瘤学药房中与药物相关的不良事件的大型语言模型:检测,分级和采取行动
Md Muntasir Zitu1, Ashish Manne2, Yuxi Zhu3
1Department of Machine Learning, Moffitt Cancer Center and Research Institute, Tampa, FL 33612, USA.
大型语言模型 (LLM) 可以帮助从临床笔记中检测瘤学中的不良事件 (AE),帮助药剂师在药物安全方面. 人工智能显示出AE监测和审查的前景,改善了患者的护理.
科学领域:
- * 临床信息学 * 临床信息学
- * 医学中的人工智能
- * 药物监督 * 药物监督
背景情况:
- * 在瘤学中,可预防的药物危害往往是与药物相关的不良事件 (AE) 的结果.
- *关于AE的临床决策依赖于经常在非结构化临床文本中发现的证据.
- *大型语言模型 (LLM) 提供了从临床文本数据中提取和推理的高级功能.
研究的目的:
- *综合对LLM和NLP系统的实证研究,用于瘤学AE检测,分级和行动分配.
- * 评估LLM在从临床文档中识别AE方面的潜力.
- * 为提高订单级药物安全性的药剂师面向建议提供信息.
主要方法:
- * 进行了PubMed,Ovid MEDLINE和Embase索引的英语研究的叙事审查.
- *包括使用临床叙述和/或权威指导的LLMs的研究.
- *不包括非文本形式和非实证文章;19项研究符合纳入标准.
主要成果:
- *LLM显示出从常规笔记中检测瘤学AE的潜力,往往超过监测的诊断代码.
- *根据常用术语标准对不良事件 (CTCAE) 的分级是可行的,但不如检测那么稳定,通过受限制的输出和患者级聚合得到改善.
- *直接评估等级一致的行动是不常见的;研究报告了代理,突出了未来影响报告的需要.
结论:
- * 有证据支持近期,药剂师在循环中使用AI进行AE监测和审查.
- * CTCAE结构化的,引用支持的AI输出可以集成到药剂师的工作流程中进行审查.
- * 未来的研究应该标准化报告,CTCAE的使用,并前性地测量等级到行动的正确性,以加强决策支持.
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