# Aligning Large Language Models for Clinical Tasks

arXiv: https://arxiv.org/abs/2309.02884 · HTML: https://mlsanity.com/paper/2309.02884/

## Key facts

- Cited by 6 papers in the map (data through 14 Oct 2026).
- Placed in Medical LLM alignment, one of 10 directions in LLM alignment / RLHF / preference optimisation.
- Builds on 35 of its 55 references that are in the map.
- First posted on arXiv 6 Sep 2023.

## Placed in

- LLM alignment / RLHF / preference optimisation / [Medical LLM alignment](https://mlsanity.com/alignment/medical-llm-alignment/)

## Builds on (most cited first, 30 of 35)

- [Attention Is All You Need](https://mlsanity.com/paper/1706.03762/) (2017)
- [Language Models are Few-Shot Learners](https://mlsanity.com/paper/2005.14165/) (2020)
- [Training language models to follow instructions with human feedback](https://mlsanity.com/paper/2203.02155/) (2022)
- [Chain-of-Thought Prompting Elicits Reasoning in Large Language Models](https://mlsanity.com/paper/2201.11903/) (2022)
- [Retrieval-Augmented Generation for Knowledge-Intensive NLP Tasks](https://mlsanity.com/paper/2005.11401/) (2020)
- [Measuring Massive Multitask Language Understanding](https://mlsanity.com/paper/2009.03300/) (2020)
- [Scaling Laws for Neural Language Models](https://mlsanity.com/paper/2001.08361/) (2020)
- [Self-Consistency Improves Chain of Thought Reasoning in Language Models](https://mlsanity.com/paper/2203.11171/) (2022)
- [PaLM: Scaling Language Modeling with Pathways](https://mlsanity.com/paper/2204.02311/) (2022)
- [On the Opportunities and Risks of Foundation Models](https://mlsanity.com/paper/2108.07258/) (2021)
- [Self-Refine: Iterative Refinement with Self-Feedback](https://mlsanity.com/paper/2303.17651/) (2023)
- [TriviaQA: A Large Scale Distantly Supervised Challenge Dataset for Reading Comprehension](https://mlsanity.com/paper/1705.03551/) (2017)
- [Sparks of Artificial General Intelligence: Early experiments with GPT-4](https://mlsanity.com/paper/2303.12712/) (2023)
- [Billion-scale similarity search with GPUs](https://mlsanity.com/paper/1702.08734/) (2017)
- [Pre-train, Prompt, and Predict: A Systematic Survey of Prompting Methods in Natural Language Processing](https://mlsanity.com/paper/2107.13586/) (2021)
- [REALM: Retrieval-Augmented Language Model Pre-Training](https://mlsanity.com/paper/2002.08909/) (2020)
- [BioBERT: a pre-trained biomedical language representation model for biomedical text mining](https://mlsanity.com/paper/1901.08746/) (2019)
- [Large Language Models Encode Clinical Knowledge](https://mlsanity.com/paper/2212.13138/) (2022)
- [SciBERT: A Pretrained Language Model for Scientific Text](https://mlsanity.com/paper/1903.10676/) (2019)
- [What Disease does this Patient Have? A Large-scale Open Domain Question Answering Dataset from Medical Exams](https://mlsanity.com/paper/2009.13081/) (2020)
- [PubMedQA: A Dataset for Biomedical Research Question Answering](https://mlsanity.com/paper/1909.06146/) (2019)
- [Domain-Specific Language Model Pretraining for Biomedical Natural Language Processing](https://mlsanity.com/paper/2007.15779/) (2020)
- [Large Language Models Can Be Easily Distracted by Irrelevant Context](https://mlsanity.com/paper/2302.00093/) (2023)
- [SelfCheckGPT: Zero-Resource Black-Box Hallucination Detection for Generative Large Language Models](https://mlsanity.com/paper/2303.08896/) (2023)
- [Galactica: A Large Language Model for Science](https://mlsanity.com/paper/2211.09085/) (2022)
- [Capabilities of GPT-4 on Medical Challenge Problems](https://mlsanity.com/paper/2303.13375/) (2023)
- [MedMCQA : A Large-scale Multi-Subject Multi-Choice Dataset for Medical domain Question Answering](https://mlsanity.com/paper/2203.14371/) (2022)
- [BioGPT: Generative Pre-trained Transformer for Biomedical Text Generation and Mining](https://mlsanity.com/paper/2210.10341/) (2022)
- [Towards Expert-Level Medical Question Answering with Large Language Models](https://mlsanity.com/paper/2305.09617/) (2023)
- [Can large language models reason about medical questions?](https://mlsanity.com/paper/2207.08143/) (2022)

## Built on by (most cited first, 6 of 6)

- [A Survey on Medical Large Language Models: Technology, Application, Trustworthiness, and Future Directions](https://mlsanity.com/paper/2406.03712/) (2024)
- [Aligning (Medical) LLMs for (Counterfactual) Fairness](https://mlsanity.com/paper/2408.12055/) (2024)
- [Evaluating Fine-Tuning Efficiency of Human-Inspired Learning Strategies in Medical Question Answering](https://mlsanity.com/paper/2408.07888/) (2024)
- [On the Reliability of Large Language Models to Misinformed and Demographically-Informed Prompts](https://mlsanity.com/paper/2410.10850/) (2024)
- [LanguaShrink: Reducing Token Overhead with Psycholinguistics](https://mlsanity.com/paper/2409.00855/) (2024)
- [MedOrchestra: A Hybrid Cloud-Local LLM Approach for Clinical Data Interpretation](https://mlsanity.com/paper/2505.23806/) (2025)

## Abstract (arXiv)

Large Language Models (LLMs) have demonstrated remarkable adaptability, showcasing their capacity to excel in tasks for which they were not explicitly trained. However, despite their impressive natural language processing (NLP) capabilities, effective alignment of LLMs remains a crucial challenge when deploying them for specific clinical applications. The ability to generate responses with factually accurate content and to engage in non-trivial reasoning steps are crucial for the LLMs to be eligible for applications in clinical medicine. Employing a combination of techniques including instruction-tuning and in-prompt strategies like few-shot and chain-of-thought prompting has significantly enhanced the performance of LLMs. Our proposed alignment strategy for medical question-answering, known as 'expand-guess-refine', offers a parameter and data-efficient solution. A preliminary analysis of this method demonstrated outstanding performance, achieving a score of 70.63% on a subset of questions sourced from the USMLE dataset.