{"id":"https://openalex.org/W7158937755","doi":"https://doi.org/10.48550/arxiv.2604.26766","title":"Domain-Adapted Small Language Models for Reliable Clinical Triage","display_name":"Domain-Adapted Small Language Models for Reliable Clinical Triage","publication_year":2026,"publication_date":"2026-04-29","ids":{"openalex":"https://openalex.org/W7158937755","doi":"https://doi.org/10.48550/arxiv.2604.26766"},"language":null,"primary_location":{"id":"doi:10.48550/arxiv.2604.26766","is_oa":true,"landing_page_url":"https://doi.org/10.48550/arxiv.2604.26766","pdf_url":null,"source":{"id":"https://openalex.org/S4306400194","display_name":"arXiv (Cornell University)","issn_l":null,"issn":null,"is_oa":true,"is_in_doaj":false,"is_core":false,"host_organization":"https://openalex.org/I205783295","host_organization_name":"Cornell University","host_organization_lineage":["https://openalex.org/I205783295"],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":null,"is_accepted":false,"is_published":false,"raw_source_name":null,"raw_type":"Preprint"},"type":"preprint","indexed_in":["datacite"],"open_access":{"is_oa":true,"oa_status":"green","oa_url":"https://doi.org/10.48550/arxiv.2604.26766","any_repository_has_fulltext":true},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5134888437","display_name":"Manar Aljohani","orcid":null},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Aljohani, Manar","raw_affiliation_strings":[],"raw_orcid":null,"affiliations":[]},{"author_position":"middle","author":{"id":"https://openalex.org/A5134891236","display_name":"Brandon Ho","orcid":null},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Ho, Brandon","raw_affiliation_strings":[],"raw_orcid":null,"affiliations":[]},{"author_position":"middle","author":{"id":"https://openalex.org/A5073493311","display_name":"Kenneth McKinley","orcid":"https://orcid.org/0000-0003-4624-5778"},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"McKinley, Kenneth","raw_affiliation_strings":[],"raw_orcid":null,"affiliations":[]},{"author_position":"middle","author":{"id":"https://openalex.org/A5090093996","display_name":"Dennis Ren","orcid":"https://orcid.org/0009-0008-2146-7140"},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Ren, Dennis","raw_affiliation_strings":[],"raw_orcid":null,"affiliations":[]},{"author_position":"last","author":{"id":"https://openalex.org/A5134911289","display_name":"Xuan Wang","orcid":null},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Wang, Xuan","raw_affiliation_strings":[],"raw_orcid":null,"affiliations":[]}],"institutions":[],"countries_distinct_count":0,"institutions_distinct_count":0,"corresponding_author_ids":[],"corresponding_institution_ids":[],"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":null,"issue":null,"first_page":null,"last_page":null},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T11095","display_name":"Emergency and Acute Care Studies","score":0.5271999835968018,"subfield":{"id":"https://openalex.org/subfields/2711","display_name":"Emergency 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/T11095","display_name":"Emergency and Acute Care Studies","score":0.5271999835968018,"subfield":{"id":"https://openalex.org/subfields/2711","display_name":"Emergency 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/T11636","display_name":"Artificial Intelligence in Healthcare and Education","score":0.08720000088214874,"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"}},{"id":"https://openalex.org/T10028","display_name":"Topic Modeling","score":0.06620000302791595,"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"}}],"keywords":[{"id":"https://openalex.org/keywords/triage","display_name":"Triage","score":0.9273999929428101},{"id":"https://openalex.org/keywords/workflow","display_name":"Workflow","score":0.7152000069618225},{"id":"https://openalex.org/keywords/documentation","display_name":"Documentation","score":0.5946000218391418},{"id":"https://openalex.org/keywords/inference","display_name":"Inference","score":0.421999990940094},{"id":"https://openalex.org/keywords/adaptation","display_name":"Adaptation (eye)","score":0.4133000075817108},{"id":"https://openalex.org/keywords/domain","display_name":"Domain (mathematical analysis)","score":0.40630000829696655},{"id":"https://openalex.org/keywords/medline","display_name":"MEDLINE","score":0.32089999318122864}],"concepts":[{"id":"https://openalex.org/C2777120189","wikidata":"https://www.wikidata.org/wiki/Q780067","display_name":"Triage","level":2,"score":0.9273999929428101},{"id":"https://openalex.org/C177212765","wikidata":"https://www.wikidata.org/wiki/Q627335","display_name":"Workflow","level":2,"score":0.7152000069618225},{"id":"https://openalex.org/C56666940","wikidata":"https://www.wikidata.org/wiki/Q788790","display_name":"Documentation","level":2,"score":0.5946000218391418},{"id":"https://openalex.org/C41008148","wikidata":"https://www.wikidata.org/wiki/Q21198","display_name":"Computer science","level":0,"score":0.5228999853134155},{"id":"https://openalex.org/C545542383","wikidata":"https://www.wikidata.org/wiki/Q2751242","display_name":"Medical emergency","level":1,"score":0.45559999346733093},{"id":"https://openalex.org/C2776214188","wikidata":"https://www.wikidata.org/wiki/Q408386","display_name":"Inference","level":2,"score":0.421999990940094},{"id":"https://openalex.org/C139807058","wikidata":"https://www.wikidata.org/wiki/Q352374","display_name":"Adaptation (eye)","level":2,"score":0.4133000075817108},{"id":"https://openalex.org/C36503486","wikidata":"https://www.wikidata.org/wiki/Q11235244","display_name":"Domain (mathematical analysis)","level":2,"score":0.40630000829696655},{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.3880000114440918},{"id":"https://openalex.org/C2779473830","wikidata":"https://www.wikidata.org/wiki/Q1540899","display_name":"MEDLINE","level":2,"score":0.32089999318122864},{"id":"https://openalex.org/C137293760","wikidata":"https://www.wikidata.org/wiki/Q3621696","display_name":"Language model","level":2,"score":0.3100999891757965},{"id":"https://openalex.org/C2780724011","wikidata":"https://www.wikidata.org/wiki/Q1295316","display_name":"Emergency department","level":2,"score":0.30709999799728394},{"id":"https://openalex.org/C160798450","wikidata":"https://www.wikidata.org/wiki/Q4230870","display_name":"Concordance","level":2,"score":0.30309998989105225},{"id":"https://openalex.org/C2989179672","wikidata":"https://www.wikidata.org/wiki/Q6806500","display_name":"Clinical decision making","level":2,"score":0.2989000082015991},{"id":"https://openalex.org/C2777671062","wikidata":"https://www.wikidata.org/wiki/Q6889402","display_name":"Early warning score","level":2,"score":0.2777999937534332},{"id":"https://openalex.org/C2778358025","wikidata":"https://www.wikidata.org/wiki/Q4309761","display_name":"Mews","level":3,"score":0.2736000120639801},{"id":"https://openalex.org/C182365436","wikidata":"https://www.wikidata.org/wiki/Q50701","display_name":"Variable (mathematics)","level":2,"score":0.27320000529289246}],"mesh":[],"locations_count":1,"locations":[{"id":"doi:10.48550/arxiv.2604.26766","is_oa":true,"landing_page_url":"https://doi.org/10.48550/arxiv.2604.26766","pdf_url":null,"source":{"id":"https://openalex.org/S4306400194","display_name":"arXiv (Cornell University)","issn_l":null,"issn":null,"is_oa":true,"is_in_doaj":false,"is_core":false,"host_organization":"https://openalex.org/I205783295","host_organization_name":"Cornell University","host_organization_lineage":["https://openalex.org/I205783295"],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":null,"is_accepted":false,"is_published":null,"raw_source_name":null,"raw_type":"Preprint"}],"best_oa_location":{"id":"doi:10.48550/arxiv.2604.26766","is_oa":true,"landing_page_url":"https://doi.org/10.48550/arxiv.2604.26766","pdf_url":null,"source":{"id":"https://openalex.org/S4306400194","display_name":"arXiv (Cornell University)","issn_l":null,"issn":null,"is_oa":true,"is_in_doaj":false,"is_core":false,"host_organization":"https://openalex.org/I205783295","host_organization_name":"Cornell University","host_organization_lineage":["https://openalex.org/I205783295"],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":null,"is_accepted":false,"is_published":false,"raw_source_name":null,"raw_type":"Preprint"},"sustainable_development_goals":[{"score":0.7960264086723328,"id":"https://metadata.un.org/sdg/16","display_name":"Peace, Justice and strong institutions"}],"awards":[],"funders":[],"has_content":{"grobid_xml":false,"pdf":false},"content_urls":null,"referenced_works_count":0,"referenced_works":[],"related_works":[],"abstract_inverted_index":{"Accurate":[0],"and":[1,24,55,80,89,100,108,131],"consistent":[2],"Emergency":[3],"Severity":[4],"Index":[5],"(ESI)":[6],"assignment":[7],"remains":[8],"a":[9],"persistent":[10],"challenge":[11],"in":[12],"emergency":[13],"departments,":[14],"where":[15],"highly":[16],"variable":[17],"free-text":[18],"triage":[19,63,92],"documentation":[20],"contributes":[21],"to":[22],"mistriage":[23],"workflow":[25],"inefficiencies.":[26],"This":[27],"study":[28],"evaluates":[29],"whether":[30],"open-source":[31],"small":[32],"language":[33,112],"models":[34,96,113],"(SLMs)":[35],"can":[36],"serve":[37],"as":[38],"reliable,":[39,126],"privacy-preserving":[40,127],"decision-support":[41],"tools":[42],"for":[43,125],"clinical":[44,58],"triage.":[45],"We":[46],"systematically":[47],"compared":[48],"multiple":[49],"SLMs":[50,107,124],"across":[51],"diverse":[52],"prompting":[53],"pipelines":[54],"found":[56],"that":[57],"vignettes,":[59],"concise":[60],"summaries":[61],"of":[62,77,122,135],"narratives,":[64],"yielded":[65],"the":[66,74,120,133],"most":[67],"accurate":[68],"predictions.":[69],"The":[70],"SLM,":[71],"Qwen2.5-7B,":[72],"demonstrated":[73],"strongest":[75],"balance":[76],"accuracy,":[78],"stability,":[79],"computational":[81],"efficiency.":[82],"Through":[83],"large-scale":[84],"domain":[85],"adaptation":[86],"using":[87],"expert-curated":[88],"silver-standard":[90],"pediatric":[91],"data,":[93],"fine-tuned":[94],"Qwen2.5-7B":[95],"substantially":[97],"reduced":[98],"discordance":[99],"clinically":[101],"significant":[102],"errors,":[103],"outperforming":[104],"all":[105],"baseline":[106],"advanced":[109],"proprietary":[110],"large":[111],"(LLMs,":[114],"e.g.,":[115],"GPT-4o).":[116],"These":[117],"findings":[118],"highlight":[119],"feasibility":[121],"institution-specific":[123],"ESI":[128],"decision":[129],"support":[130],"underscore":[132],"importance":[134],"targeted":[136],"fine-tuning":[137],"over":[138],"more":[139],"complex":[140],"inference":[141],"strategies.":[142]},"counts_by_year":[],"updated_date":"2026-07-01T06:00:48.157686","created_date":"2026-05-01T00:00:00"}
