arXiv:2410.00292cs.CLcs.CV2024-10中稿 · MICCAI 2024被引 9

用大模型整合眼表影像与临床数据,生成有依据的诊断报告

Insight: A Multi-Modal Diagnostic Pipeline using LLMs for Ocular Surface Disease Diagnosis

  • 将睑板腺图像转为可量化的形态数据,融合临床信息输入大模型
  • 在多个疾病诊断基准上优于GPT-4,给出符合临床逻辑的解释
  • 适合需要可解释性诊断的医疗场景,如眼科辅助决策

准确诊断眼表疾病对验光与眼科至关重要,依赖于整合临床数据(如睑板腺成像和临床元数据)。传统人工评估难以量化观察结果,现有机器方法多将诊断视为封闭集多分类问题,缺乏对各变量临床相关性的推理。为此,我们提出基于大语言模型(LLMs)的多模态诊断管道(MDPipe)。首先使用视觉翻译器将睑板腺图像转化为可量化的形态数据,实现与临床元数据的融合,便于向大模型传递细微医学洞察。进一步引入基于大模型的摘要生成器,对融合后的形态与临床数据进行上下文建模,生成临床报告摘要。最后通过真实医生诊断中的领域知识,优化大模型的推理能力。在多个眼表疾病诊断基准上的评估表明,MDPipe优于现有标准,包括GPT-4,且能提供符合临床逻辑的诊断理由。

原文摘要 · Abstract (English)

Accurate diagnosis of ocular surface diseases is critical in optometry and ophthalmology, which hinge on integrating clinical data sources (e.g., meibography imaging and clinical metadata). Traditional human assessments lack precision in quantifying clinical observations, while current machine-based methods often treat diagnoses as multi-class classification problems, limiting the diagnoses to a predefined closed-set of curated answers without reasoning the clinical relevance of each variable to the diagnosis. To tackle these challenges, we introduce an innovative multi-modal diagnostic pipeline (MDPipe) by employing large language models (LLMs) for ocular surface disease diagnosis. We first employ a visual translator to interpret meibography images by converting them into quantifiable morphology data, facilitating their integration with clinical metadata and enabling the communication of nuanced medical insight to LLMs. To further advance this communication, we introduce a LLM-based summarizer to contextualize the insight from the combined morphology and clinical metadata, and generate clinical report summaries. Finally, we refine the LLMs' reasoning ability with domain-specific insight from real-life clinician diagnoses. Our evaluation across diverse ocular surface disease diagnosis benchmarks demonstrates that MDPipe outperforms existing standards, including GPT-4, and provides clinically sound rationales for diagnoses.

眼表疾病多模态大模型诊断可解释性

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