从临床笔记中提取健康的社会决定因素,跨机构使用大型语言模型
Vipina K Keloth1, Salih Selek2, Qingyu Chen1
1Department of Biomedical Informatics and Data Science, Yale School of Medicine, New Haven, CT, USA.
NPJ digital medicine
|May 16, 2025
概括
大型语言模型 (LLM) 可以有效地检测电子健康记录中的健康社会决定因素 (SDoH). 在多个机构中开发可通用的NLP模型对于全面的SDoH数据提取至关重要.
科学领域:
- 计算语言学计算语言学
- 医疗信息学 医疗信息学
- 健康研究的社会决定因素
背景情况:
- 健康的社会决定因素 (SDoH) 数据通常嵌入在电子健康记录 (EHR) 中的非结构化临床文本中.
- 目前用于SDoH提取的自然语言处理 (NLP) 方法面临范围,数据源多样性和通用性的限制.
- 需要强有力的跨机构方法来获取全面的SDoH信息.
研究的目的:
- 开发和评估可通用的NLP分类模型,用于检测EHR临床笔记中的SDoH因素.
- 通过创建跨机构的机构和测试模型通用性来解决当前SDoH NLP的局限性.
- 为了比较各种模型的性能,包括大型语言模型 (LLM),用于SDoH检测.
主要方法:
- 从四个不同的机构创建多机构的临床笔记库.
- 用21个SDoH因子对临床注释进行注释,分两个层次:因子识别 (一级) 和因子值关联 (二级).
- 开发和评估NLP模型,包括指令调整的LLM,用于SDoH分类.
主要成果:
- 调整指令的LLM表现出卓越的性能,实现微平均F1得分超过0.9的1级和超过0.84的2级SDoH检测.
- 在来自各个机构的数据上训练并测试的模型表现良好.
- 跨数据集概括测试揭示了持续存在的挑战,表明了未来改进的领域.
结论:
- 从临床文本中准确和可扩展地提取SDoH信息,LLM显示出显著的希望.
- 跨机构协作和模型通用性对于推进SDoH NLP至关重要.
- 开发的模型和 corpora 将公开提供,以促进进一步的研究.
更多相关视频
相关概念视频
Health Literacy
3.9K
Health literacy is an individual's or a community's capacity to comprehend, receive, read, and use relevant healthcare information and services. The World Health Organization (WHO, 2018) defines health literacy as the cognitive and social skills that determine the ability of individuals to gain access to, understand, and use information in ways that promote and maintain good health. As a result, the WHO helps individuals manage long-term health concerns, participate in preventative...
3.9K
Dimensions of Health and Illness
7.0K
The factors influencing the health-illness continuum can be internal or external and may or may not be under conscious control. They are related to the following eight human dimensions, and each dimension is interrelated to one other.
7.0K
Models of Health Promotion and Illness Prevention II
1.5K
The person's health status fluctuates continually, varying from being in good health to becoming ill and returning to being healthy. To understand the concept of illness prevention, there are two models. First, the health-illness continuum model is a graphic representation of an individual's wellness. It states that a person is considered healthy in the absence of physical disease and the presence of good emotional health.
The agent-host-environment model states that disease results...
The agent-host-environment model states that disease results...
1.5K
Documentation in Long-Term and Home Healthcare Setting
858
Documentation in long-term care facilities and home healthcare settings is crucial for ensuring continuous, coordinated, and comprehensive care for patients. Each setting has its specific documentation processes and tools:
Long-Term Care Facilities
Long-Term Care Facilities
858
Classification of Illness
7.2K
The meaning of illness is individualized to each person who experiences an alteration in health. In contrast, disease is a medical term indicating a pathological change in the structure and function of the body or mind. It is a condition that has specific symptoms and boundaries.
An illness is a response to a disease in which the person's level of functioning is changed compared with a previous level. The general classification of illness includes acute and chronic.
Acute illness is severe...
An illness is a response to a disease in which the person's level of functioning is changed compared with a previous level. The general classification of illness includes acute and chronic.
Acute illness is severe...
7.2K
Models of Health Promotion and Illness Prevention I
2.0K
A model is a theoretical way to understand a concept or an idea. Models can overcome barriers to health regardless of diverse economic and cultural backgrounds. In addition, models make the task easier by providing different ways to approach complex issues. There are two major health promotion models: the health belief model and the health promotion model.
The health belief model (HBM) attempts to predict health-related behavior in specific belief patterns. According to the HBM, a person's...
The health belief model (HBM) attempts to predict health-related behavior in specific belief patterns. According to the HBM, a person's...
2.0K


