用专业医学文档增强大模型,让眼科问答更准确可信。
Enhancing Large Language Models with Domain-specific Retrieval Augment Generation: A Case Study on Long-form Consumer Health Question Answering in Ophthalmology
- 构建眼科专用文档库,通过检索增强生成提升回答依据。
- 使用RAG后,正确引用率从20.6%升至54.5%,幻觉减少近半。
- 适合医疗AI研究者、临床信息助手开发者参考。
尽管大语言模型在医学领域具有潜力,但其生成内容常缺乏真实证据或存在幻觉。虽然检索增强生成(RAG)被广泛用于解决此问题,但很少有研究在特定下游应用中实施并评估该方法。本研究构建了包含7万篇眼科专有文献的RAG管道,在推理时检索相关文档以增强大模型。针对100个长篇消费者健康问题,由10名医疗专业人员系统评估了含与不含RAG的大模型响应,共涉及500余条引用。评估涵盖证据事实性、证据选择与排序、证据归因、答案准确性和完整性。无RAG的模型共生成252条引用,其中45.3%为幻觉,34.1%含小错误,仅20.6%正确;而启用RAG后,正确引用率达54.5%,幻觉和错误率分别降至18.8%和26.7%。RAG前10名检索结果中,62.5%被选为模型响应的首选引用,平均排名为4.9。此外,证据归因得分从1.85提升至2.49(P<0.001),但准确性(3.52→3.23,P=0.03)和完整性(3.47→3.27,P=0.17)略有下降。结果表明,大模型在医疗问答中普遍存在幻觉和错误,而RAG显著改善了证据质量,但仍面临检索、选择与归因挑战。
原文摘要 · Abstract (English)
Despite the potential of Large Language Models (LLMs) in medicine, they may generate responses lacking supporting evidence or based on hallucinated evidence. While Retrieval Augment Generation (RAG) is popular to address this issue, few studies implemented and evaluated RAG in downstream domain-specific applications. We developed a RAG pipeline with 70,000 ophthalmology-specific documents that retrieve relevant documents to augment LLMs during inference time. In a case study on long-form consumer health questions, we systematically evaluated the responses including over 500 references of LLMs with and without RAG on 100 questions with 10 healthcare professionals. The evaluation focuses on factuality of evidence, selection and ranking of evidence, attribution of evidence, and answer accuracy and completeness. LLMs without RAG provided 252 references in total. Of which, 45.3% hallucinated, 34.1% consisted of minor errors, and 20.6% were correct. In contrast, LLMs with RAG significantly improved accuracy (54.5% being correct) and reduced error rates (18.8% with minor hallucinations and 26.7% with errors). 62.5% of the top 10 documents retrieved by RAG were selected as the top references in the LLM response, with an average ranking of 4.9. The use of RAG also improved evidence attribution (increasing from 1.85 to 2.49 on a 5-point scale, P<0.001), albeit with slight decreases in accuracy (from 3.52 to 3.23, P=0.03) and completeness (from 3.47 to 3.27, P=0.17). The results demonstrate that LLMs frequently exhibited hallucinated and erroneous evidence in the responses, raising concerns for downstream applications in the medical domain. RAG substantially reduced the proportion of such evidence but encountered challenges.
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