# "Nothing Abnormal": Disambiguating Medical Reports via Contrastive Knowledge Infusion

arXiv: https://arxiv.org/abs/2305.08300 · HTML: https://mlsanity.com/paper/2305.08300/

## Key facts

- Cited by 2 papers in the map (data through 14 Oct 2026).
- Builds on 23 of its 38 references that are in the map.
- First posted on arXiv 15 May 2023.

## Builds on (most cited first, 23 of 23)

- [Representation Learning with Contrastive Predictive Coding](https://mlsanity.com/paper/1807.03748/) (2018)
- [BART: Denoising Sequence-to-Sequence Pre-training for Natural Language Generation, Translation, and Comprehension](https://mlsanity.com/paper/1910.13461/) (2019)
- [Supervised Contrastive Learning](https://mlsanity.com/paper/2004.11362/) (2020)
- [Don't Stop Pretraining: Adapt Language Models to Domains and Tasks](https://mlsanity.com/paper/2004.10964/) (2020)
- [CheXpert: A Large Chest Radiograph Dataset with Uncertainty Labels and Expert Comparison](https://mlsanity.com/paper/1901.07031/) (2019)
- [Plug and Play Language Models: A Simple Approach to Controlled Text Generation](https://mlsanity.com/paper/1912.02164/) (2019)
- [CTRL: A Conditional Transformer Language Model for Controllable Generation](https://mlsanity.com/paper/1909.05858/) (2019)
- [MIMIC-CXR-JPG, a large publicly available database of labeled chest radiographs](https://mlsanity.com/paper/1901.07042/) (2019)
- [FUDGE: Controlled Text Generation With Future Discriminators](https://mlsanity.com/paper/2104.05218/) (2021)
- [Generating Radiology Reports via Memory-driven Transformer](https://mlsanity.com/paper/2010.16056/) (2020)
- [Hidden Stratification Causes Clinically Meaningful Failures in Machine Learning for Medical Imaging](https://mlsanity.com/paper/1909.12475/) (2019)
- [No Subclass Left Behind: Fine-Grained Robustness in Coarse-Grained Classification Problems](https://mlsanity.com/paper/2011.12945/) (2020)
- [Hybrid Retrieval-Generation Reinforced Agent for Medical Image Report Generation](https://mlsanity.com/paper/1805.08298/) (2018)
- [Self-Guided Contrastive Learning for BERT Sentence Representations](https://mlsanity.com/paper/2106.07345/) (2021)
- [Style Transformer: Unpaired Text Style Transfer without Disentangled Latent Representation](https://mlsanity.com/paper/1905.05621/) (2019)
- [A Simple but Tough-to-Beat Data Augmentation Approach for Natural Language Understanding and Generation](https://mlsanity.com/paper/2009.13818/) (2020)
- [CoDA: Contrast-enhanced and Diversity-promoting Data Augmentation for Natural Language Understanding](https://mlsanity.com/paper/2010.08670/) (2020)
- [Weakly Supervised Contrastive Learning for Chest X-Ray Report Generation](https://mlsanity.com/paper/2109.12242/) (2021)
- [Personalized Showcases: Generating Multi-Modal Explanations for Recommendations](https://mlsanity.com/paper/2207.00422/) (2022)
- [Visualize Before You Write: Imagination-Guided Open-Ended Text Generation](https://mlsanity.com/paper/2210.03765/) (2022)
- [Detect and Perturb: Neutral Rewriting of Biased and Sensitive Text via Gradient-based Decoding](https://mlsanity.com/paper/2109.11708/) (2021)
- [Addressing Data Bias Problems for Chest X-ray Image Report Generation](https://mlsanity.com/paper/1908.02123/) (2019)
- [Self-Supervised Knowledge Assimilation for Expert-Layman Text Style Transfer](https://mlsanity.com/paper/2110.02950/) (2021)

## Built on by (most cited first, 2 of 2)

- [Robust and Interpretable Medical Image Classifiers via Concept Bottleneck Models](https://mlsanity.com/paper/2310.03182/) (2023)
- [MedEval: A Multi-Level, Multi-Task, and Multi-Domain Medical Benchmark for Language Model Evaluation](https://mlsanity.com/paper/2310.14088/) (2023)

## Abstract (arXiv)

Sharing medical reports is essential for patient-centered care. A recent line of work has focused on automatically generating reports with NLP methods. However, different audiences have different purposes when writing/reading medical reports -- for example, healthcare professionals care more about pathology, whereas patients are more concerned with the diagnosis ("Is there any abnormality?"). The expectation gap results in a common situation where patients find their medical reports to be ambiguous and therefore unsure about the next steps. In this work, we explore the audience expectation gap in healthcare and summarize common ambiguities that lead patients to be confused about their diagnosis into three categories: medical jargon, contradictory findings, and misleading grammatical errors. Based on our analysis, we define a disambiguation rewriting task to regenerate an input to be unambiguous while preserving information about the original content. We further propose a rewriting algorithm based on contrastive pretraining and perturbation-based rewriting. In addition, we create two datasets, OpenI-Annotated based on chest reports and VA-Annotated based on general medical reports, with available binary labels for ambiguity and abnormality presence annotated by radiology specialists. Experimental results on these datasets show that our proposed algorithm effectively rewrites input sentences in a less ambiguous way with high content fidelity. Our code and annotated data are released to facilitate future research.