用大模型模拟临床路径,自动区分贫血类型
Prompting Large Language Models for Supporting the Differential Diagnosis of Anemia
- 基于临床指南思路,用提示词技术引导大模型生成诊断路径
- 在1000例合成患者数据上,GPT-4诊断准确率最高
- 适合医学AI研究者和临床辅助系统开发者参考
实践中,临床医生通过一系列步骤(如实验室检查、观察或影像学)进行诊断。这些诊断路径由专家组织制定的指南记录,指导医生按序做出正确判断。尽管指南有助于规范医学推理与知识整合,但存在局限:常忽略罕见病例,且更新缓慢,难以应对新发疾病或新诊疗方法。受临床指南启发,本研究旨在构建类似诊断路径。我们使用三种大语言模型(GPT-4、LLaMA、Mistral)在包含1000名患者的合成真实数据集上,对贫血及其亚型进行鉴别诊断。通过先进提示工程技术增强决策过程,生成了诊断路径。实验结果表明,大模型在从患者数据中发现临床路径方面具有巨大潜力,其中GPT-4在所有测试中表现最佳。
原文摘要 · Abstract (English)
In practice, clinicians achieve a diagnosis by following a sequence of steps, such as laboratory exams, observations, or imaging. The pathways to reach diagnosis decisions are documented by guidelines authored by expert organizations, which guide clinicians to reach a correct diagnosis through these sequences of steps. While these guidelines are beneficial for following medical reasoning and consolidating medical knowledge, they have some drawbacks. They often fail to address patients with uncommon conditions due to their focus on the majority population, and are slow and costly to update, making them unsuitable for rapidly emerging diseases or new practices. Inspired by clinical guidelines, our study aimed to develop pathways similar to those that can be obtained in clinical guidelines. We tested three Large Language Models (LLMs) -Generative Pretrained Transformer 4 (GPT-4), Large Language Model Meta AI (LLaMA), and Mistral -on a synthetic yet realistic dataset to differentially diagnose anemia and its subtypes. By using advanced prompting techniques to enhance the decision-making process, we generated diagnostic pathways using these models. Experimental results indicate that LLMs hold huge potential in clinical pathway discovery from patient data, with GPT-4 exhibiting the best performance in all conducted experiments.
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