Automating Aircraft Defect Report Code Classification Using Natural Language Processing

Background and Aims Large language models (LLMs) have gained significant attention in the field of natural language processing (NLP), marking a shift from traditional techniques like Term Frequency-Inverse Document Frequency (TF-IDF). We developed a traditional NLP model to predict arteriovenous fistula (AVF) failure within next 30 days using clinical notes. The goal of this analysis was to investigate whether LLMs would outperform traditional NLP techniques, specifically in the context of predicting AVF failure within the next 30 days using clinical notes. Method We defined AVF failure as the change in status from active to permanently unusable status or temporarily unusable status. We used data from a large kidney care network from January 2021 to December 2021. Two models were created using LLMs and traditional TF-IDF technique. We used “distilbert-base-uncased”, a distilled version of BERT base model [1], and compared its performance with traditional TF-IDF-based NLP techniques. The dataset was randomly divided into 60% training, 20% validation and 20% test dataset. The test data, comprising of unseen patients’ data was used to evaluate the performance of the model. Both models were evaluated using metrics such as area under the receiver operating curve (AUROC), accuracy, sensitivity, and specificity. Results The incidence of 30 days AVF failure rate was 2.3% in the population. Both LLMs and traditional showed similar overall performance as summarized in Table 1. Notably, LLMs showed marginally better performance in certain evaluation metrics. Both models had same AUROC of 0.64 on test data. The accuracy and balanced accuracy for LLMs were 72.9% and 59.7%, respectively, compared to 70.9% and 59.6% for the traditional TF-IDF approach. In terms of specificity, LLMs scored 73.2%, slightly higher than the 71.2% observed for traditional NLP methods. However, LLMs had a lower sensitivity of 46.1% compared to 48% for traditional NLP. However, it is worth noting that training on LLMs took considerably longer than TF-IDF. Moreover, it also used higher computational resources such as utilization of graphics processing units (GPU) instances in cloud-based services, leading to higher cost. Conclusion In our study, we discovered that advanced LLMs perform comparably to traditional TF-IDF modeling techniques in predicting the failure of AVF. Both models demonstrated identical AUROC. While specificity was higher in LLMs compared to traditional NLP, sensitivity was higher in traditional NLP compared to LLMs. LLM was fine-tuned with a limited dataset, which could have influenced its performance to be similar to that of traditional NLP methods. This finding suggests that while LLMs may excel in certain scenarios, such as performing in-depth sentiment analysis of patient data for complex tasks, their effectiveness is highly dependent on the specific use case. It is crucial to weigh the benefits against the resources required for LLMs, as they can be significantly more resource-intensive and costly compared to traditional TF-IDF methods. This highlights the importance of a use-case-driven approach in selecting the appropriate NLP technique for healthcare applications.

BackgroundQualitative research methods are increasingly being used across disciplines because of their ability to help investigators understand the perspectives of participants in their own words. However, qualitative analysis is a laborious and resource-intensive process. To achieve depth, researchers are limited to smaller sample sizes when analyzing text data. One potential method to address this concern is natural language processing (NLP). Qualitative text analysis involves researchers reading data, assigning code labels, and iteratively developing findings; NLP has the potential to automate part of this process. Unfortunately, little methodological research has been done to compare automatic coding using NLP techniques and qualitative coding, which is critical to establish the viability of NLP as a useful, rigorous analysis procedure.ObjectiveThe purpose of this study was to compare the utility of a traditional qualitative text analysis, an NLP analysis, and an augmented approach that combines qualitative and NLP methods.MethodsWe conducted a 2-arm cross-over experiment to compare qualitative and NLP approaches to analyze data generated through 2 text (short message service) message survey questions, one about prescription drugs and the other about police interactions, sent to youth aged 14-24 years. We randomly assigned a question to each of the 2 experienced qualitative analysis teams for independent coding and analysis before receiving NLP results. A third team separately conducted NLP analysis of the same 2 questions. We examined the results of our analyses to compare (1) the similarity of findings derived, (2) the quality of inferences generated, and (3) the time spent in analysis.ResultsThe qualitative-only analysis for the drug question (n=58) yielded 4 major findings, whereas the NLP analysis yielded 3 findings that missed contextual elements. The qualitative and NLP-augmented analysis was the most comprehensive. For the police question (n=68), the qualitative-only analysis yielded 4 primary findings and the NLP-only analysis yielded 4 slightly different findings. Again, the augmented qualitative and NLP analysis was the most comprehensive and produced the highest quality inferences, increasing our depth of understanding (ie, details and frequencies). In terms of time, the NLP-only approach was quicker than the qualitative-only approach for the drug (120 vs 270 minutes) and police (40 vs 270 minutes) questions. An approach beginning with qualitative analysis followed by qualitative- or NLP-augmented analysis took longer time than that beginning with NLP for both drug (450 vs 240 minutes) and police (390 vs 220 minutes) questions.ConclusionsNLP provides both a foundation to code qualitatively more quickly and a method to validate qualitative findings. NLP methods were able to identify major themes found with traditional qualitative analysis but were not useful in identifying nuances. Traditional qualitative text analysis added important details and context.

1 IntroductionOrganizations focus on automate their processes in order to improve efficiency, reduce costs, and/or reduce human beings' errors in an easy and rapid manner. Business process management (BPM) methods provide a solution to this issue. In this context, information systems like CRM, ERP, SCM, etc. have known an increasing demand. The main problem consists of the length of the business process specifications. If new regulations appear, these specifications must be adapted. Manually extraction of visual models is time consuming. During time, a series of solutions were proposed. The literature shows a crowd of approaches that extracts data models [1], [2], [3], and process models [4], [5] from Natural Language (NL) text. This paper aims to analyze the Natural Language Processing (NLP) techniques and tools used in order to provide different types of visual representations.On the last few years, approaches based on NLP have been developed in order to automate process conversion from NL text. NLP plays an important role in NL text analysis as NLP tries to understand speech and text as humans beings would do. Colloquialism, abbreviations or typos make this task a challenging one. NLP has the origins in 1950s when Alan Turing proposed the Turing test [6], by introducing the imitation game. Since then, the literature shows a plethora of NLP tools [7], [8], [9], [10] using several machine learning techniques, our focus being on those applied on data models and process models discovery from NL text, starting with the first language parser [11] to the actual ones like NLTk [7], [8], ANTLR1, etc.Linguistic analysis is closely tied to NLP. Liddy [12] highlights 7 levels of linguistic analysis: a) Phonetic or Phonological level: how words are pronounced, b) Morphological level: prefixes, suffixes and roots analysis, c) Lexical level: word level analysis including lexical meaning and Part-Of-Speech (POS) analysis, d) Syntactic level: grammatical analysis of words in a sentence, e) Semantic level: determining the possible meanings of sentences, f) Discourse level: interpreting structure and meaning for texts larger than a sentence, g) Pragmatic level: understanding the purpose of a language.Some of the problems approached by NLP are: POS tagging, parsing, Named Entity Recognition (NER), chunking, Semantic Role Labeling (SRL). Anaphora resolution [13] refers to the interpretation of the link between the anaphor and its antecedents.The remainder of the paper is organized as follows: Section 2 briefly outlines the NLP domain, describing the levels of linguistic analysis and the main NLP approaches of analyzing NL requirements. Section 3 focuses on data and process models extraction from NL text. This section makes an introduction to Object Oriented Analysis and Business Process Modeling and analyses the existing tools that discover data and process models from text. Subsequently, Section 4 summarizes the results of this work and the conclusions are drawn in Section 5.2NLPA detailed review on NLP is given in [14] and in [15]. Jones [14] divides the history of NLP into four phases: the first starts at the beginning of the 1940s and lasts to the late 1960s, the second begins from the end of 60s and lasts to the end of 70s, the third is represented by late 80s, where the fourth phase starts in the late of 90s. Next, we will detail each phase as they were defined in [14] and [15]. First phase treated machine translation issues, while the second focused on artificial intelligence. The third phase can be called grammatico-logical phase, which is followed by the lexical phase. A fifth phase is proposed in [16] where formal theories and statistical data are combined. Since this study was published first in 1994 and then it was re-organized in 2001 we can add the sixth phase: from 2000 until present where NLP techniques are combined in order to contribute to visual models extraction.Software requirements are usually written in NL which is asymmetric and irregular [17]. …

Abstract. Large language models (LLMs) have revolutionized the field of natural language processing (NLP), demonstrating remarkable capabilities in understanding, generating, and manipulating human language. This comprehensive review explores the development, applications, optimizations, and challenges of LLMs. This paper begin by tracing the evolution of these models and their foundational architectures, such as the Transformer, GPT, and BERT. We then delve into the applications of LLMs in natural language understanding tasks, including sentiment analysis, named entity recognition, question answering, and text summarization, highlighting real-world use cases. Next, we examine the role of LLMs in natural language generation, covering areas such as content creation, language translation, personalized recommendations, and automated responses. We further discuss LLM applications in other NLP tasks like text style transfer, text correction, and language model pre-training. Subsequently, we explore techniques for optimizing and improving LLMs, including model compression, explainability, robustness, and security. Finally, we address the challenges posed by the significant computational requirements, sample inefficiency, and ethical considerations surrounding LLMs. We conclude by discussing potential future research directions, such as efficient architectures, few-shot learning, bias mitigation, and privacy-preserving techniques, which will shape the ongoing development and responsible deployment of LLMs in NLP.

447 Background: Mortality from bladder cancer (BC) increases exponentially once it invades the muscle. At the population level, accurate delineation of these patients is challenging. Methods: To develop and validate a natural language processing (NLP) model for automatically identifying muscle-invasive BC (MIBC) patients, aiding in population-based BC research. All patients with a CPT code for transurethral resection of bladder tumor (TURBT) (N = 76,060) were selected from the Department of Veterans Affairs (VA) Corporate Data Warehouse database. A sample of 600 patients (with 2,337 full-text notes) who had TURBT and confirmed pathology results were selected for NLP model development (500 patients) and validation (100 patients). Muscle-invasion (yes/no), unknown, or no cancer, were confirmed by detailed chart review of pathology notes. The NLP performance was assessed by calculating the sensitivity, positive predictive value (PPV), and overall accuracy at the individual note and patient levels. Results: In the validation cohort, the NLP model had overall accuracy of 88% and 92% at the note and patient levels. Specifically, PPV and specificity for predicting muscle-invasion on note level were 83% and 70%, respectively. The model classified non-muscle invasive BC (NMIBC) with 98% sensitivity at both the note and patient levels. Although the sensitivity for MIBC was 70% for note-level determination, the sensitivity was 86% when evaluated at the patient level. When applying the model to 71,200 patients VA-wide, the model classified 13,642 (19%) as having MIBC and 47,595 (66%) as NMIBC. The NLP model was able to identify invasion status for 96% TURBT patients at the population level. Inherent limitations include relatively small training set given the size of the VA population. Conclusions: This NLP model for identifying muscle-invasion at the population level had high accuracy. The NLP model may be a practical and accurate tool for efficiently identifying BC invasion status and may potentially aid in population-based BC research in the VA.

Aspirin-exacerbated respiratory disease (AERD) is an acquired inflammatory condition characterized by the presence of asthma, chronic rhinosinusitis with nasal polyposis, and respiratory hypersensitivity reactions on ingestion of aspirin or other nonsteroidal anti-inflammatory drugs (NSAIDs). Despite AERD having a classic constellation of symptoms, the diagnosis is often overlooked, with an average of greater than 10 years between the onset of symptoms and diagnosis of AERD. Without a diagnosis, individuals will lack opportunities to receive effective treatments, such as aspirin desensitization or biologic medications. Our aim was to develop a combined algorithm that integrates both natural language processing (NLP) and machine learning (ML) techniques to identify patients with AERD from an electronic health record (EHR). A rule-based decision tree algorithm incorporating NLP-based features was developed using clinical documents from the EHR at Mayo Clinic. From clinical notes, using NLP techniques, 7 features were extracted that included the following: AERD, asthma, NSAID allergy, nasal polyps, chronic sinusitis, elevated urine leukotriene E4 level, and documented no-NSAID allergy. MedTagger was used to extract these 7 features from the unstructured clinical text given a set of keywords and patterns based on the chart review of 2 allergy and immunology experts for AERD. The status of each extracted feature was quantified by assigning the frequency of its occurrence in clinical documents per subject. We optimized the decision tree classifier's hyperparameters cutoff threshold on the training set to determine the representative feature combination to discriminate AERD. We then evaluated the resulting model on the test set. The AERD algorithm, which combines NLP and ML techniques, achieved an area under the receiver operating characteristic curve score, sensitivity, and specificity of 0.86 (95% CI 0.78-0.94), 80.00 (95% CI 70.82-87.33), and 88.00 (95% CI 79.98-93.64) for the test set, respectively. We developed a promising AERD algorithm that needs further refinement to improve AERD diagnosis. Continued development of NLP and ML technologies has the potential to reduce diagnostic delays for AERD and improve the health of our patients.

BackgroundLarge language models have had a huge impact on natural language processing (NLP) in recent years. However, their application in epidemiological research is still limited to the analysis of electronic health records and social media data.ObjectivesTo demonstrate the potential of NLP beyond these domains, we aimed to develop prediction models based on texts collected from an epidemiological cohort and compare their performance to classical regression methods.MethodsWe used data from the British National Child Development Study, where 10,567 children aged 11 years wrote essays about how they imagined themselves as 25-year-olds. Overall, 15% of the data set was set aside as a test set for performance evaluation. Pretrained language models were fine-tuned using AutoTrain (Hugging Face) to predict current reading comprehension score (range: 0-35) and future BMI and physical activity (active vs inactive) at the age of 33 years. We then compared their predictive performance (accuracy or discrimination) with linear and logistic regression models, including demographic and lifestyle factors of the parents and children from birth to the age of 11 years as predictors.ResultsNLP clearly outperformed linear regression when predicting reading comprehension scores (root mean square error: 3.89, 95% CI 3.74-4.05 for NLP vs 4.14, 95% CI 3.98-4.30 and 5.41, 95% CI 5.23-5.58 for regression models with and without general ability score as a predictor, respectively). Predictive performance for physical activity was similarly poor for the 2 methods (area under the receiver operating characteristic curve: 0.55, 95% CI 0.52-0.60 for both) but was slightly better than random assignment, whereas linear regression clearly outperformed the NLP approach when predicting BMI (root mean square error: 4.38, 95% CI 4.02-4.74 for NLP vs 3.85, 95% CI 3.54-4.16 for regression). The NLP approach did not perform better than simply assigning the mean BMI from the training set as a predictor.ConclusionsOur study demonstrated the potential of using large language models on text collected from epidemiological studies. The performance of the approach appeared to depend on how directly the topic of the text was related to the outcome. Open-ended questions specifically designed to capture certain health concepts and lived experiences in combination with NLP methods should receive more attention in future epidemiological studies.

Current state-of-the-art natural language processing (NLP) techniques use transformer deep-learning architectures, which depend on large training datasets. We hypothesized that traditional NLP techniques may outperform transformers for smaller radiology report datasets. We compared the performance of BioBERT, a deep-learning-based transformer model pre-trained on biomedical text, and three traditional machine-learning models (gradient boosted tree, random forest, and logistic regression) on seven classification tasks given free-text radiology reports. Tasks included detection of appendicitis, diverticulitis, bowel obstruction, and enteritis/colitis on abdomen/pelvis CT reports, ischemic infarct on brain CT/MRI reports, and medial and lateral meniscus tears on knee MRI reports (7,204 total annotated reports). The performance of NLP models on held-out test sets was compared after training using the full training set, and 2.5%, 10%, 25%, 50%, and 75% random subsets of the training data. In all tested classification tasks, BioBERT performed poorly at smaller training sample sizes compared to non-deep-learning NLP models. Specifically, BioBERT required training on approximately 1,000 reports to perform similarly or better than non-deep-learning models. At around 1,250 to 1,500 training samples, the testing performance for all models began to plateau, where additional training data yielded minimal performance gain. With larger sample sizes, transformer NLP models achieved superior performance in radiology report binary classification tasks. However, with smaller sizes (<1000) and more imbalanced training data, traditional NLP techniques performed better. Our benchmarks can help guide clinical NLP researchers in selecting machine-learning models according to their dataset characteristics.

Large Language Models (LLMs) have ushered in a transformative era in Natural Language Processing (NLP), reshaping research and extending NLP's influence to other fields of study. However, there is little to no work examining the degree to which LLMs influence other research fields. This work empirically and systematically examines the influence and use of LLMs in fields beyond NLP. We curate 106 LLMs and analyze ∼148k papers citing LLMs to quantify their influence and reveal trends in their usage patterns. Our analysis reveals not only the increasing prevalence of LLMs in non-CS fields but also the disparities in their usage, with some fields utilizing them more frequently than others since 2018, notably Linguistics and Engineering together accounting for ∼45% of LLM citations. Our findings further indicate that most of these fields predominantly employ task-agnostic LLMs, proficient in zero or few-shot learning without requiring further fine-tuning, to address their domain-specific problems. This study sheds light on the cross-disciplinary impact of NLP through LLMs, providing a better understanding of the opportunities and challenges.

BackgroundMortality is a critical variable in health care research, especially for evaluating medical product safety and effectiveness. However, inconsistencies in the availability and timeliness of death date and cause of death (CoD) information present significant challenges. Conventional sources such as the National Death Index and electronic health records often experience data lags, missing fields, or incomplete coverage, limiting their utility in time-sensitive or large-scale studies. With the growing use of social media, crowdfunding platforms, and web-based memorials, publicly available digital content has emerged as a potential supplementary source for mortality surveillance. Despite this potential, accurate tools for extracting mortality information from such unstructured data sources remain underdeveloped.ObjectiveThe aim of the study is to develop scalable approaches using natural language processing (NLP) and large language models (LLMs) for the extraction of mortality information from publicly available web-based data sources, including social media platforms, crowdfunding websites, and web-based obituaries, and to evaluate their performance across various sources.MethodsData were collected from public posts on X (formerly known as Twitter), GoFundMe campaigns, memorial websites (EverLoved and TributeArchive), and web-based obituaries from 2015 to 2022, focusing on US-based content relevant to mortality. We developed an NLP pipeline using transformer-based models to extract key mortality information such as decedent names, dates of birth, and dates of death. We then used a few-shot learning (FSL) approach with LLMs to identify primary and secondary CoDs. Model performance was assessed using precision, recall, F1-score, and accuracy metrics, with human-annotated labels serving as the reference standard for the transformer-based model and a human adjudicator blinded to the labeling source for the FSL model reference standard.ResultsThe best-performing model obtained a microaveraged F1-score of 0.88 (95% CI 0.86‐0.90) in extracting mortality information. The FSL-LLM approach demonstrated high accuracy in identifying primary CoD across various web-based sources. For GoFundMe, the FSL-LLM achieved 95.9% accuracy for primary cause identification compared to 97.9% for human annotators. In obituaries, FSL-LLM accuracy was 96.5% for primary causes, while human accuracy was 99%. For memorial websites, FSL-LLM achieved 98% accuracy for primary causes, with human accuracy at 99.5%.ConclusionsThis study demonstrates the feasibility of using advanced NLP and LLM techniques to extract mortality data from publicly available web-based sources. These methods can significantly enhance the timeliness, completeness, and granularity of mortality surveillance, offering a valuable complement to traditional data systems. By enabling earlier detection of mortality signals and improving CoD classification across large populations, this approach may support more responsive public health monitoring and medical product safety assessments. Further work is needed to validate these findings in real-world health care settings and facilitate the integration of digital data sources into national public health surveillance systems.

In an increasingly technologized and automated world, workplace safety and health remain a major global challenge. After decades of regulatory frameworks and substantial technical and organizational advances, the expanding interaction between humans and machines and the growing complexity of work systems are gaining importance. In parallel, the digitalization of Industry 4.0/5.0 is generating unprecedented volumes of safety-relevant data and new opportunities to move from reactive analysis to proactive, data-driven prevention. This review maps how artificial intelligence (AI), with a specific focus on natural language processing (NLP) and large language models (LLMs), is being applied to occupational risk prevention across sectors. A structured search of the Web of Science Core Collection (2013–October 2025), combined OSH-related terms with AI, NLP and LLM terms. After screening and full-text assessment, 123 studies were discussed. Early work relied on text mining and traditional machine learning to classify accident types and causes, extract risk factors and support incident analysis from free-text narratives. More recent contributions use deep learning to predict injury severity, potential serious injuries and fatalities (PSIF) and field risk control program (FRCP) levels and to fuse textual data with process, environmental and sensor information in multi-source risk models. The latest wave of studies deploys LLMs, retrieval-augmented generation and vision–language architectures to generate task-specific safety guidance, support accident investigation, map occupations and job tasks and monitor personal protective equipment (PPE) compliance. Together, these developments show that AI-, NLP- and LLM-based systems can exploit unstructured OSH information to provide more granular, timely and predictive safety insights. However, the field is still constrained by data quality and bias, limited external validation, opacity, hallucinations and emerging regulatory and ethical requirements. In conclusion, this review positions AI and LLMs as tools to support human decision-making in OSH and outlines a research agenda centered on high-quality datasets and rigorous evaluation of fairness, robustness, explainability and governance.

Generative large language models (LLMs) are a subset of transformers-based neural network architecture models. LLMs have successfully leveraged a combination of an increased number of parameters, improvements in computational efficiency, and large pre-training datasets to perform a wide spectrum of natural language processing (NLP) tasks. Using a few examples (few-shot) or no examples (zero-shot) for prompt-tuning has enabled LLMs to achieve state-of-the-art performance in a broad range of NLP applications. This article by the American Medical Informatics Association (AMIA) NLP Working Group characterizes the opportunities, challenges, and best practices for our community to leverage and advance the integration of LLMs in downstream NLP applications effectively. This can be accomplished through a variety of approaches, including augmented prompting, instruction prompt tuning, and reinforcement learning from human feedback (RLHF). Our focus is on making LLMs accessible to the broader biomedical informatics community, including clinicians and researchers who may be unfamiliar with NLP. Additionally, NLP practitioners may gain insight from the described best practices. We focus on 3 broad categories of NLP tasks, namely natural language understanding, natural language inferencing, and natural language generation. We review the emerging trends in prompt tuning, instruction fine-tuning, and evaluation metrics used for LLMs while drawing attention to several issues that impact biomedical NLP applications, including falsehoods in generated text (confabulation/hallucinations), toxicity, and dataset contamination leading to overfitting. We also review potential approaches to address some of these current challenges in LLMs, such as chain of thought prompting, and the phenomena of emergent capabilities observed in LLMs that can be leveraged to address complex NLP challenge in biomedical applications.

Purpose This study examines the evolution of education research in Kazakhstan from 1992 to 2024, a period marked by profound transformation, aiming to assess how scholarly output aligns with national education policy and broader developmental priorities. Design/methodology/approach A mixed bibliometric and natural language processing (NLP) approach was employed to analyze 956 English-language publications indexed in the Web of Science. The study combined quantitative analyses of publication trends, authorship and institutional collaboration with NLP techniques, including keyword co-occurrence, topic modeling and sentiment analysis, framed by a review of Kazakhstan’s education policy phases: post-Soviet foundational reforms and an era of global alignment. Findings Results reveal a substantial surge in research output, particularly after 2020, driven by a core set of highly productive authors and institutions. Thematic analyses indicate partial alignment with policy priorities, with multilingual education, digitalization and pedagogical innovation prominent, while inclusive education and social justice appear less substantively addressed. Collaboration networks display a core-periphery structure, with Nazarbayev University acting as the primary international and national hub. Originality/value This study offers the first comprehensive, longitudinal mapping of Kazakhstani education research, integrating bibliometric and NLP methods with policy analysis. It highlights both the rapid quantitative growth and the structural and thematic limitations of the field, providing a foundation for policy and institutional strategies aimed at fostering more diverse, critical and sustainable research.

BackgroundMachine learning systems are part of the field of artificial intelligence that automatically learn models from data to make better decisions. Natural language processing (NLP), by using corpora and learning approaches, provides good performance in statistical tasks, such as text classification or sentiment mining.ObjectiveThe primary aim of this systematic review was to summarize and characterize, in methodological and technical terms, studies that used machine learning and NLP techniques for mental health. The secondary aim was to consider the potential use of these methods in mental health clinical practiceMethodsThis systematic review follows the PRISMA (Preferred Reporting Items for Systematic Review and Meta-analysis) guidelines and is registered with PROSPERO (Prospective Register of Systematic Reviews; number CRD42019107376). The search was conducted using 4 medical databases (PubMed, Scopus, ScienceDirect, and PsycINFO) with the following keywords: machine learning, data mining, psychiatry, mental health, and mental disorder. The exclusion criteria were as follows: languages other than English, anonymization process, case studies, conference papers, and reviews. No limitations on publication dates were imposed.ResultsA total of 327 articles were identified, of which 269 (82.3%) were excluded and 58 (17.7%) were included in the review. The results were organized through a qualitative perspective. Although studies had heterogeneous topics and methods, some themes emerged. Population studies could be grouped into 3 categories: patients included in medical databases, patients who came to the emergency room, and social media users. The main objectives were to extract symptoms, classify severity of illness, compare therapy effectiveness, provide psychopathological clues, and challenge the current nosography. Medical records and social media were the 2 major data sources. With regard to the methods used, preprocessing used the standard methods of NLP and unique identifier extraction dedicated to medical texts. Efficient classifiers were preferred rather than transparent functioning classifiers. Python was the most frequently used platform.ConclusionsMachine learning and NLP models have been highly topical issues in medicine in recent years and may be considered a new paradigm in medical research. However, these processes tend to confirm clinical hypotheses rather than developing entirely new information, and only one major category of the population (ie, social media users) is an imprecise cohort. Moreover, some language-specific features can improve the performance of NLP methods, and their extension to other languages should be more closely investigated. However, machine learning and NLP techniques provide useful information from unexplored data (ie, patients’ daily habits that are usually inaccessible to care providers). Before considering It as an additional tool of mental health care, ethical issues remain and should be discussed in a timely manner. Machine learning and NLP methods may offer multiple perspectives in mental health research but should also be considered as tools to support clinical practice.

Natural language processing (NLP) and large language models (LLMs) have emerged as powerful tools in healthcare, offering advanced methods for analysing unstructured clinical texts. This systematic review aims to evaluate the current applications of NLP and LLMs in rheumatology, focusing on their potential to improve disease detection, diagnosis and patient management. We screened seven databases. We included original research articles that evaluated the performance of NLP models in rheumatology. Data extraction and risk of bias assessment were performed independently by two reviewers, following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies was used to evaluate the risk of bias. Of 1491 articles initially identified, 35 studies met the inclusion criteria. These studies utilized various data types, including electronic medical records and clinical notes, and employed models like Bidirectional Encoder Representations from Transformers and Generative Pre-trained Transformers. High accuracy was observed in detecting conditions such as RA, SpAs and gout. The use of NLP also showed promise in managing diseases and predicting flares. NLP showed significant potential in enhancing rheumatology by improving diagnostic accuracy and personalizing patient care. While applications in detecting diseases like RA and gout are well developed, further research is needed to extend these technologies to rarer and more complex clinical conditions. Overcoming current limitations through targeted research is essential for fully realizing NLP's potential in clinical practice.