{"id":"https://openalex.org/W4404358993","doi":"https://doi.org/10.1161/circ.150.suppl_1.4144857","title":"Abstract 4144857: Large Language Models to Understand Reasons for Anticoagulation Nonprescription in Atrial Fibrillation","display_name":"Abstract 4144857: Large Language Models to Understand Reasons for Anticoagulation Nonprescription in Atrial Fibrillation","publication_year":2024,"publication_date":"2024-11-12","ids":{"openalex":"https://openalex.org/W4404358993","doi":"https://doi.org/10.1161/circ.150.suppl_1.4144857"},"language":"en","primary_location":{"id":"doi:10.1161/circ.150.suppl_1.4144857","doi":"https://doi.org/10.1161/circ.150.suppl_1.4144857","is_oa":false,"landing_page_url":"https://doi.org/10.1161/circ.150.suppl_1.4144857","pdf_url":null,"source":{"id":"https://openalex.org/S116251202","display_name":"Circulation","issn_l":"0009-7322","issn":["0009-7322","1524-4539"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["anvur-scientific","cwts-core","dongbi-a","doyens","jufo-3","ki-jl-3","medline","norway-2","poland-200","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310315671","host_organization_name":"Lippincott Williams & Wilkins","host_organization_lineage":["https://openalex.org/P4310315671","https://openalex.org/P4310318547"],"host_organization_lineage_names":["Lippincott Williams & Wilkins","Wolters Kluwer"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Circulation","raw_type":"journal-article"},"volume":null,"type":"conference-abstract","is_traditional":false,"indexed_in":["crossref"],"open_access":{"is_oa":false,"oa_status":"closed","oa_url":null,"any_repository_has_fulltext":false},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5032914921","display_name":"Sulaiman S. Somani","orcid":"https://orcid.org/0000-0003-0913-8674","observed_orcids":["https://orcid.org/0000-0003-0913-8674"]},"institutions":[{"id":"https://openalex.org/I97018004","display_name":"Stanford University","ror":"https://ror.org/00f54p054","country_code":"US","type":"education","lineage":["https://openalex.org/I97018004"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Sulaiman Somani","raw_affiliation_strings":["Stanford University, Menlo Park, California, United States"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Stanford University, Menlo Park, California, United States","institution_ids":["https://openalex.org/I97018004"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5075727557","display_name":"Dale Daniel Kim","orcid":"https://orcid.org/0000-0003-1987-3680","observed_orcids":["https://orcid.org/0000-0003-1987-3680"]},"institutions":[{"id":"https://openalex.org/I97018004","display_name":"Stanford University","ror":"https://ror.org/00f54p054","country_code":"US","type":"education","lineage":["https://openalex.org/I97018004"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Dale Kim","raw_affiliation_strings":["Stanford University, Menlo Park, California, United States"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Stanford University, Menlo Park, California, United States","institution_ids":["https://openalex.org/I97018004"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5104277899","display_name":"Eduardo J P\u00e9rez-Guerrero","orcid":"https://orcid.org/0009-0006-1899-7074","observed_orcids":["https://orcid.org/0009-0006-1899-7074"]},"institutions":[{"id":"https://openalex.org/I97018004","display_name":"Stanford University","ror":"https://ror.org/00f54p054","country_code":"US","type":"education","lineage":["https://openalex.org/I97018004"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Eduardo Perez","raw_affiliation_strings":["Stanford University, Menlo Park, California, United States"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Stanford University, Menlo Park, California, United States","institution_ids":["https://openalex.org/I97018004"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5045580090","display_name":"Summer Ngo","orcid":"https://orcid.org/0000-0002-7434-4143","observed_orcids":["https://orcid.org/0000-0002-7434-4143"]},"institutions":[{"id":"https://openalex.org/I97018004","display_name":"Stanford University","ror":"https://ror.org/00f54p054","country_code":"US","type":"education","lineage":["https://openalex.org/I97018004"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Summer Ngo","raw_affiliation_strings":["Stanford University, Menlo Park, California, United States"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Stanford University, Menlo Park, California, United States","institution_ids":["https://openalex.org/I97018004"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5023944464","display_name":"Tina Hernandez\u2010Boussard","orcid":"https://orcid.org/0000-0001-6553-3455","observed_orcids":["https://orcid.org/0000-0001-6553-3455"]},"institutions":[{"id":"https://openalex.org/I97018004","display_name":"Stanford University","ror":"https://ror.org/00f54p054","country_code":"US","type":"education","lineage":["https://openalex.org/I97018004"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Tina Hernandez-Boussard","raw_affiliation_strings":["Stanford University, Menlo Park, California, United States"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Stanford University, Menlo Park, California, United States","institution_ids":["https://openalex.org/I97018004"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5026322684","display_name":"F\u00e1tima Rodr\u00edguez","orcid":"https://orcid.org/0000-0002-5226-0723","observed_orcids":["https://orcid.org/0000-0002-5226-0723"]},"institutions":[{"id":"https://openalex.org/I97018004","display_name":"Stanford University","ror":"https://ror.org/00f54p054","country_code":"US","type":"education","lineage":["https://openalex.org/I97018004"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Fatima Rodriguez","raw_affiliation_strings":["Stanford University, Menlo Park, California, United States"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Stanford University, Menlo Park, California, United States","institution_ids":["https://openalex.org/I97018004"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":1,"corresponding_author_ids":[],"corresponding_institution_ids":["https://openalex.org/I97018004"],"apc_list":null,"apc_paid":null,"fwci":null,"has_fulltext":false,"cited_by_count":0,"citation_normalized_percentile":null,"cited_by_percentile_year":null,"biblio":{"volume":"150","issue":"Suppl_1","first_page":null,"last_page":null},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10065","display_name":"Atrial Fibrillation Management and Outcomes","score":0.9115999937057495,"subfield":{"id":"https://openalex.org/subfields/2705","display_name":"Cardiology and Cardiovascular Medicine"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T10065","display_name":"Atrial Fibrillation Management and Outcomes","score":0.9115999937057495,"subfield":{"id":"https://openalex.org/subfields/2705","display_name":"Cardiology and Cardiovascular Medicine"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T13702","display_name":"Machine Learning in Healthcare","score":0.05860000103712082,"subfield":{"id":"https://openalex.org/subfields/1702","display_name":"Artificial Intelligence"},"field":{"id":"https://openalex.org/fields/17","display_name":"Computer Science"},"domain":{"id":"https://openalex.org/domains/3","display_name":"Physical Sciences"}},{"id":"https://openalex.org/T11636","display_name":"Artificial Intelligence in Healthcare and Education","score":0.006000000052154064,"subfield":{"id":"https://openalex.org/subfields/2718","display_name":"Health Informatics"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/atrial-fibrillation","display_name":"atrial fibrillation","score":0.9649999737739563},{"id":"https://openalex.org/keywords/anticoagulation","display_name":"anticoagulation","score":0.8569999933242798},{"id":"https://openalex.org/keywords/care-gaps","display_name":"care gaps","score":0.5899999737739563},{"id":"https://openalex.org/keywords/large-language-models","display_name":"large language models","score":0.8920000195503235},{"id":"https://openalex.org/keywords/gpt-4","display_name":"GPT-4","score":0.8740000128746033},{"id":"https://openalex.org/keywords/clinical-notes","display_name":"clinical notes","score":0.796999990940094},{"id":"https://openalex.org/keywords/natural-language-processing","display_name":"natural language processing","score":0.7879999876022339},{"id":"https://openalex.org/keywords/antiplatelet-therapy","display_name":"antiplatelet therapy","score":0.5979999899864197},{"id":"https://openalex.org/keywords/patient-preferences","display_name":"patient preferences","score":0.765999972820282},{"id":"https://openalex.org/keywords/stroke-risk","display_name":"stroke risk","score":0.621999979019165},{"id":"https://openalex.org/keywords/inter-annotator-reliability","display_name":"inter-annotator reliability","score":0.8529999852180481},{"id":"https://openalex.org/keywords/clinical-decision-support","display_name":"clinical decision support","score":0.49399998784065247}],"concepts":[{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.9622501134872437},{"id":"https://openalex.org/C2779161974","wikidata":"https://www.wikidata.org/wiki/Q815819","display_name":"Atrial fibrillation","level":2,"score":0.845308780670166},{"id":"https://openalex.org/C164705383","wikidata":"https://www.wikidata.org/wiki/Q10379","display_name":"Cardiology","level":1,"score":0.4924348294734955},{"id":"https://openalex.org/C177713679","wikidata":"https://www.wikidata.org/wiki/Q679690","display_name":"Intensive care medicine","level":1,"score":0.44540610909461975},{"id":"https://openalex.org/C126322002","wikidata":"https://www.wikidata.org/wiki/Q11180","display_name":"Internal medicine","level":1,"score":0.4216890335083008}],"mesh":[],"locations_count":1,"locations":[{"id":"doi:10.1161/circ.150.suppl_1.4144857","doi":"https://doi.org/10.1161/circ.150.suppl_1.4144857","is_oa":false,"landing_page_url":"https://doi.org/10.1161/circ.150.suppl_1.4144857","pdf_url":null,"source":{"id":"https://openalex.org/S116251202","display_name":"Circulation","issn_l":"0009-7322","issn":["0009-7322","1524-4539"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["anvur-scientific","cwts-core","dongbi-a","doyens","jufo-3","ki-jl-3","medline","norway-2","poland-200","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310315671","host_organization_name":"Lippincott Williams & Wilkins","host_organization_lineage":["https://openalex.org/P4310315671","https://openalex.org/P4310318547"],"host_organization_lineage_names":["Lippincott Williams & Wilkins","Wolters Kluwer"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Circulation","raw_type":"journal-article"}],"best_oa_location":null,"sustainable_development_goals":[{"display_name":"Good health and well-being","score":0.9922999739646912,"id":"https://metadata.un.org/sdg/3"}],"study_designs":[],"awards":[],"funders":[],"has_content":{"pdf":false,"grobid_xml":false},"content_urls":null,"referenced_works_count":0,"referenced_works":[],"related_works":["https://openalex.org/W4408883481","https://openalex.org/W4415790601","https://openalex.org/W7124254322","https://openalex.org/W4283760184","https://openalex.org/W4402716977","https://openalex.org/W2807498743","https://openalex.org/W4396768330","https://openalex.org/W7154950429","https://openalex.org/W4410896853","https://openalex.org/W7155357230"],"abstract_inverted_index":{"Introduction/Aims:":[0],"Anticoagulation":[1],"(AC)":[2],"reduces":[3],"the":[4,90,98,122,216],"risk":[5,265],"of":[6,51,81,105,141,147,176,211,285],"stroke":[7,264],"in":[8,43,194],"atrial":[9],"fibrillation":[10],"(AF),":[11],"yet":[12],"nonprescription":[13,39,94,101,191,317],"rates":[14],"near":[15],"50%.":[16],"Reasons":[17],"for":[18,37,62,88,92,100,116,121,185,189,222,252,273,282,295,315],"this":[19],"care":[20],"gap":[21],"are":[22],"not":[23,152],"well":[24],"understood.":[25],"Large":[26],"language":[27],"models":[28],"(LLMs)":[29],"may":[30],"be":[31,334],"able":[32],"to":[33,108,336,342],"extract":[34],"documented":[35,96,224],"reasons":[36,225,314],"AC":[38,93,156,169,190,204,276,300,316,325],"from":[40,68,164],"unstructured":[41],"text":[42],"clinical":[44],"notes.":[45],"Methods:":[46],"We":[47],"created":[48],"a":[49,57,117,308],"cohort":[50],"all":[52,82],"index":[53],"patient":[54,254],"encounters":[55,144,159],"with":[56,102,198,234],"clinician-billed":[58],"ICD10":[59],"diagnosis":[60],"code":[61],"AF":[63,212,286,304,310,329],"at":[64],"Stanford":[65],"Health":[66],"Care":[67],"January":[69],"1,":[70],"2015":[71],"through":[72],"December":[73],"31,":[74],"2023.":[75],"Three":[76],"trained":[77],"reviewers":[78,221],"annotated":[79],"10%":[80],"AF-":[83,167],"or":[84],"AC-related":[85],"note":[86],"excerpts":[87,171],"whether":[89],"reason":[91,99],"was":[95,192,226,236,270],"and":[97,128,168,180,208,262,289,302,327,338],"an":[103,154],"overlap":[104],"100":[106],"notes":[107,179],"assess":[109],"annotator":[110],"performance.":[111],"Zero-shot":[112],"prompts":[113],"were":[114,132,145,172,183],"designed":[115],"proprietary":[118],"LLM":[119],"(GPT4)":[120],"same":[123],"tasks.":[124],"Inter-annotator":[125],"reliability":[126,130],"(IRR)":[127],"model-annotator":[129],"(MAR)":[131],"assessed":[133],"using":[134],"Cohen\u2019s":[135],"kappa":[136],"coefficient.":[137],"Results:":[138],"A":[139],"total":[140],"35,737":[142],"AF-related":[143],"identified,":[146],"which":[148,165],"7,712":[149],"(21.6%)":[150],"did":[151],"have":[153],"active":[155],"prescription.":[157],"These":[158],"contained":[160],"9,143":[161],"associated":[162],"notes,":[163,197],"21,573":[166],"related":[170],"extracted.":[173],"Ten":[174],"percent":[175],"these":[177],"(911":[178],"2,175":[181],"excerpts)":[182],"allocated":[184],"manual":[186],"annotation.":[187],"Reason":[188],"recorded":[193],"497":[195],"(54.6%)":[196],"antiplatelet":[199,258,319],"use":[200,259,320],"(N=172,":[201],"18.6%),":[202],"perceived":[203,275,324],"contraindication":[205,277],"(N=134,":[206],"14.7%),":[207],"low":[209,263,283,328],"burden":[210,284],"(N=131,":[213],"13.9%)":[214],"being":[215],"most":[217],"common.":[218],"IRR":[219],"across":[220],"identifying":[223,253,274,296],"0.776":[227],"(95%":[228,238],"CI":[229,239],"0.716,":[230],"0.837),":[231],"while":[232],"MAR":[233,267],"GPT4":[235,245],"0.609,":[237],"0.460,":[240],"0.758;":[241],"P":[242],"=":[243],"0.011).":[244],"achieved":[246],"substantial":[247],"agreement":[248,272,281,291],"(MAR":[249,256,260,278,287,292],">":[250],"0.6)":[251],"preference":[255],"0.763),":[257],"0.676),":[261],"(mean":[266],"0.891).":[268],"There":[269],"moderate":[271],"0.589),":[279],"fair":[280],"0.282),":[288],"poor":[290],"<":[293],"0.2)":[294],"therapeutic":[297],"inertia,":[298],"existing":[299],"use,":[301],"prior":[303],"ablation.":[305],"Conclusions:":[306],"Across":[307],"contemporary":[309],"cohort,":[311],"LLMs":[312],"categorized":[313],"including":[318],"as":[321],"alternative":[322],"agents,":[323],"contraindication,":[326],"burden.":[330],"This":[331],"approach":[332],"can":[333],"leveraged":[335],"understand":[337],"mitigate":[339],"actionable":[340],"barriers":[341],"guideline":[343],"directed":[344],"cardiovascular":[345],"care.":[346]},"counts_by_year":[],"updated_date":"2026-10-14T16:39:01.820549","created_date":"2024-11-15T00:00:00"}
