# Leveraging Large Language Models to Extract Information on Substance Use Disorder Severity from Clinical Notes: A Zero-shot Learning Approach

arXiv: https://arxiv.org/abs/2403.12297 · HTML: https://mlsanity.com/paper/2403.12297/

## Key facts

- Cited by 4 papers in the map (data through 14 Oct 2026).
- Builds on 18 of its 33 references that are in the map.
- First posted on arXiv 18 Mar 2024.

## Builds on (most cited first, 18 of 18)

- [BERT: Pre-training of Deep Bidirectional Transformers for Language Understanding](https://mlsanity.com/paper/1810.04805/) (2018)
- [GPT-4 Technical Report](https://mlsanity.com/paper/2303.08774/) (2023)
- [Training language models to follow instructions with human feedback](https://mlsanity.com/paper/2203.02155/) (2022)
- [Exploring the Limits of Transfer Learning with a Unified Text-to-Text Transformer](https://mlsanity.com/paper/1910.10683/) (2019)
- [SQuAD: 100,000+ Questions for Machine Comprehension of Text](https://mlsanity.com/paper/1606.05250/) (2016)
- [Scaling Instruction-Finetuned Language Models](https://mlsanity.com/paper/2210.11416/) (2022)
- [A Survey of Large Language Models](https://mlsanity.com/paper/2303.18223/) (2023)
- [Publicly Available Clinical BERT Embeddings](https://mlsanity.com/paper/1904.03323/) (2019)
- [Large Language Models are Few-Shot Clinical Information Extractors](https://mlsanity.com/paper/2205.12689/) (2022)
- [Large Language Models to Identify Social Determinants of Health in Electronic Health Records](https://mlsanity.com/paper/2308.06354/) (2023)
- [Annotating Social Determinants of Health Using Active Learning, and Characterizing Determinants Using Neural Event Extraction](https://mlsanity.com/paper/2004.05438/) (2020)
- [Model Tuning or Prompt Tuning? A Study of Large Language Models for Clinical Concept and Relation Extraction](https://mlsanity.com/paper/2310.06239/) (2023)
- [HealthPrompt: A Zero-shot Learning Paradigm for Clinical Natural Language Processing](https://mlsanity.com/paper/2203.05061/) (2022)
- [The 2022 n2c2/UW Shared Task on Extracting Social Determinants of Health](https://mlsanity.com/paper/2301.05571/) (2023)
- [Clinical Concept and Relation Extraction Using Prompt-based Machine Reading Comprehension](https://mlsanity.com/paper/2303.08262/) (2023)
- [Prompt-based Extraction of Social Determinants of Health Using Few-shot Learning](https://mlsanity.com/paper/2306.07170/) (2023)
- [Generative Large Language Models Are All-purpose Text Analytics Engines: Text-to-text Learning Is All Your Need](https://mlsanity.com/paper/2312.06099/) (2023)
- [Zero-shot Learning with Minimum Instruction to Extract Social Determinants and Family History from Clinical Notes using GPT Model](https://mlsanity.com/paper/2309.05475/) (2023)

## Built on by (most cited first, 4 of 4)

- [When the Domain Expert Has No Time and the LLM Developer Has No Clinical Expertise: Real-World Lessons from LLM Co-Design in a Safety-Net Hospital](https://mlsanity.com/paper/2508.08504/) (2025)
- [MedPromptExtract (Medical Data Extraction Tool): Anonymization and Hi-fidelity Automated data extraction using NLP and prompt engineering](https://mlsanity.com/paper/2405.02664/) (2024)
- [Hybrid Student-Teacher Large Language Model Refinement for Cancer Toxicity Symptom Extraction](https://mlsanity.com/paper/2408.04775/) (2024)
- [From Wearables to Warnings: Predicting Pain Spikes in Patients with Opioid Use Disorder](https://mlsanity.com/paper/2511.19577/) (2025)

## Abstract (arXiv)

Substance use disorder (SUD) poses a major concern due to its detrimental effects on health and society. SUD identification and treatment depend on a variety of factors such as severity, co-determinants (e.g., withdrawal symptoms), and social determinants of health. Existing diagnostic coding systems used by American insurance providers, like the International Classification of Diseases (ICD-10), lack granularity for certain diagnoses, but clinicians will add this granularity (as that found within the Diagnostic and Statistical Manual of Mental Disorders classification or DSM-5) as supplemental unstructured text in clinical notes. Traditional natural language processing (NLP) methods face limitations in accurately parsing such diverse clinical language. Large Language Models (LLMs) offer promise in overcoming these challenges by adapting to diverse language patterns. This study investigates the application of LLMs for extracting severity-related information for various SUD diagnoses from clinical notes. We propose a workflow employing zero-shot learning of LLMs with carefully crafted prompts and post-processing techniques. Through experimentation with Flan-T5, an open-source LLM, we demonstrate its superior recall compared to the rule-based approach. Focusing on 11 categories of SUD diagnoses, we show the effectiveness of LLMs in extracting severity information, contributing to improved risk assessment and treatment planning for SUD patients.