Paging Dr. GPT: Extracting Information from Clinical Notes to Enhance Patient Predictions

원문 초록

There is a long history of building predictive models in healthcare using tabular data from electronic medical records. However, these models fail to extract the information found in unstructured clinical notes, which document diagnosis, treatment, progress, medications, and care plans. In this study, we investigate how answers generated by GPT-4o-mini (ChatGPT) to simple clinical questions about patients, when given access to the patient's discharge summary, can support patient-level mortality prediction. Using data from 14,011 first-time admissions to the Coronary Care or Cardiovascular Intensive Care Units in the MIMIC-IV Note dataset, we implement a transparent framework that uses GPT responses as input features in logistic regression models. Our findings demonstrate that GPT-based models alone can outperform models trained on standard tabular data, and that combining both sources of information yields even greater predictive power, increasing AUC by an average of 5.1 percentage points and increasing positive predictive value by 29.9 percent for the highest-risk decile. These results highlight the value of integrating large language models (LLMs) into clinical prediction tasks and underscore the broader potential for using LLMs in any domain where unstructured text data remains an underutilized resource.