A directional signal on whether a trial looks like past trials that worked — or ones that didn't.
FATE (Failure-And-Trial Embeddings) is the outcome-similarity model in the OntologerMed suite. It embeds any clinical trial into a 256-dimensional vector shaped by historical success and failure patterns, trained on 18,132 completed ClinicalTrials.gov trials with verified outcomes.
When a new Phase 3 trial is posted, there are no results. But the trial's design, population, endpoints, and sponsor carry patterns that correlate with historical outcomes. FATE captures those patterns and places the new trial in context: does it look more like historical successes or historical failures?
Also known as OntologerMed TrialPulse in the Commercializer.ai platform.
Model Overview
Property
Value
Model name
FATE-ClinicalTrials-Outcome-256
Product name
OntologerMed TrialPulse
Base model
NeuML/pubmedbert-base-embeddings (PubMedBERT)
Output dimension
256
Training method
Contrastive learning — Triplet Loss
Training data
18,132 completed trials with verified outcome labels
FATE is not a predictor. It is a neighborhood signal.
Given a new or ongoing trial, FATE embeds it into the same 256-dimensional space as 18,132 labeled historical trials. The nearest neighbors' outcome distribution tells you whether this trial's design patterns look more like historical successes or failures.
Nearby vectors = similar outcome patterns, not similar diseases or drugs
Two trials from completely different indications can be neighbors if their design profiles (phase, endpoints, enrollment, sponsor type) resemble each other
A trial that lands in a neighborhood of 80% historical successes is exhibiting success-pattern characteristics — not a guarantee, but a directional signal
This is pattern matching against known outcomes. Not causal prediction. Not a probability estimate. Report it as what it is: a similarity signal.
Base: PubMedBERT — pre-trained on 30M+ PubMed abstracts; strong biomedical language understanding
Projection: Single dense layer reducing 384 → 256 dimensions
Normalisation: L2, enabling cosine similarity via dot product
Training signal: Triplet loss — anchor and positive share the same outcome label (both success or both failure); negative sampled from the opposite label
Triplets: 10,000 generated from the 18,132 labeled trial set
Training Details
Parameter
Value
Epochs
10
Batch size
32
Learning rate
2e-5
Loss margin
0.5
Hardware
NVIDIA DGX Spark (Blackwell GB10)
Triplet grouping
success_label (success / failure)
Label source
ClinicalTrials.gov — overall_status = COMPLETED, success_label IS NOT NULL
Business Use & Applications
FATE is purpose-built for workflows where teams need a fast, scalable directional signal on trial risk — before expensive deep-dives.
Pharmaceutical & Biotech R&D
Portfolio risk triage — score every trial in your pipeline against historical outcome patterns at intake, not just at readout
Flag trials whose design profile resembles high-failure-rate historical cohorts for early intervention
Prioritise which internal trials warrant additional mechanistic validation based on outcome-similarity risk signals
Surface design features (endpoint type, phase, population definition) that correlate with your portfolio's historical failures
Competitive landscape screening — assess the historical risk profile of competitor trials before they report
Embed every competitor Phase 2/3 trial and compare neighborhood success rates
Identify which competitor programmes sit in high-risk historical patterns — informing your own BD and partnership decisions
Monitor shifting risk signals as competitors amend trial designs or endpoints
Investment & Due Diligence
Pre-investment screening — apply outcome-pattern triage across a company's entire pipeline in minutes
Score each pipeline asset against the 18K labeled trial history before deep diligence
Identify programmes sitting in historically weak outcome neighborhoods as a first-pass risk flag
Compare the overall risk profile of a portfolio company against historical base rates by phase and indication
M&A and licensing diligence — add a data-driven risk dimension to asset evaluation
Triage dozens of pipeline assets across an acquisition target simultaneously
Identify assets with outcome-pattern profiles inconsistent with management's stated confidence levels
Provide a reproducible, auditable risk signal alongside analyst qualitative assessment
Clinical Research Organisations (CROs)
Bid/no-bid risk assessment — evaluate the historical risk pattern of a prospective client trial before committing resources
Embed the protocol summary and assess its outcome-pattern neighborhood
Flag trials in historically difficult outcome neighborhoods for additional feasibility scrutiny
Benchmark the client's proposed design against historical trials with similar patterns
Regulatory Affairs
Safety pattern clustering — group trials by outcome similarity to identify systematic design patterns in failed programmes
Cluster all trials in a compound class by FATE vector; separate successful from failed cohorts
Identify structural design features (endpoints, populations, arms) associated with failure in a given indication
Use historical failure-pattern analysis to inform protocol design decisions
Example Queries
FATE is used via embedding + nearest-neighbor lookup, not question answering. Below are illustrative examples of how to interpret the output.
Example 1: New Phase 3 Trial — Positive Neighborhood
Input trial (new, no results yet):
Phase 3, double-blind RCT of oral JAK inhibitor vs placebo in 480 adults with moderate-to-severe RA who failed ≥1 bDMARD. Primary endpoint: ACR20 at Week 12. Sponsor: mid-cap pharma. Prior Phase 2 showed 58% ACR20 vs 22% placebo.
FATE embedding → 20 nearest historical neighbors:
Neighbor
Outcome
Phase 3 RCT of tofacitinib in RA (bDMARD-failure)
✓ Success
Phase 3 RCT of baricitinib in RA (MTX-IR)
✓ Success
Phase 3 RCT of upadacitinib in RA (bDMARD-failure)
✓ Success
Phase 3 RCT of filgotinib in RA (bDMARD-failure)
✓ Success
Phase 3 RCT of abrocitinib in atopic dermatitis
✓ Success
Phase 3 RCT of ruxolitinib in myelofibrosis
✗ Failure
...
Neighborhood success rate: 17/20 = 85%
Signal: This trial's design pattern sits in a historically high-success neighborhood. Consistent with the well-validated JAK inhibitor class in bDMARD-failure RA.
Example 2: New Phase 2 Trial — Mixed Neighborhood
Input trial:
Phase 2, open-label, single-arm study of novel gene therapy in 40 patients with ultra-rare metabolic disorder. Primary endpoint: biomarker normalisation at Week 24. No approved comparator exists. First-in-class.
Neighborhood success rate: 9/20 = 45%
Signal: Mixed neighborhood. First-in-class rare disease gene therapies have historically split between landmark successes and endpoint failures at Phase 2. Warrants deeper mechanistic review before Phase 3 design.
Usage
python
1from sentence_transformers import SentenceTransformer
2import numpy as np
34# Load model5model = SentenceTransformer("Ontologer/FATE-ClinicalTrials-Outcome-256")67# Embed a new trial (title | summary | interventions | primary outcome)8trial_text ="""
9Phase 3 RCT of novel JAK inhibitor vs placebo in 480 adults with RA who
10failed ≥1 bDMARD. Primary endpoint: ACR20 at Week 12.
11"""12query_vector = model.encode([trial_text])# shape: (1, 256)1314# Compare against your stored labeled-trial index15# (18K vectors, each tagged with success_label)16similarities = np.dot(query_vector, labeled_vectors.T)# cosine sim (vectors are L2-normed)17top_k_indices = np.argsort(similarities[0])[::-1][:20]1819# Neighborhood signal20success_rate = np.mean([labels[i]for i in top_k_indices])21print(f"Neighborhood success rate: {success_rate:.1%}")
Index size: 256 dims × 4 bytes × 18,132 labeled trials ≈ 18MB. If embedding all 563K trials: ≈ 550MB.
Part of the OntologerMed Suite
Model
Role
OntologerMed-ClinicalTrials-Instruct
Generative LM — reasoning, extraction, and summarisation over trial text
FATE-ClinicalTrials-Outcome-256 (TrialPulse)
Outcome-shaped embedding — similarity by historical success/failure pattern
MOAt-ClinicalTrials-MoA-256 (TargetLens)
Mechanism-of-action embedding — similarity by biological pathway
PACT-ClinicalTrials-Pop-256 (PathFinder)
Population embedding — similarity by patient demographics and disease
ORACLE-ClinicalTrials-SuccessProb-v1
Classifier — probability estimate combining all three embedding dimensions
ORACLE combines FATE + MOAt + PACT into a single probability-of-success estimate. FATE provides the outcome-pattern dimension of that combined signal.
Limitations
Similarity signal, not prediction: Neighborhood success rates are descriptive, not causal. A trial in a historically successful neighborhood can still fail.
Label selection bias: The 18,132 labeled trials are a subset of 308K+ completed ClinicalTrials.gov trials. Trials with formal outcome documentation are overrepresented in sponsored, commercial programmes.
Historical patterns may not generalise: First-in-class mechanisms and novel indications have few historical neighbors. Neighborhood signals in sparse regions are less reliable.
English only: Trained on English-language trial records. Non-English records produce degraded embeddings.
Not medical or investment advice: This model does not predict the outcome of any specific trial. Do not use as a sole input in clinical, regulatory, or financial decision-making.
Citation
bibtex
1@misc{fate-clinicaltrials-2026,
2 title = {FATE-ClinicalTrials-Outcome-256: Outcome-Similarity Embeddings for Clinical Trial Intelligence},
3 author = {Mishra, Sid},
4 year = {2026},
5 note = {Contrastive triplet embedding model trained on 18,132 completed ClinicalTrials.gov trials with verified outcome labels.},
6 howpublished = {\url{https://huggingface.co/Ontologer/FATE-ClinicalTrials-Outcome-256}}
7}
Sid is the founder of several AI-native and AI-powered startups and initiatives, based in Singapore. He founded Ontologer as the dedicated AI research arm of Convixion AI, with a focus on building domain-specific language models from the ground up — including data pipelines, training infrastructure, evaluation frameworks, and production deployment.
Ontologer generates novel LLM and embedding models purpose-built for use within Convixion AI's Commercializer.ai platform. FATE is part of the OntologerMed suite — a family of purpose-built models for clinical trial intelligence. Ontologer performs every step of model development — dataset curation, training infrastructure, evaluation, and production deployment — in-house.
Collaboration & Custom Work
Sid is open to collaborating on:
Custom domain-adapted embedding models — contrastive/triplet training on proprietary datasets for specialised retrieval tasks
End-to-end LLM and embedding pipelines — from data curation to training to production deployment
Evaluation framework design — task-specific benchmarks and retrieval evaluation pipelines
RAG + embedding system design — pairing domain-adapted models with retrieval systems for production use
Custom model architecture consulting — base model selection, training strategy, hardware planning
