Currently submitted to: Journal of Medical Internet Research
Date Submitted: Feb 4, 2026
Open Peer Review Period: Feb 5, 2026 - Apr 2, 2026
(currently open for review)
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
An Electronic Medical Record-Embedded Large Language Model for Acute Pancreatitis Diagnosis, Severity, and Prognosis
ABSTRACT
Background:
Early diagnosis, accurate severity assessment of acute pancreatitis (AP), and prediction of progression to severe acute pancreatitis (SAP) are critical. We evaluated an electronic medical record (EMR)-embedded large language model (LLM) for these tasks.
Methods:
The LLM reviewed earliest AP hospitalization records of 261 adults and answered three prompts (diagnosis, severity, and risk of progression to SAP).
Results:
224 (85.8%) had mild AP (MAP), 30 (11.5%) moderately SAP (MSAP), and 7 (2.7%) SAP. The LLM diagnosed AP with 89.3% sensitivity and 100.0% positive predictive value (PPV). Severity classification was inconsistent (MAP sensitivity 49.1%, MSAP 66.7%, SAP 42.9%). For progression prediction from initial MAP, the LLM showed high sensitivity (87.5%) but low accuracy (26.8%); Bedside index for severity in acute pancreatitis (BISAP) had higher accuracy (95.5%) but low sensitivity (12.5%). In MSAP, the LLM sensitivity was 85.7% versus BISAP 0%.
Conclusions:
An EMR-embedded LLM can detect AP and identify many who progress to SAP, but specificity and severity classification require improvement.
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