An open framework for benchmarking gene-indication evidence against clinical trial outcomes.

ct-validation tests whether a set of gene-indication pairs is enriched for clinical success. It computes risk ratios and odds ratios with confidence intervals across clinical phase transitions and supports semantic disease matching through ontology-based similarity.

Paper: Kostiuk K, Igumnov D, Fedichev P, Feizi A. ct-validation: an open framework for benchmarking gene-indication evidence against clinical trial outcomes. (2026)

Installation

Requires Python 3.11+.

pip install ct-validation

Optional extras:

pip install ct-validation[plot]  # forest plot visualization
pip install ct-validation[mcp]   # MCP server for agent workflows
pip install ct-validation[parse] # data source parsers
pip install ct-validation[fetch] # ChEMBL fetching script dependencies

Quick start

Python API

import ct_validation as ctv

results = ctv.validate(
    clinical_trials="data/clinical_trials/gene_indication_max_phase.parquet",
    targets="data/genetic_evidence/genetic_evidence.parquet",
    similarity_lookup="data/mappings/efo_similarity_lookup_0.5.parquet",
)
print(results)
#   phase_label  n_yes   n_no  rr  rr_ci_lower  rr_ci_upper  p_value  ...

Export annotated trials and/or matched-pair audit rows (returned in order):

enrichment, trials = ctv.validate(..., return_trials=True)
enrichment, matched = ctv.validate(..., return_matched_pairs=True)
enrichment, trials, matched = ctv.validate(..., return_trials=True, return_matched_pairs=True)

Or build the match-audit table directly (columns: gene, ct_efo_id, ge_efo_id, similarity, match_type):

matched = ctv.create_matched_pairs_df(
    genetic_evidence=..., clinical_trials=..., similarity_pairs=...,
    similarity_threshold=0.8,
)

Batch mode — compare multiple evidence sources at once:

results = ctv.validate(
    clinical_trials="data/clinical_trials/gene_indication_max_phase.parquet",
    targets=[
        "data/genetic_evidence/gwas_catalog.parquet",
        "data/genetic_evidence/clinvar.parquet",
        "data/genetic_evidence/omim.parquet",
    ],
    similarity_lookup="data/mappings/efo_similarity_lookup_0.5.parquet",
)
# returns a list of DataFrames, one per evidence source

Prioritized mode — test whether a novel source adds value over an established baseline:

results = ctv.validate(
    clinical_trials="data/clinical_trials/gene_indication_max_phase.parquet",
    targets="data/genetic_evidence/novel_score.parquet",
    baseline_evidence="data/genetic_evidence/established_genetics.parquet",
    similarity_lookup="data/mappings/efo_similarity_lookup_0.5.parquet",
)
# pairs supported only by baseline are excluded

Expand a disease set using semantic similarity:

expanded = ctv.get_expanded_disease_set(
    efo_ids={"EFO:0000270", "EFO:0000384"},
    similarity_pairs="data/mappings/efo_similarity_lookup_0.5.parquet",
    similarity_threshold=0.8,
)

CLI

# With config file
ct-validation --config configs/default.yaml

# With explicit arguments
ct-validation \
    --clinical-trials ct.parquet \
    --targets evidence.parquet \
    --similarity-lookup similarity.parquet \
    -o results/

# Batch mode (multiple evidence sources)
ct-validation \
    --clinical-trials ct.parquet \
    --targets gwas.parquet --targets clinvar.parquet --targets omim.parquet \
    -o results/

# Save annotated trials and/or matched-pair audit rows
ct-validation --config configs/default.yaml \
    --save-trials --save-matched-pairs -o results/

MCP server

ct-validation-mcp

Exposes two tools for agent-based workflows:

• ct_validate — compute phase-transition enrichment (includes p_value)
• expand_disease_set — expand EFO IDs via semantic similarity

Input schemas

Input	Columns	Description
clinical_trials	gene, efo_id, max_phase	Target-indication pairs with highest phase reached
targets	gene, efo_id	Gene-indication pairs with supporting evidence
similarity_lookup	efo_id_1, efo_id_2, similarity	Pairwise EFO similarity (optional)
baseline_evidence	gene, efo_id	Baseline evidence for prioritized mode (optional)
gene_universe	one gene per line (text file)	Restrict analysis to these genes (optional)

All inputs accept Parquet files or pandas DataFrames (except gene_universe, which is a text file or a Python set).

Output schema

Column	Description
phase_from, phase_to	Phase transition (e.g. 1→2, 1→4)
n_yes, n_no	Pairs entering phase (with/without evidence)
x_yes, x_no	Pairs reaching target phase
rate_yes, rate_no	Progression rates
rr, rr_ci_lower, rr_ci_upper	Risk ratio with 95% CI (Katz log method)
or, or_ci_lower, or_ci_upper	Odds ratio with 95% CI (Woolf logit method)
p_value	Two-sided Fisher's exact test p-value

When either comparison group is empty (n_yes=0 or n_no=0), rr, or, their confidence intervals, and p_value are undefined (NaN).

Matched-pairs export (optional)

When return_matched_pairs=True (API) or --save-matched-pairs (CLI) is set, a separate audit table is returned/saved with:

Column	Description
gene	Gene symbol
ct_efo_id	Disease on the clinical trial row
ge_efo_id	Supporting genetic-evidence disease
similarity	Match score (1.0 for exact matches)
match_type	exact when ct_efo_id == ge_efo_id, else similarity

Enrichment logic

For each phase transition, target-indication pairs that reached at least the starting phase are divided into supported and unsupported groups. The risk ratio is:

RR = (x_yes / n_yes) / (x_no / n_no)

A risk ratio greater than one indicates that genetically supported pairs are more likely to progress. When a similarity lookup is provided, a pair (gene, disease) is considered supported if there exists evidence (gene, disease') with similarity above the threshold (default 0.8). Similarity pairs may be stored in either orientation; matching searches both directions.

Prioritized mode

When baseline_evidence is provided, pairs supported only by the baseline are excluded. This tests whether a novel evidence source adds predictive value beyond an established benchmark.

Visualization

import ct_validation as ctv

results = ctv.validate(...)
ctv.forest_plot(results, metric="rr", title="Phase I → Approved")

Data source parsers

The scripts/ directory contains reproducible parsers for public databases:

Genetic evidence (scripts/parse/genetic_evidence/):

• GWAS Catalog — genome-wide significant associations (p < 1e-8)
• ClinVar — pathogenic/likely pathogenic variants
• OMIM — established molecular basis (mapping code 3)
• Open Targets — genetic evidence streams (score ≥ 0.5)
• Genebass — exome-wide associations (p ≤ 1e-7)

Clinical trials (scripts/parse/clinical_trials/):

• ChEMBL — gene-drug and drug-indication links (pChEMBL > 7.0)
• Open Targets — known drug and indication data
• STITCH — high-confidence activation/inhibition links
• DGIdb — drug-gene interactions
• TrialPanorama — interventional studies

Ontology (scripts/r/):

• EFO semantic similarity matrix (Lin + Resnik information content)

See DATA_SOURCES.md for download links, versions, and fetching instructions.

Configure paths in configs/parsing.yaml and run:

python scripts/parse/run_parsing.py

Configuration

See configs/default.yaml for validation settings and configs/parsing.yaml for data source paths. All config values can be overridden via CLI arguments.

Output options in configs/default.yaml:

output:
  dir: "results/"
  save_trials: false
  save_matched_pairs: false

Development

CI runs on push/PR to main (Python 3.11–3.13, ruff, pytest):

uv sync --extra mcp
uv run ruff check src tests
uv run pytest tests/ -v

License

MIT