Large language models forecast patient health trajectories enabling digital twins
Bibliographic record
Abstract
Generative artificial intelligence is revolutionizing digital twin development, enabling virtual patient representations that predict health trajectories, with large language models (LLMs) showcasing untapped clinical forecasting potential. We developed the Digital Twin-Generative Pretrained Transformer (DT-GPT), extending LLM-based forecasting solutions to clinical trajectory prediction. DT-GPT leverages electronic health records without requiring data imputation or normalization and overcomes real-world data challenges such as missingness, noise, and limited sample sizes. Benchmarking on non-small cell lung cancer, intensive care unit, and Alzheimer's disease datasets, DT-GPT outperformed state-of-the-art machine learning models, reducing the scaled mean absolute error by 3.4%, 1.3% and 1.8%, respectively. It maintained distributions and cross-correlations of clinical variables, and demonstrated explainability through a human-interpretable interface. Additionally, DT-GPT's ability to perform zero-shot forecasting highlights potential advantages of LLMs as clinical forecasting platforms, proposing a path towards digital twin applications in clinical trials, treatment selection, and adverse event mitigation.
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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 | 0.002 | 0.013 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.001 | 0.002 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.003 | 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".