臨床一般化における一般化可能性への対応：連邦学習または大規模言語モデル？：米国および英国の眼科研究所からの視力抽出に関するケーススタディ

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.