# Do Physicians Know How to Prompt? The Need for Automatic Prompt Optimization Help in Clinical Note Generation

arXiv: https://arxiv.org/abs/2311.09684 · HTML: https://mlsanity.com/paper/2311.09684/

## Key facts

- Cited by 2 papers in the map (data through 14 Oct 2026).
- Builds on 27 of its 54 references that are in the map.
- First posted on arXiv 16 Nov 2023.

## Builds on (most cited first, 27 of 27)

- [Language Models are Few-Shot Learners](https://mlsanity.com/paper/2005.14165/) (2020)
- [LoRA: Low-Rank Adaptation of Large Language Models](https://mlsanity.com/paper/2106.09685/) (2021)
- [LLaMA: Open and Efficient Foundation Language Models](https://mlsanity.com/paper/2302.13971/) (2023)
- [PaLM: Scaling Language Modeling with Pathways](https://mlsanity.com/paper/2204.02311/) (2022)
- [Prefix-Tuning: Optimizing Continuous Prompts for Generation](https://mlsanity.com/paper/2101.00190/) (2021)
- [The Power of Scale for Parameter-Efficient Prompt Tuning](https://mlsanity.com/paper/2104.08691/) (2021)
- [Self-Refine: Iterative Refinement with Self-Feedback](https://mlsanity.com/paper/2303.17651/) (2023)
- [Self-Instruct: Aligning Language Models with Self-Generated Instructions](https://mlsanity.com/paper/2212.10560/) (2022)
- [Language Models as Knowledge Bases?](https://mlsanity.com/paper/1909.01066/) (2019)
- [Large Language Models Encode Clinical Knowledge](https://mlsanity.com/paper/2212.13138/) (2022)
- [Multitask Prompted Training Enables Zero-Shot Task Generalization](https://mlsanity.com/paper/2110.08207/) (2021)
- [Large Language Models Are Human-Level Prompt Engineers](https://mlsanity.com/paper/2211.01910/) (2022)
- [Large Language Models Can Self-Improve](https://mlsanity.com/paper/2210.11610/) (2022)
- [Automatic Prompt Optimization with "Gradient Descent" and Beam Search](https://mlsanity.com/paper/2305.03495/) (2023)
- [Promptbreeder: Self-Referential Self-Improvement Via Prompt Evolution](https://mlsanity.com/paper/2309.16797/) (2023)
- [RLPrompt: Optimizing Discrete Text Prompts with Reinforcement Learning](https://mlsanity.com/paper/2205.12548/) (2022)
- [Hard Prompts Made Easy: Gradient-Based Discrete Optimization for Prompt Tuning and Discovery](https://mlsanity.com/paper/2302.03668/) (2023)
- [PromptAgent: Strategic Planning with Language Models Enables Expert-level Prompt Optimization](https://mlsanity.com/paper/2310.16427/) (2023)
- [EvoPrompt: Connecting LLMs with Evolutionary Algorithms Yields Powerful Prompt Optimizers](https://mlsanity.com/paper/2309.08532/) (2023)
- [Can Language Models be Biomedical Knowledge Bases?](https://mlsanity.com/paper/2109.07154/) (2021)
- [Generating SOAP Notes from Doctor-Patient Conversations Using Modular Summarization Techniques](https://mlsanity.com/paper/2005.01795/) (2020)
- [NoteChat: A Dataset of Synthetic Doctor-Patient Conversations Conditioned on Clinical Notes](https://mlsanity.com/paper/2310.15959/) (2023)
- [Reprompting: Automated Chain-of-Thought Prompt Inference Through Gibbs Sampling](https://mlsanity.com/paper/2305.09993/) (2023)
- [AutoHint: Automatic Prompt Optimization with Hint Generation](https://mlsanity.com/paper/2307.07415/) (2023)
- [Extracting Biomedical Factual Knowledge Using Pretrained Language Model and Electronic Health Record Context](https://mlsanity.com/paper/2209.07859/) (2022)
- [Context Variance Evaluation of Pretrained Language Models for Prompt-based Biomedical Knowledge Probing](https://mlsanity.com/paper/2211.10265/) (2022)
- [A Meta-Evaluation of Faithfulness Metrics for Long-Form Hospital-Course Summarization](https://mlsanity.com/paper/2303.03948/) (2023)

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

- [SynthEHR-Eviction: Enhancing Eviction SDoH Detection with LLM-Augmented Synthetic EHR Data](https://mlsanity.com/paper/2507.07421/) (2025)
- [UMass-BioNLP at MEDIQA-M3G 2024: DermPrompt -- A Systematic Exploration of Prompt Engineering with GPT-4V for Dermatological Diagnosis](https://mlsanity.com/paper/2404.17749/) (2024)

## Abstract (arXiv)

This study examines the effect of prompt engineering on the performance of Large Language Models (LLMs) in clinical note generation. We introduce an Automatic Prompt Optimization (APO) framework to refine initial prompts and compare the outputs of medical experts, non-medical experts, and APO-enhanced GPT3.5 and GPT4. Results highlight GPT4 APO's superior performance in standardizing prompt quality across clinical note sections. A human-in-the-loop approach shows that experts maintain content quality post-APO, with a preference for their own modifications, suggesting the value of expert customization. We recommend a two-phase optimization process, leveraging APO-GPT4 for consistency and expert input for personalization.