用大型成治疗语言模型检测临床笔记中的污名化语言
medRxiv : the preprint server for health sciences
|August 20, 2025
概括
大型语言模型 (LLM) 有效地识别了在重症监护室 (ICU) 的污名化语言. 监督微调 (SFT) 实现了97. 2%的准确性,减少了临床文档中的偏差.
科学领域:
- 自然语言处理
- 临床信息学
- 医学伦理
背景情况:
- 临床笔记中的污名化语言可能会对患者护理产生负面影响,并使偏见延续.
- 患有物质使用障碍 (SUD) 的患者在医疗保健机构中特别容易受到耻辱.
- 重症监护室 (ICU) 的进展记录是污名化语言的潜在来源.
研究的目的:
- 评估大型语言模型 (LLM) 在ICU进展记录中检测污名化语言的表现.
- 比较不同的LLM方法,包括零射击,上下文学习,检索增强生成 (RAG) 和监督微调 (SFT).
- 评估LLM为他们的污名检测提供理由的能力,并确定新的污名化术语.
主要方法:
- 创建了来自MIMIC-III的77,104份ICU笔记的数据集,以平衡污名化和非污名化遭遇.
- 测试了四种LLM方法 (零射击,上下文学习,RAG,SFT) 和一个关键字搜索基线.
- 用列车/开发/测试分组和外部验证集对模型的准确性和宏观F1评分进行了评估.
主要成果:
- 监督微调 (SFT) 获得了最高准确率 (97.2%),其次是上下文学习.
- 他们为预测提供了连贯的理由,有助于审查错误的阳性结果.
- 在SFT和语境学习中都发现了在手动注释中错过的污名化语言.
结论:
- 在ICU笔记中识别污名化语言方面,LLM,特别是SFT和上下文学习非常有效.
- 这些模型提供了一种有效的替代手动审查,减少了时间和精力.
- 可以帮助缓解临床文档中的耻辱感,改善SUD患者的护理.
更多相关视频
08:53Integrating Computerized Linguistic and Social Network Analyses to Capture Addiction Recovery Capital in an Online Community
Published on: May 31, 2019
5.3K
07:31Implementation of a Real-Time Psychosis Risk Detection and Alerting System Based on Electronic Health Records using CogStack
Published on: May 15, 2020
7.2K
相关概念视频
Drug Dependence
1.2K
Medications are typically administered to achieve therapeutic effects. Some drugs can modify an individual's mood and perception, frequently resulting in various enjoyable experiences. However, this can result in drug dependency, a condition marked by continuous drug use despite potential negative consequences. Drug dependency primarily falls into two categories: psychological and physical dependence. Psychological dependence occurs when the pleasurable feelings induced by the drug...
1.2K
Diagnostic and Statistical Manual of Mental Disorders (DSM)
141
The Diagnostic and Statistical Manual of Mental Disorders (DSM) serves as the primary classification system for mental health disorders, providing standardized diagnostic criteria for clinicians and researchers. First published by the American Psychiatric Association (APA) in 1952, the DSM has undergone several revisions to reflect evolving psychiatric understanding. The fifth edition, DSM-5, released in 2013, introduced key updates that expanded diagnostic categories and modified diagnostic...
141
Specialized Care Centers and Settings-II
776
Rural Health Centers
Rural health centers are specialized care facilities in remote locations with very few medical personnel. The primary care providers who run the centers are mostly Registered Nurse Practitioners. Here, emergency treatment is provided to critically ill or injured patients before they are transferred to the closest hospital. Fortunately, due to advancement in technology, many rural healthcare facilities and professionals have easy access to diagnostic and treatment...
Rural health centers are specialized care facilities in remote locations with very few medical personnel. The primary care providers who run the centers are mostly Registered Nurse Practitioners. Here, emergency treatment is provided to critically ill or injured patients before they are transferred to the closest hospital. Fortunately, due to advancement in technology, many rural healthcare facilities and professionals have easy access to diagnostic and treatment...
776
Drug Abuse and Addiction: Pharmacological Phenomena
653
Drug dependence, abuse, and addiction are complex phenomena that can precipitate various abnormal states. Physical dependence refers to a state of pharmacological adaptation to a drug. This adaptation often results in tolerance—a reduced response to the drug after repeated administrations. When the drug use is abruptly stopped, withdrawal symptoms occur due to the body's need to readjust from the pharmacologically induced imbalance. However, tolerance and withdrawal symptoms do not...
653
Modeling in Therapy
145
Modeling, a key technique in therapy, uses observational learning to help clients acquire and practice new skills by watching therapists demonstrate desired behaviors. This approach, rooted in Albert Bandura's concept of vicarious learning, plays a significant role in therapeutic interventions for various psychological conditions, including social anxiety, ADHD, and depression.
Participant Modeling
Participant modeling involves therapists demonstrating calm and effective behaviors in...
Participant Modeling
Participant modeling involves therapists demonstrating calm and effective behaviors in...
145
Language and Cognition
436
Language serves as a bridge between ideas and communication, influencing how individuals perceive and interact with the world. Psychologists have long debated whether language shapes thought or vice versa. This discussion gained grip with Edward Sapir and Benjamin Lee Whorf in the 1940s, who proposed that language determines thought, a concept known as linguistic determinism. They suggested that the vocabulary and structure of a language influence how its speakers think and perceive reality.
436
