arXiv AI

Safe to Stop? Risk-Constrained Stopping for Sequential Clinical Diagnosis Agents

The paper introduces Cros, a risk‑constrained stopping layer for sequential clinical diagnosis agents that determines when to stop testing and make a diagnosis. Cros combines state‑wise error ranking, policy design on disjoint development splits, and exact tests of selective diagnostic error to provide finite‑sample guarantees. On a MIMIC‑derived abdominal‑pain benchmark, Cros achieves higher state‑error AUROC and lower selective error rates compared to baseline stopping methods, though its performance varies across development resplits.

arXiv AI
Oct 16

Auditing Escalation Reliability in Healthcare LLM Agents: A Perturbation-Controlled Benchmark of Workflow-State Failures

The paper introduces a benchmark of 400 synthetic healthcare workflow episodes to evaluate large language model (LLM) agents’ reliability in escalating care when evidence is missing or conflicting. It finds that while clean decision accuracy is high (0.97), models miss a large proportion of necessary escalations (32–97%) under uncertainty, and even the largest 9.7B model’s performance drops to 0.78 in conflict scenarios. A workflow-aware controller improves utility and reduces missed escalations, but its effectiveness is limited by lexical generalization failures.

By Zihao Zheng (Washington University in St. Louis), Junyi Yao (Washington University in St. Louis), Baichuan Li (Southern Methodist University), Jiayu Long (Washington University in St. Louis)
arXiv AI
Aug 3

Reasoning in Real World Clinical Care: Why Large Language Models Are Not Yet Safe for Autonomous Clinical Decision Support

arXiv:2607. 28677v1 Announce Type: new Abstract: LLM now pass medical licensing examinations and, in curated cases, can rival physicians at diagnostic reasoning.

By Shayndhan Sivanathan, Shravan Nageswaran, Mehdi Zadem, Ryaan Sultan, Nicolas von Mallinckrodt, Max Solovyev, Alexey Matyushkin, Sumon Sadhu, Gabriele C DeLuca, Sanjeeva Jeyaretna, James Hillis, Manoj Ramachandran, Prakash Jayakumar
arXiv AI
Aug 26

When May an Agent Stop? Evidence-Carrying Termination for Tool-Using LLMs

The paper introduces Evidence-Carrying Termination (ECT), a method that allows tool‑using large language model agents to declare a task complete only when a typed certificate links every required answer claim to valid, in‑scope trace evidence and a deterministic replay confirms the claimed value. In controlled experiments across 48 synthetic tasks and 576 trajectories, ECT eliminated unsafe completions and premature unsupported terminations, outperforming existing termination critics and controllers while maintaining comparable supported completion rates.

By Jason Liu
arXiv AI
Sep 15

Same Patient, Different Order: Action-Level Reliability of Clinical LLM Agents Under Repeated Runs

The paper introduces a new evaluation method called "same-input rerun" to assess the consistency of clinical language‑model agents across repeated runs. By replaying 1,000 MedAgentBench tasks with identical inputs, the authors find that action‑level outputs—such as test orders, medication requests, and referrals—vary significantly, even when benchmark scores remain unchanged. The study demonstrates that current benchmarks, which typically evaluate only a single run per task, can miss substantial behavioral divergence.

By Rohith Reddy Bellibatlu, Manpreet Singh, Zhoutian Han, Wenbin Zhang