Enhancing Clinical Note Generation with ICD-10, Clinical Ontology Knowledge Graphs, and Chain-of-Thought Prompting Using GPT-4

Fuente: arXiv
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Autori principali: Makohon, Ivan, Najafi, Mohamad, Wu, Jian, Brochhausen, Mathias, Li, Yaohang
Natura: Preprint
Pubblicazione: 2025
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author Makohon, Ivan
Najafi, Mohamad
Wu, Jian
Brochhausen, Mathias
Li, Yaohang
author_facet Makohon, Ivan
Najafi, Mohamad
Wu, Jian
Brochhausen, Mathias
Li, Yaohang
contents In the past decade a surge in the amount of electronic health record (EHR) data in the United States, attributed to a favorable policy environment created by the Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009 and the 21st Century Cures Act of 2016. Clinical notes for patients' assessments, diagnoses, and treatments are captured in these EHRs in free-form text by physicians, who spend a considerable amount of time entering and editing them. Manually writing clinical notes takes a considerable amount of a doctor's valuable time, increasing the patient's waiting time and possibly delaying diagnoses. Large language models (LLMs) possess the ability to generate news articles that closely resemble human-written ones. We investigate the usage of Chain-of-Thought (CoT) prompt engineering to improve the LLM's response in clinical note generation. In our prompts, we use as input International Classification of Diseases (ICD) codes and basic patient information. We investigate a strategy that combines the traditional CoT with semantic search results to improve the quality of generated clinical notes. Additionally, we infuse a knowledge graph (KG) built from clinical ontology to further enrich the domain-specific knowledge of generated clinical notes. We test our prompting technique on six clinical cases from the CodiEsp test dataset using GPT-4 and our results show that it outperformed the clinical notes generated by standard one-shot prompts.
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id arxiv_https___arxiv_org_abs_2512_05256
institution arXiv
publishDate 2025
record_format arxiv
spellingShingle Enhancing Clinical Note Generation with ICD-10, Clinical Ontology Knowledge Graphs, and Chain-of-Thought Prompting Using GPT-4
Makohon, Ivan
Najafi, Mohamad
Wu, Jian
Brochhausen, Mathias
Li, Yaohang
Computation and Language
Quantitative Methods
In the past decade a surge in the amount of electronic health record (EHR) data in the United States, attributed to a favorable policy environment created by the Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009 and the 21st Century Cures Act of 2016. Clinical notes for patients' assessments, diagnoses, and treatments are captured in these EHRs in free-form text by physicians, who spend a considerable amount of time entering and editing them. Manually writing clinical notes takes a considerable amount of a doctor's valuable time, increasing the patient's waiting time and possibly delaying diagnoses. Large language models (LLMs) possess the ability to generate news articles that closely resemble human-written ones. We investigate the usage of Chain-of-Thought (CoT) prompt engineering to improve the LLM's response in clinical note generation. In our prompts, we use as input International Classification of Diseases (ICD) codes and basic patient information. We investigate a strategy that combines the traditional CoT with semantic search results to improve the quality of generated clinical notes. Additionally, we infuse a knowledge graph (KG) built from clinical ontology to further enrich the domain-specific knowledge of generated clinical notes. We test our prompting technique on six clinical cases from the CodiEsp test dataset using GPT-4 and our results show that it outperformed the clinical notes generated by standard one-shot prompts.
title Enhancing Clinical Note Generation with ICD-10, Clinical Ontology Knowledge Graphs, and Chain-of-Thought Prompting Using GPT-4
topic Computation and Language
Quantitative Methods
url https://arxiv.org/abs/2512.05256