs. It remains unclear that: (1) Can GPTs effectively answer commonsense questions? (2) Are GPTs knowledgeable in commonsense? (3) Are GPTs aware of the underlying commonsense knowledge for answering a specific question? (4) Can GPTs effectively leverage commonsense for answering questions? To evaluate the above commonsense problems, we conduct a series of experiments to evaluate ChatGPT's commonsense abilities, and the experimental results show that: (1) GPTs can achieve good QA accuracy in commonsense tasks, while they still struggle with certain types of knowledge. (2) ChatGPT is knowledgeable, and can accurately generate most of the commonsense knowledge using knowledge prompts. (3) Despite its knowledge, ChatGPT is an inexperienced commonsense problem solver, which cannot precisely identify the needed commonsense knowledge for answering a specific question, i.e., ChatGPT does not precisely know what commonsense knowledge is required to answer a question. The above findings raise the need to investigate better mechanisms for utilizing commonsense knowledge in LLMs, such as instruction following, better commonsense guidance, etc.

Comparing the Efficacy of GPT-4 and Chat-GPT in Mental Health Care: A Blind Assessment of Large Language Models for Psychological Support

Background: Rapid advancements in natural language processing have led to the development of large language models with the potential to revolutionize mental health care. These models have shown promise in assisting clinicians and providing support to individuals experiencing various psychological challenges. Objective: This study aims to compare the performance of two large language models, GPT-4 and Chat-GPT, in responding to a set of 18 psychological prompts, to assess their potential applicability in mental health care settings. Methods: A blind methodology was employed, with a clinical psychologist evaluating the models' responses without knowledge of their origins. The prompts encompassed a diverse range of mental health topics, including depression, anxiety, and trauma, to ensure a comprehensive assessment. Results: The results demonstrated a significant difference in performance between the two models (p > 0.05). GPT-4 achieved an average rating of 8.29 out of 10, while Chat-GPT received an average rating of 6.52. The clinical psychologist's evaluation suggested that GPT-4 was more effective at generating clinically relevant and empathetic responses, thereby providing better support and guidance to potential users. Conclusions: This study contributes to the growing body of literature on the applicability of large language models in mental health care settings. The findings underscore the importance of continued research and development in the field to optimize these models for clinical use. Further investigation is necessary to understand the specific factors underlying the performance differences between the two models and to explore their generalizability across various populations and mental health conditions.

Investigating the Efficacy of Large Language Models in Reflective Assessment Methods through Chain of Thoughts Prompting

Large Language Models, such as Generative Pre-trained Transformer 3 (aka. GPT-3), have been developed to understand language through the analysis of extensive text data, allowing them to identify patterns and connections between words. While LLMs have demonstrated impressive performance across various text-related tasks, they encounter challenges in tasks associated with reasoning. To address this challenge, Chain of Thought(CoT) prompting method has been proposed as a means to enhance LLMs' proficiency in complex reasoning tasks like solving math word problems and answering questions based on logical argumentative reasoning. The primary aim of this research is to assess how well four language models can grade reflective essays of third-year medical students. The assessment will specifically target the evaluation of critical thinking skills using CoT prompting. The research will provide the following contributions; to introduce and educate on the process of instructing models to evaluate reflective essays from a dataset they have not been previously trained on; to illustrate the use of CoT prompting as an instructional approach for training large models to carry out particular tasks. Our results suggest that among all the models, Llama-7b performs the least effectively, displaying the highest mean squared error. Conversely, ChatGPT emerges as the superior model, boasting a higher Cohen kappa score value of 0.53. Lastly, it's important to note that the selected models do prioritise user privacy by allowing users to delete their own conducted conversations.

Synthetic Dialogue Dataset Generation using LLM Agents

Linear programming (LP) problems are pervasive in real-life applications. However, despite their apparent simplicity, an untrained user may find it difficult to determine the linear model of their specific problem. We envisage the creation of a goal-oriented conversational agent that will engage in conversation with the user to elicit all information required so that a subsequent agent can generate the linear model. In this paper, we present an approach for the generation of sample dialogues that can be used to develop and train such a conversational agent. Using prompt engineering, we develop two agents that "talk" to each other, one acting as the conversational agent, and the other acting as the user. Using a set of text descriptions of linear problems from NL4Opt available to the user only, the agent and the user engage in conversation until the agent has retrieved all key information from the original problem description. We also propose an extrinsic evaluation of the dialogues by assessing how well the summaries generated by the dialogues match the original problem descriptions. We conduct human and automatic evaluations, including an evaluation approach that uses GPT-4 to mimic the human evaluation metrics. The evaluation results show an overall good quality of the dialogues, though research is still needed to improve the quality of the GPT-4 evaluation metrics. The resulting dialogues, including the human annotations of a subset, are available to the research community. The conversational agent used for the generation of the dialogues can be used as a baseline.

How many words does ChatGPT know? The answer is ChatWords

The introduction of ChatGPT has put Artificial Intelligence (AI) Natural Language Processing (NLP) in the spotlight. ChatGPT adoption has been exponential with millions of users experimenting with it in a myriad of tasks and application domains with impressive results. However, ChatGPT has limitations and suffers hallucinations, for example producing answers that look plausible but they are completely wrong. Evaluating the performance of ChatGPT and similar AI tools is a complex issue that is being explored from different perspectives. In this work, we contribute to those efforts with ChatWords, an automated test system, to evaluate ChatGPT knowledge of an arbitrary set of words. ChatWords is designed to be extensible, easy to use, and adaptable to evaluate also other NLP AI tools. ChatWords is publicly available and its main goal is to facilitate research on the lexical knowledge of AI tools. The benefits of ChatWords are illustrated with two case studies: evaluating the knowledge that ChatGPT has of the Spanish lexicon (taken from the official dictionary of the "Real Academia Espa\~nola") and of the words that appear in the Quixote, the well-known novel written by Miguel de Cervantes. The results show that ChatGPT is only able to recognize approximately 80% of the words in the dictionary and 90% of the words in the Quixote, in some cases with an incorrect meaning. The implications of the lexical knowledge of NLP AI tools and potential applications of ChatWords are also discussed providing directions for further work on the study of the lexical knowledge of AI tools.

Synthetic Patients: Simulating Difficult Conversations with Multimodal Generative AI for Medical Education

Problem: Effective patient-centered communication is a core competency for physicians. However, both seasoned providers and medical trainees report decreased confidence in leading conversations on sensitive topics such as goals of care or end-of-life discussions. The significant administrative burden and the resources required to provide dedicated training in leading difficult conversations has been a long-standing problem in medical education. Approach: In this work, we present a novel educational tool designed to facilitate interactive, real-time simulations of difficult conversations in a video-based format through the use of multimodal generative artificial intelligence (AI). Leveraging recent advances in language modeling, computer vision, and generative audio, this tool creates realistic, interactive scenarios with avatars, or "synthetic patients." These synthetic patients interact with users throughout various stages of medical care using a custom-built video chat application, offering learners the chance to practice conversations with patients from diverse belief systems, personalities, and ethnic backgrounds. Outcomes: While the development of this platform demanded substantial upfront investment in labor, it offers a highly-realistic simulation experience with minimal financial investment. For medical trainees, this educational tool can be implemented within programs to simulate patient-provider conversations and can be incorporated into existing palliative care curriculum to provide a scalable, high-fidelity simulation environment for mastering difficult conversations. Next Steps: Future developments will explore enhancing the authenticity of these encounters by working with patients to incorporate their histories and personalities, as well as employing the use of AI-generated evaluations to offer immediate, constructive feedback to learners post-simulation.

Étude cognitive des processus de construction d'une requête dans un système de gestion de connaissances médicales

This article presents the Cogni-CISMeF project, which aims at improving medical information search in the CISMeF system (Catalog and Index of French-language health resources) by including a conversational agent to interact with the user in natural language. To study the cognitive processes involved during the information search, a bottom-up methodology was adopted. Experimentation has been set up to obtain human dialogs between a user (playing the role of patient) dealing with medical information search and a CISMeF expert refining the request. The analysis of these dialogs underlined the use of discursive evidence: vocabulary, reformulation, implicit or explicit expression of user intentions, conversational sequences, etc. A model of artificial agent is proposed. It leads the user in its information search by proposing to him examples, assistance and choices. This model was implemented and integrated in the CISMeF system. ---- Cet article d\'ecrit le projet Cogni-CISMeF qui propose un module de dialogue Homme-Machine \`a int\'egrer dans le syst\`eme d'indexation de connaissances m\'edicales CISMeF (Catalogue et Index des Sites M\'edicaux Francophones). Nous avons adopt\'e une d\'emarche de mod\'elisation cognitive en proc\'edant \`a un recueil de corpus de dialogues entre un utilisateur (jouant le r\^ole d'un patient) d\'esirant une information m\'edicale et un expert CISMeF af inant cette demande pour construire la requ\^ete. Nous avons analys\'e la structure des dialogues ainsi obtenus et avons \'etudi\'e un certain nombre d'indices discursifs : vocabulaire employ\'e, marques de reformulation, commentaires m\'eta et \'epilinguistiques, expression implicite ou explicite des intentions de l'utilisateur, encha\^inement conversationnel, etc. De cette analyse, nous avons construit un mod\`ele d'agent artificiel dot\'e de capacit\'es cognitives capables d'aider l'utilisateur dans sa t\^ache de recherche d'information. Ce mod\`ele a \'et\'e impl\'ement\'e et int\'egr\'e dans le syst\`eme CISMeF.

Accuracy of a Vision-Language Model on Challenging Medical Cases

Background: General-purpose large language models that utilize both text and images have not been evaluated on a diverse array of challenging medical cases. Methods: Using 934 cases from the NEJM Image Challenge published between 2005 and 2023, we evaluated the accuracy of the recently released Generative Pre-trained Transformer 4 with Vision model (GPT-4V) compared to human respondents overall and stratified by question difficulty, image type, and skin tone. We further conducted a physician evaluation of GPT-4V on 69 NEJM clinicopathological conferences (CPCs). Analyses were conducted for models utilizing text alone, images alone, and both text and images. Results: GPT-4V achieved an overall accuracy of 61% (95% CI, 58 to 64%) compared to 49% (95% CI, 49 to 50%) for humans. GPT-4V outperformed humans at all levels of difficulty and disagreement, skin tones, and image types; the exception was radiographic images, where performance was equivalent between GPT-4V and human respondents. Longer, more informative captions were associated with improved performance for GPT-4V but similar performance for human respondents. GPT-4V included the correct diagnosis in its differential for 80% (95% CI, 68 to 88%) of CPCs when using text alone, compared to 58% (95% CI, 45 to 70%) of CPCs when using both images and text. Conclusions: GPT-4V outperformed human respondents on challenging medical cases and was able to synthesize information from both images and text, but performance deteriorated when images were added to highly informative text. Overall, our results suggest that multimodal AI models may be useful in medical diagnostic reasoning but that their accuracy may depend heavily on context.

InfoVisDial: An Informative Visual Dialogue Dataset by Bridging Large Multimodal and Language Models

In this paper, we build a visual dialogue dataset, named InfoVisDial, which provides rich informative answers in each round even with external knowledge related to the visual content. Different from existing datasets where the answer is compact and short, InfoVisDial contains long free-form answers with rich information in each round of dialogue. For effective data collection, the key idea is to bridge the large-scale multimodal model (e.g., GIT) and the language models (e.g., GPT-3). GIT can describe the image content even with scene text, while GPT-3 can generate informative dialogue based on the image description and appropriate prompting techniques. With such automatic pipeline, we can readily generate informative visual dialogue data at scale. Then, we ask human annotators to rate the generated dialogues to filter the low-quality conversations.Human analyses show that InfoVisDial covers informative and diverse dialogue topics: 54.4% of the dialogue rounds are related to image scene texts, and 36.7% require external knowledge. Each round's answer is also long and open-ended: 87.3% of answers are unique with an average length of 8.9, compared with 27.37% and 2.9 in VisDial. Last, we propose a strong baseline by adapting the GIT model for the visual dialogue task and fine-tune the model on InfoVisDial. Hopefully, our work can motivate more effort on this direction.

Large Language Models as Zero-shot Dialogue State Tracker through Function Calling

Large language models (LLMs) are increasingly prevalent in conversational systems due to their advanced understanding and generative capabilities in general contexts. However, their effectiveness in task-oriented dialogues (TOD), which requires not only response generation but also effective dialogue state tracking (DST) within specific tasks and domains, remains less satisfying. In this work, we propose a novel approach FnCTOD for solving DST with LLMs through function calling. This method improves zero-shot DST, allowing adaptation to diverse domains without extensive data collection or model tuning. Our experimental results demonstrate that our approach achieves exceptional performance with both modestly sized open-source and also proprietary LLMs: with in-context prompting it enables various 7B or 13B parameter models to surpass the previous state-of-the-art (SOTA) achieved by ChatGPT, and improves ChatGPT's performance beating the SOTA by 5.6% Avg. JGA. Individual model results for GPT-3.5 and GPT-4 are boosted by 4.8% and 14%, respectively. We also show that by fine-tuning on a small collection of diverse task-oriented dialogues, we can equip modestly sized models, specifically a 13B parameter LLaMA2-Chat model, with function-calling capabilities and DST performance comparable to ChatGPT while maintaining their chat capabilities. We plan to open-source experimental code and model.

DERA: Enhancing Large Language Model Completions with Dialog-Enabled Resolving Agents

Large language models (LLMs) have emerged as valuable tools for many natural language understanding tasks. In safety-critical applications such as healthcare, the utility of these models is governed by their ability to generate outputs that are factually accurate and complete. In this work, we present dialog-enabled resolving agents (DERA). DERA is a paradigm made possible by the increased conversational abilities of LLMs, namely GPT-4. It provides a simple, interpretable forum for models to communicate feedback and iteratively improve output. We frame our dialog as a discussion between two agent types - a Researcher, who processes information and identifies crucial problem components, and a Decider, who has the autonomy to integrate the Researcher's information and makes judgments on the final output. We test DERA against three clinically-focused tasks. For medical conversation summarization and care plan generation, DERA shows significant improvement over the base GPT-4 performance in both human expert preference evaluations and quantitative metrics. In a new finding, we also show that GPT-4's performance (70%) on an open-ended version of the MedQA question-answering (QA) dataset (Jin et al. 2021, USMLE) is well above the passing level (60%), with DERA showing similar performance. We release the open-ended MEDQA dataset at https://github.com/curai/curai-research/tree/main/DERA.

Capabilities of GPT-4 on Medical Challenge Problems

Large language models (LLMs) have demonstrated remarkable capabilities in natural language understanding and generation across various domains, including medicine. We present a comprehensive evaluation of GPT-4, a state-of-the-art LLM, on medical competency examinations and benchmark datasets. GPT-4 is a general-purpose model that is not specialized for medical problems through training or engineered to solve clinical tasks. Our analysis covers two sets of official practice materials for the USMLE, a three-step examination program used to assess clinical competency and grant licensure in the United States. We also evaluate performance on the MultiMedQA suite of benchmark datasets. Beyond measuring model performance, experiments were conducted to investigate the influence of test questions containing both text and images on model performance, probe for memorization of content during training, and study probability calibration, which is of critical importance in high-stakes applications like medicine. Our results show that GPT-4, without any specialized prompt crafting, exceeds the passing score on USMLE by over 20 points and outperforms earlier general-purpose models (GPT-3.5) as well as models specifically fine-tuned on medical knowledge (Med-PaLM, a prompt-tuned version of Flan-PaLM 540B). In addition, GPT-4 is significantly better calibrated than GPT-3.5, demonstrating a much-improved ability to predict the likelihood that its answers are correct. We also explore the behavior of the model qualitatively through a case study that shows the ability of GPT-4 to explain medical reasoning, personalize explanations to students, and interactively craft new counterfactual scenarios around a medical case. Implications of the findings are discussed for potential uses of GPT-4 in medical education, assessment, and clinical practice, with appropriate attention to challenges of accuracy and safety.

ChiMed-GPT: A Chinese Medical Large Language Model with Full Training Regime and Better Alignment to Human Preferences

Recently, the increasing demand for superior medical services has highlighted the discrepancies in the medical infrastructure. With big data, especially texts, forming the foundation of medical services, there is an exigent need for effective natural language processing (NLP) solutions tailored to the healthcare domain. Conventional approaches leveraging pre-trained models present promising results in this domain and current large language models (LLMs) offer advanced foundation for medical text processing. However, most medical LLMs are trained only with supervised fine-tuning (SFT), even though it efficiently empowers LLMs to understand and respond to medical instructions but is ineffective in learning domain knowledge and aligning with human preference. Another engineering barrier that prevents current medical LLM from better text processing ability is their restricted context length (e.g., 2,048 tokens), making it hard for the LLMs to process long context, which is frequently required in the medical domain. In this work, we propose ChiMed-GPT, a new benchmark LLM designed explicitly for Chinese medical domain, with enlarged context length to 4,096 tokens and undergoes a comprehensive training regime with pre-training, SFT, and RLHF. Evaluations on real-world tasks including information extraction, question answering, and dialogue generation demonstrate ChiMed-GPT's superior performance over general domain LLMs. Furthermore, we analyze possible biases through prompting ChiMed-GPT to perform attitude scales regarding discrimination of patients, so as to contribute to further responsible development of LLMs in the medical domain. The code and model are released at https://github.com/synlp/ChiMed-GPT.

Rethinking Explainability as a Dialogue: A Practitioner's Perspective

As practitioners increasingly deploy machine learning models in critical domains such as health care, finance, and policy, it becomes vital to ensure that domain experts function effectively alongside these models. Explainability is one way to bridge the gap between human decision-makers and machine learning models. However, most of the existing work on explainability focuses on one-off, static explanations like feature importances or rule lists. These sorts of explanations may not be sufficient for many use cases that require dynamic, continuous discovery from stakeholders. In the literature, few works ask decision-makers about the utility of existing explanations and other desiderata they would like to see in an explanation going forward. In this work, we address this gap and carry out a study where we interview doctors, healthcare professionals, and policymakers about their needs and desires for explanations. Our study indicates that decision-makers would strongly prefer interactive explanations in the form of natural language dialogues. Domain experts wish to treat machine learning models as "another colleague", i.e., one who can be held accountable by asking why they made a particular decision through expressive and accessible natural language interactions. Considering these needs, we outline a set of five principles researchers should follow when designing interactive explanations as a starting place for future work. Further, we show why natural language dialogues satisfy these principles and are a desirable way to build interactive explanations. Next, we provide a design of a dialogue system for explainability and discuss the risks, trade-offs, and research opportunities of building these systems. Overall, we hope our work serves as a starting place for researchers and engineers to design interactive explainability systems.

ChatGPT in the Age of Generative AI and Large Language Models: A Concise Survey

ChatGPT is a large language model (LLM) created by OpenAI that has been carefully trained on a large amount of data. It has revolutionized the field of natural language processing (NLP) and has pushed the boundaries of LLM capabilities. ChatGPT has played a pivotal role in enabling widespread public interaction with generative artificial intelligence (GAI) on a large scale. It has also sparked research interest in developing similar technologies and investigating their applications and implications. In this paper, our primary goal is to provide a concise survey on the current lines of research on ChatGPT and its evolution. We considered both the glass box and black box views of ChatGPT, encompassing the components and foundational elements of the technology, as well as its applications, impacts, and implications. The glass box approach focuses on understanding the inner workings of the technology, and the black box approach embraces it as a complex system, and thus examines its inputs, outputs, and effects. This paves the way for a comprehensive exploration of the technology and provides a road map for further research and experimentation. We also lay out essential foundational literature on LLMs and GAI in general and their connection with ChatGPT. This overview sheds light on existing and missing research lines in the emerging field of LLMs, benefiting both public users and developers. Furthermore, the paper delves into the broad spectrum of applications and significant concerns in fields such as education, research, healthcare, finance, etc.

GPT-Calls: Enhancing Call Segmentation and Tagging by Generating Synthetic Conversations via Large Language Models

Transcriptions of phone calls are of significant value across diverse fields, such as sales, customer service, healthcare, and law enforcement. Nevertheless, the analysis of these recorded conversations can be an arduous and time-intensive process, especially when dealing with extended or multifaceted dialogues. In this work, we propose a novel method, GPT-distilled Calls Segmentation and Tagging (GPT-Calls), for efficient and accurate call segmentation and topic extraction. GPT-Calls is composed of offline and online phases. The offline phase is applied once to a given list of topics and involves generating a distribution of synthetic sentences for each topic using a GPT model and extracting anchor vectors. The online phase is applied to every call separately and scores the similarity between the transcripted conversation and the topic anchors found in the offline phase. Then, time domain analysis is applied to the similarity scores to group utterances into segments and tag them with topics. The proposed paradigm provides an accurate and efficient method for call segmentation and topic extraction that does not require labeled data, thus making it a versatile approach applicable to various domains. Our algorithm operates in production under Dynamics 365 Sales Conversation Intelligence, and our research is based on real sales conversations gathered from various Dynamics 365 Sales tenants.

Code Soliloquies for Accurate Calculations in Large Language Models

High-quality conversational datasets are integral to the successful development of Intelligent Tutoring Systems (ITS) that employ a Large Language Model (LLM) backend. These datasets, when used to fine-tune the LLM backend, significantly enhance the quality of interactions between students and ITS. A common strategy for developing these datasets involves generating synthetic student-teacher dialogues using advanced GPT-4 models. However, challenges arise when these dialogues demand complex calculations, common in subjects like physics. Despite its advanced capabilities, GPT-4's performance falls short in reliably handling even simple multiplication tasks, marking a significant limitation in its utility for these subjects. To address these challenges, this paper introduces an innovative stateful prompt design. Our approach generates a mock conversation between a student and a tutorbot, both roles simulated by GPT-4. Each student response triggers a soliloquy (an inner monologue) in the GPT-tutorbot, which assesses whether its response would necessitate calculations. If so, it proceeds to script the required code in Python and then uses the resulting output to construct its response to the student. Our approach notably enhances the quality of synthetic conversation datasets, especially for subjects that are calculation-intensive. Our findings show that our Higgs model -- a LLaMA finetuned with datasets generated through our novel stateful prompt design -- proficiently utilizes Python for computations. Consequently, finetuning with our datasets enriched with code soliloquies enhances not just the accuracy but also the computational reliability of Higgs' responses.

Evaluation of GPT-3.5 and GPT-4 for supporting real-world information needs in healthcare delivery

Despite growing interest in using large language models (LLMs) in healthcare, current explorations do not assess the real-world utility and safety of LLMs in clinical settings. Our objective was to determine whether two LLMs can serve information needs submitted by physicians as questions to an informatics consultation service in a safe and concordant manner. Sixty six questions from an informatics consult service were submitted to GPT-3.5 and GPT-4 via simple prompts. 12 physicians assessed the LLM responses' possibility of patient harm and concordance with existing reports from an informatics consultation service. Physician assessments were summarized based on majority vote. For no questions did a majority of physicians deem either LLM response as harmful. For GPT-3.5, responses to 8 questions were concordant with the informatics consult report, 20 discordant, and 9 were unable to be assessed. There were 29 responses with no majority on "Agree", "Disagree", and "Unable to assess". For GPT-4, responses to 13 questions were concordant, 15 discordant, and 3 were unable to be assessed. There were 35 responses with no majority. Responses from both LLMs were largely devoid of overt harm, but less than 20% of the responses agreed with an answer from an informatics consultation service, responses contained hallucinated references, and physicians were divided on what constitutes harm. These results suggest that while general purpose LLMs are able to provide safe and credible responses, they often do not meet the specific information need of a given question. A definitive evaluation of the usefulness of LLMs in healthcare settings will likely require additional research on prompt engineering, calibration, and custom-tailoring of general purpose models.

Sparks of Artificial General Intelligence: Early experiments with GPT-4

Artificial intelligence (AI) researchers have been developing and refining large language models (LLMs) that exhibit remarkable capabilities across a variety of domains and tasks, challenging our understanding of learning and cognition. The latest model developed by OpenAI, GPT-4, was trained using an unprecedented scale of compute and data. In this paper, we report on our investigation of an early version of GPT-4, when it was still in active development by OpenAI. We contend that (this early version of) GPT-4 is part of a new cohort of LLMs (along with ChatGPT and Google's PaLM for example) that exhibit more general intelligence than previous AI models. We discuss the rising capabilities and implications of these models. We demonstrate that, beyond its mastery of language, GPT-4 can solve novel and difficult tasks that span mathematics, coding, vision, medicine, law, psychology and more, without needing any special prompting. Moreover, in all of these tasks, GPT-4's performance is strikingly close to human-level performance, and often vastly surpasses prior models such as ChatGPT. Given the breadth and depth of GPT-4's capabilities, we believe that it could reasonably be viewed as an early (yet still incomplete) version of an artificial general intelligence (AGI) system. In our exploration of GPT-4, we put special emphasis on discovering its limitations, and we discuss the challenges ahead for advancing towards deeper and more comprehensive versions of AGI, including the possible need for pursuing a new paradigm that moves beyond next-word prediction. We conclude with reflections on societal influences of the recent technological leap and future research directions.

CasiMedicos-Arg: A Medical Question Answering Dataset Annotated with Explanatory Argumentative Structures

Explaining Artificial Intelligence (AI) decisions is a major challenge nowadays in AI, in particular when applied to sensitive scenarios like medicine and law. However, the need to explain the rationale behind decisions is a main issue also for human-based deliberation as it is important to justify why a certain decision has been taken. Resident medical doctors for instance are required not only to provide a (possibly correct) diagnosis, but also to explain how they reached a certain conclusion. Developing new tools to aid residents to train their explanation skills is therefore a central objective of AI in education. In this paper, we follow this direction, and we present, to the best of our knowledge, the first multilingual dataset for Medical Question Answering where correct and incorrect diagnoses for a clinical case are enriched with a natural language explanation written by doctors. These explanations have been manually annotated with argument components (i.e., premise, claim) and argument relations (i.e., attack, support), resulting in the Multilingual CasiMedicos-Arg dataset which consists of 558 clinical cases in four languages (English, Spanish, French, Italian) with explanations, where we annotated 5021 claims, 2313 premises, 2431 support relations, and 1106 attack relations. We conclude by showing how competitive baselines perform over this challenging dataset for the argument mining task.

WavChat: A Survey of Spoken Dialogue Models

Recent advancements in spoken dialogue models, exemplified by systems like GPT-4o, have captured significant attention in the speech domain. Compared to traditional three-tier cascaded spoken dialogue models that comprise speech recognition (ASR), large language models (LLMs), and text-to-speech (TTS), modern spoken dialogue models exhibit greater intelligence. These advanced spoken dialogue models not only comprehend audio, music, and other speech-related features, but also capture stylistic and timbral characteristics in speech. Moreover, they generate high-quality, multi-turn speech responses with low latency, enabling real-time interaction through simultaneous listening and speaking capability. Despite the progress in spoken dialogue systems, there is a lack of comprehensive surveys that systematically organize and analyze these systems and the underlying technologies. To address this, we have first compiled existing spoken dialogue systems in the chronological order and categorized them into the cascaded and end-to-end paradigms. We then provide an in-depth overview of the core technologies in spoken dialogue models, covering aspects such as speech representation, training paradigm, streaming, duplex, and interaction capabilities. Each section discusses the limitations of these technologies and outlines considerations for future research. Additionally, we present a thorough review of relevant datasets, evaluation metrics, and benchmarks from the perspectives of training and evaluating spoken dialogue systems. We hope this survey will contribute to advancing both academic research and industrial applications in the field of spoken dialogue systems. The related material is available at https://github.com/jishengpeng/WavChat.

Pair Programming with Large Language Models for Sampling and Estimation of Copulas

Without writing a single line of code by a human, an example Monte Carlo simulation based application for stochastic dependence modeling with copulas is developed using a state-of-the-art large language model (LLM) fine-tuned for conversations. This includes interaction with ChatGPT in natural language and using mathematical formalism, which, under careful supervision by a human-expert, led to producing a working code in MATLAB, Python and R for sampling from a given copula model, evaluation of the model's density, performing maximum likelihood estimation, optimizing the code for parallel computing for CPUs as well as for GPUs, and visualization of the computed results. In contrast to other emerging studies that assess the accuracy of LLMs like ChatGPT on tasks from a selected area, this work rather investigates ways how to achieve a successful solution of a standard statistical task in a collaboration of a human-expert and artificial intelligence (AI). Particularly, through careful prompt engineering, we separate successful solutions generated by ChatGPT from unsuccessful ones, resulting in a comprehensive list of related pros and cons. It is demonstrated that if the typical pitfalls are avoided, we can substantially benefit from collaborating with an AI partner. For example, we show that if ChatGPT is not able to provide a correct solution due to a lack of or incorrect knowledge, the human-expert can feed it with the correct knowledge, e.g., in the form of mathematical theorems and formulas, and make it to apply the gained knowledge in order to provide a solution that is correct. Such ability presents an attractive opportunity to achieve a programmed solution even for users with rather limited knowledge of programming techniques.

Generative Large Language Models Are All-purpose Text Analytics Engines: Text-to-text Learning Is All Your Need

Objective To solve major clinical natural language processing (NLP) tasks using a unified text-to-text learning architecture based on a generative large language model (LLM) via prompt tuning. Methods We formulated 7 key clinical NLP tasks as text-to-text learning and solved them using one unified generative clinical LLM, GatorTronGPT, developed using GPT-3 architecture and trained with up to 20 billion parameters. We adopted soft prompts (i.e., trainable vectors) with frozen LLM, where the LLM parameters were not updated (i.e., frozen) and only the vectors of soft prompts were updated, known as prompt tuning. We added additional soft prompts as a prefix to the input layer, which were optimized during the prompt tuning. We evaluated the proposed method using 7 clinical NLP tasks and compared them with previous task-specific solutions based on Transformer models. Results and Conclusion The proposed approach achieved state-of-the-art performance for 5 out of 7 major clinical NLP tasks using one unified generative LLM. Our approach outperformed previous task-specific transformer models by ~3% for concept extraction and 7% for relation extraction applied to social determinants of health, 3.4% for clinical concept normalization, 3.4~10% for clinical abbreviation disambiguation, and 5.5~9% for natural language inference. Our approach also outperformed a previously developed prompt-based machine reading comprehension (MRC) model, GatorTron-MRC, for clinical concept and relation extraction. The proposed approach can deliver the ``one model for all`` promise from training to deployment using a unified generative LLM.

Interactive Dialogue Agents via Reinforcement Learning on Hindsight Regenerations

Recent progress on large language models (LLMs) has enabled dialogue agents to generate highly naturalistic and plausible text. However, current LLM language generation focuses on responding accurately to questions and requests with a single effective response. In reality, many real dialogues are interactive, meaning an agent's utterances will influence their conversational partner, elicit information, or change their opinion. Accounting for how an agent can effectively steer a conversation is a crucial ability in many dialogue tasks, from healthcare to preference elicitation. Existing methods for fine-tuning dialogue agents to accomplish such tasks would rely on curating some amount of expert data. However, doing so often requires understanding the underlying cognitive processes of the conversational partner, which is a skill neither humans nor LLMs trained on human data can reliably do. Our key insight is that while LLMs may not be adept at identifying effective strategies for steering conversations a priori, or in the middle of an ongoing conversation, they can do so post-hoc, or in hindsight, after seeing how their conversational partner responds. We use this fact to rewrite and augment existing suboptimal data, and train via offline reinforcement learning (RL) an agent that outperforms both prompting and learning from unaltered human demonstrations. We apply our approach to two domains that require understanding human mental state, intelligent interaction, and persuasion: mental health support, and soliciting charitable donations. Our results in a user study with real humans show that our approach greatly outperforms existing state-of-the-art dialogue agents.

Rare Disease Differential Diagnosis with Large Language Models at Scale: From Abdominal Actinomycosis to Wilson's Disease

Large language models (LLMs) have demonstrated impressive capabilities in disease diagnosis. However, their effectiveness in identifying rarer diseases, which are inherently more challenging to diagnose, remains an open question. Rare disease performance is critical with the increasing use of LLMs in healthcare settings. This is especially true if a primary care physician needs to make a rarer prognosis from only a patient conversation so that they can take the appropriate next step. To that end, several clinical decision support systems are designed to support providers in rare disease identification. Yet their utility is limited due to their lack of knowledge of common disorders and difficulty of use. In this paper, we propose RareScale to combine the knowledge LLMs with expert systems. We use jointly use an expert system and LLM to simulate rare disease chats. This data is used to train a rare disease candidate predictor model. Candidates from this smaller model are then used as additional inputs to black-box LLM to make the final differential diagnosis. Thus, RareScale allows for a balance between rare and common diagnoses. We present results on over 575 rare diseases, beginning with Abdominal Actinomycosis and ending with Wilson's Disease. Our approach significantly improves the baseline performance of black-box LLMs by over 17% in Top-5 accuracy. We also find that our candidate generation performance is high (e.g. 88.8% on gpt-4o generated chats).

AutoML-GPT: Automatic Machine Learning with GPT

AI tasks encompass a wide range of domains and fields. While numerous AI models have been designed for specific tasks and applications, they often require considerable human efforts in finding the right model architecture, optimization algorithm, and hyperparameters. Recent advances in large language models (LLMs) like ChatGPT show remarkable capabilities in various aspects of reasoning, comprehension, and interaction. Consequently, we propose developing task-oriented prompts and automatically utilizing LLMs to automate the training pipeline. To implement this concept, we present the AutoML-GPT, which employs GPT as the bridge to diverse AI models and dynamically trains models with optimized hyperparameters. AutoML-GPT dynamically takes user requests from the model and data cards and composes the corresponding prompt paragraph. Ultimately, with this prompt paragraph, AutoML-GPT will automatically conduct the experiments from data processing to model architecture, hyperparameter tuning, and predicted training log. By leveraging {\ours}'s robust language capabilities and the available AI models, AutoML-GPT can tackle numerous intricate AI tasks across various tasks and datasets. This approach achieves remarkable results in computer vision, natural language processing, and other challenging areas. Extensive experiments and ablation studies demonstrate that our method can be general, effective, and beneficial for many AI tasks.

Interactive Agents: Simulating Counselor-Client Psychological Counseling via Role-Playing LLM-to-LLM Interactions

Virtual counselors powered by large language models (LLMs) aim to create interactive support systems that effectively assist clients struggling with mental health challenges. To replicate counselor-client conversations, researchers have built an online mental health platform that allows professional counselors to provide clients with text-based counseling services for about an hour per session. Notwithstanding its effectiveness, challenges exist as human annotation is time-consuming, cost-intensive, privacy-protected, and not scalable. To address this issue and investigate the applicability of LLMs in psychological counseling conversation simulation, we propose a framework that employs two LLMs via role-playing for simulating counselor-client interactions. Our framework involves two LLMs, one acting as a client equipped with a specific and real-life user profile and the other playing the role of an experienced counselor, generating professional responses using integrative therapy techniques. We implement both the counselor and the client by zero-shot prompting the GPT-4 model. In order to assess the effectiveness of LLMs in simulating counselor-client interactions and understand the disparities between LLM- and human-generated conversations, we evaluate the synthetic data from various perspectives. We begin by assessing the client's performance through automatic evaluations. Next, we analyze and compare the disparities between dialogues generated by the LLM and those generated by professional counselors. Furthermore, we conduct extensive experiments to thoroughly examine the performance of our LLM-based counselor trained with synthetic interactive dialogues by benchmarking against state-of-the-art models for mental health.

Can Generalist Foundation Models Outcompete Special-Purpose Tuning? Case Study in Medicine

Generalist foundation models such as GPT-4 have displayed surprising capabilities in a wide variety of domains and tasks. Yet, there is a prevalent assumption that they cannot match specialist capabilities of fine-tuned models. For example, most explorations to date on medical competency benchmarks have leveraged domain-specific training, as exemplified by efforts on BioGPT and Med-PaLM. We build on a prior study of GPT-4's capabilities on medical challenge benchmarks in the absence of special training. Rather than using simple prompting to highlight the model's out-of-the-box capabilities, we perform a systematic exploration of prompt engineering. We find that prompting innovation can unlock deeper specialist capabilities and show that GPT-4 easily tops prior leading results for medical benchmarks. The prompting methods we explore are general purpose, and make no specific use of domain expertise, removing the need for expert-curated content. Our experimental design carefully controls for overfitting during the prompt engineering process. We introduce Medprompt, based on a composition of several prompting strategies. With Medprompt, GPT-4 achieves state-of-the-art results on all nine of the benchmark datasets in the MultiMedQA suite. The method outperforms leading specialist models such as Med-PaLM 2 by a significant margin with an order of magnitude fewer calls to the model. Steering GPT-4 with Medprompt achieves a 27% reduction in error rate on the MedQA dataset over the best methods to date achieved with specialist models and surpasses a score of 90% for the first time. Beyond medical problems, we show the power of Medprompt to generalize to other domains and provide evidence for the broad applicability of the approach via studies of the strategy on exams in electrical engineering, machine learning, philosophy, accounting, law, nursing, and clinical psychology.

Are ChatGPT and GPT-4 Good Poker Players? -- A Pre-Flop Analysis

Since the introduction of ChatGPT and GPT-4, these models have been tested across a large number of tasks. Their adeptness across domains is evident, but their aptitude in playing games, and specifically their aptitude in the realm of poker has remained unexplored. Poker is a game that requires decision making under uncertainty and incomplete information. In this paper, we put ChatGPT and GPT-4 through the poker test and evaluate their poker skills. Our findings reveal that while both models display an advanced understanding of poker, encompassing concepts like the valuation of starting hands, playing positions and other intricacies of game theory optimal (GTO) poker, both ChatGPT and GPT-4 are NOT game theory optimal poker players. Profitable strategies in poker are evaluated in expectations over large samples. Through a series of experiments, we first discover the characteristics of optimal prompts and model parameters for playing poker with these models. Our observations then unveil the distinct playing personas of the two models. We first conclude that GPT-4 is a more advanced poker player than ChatGPT. This exploration then sheds light on the divergent poker tactics of the two models: ChatGPT's conservativeness juxtaposed against GPT-4's aggression. In poker vernacular, when tasked to play GTO poker, ChatGPT plays like a nit, which means that it has a propensity to only engage with premium hands and folds a majority of hands. When subjected to the same directive, GPT-4 plays like a maniac, showcasing a loose and aggressive style of play. Both strategies, although relatively advanced, are not game theory optimal.

AI, write an essay for me: A large-scale comparison of human-written versus ChatGPT-generated essays

Background: Recently, ChatGPT and similar generative AI models have attracted hundreds of millions of users and become part of the public discourse. Many believe that such models will disrupt society and will result in a significant change in the education system and information generation in the future. So far, this belief is based on either colloquial evidence or benchmarks from the owners of the models -- both lack scientific rigour. Objective: Through a large-scale study comparing human-written versus ChatGPT-generated argumentative student essays, we systematically assess the quality of the AI-generated content. Methods: A large corpus of essays was rated using standard criteria by a large number of human experts (teachers). We augment the analysis with a consideration of the linguistic characteristics of the generated essays. Results: Our results demonstrate that ChatGPT generates essays that are rated higher for quality than human-written essays. The writing style of the AI models exhibits linguistic characteristics that are different from those of the human-written essays, e.g., it is characterized by fewer discourse and epistemic markers, but more nominalizations and greater lexical diversity. Conclusions: Our results clearly demonstrate that models like ChatGPT outperform humans in generating argumentative essays. Since the technology is readily available for anyone to use, educators must act immediately. We must re-invent homework and develop teaching concepts that utilize these AI models in the same way as math utilized the calculator: teach the general concepts first and then use AI tools to free up time for other learning objectives.

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.

What would Harry say? Building Dialogue Agents for Characters in a Story

We have a Christmas gift for Harry Potter fans all over the world. In this paper, we present Harry Potter Dialogue (HPD), a dataset that helps train Harry Potter-like dialogue agents. Such a task is typically viewed as a variant of personalized dialogue agents, but they differ significantly in three respects: 1) Harry lived in a virtual world of wizards, thus, real-world commonsense may not apply to Harry's conversations; 2) Harry's behavior is strongly linked to background information in conversations: the scene, its attributes and its relationship to other speakers; and 3) Such backgrounds are dynamically altered as the storyline goes on. The HPD dataset, as the first dataset to facilitate the study of dialogue agent construction for characters within a story, provides rich contextual information about each dialogue session such as scenes, character attributes, and relations. More importantly, all the background information will change over the course of the story. In addition, HPD could support both dialogue generation and retrieval tasks. We evaluate baselines such as Dialog-GPT and BOB to determine the extent to which they can generate Harry Potter-like responses. The experimental results disappoint us in that although the generated responses are fluent, they still seem out of character for Harry. Besides, we validate the current most robust dialogue agent, ChatGPT, which also can't generate plausible Harry-Potter-like responses in some cases, either. Our results suggest that there is much scope for future research.

Towards Interpretable Mental Health Analysis with Large Language Models

The latest large language models (LLMs) such as ChatGPT, exhibit strong capabilities in automated mental health analysis. However, existing relevant studies bear several limitations, including inadequate evaluations, lack of prompting strategies, and ignorance of exploring LLMs for explainability. To bridge these gaps, we comprehensively evaluate the mental health analysis and emotional reasoning ability of LLMs on 11 datasets across 5 tasks. We explore the effects of different prompting strategies with unsupervised and distantly supervised emotional information. Based on these prompts, we explore LLMs for interpretable mental health analysis by instructing them to generate explanations for each of their decisions. We convey strict human evaluations to assess the quality of the generated explanations, leading to a novel dataset with 163 human-assessed explanations. We benchmark existing automatic evaluation metrics on this dataset to guide future related works. According to the results, ChatGPT shows strong in-context learning ability but still has a significant gap with advanced task-specific methods. Careful prompt engineering with emotional cues and expert-written few-shot examples can also effectively improve performance on mental health analysis. In addition, ChatGPT generates explanations that approach human performance, showing its great potential in explainable mental health analysis.

Towards AGI in Computer Vision: Lessons Learned from GPT and Large Language Models

The AI community has been pursuing algorithms known as artificial general intelligence (AGI) that apply to any kind of real-world problem. Recently, chat systems powered by large language models (LLMs) emerge and rapidly become a promising direction to achieve AGI in natural language processing (NLP), but the path towards AGI in computer vision (CV) remains unclear. One may owe the dilemma to the fact that visual signals are more complex than language signals, yet we are interested in finding concrete reasons, as well as absorbing experiences from GPT and LLMs to solve the problem. In this paper, we start with a conceptual definition of AGI and briefly review how NLP solves a wide range of tasks via a chat system. The analysis inspires us that unification is the next important goal of CV. But, despite various efforts in this direction, CV is still far from a system like GPT that naturally integrates all tasks. We point out that the essential weakness of CV lies in lacking a paradigm to learn from environments, yet NLP has accomplished the task in the text world. We then imagine a pipeline that puts a CV algorithm (i.e., an agent) in world-scale, interactable environments, pre-trains it to predict future frames with respect to its action, and then fine-tunes it with instruction to accomplish various tasks. We expect substantial research and engineering efforts to push the idea forward and scale it up, for which we share our perspectives on future research directions.

The Reversal Curse: LLMs trained on "A is B" fail to learn "B is A"

We expose a surprising failure of generalization in auto-regressive large language models (LLMs). If a model is trained on a sentence of the form "A is B", it will not automatically generalize to the reverse direction "B is A". This is the Reversal Curse. For instance, if a model is trained on "Olaf Scholz was the ninth Chancellor of Germany", it will not automatically be able to answer the question, "Who was the ninth Chancellor of Germany?". Moreover, the likelihood of the correct answer ("Olaf Scholz") will not be higher than for a random name. Thus, models exhibit a basic failure of logical deduction and do not generalize a prevalent pattern in their training set (i.e. if "A is B'' occurs, "B is A" is more likely to occur). We provide evidence for the Reversal Curse by finetuning GPT-3 and Llama-1 on fictitious statements such as "Uriah Hawthorne is the composer of 'Abyssal Melodies'" and showing that they fail to correctly answer "Who composed 'Abyssal Melodies?'". The Reversal Curse is robust across model sizes and model families and is not alleviated by data augmentation. We also evaluate ChatGPT (GPT-3.5 and GPT-4) on questions about real-world celebrities, such as "Who is Tom Cruise's mother? [A: Mary Lee Pfeiffer]" and the reverse "Who is Mary Lee Pfeiffer's son?". GPT-4 correctly answers questions like the former 79% of the time, compared to 33% for the latter. This shows a failure of logical deduction that we hypothesize is caused by the Reversal Curse. Code is available at https://github.com/lukasberglund/reversal_curse.

Examining User-Friendly and Open-Sourced Large GPT Models: A Survey on Language, Multimodal, and Scientific GPT Models

Generative pre-trained transformer (GPT) models have revolutionized the field of natural language processing (NLP) with remarkable performance in various tasks and also extend their power to multimodal domains. Despite their success, large GPT models like GPT-4 face inherent limitations such as considerable size, high computational requirements, complex deployment processes, and closed development loops. These constraints restrict their widespread adoption and raise concerns regarding their responsible development and usage. The need for user-friendly, relatively small, and open-sourced alternative GPT models arises from the desire to overcome these limitations while retaining high performance. In this survey paper, we provide an examination of alternative open-sourced models of large GPTs, focusing on user-friendly and relatively small models that facilitate easier deployment and accessibility. Through this extensive survey, we aim to equip researchers, practitioners, and enthusiasts with a thorough understanding of user-friendly and relatively small open-sourced models of large GPTs, their current state, challenges, and future research directions, inspiring the development of more efficient, accessible, and versatile GPT models that cater to the broader scientific community and advance the field of general artificial intelligence. The source contents are continuously updating in https://github.com/GPT-Alternatives/gpt_alternatives.

Therapy as an NLP Task: Psychologists' Comparison of LLMs and Human Peers in CBT

Wider access to therapeutic care is one of the biggest challenges in mental health treatment. Due to institutional barriers, some people seeking mental health support have turned to large language models (LLMs) for personalized therapy, even though these models are largely unsanctioned and untested. We investigate the potential and limitations of using LLMs as providers of evidence-based therapy by using mixed methods clinical metrics. Using HELPERT, a prompt run on a large language model using the same process and training as a comparative group of peer counselors, we replicated publicly accessible mental health conversations rooted in Cognitive Behavioral Therapy (CBT) to compare session dynamics and counselor's CBT-based behaviors between original peer support sessions and their reconstructed HELPERT sessions. Two licensed, CBT-trained clinical psychologists evaluated the sessions using the Cognitive Therapy Rating Scale and provided qualitative feedback. Our findings show that the peer sessions are characterized by empathy, small talk, therapeutic alliance, and shared experiences but often exhibit therapist drift. Conversely, HELPERT reconstructed sessions exhibit minimal therapist drift and higher adherence to CBT methods but display a lack of collaboration, empathy, and cultural understanding. Through CTRS ratings and psychologists' feedback, we highlight the importance of human-AI collaboration for scalable mental health. Our work outlines the ethical implication of imparting human-like subjective qualities to LLMs in therapeutic settings, particularly the risk of deceptive empathy, which may lead to unrealistic patient expectations and potential harm.

A Complete Survey on Generative AI (AIGC): Is ChatGPT from GPT-4 to GPT-5 All You Need?

As ChatGPT goes viral, generative AI (AIGC, a.k.a AI-generated content) has made headlines everywhere because of its ability to analyze and create text, images, and beyond. With such overwhelming media coverage, it is almost impossible for us to miss the opportunity to glimpse AIGC from a certain angle. In the era of AI transitioning from pure analysis to creation, it is worth noting that ChatGPT, with its most recent language model GPT-4, is just a tool out of numerous AIGC tasks. Impressed by the capability of the ChatGPT, many people are wondering about its limits: can GPT-5 (or other future GPT variants) help ChatGPT unify all AIGC tasks for diversified content creation? Toward answering this question, a comprehensive review of existing AIGC tasks is needed. As such, our work comes to fill this gap promptly by offering a first look at AIGC, ranging from its techniques to applications. Modern generative AI relies on various technical foundations, ranging from model architecture and self-supervised pretraining to generative modeling methods (like GAN and diffusion models). After introducing the fundamental techniques, this work focuses on the technological development of various AIGC tasks based on their output type, including text, images, videos, 3D content, etc., which depicts the full potential of ChatGPT's future. Moreover, we summarize their significant applications in some mainstream industries, such as education and creativity content. Finally, we discuss the challenges currently faced and present an outlook on how generative AI might evolve in the near future.

Towards Conversational Diagnostic AI

At the heart of medicine lies the physician-patient dialogue, where skillful history-taking paves the way for accurate diagnosis, effective management, and enduring trust. Artificial Intelligence (AI) systems capable of diagnostic dialogue could increase accessibility, consistency, and quality of care. However, approximating clinicians' expertise is an outstanding grand challenge. Here, we introduce AMIE (Articulate Medical Intelligence Explorer), a Large Language Model (LLM) based AI system optimized for diagnostic dialogue. AMIE uses a novel self-play based simulated environment with automated feedback mechanisms for scaling learning across diverse disease conditions, specialties, and contexts. We designed a framework for evaluating clinically-meaningful axes of performance including history-taking, diagnostic accuracy, management reasoning, communication skills, and empathy. We compared AMIE's performance to that of primary care physicians (PCPs) in a randomized, double-blind crossover study of text-based consultations with validated patient actors in the style of an Objective Structured Clinical Examination (OSCE). The study included 149 case scenarios from clinical providers in Canada, the UK, and India, 20 PCPs for comparison with AMIE, and evaluations by specialist physicians and patient actors. AMIE demonstrated greater diagnostic accuracy and superior performance on 28 of 32 axes according to specialist physicians and 24 of 26 axes according to patient actors. Our research has several limitations and should be interpreted with appropriate caution. Clinicians were limited to unfamiliar synchronous text-chat which permits large-scale LLM-patient interactions but is not representative of usual clinical practice. While further research is required before AMIE could be translated to real-world settings, the results represent a milestone towards conversational diagnostic AI.

Applying LLM and Topic Modelling in Psychotherapeutic Contexts

This study explores the use of Large language models to analyze therapist remarks in a psychotherapeutic setting. The paper focuses on the application of BERTopic, a machine learning-based topic modeling tool, to the dialogue of two different groups of therapists (classical and modern), which makes it possible to identify and describe a set of topics that consistently emerge across these groups. The paper describes in detail the chosen algorithm for BERTopic, which included creating a vector space from a corpus of therapist remarks, reducing its dimensionality, clustering the space, and creating and optimizing topic representation. Along with the automatic topical modeling by the BERTopic, the research involved an expert assessment of the findings and manual topic structure optimization. The topic modeling results highlighted the most common and stable topics in therapists speech, offering insights into how language patterns in therapy develop and remain stable across different therapeutic styles. This work contributes to the growing field of machine learning in psychotherapy by demonstrating the potential of automated methods to improve both the practice and training of therapists. The study highlights the value of topic modeling as a tool for gaining a deeper understanding of therapeutic dialogue and offers new opportunities for improving therapeutic effectiveness and clinical supervision.

GPT-4 passes most of the 297 written Polish Board Certification Examinations

Introduction: Recently, the effectiveness of Large Language Models (LLMs) has increased rapidly, allowing them to be used in a great number of applications. However, the risks posed by the generation of false information through LLMs significantly limit their applications in sensitive areas such as healthcare, highlighting the necessity for rigorous validations to determine their utility and reliability. To date, no study has extensively compared the performance of LLMs on Polish medical examinations across a broad spectrum of specialties on a very large dataset. Objectives: This study evaluated the performance of three Generative Pretrained Transformer (GPT) models on the Polish Board Certification Exam (Pa\'nstwowy Egzamin Specjalizacyjny, PES) dataset, which consists of 297 tests. Methods: We developed a software program to download and process PES exams and tested the performance of GPT models using OpenAI Application Programming Interface. Results: Our findings reveal that GPT-3.5 did not pass any of the analyzed exams. In contrast, the GPT-4 models demonstrated the capability to pass the majority of the exams evaluated, with the most recent model, gpt-4-0125, successfully passing 222 (75%) of them. The performance of the GPT models varied significantly, displaying excellence in exams related to certain specialties while completely failing others. Conclusions: The significant progress and impressive performance of LLM models hold great promise for the increased application of AI in the field of medicine in Poland. For instance, this advancement could lead to the development of AI-based medical assistants for healthcare professionals, enhancing the efficiency and accuracy of medical services.

Governance of the AI, by the AI, and for the AI

Over the past half century, there have been several false dawns during which the "arrival" of world-changing artificial intelligence (AI) has been heralded. Tempting fate, the authors believe the age of AI has, indeed, finally arrived. Powerful image generators, such as DALL-E2 and Midjourney have suddenly allowed anyone with access the ability easily to create rich and complex art. In a similar vein, text generators, such as GPT3.5 (including ChatGPT) and BLOOM, allow users to compose detailed written descriptions of many topics of interest. And, it is even possible now for a person without extensive expertise in writing software to use AI to generate code capable of myriad applications. While AI will continue to evolve and improve, probably at a rapid rate, the current state of AI is already ushering in profound changes to many different sectors of society. Every new technology challenges the ability of humanity to govern it wisely. However, governance is usually viewed as both possible and necessary due to the disruption new technology often poses to social structures, industries, the environment, and other important human concerns. In this article, we offer an analysis of a range of interactions between AI and governance, with the hope that wise decisions may be made that maximize benefits and minimize costs. The article addresses two main aspects of this relationship: the governance of AI by humanity, and the governance of humanity by AI. The approach we have taken is itself informed by AI, as this article was written collaboratively by the authors and ChatGPT.

DDXPlus: A New Dataset For Automatic Medical Diagnosis

There has been a rapidly growing interest in Automatic Symptom Detection (ASD) and Automatic Diagnosis (AD) systems in the machine learning research literature, aiming to assist doctors in telemedicine services. These systems are designed to interact with patients, collect evidence about their symptoms and relevant antecedents, and possibly make predictions about the underlying diseases. Doctors would review the interactions, including the evidence and the predictions, collect if necessary additional information from patients, before deciding on next steps. Despite recent progress in this area, an important piece of doctors' interactions with patients is missing in the design of these systems, namely the differential diagnosis. Its absence is largely due to the lack of datasets that include such information for models to train on. In this work, we present a large-scale synthetic dataset of roughly 1.3 million patients that includes a differential diagnosis, along with the ground truth pathology, symptoms and antecedents for each patient. Unlike existing datasets which only contain binary symptoms and antecedents, this dataset also contains categorical and multi-choice symptoms and antecedents useful for efficient data collection. Moreover, some symptoms are organized in a hierarchy, making it possible to design systems able to interact with patients in a logical way. As a proof-of-concept, we extend two existing AD and ASD systems to incorporate the differential diagnosis, and provide empirical evidence that using differentials as training signals is essential for the efficiency of such systems or for helping doctors better understand the reasoning of those systems.

Evaluating the Logical Reasoning Ability of ChatGPT and GPT-4

Harnessing logical reasoning ability is a comprehensive natural language understanding endeavor. With the release of Generative Pretrained Transformer 4 (GPT-4), highlighted as "advanced" at reasoning tasks, we are eager to learn the GPT-4 performance on various logical reasoning tasks. This report analyses multiple logical reasoning datasets, with popular benchmarks like LogiQA and ReClor, and newly-released datasets like AR-LSAT. We test the multi-choice reading comprehension and natural language inference tasks with benchmarks requiring logical reasoning. We further construct a logical reasoning out-of-distribution dataset to investigate the robustness of ChatGPT and GPT-4. We also make a performance comparison between ChatGPT and GPT-4. Experiment results show that ChatGPT performs significantly better than the RoBERTa fine-tuning method on most logical reasoning benchmarks. With early access to the GPT-4 API we are able to conduct intense experiments on the GPT-4 model. The results show GPT-4 yields even higher performance on most logical reasoning datasets. Among benchmarks, ChatGPT and GPT-4 do relatively well on well-known datasets like LogiQA and ReClor. However, the performance drops significantly when handling newly released and out-of-distribution datasets. Logical reasoning remains challenging for ChatGPT and GPT-4, especially on out-of-distribution and natural language inference datasets. We release the prompt-style logical reasoning datasets as a benchmark suite and name it LogiEval.

Multiple Choice Questions and Large Languages Models: A Case Study with Fictional Medical Data

Large Language Models (LLMs) like ChatGPT demonstrate significant potential in the medical field, often evaluated using multiple-choice questions (MCQs) similar to those found on the USMLE. Despite their prevalence in medical education, MCQs have limitations that might be exacerbated when assessing LLMs. To evaluate the effectiveness of MCQs in assessing the performance of LLMs, we developed a fictional medical benchmark focused on a non-existent gland, the Glianorex. This approach allowed us to isolate the knowledge of the LLM from its test-taking abilities. We used GPT-4 to generate a comprehensive textbook on the Glianorex in both English and French and developed corresponding multiple-choice questions in both languages. We evaluated various open-source, proprietary, and domain-specific LLMs using these questions in a zero-shot setting. The models achieved average scores around 67%, with minor performance differences between larger and smaller models. Performance was slightly higher in English than in French. Fine-tuned medical models showed some improvement over their base versions in English but not in French. The uniformly high performance across models suggests that traditional MCQ-based benchmarks may not accurately measure LLMs' clinical knowledge and reasoning abilities, instead highlighting their pattern recognition skills. This study underscores the need for more robust evaluation methods to better assess the true capabilities of LLMs in medical contexts.

Generative Expressive Conversational Speech Synthesis

Conversational Speech Synthesis (CSS) aims to express a target utterance with the proper speaking style in a user-agent conversation setting. Existing CSS methods employ effective multi-modal context modeling techniques to achieve empathy understanding and expression. However, they often need to design complex network architectures and meticulously optimize the modules within them. In addition, due to the limitations of small-scale datasets containing scripted recording styles, they often fail to simulate real natural conversational styles. To address the above issues, we propose a novel generative expressive CSS system, termed GPT-Talker.We transform the multimodal information of the multi-turn dialogue history into discrete token sequences and seamlessly integrate them to form a comprehensive user-agent dialogue context. Leveraging the power of GPT, we predict the token sequence, that includes both semantic and style knowledge, of response for the agent. After that, the expressive conversational speech is synthesized by the conversation-enriched VITS to deliver feedback to the user.Furthermore, we propose a large-scale Natural CSS Dataset called NCSSD, that includes both naturally recorded conversational speech in improvised styles and dialogues extracted from TV shows. It encompasses both Chinese and English languages, with a total duration of 236 hours.We conducted comprehensive experiments on the reliability of the NCSSD and the effectiveness of our GPT-Talker. Both subjective and objective evaluations demonstrate that our model outperforms other state-of-the-art CSS systems significantly in terms of naturalness and expressiveness. The Code, Dataset, and Pre-trained Model are available at: https://github.com/AI-S2-Lab/GPT-Talker.

MathDial: A Dialogue Tutoring Dataset with Rich Pedagogical Properties Grounded in Math Reasoning Problems

While automatic dialogue tutors hold great potential in making education personalized and more accessible, research on such systems has been hampered by a lack of sufficiently large and high-quality datasets. Collecting such datasets remains challenging, as recording tutoring sessions raises privacy concerns and crowdsourcing leads to insufficient data quality. To address this, we propose a framework to generate such dialogues by pairing human teachers with a Large Language Model (LLM) prompted to represent common student errors. We describe how we use this framework to collect MathDial, a dataset of 3k one-to-one teacher-student tutoring dialogues grounded in multi-step math reasoning problems. While models like GPT-3 are good problem solvers, they fail at tutoring because they generate factually incorrect feedback or are prone to revealing solutions to students too early. To overcome this, we let teachers provide learning opportunities to students by guiding them using various scaffolding questions according to a taxonomy of teacher moves. We demonstrate MathDial and its extensive annotations can be used to finetune models to be more effective tutors (and not just solvers). We confirm this by automatic and human evaluation, notably in an interactive setting that measures the trade-off between student solving success and telling solutions. The dataset is released publicly.

Application of NotebookLM, a Large Language Model with Retrieval-Augmented Generation, for Lung Cancer Staging

Purpose: In radiology, large language models (LLMs), including ChatGPT, have recently gained attention, and their utility is being rapidly evaluated. However, concerns have emerged regarding their reliability in clinical applications due to limitations such as hallucinations and insufficient referencing. To address these issues, we focus on the latest technology, retrieval-augmented generation (RAG), which enables LLMs to reference reliable external knowledge (REK). Specifically, this study examines the utility and reliability of a recently released RAG-equipped LLM (RAG-LLM), NotebookLM, for staging lung cancer. Materials and methods: We summarized the current lung cancer staging guideline in Japan and provided this as REK to NotebookLM. We then tasked NotebookLM with staging 100 fictional lung cancer cases based on CT findings and evaluated its accuracy. For comparison, we performed the same task using a gold-standard LLM, GPT-4 Omni (GPT-4o), both with and without the REK. Results: NotebookLM achieved 86% diagnostic accuracy in the lung cancer staging experiment, outperforming GPT-4o, which recorded 39% accuracy with the REK and 25% without it. Moreover, NotebookLM demonstrated 95% accuracy in searching reference locations within the REK. Conclusion: NotebookLM successfully performed lung cancer staging by utilizing the REK, demonstrating superior performance compared to GPT-4o. Additionally, it provided highly accurate reference locations within the REK, allowing radiologists to efficiently evaluate the reliability of NotebookLM's responses and detect possible hallucinations. Overall, this study highlights the potential of NotebookLM, a RAG-LLM, in image diagnosis.

SelfCheckGPT: Zero-Resource Black-Box Hallucination Detection for Generative Large Language Models

Generative Large Language Models (LLMs) such as GPT-3 are capable of generating highly fluent responses to a wide variety of user prompts. However, LLMs are known to hallucinate facts and make non-factual statements which can undermine trust in their output. Existing fact-checking approaches either require access to token-level output probability distribution (which may not be available for systems such as ChatGPT) or external databases that are interfaced via separate, often complex, modules. In this work, we propose "SelfCheckGPT", a simple sampling-based approach that can be used to fact-check black-box models in a zero-resource fashion, i.e. without an external database. SelfCheckGPT leverages the simple idea that if a LLM has knowledge of a given concept, sampled responses are likely to be similar and contain consistent facts. However, for hallucinated facts, stochastically sampled responses are likely to diverge and contradict one another. We investigate this approach by using GPT-3 to generate passages about individuals from the WikiBio dataset, and manually annotate the factuality of the generated passages. We demonstrate that SelfCheckGPT can: i) detect non-factual and factual sentences; and ii) rank passages in terms of factuality. We compare our approach to several existing baselines and show that in sentence hallucination detection, our approach has AUC-PR scores comparable to grey-box methods, while SelfCheckGPT is best at passage factuality assessment.

TaskMatrix.AI: Completing Tasks by Connecting Foundation Models with Millions of APIs

Artificial Intelligence (AI) has made incredible progress recently. On the one hand, advanced foundation models like ChatGPT can offer powerful conversation, in-context learning and code generation abilities on a broad range of open-domain tasks. They can also generate high-level solution outlines for domain-specific tasks based on the common sense knowledge they have acquired. However, they still face difficulties with some specialized tasks because they lack enough domain-specific data during pre-training or they often have errors in their neural network computations on those tasks that need accurate executions. On the other hand, there are also many existing models and systems (symbolic-based or neural-based) that can do some domain-specific tasks very well. However, due to the different implementation or working mechanisms, they are not easily accessible or compatible with foundation models. Therefore, there is a clear and pressing need for a mechanism that can leverage foundation models to propose task solution outlines and then automatically match some of the sub-tasks in the outlines to the off-the-shelf models and systems with special functionalities to complete them. Inspired by this, we introduce TaskMatrix.AI as a new AI ecosystem that connects foundation models with millions of APIs for task completion. Unlike most previous work that aimed to improve a single AI model, TaskMatrix.AI focuses more on using existing foundation models (as a brain-like central system) and APIs of other AI models and systems (as sub-task solvers) to achieve diversified tasks in both digital and physical domains. As a position paper, we will present our vision of how to build such an ecosystem, explain each key component, and use study cases to illustrate both the feasibility of this vision and the main challenges we need to address next.

Toxicity in ChatGPT: Analyzing Persona-assigned Language Models

Large language models (LLMs) have shown incredible capabilities and transcended the natural language processing (NLP) community, with adoption throughout many services like healthcare, therapy, education, and customer service. Since users include people with critical information needs like students or patients engaging with chatbots, the safety of these systems is of prime importance. Therefore, a clear understanding of the capabilities and limitations of LLMs is necessary. To this end, we systematically evaluate toxicity in over half a million generations of ChatGPT, a popular dialogue-based LLM. We find that setting the system parameter of ChatGPT by assigning it a persona, say that of the boxer Muhammad Ali, significantly increases the toxicity of generations. Depending on the persona assigned to ChatGPT, its toxicity can increase up to 6x, with outputs engaging in incorrect stereotypes, harmful dialogue, and hurtful opinions. This may be potentially defamatory to the persona and harmful to an unsuspecting user. Furthermore, we find concerning patterns where specific entities (e.g., certain races) are targeted more than others (3x more) irrespective of the assigned persona, that reflect inherent discriminatory biases in the model. We hope that our findings inspire the broader AI community to rethink the efficacy of current safety guardrails and develop better techniques that lead to robust, safe, and trustworthy AI systems.

The impact of using an AI chatbot to respond to patient messages

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.

ArgMed-Agents: Explainable Clinical Decision Reasoning with LLM Disscusion via Argumentation Schemes

There are two main barriers to using large language models (LLMs) in clinical reasoning. Firstly, while LLMs exhibit significant promise in Natural Language Processing (NLP) tasks, their performance in complex reasoning and planning falls short of expectations. Secondly, LLMs use uninterpretable methods to make clinical decisions that are fundamentally different from the clinician's cognitive processes. This leads to user distrust. In this paper, we present a multi-agent framework called ArgMed-Agents, which aims to enable LLM-based agents to make explainable clinical decision reasoning through interaction. ArgMed-Agents performs self-argumentation iterations via Argumentation Scheme for Clinical Discussion (a reasoning mechanism for modeling cognitive processes in clinical reasoning), and then constructs the argumentation process as a directed graph representing conflicting relationships. Ultimately, use symbolic solver to identify a series of rational and coherent arguments to support decision. We construct a formal model of ArgMed-Agents and present conjectures for theoretical guarantees. ArgMed-Agents enables LLMs to mimic the process of clinical argumentative reasoning by generating explanations of reasoning in a self-directed manner. The setup experiments show that ArgMed-Agents not only improves accuracy in complex clinical decision reasoning problems compared to other prompt methods, but more importantly, it provides users with decision explanations that increase their confidence.

MentalArena: Self-play Training of Language Models for Diagnosis and Treatment of Mental Health Disorders

Mental health disorders are one of the most serious diseases in the world. Most people with such a disease lack access to adequate care, which highlights the importance of training models for the diagnosis and treatment of mental health disorders. However, in the mental health domain, privacy concerns limit the accessibility of personalized treatment data, making it challenging to build powerful models. In this paper, we introduce MentalArena, a self-play framework to train language models by generating domain-specific personalized data, where we obtain a better model capable of making a personalized diagnosis and treatment (as a therapist) and providing information (as a patient). To accurately model human-like mental health patients, we devise Symptom Encoder, which simulates a real patient from both cognition and behavior perspectives. To address intent bias during patient-therapist interactions, we propose Symptom Decoder to compare diagnosed symptoms with encoded symptoms, and dynamically manage the dialogue between patient and therapist according to the identified deviations. We evaluated MentalArena against 6 benchmarks, including biomedicalQA and mental health tasks, compared to 6 advanced models. Our models, fine-tuned on both GPT-3.5 and Llama-3-8b, significantly outperform their counterparts, including GPT-4o. We hope that our work can inspire future research on personalized care. Code is available in https://github.com/Scarelette/MentalArena/tree/main

Facilitating Pornographic Text Detection for Open-Domain Dialogue Systems via Knowledge Distillation of Large Language Models

Pornographic content occurring in human-machine interaction dialogues can cause severe side effects for users in open-domain dialogue systems. However, research on detecting pornographic language within human-machine interaction dialogues is an important subject that is rarely studied. To advance in this direction, we introduce CensorChat, a dialogue monitoring dataset aimed at detecting whether the dialogue session contains pornographic content. To this end, we collect real-life human-machine interaction dialogues in the wild and break them down into single utterances and single-turn dialogues, with the last utterance spoken by the chatbot. We propose utilizing knowledge distillation of large language models to annotate the dataset. Specifically, first, the raw dataset is annotated by four open-source large language models, with the majority vote determining the label. Second, we use ChatGPT to update the empty label from the first step. Third, to ensure the quality of the validation and test sets, we utilize GPT-4 for label calibration. If the current label does not match the one generated by GPT-4, we employ a self-criticism strategy to verify its correctness. Finally, to facilitate the detection of pornographic text, we develop a series of text classifiers using a pseudo-labeled dataset. Detailed data analysis demonstrates that leveraging knowledge distillation techniques with large language models provides a practical and cost-efficient method for developing pornographic text detectors.

Clinical Camel: An Open-Source Expert-Level Medical Language Model with Dialogue-Based Knowledge Encoding

Large Language Models (LLMs) present immense potential in the medical field, yet concerns over data privacy, regulatory compliance, and model stability restrict their widespread adoption. Although the distillation of high-performing closed-source LLMs has proven effective for general tasks, their application in healthcare is limited due to reduced domain knowledge and remnants of alignment behavior hindering clinical tasks. To address these challenges, we propose Dialogue-Based Knowledge Encoding (DBKE). DBKE enhances models' implicit knowledge base and primes them for conversational recall, augmenting their conversational capabilities and enabling a soft alignment for subsequent use cases. By transforming dense academic source text into synthetic dialogue, DBKE broadens the model's knowledge base and enables a soft alignment that guides downstream behaviours. We present Clinical Camel, an open-source, healthcare-focused conversational model, to showcase the effectiveness of DBKE. Clinical Camel outperforms GPT-3.5 on the United States Medical Licensing Examination (USMLE) Step 1 and Step 3 with scores of 53.2 % and 58.2 %, respectively, compared to GPT-3.5's scores of 36.1 % and 55.7 %. Clinical Camel adeptly handles multi-stage clinical case problems, provides adaptive counseling, and generates clinical notes. However, it is prone to hallucinations, which pose a significant obstacle in safety-critical settings. The performance of Clinical Camel underscores the importance of continued research and development of open-source models for the safe and effective integration of LLMs in healthcare settings.

DeID-GPT: Zero-shot Medical Text De-Identification by GPT-4

The digitization of healthcare has facilitated the sharing and re-using of medical data but has also raised concerns about confidentiality and privacy. HIPAA (Health Insurance Portability and Accountability Act) mandates removing re-identifying information before the dissemination of medical records. Thus, effective and efficient solutions for de-identifying medical data, especially those in free-text forms, are highly needed. While various computer-assisted de-identification methods, including both rule-based and learning-based, have been developed and used in prior practice, such solutions still lack generalizability or need to be fine-tuned according to different scenarios, significantly imposing restrictions in wider use. The advancement of large language models (LLM), such as ChatGPT and GPT-4, have shown great potential in processing text data in the medical domain with zero-shot in-context learning, especially in the task of privacy protection, as these models can identify confidential information by their powerful named entity recognition (NER) capability. In this work, we developed a novel GPT4-enabled de-identification framework (``DeID-GPT") to automatically identify and remove the identifying information. Compared to existing commonly used medical text data de-identification methods, our developed DeID-GPT showed the highest accuracy and remarkable reliability in masking private information from the unstructured medical text while preserving the original structure and meaning of the text. This study is one of the earliest to utilize ChatGPT and GPT-4 for medical text data processing and de-identification, which provides insights for further research and solution development on the use of LLMs such as ChatGPT/GPT-4 in healthcare. Codes and benchmarking data information are available at https://github.com/yhydhx/ChatGPT-API.

Encouraging Divergent Thinking in Large Language Models through Multi-Agent Debate

Modern large language models (LLMs) like ChatGPT have shown remarkable performance on general language tasks but still struggle on complex reasoning tasks, which drives the research on cognitive behaviors of LLMs to explore human-like problem-solving strategies. Along this direction, one representative strategy is self-reflection, which asks an LLM to refine the solution with the feedback generated by itself iteratively. However, our study shows that such reflection-style methods suffer from the Degeneration-of-Thought (DoT) problem: once the LLM has established confidence in its solutions, it is unable to generate novel thoughts later through reflection even if its initial stance is incorrect. To address the DoT problem, we propose a Multi-Agent Debate (MAD) framework, in which multiple agents express their arguments in the state of "tit for tat" and a judge manages the debate process to obtain a final solution. Clearly, our MAD framework encourages divergent thinking in LLMs which would be helpful for tasks that require deep levels of contemplation. Experiment results on two challenging datasets, commonsense machine translation and counter-intuitive arithmetic reasoning, demonstrate the effectiveness of our MAD framework. Extensive analyses suggest that the adaptive break of debate and the modest level of "tit for tat" state are required for MAD to obtain good performance. Moreover, we find that LLMs might not be a fair judge if different LLMs are used for agents. Codes: https://github.com/Skytliang/Multi-Agents-Debate

A Multitask, Multilingual, Multimodal Evaluation of ChatGPT on Reasoning, Hallucination, and Interactivity

This paper proposes a framework for quantitatively evaluating interactive LLMs such as ChatGPT using publicly available data sets. We carry out an extensive technical evaluation of ChatGPT using 23 data sets covering 8 different common NLP application tasks. We evaluate the multitask, multilingual and multi-modal aspects of ChatGPT based on these data sets and a newly designed multimodal dataset. We find that ChatGPT outperforms LLMs with zero-shot learning on most tasks and even outperforms fine-tuned models on some tasks. We find that it is better at understanding non-Latin script languages than generating them. It is able to generate multimodal content from textual prompts, via an intermediate code generation step. Moreover, we find that ChatGPT is 63.41% accurate on average in 10 different reasoning categories under logical reasoning, non-textual reasoning, and commonsense reasoning, hence making it an unreliable reasoner. It is, for example, better at deductive than inductive reasoning. ChatGPT suffers from hallucination problems like other LLMs and it generates more extrinsic hallucinations from its parametric memory as it does not have access to an external knowledge base. Finally, the interactive feature of ChatGPT enables human collaboration with the underlying LLM to improve its performance, i.e, 8% ROUGE-1 on summarization and 2% ChrF++ on machine translation, in a multi-turn "prompt engineering" fashion. We also release codebase for evaluation set extraction.

The political ideology of conversational AI: Converging evidence on ChatGPT's pro-environmental, left-libertarian orientation

Conversational artificial intelligence (AI) disrupts how humans interact with technology. Recently, OpenAI introduced ChatGPT, a state-of-the-art dialogue model that can converse with its human counterparts with unprecedented capabilities. ChatGPT has witnessed tremendous attention from the media, academia, industry, and the general public, attracting more than a million users within days of its release. However, its explosive adoption for information search and as an automated decision aid underscores the importance to understand its limitations and biases. This paper focuses on one of democratic society's most important decision-making processes: political elections. Prompting ChatGPT with 630 political statements from two leading voting advice applications and the nation-agnostic political compass test in three pre-registered experiments, we uncover ChatGPT's pro-environmental, left-libertarian ideology. For example, ChatGPT would impose taxes on flights, restrict rent increases, and legalize abortion. In the 2021 elections, it would have voted most likely for the Greens both in Germany (B\"undnis 90/Die Gr\"unen) and in the Netherlands (GroenLinks). Our findings are robust when negating the prompts, reversing the order of the statements, varying prompt formality, and across languages (English, German, Dutch, and Spanish). We conclude by discussing the implications of politically biased conversational AI on society.

ChatCAD: Interactive Computer-Aided Diagnosis on Medical Image using Large Language Models

Large language models (LLMs) have recently demonstrated their potential in clinical applications, providing valuable medical knowledge and advice. For example, a large dialog LLM like ChatGPT has successfully passed part of the US medical licensing exam. However, LLMs currently have difficulty processing images, making it challenging to interpret information from medical images, which are rich in information that supports clinical decisions. On the other hand, computer-aided diagnosis (CAD) networks for medical images have seen significant success in the medical field by using advanced deep-learning algorithms to support clinical decision-making. This paper presents a method for integrating LLMs into medical-image CAD networks. The proposed framework uses LLMs to enhance the output of multiple CAD networks, such as diagnosis networks, lesion segmentation networks, and report generation networks, by summarizing and reorganizing the information presented in natural language text format. The goal is to merge the strengths of LLMs' medical domain knowledge and logical reasoning with the vision understanding capability of existing medical-image CAD models to create a more user-friendly and understandable system for patients compared to conventional CAD systems. In the future, LLM's medical knowledge can be also used to improve the performance of vision-based medical-image CAD models.

Zhongjing: Enhancing the Chinese Medical Capabilities of Large Language Model through Expert Feedback and Real-world Multi-turn Dialogue

Recent advances in Large Language Models (LLMs) have achieved remarkable breakthroughs in understanding and responding to user intents. However, their performance lag behind general use cases in some expertise domains, such as Chinese medicine. Existing efforts to incorporate Chinese medicine into LLMs rely on Supervised Fine-Tuning (SFT) with single-turn and distilled dialogue data. These models lack the ability for doctor-like proactive inquiry and multi-turn comprehension and cannot align responses with experts' intentions. In this work, we introduce Zhongjing, the first Chinese medical LLaMA-based LLM that implements an entire training pipeline from continuous pre-training, SFT, to Reinforcement Learning from Human Feedback (RLHF). Additionally, we construct a Chinese multi-turn medical dialogue dataset of 70,000 authentic doctor-patient dialogues, CMtMedQA, which significantly enhances the model's capability for complex dialogue and proactive inquiry initiation. We also define a refined annotation rule and evaluation criteria given the unique characteristics of the biomedical domain. Extensive experimental results show that Zhongjing outperforms baselines in various capacities and matches the performance of ChatGPT in some abilities, despite the 100x parameters. Ablation studies also demonstrate the contributions of each component: pre-training enhances medical knowledge, and RLHF further improves instruction-following ability and safety. Our code, datasets, and models are available at https://github.com/SupritYoung/Zhongjing.

ChatGPT as your Personal Data Scientist

The rise of big data has amplified the need for efficient, user-friendly automated machine learning (AutoML) tools. However, the intricacy of understanding domain-specific data and defining prediction tasks necessitates human intervention making the process time-consuming while preventing full automation. Instead, envision an intelligent agent capable of assisting users in conducting AutoML tasks through intuitive, natural conversations without requiring in-depth knowledge of the underlying machine learning (ML) processes. This agent's key challenge is to accurately comprehend the user's prediction goals and, consequently, formulate precise ML tasks, adjust data sets and model parameters accordingly, and articulate results effectively. In this paper, we take a pioneering step towards this ambitious goal by introducing a ChatGPT-based conversational data-science framework to act as a "personal data scientist". Precisely, we utilize Large Language Models (ChatGPT) to build a natural interface between the users and the ML models (Scikit-Learn), which in turn, allows us to approach this ambitious problem with a realistic solution. Our model pivots around four dialogue states: Data Visualization, Task Formulation, Prediction Engineering, and Result Summary and Recommendation. Each state marks a unique conversation phase, impacting the overall user-system interaction. Multiple LLM instances, serving as "micro-agents", ensure a cohesive conversation flow, granting us granular control over the conversation's progression. In summary, we developed an end-to-end system that not only proves the viability of the novel concept of conversational data science but also underscores the potency of LLMs in solving complex tasks. Interestingly, its development spotlighted several critical weaknesses in the current LLMs (ChatGPT) and highlighted substantial opportunities for improvement.

Exploring the Inquiry-Diagnosis Relationship with Advanced Patient Simulators

Online medical consultation (OMC) restricts doctors to gathering patient information solely through inquiries, making the already complex sequential decision-making process of diagnosis even more challenging. Recently, the rapid advancement of large language models has demonstrated a significant potential to transform OMC. However, most studies have primarily focused on improving diagnostic accuracy under conditions of relatively sufficient information, while paying limited attention to the "inquiry" phase of the consultation process. This lack of focus has left the relationship between "inquiry" and "diagnosis" insufficiently explored. In this paper, we first extract real patient interaction strategies from authentic doctor-patient conversations and use these strategies to guide the training of a patient simulator that closely mirrors real-world behavior. By inputting medical records into our patient simulator to simulate patient responses, we conduct extensive experiments to explore the relationship between "inquiry" and "diagnosis" in the consultation process. Experimental results demonstrate that inquiry and diagnosis adhere to the Liebig's law: poor inquiry quality limits the effectiveness of diagnosis, regardless of diagnostic capability, and vice versa. Furthermore, the experiments reveal significant differences in the inquiry performance of various models. To investigate this phenomenon, we categorize the inquiry process into four types: (1) chief complaint inquiry; (2) specification of known symptoms; (3) inquiry about accompanying symptoms; and (4) gathering family or medical history. We analyze the distribution of inquiries across the four types for different models to explore the reasons behind their significant performance differences. We plan to open-source the weights and related code of our patient simulator at https://github.com/LIO-H-ZEN/PatientSimulator.

Revolutionizing Finance with LLMs: An Overview of Applications and Insights

In recent years, Large Language Models (LLMs) like ChatGPT have seen considerable advancements and have been applied in diverse fields. Built on the Transformer architecture, these models are trained on extensive datasets, enabling them to understand and generate human language effectively. In the financial domain, the deployment of LLMs is gaining momentum. These models are being utilized for automating financial report generation, forecasting market trends, analyzing investor sentiment, and offering personalized financial advice. Leveraging their natural language processing capabilities, LLMs can distill key insights from vast financial data, aiding institutions in making informed investment choices and enhancing both operational efficiency and customer satisfaction. In this study, we provide a comprehensive overview of the emerging integration of LLMs into various financial tasks. Additionally, we conducted holistic tests on multiple financial tasks through the combination of natural language instructions. Our findings show that GPT-4 effectively follow prompt instructions across various financial tasks. This survey and evaluation of LLMs in the financial domain aim to deepen the understanding of LLMs' current role in finance for both financial practitioners and LLM researchers, identify new research and application prospects, and highlight how these technologies can be leveraged to solve practical challenges in the finance industry.

Not All Large Language Models (LLMs) Succumb to the "Reversal Curse": A Comparative Study of Deductive Logical Reasoning in BERT and GPT Models

The "Reversal Curse" refers to the scenario where auto-regressive decoder large language models (LLMs), such as ChatGPT, trained on "A is B" fail to learn "B is A", demonstrating a basic failure of logical deduction. This raises a red flag in the use of GPT models for certain general tasks such as constructing knowledge graphs, considering their adherence to this symmetric principle. In our study, we examined a bidirectional LLM, BERT, and found that it is immune to the reversal curse. Driven by ongoing efforts to construct biomedical knowledge graphs with LLMs, we also embarked on evaluating more complex but essential deductive reasoning capabilities. This process included first training encoder and decoder language models to master the intersection (cap) and union (cup) operations on two sets and then moving on to assess their capability to infer different combinations of union (cup) and intersection (cap) operations on three newly created sets. The findings showed that while both encoder and decoder language models, trained for tasks involving two sets (union/intersection), were proficient in such scenarios, they encountered difficulties when dealing with operations that included three sets (various combinations of union and intersection). Our research highlights the distinct characteristics of encoder and decoder models in simple and complex logical reasoning. In practice, the choice between BERT and GPT should be guided by the specific requirements and nature of the task at hand, leveraging their respective strengths in bidirectional context comprehension and sequence prediction.

Automated speech- and text-based classification of neuropsychiatric conditions in a multidiagnostic setting

Speech patterns have been identified as potential diagnostic markers for neuropsychiatric conditions. However, most studies only compare a single clinical group to healthy controls, whereas clinical practice often requires differentiating between multiple potential diagnoses (multiclass settings). To address this, we assembled a dataset of repeated recordings from 420 participants (67 with major depressive disorder, 106 with schizophrenia and 46 with autism, as well as matched controls), and tested the performance of a range of conventional machine learning models and advanced Transformer models on both binary and multiclass classification, based on voice and text features. While binary models performed comparably to previous research (F1 scores between 0.54-0.75 for autism spectrum disorder, ASD; 0.67-0.92 for major depressive disorder, MDD; and 0.71-0.83 for schizophrenia); when differentiating between multiple diagnostic groups performance decreased markedly (F1 scores between 0.35-0.44 for ASD, 0.57-0.75 for MDD, 0.15-0.66 for schizophrenia, and 0.38-0.52 macro F1). Combining voice and text-based models yielded increased performance, suggesting that they capture complementary diagnostic information. Our results indicate that models trained on binary classification may learn to rely on markers of generic differences between clinical and non-clinical populations, or markers of clinical features that overlap across conditions, rather than identifying markers specific to individual conditions. We provide recommendations for future research in the field, suggesting increased focus on developing larger transdiagnostic datasets that include more fine-grained clinical features, and that can support the development of models that better capture the complexity of neuropsychiatric conditions and naturalistic diagnostic assessment.

BioMedGPT: Open Multimodal Generative Pre-trained Transformer for BioMedicine

Foundation models (FMs) have exhibited remarkable performance across a wide range of downstream tasks in many domains. Nevertheless, general-purpose FMs often face challenges when confronted with domain-specific problems, due to their limited access to the proprietary training data in a particular domain. In biomedicine, there are various biological modalities, such as molecules, proteins, and cells, which are encoded by the language of life and exhibit significant modality gaps with human natural language. In this paper, we introduce BioMedGPT, an open multimodal generative pre-trained transformer (GPT) for biomedicine, to bridge the gap between the language of life and human natural language. BioMedGPT allows users to easily ``communicate'' with diverse biological modalities through free text, which is the first of its kind. BioMedGPT aligns different biological modalities with natural language via a large generative language model, namely, BioMedGPT-LM. We publish BioMedGPT-10B, which unifies the feature spaces of molecules, proteins, and natural language via encoding and alignment. Through fine-tuning, BioMedGPT-10B outperforms or is on par with human and significantly larger general-purpose foundation models on the biomedical QA task. It also demonstrates promising performance in the molecule QA and protein QA tasks, which could greatly accelerate the discovery of new drugs and therapeutic targets. In addition, BioMedGPT-LM-7B is the first large generative language model based on Llama2 in the biomedical domain, therefore is commercial friendly. Both BioMedGPT-10B and BioMedGPT-LM-7B are open-sourced to the research community. In addition, we publish the datasets that are meticulously curated for the alignment of multi-modalities, i.e., PubChemQA and UniProtQA. All the models, codes, and datasets are available at https://github.com/PharMolix/OpenBioMed.

PathAsst: A Generative Foundation AI Assistant Towards Artificial General Intelligence of Pathology

As advances in large language models (LLMs) and multimodal techniques continue to mature, the development of general-purpose multimodal large language models (MLLMs) has surged, offering significant applications in interpreting natural images. However, the field of pathology has largely remained untapped, particularly in gathering high-quality data and designing comprehensive model frameworks. To bridge the gap in pathology MLLMs, we present PathAsst, a multimodal generative foundation AI assistant to revolutionize diagnostic and predictive analytics in pathology. The development of PathAsst involves three pivotal steps: data acquisition, CLIP model adaptation, and the training of PathAsst's multimodal generative capabilities. Firstly, we collect over 207K high-quality pathology image-text pairs from authoritative sources. Leveraging the advanced power of ChatGPT, we generate over 180K instruction-following samples. Furthermore, we devise additional instruction-following data specifically tailored for invoking eight pathology-specific sub-models we prepared, allowing the PathAsst to effectively collaborate with these models, enhancing its diagnostic ability. Secondly, by leveraging the collected data, we construct PathCLIP, a pathology-dedicated CLIP, to enhance PathAsst's capabilities in interpreting pathology images. Finally, we integrate PathCLIP with the Vicuna-13b and utilize pathology-specific instruction-tuning data to enhance the multimodal generation capacity of PathAsst and bolster its synergistic interactions with sub-models. The experimental results of PathAsst show the potential of harnessing AI-powered generative foundation model to improve pathology diagnosis and treatment processes.