Toward an AI Reasoning-Enabled System for Patient-Clinical Trial Matching

Screening patients for clinical trial eligibility remains a manual, time - consuming, and resource-intensive process. W e present a secure, scalable proof-of - concept system for Artificial Intelligence ( AI)- augmented patient - trial matching that addresses key implementation challenges: integrating heterogeneous electronic health record (EHR) data, facilitating expert review, and maintaining rigorous security standards. Leveraging open-source, reasoning-enabled large language models (LLMs), the system moves beyond binary classification to generate structured eligibility assessments with interpretable reasoning chains that support human-in - the - loop review. This decision support tool represents eligibility as a dynamic state rather than a fixed determination, identifying matches whe n available and offering actionable recommendations that could render a patient eligible in the future . The system aims to reduce coordinator burden, intelligently broaden the set of trials considered for each patient and guarantee comprehensive auditability of all AI - generated outputs. Introduction Applications of artificial intelligence (AI) in healthcare are increasingly focused on improving administrative efficiency and optimizing clinical workflows . Identifying relevant trials and screening them for a particular patient is traditionally manual, time - consuming, and heavily reliant on clinical expertise.