arXiv:2603.23987cs.LG2026-03中稿 · the 14th Internati…被引 3

用大模型生成可迁移的患者表示,降低临床模型部署成本。

Can we generate portable representations for clinical time series data using LLMs?

  • 将不规则监护数据转为自然语言摘要,再用固定文本模型编码成固定向量。
  • 在三个数据集上跨医院迁移时性能下降比基线小30%以上。
  • 适合需要快速部署、少调参的临床预测场景,隐私风险与基线相当。

临床机器学习部署缓慢且脆弱:在一家医院有效的模型在另一家医院常因分布偏移而性能下降。本文研究一个简单问题——大语言模型(LLMs)能否生成可迁移的患者嵌入,使下游预测器在不重新训练或微调的情况下,在不同医院间通用?我们使用冻结的LLM将不规则重症监护时间序列映射为简洁自然语言摘要,再通过冻结的文本嵌入模型生成固定长度向量,作为多种下游预测器的输入。在MIMIC-IV、HIRID和PPICU三个队列上,多个临床预测任务中,该方法简单易用,性能媲美基于网格插补、自监督表示学习和时间序列基础模型的方法,且跨医院迁移时相对性能下降更小。我们分析了提示设计的影响,发现结构化提示能显著降低预测模型方差,而不影响平均准确率。此外,这些可迁移表示提升了少样本学习效果,且未增加年龄或性别等人口统计信息的可恢复性,表明隐私风险可控。本工作揭示了大模型在降低临床预测模型工程负担、实现规模化部署方面的潜力。

原文摘要 · Abstract (English)

Deploying clinical ML is slow and brittle: models that work at one hospital often degrade under distribution shifts at the next. In this work, we study a simple question -- can large language models (LLMs) create portable patient embeddings i.e. representations of patients enable a downstream predictor built on one hospital to be used elsewhere with minimal-to-no retraining and fine-tuning. To do so, we map from irregular ICU time series onto concise natural language summaries using a frozen LLM, then embed each summary with a frozen text embedding model to obtain a fixed length vector capable of serving as input to a variety of downstream predictors. Across three cohorts (MIMIC-IV, HIRID, PPICU), on multiple clinically grounded forecasting and classification tasks, we find that our approach is simple, easy to use and competitive with in-distribution with grid imputation, self-supervised representation learning, and time series foundation models, while exhibiting smaller relative performance drops when transferring to new hospitals. We study the variation in performance across prompt design, with structured prompts being crucial to reducing the variance of the predictive models without altering mean accuracy. We find that using these portable representations improves few-shot learning and does not increase demographic recoverability of age or sex relative to baselines, suggesting little additional privacy risk. Our work points to the potential that LLMs hold as tools to enable the scalable deployment of production grade predictive models by reducing the engineering overhead.

临床建模大模型可迁移性时间序列

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