论文标题

痛苦点:基于语言的慢性疼痛和专家授权文本仪式的框架

PainPoints: A Framework for Language-based Detection of Chronic Pain and Expert-Collaborative Text-Summarization

论文作者

Fadnavis, Shreyas, Dhurandhar, Amit, Norel, Raquel, Reinen, Jenna M, Agurto, Carla, Secchettin, Erica, Schweiger, Vittorio, Perini, Giovanni, Cecchi, Guillermo

论文摘要

慢性疼痛是一种普遍的疾病,通常非常残疾,并且与抑郁症和焦虑等合并症有关。神经性疼痛(NP)是一种常见的亚型,通常是由于神经损伤引起的,并且具有已知的病理生理学。另一个常见的亚型是纤维肌痛(FM),被称为肌肉骨骼,弥漫性疼痛,在体内广泛。 FM的病理生理学知之甚少,因此很难诊断。 FM和NP的标准药物和治疗彼此不同,如果误诊,它可能会导致症状严重程度的增加。为了克服这一困难,我们提出了一个新颖的框架,即Painpoints,该框架准确地检测到疼痛的子类型,并通过总结患者访谈产生临床笔记。具体而言,Painpoints使用大型语言模型来执行从FM和NP患者访谈中获得的句子级分类,其可靠AUC为0.83。使用基于充分的可解释性方法,我们解释了微调模型如何准确地了解患者用来描述疼痛的细微差别。最后,我们通过引入一种新颖的基于方面的方法来通过专家干预来摘要这些访谈。因此,Painpoints使从业人员能够添加/删除面部,并基于“ Facet-Coverage”的概念生成自定义摘要,该概念在这项工作中也引入了。

Chronic pain is a pervasive disorder which is often very disabling and is associated with comorbidities such as depression and anxiety. Neuropathic Pain (NP) is a common sub-type which is often caused due to nerve damage and has a known pathophysiology. Another common sub-type is Fibromyalgia (FM) which is described as musculoskeletal, diffuse pain that is widespread through the body. The pathophysiology of FM is poorly understood, making it very hard to diagnose. Standard medications and treatments for FM and NP differ from one another and if misdiagnosed it can cause an increase in symptom severity. To overcome this difficulty, we propose a novel framework, PainPoints, which accurately detects the sub-type of pain and generates clinical notes via summarizing the patient interviews. Specifically, PainPoints makes use of large language models to perform sentence-level classification of the text obtained from interviews of FM and NP patients with a reliable AUC of 0.83. Using a sufficiency-based interpretability approach, we explain how the fine-tuned model accurately picks up on the nuances that patients use to describe their pain. Finally, we generate summaries of these interviews via expert interventions by introducing a novel facet-based approach. PainPoints thus enables practitioners to add/drop facets and generate a custom summary based on the notion of "facet-coverage" which is also introduced in this work.

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