Applying large language model for automated quality scoring of radiology requisitions using a standardized criteria

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Tarih

2025

Dergi Başlığı

Dergi ISSN

Cilt Başlığı

Yayıncı

Springer

Erişim Hakkı

info:eu-repo/semantics/closedAccess

Özet

ObjectivesTo create and test a locally adapted large language model (LLM) for automated scoring of radiology requisitions based on the reason for exam imaging reporting and data system (RI-RADS), and to evaluate its performance based on reference standards.Materials and methodsThis retrospective, double-center study included 131,683 radiology requisitions from two institutions. A bidirectional encoder representation from a transformer (BERT)-based model was trained using 101,563 requisitions from Center 1 (including 1500 synthetic examples) and externally tested on 18,887 requisitions from Center 2. The model's performance for two different classification strategies was evaluated by the reference standard created by three different radiologists. Model performance was assessed using Cohen's Kappa, accuracy, F1-score, sensitivity, and specificity with 95% confidence intervals.ResultsA total of 18,887 requisitions were evaluated for the external test set. External testing yielded a performance with an F1-score of 0.93 (95% CI: 0.912-0.943); kappa = 0.88 (95% CI: 0.871-0.884). Performance was highest in common categories RI-RADS D and X (F1 >= 0.96) and lowest for rare categories RI-RADS A and B (F1 <= 0.49). When grouped into three categories (adequate, inadequate, and unacceptable), overall model performance improved [F1-score = 0.97; (95% CI: 0.96-0.97)].ConclusionThe locally adapted BERT-based model demonstrated high performance and almost perfect agreement with radiologists in automated RI-RADS scoring, showing promise for integration into radiology workflows to improve requisition completeness and communication.Key PointsQuestionCan an LLM accurately and automatically score radiology requisitions based on standardized criteria to address the challenges of incomplete information in radiological practice?FindingsA locally adapted BERT-based model demonstrated high performance (F1-score 0.93) and almost perfect agreement with radiologists in automated RI-RADS scoring across a large, multi-institutional dataset.Clinical relevanceLLMs offer a scalable solution for automated scoring of radiology requisitions, with the potential to improve workflow in radiology. Further improvement and integration into clinical practice could enhance communication, contributing to better diagnoses and patient care.Key PointsQuestionCan an LLM accurately and automatically score radiology requisitions based on standardized criteria to address the challenges of incomplete information in radiological practice?FindingsA locally adapted BERT-based model demonstrated high performance (F1-score 0.93) and almost perfect agreement with radiologists in automated RI-RADS scoring across a large, multi-institutional dataset.Clinical relevanceLLMs offer a scalable solution for automated scoring of radiology requisitions, with the potential to improve workflow in radiology. Further improvement and integration into clinical practice could enhance communication, contributing to better diagnoses and patient care.Key PointsQuestionCan an LLM accurately and automatically score radiology requisitions based on standardized criteria to address the challenges of incomplete information in radiological practice?FindingsA locally adapted BERT-based model demonstrated high performance (F1-score 0.93) and almost perfect agreement with radiologists in automated RI-RADS scoring across a large, multi-institutional dataset.Clinical relevanceLLMs offer a scalable solution for automated scoring of radiology requisitions, with the potential to improve workflow in radiology. Further improvement and integration into clinical practice could enhance communication, contributing to better diagnoses and patient care.

Açıklama

Anahtar Kelimeler

Radiology, Workflow, Large language models, Electronic health records, Natural language processing

Kaynak

European Radiology

WoS Q Değeri

Q1

Scopus Q Değeri

Q1

Cilt

Sayı

Künye