# AlpaPICO: Extraction of PICO Frames from Clinical Trial Documents Using LLMs

arXiv: https://arxiv.org/abs/2409.09704 · HTML: https://mlsanity.com/paper/2409.09704/

## Key facts

- Cited by 4 papers in the map (data through 14 Oct 2026).
- Builds on 57 of its 104 references that are in the map.
- First posted on arXiv 15 Sep 2024.

## Builds on (most cited first, 30 of 57)

- [Language Models are Few-Shot Learners](https://mlsanity.com/paper/2005.14165/) (2020)
- [Exploring the Limits of Transfer Learning with a Unified Text-to-Text Transformer](https://mlsanity.com/paper/1910.10683/) (2019)
- [PaLM: Scaling Language Modeling with Pathways](https://mlsanity.com/paper/2204.02311/) (2022)
- [SQuAD: 100,000+ Questions for Machine Comprehension of Text](https://mlsanity.com/paper/1606.05250/) (2016)
- [Unsupervised Cross-lingual Representation Learning at Scale](https://mlsanity.com/paper/1911.02116/) (2019)
- [Finetuned Language Models Are Zero-Shot Learners](https://mlsanity.com/paper/2109.01652/) (2021)
- [Scaling Instruction-Finetuned Language Models](https://mlsanity.com/paper/2210.11416/) (2022)
- [Training Compute-Optimal Large Language Models](https://mlsanity.com/paper/2203.15556/) (2022)
- [XLNet: Generalized Autoregressive Pretraining for Language Understanding](https://mlsanity.com/paper/1906.08237/) (2019)
- [Deep contextualized word representations](https://mlsanity.com/paper/1802.05365/) (2018)
- [BioBERT: a pre-trained biomedical language representation model for biomedical text mining](https://mlsanity.com/paper/1901.08746/) (2019)
- [Multitask Prompted Training Enables Zero-Shot Task Generalization](https://mlsanity.com/paper/2110.08207/) (2021)
- [SciBERT: A Pretrained Language Model for Scientific Text](https://mlsanity.com/paper/1903.10676/) (2019)
- [Scaling Language Models: Methods, Analysis & Insights from Training Gopher](https://mlsanity.com/paper/2112.11446/) (2021)
- [Fantastically Ordered Prompts and Where to Find Them: Overcoming Few-Shot Prompt Order Sensitivity](https://mlsanity.com/paper/2104.08786/) (2021)
- [Cross-lingual Language Model Pretraining](https://mlsanity.com/paper/1901.07291/) (2019)
- [Aligning Books and Movies: Towards Story-like Visual Explanations by Watching Movies and Reading Books](https://mlsanity.com/paper/1506.06724/) (2015)
- [Super-NaturalInstructions: Generalization via Declarative Instructions on 1600+ NLP Tasks](https://mlsanity.com/paper/2204.07705/) (2022)
- [Efficient and robust approximate nearest neighbor search using Hierarchical Navigable Small World graphs](https://mlsanity.com/paper/1603.09320/) (2016)
- [How Much Knowledge Can You Pack Into the Parameters of a Language Model?](https://mlsanity.com/paper/2002.08910/) (2020)
- [Instruction Tuning with GPT-4](https://mlsanity.com/paper/2304.03277/) (2023)
- [Annotation Artifacts in Natural Language Inference Data](https://mlsanity.com/paper/1803.02324/) (2018)
- [Learning To Retrieve Prompts for In-Context Learning](https://mlsanity.com/paper/2112.08633/) (2021)
- [Using DeepSpeed and Megatron to Train Megatron-Turing NLG 530B, A Large-Scale Generative Language Model](https://mlsanity.com/paper/2201.11990/) (2022)
- [MetaICL: Learning to Learn In Context](https://mlsanity.com/paper/2110.15943/) (2021)
- [How Far Can Camels Go? Exploring the State of Instruction Tuning on Open Resources](https://mlsanity.com/paper/2306.04751/) (2023)
- [True Few-Shot Learning with Language Models](https://mlsanity.com/paper/2105.11447/) (2021)
- [Multi-Task Identification of Entities, Relations, and Coreference for Scientific Knowledge Graph Construction](https://mlsanity.com/paper/1808.09602/) (2018)
- [TabLLM: Few-shot Classification of Tabular Data with Large Language Models](https://mlsanity.com/paper/2210.10723/) (2022)
- [The False Promise of Imitating Proprietary LLMs](https://mlsanity.com/paper/2305.15717/) (2023)

## Built on by (most cited first, 4 of 4)

- [Natural Language Processing in Support of Evidence-based Medicine: A Scoping Review](https://mlsanity.com/paper/2505.22280/) (2025)
- [Expediting data extraction using a large language model (LLM) and scoping review protocol: a methodological study within a complex scoping review](https://mlsanity.com/paper/2507.06623/) (2025)
- [Eligibility-Aware Evidence Synthesis: An Agentic Framework for Clinical Trial Meta-Analysis](https://mlsanity.com/paper/2604.02678/) (2026)
- [Predicting Causal Effects from Natural Language Queries using Structured Representations](https://mlsanity.com/paper/2605.29631/) (2026)

## Abstract (arXiv)

In recent years, there has been a surge in the publication of clinical trial reports, making it challenging to conduct systematic reviews. Automatically extracting Population, Intervention, Comparator, and Outcome (PICO) from clinical trial studies can alleviate the traditionally time-consuming process of manually scrutinizing systematic reviews. Existing approaches of PICO frame extraction involves supervised approach that relies on the existence of manually annotated data points in the form of BIO label tagging. Recent approaches, such as In-Context Learning (ICL), which has been shown to be effective for a number of downstream NLP tasks, require the use of labeled examples. In this work, we adopt ICL strategy by employing the pretrained knowledge of Large Language Models (LLMs), gathered during the pretraining phase of an LLM, to automatically extract the PICO-related terminologies from clinical trial documents in unsupervised set up to bypass the availability of large number of annotated data instances. Additionally, to showcase the highest effectiveness of LLM in oracle scenario where large number of annotated samples are available, we adopt the instruction tuning strategy by employing Low Rank Adaptation (LORA) to conduct the training of gigantic model in low resource environment for the PICO frame extraction task. Our empirical results show that our proposed ICL-based framework produces comparable results on all the version of EBM-NLP datasets and the proposed instruction tuned version of our framework produces state-of-the-art results on all the different EBM-NLP datasets. Our project is available at urlhttps://github.com/shrimonmuke0202/AlpaPICO.git.