Addressing Generalizability in Clinical Named Entity Recognition: Federated Learning or Large Language Models?: A...

Clinical Named Entity Recognition (NER) is vital for extracting structured data from clinical text, but ensuring model generalizability across institutions remains challenging. This study compares two approaches: (1) Federated Learning (FL), a privacy-preserving decentralized method, and (2) Large Language Models (LLMs) trained on diverse corpora. We evaluate Visual Acuity (VA) extraction from ophthalmology notes at Stanford (USA) and Moorfields Eye Hospital (UK), using BERT-based models, FL strategies (FedAvg, STWT), and LLMs (Llama-3-70B, Mixtral-8x7B). Results show that FL significantly improves generalization, with STWT outperforming FedAvg in stability and accuracy. LLMs demonstrate strong performance on MEH data but struggle with structured Stanford notes. These findings highlight FL's effectiveness for cross-institutional learning while revealing domain-specific limitations of LLMs, underscoring the need for tailored approaches to clinical NER.