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Utilizing Large Language Models for Enhanced Clinical Trial Matching: A Study on Automation in Patient Screening.

作者信息

Beattie Jacob, Neufeld Sarah, Yang Daniel, Chukwuma Christian, Gul Ahmed, Desai Neil, Jiang Steve, Dohopolski Michael

机构信息

Department of Radiation Oncology, University of Texas (UT) Southwestern Medical Center, Dallas, USA.

出版信息

Cureus. 2024 May 10;16(5):e60044. doi: 10.7759/cureus.60044. eCollection 2024 May.


DOI:10.7759/cureus.60044
PMID:38854210
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11162699/
Abstract

Background Clinical trial matching, essential for advancing medical research, involves detailed screening of potential participants to ensure alignment with specific trial requirements. Research staff face challenges due to the high volume of eligible patients and the complexity of varying eligibility criteria. The traditional manual process, both time-consuming and error-prone, often leads to missed opportunities. Recently, large language models (LLMs), specifically generative pre-trained transformers (GPTs), have become impressive and impactful tools. Utilizing such tools from artificial intelligence (AI) and natural language processing (NLP) may enhance the accuracy and efficiency of this process through automated patient screening against established criteria. Methods Utilizing data from the National NLP Clinical Challenges (n2c2) 2018 Challenge, we utilized 202 longitudinal patient records. These records were annotated by medical professionals and evaluated against 13 selection criteria encompassing various health assessments. Our approach involved embedding medical documents into a vector database to determine relevant document sections and then using an LLM (OpenAI's GPT-3.5 Turbo and GPT-4) in tandem with structured and chain-of-thought prompting techniques for systematic document assessment against the criteria. Misclassified criteria were also examined to identify classification challenges. Results This study achieved an accuracy of 0.81, sensitivity of 0.80, specificity of 0.82, and a micro F1 score of 0.79 using GPT-3.5 Turbo, and an accuracy of 0.87, sensitivity of 0.85, specificity of 0.89, and micro F1 score of 0.86 using GPT-4. Notably, some criteria in the ground truth appeared mislabeled, an issue we couldn't explore further due to insufficient label generation guidelines on the website. Conclusion Our findings underscore the potential of AI and NLP technologies, including LLMs, in the clinical trial matching process. The study demonstrated strong capabilities in identifying eligible patients and minimizing false inclusions. Such automated systems promise to alleviate the workload of research staff and improve clinical trial enrollment, thus accelerating the process and enhancing the overall feasibility of clinical research. Further work is needed to determine the potential of this approach when implemented on real clinical data.

摘要
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1d9a/11162699/a7584936d0b3/cureus-0016-00000060044-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1d9a/11162699/5f90fadc4b22/cureus-0016-00000060044-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1d9a/11162699/24ca26f353cc/cureus-0016-00000060044-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1d9a/11162699/a7584936d0b3/cureus-0016-00000060044-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1d9a/11162699/5f90fadc4b22/cureus-0016-00000060044-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1d9a/11162699/24ca26f353cc/cureus-0016-00000060044-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1d9a/11162699/a7584936d0b3/cureus-0016-00000060044-i03.jpg

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Utilizing Large Language Models for Enhanced Clinical Trial Matching: A Study on Automation in Patient Screening.

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[4]
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[5]
Extracting Pulmonary Embolism Diagnoses From Radiology Impressions Using GPT-4o: Large Language Model Evaluation Study.

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[6]
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[7]
Exploration of Using an Open-Source Large Language Model for Analyzing Trial Information: A Case Study of Clinical Trials With Decentralized Elements.

Clin Transl Sci. 2025-3

[8]
Natural Language Processing in medicine and ophthalmology: A review for the 21st-century clinician.

Asia Pac J Ophthalmol (Phila). 2024

[9]
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本文引用的文献

[1]
Large Language Models for Healthcare Data Augmentation: An Example on Patient-Trial Matching.

AMIA Annu Symp Proc. 2023

[2]
Provider motivations and barriers to cancer clinical trial screening, referral, and operations: Findings from a survey.

Cancer. 2024-1-1

[3]
Barriers to Clinical Trial Accrual: Perspectives of Community-Based Providers.

Clin Breast Cancer. 2020-10

[4]
Increasing Clinical Trial Accrual via Automated Matching of Biomarker Criteria.

Pac Symp Biocomput. 2020

[5]
Cohort selection for clinical trials: n2c2 2018 shared task track 1.

J Am Med Inform Assoc. 2019-11-1

[6]
Evaluating shallow and deep learning strategies for the 2018 n2c2 shared task on clinical text classification.

J Am Med Inform Assoc. 2019-11-1

[7]
Hybrid bag of approaches to characterize selection criteria for cohort identification.

J Am Med Inform Assoc. 2019-11-1

[8]
Global Public Attitudes About Clinical Research and Patient Experiences With Clinical Trials.

JAMA Netw Open. 2018-10-5

[9]
Increasing the efficiency of trial-patient matching: automated clinical trial eligibility pre-screening for pediatric oncology patients.

BMC Med Inform Decis Mak. 2015-4-14

[10]
Adult cancer clinical trials that fail to complete: an epidemic?

J Natl Cancer Inst. 2014-9-4

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