clinical informatics developers

Abstract: Medical chart abstraction transforms unstructured clinical narratives into structured variables for research and quality monitoring. We evaluated a prompting-based large language model (LLM) framework for extracting eight clinical variables from 2,416 neurointerventional acute stroke intervention reports across three hospitals. Twenty-two instruction-tuned open-source LLMs were evaluated across architectures, model sizes, and biomedical adaptations using Quick Response and Chain-of-Thought (CoT) prompting. Non-expert staff annotations served as the cross-model reference standard. Evaluation was restricted to report-variable pairs with a valid LLaMA3.3-70B CoT prediction and a corresponding reference label. Performance measures included extraction accuracy, inference latency, and agreement with expert adjudication. Twenty discordant cases per variable underwent review by two senior physicians and four medical students. LLaMA3.3-70B achieved the highest overall accuracy (94.8%). CoT improved performance on inference-dependent variables such as site of occlusion, while Quick Response was optimal for directly stated procedural fields. Expert adjudication showed that AI predictions were more closely aligned with expert interpretations than non-expert annotations for most variables, with intracranial angioplasty remaining a challenge. Locally deployed LLMs can support scalable clinical information extraction and retrospective stroke registry curation, with expert oversight for ambiguous cases.

Abstract: Typed decision models answer schema-constrained questions about a text in one forward pass and return probabilities meant to be thresholded. We ask whether biomedical sentence encoders trained for retrieval are good starting points for such models. We present SBERT2S1, which converts Sentence-Transformers encoders into bi-encoder, cross-head (C) and prior-fused residual (PFR) decision models, together with BIODECIDE, a biomedical typed-decision suite, and MEDLINE-S1, 243k training decisions derived from NLM indexing. Across six parent-retriever pairs, retrieval training improves zero-shot matching of content-bearing options. After fine-tuning, its effect depends on the head: across five pairs and three training-set sizes, retrieval training significantly helps PFR, which keeps the retrieval prior, in 10 of 15 comparisons, but helps C in one and hurts it in five. A matched grid of two heads and five training objectives shows that C outperforms PFR under every objective, and that the released RLCD recipe of open System One models trails cross-entropy by 2.5-3.0 points. The deficit stems mainly from its reward normalisation, which inflates the noisy score-function term 3.6-15-fold; an unbiased leave-one-out estimator recovers most of the gap. After temperature scaling, no objective is clearly better calibrated than cross-entropy. We release the code, the MEDLINE-S1 labels and a model.

Abstract: Liver cancer is a complex disease responsible for a high number of deaths across the globe each year, making automated solutions for liver cancer classification urgent. The most common form of liver cancer is hepatocellular carcinoma (HCC), accounting for over 90% of liver cancer cases. There is a distinct lack of publicly available HCC datasets utilizing genomic data, which is necessary for training artificial intelligence (AI) models for automated HCC classification. This study proposes constructing a multi-stage HCC dataset using XGBoost and Semi-Supervised learning on three separate datasets of genomic biomarkers, utilizing their existing labels in the Semi-Supervised learning process to label the proposed dataset. The proposed dataset consists of 770 patient samples in total, categorized into five classes that represent normal tissue alongside different stages of HCC. Each sample in the dataset consists of 11,150 different gene expression levels. The XGBoost model demonstrated a final classification accuracy of 96.5% during the Semi-Supervised learning process.

Abstract: We introduce OntologyBench, a tiered biomedical retrieval benchmark comprising 471,854 training and 125,744 evaluation query-document relevance pairs across concept grounding, relational retrieval, and compositional phenotype-based retrieval. Although these tasks can be tractable using ontology-aware reference methods, across task tiers, embedding performance is generally lower on relational and compositional tasks than on concept-grounding tasks. Fine-tuning on ontology-derived supervision improves performance on several relational and compositional tasks, whereas the evaluated reranking and LLM-based candidate-scoring methods provide little or no end-to-end improvement. Errors frequently reflect diseases matching only subsets of the phenotype evidence. These findings indicate that the evaluated embedding and reranking configurations do not reliably recover the compatibility encoded by the selected ontology relations and phenotype combinations and motivate retrieval systems that better integrate learned representations with structured biomedical knowledge.