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Performance and Practical Considerations of Large and Small Language Models in Clinical Decision Support in Rheumatology

Created by
  • Haebom

Author

Sabine Felde, R udiger Buchkremer, Gamal Chehab, Christian Thielscher, J org HW Distler, Matthias Schneider, Jutta G. Richter

Outline

This paper presents the potential of large-scale language models (LLMs) to support clinical decision making in complex medical fields such as rheumatology. Our results show that small-scale language models (SLMs) combined with search-augmented generation (RAG) outperform large-scale models in diagnostic and therapeutic performance, while consuming significantly less energy and enabling cost-effective local deployment. These features make them attractive for resource-constrained healthcare settings. However, no model has consistently achieved rheumatologist-level accuracy, so expert supervision is essential.

Takeaways, Limitations

Takeaways:
A combination of small-scale language models (SLMs) and RAGs shows better diagnostic and therapeutic performance in rheumatology.
SLMs are more energy efficient than LLMs and can be deployed locally for cost-effective, localized deployments, making them ideal for resource-limited healthcare environments.
Limitations:
No model consistently achieves expert-level accuracy.
Professional supervision is essential.
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