Large language models (LLMs) have demonstrated impressive capabilities in natural language understanding and generation, but the quality bar for medical and clinical applications is high. Today, attempts to assess models' clinical knowledge typically rely on automated evaluations on limited benchmarks. There is no standard to evaluate model predictions and reasoning across a breadth of tasks. To address this, we present MultiMedQA, a benchmark combining six existing open question answering datasets spanning professional medical exams, research, and consumer queries; and HealthSearchQA, a new free-response dataset of medical questions searched online. We propose a framework for human evaluation of model answers along multiple axes including factuality, precision, possible harm, and bias. In addition, we evaluate PaLM (a 540-billion parameter LLM) and its instruction-tuned variant, Flan-PaLM, on MultiMedQA. Using a combination of prompting strategies, Flan-PaLM achieves state-of-the-art accuracy on every MultiMedQA multiple-choice dataset (MedQA, MedMCQA, PubMedQA, MMLU clinical topics), including 67.6% accuracy on MedQA (US Medical License Exam questions), surpassing prior state-of-the-art by over 17%. However, human evaluation reveals key gaps in Flan-PaLM responses. To resolve this we introduce instruction prompt tuning, a parameter-efficient approach for aligning LLMs to new domains using a few exemplars. The resulting model, Med-PaLM, performs encouragingly, but remains inferior to clinicians. We show that comprehension, recall of knowledge, and medical reasoning improve with model scale and instruction prompt tuning, suggesting the potential utility of LLMs in medicine. Our human evaluations reveal important limitations of today's models, reinforcing the importance of both evaluation frameworks and method development in creating safe, helpful LLM models for clinical applications.

机器学习（ML）具有改善医疗保健的巨大希望，但至关重要的是要确保其使用不会传播或扩大健康差异。一个重要的步骤是表征ML模型的（联合国）公平性 - 它们在人群的亚组中的表现趋势不同，并了解其潜在机制。当ML模拟培训数据中不正确相关性的基本预测时，就会出现算法不公平，快捷学习的潜在驱动力。但是，诊断这种现象很困难，尤其是当敏感属性与疾病有因果关系时。使用多任务学习，我们提出了第一种评估和减轻快捷方式学习的方法，作为临床ML系统公平评估的一部分，并证明了其在放射学和皮肤病学中的临床任务中的应用。最后，我们的方法揭示了捷径对不公平不公平负责的情况，强调了对医疗AI中的公平缓解的必要性。

自动生物医学图像分析的领域至关重要地取决于算法验证的可靠和有意义的性能指标。但是，当前的度量使用通常是不明智的，并且不能反映基本的域名。在这里，我们提出了一个全面的框架，该框架指导研究人员以问题意识的方式选择绩效指标。具体而言，我们专注于生物医学图像分析问题，这些问题可以解释为图像，对象或像素级别的分类任务。该框架首先编译域兴趣 - 目标结构 - ，数据集和算法与输出问题相关的属性的属性与问题指纹相关，同时还将其映射到适当的问题类别，即图像级分类，语义分段，实例，实例细分或对象检测。然后，它指导用户选择和应用一组适当的验证指标的过程，同时使他们意识到与个人选择相关的潜在陷阱。在本文中，我们描述了指标重新加载推荐框架的当前状态，目的是从图像分析社区获得建设性的反馈。当前版本是在由60多个图像分析专家的国际联盟中开发的，将在社区驱动的优化之后公开作为用户友好的工具包提供。

医疗人工智能（AI）的最新进展已提供了可以达到临床专家水平绩效的系统。但是，当在与训练环境不同的临床环境中评估时，这种系统往往会证明次优的“分布式”性能。一种常见的缓解策略是使用特定地点数据为每个临床环境开发单独的系统[1]。但是，这很快变得不切实际，因为医疗数据很耗时，可以注释且昂贵[2]。因此，“数据有效概括”的问题给医学AI开发带来了持续的困难。尽管代表性学习的进展显示出希望，但并未对其好处进行严格的研究，特别是用于分布的设置。为了应对这些挑战，我们提出了RESEDIS，这是一种统一的代表学习策略，以提高医学成像AI的鲁棒性和数据效率。雷雷迪斯使用大规模监督转移学习与自我监督学习的通用组合，几乎不需要特定于任务的自定义。我们研究各种医学成像任务，并使用回顾性数据模拟三个现实的应用程序场景。 RESEDIS表现出明显改善的分布性能，而在强有力的基线上，诊断准确性相对相对提高了11.5％。更重要的是，我们的策略会导致对医学成像AI的强大数据有效的概括，并使用跨任务的1％至33％的重新培训数据匹配强有力的监督基线。这些结果表明，Repedis可以显着加速医学成像AI开发的生命周期，从而为医学成像AI提供了重要的一步，以产生广泛的影响。

尽管自动图像分析的重要性不断增加，但最近的元研究揭示了有关算法验证的主要缺陷。性能指标对于使用的自动算法的有意义，客观和透明的性能评估和验证尤其是关键，但是在使用特定的指标进行给定的图像分析任务时，对实际陷阱的关注相对较少。这些通常与（1）无视固有的度量属性，例如在存在类不平衡或小目标结构的情况下的行为，（2）无视固有的数据集属性，例如测试的非独立性案例和（3）无视指标应反映的实际生物医学领域的兴趣。该动态文档的目的是说明图像分析领域通常应用的性能指标的重要局限性。在这种情况下，它重点介绍了可以用作图像级分类，语义分割，实例分割或对象检测任务的生物医学图像分析问题。当前版本是基于由全球60多家机构的国际图像分析专家进行的关于指标的Delphi流程。

An increasing number of public datasets have shown a marked clinical impact on assessing anatomical structures. However, each of the datasets is small, partially labeled, and rarely investigates severe tumor subjects. Moreover, current models are limited to segmenting specific organs/tumors, which can not be extended to novel domains and classes. To tackle these limitations, we introduce embedding learned from Contrastive Language-Image Pre-training (CLIP) to segmentation models, dubbed the CLIP-Driven Universal Model. The Universal Model can better segment 25 organs and 6 types of tumors by exploiting the semantic relationship between abdominal structures. The model is developed from an assembly of 14 datasets with 3,410 CT scans and evaluated on 6,162 external CT scans from 3 datasets. We rank first on the public leaderboard of the Medical Segmentation Decathlon (MSD) and achieve the state-of-the-art results on Beyond The Cranial Vault (BTCV). Compared with dataset-specific models, the Universal Model is computationally more efficient (6x faster), generalizes better to CT scans from varying sites, and shows stronger transfer learning performance on novel tasks. The design of CLIP embedding enables the Universal Model to be easily extended to new classes without catastrophically forgetting the previously learned classes.

In this work, we tackle two vital tasks in automated driving systems, i.e., driver intent prediction and risk object identification from egocentric images. Mainly, we investigate the question: what would be good road scene-level representations for these two tasks? We contend that a scene-level representation must capture higher-level semantic and geometric representations of traffic scenes around ego-vehicle while performing actions to their destinations. To this end, we introduce the representation of semantic regions, which are areas where ego-vehicles visit while taking an afforded action (e.g., left-turn at 4-way intersections). We propose to learn scene-level representations via a novel semantic region prediction task and an automatic semantic region labeling algorithm. Extensive evaluations are conducted on the HDD and nuScenes datasets, and the learned representations lead to state-of-the-art performance for driver intention prediction and risk object identification.

This paper presents a simple and effective visual prompting method for adapting pre-trained models to downstream recognition tasks. Our method includes two key designs. First, rather than directly adding together the prompt and the image, we treat the prompt as an extra and independent learnable component. We show that the strategy of reconciling the prompt and the image matters, and find that warping the prompt around a properly shrinked image empirically works the best. Second, we re-introduce two "old tricks" commonly used in building transferable adversarial examples, i.e., input diversity and gradient normalization, into visual prompting. These techniques improve optimization and enable the prompt to generalize better. We provide extensive experimental results to demonstrate the effectiveness of our method. Using a CLIP model, our prompting method sets a new record of 82.8% average accuracy across 12 popular classification datasets, substantially surpassing the prior art by +5.6%. It is worth noting that this prompting performance already outperforms linear probing by +2.1% and can even match fully fine-tuning in certain datasets. In addition, our prompting method shows competitive performance across different data scales and against distribution shifts. The code is publicly available at https://github.com/UCSC-VLAA/EVP.

Named Entity Recognition (NER) is an important and well-studied task in natural language processing. The classic CoNLL-2003 English dataset, published almost 20 years ago, is commonly used to train and evaluate named entity taggers. The age of this dataset raises the question of how well these models perform when applied to modern data. In this paper, we present CoNLL++, a new annotated test set that mimics the process used to create the original CoNLL-2003 test set as closely as possible, except with data collected from 2020. Using CoNLL++, we evaluate the generalization of 20+ different models to modern data. We observe that different models have very different generalization behavior. F\textsubscript{1} scores of large transformer-based models which are pre-trained on recent data dropped much less than models using static word embeddings, and RoBERTa-based and T5 models achieve comparable F\textsubscript{1} scores on both CoNLL-2003 and CoNLL++. Our experiments show that achieving good generalizability requires a combined effort of developing larger models and continuing pre-training with in-domain and recent data. These results suggest standard evaluation methodology may have under-estimated progress on named entity recognition over the past 20 years; in addition to improving performance on the original CoNLL-2003 dataset, we have also improved the ability of our models to generalize to modern data.

We present a human-in-the-loop evaluation framework for fact-checking novel misinformation claims and identifying social media messages that violate relevant policies. Our approach extracts structured representations of check-worthy claims, which are aggregated and ranked for review. Stance classifiers are then used to identify tweets supporting novel misinformation claims, which are further reviewed to determine whether they violate relevant policies. To demonstrate the feasibility of our approach, we develop a baseline system based on modern NLP methods for human-in-the-loop fact-checking in the domain of COVID-19 treatments. Using our baseline system, we show that human fact-checkers can identify 124 tweets per hour that violate Twitter's policies on COVID-19 misinformation. We will make our code, data, and detailed annotation guidelines available to support the evaluation of human-in-the-loop systems that identify novel misinformation directly from raw user-generated content.