Evidence map›Paper›PMID 40269253›Full record

ArticleNPJ digital medicine2025

Understanding contraceptive switching rationales from real world clinical notes using large language models.

Brenda Y Miao, Christopher Y K Williams, Ebenezer Chinedu-Eneh, Travis Zack, Emily Alsentzer, Atul J Butte, Irene Y Chen

Abstract read
In one paragraph

Article in NPJ digital medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–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

2 citing papers in PubMed.

  1. Article
  2. Article
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

7 authors.

Brenda Y MiaoBakar Computational Health Sciences Institute, University of California San Francisco, San Francisco, CA, USA. miao.brenda1@gmail.com.
Christopher Y K WilliamsBakar Computational Health Sciences Institute, University of California San Francisco, San Francisco, CA, USA.ORCID http://orcid.org/0000-0001-8867-1623
Ebenezer Chinedu-EnehDepartment of Medicine, University of California San Francisco, San Francisco, CA, USA.
Travis ZackBakar Computational Health Sciences Institute, University of California San Francisco, San Francisco, CA, USA.
Emily AlsentzerDivision of General Internal Medicine, Brigham and Women's Hospital, Boston, MA, USA.ORCID http://orcid.org/0000-0002-5370-1746
Atul J Butte *Bakar Computational Health Sciences Institute, University of California San Francisco, San Francisco, CA, USA.ORCID http://orcid.org/0000-0002-7433-2740
Irene Y Chen *Computational Precision Health, University of California, Berkeley and University of California, San Francisco, Berkeley, CA, USA.

Funding

Clinical and Translational Science InstituteUL1TR001872 · NCATS · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI COLLARD, HAROLD R, JACOBY, VANESSA · 2016 to 2025
$112.1M
NCATS NIH HHS UL1 TR001872
6 · The paper itself

Abstract

Understanding reasons for treatment switching is of significant medical interest, but these factors are often only found in unstructured clinical notes and can be difficult to extract. We evaluated the zero-shot abilities of GPT-4 and eight other open-source large language models (LLMs) to extract contraceptive switching information from 1964 clinical notes derived from the UCSF Information Commons dataset. GPT-4 extracted the contraceptives started and stopped at each switch with microF1 scores of 0.85 and 0.88, respectively, compared to 0.81 and 0.88 for the best open-source model. When evaluated by clinical experts, GPT-4 extracted reasons for switching with an accuracy of 91.4% (2.2% hallucination rate). Transformer-based topic modeling identified patient preference, adverse events, and insurance coverage as key reasons. These findings demonstrate the value of LLMs in identifying complex treatment factors and provide insights into reasons for contraceptive switching in real-world settings.

Identifiers

PMID40269253
PMCPMC12019358

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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.