Large language models are powerful electronic health record encoders

Le résumé fourni par la source

Electronic health records (EHRs) offer considerable potential for clinical prediction, but their complexity and heterogeneity challenge traditional machine learning. Domain-specific electronic health record foundation models trained on unlabeled EHR data have shown improved predictive accuracy and generalization. However, their development is constrained by limited data access and site-specific vocabularies. We convert EHR data into plain text by replacing medical codes with natural-language descriptions, enabling general-purpose large language models (LLMs) to produce high-dimensional embeddings for downstream prediction tasks without access to private medical training data. LLM-based embeddings perform on par with a specialized EHR foundation model, CLMBR-T-Base, across 15 clinical tasks from the EHRSHOT benchmark. In an external validation using the UK Biobank, an LLM-based model shows statistically significant improvements for some tasks, which we attribute to higher vocabulary coverage and slightly better generalization. Overall, we reveal a trade-off between the computational efficiency of specialized EHR models and the portability and data independence of LLM-based embeddings.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.