{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T17:50:48Z","timestamp":1791395448803,"version":"4.3.3"},"reference-count":14,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T00:00:00Z","timestamp":1784160000000},"content-version":"vor","delay-in-days":15,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["alz-journals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Alz &amp;amp; Dem Diag Ass &amp;amp; Dis Mo"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>INTRODUCTION<\/jats:title>\n                    <jats:p>Anti\u2010amyloid beta (A\u03b2) therapies for early Alzheimer's disease require enhanced safety monitoring, yet adverse event (AE) documentation is diffuse across heterogeneous electronic health record documents. Large language models (LLMs) may improve scalable pharmacovigilance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>We analyzed 20,123 clinical documents from 46 patients who received at least one dose of anti\u2010A\u03b2 therapy (June 24, 2024\u2013July 30, 2025) at a large mid\u2010Atlantic health\u2010care system. We compared standard expert review versus an LLM\u2010augmented workflow applied to the same documents. Expert reviewers annotated therapy\u2010related AEs (e.g., amyloid\u2010related imaging abnormalities with edema or hemorrhage, headache, syncope, hypersensitivity, gastrointestinal symptoms, infusion reactions). Discordant cases were adjudicated to establish a reference label.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>After adjudication, 76% (35\/46) patients had an AE. The LLM\u2010augmented workflow achieved 100% sensitivity (positive predictive value [PPV] 89.7%) versus expert review 88.6% sensitivity (PPV 100%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>DISCUSSION<\/jats:title>\n                    <jats:p>Findings provide preliminary indications that LLMs may serve as a pharmacovigilance signal detection tool, with a need for further validation and evaluation of clinical integration.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/dad2.70412","type":"journal-article","created":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T03:40:14Z","timestamp":1784259614000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Real\u2010world pharmacovigilance for anti\u2010A\u03b2 therapies using a large language model"],"prefix":"10.1002","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7550-1569","authenticated-orcid":false,"given":"Allan","family":"Fong","sequence":"first","affiliation":[{"name":"Center for Biostatistics, Informatics, and Data Science MedStar Health Research Institute, MedStar Health  Washington District of Columbia USA"},{"name":"MedStar Health Research Institute\u2013National Center for Human Factors in Healthcare  Washington District of Columbia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Azade","family":"Tabaie","sequence":"additional","affiliation":[{"name":"Center for Biostatistics, Informatics, and Data Science MedStar Health Research Institute, MedStar Health  Washington District of Columbia USA"},{"name":"MedStar Health Research Institute\u2013National Center for Human Factors in Healthcare  Washington District of Columbia USA"},{"name":"Georgetown University School of Medicine  Washington District of Columbia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samantha","family":"Paylor","sequence":"additional","affiliation":[{"name":"University of Maryland School of Pharmacy  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tien","family":"Tran","sequence":"additional","affiliation":[{"name":"University of Maryland School of Pharmacy  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rabbiya","family":"Iqbal","sequence":"additional","affiliation":[{"name":"Georgetown University School of Medicine  Washington District of Columbia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raj M.","family":"Ratwani","sequence":"additional","affiliation":[{"name":"MedStar Health Research Institute\u2013National Center for Human Factors in Healthcare  Washington District of Columbia USA"},{"name":"Georgetown University School of Medicine  Washington District of Columbia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zafar","family":"Zafari","sequence":"additional","affiliation":[{"name":"University of Maryland School of Pharmacy  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lauren R.","family":"Bangerter","sequence":"additional","affiliation":[{"name":"MedStar Health Research Institute\u2013National Center for Human Factors in Healthcare  Washington District of Columbia USA"},{"name":"University of Maryland School of Pharmacy  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicole J.","family":"Brandt","sequence":"additional","affiliation":[{"name":"University of Maryland School of Pharmacy  Baltimore Maryland USA"},{"name":"MedStar Health Center for Successful Aging  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,16]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.3389\/fnins.2024.1326784"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000209402"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/alz.13441"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/bcp.70021"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13195\u2010025\u201001699\u20106"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm14155490"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.isci.2024.109713"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bj.2025.100868"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0279842"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1197\/jamia.M1586"},{"key":"e_1_2_8_12_1","unstructured":"OpenAI. 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Accessed August 1 2025 2025."},{"key":"e_1_2_8_13_1","unstructured":"SettlesB.Active Learning Literature Survey.2009."},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13195\u2010024\u201001441\u20108"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1177\/20420986251361435"}],"container-title":["Alzheimer's &amp; Dementia: Diagnosis, Assessment &amp; Disease Monitoring"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/alz-journals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/dad2.70412","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/alz-journals.onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/dad2.70412","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/alz-journals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/dad2.70412","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T16:56:00Z","timestamp":1791392160000},"score":1,"resource":{"primary":{"URL":"https:\/\/alz-journals.onlinelibrary.wiley.com\/doi\/10.1002\/dad2.70412"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7]]},"references-count":14,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026,7]]}},"alternative-id":["10.1002\/dad2.70412"],"URL":"https:\/\/doi.org\/10.1002\/dad2.70412","archive":["Portico"],"relation":{},"ISSN":["2352-8729","2352-8729"],"issn-type":[{"value":"2352-8729","type":"print"},{"value":"2352-8729","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7]]},"assertion":[{"value":"2026-03-04","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-05","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-16","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70412"}}