Decode Like a Clinician: Enhancing LLM Fine-Tuning with Temporal Structured Data Representation

Daniel Fadlon, David Dov, Aviya Bennett, Daphna Heller-Miron, Gad Levy, Kfir Bar, Ahuva Weiss-Meilik


Abstract
Predictive modeling of hospital patient data is challenging due to its structured format, irregular timing of measurements, and variation in data representation across institutions. While traditional models often struggle with such inconsistencies, Large Language Models (LLMs) offer a flexible alternative. In this work, we propose a method for verbalizing structured Electronic Health Records (EHRs) into a format suitable for LLMs and systematically examine how to include time-stamped clinical observations—such as lab tests and vital signs—from previous time points in the prompt. We study how different ways of structuring this temporal information affect predictive performance, and whether fine-tuning alone enables LLMs to effectively reason over such data. Evaluated on two real-world hospital datasets and MIMIC-IV, our approach achieves strong in-hospital and cross-hospital performance, laying the groundwork for more generalizable clinical modeling.
Anthology ID:
2025.ijcnlp-long.103
Volume:
Proceedings of the 14th International Joint Conference on Natural Language Processing and the 4th Conference of the Asia-Pacific Chapter of the Association for Computational Linguistics
Month:
December
Year:
2025
Address:
Mumbai, India
Editors:
Kentaro Inui, Sakriani Sakti, Haofen Wang, Derek F. Wong, Pushpak Bhattacharyya, Biplab Banerjee, Asif Ekbal, Tanmoy Chakraborty, Dhirendra Pratap Singh
Venues:
IJCNLP | AACL
SIG:
Publisher:
The Asian Federation of Natural Language Processing and The Association for Computational Linguistics
Note:
Pages:
1906–1922
Language:
URL:
https://aclanthology.org/2025.ijcnlp-long.103/
DOI:
Bibkey:
Cite (ACL):
Daniel Fadlon, David Dov, Aviya Bennett, Daphna Heller-Miron, Gad Levy, Kfir Bar, and Ahuva Weiss-Meilik. 2025. Decode Like a Clinician: Enhancing LLM Fine-Tuning with Temporal Structured Data Representation. In Proceedings of the 14th International Joint Conference on Natural Language Processing and the 4th Conference of the Asia-Pacific Chapter of the Association for Computational Linguistics, pages 1906–1922, Mumbai, India. The Asian Federation of Natural Language Processing and The Association for Computational Linguistics.
Cite (Informal):
Decode Like a Clinician: Enhancing LLM Fine-Tuning with Temporal Structured Data Representation (Fadlon et al., IJCNLP-AACL 2025)
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PDF:
https://aclanthology.org/2025.ijcnlp-long.103.pdf