PRISM: Patient Records Interpretation for Semantic Clinical Trial Matching using Large Language Models

Fuente: arXiv
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Main Authors: Gupta, Shashi Kant, Basu, Aditya, Nievas, Mauro, Thomas, Jerrin, Wolfrath, Nathan, Ramamurthi, Adhitya, Taylor, Bradley, Kothari, Anai N., Schwind, Regina, Miller, Therica M., Nadaf-Rahrov, Sorena, Wang, Yanshan, Singh, Hrituraj
Format: Preprint
Published: 2024
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author Gupta, Shashi Kant
Basu, Aditya
Nievas, Mauro
Thomas, Jerrin
Wolfrath, Nathan
Ramamurthi, Adhitya
Taylor, Bradley
Kothari, Anai N.
Schwind, Regina
Miller, Therica M.
Nadaf-Rahrov, Sorena
Wang, Yanshan
Singh, Hrituraj
author_facet Gupta, Shashi Kant
Basu, Aditya
Nievas, Mauro
Thomas, Jerrin
Wolfrath, Nathan
Ramamurthi, Adhitya
Taylor, Bradley
Kothari, Anai N.
Schwind, Regina
Miller, Therica M.
Nadaf-Rahrov, Sorena
Wang, Yanshan
Singh, Hrituraj
contents Clinical trial matching is the task of identifying trials for which patients may be potentially 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 is manual, time-intensive, and challenging to scale up, resulting 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 the first, end-to-end large-scale empirical evaluation of clinical trial matching using real-world EHRs. Our study showcases the capability of LLMs to accurately match patients with appropriate clinical trials. We perform experiments with proprietary LLMs, including GPT-4 and GPT-3.5, as well as our custom fine-tuned model called OncoLLM and show that OncoLLM, despite its significantly smaller size, not only outperforms GPT-3.5 but also matches the performance of qualified medical doctors. All experiments were carried out on real-world EHRs that include clinical notes and available clinical trials from a single cancer center in the United States.
format Preprint
id arxiv_https___arxiv_org_abs_2404_15549
institution arXiv
publishDate 2024
record_format arxiv
spellingShingle PRISM: Patient Records Interpretation for Semantic Clinical Trial Matching using Large Language Models
Gupta, Shashi Kant
Basu, Aditya
Nievas, Mauro
Thomas, Jerrin
Wolfrath, Nathan
Ramamurthi, Adhitya
Taylor, Bradley
Kothari, Anai N.
Schwind, Regina
Miller, Therica M.
Nadaf-Rahrov, Sorena
Wang, Yanshan
Singh, Hrituraj
Computation and Language
Artificial Intelligence
Clinical trial matching is the task of identifying trials for which patients may be potentially 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 is manual, time-intensive, and challenging to scale up, resulting 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 the first, end-to-end large-scale empirical evaluation of clinical trial matching using real-world EHRs. Our study showcases the capability of LLMs to accurately match patients with appropriate clinical trials. We perform experiments with proprietary LLMs, including GPT-4 and GPT-3.5, as well as our custom fine-tuned model called OncoLLM and show that OncoLLM, despite its significantly smaller size, not only outperforms GPT-3.5 but also matches the performance of qualified medical doctors. All experiments were carried out on real-world EHRs that include clinical notes and available clinical trials from a single cancer center in the United States.
title PRISM: Patient Records Interpretation for Semantic Clinical Trial Matching using Large Language Models
topic Computation and Language
Artificial Intelligence
url https://arxiv.org/abs/2404.15549