Toward Automatic Filling of Case Report Forms: A Case Study on Data from an Italian Emergency Department
Organizations: Fondazione Bruno Kessler, Povo, Trento, Italy · University of Padova, Padova, Italy · Emergency Medicine Unit, Fatebenefratelli Hospital, Milan, Italy · University of Milan, Milan, Italy
Abstract
Case Report Forms (CRFs) collect data about patients and are at the core of well-established practices to conduct research in clinical settings. With the recent progress of language technologies, there is an increasing interest in automatic CRF-filling from clinical notes, mostly based on the use of Large Language Models (LLMs). However, there is a general scarcity of annotated CRF data, both for training and testing LLMs, which limits the progress on this task. As a step in the direction of providing such data, we present a new dataset of clinical notes from an Italian Emergency Department annotated with respect to a pre-defined CRF containing 134 items to be filled. We provide an analysis of the data, define the CRF-filling task and metric for its evaluation, and report on pilot experiments where we use an open-source state-of-the-art LLM to automatically execute the task. Results of the case-study show that (i) CRF-filling from real clinical notes in Italian can be approached in a zero-shot setting; (ii) LLMs' results are affected by biases (e.g., a cautious behaviour favours "unknown" answers), which need to be corrected.
Figures & tables
| Model / Baseline | Micro F1 | Macro F1 |
|---|---|---|
| Most-frequent baseline | 0.963 | 0.353 |
| LLaMA-3 8B (pilot) | 0.920 | 0.548 |
| Ground truth value: | unknown | other |
|---|---|---|
| Correct predictions (%) | 90.42 | 1.57 |
| Incorrect predictions (%) | 5.96 | 2.05 |
| Total share in dataset (%) | 96.38 | 3.62 |
| Model | Precision | Recall |
|---|---|---|
| LLaMA-3 8B | 0.562 | 0.569 |
Clinical NLP
Clinical natural language processing (NLP) develops methods to extract, interpret, and generate information from healthcare text and conversations.
See all 142 papers