Clinical Medical Engineering is an interdisciplinary field that combines medical knowledge, engineering techniques, and data analysis to enhance the quality and efficiency of medical services. With the explosive growth of medical data and the advancement of artificial intelligence technology, large models play an increasingly crucial role in this field [1][2][3][4][5]. Large models, with their vast data capacity and complex network structures, can capture and learn subtle patterns and deep features in medical data. Compared to traditional machine learning models, large models demonstrate higher flexibility and accuracy when dealing with high-dimensional data. They can automatically extract features using deep learning technology, significantly reducing the dependency on specialized knowledge while improving the model's generalization ability. In the field of clinical medicine, large models refer to machine learning models with complex network structures trained on massive data. These models, with their powerful data processing capabilities, pattern recognition, and prediction accuracy, provide unprecedented support for clinical decision-making. They can automatically extract deep features from medical data, identifying patterns and associations that may be difficult for human experts to detect, playing a significant role in disease diagnosis, treatment recommendation, and patient monitoring. The self-learning and continuous optimization capabilities of large models enable them to adapt to changing medical environments, improving the efficiency and quality of medical services. Large models exhibit exceptional capabilities in handling clinical data. They can process and analyze large-scale medical datasets from various sources, such as Electronic Health Records (EHR), medical imaging, and genomic sequences. These data usually feature high dimensionality and complexity, making them challenging to handle with traditional analysis methods. Large models, through deep learning technology, can automatically identify and extract key features, providing support for clinical decision-making. For example, in radiology, large models can identify and categorize lesions, assisting physicians in making more accurate diagnoses. Large models have a significant advantage in pattern recognition. They can discover potential patterns and associations from complex medical data, which may be difficult for human experts to identify. In disease diagnosis, large models can predict the occurrence and progression of diseases by analyzing physiological data and medical history of patients. Furthermore, they can identify subtle connections between different diseases, providing a basis for personalized treatment. Large models surpass traditional methods in prediction accuracy. They can handle datasets with high-dimensional features, providing more precise prediction results. In clinical practice, accurate predictions are crucial for early diagnosis of diseases, formulation of treatment plans, and evaluation of patient prognosis. Large models, by learning from extensive historical data, can predict a patient's response to specific treatments, thereby assisting physicians in selecting the most appropriate treatment plan. Large models can automate many clinical processes, enhancing the efficiency of medical services. They can be used for patient classification, risk assessment, resource allocation, and other tasks, reducing the workload of doctors and nurses and allowing them to focus on more complex clinical decisions. Automated processes not only speed up medical services but also reduce human errors, improving the quality and safety of patient care. Unlike traditional static models, large models possess the ability for continuous learning and self-optimization. With the continuous input of new data, they can constantly adjust and optimize their parameters to adapt to changes in the medical environment. This ability enables large models to quickly adapt and provide effective solutions when dealing with emerging diseases or rare cases. Large models can integrate knowledge and data from different disciplines, providing comprehensive solutions for complex clinical problems [6][7][8]. They can fuse data and knowledge from fields such as bioinformatics, radiology, and epidemiology, providing comprehensive support for disease diagnosis, treatment, and prevention. Interdisciplinary integration not only promotes the exchange and innovation of knowledge but also provides patients with more comprehensive and personalized medical services.
MedGPT is a medical large language model based on the Transformer architecture, specifically designed for predicting medical concepts in clinical narratives[9]. Unlike traditional prediction methods, MedGPT can extract valuable medical information from unstructured Electronic Health Records (EHRs) for disease prediction and diagnostic assistance. MedGPT has demonstrated superior performance, particularly in handling noisy and fine-grained data, with an accuracy ranging from 0.344 to 0.640, a significant improvement over the LSTM model's 0.329 to 0.633. A medical large model developed jointly by Huimei Technology and Intel, based on CPU large model inference technology, has achieved seamless integration with the Clinical Decision Support System (CDSS) deployed in hospitals[10]. This deployment method not only reduces costs but also enhances the accessibility and practicality of large models in medical institutions. The Huimei medical large model already possesses the ability for differential diagnosis and automatic generation of medical records, and is expected to show its potential in more diagnostic and treatment processes in the future. MedicalGPT is a Chinese-English medical question-answering model based on LLaMA-13B, fine-tuned using Low-Rank Adaptation (LoRA) technology. The project implements a four-stage training process: secondary pre-training, supervised fine-tuning, reward modeling, and reinforcement learning training. The training of Chimed-gpt used a large amount of Chinese medical data to enhance the model's performance in medical question answering[11]. Moreover, the Chimed-gpt project also provides a call example based on the textgen library, facilitating developers to use and integrate the LLaMA model for medical question answering. The code and model of Chimed-gpt have been open-sourced on GitHub for interested researchers and developers. Current medical large models have some significant deficiencies and challenges in research and application, which limit their widespread application and deep development in the field of clinical medicine. Medical large models have limitations in realizing private offline deployment, mainly because the architectural design of some models does not take into account the sensitivity of medical data and the high demands of medical institutions for data privacy. Medical institutions often need to process data locally to ensure compliance, but existing models may require cloud infrastructure support, restricting their applicability under strict data protection policies. The high demand of medical large models for computational resources leads to dual pressures of cost and environment in actual application. These models usually require high-performance GPU clusters for training and inference, which not only increases the financial burden of medical institutions but also contradicts global carbon reduction targets. Therefore, researchers need to explore more efficient algorithms and hardware optimizations to reduce the model's dependence on computational resources. Although medical large models have made progress in general medical information processing, their application in specific clinical medical fields is still lacking. The field of clinical medicine is highly segmented, with each area having its unique terminology, processes, and diagnostic standards. Existing models often lack in-depth learning and understanding of these segmented fields, resulting in limited accuracy and applicability in actual clinical applications. Some medical large models are based on older versions of LLaMA or other early model architectures. These architectures may not fully utilize the latest technological advances, such as innovative algorithms in natural language processing and machine learning. As medical knowledge continues to update, older architectures may not adapt to new data representation and processing needs, resulting in a lack of accuracy in understanding complex clinical problems. The performance of medical large models largely depends on the quality and diversity of training data. However, existing data may have biases, such as insufficient representation of patient groups or bias in data collection methods, which may limit the model's generalization ability in specific situations. Additionally, the timeliness and accuracy of data are critical factors; outdated or incorrect data will directly affect the quality of the model's output.
In response to the limitations of existing medical large models, we propose ClinMed-LLAMA3, a large model aimed at providing more accurate, secure, and efficient clinical medical solutions through a series of innovative methods. One of the core contributions of ClinMed-LLAMA3 is the establishment of its dedicated clinical medical 50K dataset. This dataset is meticulously curated through in-depth analysis and collection of daily hospital consultation records, combined with the knowledge of human experts and the advanced language understanding capabilities of GPT4. This dual-channel data collection and screening mechanism ensures the high quality and coverage of the dataset, enabling the model to more accurately understand and respond to complex scenarios in clinical consultations. ClinMed-LLAMA3 adopts the latest LLAMA3-8B-Instruct model as its base, a large language model with 8 billion parameters, possessing powerful understanding and generation capabilities. Through specialized fine-tuning in the field of clinical medicine, ClinMed-LLAMA3 not only inherits the strong performance of the base model but also further adapts to human consultation processes and habits. It can clearly understand the descriptive language of patients' conditions and provide more professional and humanized medical consultations. ClinMed-LLAMA3 supports offline private deployment, a feature that effectively addresses the concerns of medical institutions regarding data privacy and security. The model can run on the local servers of medical institutions, ensuring that all sensitive data is retained within the institution, preventing leakage or unauthorized access, and meeting the strict requirements of the medical industry for data protection. In terms of energy consumption, ClinMed-LLAMA3 has undergone special optimization to achieve a lower energy consumption ratio. Through algorithm improvement and model simplification, ClinMed-LLAMA3 significantly reduces the demand for computational resources while maintaining high performance, reducing energy consumption, which is of significant importance for reducing the operating costs and environmental impact of medical institutions. The development of the ClinMed-LLAMA3 large model is an important supplement and improvement to existing medical large models. Through the establishment of a dedicated dataset, the application of advanced base models, the support for private deployment, and the optimization of the energy consumption ratio, it provides a more accurate, secure, and efficient intelligent tool for the field of clinical medicine. With continuous technological advancement and deepening application, ClinMed-LLAMA3 is expected to become an important aid in the medical industry, promoting the improvement of medical service quality and the development of medical innovation.