arXiv:2604.22061cs.CLcs.AI2026-04

用轻量框架提升患者与临床试验匹配效率,兼顾准确与速度。

Lightweight Retrieval-Augmented Generation and Large Language Model-Based Modeling for Scalable Patient-Trial Matching

  • 分两步:先用检索选关键病历片段,再用大模型编码
  • 计算成本降低,性能接近全模型端到端方法
  • 适合医疗系统部署,尤其对资源有限的机构

患者-试验匹配需处理长而异构的电子健康记录(EHR)和复杂的入组标准,对可扩展性、泛化性和计算效率构成挑战。现有方法要么依赖大语言模型(LLM)处理全文,计算开销大;要么采用传统机器学习,难以捕捉非结构化临床文本。本文提出一种轻量级框架,结合检索增强生成与基于大模型的建模,实现可扩展的患者-试验匹配。该框架显式分离两个关键组件:检索增强生成用于从长EHR中识别临床相关段落,降低输入复杂度;大模型则对选定段落进行编码,生成信息表示。这些表示经降维后由轻量级预测器建模,实现高效下游分类。我们在多个公开基准(n2c2、SIGIR、TREC 2021/2022)和梅奥诊所真实多模态数据集(MCPMD)上评估,结果表明:基于检索的信息筛选显著降低计算负担,同时保留临床有意义信号。进一步发现:冻结的LLM对结构化临床数据提供强表示,而微调对建模非结构化叙事至关重要。重要的是,该轻量级流程在性能上媲美端到端LLM方法,但计算成本大幅下降。

原文摘要 · Abstract (English)

Patient-trial matching requires reasoning over long, heterogeneous electronic health records (EHRs) and complex eligibility criteria, posing significant challenges for scalability, generalization, and computational efficiency. Existing approaches either rely on full-document processing with large language models (LLMs), which is computationally expensive, or use traditional machine learning methods that struggle to capture unstructured clinical narratives. In this work, we propose a lightweight framework that combines retrieval-augmented generation and large language model-based modeling for scalable patient-trial matching. The framework explicitly separates two key components: retrieval-augmented generation is used to identify clinically relevant segments from long EHRs, reducing input complexity, while large language models are used to encode these selected segments into informative representations. These representations are further refined through dimensionality reduction and modeled using lightweight predictors, enabling efficient and scalable downstream classification. We evaluate the proposed approach on multiple public benchmarks (n2c2, SIGIR, TREC 2021/2022) and a real-world multimodal dataset from Mayo Clinic (MCPMD). Results show that retrieval-based information selection significantly reduces computational burden while preserving clinically meaningful signals. We further demonstrate that frozen LLMs provide strong representations for structured clinical data, whereas fine-tuning is essential for modeling unstructured clinical narratives. Importantly, the proposed lightweight pipeline achieves performance comparable to end-to-end LLM approaches with substantially lower computational cost.

医疗AI大模型轻量级匹配系统

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