Retrieval-Reasoning Large Language Model-based Synthetic Clinical Trial Generation

Abstract

Machine learning (ML) holds great promise for clinical applications but is often hindered by limited access to high-quality data due to privacy concerns, high costs, and long timelines associated with clinical trials. While large language models (LLMs) have demonstrated strong performance in general-purpose generation tasks, their application to synthesizing realistic clinical trials remains underexplored. In this work, we propose a novel Retrieval-Reasoning framework that leverages few-shot prompting with LLMs to generate synthetic clinical trial reports annotated with binary success/failure outcomes. Our approach integrates a retrieval module to ground the generation on relevant trial data and a reasoning module to ensure domain-consistent justifications. Experiments conducted on real clinical trials from the ClinicalTrials.gov database demonstrate that the generated synthetic trials effectively augment real datasets. Fine-tuning a BioBERT classifier on synthetic data, real data, or their combination shows that hybrid fine-tuning leads to improved performance on clinical trial outcome prediction tasks. Our results suggest that LLM-based synthetic data can serve as a powerful tool for privacy-preserving data augmentation in clinical research. The code is available at https://github.com/XuZR3x/Retrieval_Reasoning_Clinical_Trial_Generation.