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May 26

Serialisation Strategy Matters: How FHIR Data Format Affects LLM Medication Reconciliation

Medication reconciliation at clinical handoffs is a high-stakes, error-prone process. Large language models are increasingly proposed to assist with this task using FHIR-structured patient records, but a fundamental and largely unstudied variable is how the FHIR data is serialised before being passed to the model. We present the first systematic comparison of four FHIR serialisation strategies (Raw JSON, Markdown Table, Clinical Narrative, and Chronological Timeline) across five open-weight models (Phi-3.5-mini, Mistral-7B, BioMistral-7B, Llama-3.1-8B, Llama-3.3-70B) on a controlled benchmark of 200 synthetic patients, totalling 4,000 inference runs. We find that serialisation strategy has a large, statistically significant effect on performance for models up to 8B parameters: Clinical Narrative outperforms Raw JSON by up to 19 F1 points for Mistral-7B (r = 0.617, p < 10^{-10}). This advantage reverses at 70B, where Raw JSON achieves the best mean F1 of 0.9956. In all 20 model and strategy combinations, mean precision exceeds mean recall: omission is the dominant failure mode, with models more often missing an active medication than fabricating one, which changes how clinical safety auditing priorities should be set. Smaller models plateau at roughly 7-10 concurrent active medications, leaving polypharmacy patients, the patients most at risk from reconciliation errors, systematically underserved. BioMistral-7B, a domain-pretrained model without instruction tuning, produces zero usable output in all conditions, showing that domain pretraining alone is not sufficient for structured extraction. These results offer practical, evidence-based format recommendations for clinical LLM deployment: Clinical Narrative for models up to 8B, Raw JSON for 70B and above. The complete pipeline is reproducible on open-source tools running on an AWS g6e.xlarge instance (NVIDIA L40S, 48 GB VRAM).

  • 1 authors
·
Apr 21

BitMoD: Bit-serial Mixture-of-Datatype LLM Acceleration

Large language models (LLMs) have demonstrated remarkable performance across various machine learning tasks. Yet the substantial memory footprint of LLMs significantly hinders their deployment. In this paper, we improve the accessibility of LLMs through BitMoD, an algorithm-hardware co-design solution that enables efficient LLM acceleration at low weight precision. On the algorithm side, BitMoD introduces fine-grained data type adaptation that uses a different numerical data type to quantize a group of (e.g., 128) weights. Through the careful design of these new data types, BitMoD is able to quantize LLM weights to very low precision (e.g., 4 bits and 3 bits) while maintaining high accuracy. On the hardware side, BitMoD employs a bit-serial processing element to easily support multiple numerical precisions and data types; our hardware design includes two key innovations: First, it employs a unified representation to process different weight data types, thus reducing the hardware cost. Second, it adopts a bit-serial dequantization unit to rescale the per-group partial sum with minimal hardware overhead. Our evaluation on six representative LLMs demonstrates that BitMoD significantly outperforms state-of-the-art LLM quantization and acceleration methods. For discriminative tasks, BitMoD can quantize LLM weights to 4-bit with <!0.5% accuracy loss on average. For generative tasks, BitMoD is able to quantize LLM weights to 3-bit while achieving better perplexity than prior LLM quantization scheme. Combining the superior model performance with an efficient accelerator design, BitMoD achieves an average of 1.69times and 1.48times speedups compared to prior LLM accelerators ANT and OliVe, respectively.

  • 7 authors
·
Nov 18, 2024

LoRA-Mixer: Coordinate Modular LoRA Experts Through Serial Attention Routing

Recent efforts to combine low-rank adaptation (LoRA) with mixture-of-experts (MoE) for adapting large language models (LLMs) to multiple tasks still exhibit prevailing limitations: they either swap entire attention/feed-forward layers for switch experts or bolt on parallel expert branches, diluting parameter efficiency and task fidelity. We propose the LoRA-Mixer, a modular and lightweight MoE framework that integrates LoRA experts. Our core innovation lies in replacing the projection matrices of the attention module's input/output linear layers with dynamically routed, task-specific LoRA experts. This design ensures seamless compatibility with diverse foundation models, including transformers and state space models (SSMs), by leveraging their inherent linear projection structures. The framework supports two operational paradigms: (1) joint optimization of LoRA experts and routing mechanisms via a novel hard-soft routing strategy, or (2) direct deployment of pre-trained, frozen LoRA modules sourced from external repositories. To enable robust router training with limited data while ensuring stable routing decisions and maximizing expert reuse, we introduce an adaptive Specialization Balance Loss (SBL) that jointly optimizes expert balance and task-specific alignment. Extensive experiments on seven benchmark datasets, including MedQA, CoLA, SST-2, GSM8K, ARC-E, ARC-C, and HumanEval, demonstrate the effectiveness of LoRA-Mixer. On datasets such as GSM8K, HumanEval, and MedQA, LoRA-Mixer achieves significant improvements of 7.61%, 4.88%, and 3.08% over the base models, respectively. Compared with state-of-the-art methods, LoRA-Mixer achieves additional improvements of 1.09%, 1.45%, and 1.68%, respectively, using only 48% of the parameters, demonstrating its efficiency and strong performance.

  • 6 authors
·
Jun 17, 2025

Mirror Speculative Decoding: Breaking the Serial Barrier in LLM Inference

Speculative decoding accelerates LLM inference by using a draft model to look ahead, but gains are capped by the cost of autoregressive draft generation: increasing draft size elevates acceptance rates but introduces additional latency overhead exacerbating the speed-accuracy tradeoff. Prior methods (Medusa, Hydra, EAGLE) partially reduce draft cost but either degrade acceptance or introduce overheads that limit scaling. We present Mirror Speculative Decoding (Mirror-SD), an inference algorithm that breaks the latency-acceptance tradeoff. Mirror-SD launches branch-complete rollouts from early-exit signals in parallel with the target model's suffix and explicitly maps computation across heterogeneous accelerators (GPU and NPU) to exploit cross-device parallelism. The draft speculates forward continuations for the target to verify, while the target simultaneously speculates correction paths for the draft, converting speculation into two complementary execution pipelines. To further cut draft latency without weakening acceptance semantics, we add speculative streaming so the draft emits multiple tokens per step. This dual strategy of parallel heterogeneous execution plus multi-token speculative streaming pushes speculative decoding toward its ideal regime of high acceptance with low overhead. On SpecBench with server-scale models from 14B to 66B parameters, Mirror-SD delivers consistent end-to-end gains, achieving 2.8x-5.8x wall-time speedups across diverse tasks and a 30% average relative improvement over the strongest baseline, EAGLE3.

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Oct 15, 2025 2