Benchmarking LLMs and SLMs for patient reported outcomes

LLMs have transformed the execution of numerous tasks, including those in the medical domain. Among these, summarizing patient-reported outcomes (PROs) into concise natural language reports is of particular interest to clinicians, as it enables them to focus on critical patient concerns and spend more time in meaningful discussions. While existing work with LLMs like GPT-4 has shown impressive results, real breakthroughs could arise from leveraging SLMs as they offer the advantage of being deployable locally, ensuring patient data privacy and compliance with healthcare regulations. This study benchmarks several SLMs against LLMs for summarizing patient-reported Q\&A forms in the context of radiotherapy. Using various metrics, we evaluate their precision and reliability. The findings highlight both the promise and limitations of SLMs for high-stakes medical tasks, fostering more efficient and privacy-preserving AI-driven healthcare solutions.

Development and external validation of a lung cancer risk estimation tool using gradient-boosting

Lung cancer is a significant cause of mortality worldwide, emphasizing the importance of early detection for improved survival rates. In this study, we propose a machine learning (ML) tool trained on data from the PLCO Cancer Screening Trial and validated on the NLST to estimate the likelihood of lung cancer occurrence within five years. The study utilized two datasets, the PLCO (n=55,161) and NLST (n=48,595), consisting of comprehensive information on risk factors, clinical measurements, and outcomes related to lung cancer. Data preprocessing involved removing patients who were not current or former smokers and those who had died of causes unrelated to lung cancer. Additionally, a focus was placed on mitigating bias caused by censored data. Feature selection, hyper-parameter optimization, and model calibration were performed using XGBoost, an ensemble learning algorithm that combines gradient boosting and decision trees. The ML model was trained on the pre-processed PLCO dataset and tested on the NLST dataset. The model incorporated features such as age, gender, smoking history, medical diagnoses, and family history of lung cancer. The model was well-calibrated (Brier score=0.044). ROC-AUC was 82% on the PLCO dataset and 70% on the NLST dataset. PR-AUC was 29% and 11% respectively. When compared to the USPSTF guidelines for lung cancer screening, our model provided the same recall with a precision of 13.1% vs. 9.3% on the PLCO dataset and 3.2% vs. 3.1% on the NLST dataset. The developed ML tool provides a freely available web application for estimating the likelihood of developing lung cancer within five years. By utilizing risk factors and clinical data, individuals can assess their risk and make informed decisions regarding lung cancer screening. This research contributes to the efforts in early detection and prevention strategies, aiming to reduce lung cancer-related mortality rates.