东部合作性瘤组状态提取的快速工程:比较大型语言模型技术
Meenakshi Dubey1, Kok Joon Chong1, Yuba Raj Pun1
1Saw Swee Hock School of Public Health, National University of Singapore, Singapore City, Singapore.
JCO clinical cancer informatics
|February 12, 2026
概括
先进的大型语言模型 (LLM) 提示显著改善了从临床笔记中提取东部合作性瘤组 (ECOG) 的性能状态. 像双过和思维链这样的技术为癌症患者数据管理提供了卓越的准确性和可靠性.
科学领域:
- 在瘤学中使用自然语言处理 (NLP).
- 临床数据提取
- 医疗保健中的人工智能
背景情况:
- 东方合作瘤学集团 (ECOG) 的绩效状况对于癌症患者的管理至关重要.
- ECOG状态经常被记录在非结构化的临床笔记中,这给提取带来了挑战.
- 目前从临床文本中提取ECOG状态的方法通常是有限的.
研究的目的:
- 从非结构化瘤学临床笔记中提取ECOG性能状态的各种方法进行比较.
- 在此任务中,评估大型语言模型 (LLM) 的高级提示技术的有效性.
- 评估这些方法在不同癌症类型中的通用性.
主要方法:
- 评估了四种ECOG提取方法:基于规则的NLP,简单的LLM提示,思维链 (CoT) 和双过 (DFT).
- 利用非小细胞肺癌,多发性骨髓瘤和卵巢癌患者 (2017-2021) 的非结构化临床笔记.
- 使用二进制和三类结果评估绩效,以及用于人类评估的QUEST问卷.
主要成果:
- CoT和DFT都实现了94%的准确性,超过了基于规则的 (91%) 和简单的提示 (86%).
- DFT表现出最高的特异性 (0.91) 和PPV (0.93);CoT实现了最高的灵敏度 (0.98).
- DFT和CoT显示出优越的输出质量,推理,偏差减少和用户满意度,其中DFT获得了最高的评分.
结论:
- 先进的LLM提示技术 (DFT,CoT) 显著提高了ECOG状态提取的准确性和可靠性.
- 这些方法可以标准化ECOG文档,促进患者队列识别,并支持个性化治疗规划.
- 实施需要考虑计算成本和人类监督的必要性.
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