将临床医生的专业知识与快速工程结合起来,可以提高小语言模型的可靠性,用于在电子健康记录中识别癌症实体
Federica Corso1, Vittoria Peppoloni1, Laura Mazzeo1,2
1Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy.
medRxiv : the preprint server for health sciences
|November 24, 2025
概括
小语言模型 (SLM) 显示出从电子健康记录 (EHR) 中提取癌症信息的希望. 在这项针对意大利电子健康记录的研究中,一般模型表现更好,几次拍摄提示和母语提高了准确性.
科学领域:
- 在瘤学瘤学.
- 医疗信息学 医疗信息学
- 自然语言处理自然语言处理.
背景情况:
- 非结构化电子健康记录 (EHR) 中的真实世界数据 (RWD) 对癌症研究至关重要.
- 从EHR中提取结构化信息是具有挑战性的,因为语言复杂性和隐私问题.
研究的目的:
- 评估四个小语言模型 (SLMs) 的性能,用于从意大利EHR在非小细胞肺癌 (NSCLC) 中提取信息 (IE).
- 评估提示策略和临床医生的专业知识对IE准确性的影响.
主要方法:
- 使用零射击,少数射击和注释的少数射击提示进行对比LLaMA,Mistral,BioMistral和MedLLaMA.
- 从NSCLC的APOLLO 11试验中评估意大利EHR的性能.
- 涉及不同专业知识的临床医生来分析快速设计的有效性.
主要成果:
- 一般用途的SLM在二进制特征提取方面表现优于生物医学模型.
- 多类变量 (TNM分阶段,PD-L1,ECOG) 由于隐含语言提出了挑战.
- 短暂的提示和母语输入提高了表现,减少了幻觉.
- 临床专业知识改善了注释的一致性,特别是对于新手用户.
结论:
- 保护隐私的SLM可以在本地部署,以从意大利EHR中安全有效地提取癌症数据.
- 建议使用混合系统,将SLM与专家临床输入相结合.
- 将临床文档与SLM能力结合起来,对于未来的整合至关重要.
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