用大模型将病历数据转为自然语言,实现隐私保护下的心血管风险预测。
LLMs for Cardiovascular Risk Prediction from Structured Clinical Data

- 将11项临床数据转为可解释的自然语言描述,保留94.61%原始信息一致性。
- 随机森林在结构化数据上表现最优,但大模型支持零样本/少样本推理。
- 适合需保护患者敏感数值的临床场景,推动隐私友好型医疗系统发展。
冠状动脉疾病(CAD)是全球主要死因之一,亟需可靠的预测系统以支持早期诊断与风险评估。传统机器学习在结构化临床数据上表现良好,而大型语言模型(LLMs)则为解读自然语言医学信息提供了新可能。本文构建了一个混合框架,将结构化临床数据与自然语言表示相连接以进行CAD预测。基于包含1,190名患者记录、11个临床属性的公开数据集,我们利用大模型将结构化变量转换为可解释的特征表示和合成临床叙述。通过反向提取验证管道计算一致性得分,平均保真度达94.61%。随后评估四种经典机器学习模型,并在零样本与少样本提示设置下与基于LLM的分类方法对比。实验使用GPT与Gemini两个模型,结果表明随机森林准确率最高。尽管如此,基于大模型的分类在真实临床环境中仍具优势:因其直接处理自然语言患者描述,可避免暴露精确的实验室值、血压读数及诊断编码等敏感数据。研究显示,结合结构化数据与大模型生成叙述,能为混合型临床预测系统开辟新路径。
原文摘要 · Abstract (English)
Coronary artery disease (CAD) remains one of the leading causes of death globally, highlighting the need for reliable predictive systems to support early diagnosis and risk assessment. While traditional machine learning models perform well on structured clinical data, large language models (LLMs) present new possibilities to interpret medical information expressed in natural language. In this work, we develop a hybrid framework that bridges structured clinical data and natural-language representations for CAD prediction. Using a publicly available dataset of 1,190 patient records with 11 clinical attributes, structured variables are converted into interpretable feature representations and synthetic clinical narratives using LLMs. A validation pipeline performs reverse extraction of clinical variables and computes a consistency score with the original records, achieving an average fidelity of 94.61%. We then evaluate four conventional machine learning models and compare their performance with LLM-based classification under zero-shot and few-shot prompting settings. We use two LLMs here, GPT and Gemini. Experimental results show that Random Forest achieves the highest accuracy. Despite this advantage, LLM-based classification remains beneficial in real-world clinical settings. This is because LLMs operate directly on natural language patient descriptions, meaning that sensitive numerical patient data such as exact lab values, blood pressure readings, and diagnostic codes are kept private. Findings suggest that combining structured clinical data with LLM-generated narratives can enable new directions for hybrid clinical prediction systems.
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