在现实世界急诊室设置中,用于诊断预测的大型语言模型
Alexandre Niset1,2,3, Ines Melot4, Margaux Pireau1
1Emergency Department, Cliniques Universitaires Saint-Luc, Brussels, 1200, Belgium.
JAMIA open
|October 23, 2025
概括
大型语言模型 (LLM) 显示了紧急医疗决策支持的希望,但准确性取决于具体情况,而不仅仅是AI模型. 开源的LLM为透明的临床推理提供了更好的来源.
科学领域:
- 人工智能在医学中的应用
- 临床决策支持系统 临床决策支持系统
- 紧急医疗 信息学 信息学
背景情况:
- 随着患者数量的增加和人员短缺,急诊医学需要创新的临床决策支持工具.
- 大型语言模型 (LLM) 为增强诊断能力提供了潜在的解决方案.
研究的目的:
- 评估开源和封闭源LLM在紧急医疗中的预测诊断性能.
- 评估病例特征对LLM诊断准确性的影响.
主要方法:
- 在79个急诊病例中使用6个模型管道 (开源和闭源LLM) 生成了2370个AI诊断预测.
- 利用检索增强生成与急诊医学教科书用于基础LLM预测.
- 评估模型性能与专家共识诊断的对比.
主要成果:
- 所有LLM管道都实现了可比的诊断匹配率 (62.03%-72.15%).
- 诊断准确度受到病例特征 (特定与非特定,手术与医学) 的显著影响.
- 与封闭源代码模型相比,开源模型表现出优越的采购能力和引用验证.
结论:
- 法学士学位的诊断准确性主要取决于病例的复杂性,而不是模型的选择,这表明AI对临床推理的调整挑战.
- 开源的LLM提供了加强的采购,对于透明和可解释的临床决策至关重要.
- 未来的研究应该纳入医院指导方针,并探索本地解决方案,以更好地实现临床整合和隐私合规.
相关概念视频
Higher Mental Functions of the Brain: Language
Language is a system of communication that allows the expression of thoughts, ideas, and feelings. The brain processes language in both hemispheres.
Language formation and comprehension take place in the dominant hemisphere. The dominant hemisphere is responsible for understanding the meaning of spoken, written, or sign language, as well as the ability to communicate. For most people, the left hemisphere is the dominant one. The right hemisphere, then, gives tone and emotional context to the...
Language formation and comprehension take place in the dominant hemisphere. The dominant hemisphere is responsible for understanding the meaning of spoken, written, or sign language, as well as the ability to communicate. For most people, the left hemisphere is the dominant one. The right hemisphere, then, gives tone and emotional context to the...
Introduction to Language of Pathophysiology l
Pathophysiology investigates how biological mechanisms—typically starting at the cellular level—disrupt normal bodily functions. It bridges anatomy and physiology to explain the progression of disease. With this foundation, it is important to understand the following key terms used to describe disease processes: Diagnosis:The process of identifying a disease using clinical evaluation, including signs (objective evidence like rashes), symptoms (subjective experiences like pain), laboratory test...
Introduction to Language of Pathophysiology ll
This lesson explores key terms that describe how diseases progress, their outcomes, and their distribution in populations.Diagnostic tests identify diseases and monitor treatment. These include blood and urine tests, biopsies, imaging (X-ray, MRI), and detection of infectious agents.Remission is a reduction or disappearance of symptoms.Exacerbation refers to the worsening of symptoms, such as increased wheezing during an asthma attack.A precipitating factor triggers an acute episode, while a...

