Evidence map›Paper›PMID 39001463›Full record

ArticleCancers2024

Outcome Prediction Using Multi-Modal Information: Integrating Large Language Model-Extracted Clinical Information and Image Analysis.

Di Sun, Lubomir Hadjiiski, John Gormley, Heang-Ping Chan, Elaine Caoili, Richard Cohan, Ajjai Alva, Grace Bruno, Rada Mihalcea, Chuan Zhou and 1 more

Abstract read
In one paragraph

Article in Cancers, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
13citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

13 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Article
  4. Review
  5. Article
  6. Article
  7. Article
  8. Article
  9. Article
  10. Article
  11. Article
  12. Review
  13. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Di SunDepartment of Radiology, University of Michigan, Ann Arbor, MI 48109, USA.ORCID 0000-0001-6578-5142
Lubomir HadjiiskiDepartment of Radiology, University of Michigan, Ann Arbor, MI 48109, USA.
John GormleyDepartment of Radiology, University of Michigan, Ann Arbor, MI 48109, USA.
Heang-Ping ChanDepartment of Radiology, University of Michigan, Ann Arbor, MI 48109, USA.
Elaine CaoiliDepartment of Radiology, University of Michigan, Ann Arbor, MI 48109, USA.
Richard CohanDepartment of Radiology, University of Michigan, Ann Arbor, MI 48109, USA.
Ajjai AlvaDepartment of Internal Medicine-Hematology/Oncology, University of Michigan, Ann Arbor, MI 48109, USA.
Grace BrunoDepartment of Radiology, University of Michigan, Ann Arbor, MI 48109, USA.
Rada MihalceaDepartment of Electrical Engineering and Computer Science, University of Michigan, Ann Arbor, MI 48109, USA.
Chuan ZhouDepartment of Radiology, University of Michigan, Ann Arbor, MI 48109, USA.ORCID 0000-0002-0609-1658
Vikas GulaniDepartment of Radiology, University of Michigan, Ann Arbor, MI 48109, USA.ORCID 0000-0003-0889-5999

Funding

Biomarker-Based Tools for Treatment Response Decision Support of Bladder CancerU01CA232931 · NCI · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI ALVA, AJJAI SHIVARAM, HADJIYSKI, LUBOMIR M · 2019 to 2024
$3.1M
NCI NIH HHS U01 CA232931NIH HHS U01-CA232931
6 · The paper itself

Abstract

Survival prediction post-cystectomy is essential for the follow-up care of bladder cancer patients. This study aimed to evaluate artificial intelligence (AI)-large language models (LLMs) for extracting clinical information and improving image analysis, with an initial application involving predicting five-year survival rates of patients after radical cystectomy for bladder cancer. Data were retrospectively collected from medical records and CT urograms (CTUs) of bladder cancer patients between 2001 and 2020. Of 781 patients, 163 underwent chemotherapy, had pre- and post-chemotherapy CTUs, underwent radical cystectomy, and had an available post-surgery five-year survival follow-up. Five AI-LLMs (Dolly-v2, Vicuna-13b, Llama-2.0-13b, GPT-3.5, and GPT-4.0) were used to extract clinical descriptors from each patient's medical records. As a reference standard, clinical descriptors were also extracted manually. Radiomics and deep learning descriptors were extracted from CTU images. The developed multi-modal predictive model, CRD, was based on the clinical (C), radiomics (R), and deep learning (D) descriptors. The LLM retrieval accuracy was assessed. The performances of the survival predictive models were evaluated using AUC and Kaplan-Meier analysis. For the 163 patients (mean age 64 ± 9 years; M:F 131:32), the LLMs achieved extraction accuracies of 74%~87% (Dolly), 76%~83% (Vicuna), 82%~93% (Llama), 85%~91% (GPT-3.5), and 94%~97% (GPT-4.0). For a test dataset of 64 patients, the CRD model achieved AUCs of 0.89 ± 0.04 (manually extracted information), 0.87 ± 0.05 (Dolly), 0.83 ± 0.06~0.84 ± 0.05 (Vicuna), 0.81 ± 0.06~0.86 ± 0.05 (Llama), 0.85 ± 0.05~0.88 ± 0.05 (GPT-3.5), and 0.87 ± 0.05~0.88 ± 0.05 (GPT-4.0). This study demonstrates the use of LLM model-extracted clinical information, in conjunction with imaging analysis, to improve the prediction of clinical outcomes, with bladder cancer as an initial example.

Indexed as

bladder cancerdeep learninglarge language modelsradiomicssurvival prediction

Identifiers

PMID39001463
PMCPMC11240460

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.