# Cutaneous immune-related adverse event detection

Identifying cutaneous immune-related adverse events (cirAEs) in outpatient notes of patients on immune checkpoint inhibitors has depended on manual chart review, which is slow and inconsistent between reviewers. In a multi-institution study, non-dermatologist reviewers adjudicated with a retrieval-augmented, multi-agent large language model that returned a binary recommendation plus the supporting note excerpts. Against ground truth from an oncodermatologist, the assisted group reached F1 0.88 and Cohen's κ 0.82 versus 0.77 and 0.50 for manual review, and reviewers self-reported a drop from 15 to 10 minutes per chart.

Identifying cutaneous immune-related adverse events (cirAEs) in outpatient notes of patients on immune checkpoint inhibitors has depended on manual chart review, which is slow and inconsistent between reviewers. In a multi-institution study, non-dermatologist reviewers adjudicated with a retrieval-augmented, multi-agent large language model that returned a binary recommendation plus the supporting note excerpts. Against ground truth from an oncodermatologist, the assisted group reached F1 0.88 and Cohen's κ 0.82 versus 0.77 and 0.50 for manual review, and reviewers self-reported a drop from 15 to 10 minutes per chart.