arXiv:2506.19702cs.AI2025-06中稿 · ICDAR 2025被引 1

用低秩微调LLaMA-v3实现可解释的病理诊断,保护隐私且准确率更高

LLM-Driven Medical Document Analysis: Enhancing Trustworthy Pathology and Differential Diagnosis

  • 用低秩适应微调LLaMA-v3,适配临床病历分析任务
  • 在DDXPlus数据集上病理预测准确率超越现有模型
  • 支持私有部署的网页平台,结果可解释,适合医生辅助诊断

医疗文档分析在从非结构化病历中提取关键临床信息方面至关重要,支撑如鉴别诊断等关键任务。面对症状重叠时确定最可能疾病需精准评估与深厚医学知识。尽管大语言模型(LLMs)在医疗文档分析中性能显著提升,但敏感患者数据的隐私问题限制了在线LLM服务在临床中的使用。为此,我们提出一个可信的医疗文档分析平台,采用低秩适配(LoRA)微调LLaMA-v3,专用于鉴别诊断任务。该方法利用最大的鉴别诊断基准数据集DDXPlus,相比现有方法在病理预测和变长鉴别诊断任务上表现更优。开发的基于Web的平台允许用户上传非结构化医疗文档,获得准确且可解释的诊断结果。通过集成先进可解释性技术,系统确保预测透明可靠,增强用户信任。大量评估证实,该方法在预测准确性上超越当前最优模型,同时具备临床实用性。本工作回应了真实医疗场景中对可靠、可解释、隐私保护AI解决方案的迫切需求,是智能医疗文档分析的重要进展。代码见:https://github.com/leitro/Differential-Diagnosis-LoRA。

原文摘要 · Abstract (English)

Medical document analysis plays a crucial role in extracting essential clinical insights from unstructured healthcare records, supporting critical tasks such as differential diagnosis. Determining the most probable condition among overlapping symptoms requires precise evaluation and deep medical expertise. While recent advancements in large language models (LLMs) have significantly enhanced performance in medical document analysis, privacy concerns related to sensitive patient data limit the use of online LLMs services in clinical settings. To address these challenges, we propose a trustworthy medical document analysis platform that fine-tunes a LLaMA-v3 using low-rank adaptation, specifically optimized for differential diagnosis tasks. Our approach utilizes DDXPlus, the largest benchmark dataset for differential diagnosis, and demonstrates superior performance in pathology prediction and variable-length differential diagnosis compared to existing methods. The developed web-based platform allows users to submit their own unstructured medical documents and receive accurate, explainable diagnostic results. By incorporating advanced explainability techniques, the system ensures transparent and reliable predictions, fostering user trust and confidence. Extensive evaluations confirm that the proposed method surpasses current state-of-the-art models in predictive accuracy while offering practical utility in clinical settings. This work addresses the urgent need for reliable, explainable, and privacy-preserving artificial intelligence solutions, representing a significant advancement in intelligent medical document analysis for real-world healthcare applications. The code can be found at \href{https://github.com/leitro/Differential-Diagnosis-LoRA}{https://github.com/leitro/Differential-Diagnosis-LoRA}.

大模型诊断辅助可解释性隐私保护

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