arXiv Computation and Language By S. M. Mahbub Uddin Ahmed

Is a 9B Decision Foundation Model Needed for Symptom-to-Disease Classification? Fine-Tuning Clef-Flash Against TF-IDF Baselines

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The paper evaluates whether a 9‑billion parameter decision foundation model, Clef‑Flash, is necessary for symptom‑to‑disease classification. Fine‑tuning the model on the 24‑class Symptom2Disease benchmark yields 95.42% accuracy, but simple TF‑IDF linear classifiers achieve higher accuracy (98.75%) with far faster inference. Ablation studies show that predictions can hinge on single descriptive clauses, indicating that the benchmark may not fully capture the model’s capabilities.

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arXiv AI
Aug 24

Inhibitory Attention for Clinical Long-Context Reasoning: Characterizing and Mitigating Lost-in-the-Middle Effects in EHR Processing

The paper identifies a new problem in clinical natural language processing called the clinical lost‑in‑the‑middle (CLitM) effect, where large language models perform poorly on information located near the center of long electronic health record (EHR) documents. Using the MedAlign dataset, the authors quantify a 21.9‑percentage‑point accuracy gap across 2,196 instruction‑response pairs and six models, showing that most critical facts lie in the CLitM trough. They propose Query‑Conditioned Clinical Suppression (QCCS), a lightweight context‑selection gate that outperforms traditional retrieval methods (BM25, dense retrieval, cross‑encoder reranking) on a held‑out set of 83 instructions, achieving up to 25.3% accuracy for middle‑position queries. whyItMatters":"The study demonstrates that standard retrieval strategies fail to reliably surface central clinical information, and that a query‑aligned selection mechanism can substantially improve model performance on critical EHR data."

By Sanjay Basu