Automated Pathologic TN Classification Prediction and Rationale Generation From Lung Cancer Surgical Pathology Reports Using a Large Language Model Fine-Tuned With Chain-of-Thought: Algorithm Development and Validation Study.

Journal: JMIR medical informatics
PMID:

Abstract

BACKGROUND: Traditional rule-based natural language processing approaches in electronic health record systems are effective but are often time-consuming and prone to errors when handling unstructured data. This is primarily due to the substantial manual effort required to parse and extract information from diverse types of documentation. Recent advancements in large language model (LLM) technology have made it possible to automatically interpret medical context and support pathologic staging. However, existing LLMs encounter challenges in rapidly adapting to specialized guideline updates. In this study, we fine-tuned an LLM specifically for lung cancer pathologic staging, enabling it to incorporate the latest guidelines for pathologic TN classification.

Authors

  • Sanghwan Kim
    ezCaretech Research & Development Center, Jung-gu, Seoul, Republic of Korea.
  • Sowon Jang
    From the Department of Radiology, Seoul National University Bundang Hospital, 300 Gumi-dong, Bundang-gu, Seongnam-si, Gyeonggi-do 13620, Korea (S.J., H.S., Junghoon Kim, Jihang Kim, K.W.L., S.S.L., K.H.L.); Department of Radiology, Konkuk University Medical Center, Seoul, Korea (Y.J.S.); Seoul National University College of Medicine, Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, Korea (K.W.L.); Department of Public Health Science, Graduate School of Public Health, Seoul National University, Seoul, Korea (W.L.); and Program in Biomedical Radiation Sciences, Department of Transdisciplinary Studies, Graduate School of Convergence Science and Technology, Seoul National University, Seoul, Korea (S.L.).
  • Borham Kim
    Office of eHealth Research and Business, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.
  • Leonard Sunwoo
    Department of Radiology, Seoul National University Bundang Hospital, 82, Gumi-ro 173 Beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do 13620, Republic of Korea.
  • Seok Kim
    Office of eHealth Research and Business, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.
  • Jin-Haeng Chung
    Department of Pathology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea (the Republic of).
  • SeJin Nam
    National Center of Excellence in Software, Chungnam National University, 99 Daehak-ro, Yuseong-gu, Daejeon, 34134, Republic of Korea.
  • Hyeongmin Cho
    ezCaretech Research & Development Center, Jung-gu, Seoul, Republic of Korea.
  • Donghyoung Lee
    ezCaretech Research & Development Center, Jung-gu, Seoul, Republic of Korea.
  • Keehyuck Lee
    Department of Family Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.
  • Sooyoung Yoo
    Office of eHealth Research and Business, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.