---
title: "Few-Shot and Zero-Shot Multi-Label Learning for Structured Label Spaces — Rios 2018"
description: "Clinical coding datasets such as MIMIC follow a power-law distribution. 47 references, cited by 64 papers here."
authors: ["Anthony Rios", "Ramakanth Kavuluru"]
year: 2018
venue: "Proceedings of the 2018 Conference on Empirical Methods in Natural Language Processing"
source: "https://aclanthology.org/D18-1352/"
doi: "10.18653/v1/d18-1352"
licence: "CC BY 4.0 (ACL Anthology)"
licence_url: "https://creativecommons.org/licenses/by/4.0/"
summary_licence: "Elamur Cosmic License"
canonical: "https://research.elamur.ai/free/en/papers/rios-2018-few-shot-zero-shot-multi/"
---
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# Few-Shot and Zero-Shot Multi-Label Learning for Structured Label Spaces

**Authors:** [Anthony Rios](https://md.research.elamur.ai/free/en/authors/anthony-rios/) and Ramakanth Kavuluru · **Year:** 2018 · **Venue:** Proceedings of the 2018 Conference on Empirical Methods in Natural Language Processing · **Licence:** [CC BY 4.0 (ACL Anthology)](https://creativecommons.org/licenses/by/4.0/)

**Links:** [Publisher's page](https://aclanthology.org/D18-1352/) · [PDF](https://aclanthology.org/D18-1352.pdf) · [DOI 10.18653/v1/d18-1352](https://doi.org/10.18653/v1/d18-1352) · [OpenAlex](https://openalex.org/W2889577585)

**Citations:** 181 citations (OpenAlex, 2026-10-14) · [64](https://md.research.elamur.ai/free/en/papers/rios-2018-few-shot-zero-shot-multi/cited-by/) in our library, of the 140,884 papers whose bibliographies we read

## Summary
Clinical coding datasets such as MIMIC follow a power-law distribution. A handful of ICD-9 codes appear thousands of times, while most are rare or never appear in training data. Common metrics like micro-F1 or P@k hide how models handle these rare codes. Rios and Kavuluru address both the evaluation and the modeling side of this problem. They adapt the generalized zero-shot protocol of Xian et al. (2017) to multi-label classification, scoring frequent, few-shot and zero-shot labels separately. Their model, ZAGCNN, extends the label-wise attention CNN (ACNN) of Mullenbach et al. (2018). Instead of learning an independent vector for every code, it builds attention and output vectors from each code's textual descriptor. A two-layer GCNN then refines these vectors over the ICD-9 hierarchy, so the network can score codes it never saw during training. On discharge summaries from MIMIC II and MIMIC III, the method substantially improves recall for rare and unseen codes, with only a small loss on frequent ones. This matters because missed rare codes cause billing errors.

## Key points
- In MIMIC III, over half of roughly 17,000 ICD-9 diagnosis/procedure codes never occur, and about 5,000 occur only 1–10 times.
- The architecture assumes the labels form a DAG and each label has a short natural-language descriptor. It combines a CNN over EMR text, label-wise attention, and a 2-layer GCNN (Kipf and Welling, 2017) over the label graph.
- Compared with prior work, R@10 on few-shot labels rises by 6.2% (MIMIC II) and 4.8% (MIMIC III). On zero-shot labels the gains are 17.3% and 19%. ZAGCNN beats the strongest ESZSL baseline by about 16–20% on zero-shot labels.
- ACNN remains slightly better on frequent labels (by about 0.3% R@10 on MIMIC III) and also on overall P@10 and macro-F1. The authors show that its macro-F1 advantage comes from frequent labels, which reveals a trade-off between frequent and rare labels.
- When all labels are ranked together, a correct few-shot code reaches the top 16 for only 6% of the test documents that contain one. The authors therefore propose future work on novelty detection and on transferring knowledge from MeSH/UMLS.

*Our summary of the paper, in our own words — not its text. The work belongs to its authors; read it at the links above.*

Fields: [Natural language processing](https://md.research.elamur.ai/free/en/shelves/nlp/)

## Institutions

- [University of Kentucky](https://md.research.elamur.ai/free/en/universities/university-of-kentucky/) — University, Lexington, United States · 2 works · 259 citations

## Cite

Cite as: Anthony Rios and Ramakanth Kavuluru. 2018. Few-Shot and Zero-Shot Multi-Label Learning for Structured Label Spaces. Proceedings of the 2018 Conference on Empirical Methods in Natural Language Processing.

The paper itself, not this page. BibTeX from the library's record of the work.

```bibtex
@inproceedings{rios2018few,
  title = {{Few-Shot and Zero-Shot Multi-Label Learning for Structured Label Spaces}},
  author = {Anthony Rios and Ramakanth Kavuluru},
  booktitle = {Proceedings of the 2018 Conference on Empirical Methods in Natural Language Processing},
  year = {2018},
  doi = {10.18653/v1/d18-1352},
  url = {https://doi.org/10.18653/v1/d18-1352}
}
```

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