Improving Mortality Prediction After Radiotherapy with Large Language Model Structuring of Large-Scale Unstructured Electronic Health Records

• URL: http://arxiv.org/abs/2408.05074v5
• Date: Wed, 11 Dec 2024 10:14:32 GMT
• Title: Improving Mortality Prediction After Radiotherapy with Large Language Model Structuring of Large-Scale Unstructured Electronic Health Records
• Authors: Sangjoon Park, Chan Woo Wee, Seo Hee Choi, Kyung Hwan Kim, Jee Suk Chang, Hong In Yoon, Ik Jae Lee, Yong Bae Kim, Jaeho Cho, Ki Chang Keum, Chang Geol Lee, Hwa Kyung Byun, Woong Sub Koom,
• Abstract summary: This study developed and validated the RTSurv framework to structure unstructured electronic health records alongside structured clinical data. Using unstructured data from 34,276 patients and an external cohort of 852, the framework successfully transformed unstructured information into structured formats.
• Score: 2.608410928225647
• License:
• Abstract: Accurate survival prediction in radiotherapy (RT) is critical for optimizing treatment decisions. This study developed and validated the RT-Surv framework, which integrates general-domain, open-source large language models (LLMs) to structure unstructured electronic health records alongside structured clinical data. Using data from 34,276 patients and an external cohort of 852, the framework successfully transformed unstructured clinical information into structured formats. Incorporating LLM-structured clinical features improved the concordance index from 0.779 to 0.842 during external validation, demonstrating a significant performance enhancement. Key LLM-structured features, such as disease extent, general condition, and RT purpose, showed high predictive importance and aligned closely with statistically significant predictors identified through conventional statistical analyses, thereby improving model interpretability. Furthermore, the framework enhanced risk stratification, enabling more distinct differentiation among low-, intermediate-, and high-risk groups (p < 0.001) using LLM-structured clinical features. These findings highlight the potential of LLMs to convert unstructured data into actionable insights, improving predictive modeling and patient outcomes in clinics.

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