Evidence map›Paper›PMID 42260611›Full record

ArticleSystematic reviews2026

Comparing supervised machine learning and large language models in title-abstract screening.

Marco F Aigner, Matthias Ganzinger, Pascal Probst, Moritz Rinckens, Thomas M Pausch

Abstract readComparative Study
In one paragraph

Article in Systematic reviews, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Marco F Aigner *Institute of Medical Informatics, Heidelberg University, Heidelberg, Germany.ORCID 0000-0002-0433-4556
Matthias Ganzinger *Institute of Medical Informatics, Heidelberg University, Heidelberg, Germany. matthias.ganzinger@med.uni-heidelberg.de.ORCID 0000-0002-2716-5425
Pascal ProbstDepartment of Surgery, Cantonal Hospital Thurgau, Frauenfeld, Switzerland.ORCID 0000-0002-0895-4015
Moritz RinckensEVIglance AG., Hüttlingen, Switzerland.
Thomas M PauschInstitute of Medical Informatics, Heidelberg University, Heidelberg, Germany.ORCID 0000-0001-6145-3263

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundSystematic reviews require reviewers to decide on the eligibility of large numbers of articles derived from database searches. To accelerate review conduct while continuously more literature gets published, past studies proposed automating the title/abstract-screening step by either supervised machine learning or large language models. Because prior studies mainly compared results within the same model family, we directly compared common TF-IDF-based supervised baselines and a zero-shot, criteria-prompted, and open-weight large language model on the same data to discuss whether, and in which scenarios, they are feasible for review screening automation.

methodsWe predicted the eligibility of labeled articles by four supervised machine learning models (Naïve Bayes, support vector machine, random forest, logistic regression) and one large language model (Llama-3.1-8B-Instruct). Articles were labeled with eligibility as decided by human reviewers in six systematic reviews. We evaluated the performance by binary confusion matrices and calculated recall, specificity, precision, F1-score, and accuracy over a thousand bootstrap samples each. We compared these results to a reported performance of 0.86 (recall) and 0.79 (specificity) in single human reviewers.

resultsModel performance varies greatly between the data sets. Except for Naïve Bayes, recall and specificity are closer aligned in the supervised machine learning models compared to llama. Averaged across all datasets, llama matches human recall and the Naïve Bayes classifier exceeds it, while both fall behind human specificity. Conversely, logistic regression, random forest and support vector machine fall behind human recall while all three exceed human specificity.

conclusionsBoth supervised machine learning and large language models achieve recalls close to or above those of human reviewers. The supervised machine learning models achieve a higher harmonic mean of recall and specificity, while the llama model is more sensitive. Considering the reliance on training data and the all-or-nothing automation with supervised machine learning, this study's results warrant their use in the extension of pre-existing, non-critical, systematic reviews. Contrarily, as large language models decide on articles individually and as they provide comprehensive, discussable, reasoning they may be used in tandem with human reviewers while the performance of ensembles of large language models is yet to be analyzed.

Indexed as

Large Language ModelsSupervised Machine LearningAbstracting and IndexingBayes TheoremClassification AlgorithmsHumansLogistic ModelsPredictive Learning ModelsRandom ForestSupport Vector MachineSystematic Reviews as TopicLarge language modelSupervised machine learningSystematic reviewTitle/abstract-screening

Identifiers

PMID42260611
PMCPMC13248334

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.