arXiv subjects

Heloisa Oss Boll

Publications and source records attributed to Heloisa Oss Boll.

3 recordsLinked to original sources

arXiv2026

DeVisE: Behavioral Testing of Medical Large Language Models

Large language models (LLMs) are increasingly applied in clinical decision support, yet current evaluations rarely reveal whether their outputs reflect genuine medical reasoning or superficial correlations. We introduce DeVisE (Demographics and Vital signs Evaluation), a behavioral testing framework that probes fine-grained clinical understanding through controlled counterfactuals. Using intensive care unit (ICU) discharge notes from MIMIC-IV, we construct both raw (real-world) and template-based (synthetic) variants with single-variable perturbations in demographic (age, gender, ethnicity) and vital sign attributes. We evaluate eight LLMs, spanning general-purpose and medical variants, under zero-shot setting. Model behavior is analyzed through (1) input-level sensitivity, capturing how counterfactuals alter perplexity, and (2) downstream reasoning, measuring their effect on predicted ICU length-of-stay and mortality. Overall, our results show that standard task metrics obscure clinically relevant differences in model behavior, with models differing substantially in how consistently and proportionally they adjust predictions to counterfactual perturbations.

cs.CL↗

arXiv2026

DistillNote: Toward a Functional Evaluation Framework of LLM-Generated Clinical Note Summaries

Large language models (LLMs) are increasingly used to generate summaries from clinical notes. However, their ability to preserve essential diagnostic information remains underexplored, which could lead to serious risks for patient care. This study introduces DistillNote, an evaluation framework for LLM summaries that targets their functional utility by applying the generated summary downstream in a complex clinical prediction task, explicitly quantifying how much prediction signal is retained. We generated over 192,000 LLM summaries from MIMIC-IV clinical notes with increasing compression rates: standard, section-wise, and distilled section-wise. Heart failure diagnosis was chosen as the prediction task, as it requires integrating a wide range of clinical signals. LLMs were fine-tuned on both the original notes and their summaries, and their diagnostic performance was compared using the AUROC metric. We contrasted DistillNote's results with evaluations from LLM-as-judge and clinicians, assessing consistency across different evaluation methods. Summaries generated by LLMs maintained a strong level of heart failure diagnostic signal despite substantial compression. Models trained on the most condensed summaries (about 20 times smaller) achieved an AUROC of 0.92, compared to 0.94 with the original note baseline (97 percent retention). Functional evaluation provided a new lens for medical summary assessment, emphasizing clinical utility as a key dimension of quality. DistillNote introduces a new scalable, task-based method for assessing the functional utility of LLM-generated clinical summaries. Our results detail compression-to-performance tradeoffs from LLM clinical summarization for the first time. The framework is designed to be adaptable to other prediction tasks and clinical domains, aiding data-driven decisions about deploying LLM summarizers in real-world healthcare settings.

cs.CL↗

arXiv2024

Graph Neural Networks for Heart Failure Prediction on an EHR-Based Patient Similarity Graph

Objective: In modern healthcare, accurately predicting diseases is a crucial matter. This study introduces a novel approach using graph neural networks (GNNs) and a Graph Transformer (GT) to predict the incidence of heart failure (HF) on a patient similarity graph at the next hospital visit. Materials and Methods: We used electronic health records (EHR) from the MIMIC-III dataset and applied the K-Nearest Neighbors (KNN) algorithm to create a patient similarity graph using embeddings from diagnoses, procedures, and medications. Three models - GraphSAGE, Graph Attention Network (GAT), and Graph Transformer (GT) - were implemented to predict HF incidence. Model performance was evaluated using F1 score, AUROC, and AUPRC metrics, and results were compared against baseline algorithms. An interpretability analysis was performed to understand the model's decision-making process. Results: The GT model demonstrated the best performance (F1 score: 0.5361, AUROC: 0.7925, AUPRC: 0.5168). Although the Random Forest (RF) baseline achieved a similar AUPRC value, the GT model offered enhanced interpretability due to the use of patient relationships in the graph structure. A joint analysis of attention weights, graph connectivity, and clinical features provided insight into model predictions across different classification groups. Discussion and Conclusion: Graph-based approaches such as GNNs provide an effective framework for predicting HF. By leveraging a patient similarity graph, GNNs can capture complex relationships in EHR data, potentially improving prediction accuracy and clinical interpretability.

cs.LG↗