Automatic Conversion of NICE Guidelines to an Executable Computational Model Using Large Language Models

Introduction: NICE guidelines provide evidence-based recommendations for clinical care but remain largely in unstructured natural language. Existing approaches to converting them into computable representations often focus on individual diseases, require substantial manual encoding, and do not scale. Large language models (LLMs) may enable much of this translation to be automated. Methods: We present an end-to-end approach that converts textual clinical guidelines into executable models capable of generating explainable, patient-specific recommendations. A stepwise LLM-based transformation with in-context examples produces human-inspectable intermediate artifacts. We apply the approach to NICE pancreatic and lung cancer guidelines, use expert review to assess rule alignment, and evaluate the executable pancreatic cancer model on 20 patient vignettes. Results: Expert review showed strong alignment between the source guidelines and generated executable models. Most discrepancies were partial omissions rather than incorrect logic, while hallucinated or fundamentally incorrect rules were rare. On the patient vignettes, the executable model achieved an F1 score of 82.5%. Conclusion: LLMs can transform natural-language NICE guidelines into interpretable, executable models that preserve guideline structure, support transparent inspection and modification, and generate patient-specific recommendations. These findings demonstrate the feasibility of scalable automated generation of computable clinical guidelines.

REFINE: A Multi-Agent LLM Approach for Evidence-Guided Code Refactoring

Large Language Models (LLMs) offer new opportunities for automated code refactoring. However, generated changes must reduce targeted quality problems without introducing new issues or altering behaviour-relevant code structures. We introduce REFINE (Refactoring with Evidence-aware Flow for Integrated ageNtic Execution), a tool-agnostic, evidence-aware multi-agent approach for generating Java file-level refactoring candidates. REFINE combines static-analysis-guided smell identification, smell-informed planning, LLM-based transformation, automated re-analysis, preservation checks, and structured reporting. We evaluate REFINE on 450 Java files from 15 open-source systems, producing 1,350 model-pass outputs using OpenAI GPT-5.5, Google Gemini 3.1 Pro Preview, and Anthropic Claude Opus 4.8. REFINE reduces detected code smells by 68.26%, 72.79%, and 68.49% across the three configurations, respectively, with the strongest reductions observed for major smells. A matched 150-file direct-prompt baseline shows that REFINE achieves a higher median code-smell reduction with smaller edits and fewer public-method removals. However, broader quality improvements are inconsistent, and preservation checks reveal residual risks, including assert/fail-call changes and public-method removal. Therefore, REFINE outputs should be treated as refactoring candidates requiring compilation, testing, dependency analysis, and human review before adoption in repository- or system-level settings.