Health text simplification: An annotated corpus for digestive cancer education and novel strategies for reinforcement learning

Abstract

Objective: The reading level of health educational materials significantly influences the understandability and accessibility of the information, particularly for minoritized populations. Many patient educational resources surpass widely accepted standards for reading level and complexity. There is a critical need for high-performing text simplification models for health information to enhance dissemination and literacy. This need is particularly acute in cancer education, where effective prevention and screening education can substantially reduce morbidity and mortality.

Methods: We introduce Simplified Digestive Cancer (SimpleDC), a parallel corpus of cancer education materials tailored for health text simplification research, comprising educational content from the American Cancer Society, Centers for Disease Control and Prevention, and National Cancer Institute. The corpus includes 31 web pages with the corresponding manually simplified versions. It consists of 1183 annotated sentence pairs (361 train, 294 development, and 528 test). Utilizing SimpleDC and the existing Med-EASi corpus, we explore Large Language Model (LLM)-based simplification methods, including fine-tuning, reinforcement learning (RL), reinforcement learning with human feedback (RLHF), domain adaptation, and prompt-based approaches. Our experimentation encompasses Llama 2, Llama 3, and GPT-4. We introduce a novel RLHF reward function featuring a lightweight model adept at distinguishing between original and simplified texts when enables training on unlabeled data.

Results: Fine-tuned Llama models demonstrated high performance across various metrics. Our RLHF reward function outperformed existing RL text simplification reward functions. The results underscore that RL/RLHF can achieve performance comparable to fine-tuning and improve the performance of fine-tuned models. Additionally, these methods effectively adapt out-of-domain text simplification models to a target domain. The best-performing RL-enhanced Llama models outperformed GPT-4 in both automatic metrics and manual evaluation by subject matter experts.

Conclusion: The newly developed SimpleDC corpus will serve as a valuable asset to the research community, particularly in patient education simplification. The RL/RLHF methodologies presented herein enable effective training of simplification models on unlabeled text and the utilization of out-of-domain simplification corpora.

Keywords: Health literacy; Large language models; Text simplification.