arXiv:2511.18274cs.HCcs.AI2025-11

医生口述康复训练,大模型自动转成可执行软件。

Clinician-Directed Large Language Model Software Generation for Therapeutic Interventions in Physical Rehabilitation

  • 医生现场定制方案,大模型将其转化为可运行的康复程序。
  • 99.7%指令正确执行,88.4%动作监测准确率。
  • 90%医生认为安全,75%愿在临床使用。

数字健康干预通过智能手机等传感设备提供居家康复训练,实现远程依从性与表现监控。但现有软件多为预设模块库,临床中仅能调整少量参数,难以反映患者个体差异、目标与环境限制,个性化程度低。本文提出新范式:由大语言模型(LLM)作为受控翻译器,将医生在诊疗中即时制定的康复处方转化为可执行软件。20名注册物理与作业治疗师为标准化患者设计了40个上肢康复计划,100%的处方成功生成可运行软件,显著高于典型模板系统55%的转化率(p < 0.01)。LLM生成的软件正确执行99.7%的指令,动作监测准确率达88.4%(95%置信区间:0.843–0.915)。总体90%的治疗师认为系统对患者安全,75%表示愿意在实践中采用。这是首个针对医疗场景下医生主导的LLM干预软件生成的前瞻性评估,证明其可行性并推动后续真实患者群体的大规模试验。

原文摘要 · Abstract (English)

Digital health interventions increasingly deliver home exercise programs via sensor-equipped devices such as smartphones, enabling remote monitoring of adherence and performance. However, current software is usually authored before clinical encounters as libraries of modules for broad impairment categories. At the point of care, clinicians can only choose from these modules and adjust a few parameters (for example, duration or repetitions). As a result, individual limitations, goals, and environmental constraints are often not reflected, limiting personalization and benefit. We propose a paradigm in which large language models (LLMs) act as constrained translators that convert clinicians' exercise prescriptions into intervention software. Clinicians remain the decision makers: they design exercises during the encounter, tailored to each patient's impairments, goals, and environment, and the LLM generates matching software. We conducted a prospective single-arm feasibility study with 20 licensed physical and occupational therapists who created 40 individualized upper extremity programs for a standardized patient; 100% of prescriptions were translated into executable software, compared with 55% under a representative template-based digital health intervention (p < 0.01). LLM-generated software correctly delivered 99.7% of instructions and monitored performance with 88.4% accuracy (95% confidence interval, 0.843-0.915). Overall, 90% of therapists judged the system safe for patient interaction and 75% expressed willingness to adopt it in practice. To our knowledge, this is the first prospective evaluation of clinician-directed intervention software generation with an LLM in health care, demonstrating feasibility and motivating larger trials in real patient populations.

康复医学大模型应用个性化干预

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