DALL-M: Context-aware clinical data augmentation with large language models

X-ray images are vital in medical diagnostics, but their effectiveness is limited without clinical context. Radiologists often find chest X-rays insufficient for diagnosing underlying diseases, necessitating the integration of structured clinical features with radiology reports. To address this, we introduce DALL-M, a novel framework that enhances clinical datasets by generating contextual synthetic data. DALL-M augments structured patient data, including vital signs (e.g., heart rate, oxygen saturation), radiology findings (e.g., lesion presence), and demographic factors. It integrates this tabular data with contextual knowledge extracted from radiology reports and domain-specific resources (e.g., Radiopaedia, Wikipedia), ensuring clinical consistency and reliability. DALL-M follows a three-phase process: (i) clinical context storage, (ii) expert query generation, and (iii) context-aware feature augmentation. Using large language models (LLMs), it generates both contextual synthetic values for existing clinical features and entirely new, clinically relevant features. Applied to 799 cases from the MIMIC-IV dataset, DALL-M expanded the original 9 clinical features to 91. Empirical validation with machine learning models - including Decision Trees, Random Forests, XGBoost, and TabNET - demonstrated a 16.5% improvement in F1 score and a 25% increase in Precision and Recall. DALL-M bridges an important gap in clinical data augmentation by preserving data integrity while enhancing predictive modeling in healthcare. Our results show that integrating LLM-generated synthetic features significantly improves model performance, making DALL-M a scalable and practical approach for AI-driven medical diagnostics.