# Low-resource classification of mobility functioning information in clinical sentences using large language models

arXiv: https://arxiv.org/abs/2312.10202 · HTML: https://mlsanity.com/paper/2312.10202/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 27 of its 41 references that are in the map.
- First posted on arXiv 15 Dec 2023.

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

- [Language Models are Few-Shot Learners](https://mlsanity.com/paper/2005.14165/) (2020)
- [GPT-4 Technical Report](https://mlsanity.com/paper/2303.08774/) (2023)
- [Training language models to follow instructions with human feedback](https://mlsanity.com/paper/2203.02155/) (2022)
- [LoRA: Low-Rank Adaptation of Large Language Models](https://mlsanity.com/paper/2106.09685/) (2021)
- [Llama 2: Open Foundation and Fine-Tuned Chat Models](https://mlsanity.com/paper/2307.09288/) (2023)
- [Sentence-BERT: Sentence Embeddings using Siamese BERT-Networks](https://mlsanity.com/paper/1908.10084/) (2019)
- [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)
- [Scaling Instruction-Finetuned Language Models](https://mlsanity.com/paper/2210.11416/) (2022)
- [Multitask Prompted Training Enables Zero-Shot Task Generalization](https://mlsanity.com/paper/2110.08207/) (2021)
- [Rethinking the Role of Demonstrations: What Makes In-Context Learning Work?](https://mlsanity.com/paper/2202.12837/) (2022)
- [Calibrate Before Use: Improving Few-Shot Performance of Language Models](https://mlsanity.com/paper/2102.09690/) (2021)
- [Scaling Language Models: Methods, Analysis & Insights from Training Gopher](https://mlsanity.com/paper/2112.11446/) (2021)
- [What Makes Good In-Context Examples for GPT-3?](https://mlsanity.com/paper/2101.06804/) (2021)
- [Fantastically Ordered Prompts and Where to Find Them: Overcoming Few-Shot Prompt Order Sensitivity](https://mlsanity.com/paper/2104.08786/) (2021)
- [Large Language Models Are Human-Level Prompt Engineers](https://mlsanity.com/paper/2211.01910/) (2022)
- [Publicly Available Clinical BERT Embeddings](https://mlsanity.com/paper/1904.03323/) (2019)
- [Capabilities of GPT-4 on Medical Challenge Problems](https://mlsanity.com/paper/2303.13375/) (2023)
- [Prompt Programming for Large Language Models: Beyond the Few-Shot Paradigm](https://mlsanity.com/paper/2102.07350/) (2021)
- [Towards Expert-Level Medical Question Answering with Large Language Models](https://mlsanity.com/paper/2305.09617/) (2023)
- [UL2: Unifying Language Learning Paradigms](https://mlsanity.com/paper/2205.05131/) (2022)
- [GatorTron: A Large Clinical Language Model to Unlock Patient Information from Unstructured Electronic Health Records](https://mlsanity.com/paper/2203.03540/) (2022)
- [Dynamic Demonstrations Controller for In-Context Learning](https://mlsanity.com/paper/2310.00385/) (2023)
- [Embedding Transfer for Low-Resource Medical Named Entity Recognition: A Case Study on Patient Mobility](https://mlsanity.com/paper/1806.02814/) (2018)
- [Classifying the reported ability in clinical mobility descriptions](https://mlsanity.com/paper/1906.03348/) (2019)
- [Leveraging deep active learning to identify low-resource mobility functioning information in public clinical notes](https://mlsanity.com/paper/2311.15946/) (2023)

## Abstract (arXiv)

Objective: Function is increasingly recognized as an important indicator of whole-person health. This study evaluates the ability of publicly available large language models (LLMs) to accurately identify the presence of functioning information from clinical notes. We explore various strategies to improve the performance on this task. Materials and Methods: We collect a balanced binary classification dataset of 1000 sentences from the Mobility NER dataset, which was curated from n2c2 clinical notes. For evaluation, we construct zero-shot and few-shot prompts to query the LLMs whether a given sentence contains mobility functioning information. Two sampling techniques, random sampling and k-nearest neighbor (kNN)-based sampling, are used to select the few-shot examples. Furthermore, we apply a parameter-efficient prompt-based fine-tuning method to the LLMs and evaluate their performance under various training settings. Results: Flan-T5-xxl outperforms all other models in both zero-shot and few-shot settings, achieving a F1 score of 0.865 with a single demonstrative example selected by kNN sampling. In prompt-based fine-tuning experiments, this foundation model also demonstrates superior performance across all low-resource settings, particularly achieving an impressive F1 score of 0.922 using the full training dataset. The smaller model, Flan-T5-xl, requires fine-tuning with only 2.3M additional parameters to achieve comparable performance to the fully fine-tuned Gatortron-base model, both surpassing 0.9 F1 score. Conclusion: Open-source instruction-tuned LLMs demonstrate impressive in-context learning capability in the mobility functioning classification task. The performance of these models can be further improved by continuing fine-tuning on a task-specific dataset.