Longitudinal Data and a Semantic Similarity Reward for Chest X-Ray Report Generation
CoRR(2023)
摘要
The burnout rate of radiologists is high in part due to the large and ever
growing number of Chest X-rays (CXRs) needing interpretation and reporting.
Promisingly, automatic CXR report generation has the potential to aid
radiologists with this laborious task and improve patient care. The diagnostic
inaccuracy of current CXR report generators prevents their consideration for
clinical trials. To improve diagnostic accuracy, we propose a CXR report
generator that integrates aspects of the radiologist workflow and is trained
with our proposed reward for reinforcement learning. It imitates the
radiologist workflow by conditioning on the longitudinal history available from
a patient's previous CXR study, conditioning on multiple CXRs from a patient's
study, and differentiating between report sections with section embeddings and
separator tokens. Our reward for reinforcement learning leverages CXR-BERT –
which captures the clinical semantic similarity between reports. Training with
this reward forces our model to learn the clinical semantics of radiology
reporting. We also highlight issues with the evaluation of a large portion of
CXR report generation models in the literature introduced by excessive
formatting. We conduct experiments on the publicly available MIMIC-CXR and IU
X-ray datasets with metrics shown to be more closely correlated with
radiologists' assessment of reporting. The results demonstrate that our model
generates radiology reports that are quantitatively more aligned with those of
radiologists than state-of-the-art models, such as those utilising large
language models, reinforcement learning, and multi-task learning. Through this,
our model brings CXR report generation one step closer to clinical trial
consideration. Our Hugging Face checkpoint
(https://huggingface.co/aehrc/cxrmate) and code
(https://github.com/aehrc/cxrmate) are publicly available.
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关键词
semantic similarity reward,chest,longitudinal data,report,x-ray
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