Discharge summaries are crucial clinical documents containing the context of a patient's overall hospital stay, and are routinely reviewed by medical experts for patient readmission, ongoing care, and diagnostic decision-making. When reviewing them, medical experts often must iteratively synthesize information across multiple summaries while verifying the evidence supporting each answer. Although large language models (LLMs) are increasingly explored for clinical question answering, existing benchmarks do not sufficiently reflect this setting: they often evaluate exam-style medical knowledge or focus on single-turn question answering with limited evidence-grounding evaluation. We introduce EHRNote-ChatQA, the first benchmark for evidence-grounded multi-turn clinical question answering over patients' multiple discharge summaries. Built from de-identified MIMIC-IV discharge summaries, EHRNote-ChatQA contains 967 patient-level multi-turn samples spanning one to five notes and 16,072 medical-expert-verified QA pairs (8,036 content questions, each paired with an evidence-grounding question) across eight clinical categories. The benchmark is constructed through an expert-informed pipeline combining discharge-summary structuring schema, expert-curated multi-turn QA templates, and LLM-based generation, followed by review and revision of every single QA sample by 11 medical experts. Benchmarking 22 open- and closed-source LLMs reveals several challenges, including that LLMs struggle more with evidence grounding than content answering, multi-turn errors compound across turns, and single-turn clinical QA performance does not reliably transfer to this setting. These findings establish EHRNote-ChatQA as a rigorous and practical benchmark for evaluating clinical QA systems. The dataset will be made publicly available through PhysioNet credentialed access.
We introduce KorMedMCQA-V, a Korean medical licensing-exam-style multimodal multiple-choice question answering benchmark for evaluating vision-language models (VLMs). The dataset consists of 1,534 questions with 2,043 associated images from Korean Medical Licensing Examinations (2012-2023), with about 30
Virtual Teaching Assistants (VTAs) powered by Large Language Models (LLMs) have the potential to enhance student learning by providing instant feedback and facilitating multi-turn interactions. However, empirical studies on their effectiveness and acceptance in real-world classrooms are limited, leaving their practical impact uncertain. In this study, we develop an LLM-based VTA and deploy it in an introductory AI programming course with 477 graduate students. To assess how student perceptions of the VTA’s performance evolve over time, we conduct three rounds of comprehensive surveys at different stages of the course. Additionally, we analyze 3,869 student–VTA interaction pairs to identify common question types and engagement patterns. We then compare these interactions with traditional student-human instructor interactions to evaluate the VTA’s role in the learning process. Through a large-scale empirical study and interaction analysis, we assess the feasibility of deploying VTAs in real-world classrooms and identify key challenges for broader adoption. Finally, we release the source code of our VTA system, fostering future advancements in AI-driven education.
This study introduces EHRNoteQA, a novel patient-specific question answering benchmark tailored for evaluating Large Language Models (LLMs) in clinical environments. Based on MIMIC-IV Electronic Health Record (EHR), a team of three medical professionals has curated the dataset comprising 962 unique questions, each linked to a specific patient's EHR clinical notes. What makes EHRNoteQA distinct from existing EHR-based benchmarks is as follows: Firstly, it is the first dataset to adopt a multi-choice question answering format, a design choice that effectively evaluates LLMs with reliable scores in the context of automatic evaluation, compared to other formats. Secondly, it requires an analysis of multiple clinical notes to answer a single question, reflecting the complex nature of real-world clinical decision-making where clinicians review extensive records of patient histories. Our comprehensive evaluation on various large language models showed that their scores on EHRNoteQA correlate more closely with their performance in addressing real-world medical questions evaluated by clinicians than their scores from other LLM benchmarks. This underscores the significance of EHRNoteQA in evaluating LLMs for medical applications and highlights its crucial role in facilitating the integration of LLMs into healthcare systems. The dataset will be made available to the public under PhysioNet credential access, promoting further research in this vital field.
Electronic Health Records (EHRs) are relational databases that store the entire medical histories of patients within hospitals. They record numerous aspects of patients' medical care, from hospital admission and diagnosis to treatment and discharge. While EHRs are vital sources of clinical data, exploring them beyond a predefined set of queries requires skills in query languages like SQL. To make information retrieval more accessible, one strategy is to build a question-answering system, possibly leveraging text-to-SQL models that can automatically translate natural language questions into corresponding SQL queries and use these queries to retrieve the answers. The EHRSQL 2024 shared task aims to advance and promote research in developing a question-answering system for EHRs using text-to-SQL modeling, capable of reliably providing requested answers to various healthcare professionals to improve their clinical work processes and satisfy their needs. Among more than 100 participants who applied to the shared task, eight teams completed the entire shared task processes and demonstrated a wide range of methods to effectively solve this task. In this paper, we describe the task of reliable text-to-SQL modeling, the dataset, and the methods and results of the participants. We hope this shared task will spur further research and insights into developing reliable question-answering systems for EHRs.
The development of large language models tailored for handling patients' clinical notes is often hindered by the limited accessibility and usability of these notes due to strict privacy regulations. To address these challenges, we first create synthetic large-scale clinical notes using publicly available case reports extracted from biomedical literature. We then use these synthetic notes to train our specialized clinical large language model, Asclepius. While Asclepius is trained on synthetic data, we assess its potential performance in real-world applications by evaluating it using real clinical notes. We benchmark Asclepius against several other large language models, including GPT-3.5-turbo and other open-source alternatives. To further validate our approach using synthetic notes, we also compare Asclepius with its variants trained on real clinical notes. Our findings convincingly demonstrate that synthetic clinical notes can serve as viable substitutes for real ones when constructing high-performing clinical language models. This conclusion is supported by detailed evaluations conducted by both GPT-4 and medical professionals. All resources including weights, codes, and data used in the development of Asclepius are made publicly accessible for future research. (https://github.com/starmpcc/Asclepius)
We present KorMedMCQA, the first Korean Medical Multiple-Choice Question Answering benchmark, derived from professional healthcare licensing examinations conducted in Korea between 2012 and 2024. The dataset contains 7,469 questions from examinations for doctor, nurse, pharmacist, and dentist, covering a wide range of medical disciplines. We evaluate the performance of 59 large language models, spanning proprietary and open-source models, multilingual and Korean-specialized models, and those fine-tuned for clinical applications. Our results show that applying Chain of Thought (CoT) reasoning can enhance the model performance by up to 4.5 approaches. We also investigate whether MedQA, one of the most widely used medical benchmarks derived from the U.S. Medical Licensing Examination, can serve as a reliable proxy for evaluating model performance in other regions-in this case, Korea. Our correlation analysis between model scores on KorMedMCQA and MedQA reveals that these two benchmarks align no better than benchmarks from entirely different domains (e.g., MedQA and MMLU-Pro). This finding underscores the substantial linguistic and clinical differences between Korean and U.S. medical contexts, reinforcing the need for region-specific medical QA benchmarks. To support ongoing research in Korean healthcare AI, we publicly release the KorMedMCQA via Huggingface.
Discharge summaries in Electronic Health Records (EHRs) are crucial for clinical decision-making, but their length and complexity make information extraction challenging, especially when dealing with accumulated summaries across multiple patient admissions. Large Language Models (LLMs) show promise in addressing this challenge by efficiently analyzing vast and complex data. Existing benchmarks, however, fall short in properly evaluating LLMs' capabilities in this context, as they typically focus on single-note information or limited topics, failing to reflect the real-world inquiries required by clinicians. To bridge this gap, we introduce EHRNoteQA, a novel benchmark built on the MIMIC-IV EHR, comprising 962 different QA pairs each linked to distinct patients' discharge summaries. Every QA pair is initially generated using GPT-4 and then manually reviewed and refined by three clinicians to ensure clinical relevance. EHRNoteQA includes questions that require information across multiple discharge summaries and covers eight diverse topics, mirroring the complexity and diversity of real clinical inquiries. We offer EHRNoteQA in two formats: open-ended and multi-choice question answering, and propose a reliable evaluation method for each. We evaluate 27 LLMs using EHRNoteQA and examine various factors affecting the model performance (e.g., the length and number of discharge summaries). Furthermore, to validate EHRNoteQA as a reliable proxy for expert evaluations in clinical practice, we measure the correlation between the LLM performance on EHRNoteQA, and the LLM performance manually evaluated by clinicians. Results show that LLM performance on EHRNoteQA have higher correlation with clinician-evaluated performance (Spearman: 0.78, Kendall: 0.62) compared to other benchmarks, demonstrating its practical relevance in evaluating LLMs in clinical settings.
Despite recent interest in open domain question answering (ODQA) over tables, many studies still rely on datasets that are not truly optimal for the task with respect to utilizing structural nature of table. These datasets assume answers reside as a single cell value and do not necessitate exploring over multiple cells such as aggregation, comparison, and sorting. Thus, we release Open-WikiTable, the first ODQA dataset that requires complex reasoning over tables. Open-WikiTable is built upon WikiSQL and WikiTableQuestions to be applicable in the open-domain setting. As each question is coupled with both textual answers and SQL queries, Open-WikiTable opens up a wide range of possibilities for future research, as both reader and parser methods can be applied. The dataset and code are publicly available.
Electronic Health Records (EHRs), which contain patients' medical histories in various multi-modal formats, often overlook the potential for joint reasoning across imaging and table modalities underexplored in current EHR Question Answering (QA) systems. In this paper, we introduce EHRXQA, a novel multi-modal question answering dataset combining structured EHRs and chest X-ray images. To develop our dataset, we first construct two uni-modal resources: 1) The MIMIC-CXR-VQA dataset, our newly created medical visual question answering (VQA) benchmark, specifically designed to augment the imaging modality in EHR QA, and 2) EHRSQL (MIMIC-IV), a refashioned version of a previously established table-based EHR QA dataset. By integrating these two uni-modal resources, we successfully construct a multi-modal EHR QA dataset that necessitates both uni-modal and cross-modal reasoning. To address the unique challenges of multi-modal questions within EHRs, we propose a NeuralSQL-based strategy equipped with an external VQA API. This pioneering endeavor enhances engagement with multi-modal EHR sources and we believe that our dataset can catalyze advances in real-world medical scenarios such as clinical decision-making and research. EHRXQA is available at https://github.com/baeseongsu/ehrxqa.