{"id":32880,"date":"2026-01-21T17:02:49","date_gmt":"2026-01-21T17:02:49","guid":{"rendered":"https:\/\/lamarr-institute.org\/publication\/development-of-image-based-decision-support-systems-utilizing-information-extracted-from-radiological-free-text-report-databases-with-text-based-transformers\/"},"modified":"2026-09-17T11:26:44","modified_gmt":"2026-09-17T11:26:44","slug":"development-of-image-based-decision-support-systems-utilizing-information-extracted-from-radiological-free-text-report-databases-with-text-based-transformers","status":"publish","type":"publication","link":"https:\/\/lamarr-institute.org\/de\/publication\/development-of-image-based-decision-support-systems-utilizing-information-extracted-from-radiological-free-text-report-databases-with-text-based-transformers\/","title":{"rendered":"Development of image-based decision support systems utilizing information extracted from radiological free-text report databases with text-based transformers"},"content":{"rendered":"<p>Objectives: To investigate the potential and limitations of utilizing transformer-based report annotation for on-site development of image-based diagnostic decision support systems (DDSS).<\/p>\n<p>Methods: The study included 88,353 chest X-rays from 19,581 intensive care unit (ICU) patients. To label the presence of six typical findings in 17,041 images, the corresponding free-text reports of the attending radiologists were assessed by medical research assistants (&#8222;gold labels&#8220;). Automatically generated &#8222;silver&#8220; labels were extracted for all reports by transformer models trained on gold labels. To investigate the benefit of such silver labels, the image-based models were trained using three approaches: with gold labels only (MG), with silver labels first, then with gold labels (MS\/G), and with silver and gold labels together (MS+G). To investigate the influence of invested annotation effort, the experiments were repeated with different numbers (N) of gold-annotated reports for training the transformer and image-based models and tested on 2099 gold-annotated images. Significant differences in macro-averaged area under the receiver operating characteristic curve (AUC) were assessed by non-overlapping 95\\% confidence intervals.<\/p>\n<p>Results: Utilizing transformer-based silver labels showed significantly higher macro-averaged AUC than training solely with gold labels (N = 1000: MG 67.8 [66.0-69.6], MS\/G 77.9 [76.2-79.6]; N = 14,580: MG 74.5 [72.8-76.2], MS\/G 80.9 [79.4-82.4]). Training with silver and gold labels together was beneficial using only 500 gold labels (MS+G 76.4 [74.7-78.0], MS\/G 75.3 [73.5-77.0]).<\/p>\n<p>Conclusions: Transformer-based annotation has potential for unlocking free-text report databases for the development of image-based DDSS. However, on-site development of image-based DDSS could benefit from more sophisticated annotation pipelines including further information than a single radiological report.<\/p>\n<p>Clinical relevance statement: Leveraging clinical databases for on-site development of artificial intelligence (AI)-based diagnostic decision support systems by text-based transformers could promote the application of AI in clinical practice by circumventing highly regulated data exchanges with third parties.<\/p>\n<p>Key points: \u2022 The amount of data from a database that can be used to develop AI-assisted diagnostic decision systems is often limited by the need for time-consuming identification of pathologies by radiologists. \u2022 The transformer-based structuring of free-text radiological reports shows potential to unlock corresponding image databases for on-site development of image-based diagnostic decision support systems. \u2022 However, the quality of image annotations generated solely on the content of a single radiology report may be limited by potential inaccuracies and incompleteness of this report.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Objectives: To investigate the potential and limitations of utilizing transformer-based report annotation for on-site development of image-based diagnostic decision support systems (DDSS). Methods: The study included 88,353 chest X-rays from 19,581 intensive care unit (ICU) patients. To label the presence of six typical findings in 17,041 images, the corresponding free-text reports of the attending radiologists were assessed by medical research assistants (&#8222;gold labels&#8220;). Automatically generated &#8222;silver&#8220; labels were extracted for [&hellip;]<\/p>\n","protected":false},"author":14,"featured_media":0,"template":"","meta":{"_acf_changed":false,"footnotes":""},"publication-type":[30],"class_list":["post-32880","publication","type-publication","status-publish","hentry","publication-type-article"],"acf":[],"publishpress_future_workflow_manual_trigger":{"enabledWorkflows":[]},"_links":{"self":[{"href":"https:\/\/lamarr-institute.org\/de\/wp-json\/wp\/v2\/publication\/32880","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/lamarr-institute.org\/de\/wp-json\/wp\/v2\/publication"}],"about":[{"href":"https:\/\/lamarr-institute.org\/de\/wp-json\/wp\/v2\/types\/publication"}],"author":[{"embeddable":true,"href":"https:\/\/lamarr-institute.org\/de\/wp-json\/wp\/v2\/users\/14"}],"version-history":[{"count":0,"href":"https:\/\/lamarr-institute.org\/de\/wp-json\/wp\/v2\/publication\/32880\/revisions"}],"wp:attachment":[{"href":"https:\/\/lamarr-institute.org\/de\/wp-json\/wp\/v2\/media?parent=32880"}],"wp:term":[{"taxonomy":"publication-type","embeddable":true,"href":"https:\/\/lamarr-institute.org\/de\/wp-json\/wp\/v2\/publication-type?post=32880"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}