arXiv:2603.00924cs.CLcs.AI2026-03被引 1

用置信区间方法让大模型在医疗文本中更可靠地提取实体。

Conformal Prediction for Risk-Controlled Medical Entity Extraction Across Clinical Domains

  • 基于置信区间校准大模型输出,确保结果在有限样本下有保障。
  • 在药物标签和放射报告中均实现超90%的覆盖准确率,拒绝率仅9-13%。
  • 发现模型信心偏差随文档类型变化,需按领域定制校准策略。

大型语言模型(LLMs)在医疗实体抽取中应用日益广泛,但其置信度常出现校准偏差,限制了在临床环境中的安全部署。本文提出一种置信区间预测框架,为跨两个临床领域的LLM抽取提供有限样本覆盖保证。首先,使用GPT-4.1从1,000份FDA药品说明书的八个部分中提取结构化实体,通过FactScore原子陈述评估,共128,906个实体,准确率达97.7%。其次,利用GPT-4.1与Llama-4-Maverick在MIMIC-CXR报告中基于RadGraph模式提取放射学实体,与医生标注对比,实体F1值为0.81至0.84。核心发现是:在结构化强的药品标签上模型偏保守(需τ≈0.06),而在自由文本放射报告中则过度自信(τ高达0.99)。尽管存在差异,该框架在两类场景中均实现≥90%的目标覆盖率,且拒接率可控(9–13%)。结果表明,模型校准并非全局属性,而是受文档结构、抽取类别及模型架构影响,呼吁针对不同领域进行个性化置信校准以保障临床安全部署。

原文摘要 · Abstract (English)

Large Language Models (LLMs) are increasingly used for medical entity extraction, yet their confidence scores are often miscalibrated, limiting safe deployment in clinical settings. We present a conformal prediction framework that provides finite-sample coverage guarantees for LLM-based extraction across two clinical domains. First, we extract structured entities from 1,000 FDA drug labels across eight sections using GPT-4.1, verified via FactScore-based atomic statement evaluation (97.7\% accuracy over 128,906 entities). Second, we extract radiological entities from MIMIC-CXR reports using the RadGraph schema with GPT-4.1 and Llama-4-Maverick, evaluated against physician annotations (entity F1: 0.81 to 0.84). Our central finding is that miscalibration direction reverses across domains: on well-structured FDA labels, models are underconfident, requiring modest conformal thresholds ($τ\approx 0.06$), while on free-text radiology reports, models are overconfident, demanding strict thresholds ($τ$ up to 0.99). Despite this heterogeneity, conformal prediction achieves target coverage ($\geq 90\%$) in both settings with manageable rejection rates (9--13\%). These results demonstrate that calibration is not a global model property but depends on document structure, extraction category, and model architecture, motivating domain-specific conformal calibration for safe clinical deployment.

医疗实体抽取置信区间大模型校准

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