The Digital Registrar — a schema-first framework for multi-cancer, privacy-preserving pathology abstraction via local LLMs.
Project description
Digital Registrar
A schema-first framework for multi-cancer, privacy-preserving pathology abstraction via local LLMs.
TL;DR — pip install digital-registrar-gui && registrar-infer-gui → paste a pathology report → get structured JSON. Requires either a local Ollama server with one of gpt-oss:20b / qwen3:30b / gemma3:27b pulled, or an OPENAI_API_KEY. See Quickstart.
Digital Registrar transforms free-text surgical pathology reports into machine-readable registry records using a College of American Pathologists (CAP)-aligned clinical ontology, encoded as strictly-typed DSPy signatures. The system covers 10 major cancer types across 192 per-organ registry field cells (60 unique field names) — including complex variable-length structures like lymph-node groups and surgical margins — and is model-agnostic: any local LLM can serve as the inference engine. Designed for on-premise deployment on a single 48 GB GPU, it keeps sensitive clinical text inside the institution.
Highlights
- Schema-first architecture — the clinical ontology is the durable contribution; LLMs are interchangeable engines.
- CAP-aligned, registry-grade — 10 cancer types, 192 per-organ field cells (60 unique), validated against gold-standard human annotations.
- Privacy-preserving by design — local LLMs only, single 48 GB GPU, no cloud round-trip required.
- Validated generalizability — 92.0 % macro-mean exact-match on 893 internal reports (10 organs); 77.5 % on the external TCGA cohort of 242 reports — 88.0 % after excluding structurally-silent fields (paper).
Quickstart (end users)
Prerequisites — pick one LLM backend
The toolkit is BYO-LLM. You need either:
-
Local Ollama with one of the three paper-benchmarked models pulled:
ollama pull gpt-oss:20b # default — best accuracy on internal validation ollama pull qwen3:30b # alt MoE (Qwen3-30B-A3B) ollama pull gemma3:27b # alt dense
Sized for a single ~48 GB GPU. Smaller VRAM works with quantised tags but is unbenchmarked.
-
OpenAI: set
OPENAI_API_KEYin your env (or in~/.config/digital-registrar/.env), then pickgpt5_4_miniin the GUI's model dropdown.
Run the GUI in 30 seconds
# Path A — local Ollama (default)
pip install digital-registrar-gui
registrar-infer-gui # opens http://localhost:8502 with gpt-oss:20b
# Path B — OpenAI
export OPENAI_API_KEY=sk-...
pip install digital-registrar-gui
registrar-infer-gui # then change the model selector to gpt5_4_mini
Paste a report (or point at a folder of .txt files) and the structured JSON appears on the right. The expander shows the full DSPy LM trace (router + group extractors).
Other packages
The toolkit ships as four pip-installable packages. Pick the apps you need:
# Inference GUI — paste a report, see the structured extraction
pip install digital-registrar-gui
registrar-infer-gui # opens http://localhost:8502
# Annotation tool — review pipeline output against gold
pip install digital-registrar-annotator
registrar-annotate-workspace
# Schema editor — curate the CAP-aligned per-organ schema
pip install digital-registrar-schema-editor
registrar-schema-gui
# Core only (CLI + Python API) — for pipelines, scripts, and downstream tools
pip install digital-registrar
registrar-pipeline --input <folder>
Each app depends on digital-registrar (the core), so installing any of the apps brings the pipeline along automatically.
Audience
Built for cancer registrars, pathology informatics teams, and clinical researchers who need registry-grade structured extraction from narrative pathology reports without sending PHI off-premise.
Repository layout
drr-next/
├── src/digital_registrar/ ← THE core (pipeline, schemas, signatures, eval, paths)
├── apps/
│ ├── infer-gui/ ← digital-registrar-gui (Streamlit inference)
│ ├── schema-editor/ ← digital-registrar-schema-editor
│ └── annotator/ ← digital-registrar-annotator
├── attic/ ← research scaffolding (benchmarks, ablations, baselines, obfuscator)
├── packaging/ ← release pipeline (PyInstaller, Docker, hosted demo)
├── workspace/ ← gitignored runtime data (data, results, runs)
├── examples/ ← small read-only fixtures
├── tests/ ← core tests
└── docs/ ← architecture, API, eval, release
Dev install (cloners)
git clone https://github.com/kblab2024/digitalregistrar.git digitalregistrar
cd digitalregistrar
make install-dev # installs core + 3 apps + dev tooling
make test # core + app test suites
make lint # ruff
make install-dev installs the vendored tnmhelper wheel first, then pip install -e . (core), then pip install -e apps/<each> for the three downstream apps. Anyone with pip can clone and install in one command — no uv required.
Public Python API
from digital_registrar import (
run_pipeline, setup_pipeline, # extraction
load_pydantic_model, load_json_schema, # schemas
list_organs, CASE_MODELS, build_case_model,
build_extraction_signatures, ExtractionStep, # signatures
field_metrics, nested_field_metrics, # eval
pairwise_compare, completeness, score_case,
WORKSPACE_ROOT, workspace_root, results_root, # paths
)
See docs/api.md for the full reference.
Documentation
| Topic | Where |
|---|---|
| Pipeline architecture (v1 legacy, v2 factory) | docs/architecture/pipeline.md |
| Three-layer schema architecture | docs/architecture/schemas.md |
AJCC TNM staging via tnmhelper |
docs/architecture/staging.md |
| DSPy deep dive | docs/architecture/dspy_deep_dive.md |
| Annotation workflow | docs/workflows/annotation.md |
| Eval (prediction vs annotation) | docs/eval/index.md |
| Public Python API | docs/api.md |
| Release pipeline (PyPI / hosted demo / bundles / Docker) | docs/release.md |
| Research scaffolding (benchmarks, ablations, obfuscator) | attic/README.md |
Releasing
The project supports three distribution paths for layman users (see docs/release.md):
- PyPI —
pip install digital-registrar-guifor Python users. - Hosted Streamlit demo — public URL for paper reviewers / casual visitors. Safety checklist in docs/release.md.
- Native bundles + Docker —
.dmg/.exe/ Docker images for non-technical end users, built viamake bundleandmake docker-build.
Citation
If you use the Digital Registrar in your research, please cite:
Chow N-H, Chang H, Chen H-K, et al. Digital Registrar: A Schema-First Framework for Multi-Cancer Privacy-Preserving Pathology Abstraction via Local LLMs. Diagnostics. 2026;16(11):1644. doi: 10.3390/diagnostics16111644
Machine-readable metadata in CITATION.cff.
License
MIT — see LICENSE.
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