Retrieving Evidence from EHRs with LLMs: Possibilities and Challenges

Fuente: arXiv
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Auteurs principaux: Ahsan, Hiba, McInerney, Denis Jered, Kim, Jisoo, Potter, Christopher, Young, Geoffrey, Amir, Silvio, Wallace, Byron C.
Format: Preprint
Publié: 2023
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author Ahsan, Hiba
McInerney, Denis Jered
Kim, Jisoo
Potter, Christopher
Young, Geoffrey
Amir, Silvio
Wallace, Byron C.
author_facet Ahsan, Hiba
McInerney, Denis Jered
Kim, Jisoo
Potter, Christopher
Young, Geoffrey
Amir, Silvio
Wallace, Byron C.
contents Unstructured data in Electronic Health Records (EHRs) often contains critical information -- complementary to imaging -- that could inform radiologists' diagnoses. But the large volume of notes often associated with patients together with time constraints renders manually identifying relevant evidence practically infeasible. In this work we propose and evaluate a zero-shot strategy for using LLMs as a mechanism to efficiently retrieve and summarize unstructured evidence in patient EHR relevant to a given query. Our method entails tasking an LLM to infer whether a patient has, or is at risk of, a particular condition on the basis of associated notes; if so, we ask the model to summarize the supporting evidence. Under expert evaluation, we find that this LLM-based approach provides outputs consistently preferred to a pre-LLM information retrieval baseline. Manual evaluation is expensive, so we also propose and validate a method using an LLM to evaluate (other) LLM outputs for this task, allowing us to scale up evaluation. Our findings indicate the promise of LLMs as interfaces to EHR, but also highlight the outstanding challenge posed by "hallucinations". In this setting, however, we show that model confidence in outputs strongly correlates with faithful summaries, offering a practical means to limit confabulations.
format Preprint
id arxiv_https___arxiv_org_abs_2309_04550
institution arXiv
publishDate 2023
record_format arxiv
spellingShingle Retrieving Evidence from EHRs with LLMs: Possibilities and Challenges
Ahsan, Hiba
McInerney, Denis Jered
Kim, Jisoo
Potter, Christopher
Young, Geoffrey
Amir, Silvio
Wallace, Byron C.
Computation and Language
Unstructured data in Electronic Health Records (EHRs) often contains critical information -- complementary to imaging -- that could inform radiologists' diagnoses. But the large volume of notes often associated with patients together with time constraints renders manually identifying relevant evidence practically infeasible. In this work we propose and evaluate a zero-shot strategy for using LLMs as a mechanism to efficiently retrieve and summarize unstructured evidence in patient EHR relevant to a given query. Our method entails tasking an LLM to infer whether a patient has, or is at risk of, a particular condition on the basis of associated notes; if so, we ask the model to summarize the supporting evidence. Under expert evaluation, we find that this LLM-based approach provides outputs consistently preferred to a pre-LLM information retrieval baseline. Manual evaluation is expensive, so we also propose and validate a method using an LLM to evaluate (other) LLM outputs for this task, allowing us to scale up evaluation. Our findings indicate the promise of LLMs as interfaces to EHR, but also highlight the outstanding challenge posed by "hallucinations". In this setting, however, we show that model confidence in outputs strongly correlates with faithful summaries, offering a practical means to limit confabulations.
title Retrieving Evidence from EHRs with LLMs: Possibilities and Challenges
topic Computation and Language
url https://arxiv.org/abs/2309.04550