Evidence map›Paper›PMID 40311258›Full record

ArticleInternational journal of medical informatics2025

Ontology accelerates few-shot learning capability of large language model: A study in extraction of drug efficacy in a rare pediatric epilepsy.

Pedram Golnari, Katrina Prantzalos, Veronica Hood, Mary Anne Meskis, Lori L Isom, Karen Wilcox, Jack M Parent, Dennis Lal, Samden D Lhatoo, Howard P Goodkin and 9 more

Abstract read
In one paragraph

Article in International journal of medical informatics, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing 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

3 citing papers in PubMed.

  1. Review
  2. Article
  3. 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

19 authors.

Pedram GolnariDepartment of Population and Quantitative Sciences, School of Medicine, Case Western Reserve University, Cleveland, OH 44106, USA.
Katrina PrantzalosDepartment of Population and Quantitative Sciences, School of Medicine, Case Western Reserve University, Cleveland, OH 44106, USA.
Veronica HoodDravet Syndrome Foundation, Inc, PO Box 3026, Cherry Hill, NJ 08034, USA.
Mary Anne MeskisDravet Syndrome Foundation, Inc, PO Box 3026, Cherry Hill, NJ 08034, USA.
Lori L IsomDepartment of Pharmacology, University of Michigan Medical School, Ann Arbor, MI 48109-5632, USA.
Karen WilcoxDepartment of Pharmacology and Toxicology, University of Utah, Salt Lake City, UT 84112, USA.
Jack M ParentDepartment of Neurology and Michigan Neuroscience Institute, University of Michigan Medical School, Ann Arbor, MI 48109, USA.
Dennis LalDepartment of Neurology, The University of Texas Health Science Center at Houston, Houston, TX 77030, USA; Center for Neurogenetics, The University of Texas Health Science Center at Houston, Houston, TX 77030, USA; Stanley Center for Psychiatric Research, Broad Institute of Harvard and M.I.T., Cambridge, MA 02142, USA.
Samden D LhatooDepartment of Neurology, The University of Texas Health Science Center at Houston, Houston, TX 77030, USA.
Howard P GoodkinDepartment of Neurology and Pediatrics, University of Virginia, Charlottesville VA 22903, USA.
Elaine C WirrellDivisions of Child & Adolescent Neurology and Epilepsy, Department of Neurology, Mayo Clinic, Rochester, MN 55905, USA.
Kelly G KnuppDepartment of Pediatrics and Neurology, University of Colorado School of Medicine, Aurora, CO 80045, USA.
Manisha PatelDepartment of Pharmaceutical Sciences, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado Anschutz Medical Campus School of Medicine, Aurora, CO 80045, USA.
Jeffrey A LoebDepartment of Neurology and Rehabilitation, University of Illinois Chicago, Chicago, IL 60612, USA.
Joseph E SullivanDepartments of Neurology and Pediatrics, Benioff Children's Hospital, University of California, San Francisco, San Francisco, CA 94158, USA.
Lauren Harte-HargroveCURE Epilepsy, Chicago, IL 60611, USA.
Brandy E FuremanEpilepsy Foundation, 3540 Crain Highway, Suite 675, Bowie, MD 20716, USA.
Jeffrey BuchhalterDepartment of Pediatrics, University of Calgary School of Medicine, Calgary AB T2N 4N1, Canada.
Satya S SahooDepartment of Population and Quantitative Sciences, School of Medicine, Case Western Reserve University, Cleveland, OH 44106, USA.

Funding

Clinical and Translational Science Collaborative of ClevelandUL1TR002548 · NCATS · CASE WESTERN RESERVE UNIVERSITY · PI MCCOMSEY, GRACE A · 2018 to 2022
$35.5M
Clinical and Translational Science Collaborative of Northern Ohio, Catalyzing Linkages to Equity in Health (CLE Health)UM1TR004528 · NCATS · CASE WESTERN RESERVE UNIVERSITY · PI GRACE A MCCOMSEY · 2023 to 2026
$32.1M
Neuroscience Gateway to Enable Dissemination of Computational And Data Processing Tools And Software.U24EB029005 · NIBIB · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI MAJUMDAR, AMITAVA · 2019 to 2023
$2.2M
CRCNS:NeuroBridge: Connecting Big Data for Reproducible Clinical NeuroscienceR01DA053028 · NIDA · OHIO STATE UNIVERSITY · PI AMBITE, JOSE LUIS, RAJASEKAR, ARCOT · 2020 to 2023
$1.7M
The Alzheimer's Disease Translational Data Science Training ProgramT32AG071474 · NIA · CASE WESTERN RESERVE UNIVERSITY · PI BUSH, WILLIAM S · 2021 to 2025
$1.1M
NCATS NIH HHS UL1 TR002548NCATS NIH HHS UM1 TR004528NIA NIH HHS T32 AG071474NIBIB NIH HHS U24 EB029005NIDA NIH HHS R01 DA053028
6 · The paper itself

Abstract

objectiveDravet Syndrome (DS) is a developmental and epileptic encephalopathy that is characterized by severe, prolonged motor seizures and high resistance to multiple antiseizure medications (ASMs) with multiple comorbidities. Evaluating the efficacy of new drugs in DS preclinical models and mapping them to human phenotypes of DS through analysis of published literature is an important goal for improving outcomes in this rare pediatric epilepsy. MATERIALS AND

methodsLarge language models (LLM) have demonstrated great promise in parsing published literature; however, the performance of LLMs falls short in medical applications. In this study, we investigate the effectiveness of domain ontology developed by human experts to optimize LLMs for medical text processing in a rare disease. Utilizing a benchmark dataset that describes the efficacy of 17 ASMs tested in preclinical models and DS patients, we define a new ontology-augmented phased in-context learning (PCL) approach to process 4935 full-text DS articles. We expand this analysis to 7 new drugs that demonstrate efficacy in reducing seizures to identify gaps in current knowledge for designing new experimental studies for drug discovery in DS.

resultsFew-shot or in-context learning is a foundational capability of LLMs and the few-shot learning capability of the Gemini 1.0 Pro version LLM dramatically increases when we augment prompts with the DS epilepsy ontology. The DS epilepsy ontology is the largest epilepsy and seizure ontology in clinical use that was developed by DS basic scientists and clinical neurologists. The ontology-augmented PCL prompt achieves 100% accuracy in reproducing the benchmark drug efficacy dataset for 17 ASMs with only two examples for in-context learning.

conclusionThe new ontology-augmented PCL approach significantly accelerates the few-shot learning capabilities of the Gemini LLM, thereby reducing the number of required examples and time needed to optimize LLMs for medical applications.

Indexed as

AnticonvulsantsBiological OntologiesEpilepsies, MyoclonicMachine LearningNatural Language ProcessingChildHumansLarge Language ModelsRare DiseasesAnticonvulsantsBiomedical OntologyDravet SyndromeDrug EfficacyFew-shot LearningOptimizing Large Language Models

Identifiers

PMID40311258
PMCPMC12208729

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Registered trials

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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.