Training Large Language Models with Clinical Data: Challenges and Future Directions
Keywords:
Large language models (LLMs), Clinical data, Healthcare AI, Privacy-preserving techniques, Model interpretability, Ethical AI in healthcare, Federated learning, Data standardization and Explainable AI (XAI)Abstract
LLMs show high performance in multiple fields and applications and could benefit healthcare for better patient management, prediction and decision support. However, the sensitivity and complexity of healthcare data makes it challenging to use clinical data in these models. Here, we examine these issues with reference to the four domains of data privacy, model interpretability, technical limitations and ethical implications; with a view to their relevance in relation to applications in healthcare. We examine the current best practices, suggest approaches for safe data exchange, transparent model interpretation and domain-specific training processes in real clinical settings. Finally, we outline future research directions to help develop LLMs for clinical use that protect patient privacy, which we argue can only be achieved with strong interdisciplinary collaboration and regulation of clinical data use. We hope that our results will help scholars, policymakers, and clinicians navigate toward ethical and efficient solutions for utilizing LLMs in healthcare.
References
Lee, J., et al. (2020). BioBERT: a pre-trained biomedical language representation model for biomedical text mining. Bioinformatics, 36(4), 1234-1240.
Abd-Alrazaq, A., AlSaad, R., Alhuwail, D., Ahmed, A., Healy, P. M., Latifi, S., ... & Sheikh, J. (2023). Large language models in medical education: opportunities, challenges, and future directions. JMIR Medical Education, 9(1), e48291.
Brown, T. B., et al. (2020). Language models are few-shot learners. Advances in Neural Information Processing Systems, 33, 1877-1901.
JOSHI, D., SAYED, F., BERI, J., & PAL, R. (2021). An efficient supervised machine learning model approach for forecasting of renewable energy to tackle climate change. Int J Comp Sci Eng Inform Technol Res, 11, 25-32.
Yadav N, Pandey S, Gupta A, Dudani P, Gupta S, Rangarajan K. Data Privacy in Healthcare: In the Era of Artificial Intelligence. Indian Dermatol Online J. 2023 Oct 27;14(6):788-792. doi: 10.4103/idoj.idoj_543_23. PMID: 38099022; PMCID: PMC10718098.
Wang, F., & Preininger, A. (2019). AI in health: state of the art, challenges, and future directions. Yearbook of medical informatics, 28(01), 016-026.
Kenneth, E., & Ohia, P. (2021). Integrating Real-Time Drilling Fluid Monitoring and Predictive Analytics for Incident Prevention and Environmental Protection in Complex Drilling Operations. Journal of Artificial Intelligence Research, 1(1), 157-185.
Thirunavukarasu, A. J., Ting, D. S. J., Elangovan, K., Gutierrez, L., Tan, T. F., & Ting, D. S. W. (2023). Large language models in medicine. Nature medicine, 29(8), 1930-1940.
Rudresh Dwivedi, Devam Dave, Het Naik, Smiti Singhal, Rana Omer, Pankesh Patel, Bin Qian, Zhenyu Wen, Tejal Shah, Graham Morgan, and Rajiv Ranjan. 2023. Explainable AI (XAI): Core Ideas, Techniques, and Solutions. ACM Comput. Surv. 55, 9, Article 194 (September 2023), 33 pages. https://doi.org/10.1145/3561048
Doshi-Velez, F., & Kim, B. (2017). Towards a rigorous science of interpretable machine learning. arXiv preprint arXiv:1702.08608.
Dwork, C., & Roth, A. (2014). The algorithmic foundations of differential privacy. Foundations and Trends® in Theoretical Computer Science, 9(3–4), 211-407.
Khambati, A. (2021). Innovative Smart Water Management System Using Artificial Intelligence. Turkish Journal of Computer and Mathematics Education (TURCOMAT), 12(3), 4726-4734..
Doe, A., & Garcia, K. (2021). Privacy-Preserving Methods for Machine Learning in Healthcare. Medical Data Privacy Journal, 14(1), 37-49.
Joshi, D., Sayed, F., Saraf, A., Sutaria, A., & Karamchandani, S. (2021). Elements of Nature Optimized into Smart Energy Grids using Machine Learning. Design Engineering, 1886-1892.
Ampavathi, A. (2022). Research challenges and future directions towards medical data processing. Computer Methods in Biomechanics and Biomedical Engineering: Imaging & Visualization, 10(6), 633-652.
Chow, J. C., Wong, V., & Li, K. (2024). Generative Pre-Trained Transformer-Empowered Healthcare Conversations: Current Trends, Challenges, and Future Directions in Large Language Model-Enabled Medical Chatbots. BioMedInformatics, 4(1), 837-852.
Subramanian, C. R., Yang, D. A., & Khanna, R. (2024). Enhancing health care communication with large language models—the role, challenges, and future directions. JAMA Network Open, 7(3), e240347-e240347.
Kenneth, E. (2020). Evaluating the Impact of Drilling Fluids on Well Integrity and Environmental Compliance: A Comprehensive Study of Offshore and Onshore Drilling Operations. Journal of Science & Technology, 1(1), 829-864.
Singhal, K., Azizi, S., Tu, T., Mahdavi, S. S., Wei, J., Chung, H. W., ... & Natarajan, V. (2023). Large language models encode clinical knowledge. Nature, 620(7972), 172-180.
Joshi, D., Parikh, A., Mangla, R., Sayed, F., & Karamchandani, S. H. (2021). AI Based Nose for Trace of Churn in Assessment of Captive Customers. Turkish Online Journal of Qualitative Inquiry, 12(6).
Khabibullaev, T. (2024). Navigating the Ethical, Organizational, and Societal Impacts of Generative AI: Balancing Innovation with Responsibility. Zenodo. https://doi.org/10.5281/zenodo.13995243
Tan, Z., & Jiang, M. (2023). User modeling in the era of large language models: Current research and future directions. arXiv preprint arXiv:2312.11518.
Khambaty, A., Joshi, D., Sayed, F., Pinto, K., & Karamchandani, S. (2022, January). Delve into the Realms with 3D Forms: Visualization System Aid Design in an IOT-Driven World. In Proceedings of International Conference on Wireless Communication: ICWiCom 2021 (pp. 335-343). Singapore: Springer Nature Singapore.
SHUKLA, TANMAY. "Beyond Diagnosis: AI’s Role in Preventive Healthcare and Early Detection." (2024)
Yao, Y., Zhang, J., Wu, J., Huang, C., Xia, Y., Yu, T., ... & Joe-Wong, C. (2024). Federated Large Language Models: Current Progress and Future Directions. arXiv preprint arXiv:2409.15723.
He, Y., Huang, F., Jiang, X., Nie, Y., Wang, M., Wang, J., & Chen, H. (2024). Foundation model for advancing healthcare: Challenges, opportunities, and future directions. arXiv preprint arXiv:2404.03264.
Wu, D. (2024). The effects of data preprocessing on probability of default model fairness. arXiv preprint arXiv:2408.15452.
Downloads
Published
How to Cite
Issue
Section
License
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
License Terms
Ownership and Licensing:
Authors of this research paper submitted to the journal owned and operated by The Science Brigade Group retain the copyright of their work while granting the journal certain rights. Authors maintain ownership of the copyright and have granted the journal a right of first publication. Simultaneously, authors agreed to license their research papers under the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International (CC BY-NC-SA 4.0) License.
License Permissions:
Under the CC BY-NC-SA 4.0 License, others are permitted to share and adapt the work, as long as proper attribution is given to the authors and acknowledgement is made of the initial publication in the Journal. This license allows for the broad dissemination and utilization of research papers.
Additional Distribution Arrangements:
Authors are free to enter into separate contractual arrangements for the non-exclusive distribution of the journal's published version of the work. This may include posting the work to institutional repositories, publishing it in journals or books, or other forms of dissemination. In such cases, authors are requested to acknowledge the initial publication of the work in this Journal.
Online Posting:
Authors are encouraged to share their work online, including in institutional repositories, disciplinary repositories, or on their personal websites. This permission applies both prior to and during the submission process to the Journal. Online sharing enhances the visibility and accessibility of the research papers.
Responsibility and Liability:
Authors are responsible for ensuring that their research papers do not infringe upon the copyright, privacy, or other rights of any third party. The Science Brigade Publishers disclaim any liability or responsibility for any copyright infringement or violation of third-party rights in the research papers.