用大模型增强医院住院预测,让决策更稳更准。
Context-Aware Hospitalization Forecasting Evaluations for Decision Support using LLMs

- 将大模型的上下文理解能力融入传统时间序列模型
- 混合模型在60个县中提升预测稳定性和校准度
- 适合医疗资源调度、应急响应等实际决策场景
在大规模医疗危机(如疫情或系统故障)期间,医疗与公共卫生专家需基于住院趋势预判实时调配资源(如增加床位)。传统时间序列模型依赖历史数据,而大语言模型(LLMs)可融合人口、地理等非时间上下文信息。为评估其在真实医疗环境中的有效性,我们在美国60个低、中、高住院强度的县中对比三种方法:直接使用LLM预测、经典时间序列模型(ARX),以及结合LLM信号的混合模型(HybridARX)。评价标准不仅包括常规误差指标,还关注偏差和前后错位(lead-lag alignment)。结果表明,HybridARX相比传统ARX显著提升预测稳定性与校准性,尤其在引入噪声上下文信号时表现更优。这说明在非平稳的医疗资源预测中,LLM最适合嵌入结构化混合模型中发挥作用。
原文摘要 · Abstract (English)
Medical and public health experts must make real-time resource decisions, such as expanding hospital bed capacity, based on projected hospitalization trends during large-scale healthcare disruptions (e.g., operational failures or pandemics). Forecasting models can assist in this task by analyzing large volumes of resource-related data at the facility level, but they must be reliable for decision-making under real-world data conditions. Recent work shows that large language models (LLMs) can incorporate richer forms of context into numerical forecasting. Whereas traditional models rely primarily on temporal context (i.e., past observations), LLMs can also leverage non-temporal public health context such as demographic, geographic, and population-level features. However, it remains unclear how these models should be used to produce stable or decision-relevant predictions in real-world healthcare settings. To evaluate how LLMs can be effectively used in this setting, we evaluate three approaches across 60 counties with low-,mid-, and high-hospitalization intensities in the United States: direct LLM-based forecasting, classical time-series models, and a context-augmented hybrid pipeline (HybridARX) that incorporates LLM-derived signals into structured models. Because the goal is operational decision-making rather than error minimization alone, we evaluate performance with bias and lead-lag alignment in addition to standard forecasting metrics. Our results show that HybridARX improves over classical ARX by yielding more stable and better-calibrated forecasts, particularly when incorporating noisy contextual signals into structured time-series models. These findings suggest that, in non-stationary healthcare resource forecasting, LLMs are most useful when embedded within structured hybrid models.
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