Evidence map›Paper›PMID 40764995›Full record

ArticleJournal of translational medicine2025

eCBT-I dialogue system: a comparative evaluation of large language models and adaptation strategies for insomnia treatment.

Xueying Bao, Xingyu Zhu, Dongren Yang, Hao Lou, Ruoyun Wang, Yutong Wu, Wenhui Li, Yu Xia, Li Zeng, Yingying Pan and 7 more

Abstract readComparative Study
In one paragraph

Article in Journal of translational medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

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3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

17 authors.

Xueying Bao *Department of Intensive Care Unit, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, China.
Xingyu Zhu *The First School of Medicine, School of Information and Engineering, Wenzhou Medical University, Wenzhou, 325001, China.
Dongren Yang *The First School of Medicine, School of Information and Engineering, Wenzhou Medical University, Wenzhou, 325001, China.
Hao Lou *The Second Clinical Medical College, Wenzhou Medical University, Wenzhou, 325000, China.
Ruoyun Wang *The First School of Medicine, School of Information and Engineering, Wenzhou Medical University, Wenzhou, 325001, China.
Yutong WuSchool of Nursing, Wenzhou Medical University, Wenzhou, 325000, China.
Wenhui LiThe First School of Medicine, School of Information and Engineering, Wenzhou Medical University, Wenzhou, 325001, China.
Yu XiaThe First School of Medicine, School of Information and Engineering, Wenzhou Medical University, Wenzhou, 325001, China.
Li ZengThe Second Clinical Medical College, Wenzhou Medical University, Wenzhou, 325000, China.
Yingying PanSchool of Laboratory Medicine and Life Science, Wenzhou Medical University, Wenzhou, 32500, China.
Xiqin WangThe Second Clinical Medical College, Wenzhou Medical University, Wenzhou, 325000, China.
Xian ZhangThe Second Clinical Medical College, Wenzhou Medical University, Wenzhou, 325000, China.
Cheng LingSchool of Biomedical Engineering, School of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou, 325000, China.
Youhui LingDepartment of Physics, Research Institute for Biomimetics and Soft Matter, Fujian Provincial Key Laboratory for Soft Functional Materials Research, Xiamen University, Xiamen, 361005, China.
Yan ZhangDepartment of Urology, The First Affiliated Hospital, Wenzhou Medical University, Wenzhou, 325000, China. zhangyan@wmu.edu.cn.
Qi ZhaoSchool of Computer Science and Software Engineering, University of Science and Technology Liaoning, Anshan, 114051, China. zhaoqi@lnu.edu.cn.ORCID 0000-0001-9713-1864
Mei YangDepartment of Intensive Care Unit, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, China. yangmei1@wmu.edu.cn.

Funding

Fundamental Research Funds for the Liaoning Universities LJ212410146026Zhejiang Provincial Medical and Health Science and Technology Plan 2024KY1262Zhejiang Provincial Medical and Health Science and Technology Plan 2025KY1000Zhejiang Provincial Natural Science Foundation of China LY21H050006
6 · The paper itself

Abstract

backgroundTraditional face-to-face mental health treatments are often limited by time and space. Thanks to the development of advanced large language models (LLMs), digital mental health treatments can provide personalized advice to patients and improve compliance. However, in the field of CBT-I, specialized, real-time interactive dialogue platforms have not been fully developed.

methodsOur research team construct an eCBT-I intelligent dialogue system based on the RAG architecture, aiming to provide an example of the deep integration of CBT-I knowledge graphs and large language models. Furthermore, in order to optimize the performance of the system's core language generation module on the insomnia dialogue dataset, we systematically include eight mainstream large language models (ChatGLM2-6b, ChatGLM3-6b, Baichuan-7b, Baichuan-13b, Qwen-7b, Qwen2-7b, Llama-2-7b-chat-hf, and Llama-2-13b-chat-hf) and three adaptation strategies (LoRA, QLoRA, and Freeze). We screen the suitability of the three adaptation strategies for the eight major language models in the group, and thus determine the best adaptation method for each language model to maximize performance improvement. The eight best-adapted language models are then evaluated in three dimensions to compare their performance on the small sample sleep dialogue dataset and the C-eval dataset. All subjects that evaluated under experimental conditions are historical medical records and patients who did not exhibit delirium and had normal language expression abilities.

resultsThrough the matching of model characteristics to adaptation strategies and the horizontal evaluation of multiple models, we compare the contribution of different fine-tuning strategies to the performance improvement of different language models on the small insomnia dialogue dataset, and finally determine that Qwen2-7b (Freeze) is the model with the best performance on the insomnia dialogue dataset.

conclusionsThis study effectively integrates the CBT-I knowledge graph with the large language model through the RAG architecture, which improves the professionalism of the eCBT-I intelligent dialogue system. The systematic fine-tuning method selection process and the confirmation of the optimal model not only improve the adaptability of the large language model in the CBT-I task, but also provide a useful paradigm for AI applications in medical subfields with resource constraints and difficulties in data collection, laying a solid foundation for more accurate and efficient digital CBT-I clinical practice in the future.

Indexed as

Cognitive Behavioral TherapyLanguageSleep Initiation and Maintenance DisordersHumansLarge Language ModelsAdaptation strategyeCBT-ILarge language modelsMental healthRAG architecture

Identifiers

PMID40764995
PMCPMC12326588

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.