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Improving Trauma Triage Accuracy with Large Language Models: A Comparison to Human Expert Decisions.

Ascharya Kushidhan Balaji1, Brendan T Fox1, Philip Seger1

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Large language models (LLMs) show promise in improving pediatric trauma triage accuracy. While retrospective review showed comparable performance to human clinicians, further validation is needed for clinical outcomes.

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Area of Science:

  • Medical Informatics
  • Artificial Intelligence in Healthcare
  • Trauma Surgery

Background:

  • Accurate prehospital trauma triage is critical for patient outcomes and healthcare system efficiency.
  • Large language models (LLMs) present a novel opportunity to enhance prehospital trauma triage processes.
  • Current implementation of LLMs in prehospital trauma care is limited.

Purpose of the Study:

  • To evaluate the performance of LLMs in pediatric trauma triage.
  • To assess the accuracy of LLM-assisted prehospital tele-communication.
  • To compare LLM triage accuracy against human clinician performance.

Main Methods:

  • Retrospective cohort study of 133 pediatric trauma activations at a Level I center.
  • Analysis of EMS recordings, trauma pages, and Injury Severity Scores (ISS).
  • Utilized OpenAI Whisper for transcription and Named Entity Recognition (NER) for structured data extraction; prospective evaluation involved trauma surgeons.

Main Results:

  • LLM triage demonstrated comparable accuracy to human clinicians in retrospective analysis (83.5% vs. 78.9%).
  • LLM-assisted triage showed a trend towards reduced under-triage (4.8% vs. 5.1%) and significantly reduced over-triage (58.6% vs. 71.8%).
  • Prospective evaluation indicated improved human triage accuracy after LLM exposure, enhancing correct triage decision odds.

Conclusions:

  • LLMs achieve comparable accuracy to trauma staff in retrospective pediatric trauma triage.
  • The use of structured "Essential Transcripts" significantly reduced data length while maintaining accuracy.
  • Further research is essential to validate LLM generalizability, clinical outcomes, and user acceptance for widespread deployment.