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Makarov, N. ; Bordukova, M. ; Quengdaeng, P ; Garger, D. ; Rodriguez-Esteban, R.* ; Schmich, F.* ; Menden, M.P.

Large language models forecast patient health trajectories enabling digital twins.

NPJ Digit. Med. 8:588 (2025)
Verlagsversion Forschungsdaten DOI PMC
Open Access Gold
Creative Commons Lizenzvertrag
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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Publikationstyp Artikel: Journalartikel
Dokumenttyp Wissenschaftlicher Artikel
Schlagwörter Scale; Survival; Anemia
ISSN (print) / ISBN 2398-6352
e-ISSN 2398-6352
Zeitschrift NPJ digital medicine
Quellenangaben Band: 8, Heft: 1, Seiten: , Artikelnummer: 588 Supplement: ,
Verlag Springer
Verlagsort Heidelberger Platz 3, Berlin, 14197, Germany
Begutachtungsstatus Peer reviewed
Institut(e) Institute of Computational Biology (ICB)
Förderungen Takeda Pharmaceutical Company
Biogen
Araclon Biotech
Alzheimer's Drug Discovery Foundation
Alzheimer's Association
Foundation for the National In-Institutes of Health (FNIH)
Canadian Institutes of Health Research
National Institute of Biomedical Imaging and Bioengineering
Northern California Institute for Research and Education
Alzheimer's Disease Neuroimaging Initiative (ADNI) - National Institute on Aging (National Institutes of Health)
European Union
F. Hoffmann-La Roche
CereSpir, Inc.
Cogstate
Piramal Imaging
Pfizer Inc.
Novartis Pharmaceuticals Corporation
NeuroRx Research
Meso Scale Diagnostics
Johnson & Johnson Pharmaceutical Research & Development LLC.
Fujirebio
F. Hoffmann-La Roche Ltd
EuroImmun
Eli Lilly and Company
Elan Pharmaceuticals, Inc.
F. Hoffmann-La Roche AG