基于BERT的大型语言模型的开发,用于使用现实世界的对话进行紧急部门分拣
Sukyo Lee1, Sumin Jung2, Jong-Hak Park1
1Department of Emergency Medicine, Korea University Ansan Hospital, Ansan-si, Gyeonggi-do 15355, Republic of Korea.
Journal of the American Medical Informatics Association : JAMIA
|February 6, 2026
概括
这项研究开发了基于BERT的大型语言模型 (LLM),训练了真实急诊室对话,用于患者紧急分类. 人工智能模型在准确识别紧急案件方面显著超过了ChatGPT.
科学领域:
- 人工智能在医学中的应用
- 临床信息学 临床信息学
- 自然语言处理 (Natural Language Processing) 是一种自然语言处理.
背景情况:
- 准确的急救部门 (ED) 选对于有效的资源分配至关重要.
- 以前用于分组的AI模型使用了总结的临床数据,限制了现实世界的适用性.
- 大型语言模型 (LLM) 为分析复杂的临床对话提供了潜力.
研究的目的:
- 开发和评估经过实际临床对话培训的LLM,以对患者紧急情况进行分类.
- 将这些LLM的性能与现有的AI模型和通用聊天机器人进行比较.
- 评估开发的LLM在临床决策中的可解释性.
主要方法:
- 利用来自韩国三级医院的匿名分拣对话的精心策划的数据集.
- 开发了两个基于BERT的LLM:一个是标记整个对话,另一个是使用层次结构与演讲角色嵌入的层次结构.
- 根据韩国分辨和敏度度量表 (KTAS) 将患者紧急情况分类为紧急 (KTAS 3) 和非紧急 (KTAS 4-5).
- 评估模型使用准确度,精度,回忆和F1得分,与ChatGPT GPT-4o和ClinicalBERT进行比较.
- 使用夏普利添加式解释 (SHAP) 评估模型可解释性.
主要成果:
- 一个基于BERT的等级LLM实现了75.94%的准确性,明显优于ChatGPT (56.68%) 和临床BERT (69.42%).
- 最好的模型在紧急情况下显示了0.9610的召回率,超过了ChatGPT的0.5352.
- SHAP分析证实了该模型的重点是与KTAS标准一致的临床相关线索.
结论:
- 在现实世界ED对话中接受培训的基于BERT的LLM提供了与一般AI模型相比更高的分类准确性.
- 这种方法通过可解释和高效的AI增强了临床决策支持系统.
- 这些发现突出了专门的LLM在改善紧急护理工作流程方面的潜力.
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