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Radiology report generation, translating radiological images into precise and clinically relevant description, may face the data imbalance challenge — medical tokens appear less frequently than regular tokens, and normal entries are significantly more than abnormal ones. However, very few studies consider the imbalance issues, not even with conjugate imbalance factors. In this study, we propose a Joint Imbalance Adaptation (JIMA) model to promote task robustness by leveraging token and label imbalance. We employ a hard-to-easy learning strategy that mitigates overfitting to frequent labels and tokens, thereby encouraging the model to focus more on infrequent labels and clinical tokens. JIMA presents notable improvements (16.75–50.50% on average) across evaluation metrics on IU X-ray and MIMIC-CXR datasets. Our ablation analysis and human evaluations show the improvements mainly come from enhancing performance on infrequent tokens and abnormal radiological entries, which can also lead to more clinically accurate reports. While data imbalance (e.g., infrequent tokens and abnormal labels) can lead to the underperformance of radiology report generation, our imbalance learning strategy opens promising directions on how to encounter data imbalance by reducing overfitting on frequent patterns and underfitting on infrequent patterns. 

Lengthy documents pose a unique challenge to neural language models due to substantial memory consumption. While existing state-of-the-art (SOTA) models segment long texts into equal-length snippets (e.g., 128 tokens per snippet) or deploy sparse attention networks, these methods have new challenges of context fragmentation and generalizability due to sentence boundaries and varying text lengths. For example, our empirical analysis has shown that SOTA models consistently overfit one set of lengthy documents (e.g., 2000 tokens) while performing worse on texts with other lengths (e.g., 1000 or 4000). In this study, we propose a Length-Aware Multi-Kernel Transformer (LAMKIT) to address the new challenges for the long document classification. LAMKIT encodes lengthy documents by diverse transformer-based kernels for bridging context boundaries and vectorizes text length by the kernels to promote model robustness over varying document lengths. Experiments on five standard benchmarks from health and law domains show LAMKIT outperforms SOTA models up to an absolute 10.9% improvement. We conduct extensive ablation analyses to examine model robustness and effectiveness over varying document lengths. 

Automatic coding patient behaviors is essential to support decision making for psychotherapists during the motivational interviewing (MI), a collaborative communication intervention approach to address psychiatric issues, such as alcohol and drug addiction. While the behavior coding task has rapidly adapted language models to predict patient states during the MI sessions, lacking of domain-specific knowledge and overlooking patient-therapist interactions are major challenges in developing and deploying those models in real practice. To encounter those challenges, we introduce the Chain-of- Interaction (CoI) prompting method aiming to contextualize large language models (LLMs) for psychiatric decision support by the dyadic interactions. The CoI prompting approach systematically breaks down the coding task into three key reasoning steps, extract patient engagement, learn therapist question strategies, and integrates dyadic interactions between patients and therapists. This approach enables large language models to leverage the coding scheme, patient state, and domain knowledge for patient behavioral coding. Experiments on real-world datasets can prove the effectiveness and flexibility of our prompting method with multiple state-of-the-art LLMs over existing prompting baselines. We have conducted extensive ablation analysis and demonstrate the critical role of dyadic interactions in applying LLMs for psychotherapy behavior understanding.