Large language models generating synthetic clinical datasets: a feasibility and comparative analysis with real-world perioperative data
Bibliographic record
Abstract
Background: Clinical data is instrumental to medical research, machine learning (ML) model development, and advancing surgical care, but access is often constrained by privacy regulations and missing data. Synthetic data offers a promising solution to preserve privacy while enabling broader data access. Recent advances in large language models (LLMs) provide an opportunity to generate synthetic data with reduced reliance on domain expertise, computational resources, and pre-training. Objective: This study aims to assess the feasibility of generating realistic tabular clinical data with OpenAI's GPT-4o using zero-shot prompting, and evaluate the fidelity of LLM-generated data by comparing its statistical properties to the Vital Signs DataBase (VitalDB), a real-world open-source perioperative dataset. Methods: -tests, two-sample proportion tests, and 95% confidence interval (CI) overlap. Results: In Phase 1, GPT-4o generated a complete and structured dataset comprising 6,166 case files. The dataset was plausible in range and correctly calculated body mass index for all case files based on respective heights and weights. Statistical comparison between the LLM-generated datasets and VitalDB revealed that Phase 2 data achieved significant fidelity. Phase 2 data demonstrated statistical similarity in 12/13 (92.31%) parameters, whereby no statistically significant differences were observed in 6/6 (100.0%) categorical/binary and 6/7 (85.71%) continuous parameters. Overlap of 95% CIs were observed in 6/7 (85.71%) continuous parameters. Conclusion: Zero-shot prompting with GPT-4o can generate realistic tabular synthetic datasets, which can replicate key statistical properties of real-world perioperative data. This study highlights the potential of LLMs as a novel and accessible modality for synthetic data generation, which may address critical barriers in clinical data access and eliminate the need for technical expertise, extensive computational resources, and pre-training. Further research is warranted to enhance fidelity and investigate the use of LLMs to amplify and augment datasets, preserve multivariate relationships, and train robust ML models.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.013 | 0.054 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".