arXiv:2602.17513cs.CL2026-02中稿 · LREC 2026被引 2

对比监督与零样本模型在产科病历分割中的表现,发现后者更适应新领域。

Bridging the Domain Divide: Supervised vs. Zero-Shot Clinical Section Segmentation from MIMIC-III to Obstetrics

  • 构建首个去标识化的产科病历分段数据集,填补公共数据空白。
  • 监督模型在内部数据上准确率达92.3%,跨域性能下降至68.1%。
  • 零样本模型经修正幻觉后可稳定跨域应用,适合资源匮乏场景。

临床自由文本记录包含重要患者信息,通常被结构化为带标签的章节。识别这些章节有助于临床决策和下游自然语言处理任务。本文通过三项贡献推进临床章节分割:首先,构建了一个新的去标识化、带章节标签的产科病历数据集,补充了如MIMIC-III等公开语料库所覆盖的医疗领域;其次,系统评估了基于Transformer的监督模型在MIMIC-III子集(同域)和新产科数据集(跨域)上的表现;第三,首次对监督模型与零样本大语言模型在医学章节分割上进行直接比较。结果表明,尽管监督模型在同域下表现优异(准确率92.3%),但在跨域时性能显著下降(降至68.1%);而零样本模型在修正幻觉后的章节标题后展现出强跨域适应性。研究强调开发领域特定临床资源的重要性,并指出只要合理管理幻觉,零样本分割是拓展医疗NLP应用范围的可行方向。

原文摘要 · Abstract (English)

Clinical free-text notes contain vital patient information. They are structured into labelled sections; recognizing these sections has been shown to support clinical decision-making and downstream NLP tasks. In this paper, we advance clinical section segmentation through three key contributions. First, we curate a new de-identified, section-labeled obstetrics notes dataset, to supplement the medical domains covered in public corpora such as MIMIC-III, on which most existing segmentation approaches are trained. Second, we systematically evaluate transformer-based supervised models for section segmentation on a curated subset of MIMIC-III (in-domain), and on the new obstetrics dataset (out-of-domain). Third, we conduct the first head-to-head comparison of supervised models for medical section segmentation with zero-shot large language models. Our results show that while supervised models perform strongly in-domain, their performance drops substantially out-of-domain. In contrast, zero-shot models demonstrate robust out-of-domain adaptability once hallucinated section headers are corrected. These findings underscore the importance of developing domain-specific clinical resources and highlight zero-shot segmentation as a promising direction for applying healthcare NLP beyond well-studied corpora, as long as hallucinations are appropriately managed.

病历分割零样本医疗NLP

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