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Outcome Prediction Using Multi-Modal Information: Integrating Large Language Model-Extracted Clinical Information and

Di Sun1, Lubomir Hadjiiski1, John Gormley1

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Summary
This summary is machine-generated.

Artificial intelligence (AI) large language models (LLMs) can extract clinical data to improve bladder cancer survival prediction after cystectomy. This multi-modal approach enhances prognostic accuracy using LLM-extracted information and imaging analysis.

Keywords:
bladder cancerdeep learninglarge language modelsradiomicssurvival prediction

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Area of Science:

  • Oncology
  • Artificial Intelligence
  • Medical Imaging

Background:

  • Accurate survival prediction is crucial for bladder cancer patient management post-cystectomy.
  • Artificial intelligence (AI) and large language models (LLMs) show potential in extracting clinical data and enhancing medical image analysis.

Purpose of the Study:

  • To evaluate the efficacy of AI-LLMs in extracting clinical information for predicting five-year survival rates in bladder cancer patients post-radical cystectomy.
  • To develop and assess a multi-modal predictive model integrating clinical, radiomics, and deep learning descriptors.

Main Methods:

  • Retrospective analysis of medical records and CT urograms (CTUs) from 163 bladder cancer patients with post-surgery survival data.
  • Extraction of clinical descriptors using five AI-LLMs (Dolly-v2, Vicuna-13b, Llama-2.0-13b, GPT-3.5, GPT-4.0) and manual extraction for comparison.
  • Extraction of radiomics and deep learning descriptors from CTU images.
  • Development of a multi-modal model (CRD) combining clinical, radiomics, and deep learning features.

Main Results:

  • AI-LLMs achieved high extraction accuracies, ranging from 74% to 97%, with GPT-4.0 showing the highest performance (94%-97%).
  • The CRD multi-modal model, utilizing LLM-extracted clinical data, demonstrated strong predictive performance (AUCs 0.81-0.88) comparable to models using manually extracted data (AUC 0.89).
  • GPT-3.5 and GPT-4.0 based CRD models achieved AUCs of 0.85-0.88 and 0.87-0.88, respectively.

Conclusions:

  • AI-LLMs can effectively extract clinical information from medical records for survival prediction in bladder cancer.
  • Integrating LLM-derived clinical data with imaging analysis (radiomics, deep learning) improves the prediction of clinical outcomes post-cystectomy.
  • This multi-modal approach offers a promising tool for enhancing prognostic accuracy and patient follow-up in bladder cancer care.