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Streamlining evidence based clinical recommendations with large language models

arXiv:2505.10282v2 Announce Type: replace-cross Abstract: Clinical evidence underpins informed healthcare decisions, yet integrating it into real-time practice remains challenging due to intensive workloads, complex procedures, and time constraints. This study presents Quicker, an LLM-powered system that automates evidence synthesis and generates clinical recommendations following standard guideline development workflows. Quicker delivers an end-to-end pipeline from clinical questions to recommendations and supports customized decision-making through integrated tools and interactive interfaces. To evaluate how closely Quicker can reproduce guideline development processes, we constructed Q2CRBench-3, a benchmark derived from guideline development records for three diseases. Experiments show that Quicker produces precise question decomposition, expert-aligned retrieval, and near-comprehensive screening. Quicker assistance improved the accuracy of extracted study data, and its recommendations were more comprehensive and coherent than clinician-written ones. In system-level testing, Quicker working with one participant reduced recommendation development to 20-40 min. Overall, the findings demonstrate Quicker's potential to enhance the speed and reliability of evidence-based clinical decision-making.

CliCARE: Grounding Large Language Models in Clinical Guidelines for Decision Support over Longitudinal Cancer Electronic Health Records

arXiv:2507.22533v2 Announce Type: replace-cross Abstract: Large Language Models (LLMs) hold significant promise for improving clinical decision support and reducing physician burnout by synthesizing complex, longitudinal cancer Electronic Health Records (EHRs). However, their implementation in this critical field faces three primary challenges: the inability to effectively process the extensive length and fragmented nature of patient records for accurate temporal analysis; a heightened risk of clinical hallucination, as conventional grounding techniques such as Retrieval-Augmented Generation (RAG) do not adequately incorporate process-oriented clinical guidelines; and unreliable evaluation metrics that hinder the validation of AI systems in oncology. To address these issues, we propose CliCARE, a framework for Grounding Large Language Models in Clinical Guidelines for Decision Support over Longitudinal Cancer Electronic Health Records. The framework operates by transforming unstructured, longitudinal EHRs into patient-specific Temporal Knowledge Graphs (TKGs) to capture long-range dependencies, and then grounding the decision support process by aligning these real-world patient trajectories with a normative guideline knowledge graph. This approach provides oncologists with evidence-grounded decision support by generating a high-fidelity clinical summary and an actionable recommendation. We validated our framework using large-scale, longitudinal data from a private Chinese cancer dataset and the public English MIMIC-IV dataset. In these settings, CliCARE significantly outperforms baselines, including leading long-context LLMs and Knowledge Graph-enhanced RAG methods. The clinical validity of our results is supported by a robust evaluation protocol, which demonstrates a high correlation with assessments made by oncologists.
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