Evaluating Large Language Models for Translating Multimodal Phenotype Documentations into Executable EHR Phenotyping...

Research applications of electronic health record (EHR) phenotypes require translating clinical definitions into executable EHR database queries, a labor-intensive process. We evaluated two frontier large language models across five phenotypes and three documentation modalities. Both models captured high-level logic from structured text but degraded markedly with diagram-only input. Error analysis revealed seven failure categories. Documentation, rather than model capability, was the primary bottleneck, reinforcing the need for standardization and expert oversight.