The paper investigates why retrieval‑based open‑ended evaluation fails in medical fact verification. By creating two detailed taxonomies—one for retrieval‑stage errors across five quality dimensions and another for verifier‑reasoning errors across six steps—the authors automatically label evidence quality and reasoning errors using an LLM‑as‑Judge pipeline. Their large‑scale stress tests across multiple retrieval methods and verifier models show that increasing model size, reasoning effort, source breadth, or medical fine‑tuning does not eliminate these failure modes, indicating fundamental limits of the retrieve‑then‑verify paradigm in open‑ended medical contexts.
By Heyuan Huang, Jirui Dai, Alexandra DeLucia, Sonal Joshi, Mahsa Yarmohammadi, Jie Gao, Bernal Jim\'enez Guti\'errez, Mark Dredze
arXiv:2608.21948v1 Announce Type: new
Abstract: Complex clinical reasoning requires models to update diagnostic hypotheses as new evidence emerges and to coordinate different medical specialities und...
By Sike Xiang, Shuang Chen, Qian sun, Jia Cheng, Yusi Wei, Amir Atapour-Abarghouei
arXiv:2607. 08038v1 Announce Type: new Abstract: Diagnostic error is a major threat to patient safety, yet current large language model (LLM) systems often treat diagnosis as a one-shot prediction task, lacking safeguards against missed high-risk alternatives or rigorous verification of their reasoning.
By Fan Ma, Mauro Giuffr\`e, Donald Wright, Kent McCann, Mark Iscoe, Lingfei Qian, Mingyang Jiang, Chi Wing Ng, Na Hong, Huan He, Cathy Shyr, Qingyu Chen, Lee Schwamm, Lucila Ohno-Machado, Hua Xu
arXiv:2607. 26160v1 Announce Type: new Abstract: Clinical practice guidelines (CPGs) encode diagnostic criteria, but LLM systems typically retrieve guideline text or absorb it through training rather than execute its rules.
By Lang Cao, Yuhao Shen, Tianyang Luo, Simo Du, Hao Peng, Yue Guo
arXiv:2610.01938v1 Announce Type: cross
Abstract: Exam-style accuracy does not establish whether large language models (LLMs) reason well over clinical records. We define clinical reasoning as integr...
By Zhangshu Joshua Jiang, Zina Ibrahim, James T. Teo
arXiv:2603. 01131v3 Announce Type: replace-cross Abstract: Clinical diagnosis is a gradual process of evidence integration, in which physicians move from symptoms and medical history to examinations, competing hypotheses, disease relations, and treatment decisions.
By Yuqi Zhan, Xinyue Wu, Tianyu Lin, Yutong Bao, Xiaoyu Wang, Weihao Cheng, Huangwei Chen, Feiwei Qin, Zhu Zhu
arXiv:2606. 29876v1 Announce Type: cross Abstract: Modern large language models (LLMs) reach 60-70% diagnostic accuracy on complex clinical case benchmarks, but accuracy alone cannot distinguish stable clinically-grounded reasoning from pattern matching.
By Nisarg A. Patel (University of California, San Francisco)
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:2505. 14107v5 Announce Type: replace-cross Abstract: The emergence of groundbreaking large language models capable of performing complex reasoning tasks holds significant promise for addressing various scientific challenges, including those arising in complex clinical scenarios.
By Yakun Zhu, Zhongzhen Huang, Linjie Mu, Yutong Huang, Wei Nie, Jiaji Liu, Shaoting Zhang, Pengfei Liu, Xiaofan Zhang
The paper introduces MIMIC-DOS, a dataset derived from MIMIC-IV that focuses on ICU cases where patient symptoms and medical signs are discordant. It presents CARE, a privacy‑compliant multi‑stage agentic reasoning framework that uses a proprietary LLM to generate structured categories and transitions, while a local LLM performs evidence acquisition and decision‑making. In retrospective evaluations on MIMIC‑DOS, CARE outperforms other LLMs and agentic workflows, demonstrating stronger handling of conflicting clinical evidence while preserving patient privacy.
By Haochen Liu, Weien Li, Rui Song, Zeyu Li, Chun Jason Xue, Xiao-Yang Liu, Sam Nallaperuma-Herzberg, Xue Liu, Ye Yuan
arXiv:2606. 05463v1 Announce Type: new Abstract: Patient safety event triage, determining whether a clinical event is reportable under jurisdiction-specific policy, is a high-stakes task typically performed manually by patient safety experts.
By Keqi Han, Ryan Young, Annabel Strauss, Lindsey Hughes, Katharine M. Nesbitt, Nicole Schueler, Che Ngufor, Carl Yang, Yuan Xue, Zhijun Yin
MedRAGChecker is a claim-level verification framework designed for biomedical retrieval‑augmented generation (RAG). It decomposes generated answers into atomic claims and assesses each claim’s support by combining evidence‑grounded natural language inference with biomedical knowledge‑graph consistency signals. The aggregated claim decisions provide diagnostics that distinguish retrieval and generation failures, such as faithfulness, under‑evidence, contradiction, and safety‑critical errors, and the system is distilled into compact models for scalable evaluation.
By Yuelyu Ji, Min Gu Kwak, Hang Zhang, Xizhi Wu, Chenyu Li, Yanshan Wang