arXiv:2507.03067cs.CLcs.AI2025-07被引 2

用大模型自动把临床数据转成FHIR标准,提升医疗数据互通效率。

Large Language Models for Automating Clinical Data Standardization: HL7 FHIR Use Case

  • 用大模型+提示工程将表格数据映射到FHIR资源,结合嵌入与聚类优化提示。
  • 识别准确率达94%,使用FHIR Schema提示后GPT-4o表现优于Llama 3.2。
  • 适合医疗数据工程师、科研人员,可加速电子病历标准化流程。

多年来,语义互操作性标准旨在简化临床数据交换,但其部署仍耗时、费力且技术复杂。为解决此问题,我们提出一种半自动化方法,利用大语言模型(GPT-4o 和 Llama 3.2 405b)将结构化临床数据集转换为 HL7 FHIR 格式,并评估其准确性、可靠性与安全性。在 MIMIC-IV 数据库上,结合嵌入技术、聚类算法与语义检索构建提示,引导模型将每个表字段映射至对应 FHIR 资源。初步基准测试中,资源识别实现完美的 F1 得分;实际条件下准确率略降至 94%,通过优化提示策略恢复了稳定映射。错误分析显示存在非存在属性的幻觉和粒度不匹配问题,更详细的提示可缓解。研究证明上下文感知的 LLM 驱动临床数据向 HL7 FHIR 转换的可行性,为半自动化互操作工作流奠定基础。未来将聚焦于基于医学语料的模型微调,扩展支持 HL7 CDA 与 OMOP 等标准,并开发交互界面以支持专家验证与迭代优化。

原文摘要 · Abstract (English)

For years, semantic interoperability standards have sought to streamline the exchange of clinical data, yet their deployment remains time-consuming, resource-intensive, and technically challenging. To address this, we introduce a semi-automated approach that leverages large language models specifically GPT-4o and Llama 3.2 405b to convert structured clinical datasets into HL7 FHIR format while assessing accuracy, reliability, and security. Applying our method to the MIMIC-IV database, we combined embedding techniques, clustering algorithms, and semantic retrieval to craft prompts that guide the models in mapping each tabular field to its corresponding FHIR resource. In an initial benchmark, resource identification achieved a perfect F1-score, with GPT-4o outperforming Llama 3.2 thanks to the inclusion of FHIR resource schemas within the prompt. Under real-world conditions, accuracy dipped slightly to 94 %, but refinements to the prompting strategy restored robust mappings. Error analysis revealed occasional hallucinations of non-existent attributes and mismatches in granularity, which more detailed prompts can mitigate. Overall, our study demonstrates the feasibility of context-aware, LLM-driven transformation of clinical data into HL7 FHIR, laying the groundwork for semi-automated interoperability workflows. Future work will focus on fine-tuning models with specialized medical corpora, extending support to additional standards such as HL7 CDA and OMOP, and developing an interactive interface to enable expert validation and iterative refinement.

医疗AI大模型数据标准化FHIR

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