{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T15:05:08Z","timestamp":1790262308803,"version":"4.1.0"},"reference-count":48,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T00:00:00Z","timestamp":1782777600000},"content-version":"vor","delay-in-days":29,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82225049"],"award-info":[{"award-number":["82225049"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82305436"],"award-info":[{"award-number":["82305436"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["72204173"],"award-info":[{"award-number":["72204173"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82274368"],"award-info":[{"award-number":["82274368"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Evidence Based Medicine"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Identifying stroke patients at different disease stages is a prerequisite for clinical research using electronic medical records (EMRs), whereas an artificial intelligence\u2010based model that can be directly applied remains lacking. We therefore develop a large language model (LLM) pipeline for stroke staging model (StrokeSM) in retrospective clinical research.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>StrokeSM was developed using a Chinese national stroke database comprising EMRs from 33,637 patients. A total of 2000 patients were randomly selected from the Tianjin regional stroke database for external validation. StrokeSM comprised three phases: stroke hospitalization identification based on BERT and a bidirectional cross\u2010attention network to fuse present illness history and discharge diagnosis, symptom\u2013time extraction based on chief complaint through a UIE\u2010base LLM, and stroke staging classification according to the predefined rules.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      On the test set, StrokeSM achieved accuracy,\n                      <jats:italic>F<\/jats:italic>\n                      1 score, precision, and recall of 0.90, 0.91, 0.91, and 0.90, respectively. The\n                      <jats:italic>F<\/jats:italic>\n                      1 score, precision, and recall of StrokeSM for acute phase was 0.91, 0.89, and 0.93, respectively. On the external validation set, StrokeSM had an accuracy,\n                      <jats:italic>F<\/jats:italic>\n                      1 score, precision, and recall of 0.92, 0.93, 0.93, and 0.92, respectively. Moreover, StrokeSM performed remarkably well in acute phase, with\n                      <jats:italic>F<\/jats:italic>\n                      1 score, precision, and recall of 0.97, 0.98, and 0.96, respectively.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>StrokeSM had achieved state\u2010of\u2010the\u2010art performance, providing an accurate method of classifying stroke populations with different disease stages in EMRs, especially in the acute phase. StrokeSM heralds automatic and accurate identification of disease stage phenotypes based on LLM in EMRs, laying the foundation for drawing reliable conclusions in clinical research.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jebm.70159","type":"journal-article","created":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T05:22:52Z","timestamp":1782883372000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["A Large Language Model Pipeline for Stroke Staging Using Electronical Medical Records"],"prefix":"10.1111","volume":"19","author":[{"given":"Xiaochao","family":"Luo","sequence":"first","affiliation":[{"name":"Clinical Epidemiology and Evidence\u2010Based Medicine Center, West China Hospital Sichuan University  Chengdu China"},{"name":"Department of Neuro surgery, West China Hospital Sichuan University  Chengdu China"},{"name":"Cochrane China and MAGIC China Center, West China Hospital Sichuan University Chengdu China"},{"name":"NHC Key Laboratory of Clinical Epidemiology and Evidence\u2010Based Medicine, West China Hospital Sichuan University Chengdu China"},{"name":"Sichuan Center of Technology Innovation for Real World Data Chengdu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanmei","family":"Liu","sequence":"additional","affiliation":[{"name":"Clinical Epidemiology and Evidence\u2010Based Medicine Center, West China Hospital Sichuan University  Chengdu China"},{"name":"Department of Neuro surgery, West China Hospital Sichuan University  Chengdu China"},{"name":"Cochrane China and MAGIC China Center, West China Hospital Sichuan University Chengdu China"},{"name":"NHC Key Laboratory of Clinical Epidemiology and Evidence\u2010Based Medicine, West China Hospital Sichuan University Chengdu China"},{"name":"Sichuan Center of Technology Innovation for Real World Data Chengdu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu","family":"Ma","sequence":"additional","affiliation":[{"name":"Clinical Epidemiology and Evidence\u2010Based Medicine Center, West China Hospital Sichuan University  Chengdu China"},{"name":"Department of Neuro surgery, West China Hospital Sichuan University  Chengdu China"},{"name":"Cochrane China and MAGIC China Center, West China Hospital Sichuan University Chengdu China"},{"name":"NHC Key Laboratory of Clinical Epidemiology and Evidence\u2010Based Medicine, West China Hospital Sichuan University Chengdu China"},{"name":"Sichuan Center of Technology Innovation for Real World Data Chengdu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chuwei","family":"Li","sequence":"additional","affiliation":[{"name":"School of International Pharmaceutical Business China Pharmaceutical University Nanjing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Minghong","family":"Yao","sequence":"additional","affiliation":[{"name":"Clinical Epidemiology and Evidence\u2010Based Medicine Center, West China Hospital Sichuan University  Chengdu China"},{"name":"Department of Neuro surgery, West China Hospital Sichuan University  Chengdu China"},{"name":"Cochrane China and MAGIC China Center, West China Hospital Sichuan University Chengdu China"},{"name":"NHC Key Laboratory of Clinical Epidemiology and Evidence\u2010Based Medicine, West China Hospital Sichuan University Chengdu China"},{"name":"Sichuan Center of Technology Innovation for Real World Data Chengdu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hunong","family":"Xiang","sequence":"additional","affiliation":[{"name":"Clinical Epidemiology and Evidence\u2010Based Medicine Center, West China Hospital Sichuan University  Chengdu China"},{"name":"Department of Neuro surgery, West China Hospital Sichuan University  Chengdu China"},{"name":"Cochrane China and MAGIC China Center, West China Hospital Sichuan University Chengdu China"},{"name":"NHC Key Laboratory of Clinical Epidemiology and Evidence\u2010Based Medicine, West China Hospital Sichuan University Chengdu China"},{"name":"Sichuan Center of Technology Innovation for Real World Data Chengdu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xuan","family":"Qin","sequence":"additional","affiliation":[{"name":"Yibin University Yibin China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiali","family":"Liu","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Southwestern Chinese Medicine Resources School of Pharmacy Chengdu University of Traditional Chinese Medicine Chengdu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoping","family":"Zhan","sequence":"additional","affiliation":[{"name":"Beijing Baymax Technology Co. 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