Dave Van Veen, Cara Van Uden, Louis Blankemeier, Jean-Benoit Delbrouck, Asad Aali, Christian Bluethgen, Anuj Pareek, Malgorzata Polacin, Eduardo Pontes Reis, Anna Seehofnerová, Nidhi Rohatgi, Poonam Hosamani, William Collins, Neera Ahuja, Curtis P Langlotz, Jason Hom, Sergios Gatidis, John Pauly, Akshay S Chaudhari
Nat Med . 2024 Feb 27. doi: 10.1038/s41591-024-02855-5. Online ahead of print.
Analyzing vast textual data and summarizing key information from electronic health records imposes a substantial burden on how clinicians allocate their time. Although large language models (LLMs) have shown promise in natural language processing (NLP) tasks, their effectiveness on a diverse range of clinical summarization tasks remains unproven. Here we applied adaptation methods to eight LLMs, spanning four distinct clinical summarization tasks: radiology reports, patient questions, progress notes and doctor-patient dialogue. Quantitative assessments with syntactic, semantic and conceptual NLP metrics reveal trade-offs between models and adaptation methods. A clinical reader study with 10 physicians evaluated summary completeness, correctness and conciseness; in most cases, summaries from our best-adapted LLMs were deemed either equivalent (45%) or superior (36%) compared with summaries from medical experts. The ensuing safety analysis highlights challenges faced by both LLMs and medical experts, as we connect errors to potential medical harm and categorize types of fabricated information. Our research provides evidence of LLMs outperforming medical experts in clinical text summarization across multiple tasks. This suggests that integrating LLMs into clinical workflows could alleviate documentation burden, allowing clinicians to focus more on patient care.