Lightweight Retrieval-Augmented Generation and Large Language Model-Based Modeling for Scalable Patient-Trial Matching

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Main Authors: Li, Xiaodi, Xiao, Yang, Lee, Munhwan, Leventakos, Konstantinos, Juhn, Young J., Jones, David, Sio, Terence T., Liu, Wei, Vassilaki, Maria, Zong, Nansu
Format: Preprint
Published: 2026
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author Li, Xiaodi
Xiao, Yang
Lee, Munhwan
Leventakos, Konstantinos
Juhn, Young J.
Jones, David
Sio, Terence T.
Liu, Wei
Vassilaki, Maria
Zong, Nansu
author_facet Li, Xiaodi
Xiao, Yang
Lee, Munhwan
Leventakos, Konstantinos
Juhn, Young J.
Jones, David
Sio, Terence T.
Liu, Wei
Vassilaki, Maria
Zong, Nansu
contents Patient-trial matching requires reasoning over long, heterogeneous electronic health records (EHRs) and complex eligibility criteria, posing significant challenges for scalability, generalization, and computational efficiency. Existing approaches either rely on full-document processing with large language models (LLMs), which is computationally expensive, or use traditional machine learning methods that struggle to capture unstructured clinical narratives. In this work, we propose a lightweight framework that combines retrieval-augmented generation and large language model-based modeling for scalable patient-trial matching. The framework explicitly separates two key components: retrieval-augmented generation is used to identify clinically relevant segments from long EHRs, reducing input complexity, while large language models are used to encode these selected segments into informative representations. These representations are further refined through dimensionality reduction and modeled using lightweight predictors, enabling efficient and scalable downstream classification. We evaluate the proposed approach on multiple public benchmarks (n2c2, SIGIR, TREC 2021/2022) and a real-world multimodal dataset from Mayo Clinic (MCPMD). Results show that retrieval-based information selection significantly reduces computational burden while preserving clinically meaningful signals. We further demonstrate that frozen LLMs provide strong representations for structured clinical data, whereas fine-tuning is essential for modeling unstructured clinical narratives. Importantly, the proposed lightweight pipeline achieves performance comparable to end-to-end LLM approaches with substantially lower computational cost.
format Preprint
id arxiv_https___arxiv_org_abs_2604_22061
institution arXiv
publishDate 2026
record_format arxiv
spellingShingle Lightweight Retrieval-Augmented Generation and Large Language Model-Based Modeling for Scalable Patient-Trial Matching
Li, Xiaodi
Xiao, Yang
Lee, Munhwan
Leventakos, Konstantinos
Juhn, Young J.
Jones, David
Sio, Terence T.
Liu, Wei
Vassilaki, Maria
Zong, Nansu
Computation and Language
Artificial Intelligence
Machine Learning
Patient-trial matching requires reasoning over long, heterogeneous electronic health records (EHRs) and complex eligibility criteria, posing significant challenges for scalability, generalization, and computational efficiency. Existing approaches either rely on full-document processing with large language models (LLMs), which is computationally expensive, or use traditional machine learning methods that struggle to capture unstructured clinical narratives. In this work, we propose a lightweight framework that combines retrieval-augmented generation and large language model-based modeling for scalable patient-trial matching. The framework explicitly separates two key components: retrieval-augmented generation is used to identify clinically relevant segments from long EHRs, reducing input complexity, while large language models are used to encode these selected segments into informative representations. These representations are further refined through dimensionality reduction and modeled using lightweight predictors, enabling efficient and scalable downstream classification. We evaluate the proposed approach on multiple public benchmarks (n2c2, SIGIR, TREC 2021/2022) and a real-world multimodal dataset from Mayo Clinic (MCPMD). Results show that retrieval-based information selection significantly reduces computational burden while preserving clinically meaningful signals. We further demonstrate that frozen LLMs provide strong representations for structured clinical data, whereas fine-tuning is essential for modeling unstructured clinical narratives. Importantly, the proposed lightweight pipeline achieves performance comparable to end-to-end LLM approaches with substantially lower computational cost.
title Lightweight Retrieval-Augmented Generation and Large Language Model-Based Modeling for Scalable Patient-Trial Matching
topic Computation and Language
Artificial Intelligence
Machine Learning
url https://arxiv.org/abs/2604.22061