Predicting Post-Traumatic Epilepsy from Clinical Records using Large Language Model Embeddings

Fuente: arXiv
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Autori principali: Cui, Wenhui, Swingle, Nicholas, Joshi, Anand A., Nair, Dileep, Leahy, Richard M.
Natura: Preprint
Pubblicazione: 2026
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author Cui, Wenhui
Swingle, Nicholas
Joshi, Anand A.
Nair, Dileep
Leahy, Richard M.
author_facet Cui, Wenhui
Swingle, Nicholas
Joshi, Anand A.
Nair, Dileep
Leahy, Richard M.
contents Objective: Post-traumatic epilepsy (PTE) is a debilitating neurological disorder that develops after traumatic brain injury (TBI). Early prediction of PTE remains challenging due to heterogeneous clinical data, limited positive cases, and reliance on resource-intensive neuroimaging data. We investigate whether routinely collected acute clinical records alone can support early PTE prediction using language model-based approaches. Methods: Using a curated subset of the TRACK-TBI cohort, we developed an automated PTE prediction framework that implements pretrained large language models (LLMs) as fixed feature extractors to encode clinical records. Tabular features, LLM-generated embeddings, and hybrid feature representations were evaluated using gradient-boosted tree classifiers under stratified cross-validation. Results: LLM embeddings achieved performance improvements by capturing contextual clinical information compared to using tabular features alone. The best performance was achieved by a modality-aware feature fusion strategy combining tabular features and LLM embeddings, achieving an AUC-ROC of 0.892 and AUPRC of 0.798. Acute post-traumatic seizures, injury severity, neurosurgical intervention, and ICU stay are key contributors to the predictive performance. Significance: These findings demonstrate that routine acute clinical records contain information suitable for early PTE risk prediction using LLM embeddings in conjunction with gradient-boosted tree classifiers. This approach represents a promising complement to imaging-based prediction.
format Preprint
id arxiv_https___arxiv_org_abs_2604_14547
institution arXiv
publishDate 2026
record_format arxiv
spellingShingle Predicting Post-Traumatic Epilepsy from Clinical Records using Large Language Model Embeddings
Cui, Wenhui
Swingle, Nicholas
Joshi, Anand A.
Nair, Dileep
Leahy, Richard M.
Machine Learning
Objective: Post-traumatic epilepsy (PTE) is a debilitating neurological disorder that develops after traumatic brain injury (TBI). Early prediction of PTE remains challenging due to heterogeneous clinical data, limited positive cases, and reliance on resource-intensive neuroimaging data. We investigate whether routinely collected acute clinical records alone can support early PTE prediction using language model-based approaches. Methods: Using a curated subset of the TRACK-TBI cohort, we developed an automated PTE prediction framework that implements pretrained large language models (LLMs) as fixed feature extractors to encode clinical records. Tabular features, LLM-generated embeddings, and hybrid feature representations were evaluated using gradient-boosted tree classifiers under stratified cross-validation. Results: LLM embeddings achieved performance improvements by capturing contextual clinical information compared to using tabular features alone. The best performance was achieved by a modality-aware feature fusion strategy combining tabular features and LLM embeddings, achieving an AUC-ROC of 0.892 and AUPRC of 0.798. Acute post-traumatic seizures, injury severity, neurosurgical intervention, and ICU stay are key contributors to the predictive performance. Significance: These findings demonstrate that routine acute clinical records contain information suitable for early PTE risk prediction using LLM embeddings in conjunction with gradient-boosted tree classifiers. This approach represents a promising complement to imaging-based prediction.
title Predicting Post-Traumatic Epilepsy from Clinical Records using Large Language Model Embeddings
topic Machine Learning
url https://arxiv.org/abs/2604.14547