Checking Medical Process Conformance by Exploiting LLMs
Source abstract
Abstract
Clinical guidelines, which represent the normative process models for healthcare organizations, are typically available in a textual, unstructured form. This issue hampers the application of classical conformance-checking algorithms to the medical domain, which take in input of a formalized and computer-interpretable description of the process. In this paper, (i) we propose overcoming this problem by taking advantage of a Large Language Model (LLM), in order to extract normative rules from textual guidelines; (ii) we then check and quantify the conformance of the patient event log with respect to such rules. Additionally, (iii) we adopt the approach as a means for evaluating the quality of the models mined by different process discovery algorithms from the event log, by comparing their conformance to the rules. We have tested our work in the domain of stroke. As regards conformance checking, we have proved the compliance of four Northern Italy hospitals to a general rule for diagnosis timing and to two rules that refer to thrombolysis treatment, and have identified some issues related to other rules, which involve the availability of magnetic resonance instruments. As regards process model discovery evaluation, we have assessed the superiority of Heuristic Miner with respect to other mining algorithms on our dataset. It is worth noting that the easy extraction of rules in our LLM-assisted approach would make it quickly applicable to other fields as well.
Source: crossref · Quality: baseline
Research context
OpenAlex topics: Business Process Modeling and Analysis
SciVX discovery tags are terminology-based. OpenAlex topics are source-provided classifications.
Affiliations
Department of Science, Technology and Innovation (DiSIT), Computer Science Institute, University of Eastern Piedmont, Viale Teresa Michel 11, 15121 Alessandria, Italy
References (38)
Show source-provided references
1. van der Aalst, W.M.P. (2016). Process Mining—Data Science in Action, Springer. [2nd ed.].10.1007/978-3-662-49851-4 ↗
2. Reichert, M., and Weber, B. (2012). Enabling Flexibility in Process-Aware Information Systems—Challenges, Methods, Technologies, Springer.10.1007/978-3-642-30409-5 ↗
3. Desel, J., Reisig, W., and Rozenberg, G. (2004). Lectures on Concurrency and Petri Nets, Advances in Petri Nets, Springer. Lecture Notes in Computer Science.10.1007/b98282 ↗
4. Computer-interpretable Guideline Formalisms
5. On the Role of Fitness, Precision, Generalization and Simplicity in Process Discovery
6. Betz, S. (2019, January 26–28). Conformance checking: A state-of-the-art literature review. Proceedings of the 11th International Conference on Subject-Oriented Business Process Management, S-BPM ONE 2019, Seville, Spain.
7. Conformance checking of processes based on monitoring real behavior10.1016/j.is.2007.07.001 ↗
8. Scalable process discovery and conformance checking10.1007/s10270-016-0545-x ↗
9. Alignment Based Precision Checking
10. Conformance checking and diagnosis for declarative business process models in data-aware scenarios10.1016/j.eswa.2014.03.010 ↗
11. BERT: Pre-training of Deep Bidirectional Transformers for Language Understanding
12. OpenAI, Achiam, J., Adler, S., Agarwal, S., Ahmad, L., Akkaya, I., Aleman, F.L., Almeida, D., Altenschmidt, J., and Altman, S. (2024). OpenAI: GPT-4 technical report CoRR. arXiv.
13. Natural language processing: State of the art, current trends and challenges10.1007/s11042-022-13428-4 ↗
14. Berti, A., Kourani, H., Hafke, H., Li, C.Y., and Schuster, D. (2024). Evaluating Large Language Models in Process Mining: Capabilities, Benchmarks, and Evaluation Strategies. arXiv.10.1007/978-3-031-61007-3_2 ↗
15. Abstractions, Scenarios, and Prompt Definitions for Process Mining with LLMs: A Case Study
16. Kourani, H., Berti, A., Hennrich, J., Kratsch, W., Weidlich, R., Li, C.Y., Arslan, A., Schuster, D., and van der Aalst, W.M.P. (2024). Leveraging Large Language Models for Enhanced Process Model Comprehension. arXiv.10.2139/ssrn.5017379 ↗
17. Panetto, H., Debruyne, C., Hepp, M., Lewis, D., Ardagna, C.A., and Meersman, R. (2019, January 21–25). Fairness-Aware Process Mining. Proceedings of the on the Move to Meaningful Internet Systems: OTM 2019 Conferences, Rhodes, Greece.10.1007/978-3-030-33246-4 ↗
18. Kourani, H., Berti, A., Schuster, D., and van der Aalst, W.M. (2024, January 3–9). ProMoAI: Process Modeling with Generative AI. Proceedings of the Thirty-Third International Joint Conference on Artificial Intelligence. International Joint Conferences on Artificial Intelligence Organization, Jeju, Republic of Korea.
19. Grohs, M., Abb, L., Elsayed, N., and Rehse, J.R. (2023). Large Language Models can accomplish Business Process Management Tasks. arXiv.10.1007/978-3-031-50974-2_34 ↗
20. Jessen, U., Sroka, M., and Fahland, D. (2023). Chit-Chat or Deep Talk: Prompt Engineering for Process Mining. arXiv.
21. PM4Py: A process mining library for Python10.1016/j.simpa.2023.100556 ↗
22. Weijters, A.J., van Der Aalst, W.M., and De Medeiros, A.A. (2006). Process Mining with the HeuristicsMiner Algorithm, Technische Universiteit Eindhoven.
23. Bottrighi, A., Guazzone, M., Leonardi, G., Montani, S., Striani, M., and Terenziani, P. (2022). Integrating ISA and Part-of Domain Knowledge into Process Model Discovery. Future Internet, 14.10.3390/fi14120357 ↗
24. Jensen, K., and Kristensen, L.M. (2009). Coloured Petri Nets—Modelling and Validation of Concurrent Systems, Springer.10.1007/b95112 ↗
25. Reisig, W., and Rozenberg, G. (1998). Lectures on Petri Nets I: Basic Models, Advances in Petri Nets, Springer. Lecture Notes in Computer Science.10.1007/3-540-65306-6 ↗
26. van der Aalst, W.M.P., and Stahl, C. (2011). Modeling Business Processes—A Petri Net-Oriented Approach, MIT Press. Cooperative Information Systems Series.10.7551/mitpress/8811.001.0001 ↗
27. An Improvement of McMillan’s Unfolding Algorithm10.1023/A:1014746130920 ↗
28. Process mining: A two-step approach to balance between underfitting and overfitting10.1007/s10270-008-0106-z ↗
29. (2025, April 08). National Clinical Guideline for Stroke for the UK and Ireland. London: Intercollegiate Stroke Working Party. Available online: https://www.strokeguideline.org.
30. Discovering Workflow Performance Models from Timed Logs
31. Johnson, R.A. (2011). Miller and Freund’s Probability and Statistics for Engineers, Prentice Hall International. [8th ed.].
32. Process mining in healthcare: A literature review10.1016/j.jbi.2016.04.007 ↗
33. Yang, L., Xu, S., Sellergren, A., Kohlberger, T., Zhou, Y., Ktena, I., Kiraly, A., Ahmed, F., Hormozdiari, F., and Jaroensri, T. (2024). Advancing Multimodal Medical Capabilities of Gemini. arXiv.
34. Retrieval-Augmented Generation for Knowledge-Intensive NLP Tasks
35. Sahoo, P., Singh, A.K., Saha, S., Jain, V., Mondal, S., and Chadha, A. (2025). A Systematic Survey of Prompt Engineering in Large Language Models: Techniques and Applications. arXiv.10.1007/979-8-8688-0569-1_4 ↗
36. Zhou, Y., Muresanu, A.I., Han, Z., Paster, K., Pitis, S., Chan, H., and Ba, J. (2023). Large Language Models Are Human-Level Prompt Engineers. arXiv.
37. Francia, R., Leone, M., Leonardi, G., Montani, S., Pennisi, M., Striani, M., and D’Alfonso, S. (2025). AutoML-Med: A Framework for Automated Machine Learning in Medical Tabular Data. arXiv.
38. Gu, J., Jiang, X., Shi, Z., Tan, H., Zhai, X., Xu, C., Li, W., Shen, Y., Ma, S., and Liu, H. (2025). A Survey on LLM-as-a-Judge. arXiv.