用大模型生成医生间病例讨论,保护隐私还能保真实。
SynDocDis: A Metadata-Driven Framework for Generating Synthetic Physician Discussions Using Large Language Models

- 结合结构化提示与去标识病历元数据生成对话
- 九个肝癌/肿瘤场景下医生评分4.4分(满分5),91%内容相关
- 适合医疗AI训练、医学教育与临床决策支持
医生间的患者病例讨论蕴含丰富临床知识与推理过程,可为人工智能代理提供支持并参与后续互动。然而,隐私法规和伦理限制严重制约此类数据的获取。尽管大语言模型生成合成数据具有潜力,现有方法多聚焦于患者-医生互动或结构化医疗记录,缺乏对医生间交流的合成能力。本文提出SynDocDis框架,通过结构化提示技术与隐私保护的去标识病例元数据,生成临床准确的医生间对话。在九个肿瘤与肝病场景中,由五名执业医生评估,平均沟通效果得分为4.4/5,医学内容质量达4.1/5,组间一致性良好(kappa=0.70,95%置信区间:0.67–0.73)。框架实现91%的临床相关性评分,同时保障医生与患者隐私。结果表明,SynDocDis是推动医疗AI研究伦理化、负责任发展的可行方案,适用于医学教育与临床决策支持。
原文摘要 · Abstract (English)
Physician-physician discussions of patient cases represent a rich source of clinical knowledge and reasoning that could feed AI agents to enrich and even participate in subsequent interactions. However, privacy regulations and ethical considerations severely restrict access to such data. While synthetic data generation using Large Language Models offers a promising alternative, existing approaches primarily focus on patient-physician interactions or structured medical records, leaving a significant gap in physician-to-physician communication synthesis. We present SynDocDis, a novel framework that combines structured prompting techniques with privacy-preserving de-identified case metadata to generate clinically accurate physician-to-physician dialogues. Evaluation by five practicing physicians in nine oncology and hepatology scenarios demonstrated exceptional communication effectiveness (mean 4.4/5) and strong medical content quality (mean 4.1/5), with substantial interrater reliability (kappa = 0.70, 95% CI: 0.67-0.73). The framework achieved 91% clinical relevance ratings while maintaining doctors' and patients' privacy. These results place SynDocDis as a promising framework for advancing medical AI research ethically and responsibly through privacy-compliant synthetic physician dialogue generation with direct applications in medical education and clinical decision support.
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