Leveraging Large Language Models for Early Detection of Anomaly Work Injury Cases: Data-Driven Approach to Rehabilitation Efficiency.

Background: Large language models (LLMs) have demonstrated potential in automating the analysis of unstructured clinical data, yet their application in rehabilitation therapy for work injury cases remains underexplored. Objective: We aimed to evaluate the performance of an LLM-assisted approach for the rapid identification of anomalous rehabilitation cases related to work injuries to enhance scalability and precision in case management. Methods: We retrospectively analyzed 110,346 deidentified work injury cases between 2001 and 2024 from a leading rehabilitation coordination company in Hong Kong, representing approximately 20% of all work injury incidents in the region. LLMs were used to estimate the expected duration of recovery based on free-text injury descriptions. The cases in which the actual number of medically certified sick leave days exceeded the LLM-predicted maximum were classified as anomalies. Results: The LLM-assisted method achieved high accuracy, with GPT-4o achieving over 73% accuracy in nonanomalous classification and 79% accuracy in all dataset detection, outperforming comparator models. The model maintained high accuracy across subgroups and demonstrated the reliable extraction of information from free-text notes. Conclusions: The proposed method demonstrated robustness when evaluated on a large-scale dataset with a bimodal age distribution. This study highlights the potential of LLMs to transform rehabilitation workflows by automating anomaly detection at scale. The method also shows promise in tailoring rehabilitation strategies to age-specific needs and leveraging LLM tools for efficient case management. However, a key limitation is that the dataset includes only injury cases from a single geographic region, potentially limiting the generalizability of the findings to other populations or health care systems.