Learning functional sections in medical conversations: iterative pseudo-labeling and human-in-the-loop approach

TL;DR

This paper introduces a semi-supervised, human-in-the-loop method for automatically classifying functional sections in medical conversations, reducing annotation costs and improving accuracy through iterative refinement.

Contribution

It proposes a novel combination of pseudo-labeling and human-in-the-loop techniques to learn dialogue classification with minimal expert annotations.

Findings

Initial model accuracy of 69.5%

Iterative refinement improves accuracy to 82.5%

Efficient annotation process with only a few dozen decisions per iteration

Abstract

Medical conversations between patients and medical professionals have implicit functional sections, such as "history taking", "summarization", "education", and "care plan." In this work, we are interested in learning to automatically extract these sections. A direct approach would require collecting large amounts of expert annotations for this task, which is inherently costly due to the contextual inter-and-intra variability between these sections. This paper presents an approach that tackles the problem of learning to classify medical dialogue into functional sections without requiring a large number of annotations. Our approach combines pseudo-labeling and human-in-the-loop. First, we bootstrap using weak supervision with pseudo-labeling to generate dialogue turn-level pseudo-labels and train a transformer-based model, which is then applied to individual sentences to create noisy sentence-level labels. Second, we iteratively refine sentence-level labels using a cluster-based human-in-the-loop approach. Each iteration requires only a few dozen annotator decisions. We evaluate the results on an expert-annotated dataset of 100 dialogues and find that while our models start with 69.5% accuracy, we can iteratively improve it to 82.5%. The code used to perform all experiments described in this paper can be found here: https://github.com/curai/curai-research/tree/main/functional-sections.