Resource library

Deploying large language models (LLMs) is challenging because they are memory inefficient and compute-intensive for practical applications. In reaction, researchers train smaller task-specific models by either finetuning with human labels or distilling using LLMgenerated labels. However, finetuning and distillation require large amounts of training data to achieve comparable performance to LLMs. We introduce Distilling step-by-step, a new mechanism that (a)…

Multimodal datasets are a critical component in recent breakthroughs such as Stable Diffusion and GPT-4, yet their design does not receive the same research attention as model architectures or training algorithms. To address this shortcoming in the ML ecosystem, we introduce DataComp, a testbed for dataset experiments centered around a new candidate pool of 12.8 billion image-text pairs from Common…

Research patient data repositories are essential for health systems to learn from the experiences of their patients and for advancing the mission of academic medical centers. In this paper, we describe methods, tools, and practices at Stanford Medicine to maintain its research patient data repository and computing resources to support clinical and translational research, which together comprise the Stanford Medicine…

The ability of large language models (LLMs) to follow natural language instructions with human-level fluency suggests many opportunities in healthcare to reduce administrative burden and improve quality of care. However, evaluating LLMs on realistic text generation tasks for healthcare remains challenging. Existing question answering datasets for electronic health record (EHR) data fail to capture the complexity of information needs and…

The success of foundation models such as ChatGPT and AlphaFold has spurred significant interest in building similar models for electronic medical records (EMRs) to improve patient care and hospital operations. However, recent hype has obscured critical gaps in our understanding of these models’ capabilities. In this narrative review, we examine 84 foundation models trained on nonimaging EMR data (i.e., clinical…

While the general machine learning (ML) community has benefited from public datasets, tasks, and models, the progress of ML in healthcare has been hampered by a lack of such shared assets. The success of foundation models creates new challenges for healthcare ML by requiring access to shared pretrained models to validate performance benefits. We help address these challenges through three…

Electronic phenotyping entails using electronic health records (EHRs) to identify patients with specific health outcomes and determine when those outcomes occurred. Unstructured clinical notes, which contain a vast amount of information, are a valuable resource for electronic phenotyping. However, traditional methods, such as rule-based labeling functions or neural networks, require significant manual effort to tune and may not generalize well…

Temporal distribution shift negatively impacts the performance of clinical prediction models over time. Pretraining foundation models using self-supervised learning on electronic health records (EHR) may be effective in acquiring informative global patterns that can improve the robustness of task-specific models. The objective was to evaluate the utility of EHR foundation models in improving the in-distribution (ID) and out-of-distribution (OOD) performance…

We present a self-supervised, time-to-event (TTE) foundation model called MOTOR (Many Outcome Time Oriented Representations) which is pretrained on timestamped sequences of events in electronic health records (EHR) and health insurance claims. TTE models are used for estimating the probability distribution of the time until a specific event occurs, which is an important task in medical settings. TTE models provide…