CPLLM: Clinical prediction with large language models.

PLOS Digit Health

Department of Software and Information Systems Engineering, Ben-Gurion University of the Negev, Israel.

Published: December 2024

AI Article Synopsis

  • We introduce Clinical Prediction with Large Language Models (CPLLM), which fine-tunes a pre-trained Large Language Model for predicting diseases and hospital readmissions using patient medical histories.
  • We tested CPLLM against existing models like Retain and Med-BERT, generally recognized as the best in the field, and found CPLLM outperformed them in key evaluation metrics like PR-AUC and ROC-AUC.
  • This method offers a practical solution for clinicians to enhance patient care without needing extensive medical data for initial training.

Article Abstract

We present Clinical Prediction with Large Language Models (CPLLM), a method that involves fine-tuning a pre-trained Large Language Model (LLM) for predicting clinical disease and readmission. We utilized quantization and fine-tuned the LLM using prompts. For diagnostic predictions, we predicted whether patients would be diagnosed with a target disease during their next visit or in the subsequent diagnosis, leveraging their historical medical records. We compared our results to various baselines, including Retain and Med-BERT, the latter of which is the current state-of-the-art model for disease prediction using temporal structured EHR data. In addition, we also evaluated CPLLM's utility in predicting hospital readmission and compared our method's performance with benchmark baselines. Our experiments ultimately revealed that our proposed method, CPLLM, surpasses all the tested models in terms of PR-AUC and ROC-AUC metrics, providing state-of-the-art performance as a tool for predicting disease diagnosis and patient hospital readmission without requiring pre-training on medical data. Such a method can be easily implemented and integrated into the clinical workflow to help care providers plan next steps for their patients.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11623460PMC
http://dx.doi.org/10.1371/journal.pdig.0000680DOI Listing

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