Scalable Unit Harmonization in Medical Informatics via Bayesian-Optimized Retrieval and Transformer-Based Re-ranking

Objective: To develop and evaluate a scalable methodology for harmonizing inconsistent units in large-scale clinical datasets, addressing a key barrier to data interoperability. Materials and Methods: We designed a novel unit harmonization system combining BM25, sentence embeddings, Bayesian optimization, and a bidirectional transformer based binary classifier for retrieving and matching laboratory test entries. The system was evaluated using the Optum Clinformatics Datamart dataset (7.5 billion entries). We implemented a multi-stage pipeline: filtering, identification, harmonization proposal generation, automated re-ranking, and manual validation. Performance was assessed using Mean Reciprocal Rank (MRR) and other standard information retrieval metrics. Results: Our hybrid retrieval approach combining BM25 and sentence embeddings (MRR: 0.8833) significantly outperformed both lexical-only (MRR: 0.7985) and embedding-only (MRR: 0.5277) approaches. The transformer-based reranker further improved performance (absolute MRR improvement: 0.10), bringing the final system MRR to 0.9833. The system achieved 83.39% precision at rank 1 and 94.66% recall at rank 5. Discussion: The hybrid architecture effectively leverages the complementary strengths of lexical and semantic approaches. The reranker addresses cases where initial retrieval components make errors due to complex semantic relationships in medical terminology. Conclusion: Our framework provides an efficient, scalable solution for unit harmonization in clinical datasets, reducing manual effort while improving accuracy. Once harmonized, data can be reused seamlessly in different analyses, ensuring consistency across healthcare systems and enabling more reliable multi-institutional studies and meta-analyses.