arXiv:2504.10422cs.LG2025-04被引 12

研究大模型在电子病历中的表示动态与迁移能力,揭示其跨机构适用性。

Foundation models for electronic health records: representation dynamics and transferability

  • 分析大模型在MIMIC-IV上学习到的患者表征动态
  • 验证模型在芝加哥大学医疗中心数据上的预测性能与异常患者识别能力
  • 为临床部署提供实证依据,适合医疗AI研发者参考

基于电子健康记录(EHR)训练的基础模型(FMs)在多种临床预测任务中表现出色。然而,由于数据量有限和资源约束,将其适配至本地医疗系统仍具挑战。本研究探究了在MIMIC-IV上训练的FM在芝加哥大学医学中心机构级EHR数据集上的可迁移性。评估了其识别异常患者的性能,并分析了表征空间中患者轨迹与未来临床结果的关系。同时,对监督微调分类器在源数据集与目标数据集上的表现进行了对比。研究结果揭示了基础模型在不同医疗系统间的适应潜力,提出了有效实施的关键考量,并提供了影响其预测性能的内在因素的实证分析。

原文摘要 · Abstract (English)

Foundation models (FMs) trained on electronic health records (EHRs) have shown strong performance on a range of clinical prediction tasks. However, adapting these models to local health systems remains challenging due to limited data availability and resource constraints. In this study, we investigated what these models learn and evaluated the transferability of an FM trained on MIMIC-IV to an institutional EHR dataset at the University of Chicago Medical Center. We assessed their ability to identify outlier patients and examined representation-space patient trajectories in relation to future clinical outcomes. We also evaluated the performance of supervised fine-tuned classifiers on both source and target datasets. Our findings offer insights into the adaptability of FMs across different healthcare systems, highlight considerations for their effective implementation, and provide an empirical analysis of the underlying factors that contribute to their predictive performance.

电子病历基础模型迁移学习临床预测

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