A comparative study of pretrained language models for long clinical text

J Am Med Inform Assoc. 2023 Jan 18;30(2):340-347. doi: 10.1093/jamia/ocac225.

Abstract

Objective: Clinical knowledge-enriched transformer models (eg, ClinicalBERT) have state-of-the-art results on clinical natural language processing (NLP) tasks. One of the core limitations of these transformer models is the substantial memory consumption due to their full self-attention mechanism, which leads to the performance degradation in long clinical texts. To overcome this, we propose to leverage long-sequence transformer models (eg, Longformer and BigBird), which extend the maximum input sequence length from 512 to 4096, to enhance the ability to model long-term dependencies in long clinical texts.

Materials and methods: Inspired by the success of long-sequence transformer models and the fact that clinical notes are mostly long, we introduce 2 domain-enriched language models, Clinical-Longformer and Clinical-BigBird, which are pretrained on a large-scale clinical corpus. We evaluate both language models using 10 baseline tasks including named entity recognition, question answering, natural language inference, and document classification tasks.

Results: The results demonstrate that Clinical-Longformer and Clinical-BigBird consistently and significantly outperform ClinicalBERT and other short-sequence transformers in all 10 downstream tasks and achieve new state-of-the-art results.

Discussion: Our pretrained language models provide the bedrock for clinical NLP using long texts. We have made our source code available at https://github.com/luoyuanlab/Clinical-Longformer, and the pretrained models available for public download at: https://huggingface.co/yikuan8/Clinical-Longformer.

Conclusion: This study demonstrates that clinical knowledge-enriched long-sequence transformers are able to learn long-term dependencies in long clinical text. Our methods can also inspire the development of other domain-enriched long-sequence transformers.

Keywords: clinical natural language processing; named entity recognition; natural language inference; question answering; text classification.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Language*
  • Learning*
  • Natural Language Processing