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<article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns:ali="http://www.niso.org/schemas/ali/1.0/" article-type="research-article" dtd-version="1.2" xml:lang="en"><front><journal-meta><journal-id journal-id-type="publisher-id">Medical and Social Expert Evaluation and Rehabilitation</journal-id><journal-title-group><journal-title xml:lang="en">Medical and Social Expert Evaluation and Rehabilitation</journal-title><trans-title-group xml:lang="ru"><trans-title>Медико-социальная экспертиза и реабилитация</trans-title></trans-title-group></journal-title-group><issn publication-format="print">1560-9537</issn><issn publication-format="electronic">2412-2092</issn><publisher><publisher-name xml:lang="en">Eco-Vector</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="publisher-id">704964</article-id><article-id pub-id-type="doi">10.17816/MSER704964</article-id><article-id pub-id-type="edn">GBXQMH</article-id><article-categories><subj-group subj-group-type="toc-heading" xml:lang="en"><subject>Original study articles</subject></subj-group><subj-group subj-group-type="toc-heading" xml:lang="ru"><subject>Оригинальные исследования</subject></subj-group><subj-group subj-group-type="article-type"><subject>Research Article</subject></subj-group></article-categories><title-group><article-title xml:lang="en">Medical and social aspects of vocational guidance for persons with disabilities: assessing types of work activity using large language models</article-title><trans-title-group xml:lang="ru"><trans-title>Медико-социальные аспекты профориентации инвалидов: оценка видов трудовой деятельности с использованием больших языковых моделей</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-5564-6093</contrib-id><contrib-id contrib-id-type="spin">2490-5403</contrib-id><name-alternatives><name xml:lang="en"><surname>Ryabtcev</surname><given-names>Mikhail V.</given-names></name><name xml:lang="ru"><surname>Рябцев</surname><given-names>Михаил Викторович</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><email>ryabtcevmv@yandex.ru</email><xref ref-type="aff" rid="aff1"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-7853-4473</contrib-id><contrib-id contrib-id-type="spin">8234-7005</contrib-id><name-alternatives><name xml:lang="en"><surname>Ponomarenko</surname><given-names>Gennadiy N.</given-names></name><name xml:lang="ru"><surname>Пономаренко</surname><given-names>Геннадий Николаевич</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>MD, Dr. Sci. (Medicine), Professor, Сorresponding Member of the Russian Academy of Sciences</p></bio><bio xml:lang="ru"><p>д-р мед. наук, профессор, член-корреспондент РАН</p></bio><email>ponomarenko_g@mail.ru</email><xref ref-type="aff" rid="aff1"/><xref ref-type="aff" rid="aff2"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-3736-2895</contrib-id><contrib-id contrib-id-type="spin">3376-1261</contrib-id><name-alternatives><name xml:lang="en"><surname>Sokurov</surname><given-names>Andrey V.</given-names></name><name xml:lang="ru"><surname>Сокуров</surname><given-names>Андрей Владимирович</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>MD, Dr. Sci. (Medicine), Associate Professor</p></bio><bio xml:lang="ru"><p>д-р мед. наук, доцент</p></bio><email>ansokurov@yandex.ru</email><xref ref-type="aff" rid="aff1"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-9518-1945</contrib-id><contrib-id contrib-id-type="spin">9225-3365</contrib-id><name-alternatives><name xml:lang="en"><surname>Mikhaylishin</surname><given-names>Viktor V.</given-names></name><name xml:lang="ru"><surname>Михайлишин</surname><given-names>Виктор Валерьевич</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>MD, Cand. Sci. (Medicine)</p></bio><bio xml:lang="ru"><p>канд. мед. наук</p></bio><email>mikhailishin_v@mail.ru</email><xref ref-type="aff" rid="aff1"/></contrib></contrib-group><aff-alternatives id="aff1"><aff><institution xml:lang="en">Albrecht Federal Scientific and Educational Center for Medical and Social Expertise and Rehabilitation</institution></aff><aff><institution xml:lang="ru">Федеральный научно-образовательный центр медико-социальной экспертизы и реабилитации им. Г.А. Альбрехта</institution></aff></aff-alternatives><aff-alternatives id="aff2"><aff><institution xml:lang="en">North-Western State Medical University named after I.I. Mechnikov</institution></aff><aff><institution xml:lang="ru">Северо-Западный медицинский университет им. И.И. Мечникова</institution></aff></aff-alternatives><pub-date date-type="preprint" iso-8601-date="2026-04-29" publication-format="electronic"><day>29</day><month>04</month><year>2026</year></pub-date><pub-date date-type="pub" iso-8601-date="2026-06-25" publication-format="electronic"><day>25</day><month>06</month><year>2026</year></pub-date><volume>29</volume><issue>1</issue><issue-title xml:lang="en"/><issue-title xml:lang="ru"/><fpage>25</fpage><lpage>35</lpage><history><date date-type="received" iso-8601-date="2026-03-25"><day>25</day><month>03</month><year>2026</year></date><date date-type="accepted" iso-8601-date="2026-04-20"><day>20</day><month>04</month><year>2026</year></date></history><permissions><copyright-statement xml:lang="en">Copyright ©; 2026, Eco-Vector</copyright-statement><copyright-statement xml:lang="ru">Copyright ©; 2026, Эко-Вектор</copyright-statement><copyright-year>2026</copyright-year><copyright-holder xml:lang="en">Eco-Vector</copyright-holder><copyright-holder xml:lang="ru">Эко-Вектор</copyright-holder><ali:free_to_read xmlns:ali="http://www.niso.org/schemas/ali/1.0/" start_date="2029-06-25"/><license><ali:license_ref xmlns:ali="http://www.niso.org/schemas/ali/1.0/">https://eco-vector.com/for_authors.php#07</ali:license_ref></license></permissions><self-uri xlink:href="https://rjmseer.com/1560-9537/article/view/704964">https://rjmseer.com/1560-9537/article/view/704964</self-uri><abstract xml:lang="en"><p><bold>BACKGROUND: </bold>Vocational guidance for persons with disabilities requires comparable and reproducible criteria that allow correlating persistent impairments of body functions with the requirements of specific types of work activity and factors of the working environment.</p> <p><bold>AIM: </bold>To form and validate a database of assessment indicators for types of work activity as a tool for their ranking within the framework of vocational guidance.</p> <p><bold>METHODS: </bold>A total of 435 types of work activity from the initial groups of the All-Russian Classifier of Occupations were analyzed. For each of them, a profile was formed based on 21 medico-social indicators, grouped into blocks of safety, ability to perform work functions, and working conditions. Primary assessments were obtained using several large language models on a unified ten-point scale; post-processing was performed for unified interpretation (“the higher, the more suitable”) and calculation of integral values by averaging inter-model assessments. External validation was conducted on independent expert survey data (87 questionnaires): in each question, five professions were compared on a 0–100 scale; a total of 9,135 assessments were processed. Comparisons were made after intra-question min-max normalization; the consistency of ranking (Spearman coefficient, Kendall coefficient), the proportion of concordant pairs, and the normalized rank difference were assessed.</p> <p><bold>RESULTS: </bold>The proportion of informative comparison blocks was 92.3%, and constant expert assessments were identified in 7.6% of cases. The consistency of the model ranking with experts was moderate: average Spearman coefficient ρ = 0.416, average Kendall coefficient τ-b = 0.363, proportion of concordant pairs 0.653, average normalized rank difference 0.278. The highest validity was demonstrated by indicators related to impairments of neuromuscular, skeletal, and movement-related (statodynamic) functions (necessity of using a wheelchair), while the indicator of emotional tension showed minimal consistency.</p> <p><bold>CONCLUSION: </bold>The formed assessment database is applicable for profiling and preliminary selection of types of work activity in the vocational guidance of persons with disabilities. For contextual factors of working conditions, clarification of operational definitions and expert calibration are required.</p></abstract><trans-abstract xml:lang="ru"><p><bold>Обоснование. </bold>Профориентация инвалидов требует сопоставимых и воспроизводимых критериев, позволяющих соотносить стойкие нарушения функций организма с требованиями конкретных видов трудовой деятельности и факторами производственной среды.</p> <p><bold>Цель исследования. </bold>Сформировать и валидировать базу оценочных показателей видов трудовой деятельности в качестве инструмента для их ранжирования в рамках профессиональной ориентации.</p> <p><bold>Методы. </bold>Проанализировано 435 видов трудовой деятельности уровня начальных групп Общероссийского классификатора занятий. Для каждого из них сформирован профиль по 21 медико-социальному показателю, сгруппированному в блоки безопасности, возможности выполнения трудовых функций и условий труда. Первичные оценки получены с использованием нескольких больших языковых моделей по унифицированной десятибалльной шкале; выполнены постобработка для единой интерпретации («чем выше, тем выше пригодность») и расчёт интегральных значений усреднением межмодельных оценок. Внешняя валидация проведена на независимых экспертных данных анкетирования (87 анкет): в каждом вопросе сравнивались пять профессий по шкале 0–100; всего обработано 9135 оценок. Сопоставление выполняли после внутривопросной min-max нормализации; оценивали согласованность ранжирования (коэффициент Спирмена, коэффициент Кенделла), долю согласованных пар и нормированную разницу рангов.</p> <p><bold>Результаты. </bold>Доля информативных блоков сравнения составила 92,3%, константные экспертные оценки выявлены в 7,6% случаев. Согласованность ранжирования модели с экспертами была умеренной: среднее значение коэффициента Спирмена ρ=0,416, коэффициента Кенделла τ-b=0,363, доля согласованных пар — 0,653, средняя нормированная разница рангов — 0,278. Наиболее высокую валидность продемонстрировали показатели, связанные с нарушениями нейромышечных, скелетных и связанных с движением (статодинамических) функций (необходимостью использования кресла-коляски), тогда как показатель эмоционального напряжения характеризовался минимальной согласованностью.</p> <p><bold>Заключение. </bold>Сформированная оценочная база применима для профилирования и предварительного отбора видов трудовой деятельности в профориентации инвалидов; для контекстных факторов условий труда требуется уточнение операциональных определений и экспертная калибровка.</p></trans-abstract><kwd-group xml:lang="en"><kwd>disability</kwd><kwd>vocational rehabilitation</kwd><kwd>vocational guidance</kwd><kwd>types of work activity</kwd><kwd>assessment indicators</kwd><kwd>working conditions</kwd><kwd>expert validation</kwd></kwd-group><kwd-group xml:lang="ru"><kwd>инвалидность</kwd><kwd>профессиональная реабилитация</kwd><kwd>профориентация</kwd><kwd>виды трудовой деятельности</kwd><kwd>оценочные показатели</kwd><kwd>условия труда</kwd><kwd>экспертная валидация</kwd></kwd-group><funding-group/></article-meta></front><body></body><back><ref-list><ref id="B1"><label>1.</label><mixed-citation>Puzin SN, Shurgaya MA, Memetov SS, et al. 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