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Matching patients to clinical trials with large language models
Open accessAbstract
Patient recruitment is challenging for clinical trials. We introduce TrialGPT, an end-to-end framework for zero-shot patient-to-trial matching with large language models. TrialGPT comprises three modules: it first performs large-scale filtering to retrieve candidate trials (TrialGPT-Retrieval); then predicts criterion-level patient eligibility (TrialGPT-Matching); and finally generates trial-level scores (TrialGPT-Ranking). We evaluate TrialGPT on three cohorts of 183 synthetic patients with over 75,000 trial annotations. TrialGPT-Retrieval can recall over 90% of relevant trials using less than 6% of the initial collection. Manual evaluations on 1015 patient-criterion pairs show that TrialGPT-Matching achieves an accuracy of 87.3% with faithful explanations, close to the expert performance. The TrialGPT-Ranking scores are highly correlated with human judgments and outperform the best-competing models by 43.8% in ranking and excluding trials. Furthermore, our user study reveals that TrialGPT can reduce the screening time by 42.6% in patient recruitment. Overall, these results have demonstrated promising opportunities for patient-to-trial matching with TrialGPT.
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“many published approaches remain retrospective, disease-limited, or optimized for text similarity and retrieval rather than auditable patient–trial execution over longitudinal records.”
From Transforming oncology clinical trial matching through neuro-symbolic, multi-agent AI and an oncology-specific knowledge graph: a prospective evaluation in 3804 patients (2026) · cites this paper as [4]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“A pioneering system in this realm is TrialGPT, which uses a trio of agents to match patients to clinical trials [36].”
From A Review of Multi-Agent AI Systems for Biological and Clinical Data Analysis (2026) · cites this paper as [36]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“clinicians assisted by TrialGPT were able to complete trial screening tasks 42.6% faster than those working without AI assistance (35.3 s vs. 61.5 s; p < 0.001)”
From A Review of Multi-Agent AI Systems for Biological and Clinical Data Analysis (2026) · cites this paper as [36]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“the high correlation between TrialGPT’s ranking scores and human judgment suggests that MAS has the potential to serve as a reliable cognitive assistant for complex, zero-shot patient-to-trial matching”
From A Review of Multi-Agent AI Systems for Biological and Clinical Data Analysis (2026) · cites this paper as [36]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“representing a 43.8% improvement over state-of-the-art baselines like the cross-encoder BioLinkBERT (AUROC: 0.6176)”
From A Review of Multi-Agent AI Systems for Biological and Clinical Data Analysis (2026) · cites this paper as [36]
Experimental — accuracy not yet measured
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“TrialGPT-Retrieval, first conducts a large-scale search to retrieve candidate trials from databases based on a patient’s profile”
From A Review of Multi-Agent AI Systems for Biological and Clinical Data Analysis (2026) · cites this paper as [36]
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“the system achieved a precision of 90.1% and a recall of 87.9% in locating relevant supporting sentences in clinical notes”
From A Review of Multi-Agent AI Systems for Biological and Clinical Data Analysis (2026) · cites this paper as [36]
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“TrialGPT-Ranking, assigns scores to rank the trials by suitability”
From A Review of Multi-Agent AI Systems for Biological and Clinical Data Analysis (2026) · cites this paper as [36]
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In the citing paper
“the system achieved a precision of 90.1% and a recall of 87.9% in locating relevant supporting sentences in clinical notes”
From A Review of Multi-Agent AI Systems for Biological and Clinical Data Analysis (2026) · cites this paper as [36]
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“In the trial exclusion task, TrialGPT attained an AUROC of 0.7979”
From A Review of Multi-Agent AI Systems for Biological and Clinical Data Analysis (2026) · cites this paper as [36]
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“as these evaluations were conducted on synthetic patient records”
From A Review of Multi-Agent AI Systems for Biological and Clinical Data Analysis (2026) · cites this paper as [36]
The cited source says what the claim attributes to it.
In the citing paper
“manual evaluations of 1015 patient-criterion pairs demonstrated that the matching agent achieved an accuracy of 87.3%”
From A Review of Multi-Agent AI Systems for Biological and Clinical Data Analysis (2026) · cites this paper as [36]
The cited source says what the claim attributes to it.
In the citing paper
“TrialGPT-Retrieval successfully recalled over 90% of relevant trials while filtering out most irrelevant ones, requiring less than 6% of the total collection to maintain this high recall”
From A Review of Multi-Agent AI Systems for Biological and Clinical Data Analysis (2026) · cites this paper as [36]
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“TrialGPT-Matching, then evaluates the patient’s eligibility against each trial’s criteria using LLM-based reading and annotation of inclusion/exclusion criteria”
From A Review of Multi-Agent AI Systems for Biological and Clinical Data Analysis (2026) · cites this paper as [36]
The cited source says what the claim attributes to it.
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“The system was then evaluated on three cohorts comprising 183 synthetic patients with over 75,000 trial eligibility annotations.”
From A Review of Multi-Agent AI Systems for Biological and Clinical Data Analysis (2026) · cites this paper as [36]
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AI in Biomedicine—A Forward-Looking Perspective on Health Equity
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Long-Term Follow-Up Care After Treatment for Primary Breast Cancer: Strategies and Considerations
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Preparing Allergists to Practice in 2050 Using Artificial Intelligence
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“Prior systems have demonstrated that LLMs, retrieval, and ontology alignment can help identify candidate trials, 3,4,11-13 but many published approaches remain retrospective, disease-limited, or optimized for text similarity and retrieval rather than auditable patient — trial execution over…”
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“…(e.g., Pathway A - Majority Vote) delivered high precision (typical around 0.92, which compares favorably to reported manual annotation performance [30]) and also demonstrated good recall (e.g., typically > 0.85 for these tasks, as shown in Supplemental Table S3), contributing to both accuracy and…”
InfluentialPatient2Trial: From patient to participant in clinical trials using large language models
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Large Language Models in Randomized Controlled Trials Design: Observational Study
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A context-augmented large language model for accurate precision oncology medicine recommendations
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Metadata
- Authors
- Jin, Q., Wang, Z., Floudas, C. S., Chen, F., Gong, C., Bracken-Clarke, D., Xue, E., Yang, Y., Sun, J., & Lu, Z.
- Affiliations
- National Institutes of Health (US)
- University of Illinois Urbana-Champaign (US)
- University of Pittsburgh (US)
- Albert Einstein College of Medicine (US)
- Corresponding author
- Lu, Zhiyong
- ORCID
- Venue
- Nature Communications
- Published
- 2024-11-18
- Volume
- 15
- Issue
- 1
- Pages
- 9074-9074
- ISSN
- 2041-1723 (ISSN-L)
- PMC
- PMC11574183
- OpenAlex
- W4404486407
- Cited by
- 287
- References
- 43
- Citations by year
- 2026: 119 · 2025: 117 · 2024: 50
- FWCI
- 26.74
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- Nature Communications (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- arXiv (Cornell University) (submittedVersion, cc-by)
- PubMed Central (submittedVersion, cc-by)
- RePEc: Research Papers in Economics (submittedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- arXiv (Cornell University) (cc-by)
- Funders
- U.S. Department of Health & Human Services | National Institutes of Health
- Topics
- Health Sciences › Medicine › Health Informatics › Artificial Intelligence in Healthcare and Education
- Physical Sciences › Computer Science › Artificial Intelligence › Machine Learning in Healthcare
- Physical Sciences › Computer Science › Information Systems › Information Retrieval and Search Behavior
- Keywords
- clinical trial recruitment, large language models, explainable AI, synthetic patient data, user study
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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