基于大型语言模型识别静脉血栓塞栓症的诊断延迟
Verity Schaye1,2, Daniel J Sartori1, Lexi Signoriello2
1Department of Medicine, NYU Grossman School of Medicine, New York, New York, USA.
Journal of hospital medicine
|October 8, 2025
概括
一个新的大型语言模型 (LLM) 电子触发器有效地识别了入院患者静脉血栓栓塞 (VTE) 的诊断延迟. 这种先进的工具为VTE诊断和患者护理提供了更好的准确性和可扩展性.
科学领域:
- 医疗信息学 医疗信息学
- 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
背景情况:
- 静脉血栓栓塞 (VTE) 的延迟诊断是住院患者面临的重大挑战.
- 目前用于识别VTE诊断延迟的方法有限,阻碍了质量改进工作.
研究的目的:
- 开发和验证一种基于大型语言模型 (LLM) 的新型电子触发器,用于检测VTE的诊断延迟.
- 与现有方法相比,评估LLM触发器的性能.
主要方法:
- 利用两年内内科住院医生 (n=20,843) 的入院数据.
- 开发和验证的LLM提示在笔记中确定VTE考虑,并在成像报告中确认.
- 审查不一致的病例以确定诊断延迟,实施准确性排除标准.
主要成果:
- 在医疗笔记和成像研究的分类中,LLM提示实现了高精度 (98%-100%).
- 该LLM触发器确定了137个潜在的诊断延迟,在排除后的积极预测值 (PPV) 为48%和负预测值 (NPV) 为95%.
- 在所有VTE住院病例中,4.4%被确定为诊断延迟.
结论:
- 首个基于LLM的电子触发器成功开发了VTE诊断延迟.
- 与非LLM电子触发器相比,这种LLM触发器表现出优越的性能.
- 法学士课程的应用显示出可扩展的诊断反和医疗保健质量改善的前景.
相关概念视频
Venous Thrombosis II: Clinical Manifestations and Diagnostic Studies
289
The key difference between Superficial Vein Thrombosis (SVT) and Deep Vein Thrombosis (DVT) lies in their location and severity.Clinical ManifestationsSVT typically presents with localized pain, tenderness, and redness along the course of a superficial vein, often accompanied by a palpable, cord-like structure under the skin. This condition is usually less dangerous than DVT but can be uncomfortable and may lead to complications such as cellulitis or, rarely, a clot extension into the deep...
289
Venous Thrombosis III: Interprofessional Care
280
Venous thrombosis requires effective prevention and treatment strategies to improve patient outcomes and reduce potential complications.Prevention StrategiesHealthcare providers must prioritize preventing venous thromboembolism (VTE) for all adult patients upon admission. Interventions depend on bleeding and thrombosis risk, medical history, current medications, diagnoses, planned procedures, and patient preferences. Patients on bed rest should change positions every two hours and, if not...
280
Venous Thrombosis I: Introduction
364
Venous thrombosis, the most common disorder of the veins, involves the formation of a thrombus or blood clot associated with vein inflammation. It can be classified as either superficial vein thrombosis or deep vein thrombosis.Superficial Vein Thrombosis: This involves the formation of a thrombus in a superficial vein, usually the greater or lesser saphenous vein. Though less severe than deep vein thrombosis (DVT), SVT can lead to complications if untreated.Deep Vein Thrombosis (DVT): This...
364
Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care
320
Diagnosing Pulmonary EmbolismDiagnosing pulmonary embolism (PE) involves clinical assessment and advanced imaging tests. The preferred diagnostic tool is the spiral (helical) CT scan or CT angiography (CTA), which uses intravenous contrast media to visualize the pulmonary vasculature and identify emboli.A ventilation-perfusion (V/Q) scan is an alternative for patients unable to receive contrast media. This scan includes both perfusion and ventilation scanning. Perfusion scanning involves...
320


