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medRxiv PreprintsInternational9 November 2026

Multi-Agent Generative Artificial Intelligence for Transfusion Reaction Feature Extraction

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BACKGROUND: Many transfusion reactions are not reported to hemovigilance systems, and the features needed to recognize them are often documented only in free-text clinical notes. We sought to develop and evaluate an open-source, multi-agent artificial intelligence (AI) pipeline to extract transfusion reaction features defined by the National Healthcare Safety Network (NHSN) Hemovigilance Module from clinical notes. METHODS: We curated 181 features from the NHSN protocol and developed a multi-stage pipeline that extracted features, their timing, and clinical details from free-text notes. Three
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