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medRxiv

Automated Identification of Complex Percutaneous Coronary Intervention from Cardiac Catheterization Reports Using Large Language Models

Using manually annotated cardiac catheterization reports from three hospitals within Yale New Haven Health (1,412 notes, 596 PCI reports) as a reference standard, this study evaluated three open-weight large language models (Llama 3.3 70B, Meditron-7B, BioMistral-7B) for identifying PCI reports and extracting six complex PCI features, finding that Llama 3.3 70B outperformed the two smaller domain-specific models on most tasks, achieving 100.0% sensitivity, 93.8% specificity, 96.4% accuracy and 95.9% F1 for PCI identification, and among 590 evaluable PCI reports 97.7% sensitivity, 80.1% specificity, 57.6% positive predictive value, 99.2% negative predictive value and 83.