Benchmarking domain-specific pretrained language models to identify the best model for methodological rigor in clinical studies.
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OBJECTIVE: Encoder-only transformer-based language models have shown promise in automating critical appraisal of clinical literature. However, a comprehensive evaluation of the models for classifying the methodological rigor of randomized controlled trials is necessary to identify the more robust ones. This study benchmarks several state-of-the-art transformer-based language models using a diverse set of performance metrics. METHODS: Seven transformer-based language models were fine-tuned on the title and abstract of 42,575 articles from 2003 to 2023 in McMaster University's Premium LiteratUre Service database under different configurations. The studies reported in the articles addressed questions related to treatment, prevention, or quality improvement for which randomized controlled trials are the gold standard with defined criteria for rigorous methods. Models were evaluated on the validation set using 12 schemes and metrics, including optimization for cross-entropy loss, Brier score, AUROC, average precision, sensitivity, specificity, and accuracy, among others. Threshold tuning was performed to optimize threshold-dependent metrics. Models that achieved the best performance in one or more schemes on the validation set were further tested in hold-out and external datasets. RESULTS: A total of 210 models were fine-tuned. Six models achieved top performance in one or more evaluation schemes. Three BioLinkBERT models outperformed others on 8 of the 12 schemes. BioBERT, BiomedBERT, and SciBERT were best on 1, 1 and 2 schemes, respectively. While model performance remained robust on the hold-out test set, it declined in external datasets. Class weight adjustments improved performance in most instances. CONCLUSION: BioLinkBERT generally outperformed the other models. Using comprehensive evaluation metrics and threshold tuning optimizes model selection for real-world applications. Future work should assess generalizability to other datasets, explore alternate imbalance strategies, and examine training on full-text articles.
