Leveraging Retrieval Augmented Generation-Driven Large Language Models to Extract Dementia Agitation Symptoms and Triggers from Free-Text Nursing Notes

Unstructured electronic health records are a rich source of patient-specific information but are challenging for analysis due to inconsistent terminology, diverse data formats, and extensive free-text content. To address this, we developed a named entity recognition model leveraging retrieval-augmented generation (RAG) powered by generative artificial intelligence. The model identifies symptoms and triggers of agitation in dementia from nursing notes within residential aged care facilities (RACFs). By integrating RAG with few-shot learning, our re-ranking retrieval approach outperformed dense retrieval methods, achieving an accuracy of 0.87, an F1 score of 0.88, a recall of 0.90, and a precision of 0.86. This enhanced framework supports clinical decision-making, improving care quality and better management of dementia-related agitation in RACFs.