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在使用大型语言模型为前列腺癌插入水凝周向间隔器后,对不良事件的自动分类
Nishan Sohoni1, Nimit S Sohoni1, Ryan A Sutherland1
1Department of Urology, Yale University, New Haven, CT, USA.
Urology
|January 21, 2026
概括
大型语言模型 (LLM) 在分析前列腺辐射中使用的SpaceOAR水凝间隔器的不良事件 (AE) 中表现有前途. GPT-4o与人类的准确度非常相匹配,识别了常见的问题,如错位的凝和感染.
科学领域:
- 医疗器械安全和性能分析.
- 人工智能在医疗保健数据中的应用.
- 辐射瘤学和不良事件监测.
背景情况:
- 前列腺放射治疗通常使用水凝间隔器,如SpaceOAR,以尽量减少直肠毒性.
- 对设备相关不良事件 (AE) 的准确和有效分析对于患者安全至关重要.
- 对AEs的大型数据库的手动审查是耗时且资源密集的.
研究的目的:
- 评估大型语言模型 (LLM) 在分析与SpaceOAR水凝间隔器相关的不良事件中的性能.
- 将LLM与人类抽象的准确性进行比较,以对空间OAR相关的AE进行分类.
- 通过对大型数据集的LLM分析,识别与SpaceOAR相关的常见AE.
主要方法:
- 从FDA的MAUDE数据库中提取了1455个SpaceOAR报告 (2015年1月至2024年12月).
- 手动抽象97份报告来分类AE问题,辐射时间修改和严重程度 (CTCAE分数).
- 将三个LLM家族的准确性与人类审核者的准确性进行了比较,最高表现的LLM (GPT-4o) 分析了完整的数据集.
主要成果:
- 在识别AE结果方面,GPT-4o实现了高准确度 (4.96/5),与人类审查者 (4.99/5) 密切匹配.
- 在对1455份报告的LLM分析中,发现错位凝 (58.7%) 是最常见的问题.
- 其他重要的副作用包括感染/炎症/ (10.4%), (7.1%) 和直肠 (4.7%). 在ICU的护理和死亡是罕见的 (0.1%和0.3%).
结论:
- 简单的LLM可以自动分析与设备相关的AEs,大大减少手工工作.
- 与太空OAR相关的严重事故突显了持续安全监测的必要性.
- 在实施水凝间隔器时,必须仔细考虑和动态监控.
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