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Vít Nováček

Publications and source records attributed to Vít Nováček.

5 recordsLinked to original sources

CG-Probes: Recovering Guardrail Directions from Patient Query Embeddings

Patient-facing AI assistants promise valuable support to patients, but incoming queries can pose medical risks. To create guardrails, we work with oncologists to define three ordinal risk axes: Medical Urgency, Psychological Urgency, and Topic Sensitivity. We propose Clinical Guardrail Probes (CG-Probes) to measure the risks from query embeddings. We probe for each axis in the normalized embedding space of frozen embedders via the difference-in-means method, treating each axis as a potential linear direction. To train the probes, we cluster 79,658 Czech oncology search queries with BERTopic and use these clusters to generate pairs of queries with contrastive risk levels via few-shot prompting. We evaluate the approach on 200 queries (90 real, 110 synthetic), each graded by two oncologists, against two open-weight LLMs and a frontier LLM. We find that urgency-based axes are recoverable as linear directions, and the probes are competitive with open-weight LLMs (no significant differences in quadratic-weighted kappa) at a fraction of the latency. Each axis yields a scalar score that clinicians can inspect and use to set escalation thresholds. The pipeline requires only search logs, axis definitions, and black-box access to the embedding model, suggesting transferability across healthcare domains. Robust validation on new queries and axes remains future work.

cs.CL↗

Computing patient similarity based on unstructured clinical notes

Clinical notes hold rich yet unstructured details about diagnoses, treatments, and outcomes that are vital to precision medicine but hard to exploit at scale. We introduce a method that represents each patient as a matrix built from aggregated embeddings of all their notes, enabling robust patient similarity computation based on their latent low-rank representations. Using clinical notes of 4,267 Czech breast-cancer patients and expert similarity labels from Masaryk Memorial Cancer Institute, we evaluate several matrix-based similarity measures and analyze their strengths and limitations across different similarity facets, such as clinical history, treatment, and adverse events. The results demonstrate the usefulness of the presented method for downstream tasks, such as personalized therapy recommendations or toxicity warnings.

cs.LG↗

Evaluating Open-Weight Large Language Models for Structured Data Extraction from Narrative Medical Reports Across Multiple Use Cases and Languages

Large language models (LLMs) are increasingly used to extract structured information from free-text clinical records, but prior work often focuses on single tasks, limited models, and English-language reports. We evaluated 15 open-weight LLMs on pathology and radiology reports across six use cases, colorectal liver metastases, liver tumours, neurodegenerative diseases, soft-tissue tumours, melanomas, and sarcomas, at three institutes in the Netherlands, UK, and Czech Republic. Models included general-purpose and medical-specialised LLMs of various sizes, and six prompting strategies were compared: zero-shot, one-shot, few-shot, chain-of-thought, self-consistency, and prompt graph. Performance was assessed using task-appropriate metrics, with consensus rank aggregation and linear mixed-effects models quantifying variance. Top-ranked models achieved macro-average scores close to inter-rater agreement across tasks. Small-to-medium general-purpose models performed comparably to large models, while tiny and specialised models performed worse. Prompt graph and few-shot prompting improved performance by ~13%. Task-specific factors, including variable complexity and annotation variability, influenced results more than model size or prompting strategy. These findings show that open-weight LLMs can extract structured data from clinical reports across diseases, languages, and institutions, offering a scalable approach for clinical data curation.

cs.CL↗

Unsupervised extraction, labelling and clustering of segments from clinical notes

This work is motivated by the scarcity of tools for accurate, unsupervised information extraction from unstructured clinical notes in computationally underrepresented languages, such as Czech. We introduce a stepping stone to a broad array of downstream tasks such as summarisation or integration of individual patient records, extraction of structured information for national cancer registry reporting or building of semi-structured semantic patient representations for computing patient embeddings. More specifically, we present a method for unsupervised extraction of semantically-labelled textual segments from clinical notes and test it out on a dataset of Czech breast cancer patients, provided by Masaryk Memorial Cancer Institute (the largest Czech hospital specialising in oncology). Our goal was to extract, classify (i.e. label) and cluster segments of the free-text notes that correspond to specific clinical features (e.g., family background, comorbidities or toxicities). The presented results demonstrate the practical relevance of the proposed approach for building more sophisticated extraction and analytical pipelines deployed on Czech clinical notes.

cs.CL↗

Machine Learning-Assisted Recurrence Prediction for Early-Stage Non-Small-Cell Lung Cancer Patients

Background: Stratifying cancer patients according to risk of relapse can personalize their care. In this work, we provide an answer to the following research question: How to utilize machine learning to estimate probability of relapse in early-stage non-small-cell lung cancer patients? Methods: For predicting relapse in 1,387 early-stage (I-II), non-small-cell lung cancer (NSCLC) patients from the Spanish Lung Cancer Group data (65.7 average age, 24.8% females, 75.2% males) we train tabular and graph machine learning models. We generate automatic explanations for the predictions of such models. For models trained on tabular data, we adopt SHAP local explanations to gauge how each patient feature contributes to the predicted outcome. We explain graph machine learning predictions with an example-based method that highlights influential past patients. Results: Machine learning models trained on tabular data exhibit a 76% accuracy for the Random Forest model at predicting relapse evaluated with a 10-fold cross-validation (model was trained 10 times with different independent sets of patients in test, train and validation sets, the reported metrics are averaged over these 10 test sets). Graph machine learning reaches 68% accuracy over a 200-patient, held-out test set, calibrated on a held-out set of 100 patients. Conclusions: Our results show that machine learning models trained on tabular and graph data can enable objective, personalised and reproducible prediction of relapse and therefore, disease outcome in patients with early-stage NSCLC. With further prospective and multisite validation, and additional radiological and molecular data, this prognostic model could potentially serve as a predictive decision support tool for deciding the use of adjuvant treatments in early-stage lung cancer. Keywords: Non-Small-Cell Lung Cancer, Tumor Recurrence Prediction, Machine Learning

cs.LG↗