Cited by 27Machine Learning in HealthcareBiomedical Text Mining and OntologiesTopic Modeling

Evaluating local open-source large language models for data extraction from unstructured reports on mechanical thrombectomy in patients with ischemic stroke

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Meddeb, Aymen, Ebert, Philipe, Bressem, Keno Kyrill, Desser, Dmitriy, Dell'Orco, Andrea, Bohner, Georg, Kleine, Justus F, Siebert, Eberhard +5 more·2025·Journal of NeuroInterventional Surgery

Abstract

BACKGROUND: A study was undertaken to assess the effectiveness of open-source large language models (LLMs) in extracting clinical data from unstructured mechanical thrombectomy reports in patients with ischemic stroke caused by a vessel occlusion. METHODS: We deployed local open-source LLMs to extract data points from free-text procedural reports in patients who underwent mechanical thrombectomy between September 2020 and June 2023 in our institution. The external dataset was obtained from a second university hospital and comprised consecutive cases treated between September 2023 and March 2024. Ground truth labeling was facilitated by a human-in-the-loop (HITL) approach, with time metrics recorded for both automated and manual data extractions. We tested three models-Mixtral, Qwen, and BioMistral-assessing their performance on precision, recall, and F1 score across 15 clinical categories such as National Institute of Health Stroke Scale (NIHSS) scores, occluded vessels, and medication details. RESULTS: The study included 1000 consecutive reports from our primary institution and 50 reports from a secondary institution. Mixtral showed the highest precision, achieving 0.99 for first series time extraction and 0.69 for occluded vessel identification within the internal dataset. In the external dataset, precision ranged from 1.00 for NIHSS scores to 0.70 for occluded vessels. Qwen showed moderate precision with a high of 0.85 for NIHSS scores and a low of 0.28 for occluded vessels. BioMistral had the broadest range of precision, from 0.81 for first series times to 0.14 for medication details. The HITL approach yielded an average time savings of 65.6% per case, with variations from 45.95% to 79.56%. CONCLUSION: This study highlights the potential of using LLMs for automated clinical data extraction from medical reports. Incorporating HITL annotations enhances precision and also ensures the reliability of the extracted data. This methodology presents a scalable privacy-preserving option that can significantly support clinical documentation and research endeavors.

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Authors
Meddeb, A., Ebert, P., Bressem, K. K., Desser, D., Dell'Orco, A., Bohner, G., Kleine, J. F., Siebert, E., Grauhan, N., Brockmann, M. A., Othman, A., Scheel, M., & Nawabi, J.
Affiliations
  • Centre Hospitalier Universitaire de Reims (FR)
  • Stiftung Charité (DE)
  • Deutsches Herzzentrum München (DE)
  • Department of Neuroradiology, Charité Universitätsmedizin Berlin, Berlin, Germany
  • University Medical Center of the Johannes Gutenberg University Mainz (DE)
  • Department of Neuroradiology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
Corresponding author
Meddeb, Aymen
Venue
Journal of NeuroInterventional Surgery
Publisher
BMJ
Published
2024-08-02
Volume
17
Issue
9
Pages
986-991
ISSN
  • 1759-8478 (ISSN-L)
  • 1759-8486
OpenAlex
W4401248212
Cited by
27
References
33
Citations by year
2026: 12 · 2025: 15
FWCI
3.98
Type
journal article
Language
en
Open access
Locations
  • Journal of NeuroInterventional Surgery (publishedVersion, cc-by-nc)
  • PubMed Central (publishedVersion, cc-by-nc)
  • PubMed (publishedVersion)
  • mediaTUM – the media and publications repository of the Technical University Munich (Technical University Munich) (submittedVersion)
Funders
Berlin Institute of Health
Topics
  • Physical Sciences › Computer Science › Artificial Intelligence › Machine Learning in Healthcare
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Biomedical Text Mining and Ontologies
  • Physical Sciences › Computer Science › Artificial Intelligence › Topic Modeling
Keywords
large language models, clinical information extraction, mechanical thrombectomy, ischemic stroke, human-in-the-loop annotation, NIHSS score, medication extraction, Mixtral, Qwen
MeSH terms
Ischemic Stroke, Large Language Models, Aged, Female, Humans, Information Storage and Retrieval, Thrombectomy, Data Mining, Mechanical Thrombolysis

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