# High-Fidelity Pseudo-label Generation by Large Language Models for Training Robust Radiology Report Classifiers

arXiv: https://arxiv.org/abs/2505.01693 · HTML: https://mlsanity.com/paper/2505.01693/

## Key facts

- Cited by 2 papers in the map (data through 14 Oct 2026).
- Placed in Distillation for medical imaging, one of 12 directions in Knowledge distillation.
- Builds on 18 of its 30 references that are in the map.
- First posted on arXiv 3 May 2025.

## Placed in

- Knowledge distillation / [Distillation for medical imaging](https://mlsanity.com/distill/distillation-for-medical-imaging/)

## Builds on (most cited first, 18 of 18)

- [Attention Is All You Need](https://mlsanity.com/paper/1706.03762/) (2017)
- [BERT: Pre-training of Deep Bidirectional Transformers for Language Understanding](https://mlsanity.com/paper/1810.04805/) (2018)
- [Language Models are Few-Shot Learners](https://mlsanity.com/paper/2005.14165/) (2020)
- [Scaling Laws for Neural Language Models](https://mlsanity.com/paper/2001.08361/) (2020)
- [PaLM: Scaling Language Modeling with Pathways](https://mlsanity.com/paper/2204.02311/) (2022)
- [Finetuned Language Models Are Zero-Shot Learners](https://mlsanity.com/paper/2109.01652/) (2021)
- [DeBERTa: Decoding-enhanced BERT with Disentangled Attention](https://mlsanity.com/paper/2006.03654/) (2020)
- [CheXpert: A Large Chest Radiograph Dataset with Uncertainty Labels and Expert Comparison](https://mlsanity.com/paper/1901.07031/) (2019)
- [LaMDA: Language Models for Dialog Applications](https://mlsanity.com/paper/2201.08239/) (2022)
- [Capabilities of GPT-4 on Medical Challenge Problems](https://mlsanity.com/paper/2303.13375/) (2023)
- [CheXbert: Combining Automatic Labelers and Expert Annotations for Accurate Radiology Report Labeling Using BERT](https://mlsanity.com/paper/2004.09167/) (2020)
- [Adapted Large Language Models Can Outperform Medical Experts in Clinical Text Summarization](https://mlsanity.com/paper/2309.07430/) (2023)
- [Visual In-Context Learning for Large Vision-Language Models](https://mlsanity.com/paper/2402.11574/) (2024)
- [Thread of Thought Unraveling Chaotic Contexts](https://mlsanity.com/paper/2311.08734/) (2023)
- [EmoBench-M: Benchmarking Emotional Intelligence for Multimodal Large Language Models](https://mlsanity.com/paper/2502.04424/) (2025)
- [Improving Cross-modal Alignment for Text-Guided Image Inpainting](https://mlsanity.com/paper/2301.11362/) (2023)
- [DR.BENCH: Diagnostic Reasoning Benchmark for Clinical Natural Language Processing](https://mlsanity.com/paper/2209.14901/) (2022)
- [Diffusion Model with Representation Alignment for Protein Inverse Folding](https://mlsanity.com/paper/2412.09380/) (2024)

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

- [A Comprehensive Review on Harnessing Large Language Models to Overcome Recommender System Challenges](https://mlsanity.com/paper/2507.21117/) (2025)
- [Beyond English benchmarks: clinical llm evaluation in Brazilian Portuguese](https://mlsanity.com/paper/2606.07853/) (2026)

## Abstract (arXiv)

Automated labeling of chest X-ray reports is essential for enabling downstream tasks such as training image-based diagnostic models, population health studies, and clinical decision support. However, the high variability, complexity, and prevalence of negation and uncertainty in these free-text reports pose significant challenges for traditional Natural Language Processing methods. While large language models (LLMs) demonstrate strong text understanding, their direct application for large-scale, efficient labeling is limited by computational cost and speed. This paper introduces DeBERTa-RAD, a novel two-stage framework that combines the power of state-of-the-art LLM pseudo-labeling with efficient DeBERTa-based knowledge distillation for accurate and fast chest X-ray report labeling. We leverage an advanced LLM to generate high-quality pseudo-labels, including certainty statuses, for a large corpus of reports. Subsequently, a DeBERTa-Base model is trained on this pseudo-labeled data using a tailored knowledge distillation strategy. Evaluated on the expert-annotated MIMIC-500 benchmark, DeBERTa-RAD achieves a state-of-the-art Macro F1 score of 0.9120, significantly outperforming established rule-based systems, fine-tuned transformer models, and direct LLM inference, while maintaining a practical inference speed suitable for high-throughput applications. Our analysis shows particular strength in handling uncertain findings. This work demonstrates a promising path to overcome data annotation bottlenecks and achieve high-performance medical text processing through the strategic combination of LLM capabilities and efficient student models trained via distillation.