Retrieval Augmented Large Language Model System for Comprehensive Drug Contraindications

The versatility of large language models (LLMs) has been explored across various sectors, but their application in healthcare poses challenges, particularly in the domain of pharmaceutical contraindications where accurate and reliable information is required. This study enhances the capability of LLMs to address contraindications effectively by implementing a Retrieval Augmented Generation (RAG) pipeline. Utilizing OpenAI's GPT-4o-mini as the base model, and the text-embedding-3-small model for embeddings, our approach integrates Langchain to orchestrate a hybrid retrieval system with re-ranking. This system leverages Drug Utilization Review (DUR) data from public databases, focusing on contraindications for specific age groups, pregnancy, and concomitant drug use. The dataset includes 300 question-answer pairs across three categories, with baseline model accuracy ranging from 0.49 to 0.57. Post-integration of the RAG pipeline, we observed a significant improvement in model accuracy, achieving rates of 0.94, 0.87, and 0.89 for contraindications related to age groups, pregnancy, and concomitant drug use, respectively. The results indicate that augmenting LLMs with a RAG framework can substantially reduce uncertainty in prescription and drug intake decisions by providing more precise and reliable drug contraindication information.

Supervised Segmentation with Domain Adaptation for Small Sampled Orbital CT Images

Deep neural networks (DNNs) have been widely used for medical image analysis. However, the lack of access a to large-scale annotated dataset poses a great challenge, especially in the case of rare diseases, or new domains for the research society. Transfer of pre-trained features, from the relatively large dataset is a considerable solution. In this paper, we have explored supervised segmentation using domain adaptation for optic nerve and orbital tumor, when only small sampled CT images are given. Even the lung image database consortium image collection (LIDC-IDRI) is a cross-domain to orbital CT, but the proposed domain adaptation method improved the performance of attention U-Net for the segmentation in public optic nerve dataset and our clinical orbital tumor dataset. The code and dataset are available at https://github.com/cmcbigdata.