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Mar 13

Context Clues: Evaluating Long Context Models for Clinical Prediction Tasks on EHRs

Foundation Models (FMs) trained on Electronic Health Records (EHRs) have achieved state-of-the-art results on numerous clinical prediction tasks. However, most existing EHR FMs have context windows of <1k tokens. This prevents them from modeling full patient EHRs which can exceed 10k's of events. Recent advancements in subquadratic long-context architectures (e.g., Mamba) offer a promising solution. However, their application to EHR data has not been well-studied. We address this gap by presenting the first systematic evaluation of the effect of context length on modeling EHR data. We find that longer context models improve predictive performance -- our Mamba-based model surpasses the prior state-of-the-art on 9/14 tasks on the EHRSHOT prediction benchmark. For clinical applications, however, model performance alone is insufficient -- robustness to the unique properties of EHR is crucial. Thus, we also evaluate models across three previously underexplored properties of EHR data: (1) the prevalence of "copy-forwarded" diagnoses which creates artificial repetition of tokens within EHR sequences; (2) the irregular time intervals between EHR events which can lead to a wide range of timespans within a context window; and (3) the natural increase in disease complexity over time which makes later tokens in the EHR harder to predict than earlier ones. Stratifying our EHRSHOT results, we find that higher levels of each property correlate negatively with model performance, but that longer context models are more robust to more extreme levels of these properties. Our work highlights the potential for using long-context architectures to model EHR data, and offers a case study for identifying new challenges in modeling sequential data motivated by domains outside of natural language. We release our models and code at: https://github.com/som-shahlab/long_context_clues

Revisiting Referring Expression Comprehension Evaluation in the Era of Large Multimodal Models

Referring expression comprehension (REC) involves localizing a target instance based on a textual description. Recent advancements in REC have been driven by large multimodal models (LMMs) like CogVLM, which achieved 92.44% accuracy on RefCOCO. However, this study questions whether existing benchmarks such as RefCOCO, RefCOCO+, and RefCOCOg, capture LMMs' comprehensive capabilities. We begin with a manual examination of these benchmarks, revealing high labeling error rates: 14% in RefCOCO, 24% in RefCOCO+, and 5% in RefCOCOg, which undermines the authenticity of evaluations. We address this by excluding problematic instances and reevaluating several LMMs capable of handling the REC task, showing significant accuracy improvements, thus highlighting the impact of benchmark noise. In response, we introduce Ref-L4, a comprehensive REC benchmark, specifically designed to evaluate modern REC models. Ref-L4 is distinguished by four key features: 1) a substantial sample size with 45,341 annotations; 2) a diverse range of object categories with 365 distinct types and varying instance scales from 30 to 3,767; 3) lengthy referring expressions averaging 24.2 words; and 4) an extensive vocabulary comprising 22,813 unique words. We evaluate a total of 24 large models on Ref-L4 and provide valuable insights. The cleaned versions of RefCOCO, RefCOCO+, and RefCOCOg, as well as our Ref-L4 benchmark and evaluation code, are available at https://github.com/JierunChen/Ref-L4.

Scaling may be all you need for achieving human-level object recognition capacity with human-like visual experience

This paper asks whether current self-supervised learning methods, if sufficiently scaled up, would be able to reach human-level visual object recognition capabilities with the same type and amount of visual experience humans learn from. Previous work on this question only considered the scaling of data size. Here, we consider the simultaneous scaling of data size, model size, and image resolution. We perform a scaling experiment with vision transformers up to 633M parameters in size (ViT-H/14) trained with up to 5K hours of human-like video data (long, continuous, mostly egocentric videos) with image resolutions of up to 476x476 pixels. The efficiency of masked autoencoders (MAEs) as a self-supervised learning algorithm makes it possible to run this scaling experiment on an unassuming academic budget. We find that it is feasible to reach human-level object recognition capacity at sub-human scales of model size, data size, and image size, if these factors are scaled up simultaneously. To give a concrete example, we estimate that a 2.5B parameter ViT model trained with 20K hours (2.3 years) of human-like video data with a spatial resolution of 952x952 pixels should be able to reach roughly human-level accuracy on ImageNet. Human-level competence is thus achievable for a fundamental perceptual capability from human-like perceptual experience (human-like in both amount and type) with extremely generic learning algorithms and architectures and without any substantive inductive biases.