oRetrieval Augmented Generation for 10 Large Language Models and its Generalizability in Assessing Medical Fitness

Large Language Models (LLMs) show potential for medical applications but often lack specialized clinical knowledge. Retrieval Augmented Generation (RAG) allows customization with domain-specific information, making it suitable for healthcare. This study evaluates the accuracy, consistency, and safety of RAG models in determining fitness for surgery and providing preoperative instructions. We developed LLM-RAG models using 35 local and 23 international preoperative guidelines and tested them against human-generated responses. A total of 3,682 responses were evaluated. Clinical documents were processed using Llamaindex, and 10 LLMs, including GPT3.5, GPT4, and Claude-3, were assessed. Fourteen clinical scenarios were analyzed, focusing on seven aspects of preoperative instructions. Established guidelines and expert judgment were used to determine correct responses, with human-generated answers serving as comparisons. The LLM-RAG models generated responses within 20 seconds, significantly faster than clinicians (10 minutes). The GPT4 LLM-RAG model achieved the highest accuracy (96.4% vs. 86.6%, p=0.016), with no hallucinations and producing correct instructions comparable to clinicians. Results were consistent across both local and international guidelines. This study demonstrates the potential of LLM-RAG models for preoperative healthcare tasks, highlighting their efficiency, scalability, and reliability.

A Methodology for a Scalable, Collaborative, and Resource-Efficient Platform to Facilitate Healthcare AI Research

Healthcare AI holds the potential to increase patient safety, augment efficiency and improve patient outcomes, yet research is often limited by data access, cohort curation, and tooling for analysis. Collection and translation of electronic health record data, live data, and real-time high resolution device data can be challenging and time-consuming. The development of real-world AI tools requires overcoming challenges in data acquisition, scarce hospital resources and high needs for data governance. These bottlenecks may result in resource-heavy needs and long delays in research and development of AI systems. We present a system and methodology to accelerate data acquisition, dataset development and analysis, and AI model development. We created an interactive platform that relies on a scalable microservice backend. This system can ingest 15,000 patient records per hour, where each record represents thousands of multimodal measurements, text notes, and high resolution data. Collectively, these records can approach a terabyte of data. The system can further perform cohort generation and preliminary dataset analysis in 2-5 minutes. As a result, multiple users can collaborate simultaneously to iterate on datasets and models in real time. We anticipate that this approach will drive real-world AI model development, and, in the long run, meaningfully improve healthcare delivery.