前FHIR:通过快速医疗互操作资源和大型语言模型增强临床预测
Merlin Engelke1,2, Giulia Baldini1,2, Jens Kleesiek1,3,4
1Institute for Artificial Intelligence in Medicine, University Medicine Essen, Essen, 45131, Germany.
Journal of the American Medical Informatics Association : JAMIA
|October 13, 2025
概括
开源框架FHIR-Former通过将快速医疗互操作性资源 (FHIR) 与大语言模型 (LLM) 集成来实现临床预测的自动化. 这种方法提高了医疗保健任务的数据处理和预测准确性.
科学领域:
- 医疗保健信息学 医疗保健信息学
- 人工智能在医学中的应用
- 临床数据科学 临床数据科学
背景情况:
- 临床预测建模面临着数据异质性和手动特征工程方面的挑战.
- 现有的框架经常与多种数据源作斗争,需要大量的预处理.
- 对于临床预测任务,需要自动化和标准化解决方案.
研究的目的:
- 引入FHIR-Former,这是一个开源框架,用于自动化和标准化临床预测.
- 整合快速医疗互操作性资源 (FHIR) 与大型语言模型 (LLM) 进行增强的预测建模.
- 在临床环境中解决数据异质性和手动功能工程挑战.
主要方法:
- 从FHIR资源动态处理结构化和非结构化数据.
- 该框架支持多个分类任务,包括再接收,成像研究和ICD代码预测.
- 模型在110万个数据点上使用开源LLM (GeBERTa) 进行训练,并通过贝叶斯方法进行优化.
主要成果:
- 实现了70.7%的F1得分和72.9%的准确性,用于30天的再接收预测.
- 证明了51.8%的F1评分和88.1%的死亡率预测准确度.
- 在成像研究分类方面获得了61%的宏观F1分数,在ICD代码预测方面获得了94%的准确性.
结论:
- FHIR-Former消除了特定机构的预处理,适应各种FHIR实现,以实现无的多式联运数据集成.
- 该框架的可配置架构优于依赖于静态或有限文本输入的先前方法.
- 通过将FHIR标准化与LLM灵活性相协调,FHIR-Former在医疗保健中推进了可扩展,可互操作的预测建模.
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