评估医学编码和医院再接收风险分层的大型语言模型的推理能力:零射击促使方法
Parvati Naliyatthaliyazchayil1, Raajitha Muthyala1, Judy Wawira Gichoya2
1Department of Biomedical Engineering and Informatics, Luddy School of Informatics, Computing and Engineering, Indiana University Indianapolis, 535 W Michigan Street, Indianapolis, IN, 46202, United States, 1 317 274 0439.
大型语言模型在零射击临床诊断和风险预测方面表现出适度的成功,但在医学编码方面存在困难. 特定任务的微调和人类监督对于可靠的医疗保健应用程序至关重要.
科学领域:
- 医疗保健中的人工智能
- 临床决策支持系统 临床决策支持系统
- 医学中的自然语言处理.
背景情况:
- 大型语言模型 (LLM) 证明了医疗保健在临床推理和决策支持方面的潜力.
- 然而,在没有特殊培训的情况下,它们在诊断,编码和风险预测等关键任务中的可靠性是不确定的.
研究的目的:
- 评估和比较推理和非推理LLM在临床诊断,ICD-9代码预测和医院再入院风险分层方面的零射击性能.
- 评估LLM作为通用临床决策支持工具的潜力.
主要方法:
- 使用了MIMIC-IV数据集,分析了300份医院出院摘要.
- 在推理和非推理的LLM中使用了标准化的零射击提示,结合了透明度的逻辑诱导.
- 使用F1分数和正确率百分比来衡量性能,并进行统计分析.
主要成果:
- 在零射击诊断和风险预测方面,LLM表现适度成功,但在ICD-9代码预测方面表现明显不佳.
- 在测试的模型中,OpenAI-O3在诊断和ICD-9编码方面表现出卓越的性能.
- 推理模型提供了边际性能增长和更好的解释性,但产生了多言多语的输出.
结论:
- 目前的LLM需要特定任务的微调和临床使用的人在循环验证.
- 医疗编码仍然是一个重要的挑战,LLMs在零射击设置.
- 需要进一步的研究来提高LLM的稳定性,可靠性和在各种临床数据上的性能.
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