Improving automated deep phenotyping through large language models using retrieval-augmented generation
Abstract
BACKGROUND: Diagnosing rare genetic disorders relies on precise phenotypic and genotypic analysis, with the Human Phenotype Ontology (HPO) providing a standardized language for capturing clinical phenotypes. Rule-based HPO extraction tools use concept recognition to automatically identify phenotypes, but they often struggle with incomplete phenotype assignment, requiring significant manual review. While large language models (LLMs) hold promise for more context-driven phenotype extraction, they are prone to errors and "hallucinations," making them less reliable without further refinement. We present RAG-HPO, a Python-based tool that leverages retrieval-augmented generation (RAG) to elevate accuracy of HPO term assignment by LLM. This approach bypasses the limitations of baseline models and eliminates the need for time- and resource-intensive fine-tuning. RAG-HPO integrates a dynamic vector database, containing > 54,000 phenotypic phrases mapped to HPO IDs, which allows real-time retrieval and contextual matching. The RAG-HPO workflow begins by extracting phenotypic phrases from clinical text via an LLM and then matching them via semantic similarity to entries within the database. The best term matches are returned to the LLM as context for final HPO term assignment of each phrase.
RESULTS: Performance was benchmarked on 112 published case reports with 1792 manually assigned HPO terms and compared to Doc2HPO, ClinPhen, and FastHPOCR. In evaluations, RAG-HPO + LLaMa-3.1 70B…
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