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Towards AI-Assisted Clinical Trial Matching: Practical Considerations, Multicenter Evaluation, and Real-World Deployment

Yin Fang, Qiao Jin, Shubo Tian, Lauren He, Maya Geer, Noor Naffakh, Ryan Huu-Tuan Nguyen, Zifeng Wang 等 27 位作者

Clinical trials are essential for evidence-based medicine and drug development, but many fail because of insufficient patient enrollment. Although there is growing interest in using AI to support patient recruitment, existing systems largely perform eligibility assessment alone and have rarely been evaluated in real-world workflows. Here we present TrialGPT 2.0, an AI-assisted clinical trial recommendation system improved for responsible real-world deployment. Rather than asking only whether a patient may qualify, the system assesses which trials warrant further consideration given the patient's current clinical needs and local workflow priorities, and provides structured, inspectable explanations for expert review. Importantly, we evaluated TrialGPT 2.0 retrospectively and prospectively across government research, patient-advocacy, academic medical center, and community-based radiation-oncology settings. In retrospective multicenter cohorts comprising 288 cases, TrialGPT 2.0 retrieved at least one clinician-recommended trial in its top 10 recommendations for approximately 91% of cases while reducing clinician screening time by 55.0%. In a six-month prospective evaluation embedded in an active precision oncology tumor board, TrialGPT 2.0 contributed additional trial opportunities missed by the routine workflow, increasing the number of patient cases with at least one final trial recommendation by 90.9%. To support scientific reproducibility, we also developed NIH-TrialBench, a clinician-authored benchmark comprising 126 diverse synthetic patient vignettes and matching scenarios from 11 NIH Institutes and Centers. Together, these findings support the value of AI to assist clinical trial matching by improving clinician efficiency and identifying frequently overlooked trial opportunities, ultimately helping to expand and accelerate accrual to cancer trials.

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Act as you think: Reinforcing Consistent Reasoning in Medical Visual Question Answering

Songtao Jiang, Yuan Wang, Ruizhe Chen, Yan Zhang ByteDance Inc., Ruilin Luo, Bohan Lei Zhejiang University, Yeying Jin, Sibo Song Alibaba Group 等 12 位作者

While reinforcement learning from verifiable rewards (RLVR) has been proven highly effective for enhancing reasoning, its application to medical visual question answering (Med-VQA) is hampered by models producing reasoning inconsistent with either the visual evidence or the final answer. Our analysis reveals a critical flaw in RLVR training: it paradoxically encourages models to disregard visual evidence and generate answers that contradict their own reasoning. This degradation is most pronounced in specialized medical modalities (e.g., Fundus, Ultrasound) where base VLMs lack robust understanding, a failure we attribute to a flawed reward mechanism exacerbated by the scarcity of diverse training data. To tackle this, we introduce Med-Zero-17K, a large-scale dataset spanning over 30 modalities and 24 clinically relevant tasks, and the Multi-Consistency Reward (MCR) framework, which explicitly rewards both perceptual grounding and logical coherence. Extensive experiments validate our approach: integrating MCR into the RLVR framework delivers robust performance gains. This success stems from our crucial finding that rewarding internal consistency is significantly more effective than attempting to judge reasoning correctness. Furthermore, MCR proves highly versatile, exhibiting strong generalization across diverse VLM backbones, compatibility with RL algorithms like GRPO and DPO, and extending its effectiveness to 3D VQA tasks and R1-style training paradigms. Code and dataset will be released.

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Proceedings of the 64th Annual Meeting of the Association for Computational Linguistics (Volume 1: Long Papers) · 2026 · 正式发表