Clinical Information Extraction

Type 2 diabetes case reports describe complex clinical courses, but their timelines are often expressed in language that is difficult to reuse in longitudinal modeling. To address this gap, we developed a textual time-series corpus of 136 PubMed Open Access single-patient case reports involving glucagon-like peptide 1 receptor agonists, with clinical events associated with their most probable reference times. We evaluated automated LLM timeline extraction against gold-standard timelines annotated by clinical domain experts, assessing how well systems recovered clinical events and their timings. The best-performing LLM produced high event coverage (GPT5; 0.871) and reliable temporal sequencing across symptoms (GPT5; 0.843), diagnoses, treatments, laboratory tests, and outcomes. As a downstream demonstration, time-to-event analyses in diabetes suggested lower risk of respiratory sequelae among GLP-1 users versus non-users (HR=0.259, p<0.05), consistent with prior reports of improved respiratory outcomes. Temporal annotations and code will be released upon acceptance.

Treatment-resistant depression (TRD) is a severe form of major depressive disorder in which patients do not achieve remission despite multiple adequate treatment trials. Evidence across pharmacologic options for TRD remains limited, and trials often do not fully capture patient-reported tolerability. Large-scale online peer-support narratives therefore offer a complementary lens on how patients describe and evaluate medications in real-world use. In this study, we curated a corpus of 5,059 Reddit posts explicitly referencing TRD from 3,480 subscribers across 28 mental health-related subreddits from 2010 to 2025. Of these, 3,839 posts mentioned at least one medication, yielding 23,399 mentions of 81 generic-name medications after lexicon-based normalization of brand names, misspellings, and colloquialisms. We developed an aspect-based sentiment classifier by fine-tuning DeBERTa-v3 on the SMM4H 2023 therapy-sentiment Twitter corpus with large language model based data augmentation, achieving a micro-F1 score of 0.800 on the shared-task test set. Applying this classifier to Reddit, we quantified sentiment toward individual medications across three categories: positive, neutral, and negative, and tracked patterns by drug, subscriber, subreddit, and year. Overall, 72.1% of medication mentions were neutral, 14.8% negative, and 13.1% positive. Conventional antidepressants, especially SSRIs and SNRIs, showed consistently higher negative than positive proportions, whereas ketamine and esketamine showed comparatively more favorable sentiment profiles. These findings show that normalized medication extraction combined with aspect-based sentiment analysis can help characterize patient-perceived treatment experiences in TRD-related Reddit discourse, complementing clinical evidence with large-scale patient-generated perspectives.

Radiology reports capture crucial longitudinal information on tumor burden, treatment response, and disease progression, yet their unstructured narrative format complicates automated analysis. While large language models (LLMs) have advanced clinical text processing, most state-of-the-art systems remain proprietary, limiting their applicability in privacy-sensitive healthcare environments. We present a fully open-source, locally deployable pipeline for longitudinal information extraction from radiology reports, implemented using the llm_extractinator framework. The system applies the qwen2.5-72b model to extract and link target, non-target, and new lesion data across time points in accordance with RECIST criteria. Evaluation on 50 Dutch CT Thorax/Abdomen report pairs yielded high extraction performance, with attribute-level accuracies of 93.7% for target lesions, 94.9% for non-target lesions, and 94.0% for new lesions. The approach demonstrates that open-source LLMs can achieve clinically meaningful performance in multi-timepoint oncology tasks while ensuring data privacy and reproducibility. These results highlight the potential of locally deployable LLMs for scalable extraction of structured longitudinal data from routine clinical text.

Pathology underpins modern diagnosis and cancer care, yet its most valuable asset, the accumulated experience encoded in millions of narrative reports, remains largely inaccessible. Although institutions are rapidly digitizing pathology workflows, storing data without effective mechanisms for retrieval and reasoning risks transforming archives into a passive data repository, where institutional knowledge exists but cannot meaningfully inform patient care. True progress requires not only digitization, but the ability for pathologists to interrogate prior similar cases in real time while evaluating a new diagnostic dilemma. We present PathoScribe, a unified retrieval-augmented large language model (LLM) framework designed to transform static pathology archives into a searchable, reasoning-enabled living library. PathoScribe enables natural language case exploration, automated cohort construction, clinical question answering, immunohistochemistry (IHC) panel recommendation, and prompt-controlled report transformation within a single architecture. Evaluated on 70,000 multi-institutional surgical pathology reports, PathoScribe achieved perfect Recall@10 for natural language case retrieval and demonstrated high-quality retrieval-grounded reasoning (mean reviewer score 4.56/5). Critically, the system operationalized automated cohort construction from free-text eligibility criteria, assembling research-ready cohorts in minutes (mean 9.2 minutes) with 91.3% agreement to human reviewers and no eligible cases incorrectly excluded, representing orders-of-magnitude reductions in time and cost compared to traditional manual chart review. This work establishes a scalable foundation for converting digital pathology archives from passive storage systems into active clinical intelligence platforms.

Automated Drug Combination Extraction (DCE) from large-scale biomedical literature is crucial for advancing precision medicine and pharmacological research. However, existing relation extraction methods primarily focus on binary interactions and struggle to model variable-length n-ary drug combinations, where complex compatibility logic and distributed evidence need to be considered. To address these limitations, we propose RexDrug, an end-to-end reasoning-enhanced relation extraction framework for n-ary drug combination extraction based on large language models. RexDrug adopts a two-stage training strategy. First, a multi-agent collaborative mechanism is utilized to automatically generate high-quality expert-like reasoning traces for supervised fine-tuning. Second, reinforcement learning with a multi-dimensional reward function specifically tailored for DCE is applied to further refine reasoning quality and extraction accuracy. Extensive experiments on the DrugComb dataset show that RexDrug consistently outperforms state-of-the-art baselines for n-ary extraction. Additional evaluation on the DDI13 corpus confirms its generalizability to binary drugdrug interaction tasks. Human expert assessment and automatic reasoning metrics further indicates that RexDrug produces coherent medical reasoning while accurately identifying complex therapeutic regimens. These results establish RexDrug as a scalable and reliable solution for complex biomedical relation extraction from unstructured text. The source code and data are available at https://github.com/DUTIR-BioNLP/RexDrug

Clinical information extraction (e.g., 2010 i2b2/VA challenge) usually presents tasks of concept recognition, assertion classification, and relation extraction. Jointly modeling the multi-stage tasks in the clinical domain is an underexplored topic. The existing independent task setting (reference inputs given in each stage) makes the joint models not directly comparable to the existing pipeline work. To address these issues, we define a joint task setting and propose a novel end-to-end system to jointly optimize three-stage tasks. We empirically investigate the joint evaluation of our proposal and the pipeline baseline with various embedding techniques: word, contextual, and in-domain contextual embeddings. The proposed joint system substantially outperforms the pipeline baseline by +0.3, +1.4, +3.1 for the concept, assertion, and relation F1. This work bridges joint approaches and clinical information extraction. The proposed approach could serve as a strong joint baseline for future research. The code is publicly available.

Motivation: Patient-generated text contains critical information about patients' lived experiences, social circumstances, and engagement in care, including factors that strongly influence adherence, care coordination, and health equity. However, these patient voice signals are rarely available in structured form, limiting their use in patient-centered outcomes research and clinical quality improvement. Reliable extraction of such information is therefore essential for understanding and addressing non-clinical drivers of health outcomes at scale. Results: We introduce PVminer, a benchmark for structured extraction of patient voice, and propose PVminerLLM, a supervised fine-tuned large language model tailored to this task. Across multiple datasets and model sizes, PVminerLLM substantially outperforms prompt-based baselines, achieving up to 83.82% F1 for Code prediction, 80.74% F1 for Sub-code prediction, and 87.03% F1 for evidence Span extraction. Notably, strong performance is achieved even with smaller models, demonstrating that reliable patient voice extraction is feasible without extreme model scale. These results enable scalable analysis of social and experiential signals embedded in patient-generated text. Availability and Implementation: Code, evaluation scripts, and trained LLMs will be released publicly. Annotated datasets will be made available upon request for research use. Keywords: Large Language Models, Supervised Fine-Tuning, Medical Annotation, Patient-Generated Text, Clinical NLP

Large Language Models (LLMs) are increasingly used for medical entity extraction, yet their confidence scores are often miscalibrated, limiting safe deployment in clinical settings. We present a conformal prediction framework that provides finite-sample coverage guarantees for LLM-based extraction across two clinical domains. First, we extract structured entities from 1,000 FDA drug labels across eight sections using GPT-4.1, verified via FactScore-based atomic statement evaluation (97.7% accuracy over 128,906 entities). Second, we extract radiological entities from MIMIC-CXR reports using the RadGraph schema with GPT-4.1 and Llama-4-Maverick, evaluated against physician annotations (entity F1: 0.81 to 0.84). Our central finding is that miscalibration direction reverses across domains: on well-structured FDA labels, models are underconfident, requiring modest conformal thresholds ($τ\approx 0.06$), while on free-text radiology reports, models are overconfident, demanding strict thresholds ($τ$ up to 0.99). Despite this heterogeneity, conformal prediction achieves target coverage ($\geq 90\%$) in both settings with manageable rejection rates (9--13%). These results demonstrate that calibration is not a global model property but depends on document structure, extraction category, and model architecture, motivating domain-specific conformal calibration for safe clinical deployment.

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.

Extracting clinical information from medical transcripts in low-resource languages remains a significant challenge in healthcare natural language processing (NLP). This study evaluates a two-step pipeline combining Aya-expanse-8B as a Persian-to-English translation model with five open-source small language models (SLMs) -- Qwen2.5-7B-Instruct, Llama-3.1-8B-Instruct, Llama-3.2-3B-Instruct, Qwen2.5-1.5B-Instruct, and Gemma-3-1B-it -- for binary extraction of 13 clinical features from 1,221 anonymized Persian transcripts collected at a cancer palliative care call center. Using a few-shot prompting strategy without fine-tuning, models were assessed on macro-averaged F1-score, Matthews Correlation Coefficient (MCC), sensitivity, and specificity to account for class imbalance. Qwen2.5-7B-Instruct achieved the highest overall performance (median macro-F1: 0.899; MCC: 0.797), while Gemma-3-1B-it showed the weakest results. Larger models (7B--8B parameters) consistently outperformed smaller counterparts in sensitivity and MCC. A bilingual analysis of Aya-expanse-8B revealed that translating Persian transcripts to English improved sensitivity, reduced missing outputs, and boosted metrics robust to class imbalance, though at the cost of slightly lower specificity and precision. Feature-level results showed reliable extraction of physiological symptoms across most models, whereas psychological complaints, administrative requests, and complex somatic features remained challenging. These findings establish a practical, privacy-preserving blueprint for deploying open-source SLMs in multilingual clinical NLP settings with limited infrastructure and annotation resources, and highlight the importance of jointly optimizing model scale and input language strategy for sensitive healthcare applications.

Phenotyping is fundamental to rare disease diagnosis, but manual curation of structured phenotypes from clinical notes is labor-intensive and difficult to scale. Existing artificial intelligence approaches typically optimize individual components of phenotyping but do not operationalize the full clinical workflow of extracting features from clinical text, standardizing them to Human Phenotype Ontology (HPO) terms, and prioritizing diagnostically informative HPO terms. We developed RARE-PHENIX, an end-to-end AI framework for rare disease phenotyping that integrates large language model-based phenotype extraction, ontology-grounded standardization to HPO terms, and supervised ranking of diagnostically informative phenotypes. We trained RARE-PHENIX using data from 2,671 patients across 11 Undiagnosed Diseases Network clinical sites, and externally validated it on 16,357 real-world clinical notes from Vanderbilt University Medical Center. Using clinician-curated HPO terms as the gold standard, RARE-PHENIX consistently outperformed a state-of-the-art deep learning baseline (PhenoBERT) across ontology-based similarity and precision-recall-F1 metrics in end-to-end evaluation (i.e., ontology-based similarity of 0.70 vs. 0.58). Ablation analyses demonstrated performance improvements with the addition of each module in RARE-PHENIX (extraction, standardization, and prioritization), supporting the value of modeling the full clinical phenotyping workflow. By modeling phenotyping as a clinically aligned workflow rather than a single extraction task, RARE-PHENIX provides structured, ranked phenotypes that are more concordant with clinician curation and has the potential to support human-in-the-loop rare disease diagnosis in real-world settings.

Clinical free-text notes contain vital patient information. They are structured into labelled sections; recognizing these sections has been shown to support clinical decision-making and downstream NLP tasks. In this paper, we advance clinical section segmentation through three key contributions. First, we curate a new de-identified, section-labeled obstetrics notes dataset, to supplement the medical domains covered in public corpora such as MIMIC-III, on which most existing segmentation approaches are trained. Second, we systematically evaluate transformer-based supervised models for section segmentation on a curated subset of MIMIC-III (in-domain), and on the new obstetrics dataset (out-of-domain). Third, we conduct the first head-to-head comparison of supervised models for medical section segmentation with zero-shot large language models. Our results show that while supervised models perform strongly in-domain, their performance drops substantially out-of-domain. In contrast, zero-shot models demonstrate robust out-of-domain adaptability once hallucinated section headers are corrected. These findings underscore the importance of developing domain-specific clinical resources and highlight zero-shot segmentation as a promising direction for applying healthcare NLP beyond well-studied corpora, as long as hallucinations are appropriately managed.

Longitudinal information in radiology reports refers to the sequential tracking of findings across multiple examinations over time, which is crucial for monitoring disease progression and guiding clinical decisions. Many recent automated radiology report generation methods are designed to capture longitudinal information; however, validating their performance is challenging. There is no proper tool to consistently label temporal changes in both ground-truth and model-generated texts for meaningful comparisons. Large language models (LLMs) offer a promising annotation alternative, as they are capable of capturing nuanced linguistic patterns and semantic similarities without extensive manual intervention. They also adapt well to new contexts. In this study, we therefore propose an LLM-based pipeline to automatically annotate longitudinal information in radiology reports. The pipeline first identifies sentences containing relevant information and then extracts the progression of diseases. We evaluate and compare five mainstream LLMs on these two tasks using 500 manually annotated reports. Considering both efficiency and performance, Qwen2.5-32B was subsequently selected and used to annotate another 95,169 reports from the public MIMIC-CXR dataset. Our Qwen2.5-32B-annotated dataset provided us with a standardized benchmark for evaluating report generation models. Using this new benchmark, we assessed seven state-of-the-art report generation models. Our LLM-based annotation method outperforms existing annotation solutions, achieving 11.3% and 5.3% higher F1-scores for longitudinal information detection and disease tracking, respectively. The source code is available at https://github.com/wxinyi1996/Standardizing-Longitudinal-Chest-X-ray-Report-Evaluation-via-Large-Language-Model-Annotation.git.

Clinical communication is central to patient outcomes, yet large-scale human annotation of patient-provider conversation remains labor-intensive, inconsistent, and difficult to scale. Existing approaches based on large language models typically rely on single-task models that lack adaptability, interpretability, and reliability, especially when applied across various communication frameworks and clinical domains. In this study, we developed a Multi-framework Structured Agentic AI system for Clinical Communication (MOSAIC), built on a LangGraph-based architecture that orchestrates four core agents, including a Plan Agent for codebook selection and workflow planning, an Update Agent for maintaining up-to-date retrieval databases, a set of Annotation Agents that applies codebook-guided retrieval-augmented generation (RAG) with dynamic few-shot prompting, and a Verification Agent that provides consistency checks and feedback. To evaluate performance, we compared MOSAIC outputs against gold-standard annotations created by trained human coders. We developed and evaluated MOSAIC using 26 gold standard annotated transcripts for training and 50 transcripts for testing, spanning rheumatology and OB/GYN domains. On the test set, MOSAIC achieved an overall F1 score of 0.928. Performance was highest in the Rheumatology subset (F1 = 0.962) and strongest for Patient Behavior (e.g., patients asking questions, expressing preferences, or showing assertiveness). Ablations revealed that MOSAIC outperforms baseline benchmarking.

This tutorial focused on Healthcare Domain Applications of NLP, what we have achieved around HealthcareNLP, and the challenges that lie ahead for the future. Existing reviews in this domain either overlook some important tasks, such as synthetic data generation for addressing privacy concerns, or explainable clinical NLP for improved integration and implementation, or fail to mention important methodologies, including retrieval augmented generation and the neural symbolic integration of LLMs and KGs. In light of this, the goal of this tutorial is to provide an introductory overview of the most important sub-areas of a patient- and resource-oriented HealthcareNLP, with three layers of hierarchy: data/resource layer: annotation guidelines, ethical approvals, governance, synthetic data; NLP-Eval layer: NLP tasks such as NER, RE, sentiment analysis, and linking/coding with categorised methods, leading to explainable HealthAI; patients layer: Patient Public Involvement and Engagement (PPIE), health literacy, translation, simplification, and summarisation (also NLP tasks), and shared decision-making support. A hands-on session will be included in the tutorial for the audience to use HealthcareNLP applications. The target audience includes NLP practitioners in the healthcare application domain, NLP researchers who are interested in domain applications, healthcare researchers, and students from NLP fields. The type of tutorial is "Introductory to CL/NLP topics (HealthcareNLP)" and the audience does not need prior knowledge to attend this. Tutorial materials: https://github.com/4dpicture/HealthNLP

Medical report understanding from real-world document images is essential for generating patient-facing explanations and enabling structured information exchange in clinical systems. Existing VLMs and LLMs have shown strong performance on document understanding, but structured understanding of medical reports remains insufficiently benchmarked. Therefore, we introduce MedRepBench, a benchmark with 1,925 de-identified Chinese medical report images spanning diverse departments, patient demographics, and acquisition formats. In MedRepBench, we mainly focus on report-grounded interpretation rather than evaluating diagnostic reasoning, treatment recommendation, or the integration of patient history. The interpretation is defined as structured extraction of report fields (e.g., item, value, unit, reference range, abnormal flag) plus a patient-facing explanation grounded strictly in the report content. The benchmark primarily evaluates end-to-end VLMs, and also includes a controlled text-only setting (high-quality OCR + LLM) to approximate an upper bound when character recognition errors are minimized. Our evaluation framework provides two complementary protocols: (1) an objective protocol measuring field-level recall of structured items, and (2) an automated subjective protocol that uses an LLM-based judge to score factuality, interpretability, and reasoning quality under a fixed prompt. Using the objective metric as a reward signal, we also provide a lightweight GRPO-based alignment baseline for a mid-sized VLM, which improves field-level recall by up to 6%. Finally, we analyze practical limitations of OCR+LLM pipelines, including layout-related errors and additional system latency, showing the need for robust end-to-end vision-based medical report understanding. The dataset and evaluation resources are publicly available on https://huggingface.co/datasets/MedRepBench/MedRepBench.