Towards Reducing Diagnostic Errors with Interpretable Risk Prediction

Denis McInerney, William Dickinson, Lucy Flynn, Andrea Young, Geoffrey Young, Jan-Willem van de Meent, Byron Wallace


Abstract
Many diagnostic errors occur because clinicians cannot easily access relevant information in patient Electronic Health Records (EHRs). In this work we propose a method to use LLMs to identify pieces of evidence in patient EHR data that indicate increased or decreased risk of specific diagnoses; our ultimate aim is to increase access to evidence and reduce diagnostic errors. In particular, we propose a Neural Additive Model to make predictions backed by evidence with individualized risk estimates at time-points where clinicians are still uncertain, aiming to specifically mitigate delays in diagnosis and errors stemming from an incomplete differential. To train such a model, it is necessary to infer temporally fine-grained retrospective labels of eventual “true” diagnoses. We do so with LLMs, to ensure that the input text is from before a confident diagnosis can be made. We use an LLM to retrieve an initial pool of evidence, but then refine this set of evidence according to correlations learned by the model. We conduct an in-depth evaluation of the usefulness of our approach by simulating how it might be used by a clinician to decide between a pre-defined list of differential diagnoses.
Anthology ID:
2024.naacl-long.399
Volume:
Proceedings of the 2024 Conference of the North American Chapter of the Association for Computational Linguistics: Human Language Technologies (Volume 1: Long Papers)
Month:
June
Year:
2024
Address:
Mexico City, Mexico
Editors:
Kevin Duh, Helena Gomez, Steven Bethard
Venue:
NAACL
SIG:
Publisher:
Association for Computational Linguistics
Note:
Pages:
7193–7210
Language:
URL:
https://aclanthology.org/2024.naacl-long.399
DOI:
10.18653/v1/2024.naacl-long.399
Bibkey:
Cite (ACL):
Denis McInerney, William Dickinson, Lucy Flynn, Andrea Young, Geoffrey Young, Jan-Willem van de Meent, and Byron Wallace. 2024. Towards Reducing Diagnostic Errors with Interpretable Risk Prediction. In Proceedings of the 2024 Conference of the North American Chapter of the Association for Computational Linguistics: Human Language Technologies (Volume 1: Long Papers), pages 7193–7210, Mexico City, Mexico. Association for Computational Linguistics.
Cite (Informal):
Towards Reducing Diagnostic Errors with Interpretable Risk Prediction (McInerney et al., NAACL 2024)
Copy Citation:
PDF:
https://aclanthology.org/2024.naacl-long.399.pdf