基于语义知识增强的大型语言模型促进健康提取的社会决定因素。

AMIA ... Annual Symposium proceedings. AMIA Symposium Pub Date : 2025-05-22 eCollection Date: 2024-01-01
Lei Gong, Jaren Bresnick, Aidong Zhang, Cathy Wu, Kishlay Jha
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引用次数: 0

摘要

健康的社会决定因素(SDoH)显著影响健康结果,并有助于在医疗保健应用中持续存在健康差异。然而,由于包含SDoH相关信息的临床叙述的非结构化性质,从电子健康记录(EHRs)中自动提取SDoH信息是具有挑战性的。大型语言模型(llm)的最新进展显示了自动化SDoH提取的巨大前景。然而,由于数据稀缺性问题,它们的性能在不平衡的SDoH类别中受到影响。为了解决这个问题,我们提出了一种创新的方法,通过从统一医学语言系统(UMLS)获得的语义知识来增强法学硕士。该策略丰富了不平衡SDoH类的特征表示,实现了准确的SDoH提取。更具体地说,我们提出的数据增强策略在LLM预微调阶段生成语义丰富的临床叙述。这种方法使LLM能够更好地适应目标数据,并为调优阶段提供良好的初始化。通过使用公开可用的MIMIC-SDoH数据进行大量实验,所提出的方法在SDoH提取结果方面有了显着改善,特别是对于不平衡类。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Boosting Social Determinants of Health Extraction with Semantic Knowledge Augmented Large Language Model.

Social determinants of health (SDoH) significantly impacts health outcomes and contributes to perpetuating health disparities across healthcare applications. However, automatic extraction of SDoH information from Electronic Health Records (EHRs) is challenging due to the unstructured nature of clinical narratives that contain SDoH related information. Recent advances in Large Language Models (LLMs) have shown great promise for automated SDoH extraction. However, their performance suffers for the imbalanced SDoH categories due to the data scarcity issues. To address this, we propose an innovative approach that augments LLMs with semantic knowledge obtained from the Unified Medical Language Systems (UMLS). This strategy enriches the feature representations of imbalanced SDoH classes, leading to accurate SDoH extraction. More specifically, our proposed data augmentation strategy generates semantically enriched clinical narratives at the LLM pre-finetuning stage. This approach enables the LLM to better adapt to the target data and leads to a good initialization for the finetuning stage. Through extensive experiments using publicly available MIMIC-SDoH data, the proposed approach demonstrates significant improvement in results for the SDoH extraction, especially for the imbalanced classes.

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