Evidence map›Paper›PMID 38950417›Full record

ArticleJournal of the American Medical Informatics Association : JAMIA2024

The first step is the hardest: pitfalls of representing and tokenizing temporal data for large language models.

Dimitris Spathis, Fahim Kawsar

Abstract read
In one paragraph

Article in Journal of the American Medical Informatics Association : JAMIA, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Article
  2. Frontiers in digital health · 2026
    Article
  3. Article
  4. Large language models in biomedicine and health: current research landscape and future directions.Journal of the American Medical Informatics Association : JAMIA · 2024
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

2 authors.

Dimitris SpathisNokia Bell Labs, Cambridge, CB3 0FA, United Kingdom.ORCID 0000-0001-9761-951X
Fahim KawsarNokia Bell Labs, Cambridge, CB3 0FA, United Kingdom.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesLarge language models (LLMs) have demonstrated remarkable generalization and across diverse tasks, leading individuals to increasingly use them as personal assistants due to their emerging reasoning capabilities. Nevertheless, a notable obstacle emerges when including numerical/temporal data into these prompts, such as data sourced from wearables or electronic health records. LLMs employ tokenizers in their input that break down text into smaller units. However, tokenizers are not designed to represent numerical values and might struggle to understand repetitive patterns and context, treating consecutive values as separate tokens and disregarding their temporal relationships. This article discusses the challenges of representing and tokenizing temporal data. It argues that naively passing timeseries to LLMs can be ineffective due to the modality gap between numbers and text. MATERIALS AND

methodsWe conduct a case study by tokenizing a sample mobile sensing dataset using the OpenAI tokenizer. We also review recent works that feed timeseries data into LLMs for human-centric tasks, outlining common experimental setups like zero-shot prompting and few-shot learning.

resultsThe case study shows that popular LLMs split timestamps and sensor values into multiple nonmeaningful tokens, indicating they struggle with temporal data. We find that preliminary works rely heavily on prompt engineering and timeseries aggregation to "ground" LLMs, hinting that the "modality gap" hampers progress. The literature was critically analyzed through the lens of models optimizing for expressiveness versus parameter efficiency. On one end of the spectrum, training large domain-specific models from scratch is expressive but not parameter-efficient. On the other end, zero-shot prompting of LLMs is parameter-efficient but lacks expressiveness for temporal data. DISCUSSION: We argue tokenizers are not optimized for numerical data, while the scarcity of timeseries examples in training corpora exacerbates difficulties. We advocate balancing model expressiveness and computational efficiency when integrating temporal data. Prompt tuning, model grafting, and improved tokenizers are highlighted as promising directions.

conclusionWe underscore that despite promising capabilities, LLMs cannot meaningfully process temporal data unless the input representation is addressed. We argue that this paradigm shift in how we leverage pretrained models will particularly affect the area of biomedical signals, given the lack of modality-specific foundation models.

Indexed as

Natural Language ProcessingElectronic Health RecordsHumanslarge language modelstimeseriestokenization

Identifiers

PMID38950417
PMCPMC11339515

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.