Daily Papers

Background: Large language models (LLMs) are trained to follow directions, but this introduces a vulnerability to blindly comply with user requests even if they generate wrong information. In medicine, this could accelerate the generation of misinformation that impacts human well-being. Objectives/Methods: We analyzed compliance to requests to generate misleading content about medications in settings where models know the request is illogical. We investigated whether in-context directions and instruction-tuning of LLMs to prioritize logical reasoning over compliance reduced misinformation risk. Results: While all frontier LLMs complied with misinformation requests, both prompt-based and parameter-based approaches can improve the detection of logic flaws in requests and prevent the dissemination of medical misinformation. Conclusion: Shifting LLMs to prioritize logic over compliance could reduce risks of exploitation for medical misinformation.

Retrieval-augmented generation (RAG) has emerged as a promising approach to enhance the performance of large language models (LLMs) in knowledge-intensive tasks such as those from medical domain. However, the sensitive nature of the medical domain necessitates a completely accurate and trustworthy system. While existing RAG benchmarks primarily focus on the standard retrieve-answer setting, they overlook many practical scenarios that measure crucial aspects of a reliable medical system. This paper addresses this gap by providing a comprehensive evaluation framework for medical question-answering (QA) systems in a RAG setting for these situations, including sufficiency, integration, and robustness. We introduce Medical Retrieval-Augmented Generation Benchmark (MedRGB) that provides various supplementary elements to four medical QA datasets for testing LLMs' ability to handle these specific scenarios. Utilizing MedRGB, we conduct extensive evaluations of both state-of-the-art commercial LLMs and open-source models across multiple retrieval conditions. Our experimental results reveals current models' limited ability to handle noise and misinformation in the retrieved documents. We further analyze the LLMs' reasoning processes to provides valuable insights and future directions for developing RAG systems in this critical medical domain.

With the rapid development of large language models (LLMs), assessing their performance on health-related inquiries has become increasingly essential. It is critical that these models provide accurate and trustworthy health information, as their application in real-world contexts--where misinformation can have serious consequences for individuals seeking medical advice and support--depends on their reliability. In this work, we present CHBench, the first comprehensive Chinese Health-related Benchmark designed to evaluate LLMs' capabilities in understanding physical and mental health across diverse scenarios. CHBench includes 6,493 entries related to mental health and 2,999 entries focused on physical health, covering a broad spectrum of topics. This dataset serves as a foundation for evaluating Chinese LLMs' capacity to comprehend and generate accurate health-related information. Our extensive evaluations of four popular Chinese LLMs demonstrate that there remains considerable room for improvement in their understanding of health-related information. The code is available at https://github.com/TracyGuo2001/CHBench.

Over the course of the COVID-19 pandemic, large volumes of biomedical information concerning this new disease have been published on social media. Some of this information can pose a real danger to people's health, particularly when false information is shared, for instance recommendations on how to treat diseases without professional medical advice. Therefore, automatic fact-checking resources and systems developed specifically for the medical domain are crucial. While existing fact-checking resources cover COVID-19-related information in news or quantify the amount of misinformation in tweets, there is no dataset providing fact-checked COVID-19-related Twitter posts with detailed annotations for biomedical entities, relations and relevant evidence. We contribute CoVERT, a fact-checked corpus of tweets with a focus on the domain of biomedicine and COVID-19-related (mis)information. The corpus consists of 300 tweets, each annotated with medical named entities and relations. We employ a novel crowdsourcing methodology to annotate all tweets with fact-checking labels and supporting evidence, which crowdworkers search for online. This methodology results in moderate inter-annotator agreement. Furthermore, we use the retrieved evidence extracts as part of a fact-checking pipeline, finding that the real-world evidence is more useful than the knowledge indirectly available in pretrained language models.

Misinformation - false or misleading information - is considered a significant societal concern due to its associated "misinformation effects," such as political polarization, erosion of trust in institutions, problematic behavior, and public health challenges. However, the prevailing concept is misaligned with what is studied. While misinformation focuses on instances of information about factual matters, the broad spectrum of effects often manifests at a societal level and is shaped by a wide range of interdependent factors such as identity, values, opinions, epistemologies, and disagreements. Unsurprisingly, misinformation effects can occur without the prevalence of misinformation, and misinformation does not necessarily increase the effects studied. Here, we propose using disagreement - conflicting attitudes and beliefs between individuals and communities - as a way to study misinformation effects because it addresses the identified conceptual limitations of misinformation. Furthermore, unlike misinformation, disagreement does not require researchers to determine whether a given information is false or misleading. Thus, it can be studied and, more importantly, measured without the need to make a normative judgment about a given information, even when the specific topic is entirely removed, as we show in a longitudinal disagreement measurement. We demonstrate that disagreement, as a holistic concept, provides better explanations for the occurrence of misinformation effects, enhances precision in developing appropriate interventions, and offers a promising approach for evaluating them through quantification. Finally, we show how disagreement addresses current misinformation research questions and conclude with recommendations for research practice.

As the COVID-19 virus quickly spreads around the world, unfortunately, misinformation related to COVID-19 also gets created and spreads like wild fire. Such misinformation has caused confusion among people, disruptions in society, and even deadly consequences in health problems. To be able to understand, detect, and mitigate such COVID-19 misinformation, therefore, has not only deep intellectual values but also huge societal impacts. To help researchers combat COVID-19 health misinformation, therefore, we present CoAID (Covid-19 heAlthcare mIsinformation Dataset), with diverse COVID-19 healthcare misinformation, including fake news on websites and social platforms, along with users' social engagement about such news. CoAID includes 4,251 news, 296,000 related user engagements, 926 social platform posts about COVID-19, and ground truth labels. The dataset is available at: https://github.com/cuilimeng/CoAID.

Seeking health-related advice on the internet has become a common practice in the digital era. Determining the trustworthiness of medical claims found online and finding appropriate evidence for this information is increasingly challenging. Fact-checking has emerged as an approach to assess the veracity of factual claims using evidence from credible knowledge sources. To help advance the automation of this task, in this paper, we introduce a novel dataset of 750 health-related claims, labeled for veracity by medical experts and backed with evidence from appropriate clinical studies. We provide an analysis of the dataset, highlighting its characteristics and challenges. The dataset can be used for Machine Learning tasks related to automated fact-checking such as evidence retrieval, veracity prediction, and explanation generation. For this purpose, we provide baseline models based on different approaches, examine their performance, and discuss the findings.

Misinformation is an ever increasing problem that is difficult to solve for the research community and has a negative impact on the society at large. Very recently, the problem has been addressed with a crowdsourcing-based approach to scale up labeling efforts: to assess the truthfulness of a statement, instead of relying on a few experts, a crowd of (non-expert) judges is exploited. We follow the same approach to study whether crowdsourcing is an effective and reliable method to assess statements truthfulness during a pandemic. We specifically target statements related to the COVID-19 health emergency, that is still ongoing at the time of the study and has arguably caused an increase of the amount of misinformation that is spreading online (a phenomenon for which the term "infodemic" has been used). By doing so, we are able to address (mis)information that is both related to a sensitive and personal issue like health and very recent as compared to when the judgment is done: two issues that have not been analyzed in related work. In our experiment, crowd workers are asked to assess the truthfulness of statements, as well as to provide evidence for the assessments as a URL and a text justification. Besides showing that the crowd is able to accurately judge the truthfulness of the statements, we also report results on many different aspects, including: agreement among workers, the effect of different aggregation functions, of scales transformations, and of workers background / bias. We also analyze workers behavior, in terms of queries submitted, URLs found / selected, text justifications, and other behavioral data like clicks and mouse actions collected by means of an ad hoc logger.

The recent success of Large Language Models (LLMs) has had a significant impact on the healthcare field, providing patients with medical advice, diagnostic information, and more. However, due to a lack of professional medical knowledge, patients are easily misled by generated erroneous information from LLMs, which may result in serious medical problems. To address this issue, we focus on tuning the LLMs to be medical assistants who collaborate with more experienced doctors. We first conduct a two-stage survey by inspiration-feedback to gain a broad understanding of the real needs of doctors for medical assistants. Based on this, we construct a Chinese medical dataset called DoctorFLAN to support the entire workflow of doctors, which includes 92K Q\&A samples from 22 tasks and 27 specialists. Moreover, we evaluate LLMs in doctor-oriented scenarios by constructing the DoctorFLAN-test containing 550 single-turn Q\&A and DotaBench containing 74 multi-turn conversations. The evaluation results indicate that being a medical assistant still poses challenges for existing open-source models, but DoctorFLAN can help them significantly. It demonstrates that the doctor-oriented dataset and benchmarks we construct can complement existing patient-oriented work and better promote medical LLMs research.

Misinformation is a complex societal issue, and mitigating solutions are difficult to create due to data deficiencies. To address this problem, we have curated the largest collection of (mis)information datasets in the literature, totaling 75. From these, we evaluated the quality of all of the 36 datasets that consist of statements or claims. We assess these datasets to identify those with solid foundations for empirical work and those with flaws that could result in misleading and non-generalizable results, such as insufficient label quality, spurious correlations, or political bias. We further provide state-of-the-art baselines on all these datasets, but show that regardless of label quality, categorical labels may no longer give an accurate evaluation of detection model performance. We discuss alternatives to mitigate this problem. Overall, this guide aims to provide a roadmap for obtaining higher quality data and conducting more effective evaluations, ultimately improving research in misinformation detection. All datasets and other artifacts are available at https://misinfo-datasets.complexdatalab.com/.

As people increasingly prioritize their health, the speed and breadth of health information dissemination on the internet have also grown. At the same time, the presence of false health information (health rumors) intermingled with genuine content poses a significant potential threat to public health. However, current research on Chinese health rumors still lacks a large-scale, public, and open-source dataset of health rumor information, as well as effective and reliable rumor detection methods. This paper addresses this gap by constructing a dataset containing 1.12 million health-related rumors (HealthRCN) through web scraping of common health-related questions and a series of data processing steps. HealthRCN is the largest known dataset of Chinese health information rumors to date. Based on this dataset, we propose retrieval-augmented large language models for Chinese health rumor detection and explainability (HRDE). This model leverages retrieved relevant information to accurately determine whether the input health information is a rumor and provides explanatory responses, effectively aiding users in verifying the authenticity of health information. In evaluation experiments, we compared multiple models and found that HRDE outperformed them all, including GPT-4-1106-Preview, in rumor detection accuracy and answer quality. HRDE achieved an average accuracy of 91.04% and an F1 score of 91.58%.

Despite being an integral tool for finding health-related information online, YouTube has faced criticism for disseminating COVID-19 misinformation globally to its users. Yet, prior audit studies have predominantly investigated YouTube within the Global North contexts, often overlooking the Global South. To address this gap, we conducted a comprehensive 10-day geolocation-based audit on YouTube to compare the prevalence of COVID-19 misinformation in search results between the United States (US) and South Africa (SA), the countries heavily affected by the pandemic in the Global North and the Global South, respectively. For each country, we selected 3 geolocations and placed sock-puppets, or bots emulating "real" users, that collected search results for 48 search queries sorted by 4 search filters for 10 days, yielding a dataset of 915K results. We found that 31.55% of the top-10 search results contained COVID-19 misinformation. Among the top-10 search results, bots in SA faced significantly more misinformative search results than their US counterparts. Overall, our study highlights the contrasting algorithmic behaviors of YouTube search between two countries, underscoring the need for the platform to regulate algorithmic behavior consistently across different regions of the Globe.

This paper introduces a multilingual dataset of COVID-19 vaccine misinformation, consisting of annotated tweets from three middle-income countries: Brazil, Indonesia, and Nigeria. The expertly curated dataset includes annotations for 5,952 tweets, assessing their relevance to COVID-19 vaccines, presence of misinformation, and the themes of the misinformation. To address challenges posed by domain specificity, the low-resource setting, and data imbalance, we adopt two approaches for developing COVID-19 vaccine misinformation detection models: domain-specific pre-training and text augmentation using a large language model. Our best misinformation detection models demonstrate improvements ranging from 2.7 to 15.9 percentage points in macro F1-score compared to the baseline models. Additionally, we apply our misinformation detection models in a large-scale study of 19 million unlabeled tweets from the three countries between 2020 and 2022, showcasing the practical application of our dataset and models for detecting and analyzing vaccine misinformation in multiple countries and languages. Our analysis indicates that percentage changes in the number of new COVID-19 cases are positively associated with COVID-19 vaccine misinformation rates in a staggered manner for Brazil and Indonesia, and there are significant positive associations between the misinformation rates across the three countries.

Misinformation spread in online social networks is an urgent-to-solve problem having harmful consequences that threaten human health, public safety, economics, and so on. In this study, we construct a novel dataset, called MiDe-22, having 5,284 English and 5,064 Turkish tweets with their misinformation labels under several recent events, including the Russia-Ukraine war, COVID-19 pandemic, and Refugees. Moreover, we provide the user engagements to the tweets in terms of likes, replies, retweets, and quotes. We present a detailed data analysis with descriptive statistics and temporal analysis, and provide the experimental results of a benchmark evaluation for misinformation detection on our novel dataset.

The exponential surge in online health information, coupled with its increasing use by non-experts, highlights the pressing need for advanced Health Information Retrieval models that consider not only topical relevance but also the factual accuracy of the retrieved information, given the potential risks associated with health misinformation. To this aim, this paper introduces a solution driven by Retrieval-Augmented Generation (RAG), which leverages the capabilities of generative Large Language Models (LLMs) to enhance the retrieval of health-related documents grounded in scientific evidence. In particular, we propose a three-stage model: in the first stage, the user's query is employed to retrieve topically relevant passages with associated references from a knowledge base constituted by scientific literature. In the second stage, these passages, alongside the initial query, are processed by LLMs to generate a contextually relevant rich text (GenText). In the last stage, the documents to be retrieved are evaluated and ranked both from the point of view of topical relevance and factual accuracy by means of their comparison with GenText, either through stance detection or semantic similarity. In addition to calculating factual accuracy, GenText can offer a layer of explainability for it, aiding users in understanding the reasoning behind the retrieval. Experimental evaluation of our model on benchmark datasets and against baseline models demonstrates its effectiveness in enhancing the retrieval of both topically relevant and factually accurate health information, thus presenting a significant step forward in the health misinformation mitigation problem.

Several studies showed that Large Language Models (LLMs) can answer medical questions correctly, even outperforming the average human score in some medical exams. However, to our knowledge, no study has been conducted to assess the ability of language models to validate existing or generated medical text for correctness and consistency. In this paper, we introduce MEDEC (https://github.com/abachaa/MEDEC), the first publicly available benchmark for medical error detection and correction in clinical notes, covering five types of errors (Diagnosis, Management, Treatment, Pharmacotherapy, and Causal Organism). MEDEC consists of 3,848 clinical texts, including 488 clinical notes from three US hospital systems that were not previously seen by any LLM. The dataset has been used for the MEDIQA-CORR shared task to evaluate seventeen participating systems [Ben Abacha et al., 2024]. In this paper, we describe the data creation methods and we evaluate recent LLMs (e.g., o1-preview, GPT-4, Claude 3.5 Sonnet, and Gemini 2.0 Flash) for the tasks of detecting and correcting medical errors requiring both medical knowledge and reasoning capabilities. We also conducted a comparative study where two medical doctors performed the same task on the MEDEC test set. The results showed that MEDEC is a sufficiently challenging benchmark to assess the ability of models to validate existing or generated notes and to correct medical errors. We also found that although recent LLMs have a good performance in error detection and correction, they are still outperformed by medical doctors in these tasks. We discuss the potential factors behind this gap, the insights from our experiments, the limitations of current evaluation metrics, and share potential pointers for future research.

Our society is facing rampant misinformation harming public health and trust. To address the societal challenge, we introduce FACT-GPT, a system leveraging Large Language Models (LLMs) to automate the claim matching stage of fact-checking. FACT-GPT, trained on a synthetic dataset, identifies social media content that aligns with, contradicts, or is irrelevant to previously debunked claims. Our evaluation shows that our specialized LLMs can match the accuracy of larger models in identifying related claims, closely mirroring human judgment. This research provides an automated solution for efficient claim matching, demonstrates the potential of LLMs in supporting fact-checkers, and offers valuable resources for further research in the field.

Along with COVID-19 pandemic we are also fighting an `infodemic'. Fake news and rumors are rampant on social media. Believing in rumors can cause significant harm. This is further exacerbated at the time of a pandemic. To tackle this, we curate and release a manually annotated dataset of 10,700 social media posts and articles of real and fake news on COVID-19. We benchmark the annotated dataset with four machine learning baselines - Decision Tree, Logistic Regression, Gradient Boost, and Support Vector Machine (SVM). We obtain the best performance of 93.46% F1-score with SVM. The data and code is available at: https://github.com/parthpatwa/covid19-fake-news-dectection

Fact-checking is an important way to combat misinformation on social media, especially during significant social events such as the COVID-19 pandemic and the U.S. presidential elections. In this study, we thoroughly evaluated the performance of Google Fact Check, a search engine specifically for fact-checking results, by analyzing the results returned from Google Fact Check regarding 1,000 false claims about COVID-19. We found that Google Fact Check could not provide sufficient fact-checking information for most false claims, even though the results provided are relatively reliable and helpful. We also found that claims getting different fact-checking verdicts tend to contain different emotional tones, and different sources tend to check claims using dictionary words to different extents and at different lengths. Claims in different descriptions are likely to get different fact-checking results. We aimed to bring up the best practice of fact-checking for the general people based on our analyses.

With the introduction of ChatGPT, Large Language Models (LLMs) have received enormous attention in healthcare. Despite their potential benefits, researchers have underscored various ethical implications. While individual instances have drawn much attention, the debate lacks a systematic overview of practical applications currently researched and ethical issues connected to them. Against this background, this work aims to map the ethical landscape surrounding the current stage of deployment of LLMs in medicine and healthcare. Electronic databases and preprint servers were queried using a comprehensive search strategy. Studies were screened and extracted following a modified rapid review approach. Methodological quality was assessed using a hybrid approach. For 53 records, a meta-aggregative synthesis was performed. Four fields of applications emerged and testify to a vivid exploration phase. Advantages of using LLMs are attributed to their capacity in data analysis, personalized information provisioning, support in decision-making, mitigating information loss and enhancing information accessibility. However, we also identifies recurrent ethical concerns connected to fairness, bias, non-maleficence, transparency, and privacy. A distinctive concern is the tendency to produce harmful misinformation or convincingly but inaccurate content. A recurrent plea for ethical guidance and human oversight is evident. Given the variety of use cases, it is suggested that the ethical guidance debate be reframed to focus on defining what constitutes acceptable human oversight across the spectrum of applications. This involves considering diverse settings, varying potentials for harm, and different acceptable thresholds for performance and certainty in healthcare. In addition, a critical inquiry is necessary to determine the extent to which the current experimental use of LLMs is necessary and justified.

Recent advancements in Large Language Models (LLMs) have significantly improved text generation capabilities. However, they also present challenges, particularly in generating vaccine-related misinformation, which poses risks to public health. Despite research on human-authored misinformation, a notable gap remains in understanding how LLMs contribute to vaccine misinformation and how best to detect it. Existing benchmarks often overlook vaccine-specific misinformation and the diverse roles of misinformation spreaders. This paper introduces VaxGuard, a novel dataset designed to address these challenges. VaxGuard includes vaccine-related misinformation generated by multiple LLMs and provides a comprehensive framework for detecting misinformation across various roles. Our findings show that GPT-3.5 and GPT-4o consistently outperform other LLMs in detecting misinformation, especially when dealing with subtle or emotionally charged narratives. On the other hand, PHI3 and Mistral show lower performance, struggling with precision and recall in fear-driven contexts. Additionally, detection performance tends to decline as input text length increases, indicating the need for improved methods to handle larger content. These results highlight the importance of role-specific detection strategies and suggest that VaxGuard can serve as a key resource for improving the detection of LLM-generated vaccine misinformation.

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

Fact checking by professionals is viewed as a vital defense in the fight against misinformation.While fact checking is important and its impact has been significant, fact checks could have limited visibility and may not reach the intended audience, such as those deeply embedded in polarized communities. Concerned citizens (i.e., the crowd), who are users of the platforms where misinformation appears, can play a crucial role in disseminating fact-checking information and in countering the spread of misinformation. To explore if this is the case, we conduct a data-driven study of misinformation on the Twitter platform, focusing on tweets related to the COVID-19 pandemic, analyzing the spread of misinformation, professional fact checks, and the crowd response to popular misleading claims about COVID-19. In this work, we curate a dataset of false claims and statements that seek to challenge or refute them. We train a classifier to create a novel dataset of 155,468 COVID-19-related tweets, containing 33,237 false claims and 33,413 refuting arguments.Our findings show that professional fact-checking tweets have limited volume and reach. In contrast, we observe that the surge in misinformation tweets results in a quick response and a corresponding increase in tweets that refute such misinformation. More importantly, we find contrasting differences in the way the crowd refutes tweets, some tweets appear to be opinions, while others contain concrete evidence, such as a link to a reputed source. Our work provides insights into how misinformation is organically countered in social platforms by some of their users and the role they play in amplifying professional fact checks.These insights could lead to development of tools and mechanisms that can empower concerned citizens in combating misinformation. The code and data can be found in http://claws.cc.gatech.edu/covid_counter_misinformation.html.

Combating disinformation is one of the burning societal crises -- about 67% of the American population believes that disinformation produces a lot of uncertainty, and 10% of them knowingly propagate disinformation. Evidence shows that disinformation can manipulate democratic processes and public opinion, causing disruption in the share market, panic and anxiety in society, and even death during crises. Therefore, disinformation should be identified promptly and, if possible, mitigated. With approximately 3.2 billion images and 720,000 hours of video shared online daily on social media platforms, scalable detection of multimodal disinformation requires efficient fact verification. Despite progress in automatic text-based fact verification (e.g., FEVER, LIAR), the research community lacks substantial effort in multimodal fact verification. To address this gap, we introduce FACTIFY 3M, a dataset of 3 million samples that pushes the boundaries of the domain of fact verification via a multimodal fake news dataset, in addition to offering explainability through the concept of 5W question-answering. Salient features of the dataset include: (i) textual claims, (ii) ChatGPT-generated paraphrased claims, (iii) associated images, (iv) stable diffusion-generated additional images (i.e., visual paraphrases), (v) pixel-level image heatmap to foster image-text explainability of the claim, (vi) 5W QA pairs, and (vii) adversarial fake news stories.

Summaries of medical text shall be faithful by being consistent and factual with source inputs, which is an important but understudied topic for safety and efficiency in healthcare. In this paper, we investigate and improve faithfulness in summarization on a broad range of medical summarization tasks. Our investigation reveals that current summarization models often produce unfaithful outputs for medical input text. We then introduce FaMeSumm, a framework to improve faithfulness by fine-tuning pre-trained language models based on medical knowledge. FaMeSumm performs contrastive learning on designed sets of faithful and unfaithful summaries, and it incorporates medical terms and their contexts to encourage faithful generation of medical terms. We conduct comprehensive experiments on three datasets in two languages: health question and radiology report summarization datasets in English, and a patient-doctor dialogue dataset in Chinese. Results demonstrate that FaMeSumm is flexible and effective by delivering consistent improvements over mainstream language models such as BART, T5, mT5, and PEGASUS, yielding state-of-the-art performances on metrics for faithfulness and general quality. Human evaluation by doctors also shows that FaMeSumm generates more faithful outputs. Our code is available at https://github.com/psunlpgroup/FaMeSumm .

The prevalence and harms of online misinformation is a perennial concern for internet platforms, institutions and society at large. Over time, information shared online has become more media-heavy and misinformation has readily adapted to these new modalities. The rise of generative AI-based tools, which provide widely-accessible methods for synthesizing realistic audio, images, video and human-like text, have amplified these concerns. Despite intense interest on the part of the public and significant press coverage, quantitative information on the prevalence and modality of media-based misinformation remains scarce. Here, we present the results of a two-year study using human raters to annotate online media-based misinformation, mostly focusing on images, based on claims assessed in a large sample of publicly-accessible fact checks with the ClaimReview markup. We present an image typology, designed to capture aspects of the image and manipulation relevant to the image's role in the misinformation claim. We visualize the distribution of these types over time. We show the the rise of generative AI-based content in misinformation claims, and that it's commonality is a relatively recent phenomenon, occurring significantly after heavy press coverage. We also show "simple" methods dominated historically, particularly context manipulations, and continued to hold a majority as of the end of data collection in November 2023. The dataset, Annotated Misinformation, Media-Based (AMMeBa), is publicly-available, and we hope that these data will serve as both a means of evaluating mitigation methods in a realistic setting and as a first-of-its-kind census of the types and modalities of online misinformation.

Misinformation such as fake news and rumors is a serious threat on information ecosystems and public trust. The emergence of Large Language Models (LLMs) has great potential to reshape the landscape of combating misinformation. Generally, LLMs can be a double-edged sword in the fight. On the one hand, LLMs bring promising opportunities for combating misinformation due to their profound world knowledge and strong reasoning abilities. Thus, one emergent question is: how to utilize LLMs to combat misinformation? On the other hand, the critical challenge is that LLMs can be easily leveraged to generate deceptive misinformation at scale. Then, another important question is: how to combat LLM-generated misinformation? In this paper, we first systematically review the history of combating misinformation before the advent of LLMs. Then we illustrate the current efforts and present an outlook for these two fundamental questions respectively. The goal of this survey paper is to facilitate the progress of utilizing LLMs for fighting misinformation and call for interdisciplinary efforts from different stakeholders for combating LLM-generated misinformation.

Misinformation about climate change is a complex societal issue requiring holistic, interdisciplinary solutions at the intersection between technology and psychology. One proposed solution is a "technocognitive" approach, involving the synthesis of psychological and computer science research. Psychological research has identified that interventions in response to misinformation require both fact-based (e.g., factual explanations) and technique-based (e.g., explanations of misleading techniques) content. However, little progress has been made on documenting and detecting fallacies in climate misinformation. In this study, we apply a previously developed critical thinking methodology for deconstructing climate misinformation, in order to develop a dataset mapping different types of climate misinformation to reasoning fallacies. This dataset is used to train a model to detect fallacies in climate misinformation. Our study shows F1 scores that are 2.5 to 3.5 better than previous works. The fallacies that are easiest to detect include fake experts and anecdotal arguments, while fallacies that require background knowledge, such as oversimplification, misrepresentation, and slothful induction, are relatively more difficult to detect. This research lays the groundwork for development of solutions where automatically detected climate misinformation can be countered with generative technique-based corrections.

Fact-checking is the task of verifying the veracity of claims by assessing their assertions against credible evidence. The vast majority of fact-checking studies focus exclusively on political claims. Very little research explores fact-checking for other topics, specifically subject matters for which expertise is required. We present the first study of explainable fact-checking for claims which require specific expertise. For our case study we choose the setting of public health. To support this case study we construct a new dataset PUBHEALTH of 11.8K claims accompanied by journalist crafted, gold standard explanations (i.e., judgments) to support the fact-check labels for claims. We explore two tasks: veracity prediction and explanation generation. We also define and evaluate, with humans and computationally, three coherence properties of explanation quality. Our results indicate that, by training on in-domain data, gains can be made in explainable, automated fact-checking for claims which require specific expertise.

The advent of Large Language Models (LLMs) has made a transformative impact. However, the potential that LLMs such as ChatGPT can be exploited to generate misinformation has posed a serious concern to online safety and public trust. A fundamental research question is: will LLM-generated misinformation cause more harm than human-written misinformation? We propose to tackle this question from the perspective of detection difficulty. We first build a taxonomy of LLM-generated misinformation. Then we categorize and validate the potential real-world methods for generating misinformation with LLMs. Then, through extensive empirical investigation, we discover that LLM-generated misinformation can be harder to detect for humans and detectors compared to human-written misinformation with the same semantics, which suggests it can have more deceptive styles and potentially cause more harm. We also discuss the implications of our discovery on combating misinformation in the age of LLMs and the countermeasures.

The spread of online misinformation threatens public health, democracy, and the broader society. While professional fact-checkers form the first line of defense by fact-checking popular false claims, they do not engage directly in conversations with misinformation spreaders. On the other hand, non-expert ordinary users act as eyes-on-the-ground who proactively counter misinformation -- recent research has shown that 96% counter-misinformation responses are made by ordinary users. However, research also found that 2/3 times, these responses are rude and lack evidence. This work seeks to create a counter-misinformation response generation model to empower users to effectively correct misinformation. This objective is challenging due to the absence of datasets containing ground-truth of ideal counter-misinformation responses, and the lack of models that can generate responses backed by communication theories. In this work, we create two novel datasets of misinformation and counter-misinformation response pairs from in-the-wild social media and crowdsourcing from college-educated students. We annotate the collected data to distinguish poor from ideal responses that are factual, polite, and refute misinformation. We propose MisinfoCorrect, a reinforcement learning-based framework that learns to generate counter-misinformation responses for an input misinformation post. The model rewards the generator to increase the politeness, factuality, and refutation attitude while retaining text fluency and relevancy. Quantitative and qualitative evaluation shows that our model outperforms several baselines by generating high-quality counter-responses. This work illustrates the promise of generative text models for social good -- here, to help create a safe and reliable information ecosystem. The code and data is accessible on https://github.com/claws-lab/MisinfoCorrect.

This paper introduces misinfo-general, a benchmark dataset for evaluating misinformation models' ability to perform out-of-distribution generalisation. Misinformation changes rapidly, much quicker than moderators can annotate at scale, resulting in a shift between the training and inference data distributions. As a result, misinformation models need to be able to perform out-of-distribution generalisation, an understudied problem in existing datasets. We identify 6 axes of generalisation-time, event, topic, publisher, political bias, misinformation type-and design evaluation procedures for each. We also analyse some baseline models, highlighting how these fail important desiderata.

Misinformation threatens modern society by promoting distrust in science, changing narratives in public health, heightening social polarization, and disrupting democratic elections and financial markets, among a myriad of other societal harms. To address this, a growing cadre of professional fact-checkers and journalists provide high-quality investigations into purported facts. However, these largely manual efforts have struggled to match the enormous scale of the problem. In response, a growing body of Natural Language Processing (NLP) technologies have been proposed for more scalable fact-checking. Despite tremendous growth in such research, however, practical adoption of NLP technologies for fact-checking still remains in its infancy today. In this work, we review the capabilities and limitations of the current NLP technologies for fact-checking. Our particular focus is to further chart the design space for how these technologies can be harnessed and refined in order to better meet the needs of human fact-checkers. To do so, we review key aspects of NLP-based fact-checking: task formulation, dataset construction, modeling, and human-centered strategies, such as explainable models and human-in-the-loop approaches. Next, we review the efficacy of applying NLP-based fact-checking tools to assist human fact-checkers. We recommend that future research include collaboration with fact-checker stakeholders early on in NLP research, as well as incorporation of human-centered design practices in model development, in order to further guide technology development for human use and practical adoption. Finally, we advocate for more research on benchmark development supporting extrinsic evaluation of human-centered fact-checking technologies.

Security concerns related to Large Language Models (LLMs) have been extensively explored, yet the safety implications for Multimodal Large Language Models (MLLMs), particularly in medical contexts (MedMLLMs), remain insufficiently studied. This paper delves into the underexplored security vulnerabilities of MedMLLMs, especially when deployed in clinical environments where the accuracy and relevance of question-and-answer interactions are critically tested against complex medical challenges. By combining existing clinical medical data with atypical natural phenomena, we redefine two types of attacks: mismatched malicious attack (2M-attack) and optimized mismatched malicious attack (O2M-attack). Using our own constructed voluminous 3MAD dataset, which covers a wide range of medical image modalities and harmful medical scenarios, we conduct a comprehensive analysis and propose the MCM optimization method, which significantly enhances the attack success rate on MedMLLMs. Evaluations with this dataset and novel attack methods, including white-box attacks on LLaVA-Med and transfer attacks on four other state-of-the-art models, indicate that even MedMLLMs designed with enhanced security features are vulnerable to security breaches. Our work underscores the urgent need for a concerted effort to implement robust security measures and enhance the safety and efficacy of open-source MedMLLMs, particularly given the potential severity of jailbreak attacks and other malicious or clinically significant exploits in medical settings. For further research and replication, anonymous access to our code is available at https://github.com/dirtycomputer/O2M_attack. Warning: Medical large model jailbreaking may generate content that includes unverified diagnoses and treatment recommendations. Always consult professional medical advice.

The spread of misinformation is a prominent problem in today's society, and many researchers in academia and industry are trying to combat it. Due to the vast amount of misinformation that is created every day, it is unrealistic to leave this task to human fact-checkers. Data scientists and researchers have been working on automated misinformation detection for years, and it is still a challenging problem today. The goal of our research is to add a new level to automated misinformation detection; classifying segments of text with persuasive writing techniques in order to produce interpretable reasoning for why an article can be marked as misinformation. To accomplish this, we present a novel annotation scheme containing many common persuasive writing tactics, along with a dataset with human annotations accordingly. For this task, we make use of a RoBERTa model for text classification, due to its high performance in NLP. We develop several language model-based baselines and present the results of our persuasive strategy label predictions as well as the improvements these intermediate labels make in detecting misinformation and producing interpretable results.

A comprehensive bibliographic review with R statistical methods of the COVID pandemic in PubMed literature and Web of Science Core Collection, supported with Google Scholar search. In addition, a case study review of emerging new approaches in different regions, using medical literature, academic literature, news articles and other reliable data sources. Public responses of mistrust about privacy data misuse differ across countries, depending on the chosen public communication strategy.

Plain language summarization with LLMs can be useful for improving textual accessibility of technical content. But how factual are these summaries in a high-stakes domain like medicine? This paper presents FactPICO, a factuality benchmark for plain language summarization of medical texts describing randomized controlled trials (RCTs), which are the basis of evidence-based medicine and can directly inform patient treatment. FactPICO consists of 345 plain language summaries of RCT abstracts generated from three LLMs (i.e., GPT-4, Llama-2, and Alpaca), with fine-grained evaluation and natural language rationales from experts. We assess the factuality of critical elements of RCTs in those summaries: Populations, Interventions, Comparators, Outcomes (PICO), as well as the reported findings concerning these. We also evaluate the correctness of the extra information (e.g., explanations) added by LLMs. Using FactPICO, we benchmark a range of existing factuality metrics, including the newly devised ones based on LLMs. We find that plain language summarization of medical evidence is still challenging, especially when balancing between simplicity and factuality, and that existing metrics correlate poorly with expert judgments on the instance level.

With information consumption via online video streaming becoming increasingly popular, misinformation video poses a new threat to the health of the online information ecosystem. Though previous studies have made much progress in detecting misinformation in text and image formats, video-based misinformation brings new and unique challenges to automatic detection systems: 1) high information heterogeneity brought by various modalities, 2) blurred distinction between misleading video manipulation and ubiquitous artistic video editing, and 3) new patterns of misinformation propagation due to the dominant role of recommendation systems on online video platforms. To facilitate research on this challenging task, we conduct this survey to present advances in misinformation video detection research. We first analyze and characterize the misinformation video from three levels including signals, semantics, and intents. Based on the characterization, we systematically review existing works for detection from features of various modalities to techniques for clue integration. We also introduce existing resources including representative datasets and widely used tools. Besides summarizing existing studies, we discuss related areas and outline open issues and future directions to encourage and guide more research on misinformation video detection. Our corresponding public repository is available at https://github.com/ICTMCG/Awesome-Misinfo-Video-Detection.

The debate around misinformation and its potentially detrimental effects on public opinion is complex and multifaceted, to the extent that even the relevant academic research has not found unanimity on the prevalence and consumption of misinformation compared with mainstream content. The methodological framework presented here emphasises the importance of considering data representative of the complexity of the phenomenon and metrics that control for possible scale effects. By combining statistical, econometric and machine learning models, we shed light on the real impact of misinformation about a subject of general interest and social relevance, such as vaccines, on both the information available to citizens and their news diet. Our results show the prominent role achieved by misinformation sources in the news ecosystem, but also - and above all - the inability of mainstream media to drive the public debate over time on issues that are particularly sensitive and emotional. Taking properly account for the temporal dynamics of public debate seems crucial to prevent the latter from moving into uncontrolled spaces where false narratives are more easily conveyed and entrenched.

Recent large language models (LLMs) in the general domain, such as ChatGPT, have shown remarkable success in following instructions and producing human-like responses. However, such language models have not been learned individually and carefully for the medical domain, resulting in poor diagnostic accuracy and inability to give correct recommendations for medical diagnosis, medications, etc. To address this issue, we collected more than 700 diseases and their corresponding symptoms, recommended medications, and required medical tests, and then generated 5K doctor-patient conversations. By fine-tuning models of doctor-patient conversations, these models emerge with great potential to understand patients' needs, provide informed advice, and offer valuable assistance in a variety of medical-related fields. The integration of these advanced language models into healthcare can revolutionize the way healthcare professionals and patients communicate, ultimately improving the overall quality of care and patient outcomes. In addition, we will open all source code, datasets and model weights to advance the further development of dialogue models in the medical field. In addition, the training data, code, and weights of this project are available at: https://github.com/Kent0n-Li/ChatDoctor.

The goal of automated summarization techniques (Paice, 1990; Kupiec et al, 1995) is to condense text by focusing on the most critical information. Generative large language models (LLMs) have shown to be robust summarizers, yet traditional metrics struggle to capture resulting performance (Goyal et al, 2022) in more powerful LLMs. In safety-critical domains such as medicine, more rigorous evaluation is required, especially given the potential for LLMs to omit important information in the resulting summary. We propose MED-OMIT, a new omission benchmark for medical summarization. Given a doctor-patient conversation and a generated summary, MED-OMIT categorizes the chat into a set of facts and identifies which are omitted from the summary. We further propose to determine fact importance by simulating the impact of each fact on a downstream clinical task: differential diagnosis (DDx) generation. MED-OMIT leverages LLM prompt-based approaches which categorize the importance of facts and cluster them as supporting or negating evidence to the diagnosis. We evaluate MED-OMIT on a publicly-released dataset of patient-doctor conversations and find that MED-OMIT captures omissions better than alternative metrics.

Automatic medical report generation (MRG), which possesses significant research value as it can aid radiologists in clinical diagnosis and report composition, has garnered increasing attention. Despite recent progress, generating accurate reports remains arduous due to the requirement for precise clinical comprehension and disease diagnosis inference. Furthermore, owing to the limited accessibility of medical data and the imbalanced distribution of diseases, the underrepresentation of rare diseases in training data makes large-scale medical visual language models (LVLMs) prone to hallucinations, such as omissions or fabrications, severely undermining diagnostic performance and further intensifying the challenges for MRG in practice. In this study, to effectively mitigate hallucinations in medical report generation, we propose a chain-of-medical-thought approach (CoMT), which intends to imitate the cognitive process of human doctors by decomposing diagnostic procedures. The radiological features with different importance are structured into fine-grained medical thought chains to enhance the inferential ability during diagnosis, thereby alleviating hallucination problems and enhancing the diagnostic accuracy of MRG. The code and dataset have been released at https://github.com/FRENKIE-CHIANG/CoMT.

Medical coding is the task of assigning medical codes to clinical free-text documentation. Healthcare professionals manually assign such codes to track patient diagnoses and treatments. Automated medical coding can considerably alleviate this administrative burden. In this paper, we reproduce, compare, and analyze state-of-the-art automated medical coding machine learning models. We show that several models underperform due to weak configurations, poorly sampled train-test splits, and insufficient evaluation. In previous work, the macro F1 score has been calculated sub-optimally, and our correction doubles it. We contribute a revised model comparison using stratified sampling and identical experimental setups, including hyperparameters and decision boundary tuning. We analyze prediction errors to validate and falsify assumptions of previous works. The analysis confirms that all models struggle with rare codes, while long documents only have a negligible impact. Finally, we present the first comprehensive results on the newly released MIMIC-IV dataset using the reproduced models. We release our code, model parameters, and new MIMIC-III and MIMIC-IV training and evaluation pipelines to accommodate fair future comparisons.

Misinformation is becoming increasingly prevalent on social media and in news articles. It has become so widespread that we require algorithmic assistance utilising machine learning to detect such content. Training these machine learning models require datasets of sufficient scale, diversity and quality. However, datasets in the field of automatic misinformation detection are predominantly monolingual, include a limited amount of modalities and are not of sufficient scale and quality. Addressing this, we develop a data collection and linking system (MuMiN-trawl), to build a public misinformation graph dataset (MuMiN), containing rich social media data (tweets, replies, users, images, articles, hashtags) spanning 21 million tweets belonging to 26 thousand Twitter threads, each of which have been semantically linked to 13 thousand fact-checked claims across dozens of topics, events and domains, in 41 different languages, spanning more than a decade. The dataset is made available as a heterogeneous graph via a Python package (mumin). We provide baseline results for two node classification tasks related to the veracity of a claim involving social media, and demonstrate that these are challenging tasks, with the highest macro-average F1-score being 62.55% and 61.45% for the two tasks, respectively. The MuMiN ecosystem is available at https://mumin-dataset.github.io/, including the data, documentation, tutorials and leaderboards.

When deploying machine learning models in high-stakes real-world environments such as health care, it is crucial to accurately assess the uncertainty concerning a model's prediction on abnormal inputs. However, there is a scarcity of literature analyzing this problem on medical data, especially on mixed-type tabular data such as Electronic Health Records. We close this gap by presenting a series of tests including a large variety of contemporary uncertainty estimation techniques, in order to determine whether they are able to identify out-of-distribution (OOD) patients. In contrast to previous work, we design tests on realistic and clinically relevant OOD groups, and run experiments on real-world medical data. We find that almost all techniques fail to achieve convincing results, partly disagreeing with earlier findings.

With the rapid development of artificial intelligence, large language models (LLMs) have shown promising capabilities in mimicking human-level language comprehension and reasoning. This has sparked significant interest in applying LLMs to enhance various aspects of healthcare, ranging from medical education to clinical decision support. However, medicine involves multifaceted data modalities and nuanced reasoning skills, presenting challenges for integrating LLMs. This paper provides a comprehensive review on the applications and implications of LLMs in medicine. It begins by examining the fundamental applications of general-purpose and specialized LLMs, demonstrating their utilities in knowledge retrieval, research support, clinical workflow automation, and diagnostic assistance. Recognizing the inherent multimodality of medicine, the review then focuses on multimodal LLMs, investigating their ability to process diverse data types like medical imaging and EHRs to augment diagnostic accuracy. To address LLMs' limitations regarding personalization and complex clinical reasoning, the paper explores the emerging development of LLM-powered autonomous agents for healthcare. Furthermore, it summarizes the evaluation methodologies for assessing LLMs' reliability and safety in medical contexts. Overall, this review offers an extensive analysis on the transformative potential of LLMs in modern medicine. It also highlights the pivotal need for continuous optimizations and ethical oversight before these models can be effectively integrated into clinical practice. Visit https://github.com/mingze-yuan/Awesome-LLM-Healthcare for an accompanying GitHub repository containing latest papers.

This research paper focuses on the challenges posed by hallucinations in large language models (LLMs), particularly in the context of the medical domain. Hallucination, wherein these models generate plausible yet unverified or incorrect information, can have serious consequences in healthcare applications. We propose a new benchmark and dataset, Med-HALT (Medical Domain Hallucination Test), designed specifically to evaluate and reduce hallucinations. Med-HALT provides a diverse multinational dataset derived from medical examinations across various countries and includes multiple innovative testing modalities. Med-HALT includes two categories of tests reasoning and memory-based hallucination tests, designed to assess LLMs's problem-solving and information retrieval abilities. Our study evaluated leading LLMs, including Text Davinci, GPT-3.5, LlaMa-2, MPT, and Falcon, revealing significant differences in their performance. The paper provides detailed insights into the dataset, promoting transparency and reproducibility. Through this work, we aim to contribute to the development of safer and more reliable language models in healthcare. Our benchmark can be found at medhalt.github.io

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.

False assumptions about sex and gender are deeply embedded in the medical system, including that they are binary, static, and concordant. Machine learning researchers must understand the nature of these assumptions in order to avoid perpetuating them. In this perspectives piece, we identify three common mistakes that researchers make when dealing with sex/gender data: "sex confusion", the failure to identity what sex in a dataset does or doesn't mean; "sex obsession", the belief that sex, specifically sex assigned at birth, is the relevant variable for most applications; and "sex/gender slippage", the conflation of sex and gender even in contexts where only one or the other is known. We then discuss how these pitfalls show up in machine learning studies based on electronic health record data, which is commonly used for everything from retrospective analysis of patient outcomes to the development of algorithms to predict risk and administer care. Finally, we offer a series of recommendations about how machine learning researchers can produce both research and algorithms that more carefully engage with questions of sex/gender, better serving all patients, including transgender people.

Medical knowledge is context-dependent and requires consistent reasoning across various natural language expressions of semantically equivalent phrases. This is particularly crucial for drug names, where patients often use brand names like Advil or Tylenol instead of their generic equivalents. To study this, we create a new robustness dataset, RABBITS, to evaluate performance differences on medical benchmarks after swapping brand and generic drug names using physician expert annotations. We assess both open-source and API-based LLMs on MedQA and MedMCQA, revealing a consistent performance drop ranging from 1-10\%. Furthermore, we identify a potential source of this fragility as the contamination of test data in widely used pre-training datasets. All code is accessible at https://github.com/BittermanLab/RABBITS, and a HuggingFace leaderboard is available at https://huggingface.co/spaces/AIM-Harvard/rabbits-leaderboard.

People increasingly search online for answers to their medical questions but the rate at which medical questions are asked online significantly exceeds the capacity of qualified people to answer them. This leaves many questions unanswered or inadequately answered. Many of these questions are not unique, and reliable identification of similar questions would enable more efficient and effective question answering schema. COVID-19 has only exacerbated this problem. Almost every government agency and healthcare organization has tried to meet the informational need of users by building online FAQs, but there is no way for people to ask their question and know if it is answered on one of these pages. While many research efforts have focused on the problem of general question similarity, these approaches do not generalize well to domains that require expert knowledge to determine semantic similarity, such as the medical domain. In this paper, we show how a double fine-tuning approach of pretraining a neural network on medical question-answer pairs followed by fine-tuning on medical question-question pairs is a particularly useful intermediate task for the ultimate goal of determining medical question similarity. While other pretraining tasks yield an accuracy below 78.7% on this task, our model achieves an accuracy of 82.6% with the same number of training examples, an accuracy of 80.0% with a much smaller training set, and an accuracy of 84.5% when the full corpus of medical question-answer data is used. We also describe a currently live system that uses the trained model to match user questions to COVID-related FAQs.

Multimodal Large Language Models (MLLMs) have tremendous potential to improve the accuracy, availability, and cost-effectiveness of healthcare by providing automated solutions or serving as aids to medical professionals. Despite promising first steps in developing medical MLLMs in the past few years, their capabilities and limitations are not well-understood. Recently, many benchmark datasets have been proposed that test the general medical knowledge of such models across a variety of medical areas. However, the systematic failure modes and vulnerabilities of such models are severely underexplored with most medical benchmarks failing to expose the shortcomings of existing models in this safety-critical domain. In this paper, we introduce MediConfusion, a challenging medical Visual Question Answering (VQA) benchmark dataset, that probes the failure modes of medical MLLMs from a vision perspective. We reveal that state-of-the-art models are easily confused by image pairs that are otherwise visually dissimilar and clearly distinct for medical experts. Strikingly, all available models (open-source or proprietary) achieve performance below random guessing on MediConfusion, raising serious concerns about the reliability of existing medical MLLMs for healthcare deployment. We also extract common patterns of model failure that may help the design of a new generation of more trustworthy and reliable MLLMs in healthcare.

Large Language Models (LLMs) have demonstrated remarkable success in diverse natural language processing (NLP) tasks in general domains. However, LLMs sometimes generate responses with the hallucination about medical facts due to limited domain knowledge. Such shortcomings pose potential risks in the utilization of LLMs within medical contexts. To address this challenge, we propose knowledge-tuning, which leverages structured medical knowledge bases for the LLMs to grasp domain knowledge efficiently and facilitate reliable response generation. We also release cMedKnowQA, a Chinese medical knowledge question-answering dataset constructed from medical knowledge bases to assess the medical knowledge proficiency of LLMs. Experimental results show that the LLMs which are knowledge-tuned with cMedKnowQA, can exhibit higher levels of accuracy in response generation compared with vanilla instruction-tuning and offer a new reliable way for the domain adaptation of LLMs.

Two commonly-employed strategies to combat the rise of misinformation on social media are (i) fact-checking by professional organisations and (ii) community moderation by platform users. Policy changes by Twitter/X and, more recently, Meta, signal a shift away from partnerships with fact-checking organisations and towards an increased reliance on crowdsourced community notes. However, the extent and nature of dependencies between fact-checking and helpful community notes remain unclear. To address these questions, we use language models to annotate a large corpus of Twitter/X community notes with attributes such as topic, cited sources, and whether they refute claims tied to broader misinformation narratives. Our analysis reveals that community notes cite fact-checking sources up to five times more than previously reported. Fact-checking is especially crucial for notes on posts linked to broader narratives, which are twice as likely to reference fact-checking sources compared to other sources. In conclusion, our results show that successful community moderation heavily relies on professional fact-checking.

The recent emergence of Medical Large Vision Language Models (Med-LVLMs) has enhanced medical diagnosis. However, current Med-LVLMs frequently encounter factual issues, often generating responses that do not align with established medical facts. Retrieval-Augmented Generation (RAG), which utilizes external knowledge, can improve the factual accuracy of these models but introduces two major challenges. First, limited retrieved contexts might not cover all necessary information, while excessive retrieval can introduce irrelevant and inaccurate references, interfering with the model's generation. Second, in cases where the model originally responds correctly, applying RAG can lead to an over-reliance on retrieved contexts, resulting in incorrect answers. To address these issues, we propose RULE, which consists of two components. First, we introduce a provably effective strategy for controlling factuality risk through the calibrated selection of the number of retrieved contexts. Second, based on samples where over-reliance on retrieved contexts led to errors, we curate a preference dataset to fine-tune the model, balancing its dependence on inherent knowledge and retrieved contexts for generation. We demonstrate the effectiveness of RULE on three medical VQA datasets, achieving an average improvement of 20.8% in factual accuracy. We publicly release our benchmark and code in https://github.com/richard-peng-xia/RULE.

Generating synthetic text addresses the challenge of data availability in privacy-sensitive domains such as healthcare. This study explores the applicability of synthetic data in real-world medical settings. We introduce MedSyn, a novel medical text generation framework that integrates large language models with a Medical Knowledge Graph (MKG). We use MKG to sample prior medical information for the prompt and generate synthetic clinical notes with GPT-4 and fine-tuned LLaMA models. We assess the benefit of synthetic data through application in the ICD code prediction task. Our research indicates that synthetic data can increase the classification accuracy of vital and challenging codes by up to 17.8% compared to settings without synthetic data. Furthermore, to provide new data for further research in the healthcare domain, we present the largest open-source synthetic dataset of clinical notes for the Russian language, comprising over 41k samples covering 219 ICD-10 codes.

How do we most effectively treat a disease or condition? Ideally, we could consult a database of evidence gleaned from clinical trials to answer such questions. Unfortunately, no such database exists; clinical trial results are instead disseminated primarily via lengthy natural language articles. Perusing all such articles would be prohibitively time-consuming for healthcare practitioners; they instead tend to depend on manually compiled systematic reviews of medical literature to inform care. NLP may speed this process up, and eventually facilitate immediate consult of published evidence. The Evidence Inference dataset was recently released to facilitate research toward this end. This task entails inferring the comparative performance of two treatments, with respect to a given outcome, from a particular article (describing a clinical trial) and identifying supporting evidence. For instance: Does this article report that chemotherapy performed better than surgery for five-year survival rates of operable cancers? In this paper, we collect additional annotations to expand the Evidence Inference dataset by 25\%, provide stronger baseline models, systematically inspect the errors that these make, and probe dataset quality. We also release an abstract only (as opposed to full-texts) version of the task for rapid model prototyping. The updated corpus, documentation, and code for new baselines and evaluations are available at http://evidence-inference.ebm-nlp.com/.

Online misinformation has been a serious threat to public health and society. Social media users are known to reply to misinformation posts with counter-misinformation messages, which have been shown to be effective in curbing the spread of misinformation. This is called social correction. However, the characteristics of tweets that attract social correction versus those that do not remain unknown. To close the gap, we focus on answering the following two research questions: (1) ``Given a tweet, will it be countered by other users?'', and (2) ``If yes, what will be the magnitude of countering it?''. This exploration will help develop mechanisms to guide users' misinformation correction efforts and to measure disparity across users who get corrected. In this work, we first create a novel dataset with 690,047 pairs of misinformation tweets and counter-misinformation replies. Then, stratified analysis of tweet linguistic and engagement features as well as tweet posters' user attributes are conducted to illustrate the factors that are significant in determining whether a tweet will get countered. Finally, predictive classifiers are created to predict the likelihood of a misinformation tweet to get countered and the degree to which that tweet will be countered. The code and data is accessible on https://github.com/claws-lab/social-correction-twitter.

Online misinformation poses a global risk with significant real-world consequences. To combat misinformation, current research relies on professionals like journalists and fact-checkers for annotating and debunking misinformation, and develops automated machine learning methods for detecting misinformation. Complementary to these approaches, recent research has increasingly concentrated on utilizing the power of ordinary social media users, a.k.a. "crowd", who act as eyes-on-the-ground proactively questioning and countering misinformation. Notably, recent studies show that 96% of counter-misinformation responses originate from them. Acknowledging their prominent role, we present the first systematic and comprehensive survey of research papers that actively leverage the crowds to combat misinformation. We first identify 88 papers related to crowd-based efforts, following a meticulous annotation process adhering to the PRISMA framework. We then present key statistics related to misinformation, counter-misinformation, and crowd input in different formats and topics. Upon holistic analysis of the papers, we introduce a novel taxonomy of the roles played by the crowds: (i)annotators who actively identify misinformation; (ii)evaluators who assess counter-misinformation effectiveness; (iii)creators who create counter-misinformation. This taxonomy explores the crowd's capabilities in misinformation detection, identifies prerequisites for effective counter-misinformation, and analyzes crowd-generated counter-misinformation. Then, we delve into (i)distinguishing individual, collaborative, and machine-assisted labeling for annotators; (ii)analyzing the effectiveness of counter-misinformation through surveys, interviews, and in-lab experiments for evaluators; and (iii)characterizing creation patterns and creator profiles for creators. Finally, we outline potential future research in this field.

The rapid advancement of large language models (LLMs) has significantly impacted various domains, including healthcare and biomedicine. However, the phenomenon of hallucination, where LLMs generate outputs that deviate from factual accuracy or context, poses a critical challenge, especially in high-stakes domains. This paper conducts a scoping study of existing techniques for mitigating hallucinations in knowledge-based task in general and especially for medical domains. Key methods covered in the paper include Retrieval-Augmented Generation (RAG)-based techniques, iterative feedback loops, supervised fine-tuning, and prompt engineering. These techniques, while promising in general contexts, require further adaptation and optimization for the medical domain due to its unique demands for up-to-date, specialized knowledge and strict adherence to medical guidelines. Addressing these challenges is crucial for developing trustworthy AI systems that enhance clinical decision-making and patient safety as well as accuracy of biomedical scientific research.

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.

Medical abstractive summarization faces the challenge of balancing faithfulness and informativeness. Current methods often sacrifice key information for faithfulness or introduce confabulations when prioritizing informativeness. While recent advancements in techniques like in-context learning (ICL) and fine-tuning have improved medical summarization, they often overlook crucial aspects such as faithfulness and informativeness without considering advanced methods like model reasoning and self-improvement. Moreover, the field lacks a unified benchmark, hindering systematic evaluation due to varied metrics and datasets. This paper addresses these gaps by presenting a comprehensive benchmark of six advanced abstractive summarization methods across three diverse datasets using five standardized metrics. Building on these findings, we propose uMedSum, a modular hybrid summarization framework that introduces novel approaches for sequential confabulation removal followed by key missing information addition, ensuring both faithfulness and informativeness. Our work improves upon previous GPT-4-based state-of-the-art (SOTA) medical summarization methods, significantly outperforming them in both quantitative metrics and qualitative domain expert evaluations. Notably, we achieve an average relative performance improvement of 11.8% in reference-free metrics over the previous SOTA. Doctors prefer uMedSum's summaries 6 times more than previous SOTA in difficult cases where there are chances of confabulations or missing information. These results highlight uMedSum's effectiveness and generalizability across various datasets and metrics, marking a significant advancement in medical summarization.

The fluency and creativity of large pre-trained language models (LLMs) have led to their widespread use, sometimes even as a replacement for traditional search engines. Yet language models are prone to making convincing but factually inaccurate claims, often referred to as 'hallucinations.' These errors can inadvertently spread misinformation or harmfully perpetuate misconceptions. Further, manual fact-checking of model responses is a time-consuming process, making human factuality labels expensive to acquire. In this work, we fine-tune language models to be more factual, without human labeling and targeting more open-ended generation settings than past work. We leverage two key recent innovations in NLP to do so. First, several recent works have proposed methods for judging the factuality of open-ended text by measuring consistency with an external knowledge base or simply a large model's confidence scores. Second, the direct preference optimization algorithm enables straightforward fine-tuning of language models on objectives other than supervised imitation, using a preference ranking over possible model responses. We show that learning from automatically generated factuality preference rankings, generated either through existing retrieval systems or our novel retrieval-free approach, significantly improves the factuality (percent of generated claims that are correct) of Llama-2 on held-out topics compared with RLHF or decoding strategies targeted at factuality. At 7B scale, compared to Llama-2-chat, we observe 58% and 40% reduction in factual error rate when generating biographies and answering medical questions, respectively.

Public trust in science depends on honest and factual communication of scientific papers. However, recent studies have demonstrated a tendency of news media to misrepresent scientific papers by exaggerating their findings. Given this, we present a formalization of and study into the problem of exaggeration detection in science communication. While there are an abundance of scientific papers and popular media articles written about them, very rarely do the articles include a direct link to the original paper, making data collection challenging. We address this by curating a set of labeled press release/abstract pairs from existing expert annotated studies on exaggeration in press releases of scientific papers suitable for benchmarking the performance of machine learning models on the task. Using limited data from this and previous studies on exaggeration detection in science, we introduce MT-PET, a multi-task version of Pattern Exploiting Training (PET), which leverages knowledge from complementary cloze-style QA tasks to improve few-shot learning. We demonstrate that MT-PET outperforms PET and supervised learning both when data is limited, as well as when there is an abundance of data for the main task.

The emergent abilities of large language models (LLMs) have demonstrated great potential in solving medical questions. They can possess considerable medical knowledge, but may still hallucinate and are inflexible in the knowledge updates. While Retrieval-Augmented Generation (RAG) has been proposed to enhance the medical question-answering capabilities of LLMs with external knowledge bases, it may still fail in complex cases where multiple rounds of information-seeking are required. To address such an issue, we propose iterative RAG for medicine (i-MedRAG), where LLMs can iteratively ask follow-up queries based on previous information-seeking attempts. In each iteration of i-MedRAG, the follow-up queries will be answered by a vanilla RAG system and they will be further used to guide the query generation in the next iteration. Our experiments show the improved performance of various LLMs brought by i-MedRAG compared with vanilla RAG on complex questions from clinical vignettes in the United States Medical Licensing Examination (USMLE), as well as various knowledge tests in the Massive Multitask Language Understanding (MMLU) dataset. Notably, our zero-shot i-MedRAG outperforms all existing prompt engineering and fine-tuning methods on GPT-3.5, achieving an accuracy of 69.68\% on the MedQA dataset. In addition, we characterize the scaling properties of i-MedRAG with different iterations of follow-up queries and different numbers of queries per iteration. Our case studies show that i-MedRAG can flexibly ask follow-up queries to form reasoning chains, providing an in-depth analysis of medical questions. To the best of our knowledge, this is the first-of-its-kind study on incorporating follow-up queries into medical RAG.

The digitization of medical records ushered in a new era of big data to clinical science, and with it the possibility that data could be shared, to multiply insights beyond what investigators could abstract from paper records. The need to share individual-level medical data to accelerate innovation in precision medicine continues to grow, and has never been more urgent, as scientists grapple with the COVID-19 pandemic. However, enthusiasm for the use of big data has been tempered by a fully appropriate concern for patient autonomy and privacy. That is, the ability to extract private or confidential information about an individual, in practice, renders it difficult to share data, since significant infrastructure and data governance must be established before data can be shared. Although HIPAA provided de-identification as an approved mechanism for data sharing, linkage attacks were identified as a major vulnerability. A variety of mechanisms have been established to avoid leaking private information, such as field suppression or abstraction, strictly limiting the amount of information that can be shared, or employing mathematical techniques such as differential privacy. Another approach, which we focus on here, is creating synthetic data that mimics the underlying data. For synthetic data to be a useful mechanism in support of medical innovation and a proxy for real-world evidence, one must demonstrate two properties of the synthetic dataset: (1) any analysis on the real data must be matched by analysis of the synthetic data (statistical fidelity) and (2) the synthetic data must preserve privacy, with minimal risk of re-identification (privacy guarantee). In this paper we propose a framework for quantifying the statistical fidelity and privacy preservation properties of synthetic datasets and demonstrate these metrics for synthetic data generated by Syntegra technology.

A significant and growing number of published scientific articles is found to involve fraudulent practices, posing a serious threat to the credibility and safety of research in fields such as medicine. We propose Pub-Guard-LLM, the first large language model-based system tailored to fraud detection of biomedical scientific articles. We provide three application modes for deploying Pub-Guard-LLM: vanilla reasoning, retrieval-augmented generation, and multi-agent debate. Each mode allows for textual explanations of predictions. To assess the performance of our system, we introduce an open-source benchmark, PubMed Retraction, comprising over 11K real-world biomedical articles, including metadata and retraction labels. We show that, across all modes, Pub-Guard-LLM consistently surpasses the performance of various baselines and provides more reliable explanations, namely explanations which are deemed more relevant and coherent than those generated by the baselines when evaluated by multiple assessment methods. By enhancing both detection performance and explainability in scientific fraud detection, Pub-Guard-LLM contributes to safeguarding research integrity with a novel, effective, open-source tool.

In recent years, the machine learning research community has benefited tremendously from the availability of openly accessible benchmark datasets. Clinical data are usually not openly available due to their highly confidential nature. This has hampered the development of reproducible and generalisable machine learning applications in health care. Here we introduce the Health Gym - a growing collection of highly realistic synthetic medical datasets that can be freely accessed to prototype, evaluate, and compare machine learning algorithms, with a specific focus on reinforcement learning. The three synthetic datasets described in this paper present patient cohorts with acute hypotension and sepsis in the intensive care unit, and people with human immunodeficiency virus (HIV) receiving antiretroviral therapy in ambulatory care. The datasets were created using a novel generative adversarial network (GAN). The distributions of variables, and correlations between variables and trends over time in the synthetic datasets mirror those in the real datasets. Furthermore, the risk of sensitive information disclosure associated with the public distribution of the synthetic datasets is estimated to be very low.

We introduce scientific claim verification, a new task to select abstracts from the research literature containing evidence that SUPPORTS or REFUTES a given scientific claim, and to identify rationales justifying each decision. To study this task, we construct SciFact, a dataset of 1.4K expert-written scientific claims paired with evidence-containing abstracts annotated with labels and rationales. We develop baseline models for SciFact, and demonstrate that simple domain adaptation techniques substantially improve performance compared to models trained on Wikipedia or political news. We show that our system is able to verify claims related to COVID-19 by identifying evidence from the CORD-19 corpus. Our experiments indicate that SciFact will provide a challenging testbed for the development of new systems designed to retrieve and reason over corpora containing specialized domain knowledge. Data and code for this new task are publicly available at https://github.com/allenai/scifact. A leaderboard and COVID-19 fact-checking demo are available at https://scifact.apps.allenai.org.

Accurate breast lesion risk estimation can significantly reduce unnecessary biopsies and help doctors decide optimal treatment plans. Most existing computer-aided systems rely solely on mammogram features to classify breast lesions. While this approach is convenient, it does not fully exploit useful information in clinical reports to achieve the optimal performance. Would clinical features significantly improve breast lesion classification compared to using mammograms alone? How to handle missing clinical information caused by variation in medical practice? What is the best way to combine mammograms and clinical features? There is a compelling need for a systematic study to address these fundamental questions. This paper investigates several multimodal deep networks based on feature concatenation, cross-attention, and co-attention to combine mammograms and categorical clinical variables. We show that the proposed architectures significantly increase the lesion classification performance (average area under ROC curves from 0.89 to 0.94). We also evaluate the model when clinical variables are missing.

In recent years, medical information technology has made it possible for electronic health record (EHR) to store fairly complete clinical data. This has brought health care into the era of "big data". However, medical data are often sparse and strongly correlated, which means that medical problems cannot be solved effectively. With the rapid development of deep learning in recent years, it has provided opportunities for the use of big data in healthcare. In this paper, we propose a temporal-saptial correlation attention network (TSCAN) to handle some clinical characteristic prediction problems, such as predicting death, predicting length of stay, detecting physiologic decline, and classifying phenotypes. Based on the design of the attention mechanism model, our approach can effectively remove irrelevant items in clinical data and irrelevant nodes in time according to different tasks, so as to obtain more accurate prediction results. Our method can also find key clinical indicators of important outcomes that can be used to improve treatment options. Our experiments use information from the Medical Information Mart for Intensive Care (MIMIC-IV) database, which is open to the public. Finally, we have achieved significant performance benefits of 2.0\% (metric) compared to other SOTA prediction methods. We achieved a staggering 90.7\% on mortality rate, 45.1\% on length of stay. The source code can be find: https://github.com/yuyuheintju/TSCAN.

There is increasing interest in the application large language models (LLMs) to the medical field, in part because of their impressive performance on medical exam questions. While promising, exam questions do not reflect the complexity of real patient-doctor interactions. In reality, physicians' decisions are shaped by many complex factors, such as patient compliance, personal experience, ethical beliefs, and cognitive bias. Taking a step toward understanding this, our hypothesis posits that when LLMs are confronted with clinical questions containing cognitive biases, they will yield significantly less accurate responses compared to the same questions presented without such biases. In this study, we developed BiasMedQA, a benchmark for evaluating cognitive biases in LLMs applied to medical tasks. Using BiasMedQA we evaluated six LLMs, namely GPT-4, Mixtral-8x70B, GPT-3.5, PaLM-2, Llama 2 70B-chat, and the medically specialized PMC Llama 13B. We tested these models on 1,273 questions from the US Medical Licensing Exam (USMLE) Steps 1, 2, and 3, modified to replicate common clinically-relevant cognitive biases. Our analysis revealed varying effects for biases on these LLMs, with GPT-4 standing out for its resilience to bias, in contrast to Llama 2 70B-chat and PMC Llama 13B, which were disproportionately affected by cognitive bias. Our findings highlight the critical need for bias mitigation in the development of medical LLMs, pointing towards safer and more reliable applications in healthcare.

Large language models (LLMs) have received much attention and shown their potential in digital health, while their application in mental health is subject to ongoing debate. This systematic review aims to summarize and characterize the use of LLMs in mental health by investigating the strengths and limitations of the latest work in LLMs and discusses the challenges and opportunities for early screening, digital interventions, and other clinical applications in mental health. Following PRISMA guidelines, we examined English articles from PubMed, DBLP Computer Science Bibliography, and IEEE Xplore, published between 1 January 2017, and 1 September 2023, focusing on mental health and LLMs. The review analyzed 32 articles, including mental health analysis using social media datasets (n=13), mental health chatbots (n=10), and other mental health applications (n=9). Findings reveal LLMs' effectiveness in mental health issue detection and the enhancement of telepsychological services through personalised healthcare. Nonetheless, risks like text inconsistencies, hallucinatory content, and the lack of an ethical framework raise concerns about their clinical use. Despite these challenges, the advancement of LLMs underscores their potential as innovative clinical tools, necessitating further research and development. The review emphasizes that LLMs should complement, not replace, professional mental health services.

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.

COVID-19 (coronavirus disease 2019) pandemic caused by SARS-CoV-2 has led to a treacherous and devastating catastrophe for humanity. At the time of writing, no specific antivirus drugs or vaccines are recommended to control infection transmission and spread. The current diagnosis of COVID-19 is done by Reverse-Transcription Polymer Chain Reaction (RT-PCR) testing. However, this method is expensive, time-consuming, and not easily available in straitened regions. An interpretable and COVID-19 diagnosis AI framework is devised and developed based on the cough sounds features and symptoms metadata to overcome these limitations. The proposed framework's performance was evaluated using a medical dataset containing Symptoms and Demographic data of 30000 audio segments, 328 cough sounds from 150 patients with four cough classes ( COVID-19, Asthma, Bronchitis, and Healthy). Experiments' results show that the model captures the better and robust feature embedding to distinguish between COVID-19 patient coughs and several types of non-COVID-19 coughs with higher specificity and accuracy of 95.04 pm 0.18% and 96.83pm 0.18% respectively, all the while maintaining interpretability.

Large Language Models (LLMs) have the potential of facilitating the development of Artificial Intelligence technology to assist medical experts for interactive decision support, which has been demonstrated by their competitive performances in Medical QA. However, while impressive, the required quality bar for medical applications remains far from being achieved. Currently, LLMs remain challenged by outdated knowledge and by their tendency to generate hallucinated content. Furthermore, most benchmarks to assess medical knowledge lack reference gold explanations which means that it is not possible to evaluate the reasoning of LLMs predictions. Finally, the situation is particularly grim if we consider benchmarking LLMs for languages other than English which remains, as far as we know, a totally neglected topic. In order to address these shortcomings, in this paper we present MedExpQA, the first multilingual benchmark based on medical exams to evaluate LLMs in Medical Question Answering. To the best of our knowledge, MedExpQA includes for the first time reference gold explanations written by medical doctors which can be leveraged to establish various gold-based upper-bounds for comparison with LLMs performance. Comprehensive multilingual experimentation using both the gold reference explanations and Retrieval Augmented Generation (RAG) approaches show that performance of LLMs still has large room for improvement, especially for languages other than English. Furthermore, and despite using state-of-the-art RAG methods, our results also demonstrate the difficulty of obtaining and integrating readily available medical knowledge that may positively impact results on downstream evaluations for Medical Question Answering. So far the benchmark is available in four languages, but we hope that this work may encourage further development to other languages.

This paper aims to help structure the risk landscape associated with large-scale Language Models (LMs). In order to foster advances in responsible innovation, an in-depth understanding of the potential risks posed by these models is needed. A wide range of established and anticipated risks are analysed in detail, drawing on multidisciplinary expertise and literature from computer science, linguistics, and social sciences. We outline six specific risk areas: I. Discrimination, Exclusion and Toxicity, II. Information Hazards, III. Misinformation Harms, V. Malicious Uses, V. Human-Computer Interaction Harms, VI. Automation, Access, and Environmental Harms. The first area concerns the perpetuation of stereotypes, unfair discrimination, exclusionary norms, toxic language, and lower performance by social group for LMs. The second focuses on risks from private data leaks or LMs correctly inferring sensitive information. The third addresses risks arising from poor, false or misleading information including in sensitive domains, and knock-on risks such as the erosion of trust in shared information. The fourth considers risks from actors who try to use LMs to cause harm. The fifth focuses on risks specific to LLMs used to underpin conversational agents that interact with human users, including unsafe use, manipulation or deception. The sixth discusses the risk of environmental harm, job automation, and other challenges that may have a disparate effect on different social groups or communities. In total, we review 21 risks in-depth. We discuss the points of origin of different risks and point to potential mitigation approaches. Lastly, we discuss organisational responsibilities in implementing mitigations, and the role of collaboration and participation. We highlight directions for further research, particularly on expanding the toolkit for assessing and evaluating the outlined risks in LMs.

Along with the COVID-19 pandemic, an "infodemic" of false and misleading information has emerged and has complicated the COVID-19 response efforts. Social networking sites such as Facebook and Twitter have contributed largely to the spread of rumors, conspiracy theories, hate, xenophobia, racism, and prejudice. To combat the spread of fake news, researchers around the world have and are still making considerable efforts to build and share COVID-19 related research articles, models, and datasets. This paper releases "AraCOVID19-MFH" a manually annotated multi-label Arabic COVID-19 fake news and hate speech detection dataset. Our dataset contains 10,828 Arabic tweets annotated with 10 different labels. The labels have been designed to consider some aspects relevant to the fact-checking task, such as the tweet's check worthiness, positivity/negativity, and factuality. To confirm our annotated dataset's practical utility, we used it to train and evaluate several classification models and reported the obtained results. Though the dataset is mainly designed for fake news detection, it can also be used for hate speech detection, opinion/news classification, dialect identification, and many other tasks.

Large language models (LLMs), such as ChatGPT, have received substantial attention due to their impressive human language understanding and generation capabilities. Therefore, the application of LLMs in medicine to assist physicians and patient care emerges as a promising research direction in both artificial intelligence and clinical medicine. To reflect this trend, this survey provides a comprehensive overview of the principles, applications, and challenges faced by LLMs in medicine. Specifically, we aim to address the following questions: 1) How can medical LLMs be built? 2) What are the downstream performances of medical LLMs? 3) How can medical LLMs be utilized in real-world clinical practice? 4) What challenges arise from the use of medical LLMs? and 5) How can we better construct and utilize medical LLMs? As a result, this survey aims to provide insights into the opportunities and challenges of LLMs in medicine and serve as a valuable resource for constructing practical and effective medical LLMs. A regularly updated list of practical guides on medical LLMs can be found at https://github.com/AI-in-Health/MedLLMsPracticalGuide.

Large Language Models (LLMs) have attained human-level accuracy on medical question-answer (QA) benchmarks. However, their limitations in navigating open-ended clinical scenarios have recently been shown, raising concerns about the robustness and generalizability of LLM reasoning across diverse, real-world medical tasks. To probe potential LLM failure modes in clinical problem-solving, we present the medical abstraction and reasoning corpus (M-ARC). M-ARC assesses clinical reasoning through scenarios designed to exploit the Einstellung effect -- the fixation of thought arising from prior experience, targeting LLM inductive biases toward inflexible pattern matching from their training data rather than engaging in flexible reasoning. We find that LLMs, including current state-of-the-art o1 and Gemini models, perform poorly compared to physicians on M-ARC, often demonstrating lack of commonsense medical reasoning and a propensity to hallucinate. In addition, uncertainty estimation analyses indicate that LLMs exhibit overconfidence in their answers, despite their limited accuracy. The failure modes revealed by M-ARC in LLM medical reasoning underscore the need to exercise caution when deploying these models in clinical settings.

Large language models (LLMs) hold great promise in summarizing medical evidence. Most recent studies focus on the application of proprietary LLMs. Using proprietary LLMs introduces multiple risk factors, including a lack of transparency and vendor dependency. While open-source LLMs allow better transparency and customization, their performance falls short compared to proprietary ones. In this study, we investigated to what extent fine-tuning open-source LLMs can further improve their performance in summarizing medical evidence. Utilizing a benchmark dataset, MedReview, consisting of 8,161 pairs of systematic reviews and summaries, we fine-tuned three broadly-used, open-sourced LLMs, namely PRIMERA, LongT5, and Llama-2. Overall, the fine-tuned LLMs obtained an increase of 9.89 in ROUGE-L (95% confidence interval: 8.94-10.81), 13.21 in METEOR score (95% confidence interval: 12.05-14.37), and 15.82 in CHRF score (95% confidence interval: 13.89-16.44). The performance of fine-tuned LongT5 is close to GPT-3.5 with zero-shot settings. Furthermore, smaller fine-tuned models sometimes even demonstrated superior performance compared to larger zero-shot models. The above trends of improvement were also manifested in both human and GPT4-simulated evaluations. Our results can be applied to guide model selection for tasks demanding particular domain knowledge, such as medical evidence summarization.

The remarkable capabilities of Large Language Models (LLMs) make them increasingly compelling for adoption in real-world healthcare applications. However, the risks associated with using LLMs in medical applications have not been systematically characterized. We propose using five key principles for safe and trustworthy medical AI: Truthfulness, Resilience, Fairness, Robustness, and Privacy, along with ten specific aspects. Under this comprehensive framework, we introduce a novel MedGuard benchmark with 1,000 expert-verified questions. Our evaluation of 11 commonly used LLMs shows that the current language models, regardless of their safety alignment mechanisms, generally perform poorly on most of our benchmarks, particularly when compared to the high performance of human physicians. Despite recent reports indicate that advanced LLMs like ChatGPT can match or even exceed human performance in various medical tasks, this study underscores a significant safety gap, highlighting the crucial need for human oversight and the implementation of AI safety guardrails.

Artificial intelligence has significantly impacted medical applications, particularly with the advent of Medical Large Vision Language Models (Med-LVLMs), sparking optimism for the future of automated and personalized healthcare. However, the trustworthiness of Med-LVLMs remains unverified, posing significant risks for future model deployment. In this paper, we introduce CARES and aim to comprehensively evaluate the Trustworthiness of Med-LVLMs across the medical domain. We assess the trustworthiness of Med-LVLMs across five dimensions, including trustfulness, fairness, safety, privacy, and robustness. CARES comprises about 41K question-answer pairs in both closed and open-ended formats, covering 16 medical image modalities and 27 anatomical regions. Our analysis reveals that the models consistently exhibit concerns regarding trustworthiness, often displaying factual inaccuracies and failing to maintain fairness across different demographic groups. Furthermore, they are vulnerable to attacks and demonstrate a lack of privacy awareness. We publicly release our benchmark and code in https://github.com/richard-peng-xia/CARES.

Machine learning (ML) enabled classification models are becoming increasingly popular for tackling the sheer volume and speed of online misinformation and other content that could be identified as harmful. In building these models, data scientists need to take a stance on the legitimacy, authoritativeness and objectivity of the sources of ``truth" used for model training and testing. This has political, ethical and epistemic implications which are rarely addressed in technical papers. Despite (and due to) their reported high accuracy and performance, ML-driven moderation systems have the potential to shape online public debate and create downstream negative impacts such as undue censorship and the reinforcing of false beliefs. Using collaborative ethnography and theoretical insights from social studies of science and expertise, we offer a critical analysis of the process of building ML models for (mis)information classification: we identify a series of algorithmic contingencies--key moments during model development that could lead to different future outcomes, uncertainty and harmful effects as these tools are deployed by social media platforms. We conclude by offering a tentative path toward reflexive and responsible development of ML tools for moderating misinformation and other harmful content online.

Advancements in Large Language Models (LLMs) and their increasing use in medical question-answering necessitate rigorous evaluation of their reliability. A critical challenge lies in hallucination, where models generate plausible yet factually incorrect outputs. In the medical domain, this poses serious risks to patient safety and clinical decision-making. To address this, we introduce MedHallu, the first benchmark specifically designed for medical hallucination detection. MedHallu comprises 10,000 high-quality question-answer pairs derived from PubMedQA, with hallucinated answers systematically generated through a controlled pipeline. Our experiments show that state-of-the-art LLMs, including GPT-4o, Llama-3.1, and the medically fine-tuned UltraMedical, struggle with this binary hallucination detection task, with the best model achieving an F1 score as low as 0.625 for detecting "hard" category hallucinations. Using bidirectional entailment clustering, we show that harder-to-detect hallucinations are semantically closer to ground truth. Through experiments, we also show incorporating domain-specific knowledge and introducing a "not sure" category as one of the answer categories improves the precision and F1 scores by up to 38% relative to baselines.

Large language models (LLMs) have shown promise for generative and knowledge-intensive tasks including question-answering (QA) tasks. However, the practical deployment still faces challenges, notably the issue of "hallucination", where models generate plausible-sounding but unfaithful or nonsensical information. This issue becomes particularly critical in the medical domain due to the uncommon professional concepts and potential social risks involved. This paper analyses the phenomenon of hallucination in medical generative QA systems using widely adopted LLMs and datasets. Our investigation centers on the identification and comprehension of common problematic answers, with a specific emphasis on hallucination. To tackle this challenge, we present an interactive self-reflection methodology that incorporates knowledge acquisition and answer generation. Through this feedback process, our approach steadily enhances the factuality, consistency, and entailment of the generated answers. Consequently, we harness the interactivity and multitasking ability of LLMs and produce progressively more precise and accurate answers. Experimental results on both automatic and human evaluation demonstrate the superiority of our approach in hallucination reduction compared to baselines.

Despite the potential of Large Language Models (LLMs) in medicine, they may generate responses lacking supporting evidence or based on hallucinated evidence. While Retrieval Augment Generation (RAG) is popular to address this issue, few studies implemented and evaluated RAG in downstream domain-specific applications. We developed a RAG pipeline with 70,000 ophthalmology-specific documents that retrieve relevant documents to augment LLMs during inference time. In a case study on long-form consumer health questions, we systematically evaluated the responses including over 500 references of LLMs with and without RAG on 100 questions with 10 healthcare professionals. The evaluation focuses on factuality of evidence, selection and ranking of evidence, attribution of evidence, and answer accuracy and completeness. LLMs without RAG provided 252 references in total. Of which, 45.3% hallucinated, 34.1% consisted of minor errors, and 20.6% were correct. In contrast, LLMs with RAG significantly improved accuracy (54.5% being correct) and reduced error rates (18.8% with minor hallucinations and 26.7% with errors). 62.5% of the top 10 documents retrieved by RAG were selected as the top references in the LLM response, with an average ranking of 4.9. The use of RAG also improved evidence attribution (increasing from 1.85 to 2.49 on a 5-point scale, P<0.001), albeit with slight decreases in accuracy (from 3.52 to 3.23, P=0.03) and completeness (from 3.47 to 3.27, P=0.17). The results demonstrate that LLMs frequently exhibited hallucinated and erroneous evidence in the responses, raising concerns for downstream applications in the medical domain. RAG substantially reduced the proportion of such evidence but encountered challenges.

Verifying scientific claims presents a significantly greater challenge than verifying political or news-related claims. Unlike the relatively broad audience for political claims, the users of scientific claim verification systems can vary widely, ranging from researchers testing specific hypotheses to everyday users seeking information on a medication. Additionally, the evidence for scientific claims is often highly complex, involving technical terminology and intricate domain-specific concepts that require specialized models for accurate verification. Despite considerable interest from the research community, there is a noticeable lack of large-scale scientific claim verification datasets to benchmark and train effective models. To bridge this gap, we introduce two large-scale datasets, SciClaimHunt and SciClaimHunt_Num, derived from scientific research papers. We propose several baseline models tailored for scientific claim verification to assess the effectiveness of these datasets. Additionally, we evaluate models trained on SciClaimHunt and SciClaimHunt_Num against existing scientific claim verification datasets to gauge their quality and reliability. Furthermore, we conduct human evaluations of the claims in proposed datasets and perform error analysis to assess the effectiveness of the proposed baseline models. Our findings indicate that SciClaimHunt and SciClaimHunt_Num serve as highly reliable resources for training models in scientific claim verification.

In recent years, the application of Large Language Models (LLMs) in healthcare has shown significant promise in improving the accessibility and dissemination of medical knowledge. This paper presents a detailed study of various LLMs trained on the MedQuAD medical question-answering dataset, with a focus on identifying the most effective model for providing accurate medical information. Among the models tested, the Sentence-t5 combined with Mistral 7B demonstrated superior performance, achieving a precision score of 0.762. This model's enhanced capabilities are attributed to its advanced pretraining techniques, robust architecture, and effective prompt construction methodologies. By leveraging these strengths, the Sentence-t5 + Mistral 7B model excels in understanding and generating precise medical answers. Our findings highlight the potential of integrating sophisticated LLMs in medical contexts to facilitate efficient and accurate medical knowledge retrieval, thus significantly enhancing patient education and support.

Hallucinated outputs from language models pose risks in the medical domain, especially for lay audiences making health-related decisions. Existing factuality evaluation methods, such as entailment- and question-answering-based (QA), struggle with plain language summary (PLS) generation due to elaborative explanation phenomenon, which introduces external content (e.g., definitions, background, examples) absent from the source document to enhance comprehension. To address this, we introduce PlainQAFact, a framework trained on a fine-grained, human-annotated dataset PlainFact, to evaluate the factuality of both source-simplified and elaboratively explained sentences. PlainQAFact first classifies factuality type and then assesses factuality using a retrieval-augmented QA-based scoring method. Our approach is lightweight and computationally efficient. Empirical results show that existing factuality metrics fail to effectively evaluate factuality in PLS, especially for elaborative explanations, whereas PlainQAFact achieves state-of-the-art performance. We further analyze its effectiveness across external knowledge sources, answer extraction strategies, overlap measures, and document granularity levels, refining its overall factuality assessment.

Deception is the intentional practice of twisting information. It is a nuanced societal practice deeply intertwined with human societal evolution, characterized by a multitude of facets. This research explores the problem of deception through the lens of psychology, employing a framework that categorizes deception into three forms: lies of omission, lies of commission, and lies of influence. The primary focus of this study is specifically on investigating only lies of omission. We propose a novel framework for deception detection leveraging NLP techniques. We curated an annotated dataset of 876,784 samples by amalgamating a popular large-scale fake news dataset and scraped news headlines from the Twitter handle of Times of India, a well-known Indian news media house. Each sample has been labeled with four layers, namely: (i) the type of omission (speculation, bias, distortion, sounds factual, and opinion), (ii) colors of lies(black, white, etc), and (iii) the intention of such lies (to influence, etc) (iv) topic of lies (political, educational, religious, etc). We present a novel multi-task learning pipeline that leverages the dataless merging of fine-tuned language models to address the deception detection task mentioned earlier. Our proposed model achieved an F1 score of 0.87, demonstrating strong performance across all layers including the type, color, intent, and topic aspects of deceptive content. Finally, our research explores the relationship between lies of omission and propaganda techniques. To accomplish this, we conducted an in-depth analysis, uncovering compelling findings. For instance, our analysis revealed a significant correlation between loaded language and opinion, shedding light on their interconnectedness. To encourage further research in this field, we will be making the models and dataset available with the MIT License, making it favorable for open-source research.

To assess the effectiveness of any medical intervention, researchers must conduct a time-intensive and highly manual literature review. NLP systems can help to automate or assist in parts of this expensive process. In support of this goal, we release MS^2 (Multi-Document Summarization of Medical Studies), a dataset of over 470k documents and 20k summaries derived from the scientific literature. This dataset facilitates the development of systems that can assess and aggregate contradictory evidence across multiple studies, and is the first large-scale, publicly available multi-document summarization dataset in the biomedical domain. We experiment with a summarization system based on BART, with promising early results. We formulate our summarization inputs and targets in both free text and structured forms and modify a recently proposed metric to assess the quality of our system's generated summaries. Data and models are available at https://github.com/allenai/ms2

The escalating challenge of misinformation, particularly in the context of political discourse, necessitates advanced solutions for fact-checking. We introduce innovative approaches to enhance the reliability and efficiency of multimodal fact-checking through the integration of Large Language Models (LLMs) with Retrieval-augmented Generation (RAG)- based advanced reasoning techniques. This work proposes two novel methodologies, Chain of RAG (CoRAG) and Tree of RAG (ToRAG). The approaches are designed to handle multimodal claims by reasoning the next questions that need to be answered based on previous evidence. Our approaches improve the accuracy of veracity predictions and the generation of explanations over the traditional fact-checking approach of sub-question generation with chain of thought veracity prediction. By employing multimodal LLMs adept at analyzing both text and images, this research advances the capability of automated systems in identifying and countering misinformation.