← 研踪 PaperTrailarXiv:2611.17053 · v1
Evaluating Pretrained Language Semantics for Structured EHR Prediction Tasks
首次提交 2026-11-13 00:34
版本更新 2026-11-13 00:34
雷达观测 2026-11-13 14:15
摘要
Structured Electronic Health Records (EHR) models typically treat each clinical concept as a dataset-specific token, discarding the natural-language semantics associated with the event. As a result, relationships between concepts must largely be learned from EHR co-occurrence, without directly exploiting any prior semantic knowledge. We investigate how pretrained causal language models can be adapted for longitudinal EHR prediction by developing tEHR. Here, we represent events with their natural language description and use this text stream to apply EHR-adaptive continued pretraining, followed by task-specific discriminative fine-tuning using LoRA, utilising the LLM as a longitudinal patient-encoder. We evaluate this approach across four prediction tasks on the MIMIC-IV dataset and pancreatic cancer prediction on the CPRD dataset at 1 to 12 month horizons, with tEHR using the Mistral-7B-v0.3 backbone achieving the strongest overall performance. Ablations show that performance declines when clinical descriptions are removed or misaligned, when numerical values are omitted, and when either stage of adaptation is removed, while explicit elapsed-time descriptions provide little additional benefit. Analysis of the learned patient representations further reveals clinically coherent structure associated with distinct patterns of disease risk and clinical history.
作者备注：Accepted for publication in Proceedings of Machine Learning Research (PMLR), Vol. 346, 2026
观测到的版本
相邻记录可能跳过中间版本；首次发现 v2 及以上也会标为版本更新。
v1 · 2026-11-13 00:34 · 最新观测版本
Evaluating Pretrained Language Semantics for Structured EHR Prediction Tasks
Structured Electronic Health Records (EHR) models typically treat each clinical concept as a dataset-specific token, discarding the natural-language semantics associated with the event. As a result, relationships between concepts must largely be learned from EHR co-occurrence, without directly exploiting any prior semantic knowledge. We investigate how pretrained causal language models can be adapted for longitudinal EHR prediction by developing tEHR. Here, we represent events with their natural language description and use this text stream to apply EHR-adaptive continued pretraining, followed by task-specific discriminative fine-tuning using LoRA, utilising the LLM as a longitudinal patient-encoder. We evaluate this approach across four prediction tasks on the MIMIC-IV dataset and pancreatic cancer prediction on the CPRD dataset at 1 to 12 month horizons, with tEHR using the Mistral-7B-v0.3 backbone achieving the strongest overall performance. Ablations show that performance declines when clinical descriptions are removed or misaligned, when numerical values are omitted, and when either stage of adaptation is removed, while explicit elapsed-time descriptions provide little additional benefit. Analysis of the learned patient representations further reveals clinically coherent structure associated with distinct patterns of disease risk and clinical history.
查看此版本解读 →查看此版本原文 ↗