PRISM: Patient Records Interpretation for Semantic clinical trial Matching system using large language models

Abstract Clinical trial matching is the task of identifying trials for which patients may be eligible. Typically, this task is labor-intensive and requires detailed verification of patient electronic health records (EHRs) against the stringent inclusion and exclusion criteria of clinical trials. Thi...

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Main Authors: Shashi Gupta, Aditya Basu, Mauro Nievas, Jerrin Thomas, Nathan Wolfrath, Adhitya Ramamurthi, Bradley Taylor, Anai N. Kothari, Regina Schwind, Therica M. Miller, Sorena Nadaf-Rahrov, Yanshan Wang, Hrituraj Singh
Format: Article
Language:English
Published: Nature Portfolio 2024-10-01
Series:npj Digital Medicine
Online Access:https://doi.org/10.1038/s41746-024-01274-7
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author Shashi Gupta
Aditya Basu
Mauro Nievas
Jerrin Thomas
Nathan Wolfrath
Adhitya Ramamurthi
Bradley Taylor
Anai N. Kothari
Regina Schwind
Therica M. Miller
Sorena Nadaf-Rahrov
Yanshan Wang
Hrituraj Singh
author_facet Shashi Gupta
Aditya Basu
Mauro Nievas
Jerrin Thomas
Nathan Wolfrath
Adhitya Ramamurthi
Bradley Taylor
Anai N. Kothari
Regina Schwind
Therica M. Miller
Sorena Nadaf-Rahrov
Yanshan Wang
Hrituraj Singh
author_sort Shashi Gupta
collection DOAJ
description Abstract Clinical trial matching is the task of identifying trials for which patients may be eligible. Typically, this task is labor-intensive and requires detailed verification of patient electronic health records (EHRs) against the stringent inclusion and exclusion criteria of clinical trials. This process also results in many patients missing out on potential therapeutic options. Recent advancements in Large Language Models (LLMs) have made automating patient-trial matching possible, as shown in multiple concurrent research studies. However, the current approaches are confined to constrained, often synthetic, datasets that do not adequately mirror the complexities encountered in real-world medical data. In this study, we present an end-to-end large-scale empirical evaluation of a clinical trial matching system and validate it using real-world EHRs. We perform comprehensive experiments with proprietary LLMs and our custom fine-tuned model called OncoLLM and show that OncoLLM outperforms GPT-3.5 and matches the performance of qualified medical doctors for clinical trial matching.
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issn 2398-6352
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publishDate 2024-10-01
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series npj Digital Medicine
spelling doaj-art-182275fd80c34579831829800e2db4cd2025-08-20T02:18:35ZengNature Portfolionpj Digital Medicine2398-63522024-10-017111210.1038/s41746-024-01274-7PRISM: Patient Records Interpretation for Semantic clinical trial Matching system using large language modelsShashi Gupta0Aditya Basu1Mauro Nievas2Jerrin Thomas3Nathan Wolfrath4Adhitya Ramamurthi5Bradley Taylor6Anai N. Kothari7Regina Schwind8Therica M. Miller9Sorena Nadaf-Rahrov10Yanshan Wang11Hrituraj Singh12Triomics ResearchTriomics ResearchTriomics ResearchTriomics ResearchMedical College of WisconsinMedical College of WisconsinMedical College of WisconsinMedical College of WisconsinTriomics ResearchIcahn School of Medicine at Mount SinaiCancer Informatics For Cancer CentersUniversity of PittsburghTriomics ResearchAbstract Clinical trial matching is the task of identifying trials for which patients may be eligible. Typically, this task is labor-intensive and requires detailed verification of patient electronic health records (EHRs) against the stringent inclusion and exclusion criteria of clinical trials. This process also results in many patients missing out on potential therapeutic options. Recent advancements in Large Language Models (LLMs) have made automating patient-trial matching possible, as shown in multiple concurrent research studies. However, the current approaches are confined to constrained, often synthetic, datasets that do not adequately mirror the complexities encountered in real-world medical data. In this study, we present an end-to-end large-scale empirical evaluation of a clinical trial matching system and validate it using real-world EHRs. We perform comprehensive experiments with proprietary LLMs and our custom fine-tuned model called OncoLLM and show that OncoLLM outperforms GPT-3.5 and matches the performance of qualified medical doctors for clinical trial matching.https://doi.org/10.1038/s41746-024-01274-7
spellingShingle Shashi Gupta
Aditya Basu
Mauro Nievas
Jerrin Thomas
Nathan Wolfrath
Adhitya Ramamurthi
Bradley Taylor
Anai N. Kothari
Regina Schwind
Therica M. Miller
Sorena Nadaf-Rahrov
Yanshan Wang
Hrituraj Singh
PRISM: Patient Records Interpretation for Semantic clinical trial Matching system using large language models
npj Digital Medicine
title PRISM: Patient Records Interpretation for Semantic clinical trial Matching system using large language models
title_full PRISM: Patient Records Interpretation for Semantic clinical trial Matching system using large language models
title_fullStr PRISM: Patient Records Interpretation for Semantic clinical trial Matching system using large language models
title_full_unstemmed PRISM: Patient Records Interpretation for Semantic clinical trial Matching system using large language models
title_short PRISM: Patient Records Interpretation for Semantic clinical trial Matching system using large language models
title_sort prism patient records interpretation for semantic clinical trial matching system using large language models
url https://doi.org/10.1038/s41746-024-01274-7
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