LATA: A Pilot Study on LLM-Assisted Thematic Analysis of Online Social Network Data Generation Experiences

Aim/Purpose: The study investigates the factors influencing the acceptance and utilisation of large language models (LLMs) (predictor variables of LLM usage), such as ChatGPT, in Learning design by instructional designers and university-teaching academics from various countries. Background: Large language models (LLMs) have exploded onto the scene, transforming the landscape of learning design. Instructional designers and university teaching academics have been overburdened with content creation for their teaching programmes, and the arrival of LLM models will help in this regard by developing more interactive content that drives student engagement and, in turn, contributes to student success. Since LLMs are a relatively new phenomenon, little is known about the factors influencing their acceptance in learning design; therefore, this research is needed, as learning design principles are the bedrock of student engagement and success. Methodology: A cross-sectional correlational quantitative study was employed. Data was collected using an online questionnaire posted on social media, including LinkedIn, from 203 instructional designers and university teaching academics. Purposive and snowball sampling methods were used to target instructional designers and university teaching academics at colleges and universities worldwide. Participants were asked to share the survey link with fellow instructional designers and university-teaching academics in their communities. The factor structure of the data was determined using exploratory factor analysis. Nonetheless, the factor structure derived from the LLMs did not entirely reflect the original configuration of the Unified Theory of Acceptance and Use of Technology (UTAUT3), as certain predictors appeared to coalesce, indicating LLMs’ unique nature in learning design. Confirmatory factor analysis was used to verify the fit of the data on the measurement model. First-order and second-order structural modelling were used to identify the structural relationships among the variables. Contribution: The study determines significant factors for the acceptance of LLMs by instructional designers and academic teaching staff in learning design, enabling possible opportunities for best practices in the field through interventions to optimize LLM usage. The study applies the technology acceptance model to the emerging LLM technology and extends the technology acceptance model by adding the trust construct as a predictor variable. Findings: The structural analysis results indicated that the ingrained LLM practices, LLM peer-driven expectations, innovative propensity towards LLM adoption, reliability and provider trust in LLMs, and ease of use and support influenced perceived LLM benefits and usage, but community standards and infrastructure had no influence. The second-order structural equation modelling indicated that perceived LLM benefits and usage and ingrained LLM habits contributed most to the learning design. Recommendations for Practitioners: Teaching academics and instructional designers must use LLMs in designing content, assessments, and interactive learning activities, and attend LLM training workshops on prompting and best practices in integrating LLMs into learning and teaching to see their benefits; hence, regular use of LLMs will then lead to trust and innovation in LLMs usage, enhancing learning design and improving student learning outcomes. Recommendation for Researchers: Researchers must use mixed methods approaches to have a deeper understanding of the factors influencing LLMs. Since habit and perceived LLM benefits and usage contributed the most variance to learning design, researchers must investigate strategies that optimise these factors in learning design, such as effective intervention strategies that can help form positive LLM habits. In addition, the findings provide researchers with a starting point for future research. Further researchers must investigate interventions that optimise the influence of personal innovativeness and trust that contributed the least variance to learning design, hence unlocking the potential of LLMs in learning design through innovation, responsible, and ethical use. Impact on Society: The use of LLMs in learning design has a high possibility of transforming education, specifically the learning design landscape. Using LLMs will free up more time for teaching academics and instructional designers so that they spend more time on higher-order thinking skill demands. Consequently, the students will be exposed to more engaging and interactive content, resulting in improved learning outcomes. Future Research: Future research must include context-derived external variables in technology acceptance models, such as levels of prompting competencies, to provide a deeper understanding of LLMs. In addition, future research must be based on the application and impact of LLMs on student engagement and success, and their attainment of 21st-century skills.

Patient experiences and perspectives are essential for shaping patient-centered healthcare. While large language models (LLMs) in healthcare are typically applied to specific clinical or patient-facing tasks, they have not been used for qualitative patient preference assessment, which often relies on thematic analysis to understand patient views expressed in interviews or focus groups. LLMs show initial promise for performing inductive thematic analysis of healthcare interview or focus group transcripts, yet no empirical studies have investigated LLMs to facilitate qualitative patient preference assessment. We employed the open-source Hermes-3-Llama-3.1-70B LLM to perform inductive thematic analysis on focus group transcripts from a previously published qualitative patient preference assessment study using three optimized prompt frameworks, and evaluated semantic similarity of LLM generated themes against human-analyzed themes using the Sentence-T5-XXL language embedding model. Sentence-level theme similarity was assessed using Jaccard similarity coefficients (0-1 range), computing coefficient scores across a broad range of discrete cosine similarity thresholds. We further evaluated LLM themes for similarity in lexical diversity and reading grade-level metrics and benchmarked semantic similarity results with published similarity thresholds previously used with qualitative healthcare data. All prompt frameworks generated themes with median Jaccard similarity coefficients with human-analyzed themes between 0.46-0.64, indicating moderate semantic overlap. Our best-performing framework instructed to pursue thematic saturation scored closest to human-analyzed themes on all reading grade-level metrics, and demonstrated 12% higher semantic overlap with human-analyzed themes compared to published benchmarks. Our worst-performing framework produced themes with moderate semantic overlap and hallucinated findings unidentified in human-analyzed themes. We demonstrate that LLMs can perform inductive thematic analysis of qualitative patient preference data, producing themes substantively similar in content and style to human-analyzed themes when augmented with sufficient domain-specific context. While LLMs may augment thematic analysis, the contextual nature of qualitative analysis remains a challenge requiring collaborative LLM frameworks integrating human expertise.

UNSTRUCTURED Misleading information has significant implications for society but can have disastrous impact for health matters. Transformative artificial intelligence (AI) tools such as large language models (LLMs) have the potential for limitless content generation (including fake), soon making internet information impossible to assess using traditional human approaches. We asked if the same LLMs (GPT4 and Gemini1-5-Pro) could be part of a more scalable solution. We tested 2 publicly available LLMs for their ability to identify misinformation in HealthReleases previously labeled by human experts. We found that simple prompts lead to overall low accuracy (F1 Macro 0,45 (GPT4) and 0,49 (Gemini1-5Pro)), but very different profiles for each LLM. Adding specific criteria used by experts to critically assess the Releases enhanced Gemini (0.66) but surprisingly reduced GPT4 (0,37) performances. We therefore developed a novel approach incorporating summaries of expert feedback into prompts and then observed major improvements in performance for both LLMs(GPT4;0.63 and Gemini1-5Pro; 0.96). Our study provides the first use case of LLMs as high throughput proofing of medical text, but more importantly provides insights into LLMs’ “truth biases”. We provide a novel paradigm integrating knowledge into the prompts which may reduce the need for LLM training, and the requirement for ever larger datasets and compute power. Importantly, we show how experts could and need to be involved in LLMs used to enhance their performance and potentially minimize the data wall issue.

To assess the performance of state-of-the-art large language models in classifying vertebral metastasis stability using the Spinal Instability Neoplastic Score (SINS) compared to human experts, and to evaluate the impact of task-specific refinement including in-context learning on their performance. This retrospective study analyzed 100 synthetic CT and MRI reports encompassing a broad range of SINS scores. Four human experts (two radiologists and two neurosurgeons) and four large language models (Mistral, Claude, GPT-4 turbo, and GPT-4o) evaluated the reports. Large language models were tested in both generic form and with task-specific refinement. Performance was assessed based on correct SINS category assignment and attributed SINS points. Human experts demonstrated high median performance in SINS classification (98.5% correct) and points calculation (92% correct), with a median point offset of 0 [0-0]. Generic large language models performed poorly with 26-63% correct category and 4-15% correct SINS points allocation. In-context learning significantly improved chatbot performance to near-human levels (96-98/100 correct for classification, 86-95/100 for scoring, no significant difference to human experts). Refined large language models performed 71-85% better in SINS points allocation. In-context learning enables state-of-the-art large language models to perform at near-human expert levels in SINS classification, offering potential for automating vertebral metastasis stability assessment. The poor performance of generic large language models highlights the importance of task-specific refinement in medical applications of artificial intelligence.

In contemporary research, selecting the appropriate statistical test is a critical and often challenging step. The emergence of large language models (LLMs) has offered a promising avenue for automating this process, potentially enhancing the efficiency and accuracy of statistical test selection. This study aimed to assess the capability of freely available LLMs - OpenAI's ChatGPT3.5, Google Bard, Microsoft Bing Chat, and Perplexity in recommending suitable statistical tests for research, comparing their recommendations with those made by human experts. A total of 27 case vignettes were prepared for common research models with a question asking suitable statistical tests. The cases were formulated from previously published literature and reviewed by a human expert for their accuracy of information. The LLMs were asked the question with the case vignettes and the process was repeated with paraphrased cases. The concordance (if exactly matching the answer key) and acceptance (when not exactly matching with answer key, but can be considered suitable) were evaluated between LLM's recommendations and those of human experts. Among the 27 case vignettes, ChatGPT3.5-suggested statistical test had 85.19% concordance and 100% acceptance; Bard experiment had 77.78% concordance and 96.3% acceptance; Microsoft Bing Chat had 96.3% concordance and 100% acceptance; and Perplexity had 85.19% concordance and 100% acceptance. The intra-class correction coefficient of average measure among the responses of LLMs was 0.728 (95% confidence interval [CI]: 0.51-0.86), P < 0.0001. The test-retest reliability of ChatGPT was r = 0.71 (95% CI: 0.44-0.86), P < 0.0001, Bard was r = -0.22 (95% CI: -0.56-0.18), P = 0.26, Bing was r = -0.06 (95% CI: -0.44-0.33), P = 0.73, and Perplexity was r = 0.52 (95% CI: 0.16-0.75), P = 0.0059. The LLMs, namely, ChatGPT, Google Bard, Microsoft Bing, and Perplexity all showed >75% concordance in suggesting statistical tests for research case vignettes with all having acceptance of >95%. The LLMs had a moderate level of agreement among them. While not a complete replacement for human expertise, these models can serve as effective decision support systems, especially in scenarios where rapid test selection is essential.

SummarySustained engagement in HIV care and adherence to antiretroviral therapy (ART) are essential for achieving the UNAIDS “95-95-95” targets. Despite increased ART access, disengagement from care remains a significant issue, particularly in sub-Saharan Africa. Traditional machine learning (ML) models have shown moderate success in predicting care disengagement, which would enable early intervention. We develop an enhanced large language model (LLM) fine-tuned with electronic medical records (EMRs) to predict people at risk of disengaging from HIV care in Tanzania and to provide interpretative insights into modifiable risk factors.MethodsWe developed a novel AI model by enhancing a pre-trained LLM (LLaMA 3.1, an open-source pre-trained LLM released by Meta) using routinely collected EMRs from Tanzania’s National HIV Care and Treatment Program from January 1, 2018, to June 30, 2023 (4,809,765 records for 261,192 people) to identify people at risk of disengaging from HIV care or developing adverse outcomes. Outcomes included risk of ART non-adherence, non-suppressed viral load, and loss to follow-up. Models were evaluated internally (Kagera region) and externally (Geita region), with performance compared against state-of-art ML models and zero-shot LLMs. Additionally, a team of HIV physicians in Tanzania assessed the LLM’s predictions along with LLM provided justifications for a subset of patient records to evaluate their clinical relevance and reasoning.FindingsThe enhanced LLMs consistently outperformed the supervised ML model and zero-shot LLMs across all outcomes in both internal and external validation datasets. When focusing on the 25% of PLHIV predicted as most likely to lost-to-follow-up (LTFU), the model correctly identified 78% (2,515 of 3,224) of people living with HIV (PLHIV) genuinely at risk in internal validation and 73% (7,105 of 9,733) in external validation. Attention score analysis indicated that the enhanced LLM focused on keywords such as gaps in follow-up care and ART adherence. The human expert evaluation showed alignment between clinician assessments and the LLM’s predictions in 65% of cases, with experts finding the model’s justifications reasonable and clinically relevant in 92.3% of aligned cases.InterpretationIf implemented in HIV clinics, this LLM-based AI model could help allocate resources efficiently and deliver targeted interventions, improving retention in care and advancing the UNAIDS “95-95-95” targets. By functioning like a clinician–analyzing patient summaries, predicting risks, and offering reasoning–the enhanced LLM could be integrated into clinical workflows to complement human expertise, facilitating timely interventions and informed decision-making. If implemented widely, this human-AI collaboration has the potential to improve health outcomes for people living with HIV and reduce onward transmission.FundingThe study was supported by a grant from the US National Institutes of Health (NIH): NIH NIMH 1R01MH125746.

Large Language Models (LLMs) became wide-spread during only the last couple of years and are used in almost every scientific and non-scientific domain. Understanding opportunities, applications and limitations of LLMs is crucial for a risk-free, effective and useful implementation of LLMs into scientific workflows. We demonstrate that their effectiveness is maximized not through autonomous operation but through careful integration with specialized tools and contextual knowledge bases.&amp;#160;Using local deployments of modern LLMs (QWen-2.5-coder, LLaMA, Mistral) comes with a number of benefits in a scientific context. Our approach employs vector embeddings for enhanced context retention and metadata databases for structured data access, enabling guided, context-aware interactions with the LLM. Local deployments allow for improved data handling and privacy, improved cost management and a higher degree of customization. Energy consumption can more easily be observed and managed, which can be a crucial property of such a system, especially compared to the newest generation of LLMs, which have extensive power&amp;#160; (and cost) requirements.Opportunities and limitations are explored through two case studies: (1) an LLM-driven system that queries metadata databases to retrieve data from common open data sources and harmonizes patio-temporal subsets into data-cubes, and (2) a VBA-to-Python code translation project to preserve a legacy selection-system forest management software, which was developed in ACCESS / VBA over more than two decades. The LLM's translation process and reasoning are preserved in a vector database for consistent context maintenance and the original as well as the &amp;#8218;new&amp;#8216; code is searchable using the LLM to aid rebuilding a modernized software.&amp;#160;Results suggest that this tool-augmented approach leads to a more reliable and maintainable solution compared to purely LLM-driven implementations, suggesting a new paradigm for integrating AI in scientific workflows where LLMs rather facilitate than replace domain-specific tools and human expertise.

Although research evaluators and scientometricians have promoted the message of responsible bibliometrics through initiatives like the Leiden Manifesto, these do not mention Large Language Models (LLMs). LLMs can now make useful quality predictions for journal articles, giving values that correlate more strongly with expert judgements than do citation-based indicators in most fields. This has created the possibility that they could supplement or even replace citation-based indicators for some applications. As tested so far, LLMs predict the quality rating that a human expert would give a paper. They do this by reading the quality level descriptions and then processing the article title and abstract. This raises multiple new issues in comparison to the Leiden Manifesto. First, authors might try to trick LLMs into giving high scores by crafting LLM-friendly abstracts. Second, LLM models incorporate billions of parameters, so their scores are opaque. Third, it is not clear how LLMs work in terms of the main influences on their scores, so their biases are unknown. Fourth, whilst citations reflect tangible and permanent contributions to the scientific record, albeit of variable value, LLM-based predictions do not clearly link to progress. Fifth, LLM scores are ephemeral in the sense that newer LLMs may give substantially different scores and rankings.

In this article, we explore the application of Large Language Models (LLMs) in assessing the content validity of psychometric instruments, focusing on the Big Five Questionnaire (BFQ) and Big Five Inventory (BFI). Content validity, a cornerstone of test construction, ensures that psychological measures adequately cover their intended constructs. Using both human expert evaluations and advanced LLMs, we compared the accuracy of semantic item-construct alignment. Graduate psychology students employed the Content Validity Ratio to rate test items, forming the human baseline. In parallel, state-of-the-art LLMs, including multilingual and fine-tuned models, analyzed item embeddings to predict construct mappings. The results reveal distinct strengths and limitations of human and AI approaches. Human validators excelled in aligning the behaviorally rich BFQ items, while LLMs performed better with the linguistically concise BFI items. Training strategies significantly influenced LLM performance, with models tailored for lexical relationships outperforming general-purpose LLMs. Here we highlight the complementary potential of hybrid validation systems that integrate human expertise and AI precision. The findings underscore the transformative role of LLMs in psychological assessment, paving the way for scalable, objective, and robust test development methodologies.

BackgroundPatient complaints provide valuable insights into the performance of health care systems, highlighting potential risks not apparent to staff. Patient complaints can drive systemic changes that enhance patient safety. However, manual categorization and analysis pose a huge logistical challenge, hindering the ability to harness the potential of these data.ObjectiveThis study aims to evaluate the accuracy of artificial intelligence (AI)–powered categorization of patient complaints in primary care based on the Healthcare Complaint Analysis Tool (HCAT) General Practice (GP) taxonomy and assess the importance of advanced large language models (LLMs) in complaint categorization.MethodsThis cross-sectional study analyzed 1816 anonymous patient complaints from 7 public primary care clinics in Singapore. Complaints were first coded by trained human coders using the HCAT (GP) taxonomy through a rigorous process involving independent assessment and consensus discussions. LLMs (GPT-3.5 turbo, GPT-4o mini, and Claude 3.5 Sonnet) were used to validate manual classification. Claude 3.5 Sonnet was further used to identify complaint themes. LLM classifications were assessed for accuracy and consistency with human coding using accuracy and F1-score. Cohen κ and McNemar test evaluated AI-human agreement and compared AI models’ concordance, respectively.ResultsThe majority of complaints fell under the HCAT (GP) domain of management (1079/1816, 59.4%), specifically relating to institutional processes (830/1816, 45.7%). Most complaints were of medium severity (994/1816, 54.7%), occurred within the practice (627/1816, 34.5%), and resulted in minimal harm (75.4%). LLMs achieved moderate to good accuracy (58.4%‐95.5%) in HCAT (GP) field classifications, with GPT-4o mini generally outperforming GPT-3.5 turbo, except in severity classification. All 3 LLMs demonstrated moderate concordance rates (average 61.9%‐68.8%) in complaints classification with varying levels of agreement (κ=0.114‐0.623). GPT-4o mini and Claude 3.5 significantly outperformed GPT-3.5 turbo in several fields (P<.05), such as domain and stage of care classification. Thematic analysis using Claude 3.5 identified long wait times (393/1816, 21.6%), staff attitudes (287/1816, 15.8%), and appointment booking issues (191/1816, 10.5%) as the top concerns, which accounted for nearly half of all complaints.ConclusionsOur study highlighted the potential of LLMs in classifying patient complaints in primary care using HCAT (GP) taxonomy. While GPT-4o and Claude 3.5 demonstrated promising results, further fine-tuning and model training are required to improve accuracy. Integrating AI into complaint analysis can facilitate proactive identification of systemic issues, ultimately enhancing quality improvement and patient safety. By leveraging LLMs, health care organizations can prioritize complaints and escalate high-risk issues more effectively. Theoretically, this could lead to improved patient care and experience; further research is needed to confirm this potential benefit.

Computation-intensive tensor operators constitute over 90% of the computations in Large Language Models (LLMs) and Deep Neural Networks. Automatically and efficiently generating high-performance tensor operators with hardware primitives is crucial for diverse and ever-evolving hardware architectures like RISC-V, ARM, and GPUs, as manually optimized implementation takes at least months and lacks portability. LLMs excel at generating high-level language codes, but they struggle to fully comprehend hardware characteristics and produce high-performance tensor operators. We introduce a tensor-operator auto-generation framework with a one-line user prompt (QiMeng-TensorOp), which enables LLMs to automatically exploit hardware characteristics to generate tensor operators with hardware primitives, and tune parameters for optimal performance across diverse hardware. Experimental results on various hardware platforms, SOTA LLMs, and typical tensor operators demonstrate that QiMeng-TensorOp effectively unleashes the computing capability of various hardware platforms, and automatically generates tensor operators of superior performance. Compared with vanilla LLMs, QiMeng-TensorOp achieves up to 1291× performance improvement. Even compared with human experts, QiMeng-TensorOp could reach 251% of OpenBLAS on RISC-V CPUs, and 124% of cuBLAS on NVIDIA GPUs. Additionally, QiMeng-TensorOp also significantly reduces development costs by 200× compared with human experts.

BackgroundThis study evaluated the feasibility of ChatGPT and Gemini, two off-the-shelf large language models (LLMs), to automate causality assessments, focusing on Adverse Events Following Immunizations (AEFIs) of myocarditis and pericarditis related to COVID-19 vaccines.MethodsWe assessed 150 COVID-19-related cases of myocarditis and pericarditis reported to the Vaccine Adverse Event Reporting System (VAERS) in the United States of America (USA). Both LLMs and human experts conducted the World Health Organization (WHO) algorithm for vaccine causality assessments, and inter-rater agreement was measured using percentage agreement. Adherence to the WHO algorithm was evaluated by comparing LLM responses to the expected sequence of the algorithm. Statistical analyses, including descriptive statistics and Random Forest modeling, explored case complexity (e.g., string length measurements) and factors affecting LLM performance and adherence.ResultsChatGPT showed higher adherence to the WHO algorithm (34%) compared to Gemini (7%) and had moderate agreement (71%) with human experts, whereas Gemini had fair agreement (53%). Both LLMs often failed to recognize listed AEFIs, with ChatGPT and Gemini incorrectly identifying 6.7% and 13.3% of AEFIs, respectively. ChatGPT showed inconsistencies in 8.0% of cases and Gemini in 46.7%. For ChatGPT, adherence to the algorithm was associated with lower string complexity in prompt sections. The random forest analysis achieved an accuracy of 55% (95% confidence interval: 35.7–73.5) for predicting adherence to the WHO algorithm for ChatGPT.ConclusionNotable limitations of ChatGPT and Gemini have been identified in their use for aiding causality assessments in vaccine safety. ChatGPT performed better, with higher adherence and agreement with human experts. In the investigated scenario, both models are better suited as complementary tools to human expertise.Supplementary InformationThe online version contains supplementary material available at 10.1007/s40264-025-01531-y.

The emergence of Large Language Models (LLMs), such as ChatGPT and Claude, has sparked discussions on their capacity to augment qualitative research data analysis. This study investigates using LLMs in futures research, where analysing large textual datasets is paramount. LLMs were employed experimentally to assess theme generation, patterns, and insights from infrastructure futures workshops. The study conducted a comparative analysis of Claude’s Sonnet 3.5 and ChatGPT 4o to examine workshop transcripts with and without contextual data. The data reveal that LLMs exhibit exceptional speed and efficiency but face challenges in precision, ethical implications, and the need for human supervision. This research adds to current discussions on integrating LLMs with qualitative research methods, enhancing futures analytical tools like Causal Layered Analysis, the Futures Triangle, Futures Wheel, Futures Cone, visioning, and Backcasting. The paper argues that LLMs offer a promising means of improving qualitative data analysis, maximised when used with conventional methods and human expertise.

Recent breakthroughs in Large Language Models (LLMs) have positioned them as a promising paradigm for agents, with long-term planning and decision-making emerging as core general-purpose capabilities for adapting to diverse scenarios and tasks. Real-time strategy (RTS) games serve as an ideal testbed for evaluating these two capabilities, as their inherent gameplay requires both macro-level strategic planning and micro-level tactical adaptation and action execution. Existing RTS game-based environments either suffer from relatively high computational demands or lack support for textual observations, which has constrained the use of RTS games for LLM evaluation. Motivated by this, we present TowerMind, a novel environment grounded in the tower defense (TD) subgenre of RTS games. TowerMind preserves the key evaluation strengths of RTS games for assessing LLMs, while featuring low computational demands and a multimodal observation space, including pixel-based, textual, and structured game-state representations. In addition, TowerMind supports the evaluation of model hallucination and provides a high degree of customizability. We design five benchmark levels to evaluate several widely used LLMs under different multimodal input settings. The results reveal a clear performance gap between LLMs and human experts across both capability and hallucination dimensions. The experiments further highlight key limitations in LLM behavior, such as inadequate planning validation, a lack of multifinality in decision-making, and inefficient action use. We also evaluate two classic reinforcement learning algorithms: Ape-X DQN and PPO. By offering a lightweight and multimodal design, TowerMind complements the existing RTS game-based environment landscape and introduces a new benchmark for the AI agent field.

BackgroundRecognizing patient symptoms is fundamental to medicine, research, and public health. However, symptoms are often underreported in coded formats even though they are routinely documented in physician notes. Large language models (LLMs), noted for their generalizability, could help bridge this gap by mimicking the role of human expert chart reviewers for symptom identification.ObjectiveThe primary objective of this multisite study was to measure the accurate identification of infectious respiratory disease symptoms using LLMs instructed to follow chart review guidelines. The secondary objective was to evaluate LLM generalizability in multisite settings without the need for site-specific training, fine-tuning, or customization.MethodsFour LLMs were evaluated: GPT-4, GPT-3.5, Llama2 70B, and Mixtral 8×7B. LLM prompts were instructed to take on the role of chart reviewers and follow symptom annotation guidelines when assessing physician notes. Ground truth labels for each note were annotated by subject matter experts. Optimal LLM prompting strategies were selected using a development corpus of 103 notes from the emergency department at Boston Children’s Hospital. The performance of each LLM was measured using a test corpus with 202 notes from Boston Children’s Hospital. The performance of an International Classification of Diseases, Tenth Revision (ICD-10)–based method was also measured as a baseline. Generalizability of the most performant LLM was then measured in a validation corpus of 308 notes from 21 emergency departments in the Indiana Health Information Exchange.ResultsSymptom identification accuracy was superior for every LLM tested for each infectious disease symptom compared to an ICD-10–based method (F1-score=45.1%). GPT-4 was the highest scoring (F1-score=91.4%; P<.001) and was significantly better than the ICD-10–based method, followed by GPT-3.5 (F1-score=90.0%; P<.001), Llama2 (F1-score=81.7%; P<.001), and Mixtral (F1-score=83.5%; P<.001). For the validation corpus, performance of the ICD-10–based method decreased (F1-score=26.9%), while GPT-4 increased (F1-score=94.0%), demonstrating better generalizability using GPT-4 (P<.001).ConclusionsLLMs significantly outperformed an ICD-10–based method for respiratory symptom identification in emergency department electronic health records. GPT-4 demonstrated the highest accuracy and generalizability, suggesting that LLMs may augment or replace traditional approaches. LLMs can be instructed to mimic human chart reviewers with high accuracy. Future work should assess broader symptom types and health care settings.