Can JEV Support Clinical Trial Criteria Assessment?

Abstract

Clinical trial prescreening requires distinguishing unmet conditions from insufficient evidence in patient records. Given patient records, criterion questions, and predefined answer options, we retrospectively compared JEV, a non-generative decision model returning native option probabilities, with schema-constrained Qwen Flash across 2,048 test patient-condition pairs from TrialGPT and question-answer datasets derived from MIMIC-III and MIMIC-IV, all evaluated under strict Zero Data Retention (ZDR) policies to ensure clinical data privacy. Both models assessed conditions individually or in batches sharing the same patient context, with performance measured against reference labels. In batch mode, JEV and Qwen achieved similar macro-F1 scores on TrialGPT (0.652 vs. 0.660) and MIMIC-IV (0.807 vs. 0.814), whereas JEV substantially outperformed Qwen on MIMIC-III (0.768 vs. 0.534; $\Delta$ = +0.234, 95% CI: 0.187-0.281). This advantage largely reflected higher recall for conditions labeled as having insufficient information (56.3% vs. 9.9%). Across all three datasets, JEV also had lower observed median job latency (1.18-1.40 vs. 2.80-8.90 s) and 53%-74% lower estimated cost per condition. These findings position JEV as an initial assessment component that provides criterion-level judgments and flags potential information gaps for review. JEV's observed errors in interpreting clinical evidence underscore the need to verify its outputs against patient records before they inform eligibility decisions.