Clinical trials are critical for advancing medical treatments but remain prohibitively expensive and time-consuming. Accurate prediction of clinical trial outcomes can significantly reduce research and development costs and accelerate drug discovery. While recent deep learning models have shown promise by leveraging unstructured data, their black-box nature, lack of interpretability, and vulnerability to label leakage limit their practical use in high-stakes biomedical contexts. In this work, we propose AutoCT, a novel framework that combines the reasoning capabilities of large language models with the explainability of classical machine learning. AutoCT autonomously generates, evaluates, and refines tabular features based on public information without human input. Our method uses Monte Carlo Tree Search to iteratively optimize predictive performance. Experimental results show that AutoCT performs on par with or better than SOTA methods on clinical trial prediction tasks within only a limited number of self-refinement iterations, establishing a new paradigm for scalable, interpretable, and cost-efficient clinical trial prediction.

Event causality identification (ECI), a process that extracts causal relations between events from text, is crucial for distinguishing causation from correlation. Traditional approaches to ECI have primarily utilized linguistic patterns and multi-hop relational inference, risking false causality identification due to informal usage of causality and specious graphical inference. In this paper, we adopt the Rubin Causal Model to identify event causality: given two temporally ordered events, we see the first event as the treatment and the second one as the observed outcome. Determining their causality involves manipulating the treatment and estimating the resultant change in the likelihood of the outcome. Given that it is only possible to implement manipulation conceptually in the text domain, as a work-around, we try to find a twin for the protagonist from existing corpora. This twin should have identical life experiences with the protagonist before the treatment but undergoes an intervention of treatment. However, the practical difficulty of locating such a match limits its feasibility. Addressing this issue, we use the synthetic control method to generate such a twin’ from relevant historical data, leveraging text embedding synthesis and inversion techniques. This approach allows us to identify causal relations more robustly than previous methods, including GPT-4, which is demonstrated on a causality benchmark, COPES-hard.