ImpACT Project: Improving Access to Clinical Trials in Victoria, an Artificial Intelligence-Based Approach

Enhancing the speed and efficiency of clinical trial recruitment is a key objective across international health systems. This study aimed to use artificial intelligence (AI) applied in the Victorian Cancer Registry (VCR), a population-based cancer registry, to assess (1) if VCR received all relevant pathology reports for three clinical trials, (2) AI accuracy in auto-extracting information from pathology reports for recruitment, and (3) the number of participants approached for trial enrollment using the AI approach compared with standard hospital-based recruitment.

To verify pathology report accessibility for VCR trial enrollment, reports from the laboratory were cross-referenced. To determine the accuracy of a Rapid Case Ascertainment (RCA) module of the AI software in extracting key clinical variables from the pathology report, data were compared with manually reviewed reports. To examine the effectiveness of the AI recruitment approach, the number of patients approached for recruitment was compared with standard practice.

Of the 195 reports provided by the pathology laboratory, 185 (94.9%) were received by VCR, 73 of 195 (37.4%) were eligible for the studies, and 5 of 73 (6.8%) eligible cases had not been received by the VCR. The RCA module demonstrated an accuracy of 93% and an F1 score of 0.94 in extracting key clinical variables. However, the RCA false-positive rate was 10% and the false-negative rate was 5%. The standard hospital approach selected fewer cases for approach to clinical trials compared with the RCA module approach, 8 of 336 (2.4%) versus 12 of 336 (3.6%), respectively.

Using AI to screen potentially eligible cases for recruitment to three clinical trials resulted in a 50% increase in eligible cases being approached for enrollment.