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Adapted large language models can outperform medical experts in clinical text summarization.
Van Veen, Dave; Van Uden, Cara; Blankemeier, Louis; Delbrouck, Jean-Benoit; Aali, Asad; Bluethgen, Christian; Pareek, Anuj; Polacin, Malgorzata; Reis, Eduardo Pontes; Seehofnerová, Anna; Rohatgi, Nidhi; Hosamani, Poonam; Collins, William; Ahuja, Neera; Langlotz, Curtis P; Hom, Jason; Gatidis, Sergios; Pauly, John; Chaudhari, Akshay S.
Afiliación
  • Van Veen D; Department of Electrical Engineering, Stanford University, Stanford, CA, USA. vanveen@stanford.edu.
  • Van Uden C; Stanford Center for Artificial Intelligence in Medicine and Imaging, Palo Alto, CA, USA. vanveen@stanford.edu.
  • Blankemeier L; Stanford Center for Artificial Intelligence in Medicine and Imaging, Palo Alto, CA, USA.
  • Delbrouck JB; Department of Computer Science, Stanford University, Stanford, CA, USA.
  • Aali A; Department of Electrical Engineering, Stanford University, Stanford, CA, USA.
  • Bluethgen C; Stanford Center for Artificial Intelligence in Medicine and Imaging, Palo Alto, CA, USA.
  • Pareek A; Stanford Center for Artificial Intelligence in Medicine and Imaging, Palo Alto, CA, USA.
  • Polacin M; Department of Electrical and Computer Engineering, The University of Texas at Austin, Austin, TX, USA.
  • Reis EP; Stanford Center for Artificial Intelligence in Medicine and Imaging, Palo Alto, CA, USA.
  • Seehofnerová A; Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
  • Rohatgi N; Stanford Center for Artificial Intelligence in Medicine and Imaging, Palo Alto, CA, USA.
  • Hosamani P; Copenhagen University Hospital, Copenhagen, Denmark.
  • Collins W; Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
  • Ahuja N; Stanford Center for Artificial Intelligence in Medicine and Imaging, Palo Alto, CA, USA.
  • Langlotz CP; Albert Einstein Israelite Hospital, São Paulo, Brazil.
  • Hom J; Department of Medicine, Stanford University, Stanford, CA, USA.
  • Gatidis S; Department of Radiology, Stanford University, Stanford, CA, USA.
  • Pauly J; Department of Medicine, Stanford University, Stanford, CA, USA.
  • Chaudhari AS; Department of Neurosurgery, Stanford University, Stanford, CA, USA.
Nat Med ; 30(4): 1134-1142, 2024 Apr.
Article en En | MEDLINE | ID: mdl-38413730
ABSTRACT
Analyzing vast textual data and summarizing key information from electronic health records imposes a substantial burden on how clinicians allocate their time. Although large language models (LLMs) have shown promise in natural language processing (NLP) tasks, their effectiveness on a diverse range of clinical summarization tasks remains unproven. Here we applied adaptation methods to eight LLMs, spanning four distinct clinical summarization tasks radiology reports, patient questions, progress notes and doctor-patient dialogue. Quantitative assessments with syntactic, semantic and conceptual NLP metrics reveal trade-offs between models and adaptation methods. A clinical reader study with 10 physicians evaluated summary completeness, correctness and conciseness; in most cases, summaries from our best-adapted LLMs were deemed either equivalent (45%) or superior (36%) compared with summaries from medical experts. The ensuing safety analysis highlights challenges faced by both LLMs and medical experts, as we connect errors to potential medical harm and categorize types of fabricated information. Our research provides evidence of LLMs outperforming medical experts in clinical text summarization across multiple tasks. This suggests that integrating LLMs into clinical workflows could alleviate documentation burden, allowing clinicians to focus more on patient care.
Asunto(s)

Texto completo: 1 Colección: 01-internacional Banco de datos: MEDLINE Asunto principal: Semántica / Documentación Límite: Humans Idioma: En Revista: Nat Med Asunto de la revista: BIOLOGIA MOLECULAR / MEDICINA Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos

Texto completo: 1 Colección: 01-internacional Banco de datos: MEDLINE Asunto principal: Semántica / Documentación Límite: Humans Idioma: En Revista: Nat Med Asunto de la revista: BIOLOGIA MOLECULAR / MEDICINA Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos