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Main Authors: Huang, Ming, Li, Zehan, Hu, Yan, Wang, Wanjing, Wen, Andrew, Lane, Scott, Selek, Salih, Shahani, Lokesh, Machado-Vieira, Rodrigo, Soares, Jair, Xu, Hua, Liu, Hongfang
Format: Preprint
Published: 2025
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Online Access:https://arxiv.org/abs/2507.17009
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author Huang, Ming
Li, Zehan
Hu, Yan
Wang, Wanjing
Wen, Andrew
Lane, Scott
Selek, Salih
Shahani, Lokesh
Machado-Vieira, Rodrigo
Soares, Jair
Xu, Hua
Liu, Hongfang
author_facet Huang, Ming
Li, Zehan
Hu, Yan
Wang, Wanjing
Wen, Andrew
Lane, Scott
Selek, Salih
Shahani, Lokesh
Machado-Vieira, Rodrigo
Soares, Jair
Xu, Hua
Liu, Hongfang
contents Suicide remains a pressing global health crisis, with over 720,000 deaths annually and millions more affected by suicide ideation (SI) and suicide attempts (SA). Early identification of suicidality-related factors (SrFs), including SI, SA, exposure to suicide (ES), and non-suicidal self-injury (NSSI), is critical for timely intervention. While prior studies have applied AI to detect SrFs in clinical notes, most treat suicidality as a binary classification task, overlooking the complexity of cooccurring risk factors. This study explores the use of generative large language models (LLMs), specifically GPT-3.5 and GPT-4.5, for multi-label classification (MLC) of SrFs from psychiatric electronic health records (EHRs). We present a novel end to end generative MLC pipeline and introduce advanced evaluation methods, including label set level metrics and a multilabel confusion matrix for error analysis. Finetuned GPT-3.5 achieved top performance with 0.94 partial match accuracy and 0.91 F1 score, while GPT-4.5 with guided prompting showed superior performance across label sets, including rare or minority label sets, indicating a more balanced and robust performance. Our findings reveal systematic error patterns, such as the conflation of SI and SA, and highlight the models tendency toward cautious over labeling. This work not only demonstrates the feasibility of using generative AI for complex clinical classification tasks but also provides a blueprint for structuring unstructured EHR data to support large scale clinical research and evidence based medicine.
format Preprint
id arxiv_https___arxiv_org_abs_2507_17009
institution arXiv
publishDate 2025
record_format arxiv
spellingShingle Multi-Label Classification with Generative AI Models in Healthcare: A Case Study of Suicidality and Risk Factors
Huang, Ming
Li, Zehan
Hu, Yan
Wang, Wanjing
Wen, Andrew
Lane, Scott
Selek, Salih
Shahani, Lokesh
Machado-Vieira, Rodrigo
Soares, Jair
Xu, Hua
Liu, Hongfang
Computation and Language
Information Retrieval
Quantitative Methods
Suicide remains a pressing global health crisis, with over 720,000 deaths annually and millions more affected by suicide ideation (SI) and suicide attempts (SA). Early identification of suicidality-related factors (SrFs), including SI, SA, exposure to suicide (ES), and non-suicidal self-injury (NSSI), is critical for timely intervention. While prior studies have applied AI to detect SrFs in clinical notes, most treat suicidality as a binary classification task, overlooking the complexity of cooccurring risk factors. This study explores the use of generative large language models (LLMs), specifically GPT-3.5 and GPT-4.5, for multi-label classification (MLC) of SrFs from psychiatric electronic health records (EHRs). We present a novel end to end generative MLC pipeline and introduce advanced evaluation methods, including label set level metrics and a multilabel confusion matrix for error analysis. Finetuned GPT-3.5 achieved top performance with 0.94 partial match accuracy and 0.91 F1 score, while GPT-4.5 with guided prompting showed superior performance across label sets, including rare or minority label sets, indicating a more balanced and robust performance. Our findings reveal systematic error patterns, such as the conflation of SI and SA, and highlight the models tendency toward cautious over labeling. This work not only demonstrates the feasibility of using generative AI for complex clinical classification tasks but also provides a blueprint for structuring unstructured EHR data to support large scale clinical research and evidence based medicine.
title Multi-Label Classification with Generative AI Models in Healthcare: A Case Study of Suicidality and Risk Factors
topic Computation and Language
Information Retrieval
Quantitative Methods
url https://arxiv.org/abs/2507.17009