eligibility criteria
AD-CDO: A Lightweight Ontology for Representing Eligibility Criteria in Alzheimer's Disease Clinical Trials
Sun, Zenan, Abeysinghe, Rashmie, Li, Xiaojin, Hu, Xinyue, Cui, Licong, Zhang, Guo-Qiang, Bian, Jiang, Tao, Cui
Objective This study introduces the Alzheimer's Disease Common Data Element Ontology for Clinical Trials (AD-CDO), a lightweight, semantically enriched ontology designed to represent and standardize key eligibility criteria concepts in Alzheimer's disease (AD) clinical trials. Materials and Methods We extracted high-frequency concepts from more than 1,500 AD clinical trials on ClinicalTrials.gov and organized them into seven semantic categories: Disease, Medication, Diagnostic Test, Procedure, Social Determinants of Health, Rating Criteria, and Fertility. Each concept was annotated with standard biomedical vocabularies, including the UMLS, OMOP Standardized Vocabularies, DrugBank, NDC, and NLM VSAC value sets. To balance coverage and manageability, we applied the Jenks Natural Breaks method to identify an optimal set of representative concepts. Results The optimized AD-CDO achieved over 63% coverage of extracted trial concepts while maintaining interpretability and compactness. The ontology effectively captured the most frequent and clinically meaningful entities used in AD eligibility criteria. We demonstrated AD-CDO's practical utility through two use cases: (a) an ontology-driven trial simulation system for formal modeling and virtual execution of clinical trials, and (b) an entity normalization task mapping raw clinical text to ontology-aligned terms, enabling consistency and integration with EHR data. Discussion AD-CDO bridges the gap between broad biomedical ontologies and task-specific trial modeling needs. It supports multiple downstream applications, including phenotyping algorithm development, cohort identification, and structured data integration. Conclusion By harmonizing essential eligibility entities and aligning them with standardized vocabularies, AD-CDO provides a versatile foundation for ontology-driven AD clinical trial research.
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AI Adoption in NGOs: A Systematic Literature Review
Rotter, Janne, Bailkoski, William
AI has the potential to significantly improve how NGOs utilize their limited resources for societal benefits, but evidence about how NGOs adopt AI remains scattered. In this study, we systematically investigate the types of AI adoption use cases in NGOs and identify common challenges and solutions, contextualized by organizational size and geographic context. We review the existing primary literature, including studies that investigate AI adoption in NGOs related to social impact between 2020 and 2025 in English. Following the PRISMA protocol, two independent reviewers conduct study selection, with regular cross-checking to ensure methodological rigour, resulting in a final literature body of 65 studies. Leveraging a thematic and narrative approach, we identify six AI use case categories in NGOs - Engagement, Creativity, Decision-Making, Prediction, Management, and Optimization - and extract common challenges and solutions within the Technology-Organization-Environment (TOE) framework. By integrating our findings, this review provides a novel understanding of AI adoption in NGOs, linking specific use cases and challenges to organizational and environmental factors. Our results demonstrate that while AI is promising, adoption among NGOs remains uneven and biased towards larger organizations. Nevertheless, following a roadmap grounded in literature can help NGOs overcome initial barriers to AI adoption, ultimately improving effectiveness, engagement, and social impact.
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A systematic review of trial-matching pipelines using large language models
Morrison, Braxton A., Sushil, Madhumita, Young, Jacob S.
Matching patients to clinical trial options is critical for identifying novel treatments, especially in oncology. However, manual matching is labor-intensive and error-prone, leading to recruitment delays. Pipelines incorporating large language models (LLMs) offer a promising solution. We conducted a systematic review of studies published between 2020 and 2025 from three academic databases and one preprint server, identifying LLM-based approaches to clinical trial matching. Of 126 unique articles, 31 met inclusion criteria. Reviewed studies focused on matching patient-to-criterion only (n=4), patient-to-trial only (n=10), trial-to-patient only (n=2), binary eligibility classification only (n=1) or combined tasks (n=14). Sixteen used synthetic data; fourteen used real patient data; one used both. Variability in datasets and evaluation metrics limited cross-study comparability. In studies with direct comparisons, the GPT-4 model consistently outperformed other models, even finely-tuned ones, in matching and eligibility extraction, albeit at higher cost. Promising strategies included zero-shot prompting with proprietary LLMs like the GPT-4o model, advanced retrieval methods, and fine-tuning smaller, open-source models for data privacy when incorporation of large models into hospital infrastructure is infeasible. Key challenges include accessing sufficiently large real-world data sets, and deployment-associated challenges such as reducing cost, mitigating risk of hallucinations, data leakage, and bias. This review synthesizes progress in applying LLMs to clinical trial matching, highlighting promising directions and key limitations. Standardized metrics, more realistic test sets, and attention to cost-efficiency and fairness will be critical for broader deployment.
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Smart Trial: Evaluating the Use of Large Language Models for Recruiting Clinical Trial Participants via Social Media
Zhou, Xiaofan, Wang, Zisu, Krieger, Janice, Zalake, Mohan, Cheng, Lu
Clinical trials (CT) are essential for advancing medical research and treatment, yet efficiently recruiting eligible participants -- each of whom must meet complex eligibility criteria -- remains a significant challenge. Traditional recruitment approaches, such as advertisements or electronic health record screening within hospitals, are often time-consuming and geographically constrained. This work addresses the recruitment challenge by leveraging the vast amount of health-related information individuals share on social media platforms. With the emergence of powerful large language models (LLMs) capable of sophisticated text understanding, we pose the central research question: Can LLM-driven tools facilitate CT recruitment by identifying potential participants through their engagement on social media? To investigate this question, we introduce TRIALQA, a novel dataset comprising two social media collections from the subreddits on colon cancer and prostate cancer. Using eligibility criteria from public real-world CTs, experienced annotators are hired to annotate TRIALQA to indicate (1) whether a social media user meets a given eligibility criterion and (2) the user's stated reasons for interest in participating in CT. We benchmark seven widely used LLMs on these two prediction tasks, employing six distinct training and inference strategies. Our extensive experiments reveal that, while LLMs show considerable promise, they still face challenges in performing the complex, multi-hop reasoning needed to accurately assess eligibility criteria.
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Natural Language Processing in Support of Evidence-based Medicine: A Scoping Review
Xu, Zihan, Ma, Haotian, Zhang, Gongbo, Ding, Yihao, Weng, Chunhua, Peng, Yifan
Evidence-based medicine (EBM) is at the forefront of modern healthcare, emphasizing the use of the best available scientific evidence to guide clinical decisions. Due to the sheer volume and rapid growth of medical literature and the high cost of curation, there is a critical need to investigate Natural Language Processing (NLP) methods to identify, appraise, synthesize, summarize, and disseminate evidence in EBM. This survey presents an in-depth review of 129 research studies on leveraging NLP for EBM, illustrating its pivotal role in enhancing clinical decision-making processes. The paper systematically explores how NLP supports the five fundamental steps of EBM -- Ask, Acquire, Appraise, Apply, and Assess. The review not only identifies current limitations within the field but also proposes directions for future research, emphasizing the potential for NLP to revolutionize EBM by refining evidence extraction, evidence synthesis, appraisal, summarization, enhancing data comprehensibility, and facilitating a more efficient clinical workflow.
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CLaDMoP: Learning Transferrable Models from Successful Clinical Trials via LLMs
Zhang, Yiqing, Liu, Xiaozhong, Murai, Fabricio
Many existing models for clinical trial outcome prediction are optimized using task-specific loss functions on trial phase-specific data. While this scheme may boost prediction for common diseases and drugs, it can hinder learning of generalizable representations, leading to more false positives/negatives. To address this limitation, we introduce CLaDMoP, a new pre-training approach for clinical trial outcome prediction, alongside the Successful Clinical Trials dataset(SCT), specifically designed for this task. CLaDMoP leverages a Large Language Model-to encode trials' eligibility criteria-linked to a lightweight Drug-Molecule branch through a novel multi-level fusion technique. To efficiently fuse long embeddings across levels, we incorporate a grouping block, drastically reducing computational overhead. CLaDMoP avoids reliance on task-specific objectives by pre-training on a "pair matching" proxy task. Compared to established zero-shot and few-shot baselines, our method significantly improves both PR-AUC and ROC-AUC, especially for phase I and phase II trials. We further evaluate and perform ablation on CLaDMoP after Parameter-Efficient Fine-Tuning, comparing it to state-of-the-art supervised baselines, including MEXA-CTP, on the Trial Outcome Prediction(TOP) benchmark. CLaDMoP achieves up to 10.5% improvement in PR-AUC and 3.6% in ROC-AUC, while attaining comparable F1 score to MEXA-CTP, highlighting its potential for clinical trial outcome prediction. Code and SCT dataset can be downloaded from https://github.com/murai-lab/CLaDMoP.
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