Metodologia para Diagnóstico de Sepse Pediátrica via LLM, RAG e Fine-Tuning sob Escassez de Dados Reais
Resumo
A sepse pediátrica é uma emergência médica de alta complexidade, exigindo detecção precoce para reduzir a morbimortalidade. Este trabalho propõe uma metodologia para o desenvolvimento de um sistema de suporte à decisão clínica fundamentado em Grandes Modelos de Linguagem (LLM), utilizando Geração Aumentada por Recuperação (RAG) e Fine-tuning. A escassez de dados reais é mitigada pelo framework MedSyn para geração de dados sintéticos. O sistema integra os Critérios Phoenix, assegurando conformidade com consensos internacionais. A arquitetura proposta combina dados estruturados e notas clínicas, provendo recomendações fomentadas por evidências clínicas no domínio da informática em saúde.Referências
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Baracat, E. C. E. (2018). Validação Dos Sistemas De Triagem Em Emergência Pediátrica. Revista Paulista De Pediatria, 36(4), 386–387. DOI: 10.1590/1984-0462/;2018;36;4;00018
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Bender, D., & Sartipi, K. (2013). HL7 FHIR: An Agile and RESTful approach to healthcare information exchange. Proceedings of the 26th IEEE International Symposium on Computer-Based Medical Systems.
Fan, W. et al. (2024). “A Survey on RAG Meeting LLMs: Towards Retrieval-Augmented Large Language Models”. In Proceedings of the 30th ACM SIGKDD Conference on Knowledge Discovery and Data Mining (KDD '24) Health Level Seven International. (2019). Fast Healthcare Interoperability Resources (FHIR v4.0.1) [Webpage]. [link]
Kumichev, G. et al. (2024) “MedSyn: LLM-based Synthetic Medical Text Generation Framework”, In Machine Learning and Knowledge Discovery in Databases. Applied Data Science Track: European Conference, ECML PKDD 2024, Vilnius, Lithuania, September 9–13, 2024.
Lewis, P., et al. (2020). Retrieval-Augmented Generation for Knowledge-Intensive NLP Tasks. Advances in Neural Information Processing Systems.
Huang, K., Altosaar, J., & Ranganath, R. (2019). “ClinicalBERT: Modeling Clinical Notes and Predicting Hospital Readmission”. ArXiv, abs/1904.05342.
Nagori, A., Gautam, A., Wiens, M. O., Nguyen, V., Mugisha, N. K., Kabakyenga, J., Kissoon, N., Ansermino, J. M., & Kamaleswaran, R. (2025). “Contextual Phenotyping of Pediatric Sepsis Cohort Using Large Language Models”. AMIA. Annual Symposium proceedings. AMIA Symposium, 2024, Savage, T. et al. (2025) “Fine-Tuning Methods for Large Language Models in Clinical Medicine”, Journal of Medical Internet Research, Vol. 27, e76048.
Schlapbach, L. J. et al. (2024) “International Consensus Criteria for Pediatric Sepsis and Septic Shock: The Phoenix Sepsis Score”, JAMA, Vol. 331, No. 8.
Weiss, S. L., et al. (2020). Surviving Sepsis Campaign International Guidelines for the Management of Septic Shock and Sepsis-Associated Organ Dysfunction in Children. Pediatric Critical Care Medicine.
Anisuzzaman, D. M et al. (2024). “Fine-Tuning LLMs for Specialized Use Cases”. Mayo Clinic Proceedings: Digital Health, 3(1). DOI: 10.1016/j.mcpdig.2024.11.005
ANVISA (2022) “Resolução da Diretoria Colegiada - RDC nº 657, de 24 de março de 2022”, Diário Oficial da União.
Baracat, E. C. E. (2018). Validação Dos Sistemas De Triagem Em Emergência Pediátrica. Revista Paulista De Pediatria, 36(4), 386–387. DOI: 10.1590/1984-0462/;2018;36;4;00018
Chen, T. and Guestrin, C. (2016). XGBoost: A Scalable Tree Boosting System. In Proceedings of the 22nd ACM SIGKDD International Conference on Knowledge Discovery and Data Mining (KDD '16). Association for Computing Machinery, New York, NY, USA, 785–794. DOI: 10.1145/2939672.2939785
Bender, D., & Sartipi, K. (2013). HL7 FHIR: An Agile and RESTful approach to healthcare information exchange. Proceedings of the 26th IEEE International Symposium on Computer-Based Medical Systems.
Fan, W. et al. (2024). “A Survey on RAG Meeting LLMs: Towards Retrieval-Augmented Large Language Models”. In Proceedings of the 30th ACM SIGKDD Conference on Knowledge Discovery and Data Mining (KDD '24) Health Level Seven International. (2019). Fast Healthcare Interoperability Resources (FHIR v4.0.1) [Webpage]. [link]
Kumichev, G. et al. (2024) “MedSyn: LLM-based Synthetic Medical Text Generation Framework”, In Machine Learning and Knowledge Discovery in Databases. Applied Data Science Track: European Conference, ECML PKDD 2024, Vilnius, Lithuania, September 9–13, 2024.
Lewis, P., et al. (2020). Retrieval-Augmented Generation for Knowledge-Intensive NLP Tasks. Advances in Neural Information Processing Systems.
Huang, K., Altosaar, J., & Ranganath, R. (2019). “ClinicalBERT: Modeling Clinical Notes and Predicting Hospital Readmission”. ArXiv, abs/1904.05342.
Nagori, A., Gautam, A., Wiens, M. O., Nguyen, V., Mugisha, N. K., Kabakyenga, J., Kissoon, N., Ansermino, J. M., & Kamaleswaran, R. (2025). “Contextual Phenotyping of Pediatric Sepsis Cohort Using Large Language Models”. AMIA. Annual Symposium proceedings. AMIA Symposium, 2024, Savage, T. et al. (2025) “Fine-Tuning Methods for Large Language Models in Clinical Medicine”, Journal of Medical Internet Research, Vol. 27, e76048.
Schlapbach, L. J. et al. (2024) “International Consensus Criteria for Pediatric Sepsis and Septic Shock: The Phoenix Sepsis Score”, JAMA, Vol. 331, No. 8.
Weiss, S. L., et al. (2020). Surviving Sepsis Campaign International Guidelines for the Management of Septic Shock and Sepsis-Associated Organ Dysfunction in Children. Pediatric Critical Care Medicine.
Publicado
01/06/2026
Como Citar
SANTOS, Adriano Lages dos; TORRES, Isabela; OLIVEIRA, Melissa; ALMEIDA, Mylena Maria Guedes de; DINIZ, Lilian Martins Oliveira; DIAS, Cristiane Dos Santos; REIS, Zilma; OLIVEIRA, Eduardo Araujo de.
Metodologia para Diagnóstico de Sepse Pediátrica via LLM, RAG e Fine-Tuning sob Escassez de Dados Reais. In: SIMPÓSIO BRASILEIRO DE COMPUTAÇÃO APLICADA À SAÚDE (SBCAS), 26. , 2026, Ouro Preto/MG.
Anais [...].
Porto Alegre: Sociedade Brasileira de Computação,
2026
.
p. 1409-1414.
ISSN 2763-8952.
DOI: https://doi.org/10.5753/sbcas.2026.21501.
