用自相关掩码让大模型从无标签医学文本中自学分类，提升性能。

Classification tasks require annotated data, which can often be expensive, time-consuming, or even unfeasible to collect. This is the case of the medical domain, where large datasets often have few annotated examples. To address this, we propose DecSelfMask (Decoder Self-learning by Masking), an approach to enhance decoder-only performance on classification tasks. We build on common self-learning approaches by leveraging a model to create training examples from unlabeled data, and propose a novel relevance-guided masking strategy. We use relevance attribution methods to determine what portions of unannotated texts are relevant for a task. We then create self-supervised training examples by masking out those portions, training the model to reconstruct them via next-token-prediction. We hypothesize that those examples convey knowledge about the structure and semantics of unannotated data that can be useful for downstream performance. We test our approach on 136 tasks from a collection of 1.9M clinical notes from an Italian hospital. We quantify DecSelfMask's impact on downstream tasks on 5 models of different scales and families, including a probing analysis. Experiments show consistent gains, outperforming the base models (+9.1 points in Macro F1), continual pretraining (+6.3), synthetic label generation (+12.5), as well as common baselines. The results show that relevance attribution can serve as a powerful source of supervision for decoder learning from unlabeled data, beyond existing methods.