arXiv:2602.23479cs.CL2026-02中稿 · LREC 2026 CL4Healt…

将自然语言问题转为标准查询语句,让患者更安全高效地获取电子病历答案。

FHIRPath-QA: Executable Question Answering over FHIR Electronic Health Records

  • 用自然语言生成FHIRPath查询,替代传统检索方式。
  • 模型平均节省391倍令牌数,错误率从36%降至9%。
  • 适合医疗问答、健康应用开发及临床研究者使用。

尽管患者越来越多地获得对其电子健康记录(EHR)的数字访问权,但现有界面难以提供精准可信的答案。大型语言模型(LLM)在临床问答中展现潜力,但基于检索的方法计算效率低、易产生幻觉,且难以部署于真实EHR系统。本文提出FHIRPath-QA,首个公开的数据集与基准,支持基于真实临床数据的患者特定问答,包含符合开放标准的FHIRPath查询。提出文本到FHIRPath的问答范式,将推理从自由文本生成转向查询语句合成。对o4-mini模型,该方法相比检索优先提示减少了391倍的平均令牌使用量(629,829对比1,609每问题),并在临床医生表述的问题上将失败率从0.36降至0.09。数据集基于MIMIC-IV和FHIR Demo构建,包含超过14,000条自然语言问题,涵盖患者与临床医生的表述方式,并配有验证过的FHIRPath查询与答案。实证显示,所评估的LLM最多仅达42%准确率,凸显任务难度,但经监督微调后,4o-mini的查询合成准确率从27%提升至79%。结果表明,文本到FHIRPath合成具备成为安全、高效、可互操作消费者健康应用基础的潜力,而FHIRPath-QA数据集与基准为该领域未来研究提供起点。完整数据集与生成代码见:https://github.com/mooshifrew/fhirpath-qa。

原文摘要 · Abstract (English)

Though patients are increasingly granted digital access to their electronic health records (EHRs), existing interfaces may not support precise, trustworthy answers to patient-specific questions. Large language models (LLM) show promise in clinical question answering (QA), but retrieval-based approaches are computationally inefficient, prone to hallucination, and difficult to deploy over real-life EHRs. This work introduces FHIRPath-QA, the first open dataset and benchmark for patient-specific QA that includes open-standard FHIRPath queries over real-world clinical data. A text-to-FHIRPath QA paradigm is proposed that shifts reasoning from free-text generation to FHIRPath query synthesis. For o4-mini, this reduced average token usage by 391x relative to retrieval-first prompting (629,829 vs 1,609 tokens per question) and lowered failure rates from 0.36 to 0.09 on clinician-phrased questions. Built on MIMIC-IV on FHIR Demo, the dataset pairs over 14k natural language questions in patient and clinician phrasing with validated FHIRPath queries and answers. Empirically, the evaluated LLMs achieve at most 42% accuracy, highlighting the challenge of the task, but benefit strongly from supervised fine-tuning, with query synthesis accuracy improving from 27% to 79% for 4o-mini. These results highlight that text-to-FHIRPath synthesis has the potential to serve as a practical foundation for safe, efficient, and interoperable consumer health applications, and the FHIRPath-QA dataset and benchmark serve as a starting point for future research on the topic. The full dataset and generation code can be accessed at: https://github.com/mooshifrew/fhirpath-qa.

医疗AIFHIRPath问答系统大模型

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