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Main Authors: Ben-Atya, Hadas, Gavrielov, Naama, Badash, Zvi, Focht, Gili, Cytter-Kuint, Ruth, Hagopian, Talar, Turner, Dan, Freiman, Moti
Format: Preprint
Published: 2025
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Online Access:https://arxiv.org/abs/2502.01691
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author Ben-Atya, Hadas
Gavrielov, Naama
Badash, Zvi
Focht, Gili
Cytter-Kuint, Ruth
Hagopian, Talar
Turner, Dan
Freiman, Moti
author_facet Ben-Atya, Hadas
Gavrielov, Naama
Badash, Zvi
Focht, Gili
Cytter-Kuint, Ruth
Hagopian, Talar
Turner, Dan
Freiman, Moti
contents Reliable extraction of structured data from radiology reports using Large Language Models (LLMs) remains challenging, especially for complex, non-English texts like Hebrew. This study introduces an agent-based uncertainty-aware approach to improve the trustworthiness of LLM predictions in medical applications. We analyzed 9,683 Hebrew radiology reports from Crohn's disease patients (from 2010 to 2023) across three medical centers. A subset of 512 reports was manually annotated for six gastrointestinal organs and 15 pathological findings, while the remaining reports were automatically annotated using HSMP-BERT. Structured data extraction was performed using Llama 3.1 (Llama 3-8b-instruct) with Bayesian Prompt Ensembles (BayesPE), which employed six semantically equivalent prompts to estimate uncertainty. An Agent-Based Decision Model integrated multiple prompt outputs into five confidence levels for calibrated uncertainty and was compared against three entropy-based models. Performance was evaluated using accuracy, F1 score, precision, recall, and Cohen's Kappa before and after filtering high-uncertainty cases. The agent-based model outperformed the baseline across all metrics, achieving an F1 score of 0.3967, recall of 0.6437, and Cohen's Kappa of 0.3006. After filtering high-uncertainty cases (greater than or equal to 0.5), the F1 score improved to 0.4787, and Kappa increased to 0.4258. Uncertainty histograms demonstrated clear separation between correct and incorrect predictions, with the agent-based model providing the most well-calibrated uncertainty estimates. By incorporating uncertainty-aware prompt ensembles and an agent-based decision model, this approach enhances the performance and reliability of LLMs in structured data extraction from radiology reports, offering a more interpretable and trustworthy solution for high-stakes medical applications.
format Preprint
id arxiv_https___arxiv_org_abs_2502_01691
institution arXiv
publishDate 2025
record_format arxiv
spellingShingle Agent-Based Uncertainty Awareness Improves Automated Radiology Report Labeling with an Open-Source Large Language Model
Ben-Atya, Hadas
Gavrielov, Naama
Badash, Zvi
Focht, Gili
Cytter-Kuint, Ruth
Hagopian, Talar
Turner, Dan
Freiman, Moti
Computation and Language
Artificial Intelligence
Reliable extraction of structured data from radiology reports using Large Language Models (LLMs) remains challenging, especially for complex, non-English texts like Hebrew. This study introduces an agent-based uncertainty-aware approach to improve the trustworthiness of LLM predictions in medical applications. We analyzed 9,683 Hebrew radiology reports from Crohn's disease patients (from 2010 to 2023) across three medical centers. A subset of 512 reports was manually annotated for six gastrointestinal organs and 15 pathological findings, while the remaining reports were automatically annotated using HSMP-BERT. Structured data extraction was performed using Llama 3.1 (Llama 3-8b-instruct) with Bayesian Prompt Ensembles (BayesPE), which employed six semantically equivalent prompts to estimate uncertainty. An Agent-Based Decision Model integrated multiple prompt outputs into five confidence levels for calibrated uncertainty and was compared against three entropy-based models. Performance was evaluated using accuracy, F1 score, precision, recall, and Cohen's Kappa before and after filtering high-uncertainty cases. The agent-based model outperformed the baseline across all metrics, achieving an F1 score of 0.3967, recall of 0.6437, and Cohen's Kappa of 0.3006. After filtering high-uncertainty cases (greater than or equal to 0.5), the F1 score improved to 0.4787, and Kappa increased to 0.4258. Uncertainty histograms demonstrated clear separation between correct and incorrect predictions, with the agent-based model providing the most well-calibrated uncertainty estimates. By incorporating uncertainty-aware prompt ensembles and an agent-based decision model, this approach enhances the performance and reliability of LLMs in structured data extraction from radiology reports, offering a more interpretable and trustworthy solution for high-stakes medical applications.
title Agent-Based Uncertainty Awareness Improves Automated Radiology Report Labeling with an Open-Source Large Language Model
topic Computation and Language
Artificial Intelligence
url https://arxiv.org/abs/2502.01691