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arXiv 2402.03597cs.CLcs.IRcs.LG
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使用大型语言模型从真实世界数据中识别避孕药具更换原因

Identifying Reasons for Contraceptive Switching from Real-World Data Using Large Language Models

University of California San Francisco(加州大学旧金山分校);Brigham and Women’s Hospital(布列根和妇女医院);Harvard Medical School(哈佛医学院);University of California(加利福尼亚大学);University of California, Berkeley(加州大学伯克利分校)

Brenda Y. Miao, Christopher YK Williams, Ebenezer Chinedu-Eneh, Travis Zack, Emily Alsentzer, Atul J. Butte, Irene Y. Chen

AI总结:

本研究利用GPT-4从临床笔记中提取避孕药具更换原因,优于基线模型,并识别出患者偏好、不良事件和保险为主要因素,且发现特定人群中的差异。

摘要:

处方避孕药具在支持女性生殖健康方面发挥着关键作用。美国有近5000万女性使用避孕药具,了解驱动避孕药具选择和更换的因素具有重大意义。然而,许多与药物更换相关的因素往往仅记录在非结构化的临床笔记中,且难以提取。在此,我们评估了最近开发的大型语言模型GPT-4(通过符合HIPAA标准的Microsoft Azure API)的零样本能力,以从UCSF信息共享临床笔记数据集中识别不同类别避孕药具之间的更换原因。我们证明GPT-4能够准确提取避孕药具更换的原因,在避孕药具开始和停止提取方面分别以0.849和0.881的微F1分数优于基线基于BERT的模型。对GPT-4提取的更换原因进行的人工评估显示准确率为91.4%,且幻觉极少。利用提取的原因,我们通过无监督主题建模方法确定了患者偏好、不良事件和保险是更换的关键原因。值得注意的是,我们还表明,使用我们的方法,“体重增加/情绪变化”和“保险覆盖”在特定人口群体中被不成比例地发现为避孕药具更换的原因。我们的代码和补充数据可在https://github.com/BMiao10/contraceptive-switching获取。

英文摘要:

Prescription contraceptives play a critical role in supporting women's reproductive health. With nearly 50 million women in the United States using contraceptives, understanding the factors that drive contraceptives selection and switching is of significant interest. However, many factors related to medication switching are often only captured in unstructured clinical notes and can be difficult to extract. Here, we evaluate the zero-shot abilities of a recently developed large language model, GPT-4 (via HIPAA-compliant Microsoft Azure API), to identify reasons for switching between classes of contraceptives from the UCSF Information Commons clinical notes dataset. We demonstrate that GPT-4 can accurately extract reasons for contraceptive switching, outperforming baseline BERT-based models with microF1 scores of 0.849 and 0.881 for contraceptive start and stop extraction, respectively. Human evaluation of GPT-4-extracted reasons for switching showed 91.4% accuracy, with minimal hallucinations. Using extracted reasons, we identified patient preference, adverse events, and insurance as key reasons for switching using unsupervised topic modeling approaches. Notably, we also showed using our approach that "weight gain/mood change" and "insurance coverage" are disproportionately found as reasons for contraceptive switching in specific demographic populations. Our code and supplemental data are available at https://github.com/BMiao10/contraceptive-switching.

机构、总结、中文摘要均由AI分析而来,可能存在错误,请以论文正文为准。

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