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Apr 23

Panacea: A foundation model for clinical trial search, summarization, design, and recruitment

Clinical trials are fundamental in developing new drugs, medical devices, and treatments. However, they are often time-consuming and have low success rates. Although there have been initial attempts to create large language models (LLMs) for clinical trial design and patient-trial matching, these models remain task-specific and not adaptable to diverse clinical trial tasks. To address this challenge, we propose a clinical trial foundation model named Panacea, designed to handle multiple tasks, including trial search, trial summarization, trial design, and patient-trial matching. We also assemble a large-scale dataset, named TrialAlign, of 793,279 trial documents and 1,113,207 trial-related scientific papers, to infuse clinical knowledge into the model by pre-training. We further curate TrialInstruct, which has 200,866 of instruction data for fine-tuning. These resources enable Panacea to be widely applicable for a range of clinical trial tasks based on user requirements. We evaluated Panacea on a new benchmark, named TrialPanorama, which covers eight clinical trial tasks. Our method performed the best on seven of the eight tasks compared to six cutting-edge generic or medicine-specific LLMs. Specifically, Panacea showed great potential to collaborate with human experts in crafting the design of eligibility criteria, study arms, and outcome measures, in multi-round conversations. In addition, Panacea achieved 14.42% improvement in patient-trial matching, 41.78% to 52.02% improvement in trial search, and consistently ranked at the top for five aspects of trial summarization. Our approach demonstrates the effectiveness of Panacea in clinical trials and establishes a comprehensive resource, including training data, model, and benchmark, for developing clinical trial foundation models, paving the path for AI-based clinical trial development.

  • 5 authors
·
Jun 25, 2024

TrialPanorama: Database and Benchmark for Systematic Review and Design of Clinical Trials

Developing artificial intelligence (AI) for vertical domains requires a solid data foundation for both training and evaluation. In this work, we introduce TrialPanorama, a large-scale, structured database comprising 1,657,476 clinical trial records aggregated from 15 global sources. The database captures key aspects of trial design and execution, including trial setups, interventions, conditions, biomarkers, and outcomes, and links them to standard biomedical ontologies such as DrugBank and MedDRA. This structured and ontology-grounded design enables TrialPanorama to serve as a unified, extensible resource for a wide range of clinical trial tasks, including trial planning, design, and summarization. To demonstrate its utility, we derive a suite of benchmark tasks directly from the TrialPanorama database. The benchmark spans eight tasks across two categories: three for systematic review (study search, study screening, and evidence summarization) and five for trial design (arm design, eligibility criteria, endpoint selection, sample size estimation, and trial completion assessment). The experiments using five state-of-the-art large language models (LLMs) show that while general-purpose LLMs exhibit some zero-shot capability, their performance is still inadequate for high-stakes clinical trial workflows. We release TrialPanorama database and the benchmark to facilitate further research on AI for clinical trials.

  • 9 authors
·
May 21, 2025

Making, not Taking, the Best of N

Obtaining high-quality generations in modern LLMs has largely been framed as a selection problem: identifying a single winning generation from a diverse pool of N samples, the Best-of-N (BoN). Yet, this approach is inherently zero-sum, discarding diverse and potentially useful information from the pool. Instead, we explore a collaborative setup, where all candidates can potentially contribute to the final winning generation. To this end, we propose Fusion-of-N (FusioN): a method that uses a general LLM judge to synthesize the most informative elements of each sample into a single final answer. We compare FusioN to BoN in two settings, (i) test-time scaling, where we sample and aggregate from a single model at test-time (ii) synthetic data generation, where we fuse samples from a pool of diverse teachers to improve a student model. We extensively benchmark both setups across 11 languages, 3 diverse tasks and varying model scales. Across the bench, FusioN consistently outperforms BoN showing versatility and robustness both in test-time scaling and in downstream gains from synthetic data generation. We also perform extensive analysis on FusioN, where it shows surprising strengths and robustness under challenging settings. These results show that we should shift how we think about evaluating and utilizing LLM generations from a monolithic measure of quality, to embracing their polylithic nature. This shift allows us to integrate diverse strengths, unlock latent potential, and achieve improvements that were previously inaccessible through selection alone.

CohereLabs Cohere Labs
·
Oct 1, 2025 2

Scalable Best-of-N Selection for Large Language Models via Self-Certainty

Best-of-N selection is a key technique for improving the reasoning performance of Large Language Models (LLMs) through increased test-time computation. Current state-of-the-art methods often employ computationally intensive reward models for response evaluation and selection. Reward-free alternatives, like self-consistency and universal self-consistency, are limited in their ability to handle open-ended generation tasks or scale effectively. To address these limitations, we propose self-certainty, a novel and efficient metric that leverages the inherent probability distribution of LLM outputs to estimate response quality without requiring external reward models. We hypothesize that higher distributional self-certainty, aggregated across multiple samples, correlates with improved response accuracy, as it reflects greater confidence in the generated output. Through extensive experiments on various reasoning tasks, we demonstrate that self-certainty (1) scales effectively with increasing sample size N, akin to reward models but without the computational overhead; (2) complements chain-of-thought, improving reasoning performance beyond greedy decoding; and (3) generalizes to open-ended tasks where traditional self-consistency methods fall short. Our findings establish self-certainty as a practical and efficient way for improving LLM reasoning capabilities. The code is available at https://github.com/backprop07/Self-Certainty

  • 3 authors
·
Feb 25, 2025