Faculty, Staff and Student Publications

Language

English

Publication Date

4-1-2026

Journal

International Journal of Medical Informatics

DOI

10.1016/j.jbi.2026.104997

PMID

41679677

PMCID

PMC12965200

PubMedCentral® Posted Date

3-7-2026

PubMedCentral® Full Text Version

Author MSS

Abstract

Objective: This study presents a systematic review of natural language generation (NLG) methods and applications in the medical domain, providing quantitative and qualitative analyses to answer four key research questions regarding methods, evaluation, applications, and challenges of NLG in healthcare.

Methods: We searched PubMed, ACM Digital Library, Web of Science, Science Direct, Scopus, Embase, and ACL Anthology for NLG-related studies in healthcare from 2018 to 2024. Out of 3,988 research articles, 113 met the inclusion criteria and were analyzed across data modality, model architecture, evaluation metrics, and application domain.

Results and conclusion: NLG in healthcare has grown substantially, with annual publications increasing from 2 in 2018 to 40 in 2024. Of the 113 included studies, text-to-text generation was the most common data modality (65.5%), followed by image-to-text (19.5%) and multimodal-to-text (15.0%). Transformer-based architectures were dominant, especially encoder-decoder models (61.6%). Automatic evaluation metrics such as ROUGE (81.4%) and BLEU (57.5%) were widely used. Human evaluation metrics, such as Likert scales (31.9%), were increasingly adopted. The four most prevalent application domains include summarization (e.g., discharge summaries, radiology reports), clinical documentation, medical dialogue, and data augmentation. The transformer-based large language models (LLMs) and the accumulation of large-scale multimodal clinical datasets have remarkably advanced NLG in healthcare. However, challenges remain in factual consistency, explainability, evaluation robustness, and AI safety. Addressing these challenges is essential for the adoption of NLG in various healthcare applications.

Keywords

Natural Language Processing, Humans, Delivery of Health Care, Medical Informatics, Electronic Health Records, Large Language Models, Natural language generation, Healthcare, Large language model, Transformer model, Clinical text, Systematic review

Published Open-Access

yes

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