Clinical Text Summarization: Adapting Large Language Models Can Outperform Human Experts.


Journal

Research square
Titre abrégé: Res Sq
Pays: United States
ID NLM: 101768035

Informations de publication

Date de publication:
30 Oct 2023
Historique:
pubmed: 14 11 2023
medline: 14 11 2023
entrez: 14 11 2023
Statut: epublish

Résumé

Sifting through vast textual data and summarizing key information from electronic health records (EHR) imposes a substantial burden on how clinicians allocate their time. Although large language models (LLMs) have shown immense promise in natural language processing (NLP) tasks, their efficacy on a diverse range of clinical summarization tasks has not yet been rigorously demonstrated. In this work, we apply domain adaptation methods to eight LLMs, spanning six datasets and four distinct clinical summarization tasks: radiology reports, patient questions, progress notes, and doctor-patient dialogue. Our thorough quantitative assessment reveals trade-offs between models and adaptation methods in addition to instances where recent advances in LLMs may not improve results. Further, in a clinical reader study with ten physicians, we show that summaries from our best-adapted LLMs are preferable to human summaries in terms of completeness and correctness. Our ensuing qualitative analysis highlights challenges faced by both LLMs and human experts. Lastly, we correlate traditional quantitative NLP metrics with reader study scores to enhance our understanding of how these metrics align with physician preferences. Our research marks the first evidence of LLMs outperforming human experts in clinical text summarization across multiple tasks. This implies that integrating LLMs into clinical workflows could alleviate documentation burden, empowering clinicians to focus more on personalized patient care and the inherently human aspects of medicine.

Identifiants

pubmed: 37961377
doi: 10.21203/rs.3.rs-3483777/v1
pmc: PMC10635391
pii:
doi:

Types de publication

Preprint

Langues

eng

Subventions

Organisme : NIBIB NIH HHS
ID : R01 EB002524
Pays : United States
Organisme : NHLBI NIH HHS
ID : 75N92020C00021
Pays : United States
Organisme : AHRQ HHS
ID : R18 HS026886
Pays : United States
Organisme : NHLBI NIH HHS
ID : R01 HL155410
Pays : United States
Organisme : NHLBI NIH HHS
ID : R01 HL157235
Pays : United States
Organisme : NIAMS NIH HHS
ID : R01 AR077604
Pays : United States
Organisme : NIBIB NIH HHS
ID : P41 EB027060
Pays : United States
Organisme : NHLBI NIH HHS
ID : 75N92020C00008
Pays : United States
Organisme : NHLBI NIH HHS
ID : R01 HL167974
Pays : United States
Organisme : NIAMS NIH HHS
ID : R01 AR079431
Pays : United States

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Auteurs

Dave Van Veen (D)

Department of Electrical Engineering, Stanford University, Stanford, CA, USA.
Stanford Center for Artificial Intelligence in Medicine and Imaging, Palo Alto, CA, USA.

Cara Van Uden (C)

Stanford Center for Artificial Intelligence in Medicine and Imaging, Palo Alto, CA, USA.
Department of Computer Science, Stanford University, Stanford, CA, USA.

Louis Blankemeier (L)

Department of Electrical Engineering, Stanford University, Stanford, CA, USA.
Stanford Center for Artificial Intelligence in Medicine and Imaging, Palo Alto, CA, USA.

Jean-Benoit Delbrouck (JB)

Stanford Center for Artificial Intelligence in Medicine and Imaging, Palo Alto, CA, USA.

Asad Aali (A)

Department of Electrical and Computer Engineering, The University of Texas at Austin, Austin, TX, USA.

Christian Bluethgen (C)

Department of Medicine, Stanford, CA, USA.
University Hospital Zurich, Zurich, Switzerland.

Anuj Pareek (A)

Stanford Center for Artificial Intelligence in Medicine and Imaging, Palo Alto, CA, USA.
Copenhagen University Hospital, Copenhagen, Denmark.

Malgorzata Polacin (M)

Department of Medicine, Stanford, CA, USA.
University Hospital Zurich, Zurich, Switzerland.

Eduardo Pontes Reis (EP)

Stanford Center for Artificial Intelligence in Medicine and Imaging, Palo Alto, CA, USA.
Albert Einstein Israelite Hospital, São Paulo, Brazil.

Anna Seehofnerová (A)

Department of Medicine, Stanford, CA, USA.
Department of Radiology, Stanford University, Stanford, CA, USA.

Nidhi Rohatgi (N)

Department of Medicine, Stanford, CA, USA.
Department of Neurosurgery, Stanford University, Stanford, CA, USA.

Poonam Hosamani (P)

Department of Medicine, Stanford, CA, USA.

William Collins (W)

Department of Medicine, Stanford, CA, USA.

Neera Ahuja (N)

Department of Medicine, Stanford, CA, USA.

Curtis P Langlotz (CP)

Stanford Center for Artificial Intelligence in Medicine and Imaging, Palo Alto, CA, USA.
Department of Medicine, Stanford, CA, USA.
Department of Radiology, Stanford University, Stanford, CA, USA.
Department of Biomedical Data Science, Stanford, CA, USA.

Jason Hom (J)

Department of Medicine, Stanford, CA, USA.

Sergios Gatidis (S)

Stanford Center for Artificial Intelligence in Medicine and Imaging, Palo Alto, CA, USA.
Department of Radiology, Stanford University, Stanford, CA, USA.

John Pauly (J)

Department of Electrical Engineering, Stanford University, Stanford, CA, USA.

Akshay S Chaudhari (AS)

Stanford Center for Artificial Intelligence in Medicine and Imaging, Palo Alto, CA, USA.
Department of Radiology, Stanford University, Stanford, CA, USA.
Department of Biomedical Data Science, Stanford, CA, USA.

Classifications MeSH