用大模型让表格数据跨病历系统通用,提升痴呆诊断准确率
Schema-Adaptive Tabular Representation Learning with LLMs for Generalizable Multimodal Clinical Reasoning

- 将表格字段转为自然语言,用大模型生成可迁移的嵌入表示
- 在两个数据集上实现顶尖性能,零样本迁移效果超越神经科专家
- 适合临床研究中异构电子病历数据融合,无需重新训练
表格数据的机器学习受限于较差的模式泛化能力,根源在于缺乏对结构化变量的语义理解。这一问题在电子病历(EHR)领域尤为突出,其数据模式差异显著。为此,我们提出基于大语言模型(LLM)的自适应表格表征学习方法,通过将结构化变量转换为语义自然语言并用预训练大模型编码,实现无需人工特征工程或重训练的零样本跨模式对齐。我们将该编码器集成到多模态痴呆诊断框架中,融合表格与MRI数据。在NACC和ADNI数据集上的实验表明,该方法达到业界领先性能,并成功实现对未见模式的零样本迁移,其回顾性诊断表现显著优于临床基线,包括持证神经科医生。结果验证了该大模型驱动方法在异构真实数据中的可扩展性与鲁棒性,为大模型推理向结构化领域延伸提供了可行路径。
原文摘要 · Abstract (English)
Machine learning for tabular data remains constrained by poor schema generalization, a challenge rooted in the lack of semantic understanding of structured variables. This challenge is particularly acute in domains like clinical medicine, where electronic health record (EHR) schemas vary significantly. To solve this problem, we propose Schema-Adaptive Tabular Representation Learning, a novel method that leverages large language models (LLMs) to create transferable tabular embeddings. By transforming structured variables into semantic natural language statements and encoding them with a pretrained LLM, our approach enables zero-shot alignment across unseen schemas without manual feature engineering or retraining. We integrate our encoder into a multimodal framework for dementia diagnosis, combining tabular and MRI data. Experiments on NACC and ADNI datasets demonstrate state-of-the-art performance and successful zero-shot transfer to unseen schemas, significantly outperforming clinical baselines, including board-certified neurologists, in retrospective diagnostic tasks. These results validate our LLM-driven approach as a scalable, robust solution for heterogeneous real-world data, offering a pathway to extend LLM-based reasoning to structured domains.
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