CPLLM:大型语言模型的临床预测。

PLOS digital health Pub Date : 2024-12-06 eCollection Date: 2024-12-01 DOI:10.1371/journal.pdig.0000680
Ofir Ben Shoham, Nadav Rappoport
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引用次数: 0

摘要

我们提出了使用大语言模型进行临床预测(CPLLM),这是一种涉及微调预训练的大语言模型(LLM)的方法,用于预测临床疾病和再入院。我们使用了量化并使用提示对LLM进行了微调。对于诊断预测,我们利用患者的历史医疗记录,预测患者是否会在下次就诊或随后的诊断中被诊断出患有目标疾病。我们将我们的结果与各种基线进行了比较,包括Retain和Med-BERT,后者是目前使用时间结构化电子病历数据进行疾病预测的最先进模型。此外,我们还评估了CPLLM在预测医院再入院方面的效用,并将我们的方法的性能与基准基线进行了比较。我们的实验最终表明,我们提出的方法CPLLM在PR-AUC和ROC-AUC指标方面超过了所有已测试的模型,提供了最先进的性能,作为预测疾病诊断和患者再入院的工具,而无需对医疗数据进行预训练。这种方法可以很容易地实施并集成到临床工作流程中,以帮助护理提供者为患者计划下一步。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
CPLLM: Clinical prediction with large language models.

We present Clinical Prediction with Large Language Models (CPLLM), a method that involves fine-tuning a pre-trained Large Language Model (LLM) for predicting clinical disease and readmission. We utilized quantization and fine-tuned the LLM using prompts. For diagnostic predictions, we predicted whether patients would be diagnosed with a target disease during their next visit or in the subsequent diagnosis, leveraging their historical medical records. We compared our results to various baselines, including Retain and Med-BERT, the latter of which is the current state-of-the-art model for disease prediction using temporal structured EHR data. In addition, we also evaluated CPLLM's utility in predicting hospital readmission and compared our method's performance with benchmark baselines. Our experiments ultimately revealed that our proposed method, CPLLM, surpasses all the tested models in terms of PR-AUC and ROC-AUC metrics, providing state-of-the-art performance as a tool for predicting disease diagnosis and patient hospital readmission without requiring pre-training on medical data. Such a method can be easily implemented and integrated into the clinical workflow to help care providers plan next steps for their patients.

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