Translating evidence into practice: adapting TrialGPT for real-world clinical trial eligibility screening.
cross_sectional · Level IV
Where this comes from
- Record sourced from PubMed, PMID 41637159.
- Also identified by DOI 10.1093/jamia/ocag006 and PMC identifier 13035440.
- Licence recorded as CC BY.
- The licence permits redistribution, so the abstract is shown in full and the full text is available from the publisher.
Abstract
To evaluate the performance of a locally deployed adaptation of TrialGPT, a large language model (LLM) system for identifying trial-eligible patients from unstructured electronic health record (EHR) data. TrialGPT was re-engineered for secure, deployment at UT Health San Antonio using a locally hosted LLM. It was optimized for real-world data needs through a longitudinal patient-encounter-note hierarchy mirroring EHR documentation. Performance was evaluated in two stages: (1) benchmarking against an expert-adjudicated gold corpus (n = 149) and (2) comparative validation against manual screening (n = 55). Against the expert-adjudicated corpus, the system achieved 81.8% sensitivity, 97.8% specificity, and a positive predictive value of 75.0%. Compared with manual screening, it identified more than twice as many truly eligible patients (81.8% vs 36.4%) while preserving equivalent specificity. The adapted TrialGPT framework operationalizes trial matching, translating EHR data into actionable screening intelligence for efficient, scalable clinical trial recruitment.
Medical subject headings
- Electronic Health Records
- Eligibility Determination
- Clinical Trials as Topic
- Patient Selection
- Natural Language Processing