SDoH-GPT: using large language models to extract social determinants of health

作者：Bernardo Scapini Consoli, Haoyang Wang, Xizhi Wu, Song Wang, Xingyu Zhao, Yanshan Wang, Justin F. Rousseau, Tom Hartvigsen, Li Shen, Huanmei Wu, Yifan Peng, Qi Long, Tianlong Chen, Ying Ding · 发表于：Journal of the American Medical Informatics Association · 年份：2025 · DOI：10.1093/jamia/ocaf094 · 被引用次数：15 · 研究领域：Food Security and Health in Diverse Populations、Machine Learning in Healthcare、Mental Health via Writing

OBJECTIVE: Extracting social determinants of health (SDoHs) from medical notes depends heavily on labor-intensive annotations, which are typically task-specific, hampering reusability and limiting sharing. Here, we introduce SDoH-GPT, a novel framework leveraging few-shot learning large language models (LLMs) to automate the extraction of SDoH from unstructured text, aiming to improve both efficiency and generalizability. MATERIALS AND METHODS: SDoH-GPT is a framework including the few-shot learning LLM methods to extract the SDoH from medical notes and the XGBoost classifiers which continue to classify SDoH using the annotations generated by the few-shot learning LLM methods as training datasets. The unique combination of the few-shot learning LLM methods with XGBoost utilizes the strength of LLMs as great few shot learners and the efficiency of XGBoost when the training dataset is sufficient. Therefore, SDoH-GPT can extract SDoH without relying on extensive medical annotations or costly human intervention. RESULTS: Our approach achieved tenfold and twentyfold reductions in time and cost, respectively, and superior consistency with human annotators measured by Cohen's kappa of up to 0.92. The innovative combination of LLM and XGBoost can ensure high accuracy and computational efficiency while consistently maintaining 0.90+ AUROC scores. DISCUSSION: This study has verified SDoH-GPT on three datasets and highlights the potential of leveraging LLM and XGBoost to revolutionize m...