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Implementing a Resource-Light and Low-Code Large Language Model System for Information Extraction from Mammography
Fabio Dennstädt1,2, Simon Fauser3, Nikola Cihoric3
1Department of Radiation Oncology, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland. fabio.dennstaedt@insel.ch.
Abstract:
Large language models (LLMs) have been successfully used for data extraction from free-text radiology reports. Most current studies were conducted with LLMs accessed via an application programming interface (API). We evaluated the feasibility of using open-source LLMs, deployed on limited local hardware resources for data extraction from free-text mammography reports, using a common data element (CDE)-based structure. Seventy-nine CDEs were defined by an interdisciplinary expert panel, reflecting real-world reporting practice. Sixty-one reports were classified by two independent researchers to establish ground truth. Five different open-source LLMs deployable on a single GPU were used for data extraction using the general-classifier Python package. Extractions were performed for five different prompt approaches with calculation of overall accuracy, micro-recall and micro-F1. Additional analyses were conducted using thresholds for the relative probability of classifications. High inter-rater agreement was observed between manual classifiers (Cohen's kappa 0.83). Using default prompts, the LLMs achieved accuracies of 59.2-72.9%. Chain-of-thought prompting yielded mixed results, while few-shot prompting led to decreased accuracy. Adaptation of the default prompts to precisely define classification tasks improved performance for all models, with accuracies of 64.7-85.3%. Setting certainty thresholds further improved accuracies to > 90% but reduced the coverage rate to < 50%. Locally deployed open-source LLMs can effectively extract information from mammography reports, maintaining compatibility with limited computational resources. Selection and evaluation of the model and prompting strategy are critical. Clear, task-specific instructions appear crucial for high performance. Using a CDE-based framework provides clear semantics and structure for the data extraction.
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