Lessons from the TREC Plain Language Adaptation of Biomedical Abstracts (PLABA) track.

Objective: Recent advances in language models have shown potential to adapt professional-facing biomedical literature to plain language, making it accessible to patients and caregivers. However, their unpredictability, combined with the high potential for harm in this domain, means rigorous evaluation is necessary. Our goals with this track were to stimulate research and to provide high-quality evaluation of the most promising systems. Methods: We hosted the Plain Language Adaptation of Biomedical Abstracts (PLABA) track at the 2023 and 2024 Text Retrieval Conferences. Tasks included complete, sentence-level, rewriting of abstracts (Task 1) as well as identifying and replacing difficult terms (Task 2). For automatic evaluation of Task 1, we developed a four-fold set of professionally-written references. Submissions for both Tasks 1 and 2 were provided extensive manual evaluation from biomedical experts. Results: Twelve teams spanning twelve countries participated in the track, with models from multilayer perceptrons to large pretrained transformers. In manual judgments of Task 1, top-performing models rivaled human levels of factual accuracy and completeness, but not simplicity or brevity. Automatic, reference-based metrics generally did not correlate well with manual judgments. In Task 2, systems struggled with identifying difficult terms and classifying how to replace them. When generating replacements, however, LLM-based systems did well in manually judged accuracy, completeness, and simplicity, though not in brevity. Conclusion: The PLABA track showed promise for using Large Language Models to adapt biomedical literature for the general public, while also highlighting their deficiencies and the need for improved automatic benchmarking tools.