大型语言模型和传统机器学习在术后结果预测中的比较:一个回顾性,多国发展和验证研究
Jipyeong Lee1, Hyeonsik Kim2, Luke Kim3
1Healthcare AI Research Institute, Seoul National University Hospital, Seoul, Republic of Korea.
Korean journal of anesthesiology
|February 3, 2026
概括
大型语言模型 (LLM) 显示出有希望的可扩展替代方案来预测手术结果,与传统机器学习性能相匹配. 开源LLM以减少计算需求保持效率,支持临床决策支持.
科学领域:
- 人工智能在医学中的应用
- 手术预测结果的预测.
- 临床决策支持系统 临床决策支持系统
背景情况:
- 传统的机器学习 (ML) 模型在预测外科手术结果时面临普遍性挑战.
- 大型语言模型 (LLM) 为预测术后结果提供了一个可扩展的替代方案.
- 关键结果包括住院死亡率,重症监护室 (ICU) 住院和急性损伤 (AKI).
研究的目的:
- 探索LLM作为传统ML模型可扩展替代方案的有效性,以预测手术结果.
- 将不同LLM与已建立的ML模型的性能进行比较.
- 评估模型参数量化对LLM性能的影响.
主要方法:
- 使用INSPIRE数据集 (n=80,985) 进行开发和内部验证,使用MOVER数据集 (n=6,165) 进行外部验证.
- 将三个LLM (GPT-4o,Llama-3-70B,OpenBioLLM-70B) 与使用快速工程的ML模型进行了比较.
- 通过4位规范浮点和16位大脑浮点量化来评估LLM.
主要成果:
- 在外部验证过程中,OpenBioLLM-70B在死亡率,ICU入院和AKI预测方面展示了与极端梯度提升 (XGBoost) 相当的性能.
- 开源的LLM在4位量子化下保持了性能.
- 量子化将开源LLM的计算要求降低了75%.
结论:
- 在临床决策支持方面,LLM表现出了多功能性和效率,与本地部署相兼容,以解决数据隐私问题.
- 跨不同数据集的进一步验证至关重要,以确保LLM可靠性和在各种外科外科环境中的适用性.
- 在外科手术预测中,LLM提供了一种可行,高效和尊重隐私的方法.
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