arXiv subjects

Malvika Pillai

Publications and source records attributed to Malvika Pillai.

3 recordsLinked to original sources

arXiv2026

PrecLLM: A Privacy-Preserving Framework for Efficient Clinical Annotation Extraction from Unstructured EHRs using Small-Scale LLMs

Large Language Models (LLMs) have demonstrated remarkable proficiency in automated text annotation within natural language processing. However, their deployment in clinical settings is severely constrained by strict privacy regulations and the prohibitive computational cost of processing voluminous unstructured Electronic Health Records (EHRs). In this study, we developed a resource-efficient preprocessing technique that can be adopted in existing LLM procedures. This approach is particularly useful for smaller LLMs, which are often more accuracy-challenged, and forms a compact LLM framework optimized for local deployment in computational environments with stringent privacy requirements and restricted access to high-performance GPUs (PrecLLM). The preprocessing step includes both regular expressions (regex) and Retrieval-Augmented Generation (RAG) to extract and highlight key information from unstructured clinical notes. Pre-filtering long and unstructured texts enhanced the performance of smaller LLMs on EHR-related tasks. Evaluation was performed on two distinct cohorts: a locally curated private EHR dataset from the EPIC system for a Head and Neck Cancer (HNC) cohort, and the publicly available EHR dataset (MIMIC-IV). Using MIMIC-IV, we further compared PrecLLM against fine-tuned LLMs. Results demonstrated that PrecLLM substantially enhanced the performance of the original smaller LLMs in terms of sensitivity, specificity, and F1 scores, making it well-suited for privacy-sensitive and resource-constrained applications. This study offers optimized LLM performance for local, secure, and efficient healthcare applications, and provides practical guidance for clinical LLM deployment while addressing challenges related to privacy, computational feasibility, and clinical applicability.

cs.AI↗

arXiv2024

FairEHR-CLP: Towards Fairness-Aware Clinical Predictions with Contrastive Learning in Multimodal Electronic Health Records

In the high-stakes realm of healthcare, ensuring fairness in predictive models is crucial. Electronic Health Records (EHRs) have become integral to medical decision-making, yet existing methods for enhancing model fairness restrict themselves to unimodal data and fail to address the multifaceted social biases intertwined with demographic factors in EHRs. To mitigate these biases, we present FairEHR-CLP: a general framework for Fairness-aware Clinical Predictions with Contrastive Learning in EHRs. FairEHR-CLP operates through a two-stage process, utilizing patient demographics, longitudinal data, and clinical notes. First, synthetic counterparts are generated for each patient, allowing for diverse demographic identities while preserving essential health information. Second, fairness-aware predictions employ contrastive learning to align patient representations across sensitive attributes, jointly optimized with an MLP classifier with a softmax layer for clinical classification tasks. Acknowledging the unique challenges in EHRs, such as varying group sizes and class imbalance, we introduce a novel fairness metric to effectively measure error rate disparities across subgroups. Extensive experiments on three diverse EHR datasets on three tasks demonstrate the effectiveness of FairEHR-CLP in terms of fairness and utility compared with competitive baselines. FairEHR-CLP represents an advancement towards ensuring both accuracy and equity in predictive healthcare models.

cs.LG↗

arXiv2024

Unveiling and Mitigating Bias in Mental Health Analysis with Large Language Models

The advancement of large language models (LLMs) has demonstrated strong capabilities across various applications, including mental health analysis. However, existing studies have focused on predictive performance, leaving the critical issue of fairness underexplored, posing significant risks to vulnerable populations. Despite acknowledging potential biases, previous works have lacked thorough investigations into these biases and their impacts. To address this gap, we systematically evaluate biases across seven social factors (e.g., gender, age, religion) using ten LLMs with different prompting methods on eight diverse mental health datasets. Our results show that GPT-4 achieves the best overall balance in performance and fairness among LLMs, although it still lags behind domain-specific models like MentalRoBERTa in some cases. Additionally, our tailored fairness-aware prompts can effectively mitigate bias in mental health predictions, highlighting the great potential for fair analysis in this field.

cs.CL↗