arXiv Computation and Language

Towards Reliable Medical LLMs: Benchmarking and Enhancing Confidence Estimation of Large Language Models in Medical Consultation

The paper introduces the first benchmark for evaluating confidence estimation in large language models during multi‑turn medical consultations, combining three types of medical data and an information sufficiency gradient to capture how confidence and correctness evolve as evidence accumulates. Experiments with 27 methods reveal that token‑level and consistency‑level confidence approaches are limited by medical data, and that medical reasoning must be judged on both diagnostic accuracy and information completeness. Building on these findings, the authors propose MedConf, a retrieval‑augmented, linguistically grounded self‑assessment framework that aligns patient information with supporting, missing, and contradictory relations, producing interpretable confidence estimates that outperform existing methods across multiple datasets and LLMs.

arXiv AI
Jul 16

Ask Before You Diagnose: Safe-Psych, a Sequential Evaluation Benchmark for LLMs in Psychiatry

arXiv:2607. 13036v1 Announce Type: cross Abstract: Large language models (LLMs) are increasingly used for decision support in healthcare, but clinical evidence is often incomplete or evolving.

By Oriana Presacan, Andreea Grama, Larisa Irimin\u{a}, Alireza Nik, Jaya Ojha, Vajira Thambawita, Ciprian I. B\u{a}cil\u{a}, Bogdan Ionescu, Michael A. Riegler
arXiv AI
Jun 17

AIPatient Arena: EHR-grounded evaluation of large language models in end-to-end clinical consultation workflows

arXiv:2606. 17474v1 Announce Type: cross Abstract: Large language models (LLMs) are increasingly considered for use in clinical consultation tasks, yet most medical evaluations remain static, single-turn, or narrowly outcome-based, limiting their ability to reflect the sequential, uncertain, and interactive nature of real-world care.

By Jiahui Niu, Huizi Yu, Wenkong Wang, Guangxin Dai, Jingxian He, Xiang Li, Zhiying Liang, Xinxin Lin, Kent CY So, Bryan YP Yan, Yun Kwok Wing, Yanqiu Xing, Xin Ma, Lizhou Fan
arXiv Computation and Language
Sep 18

An Analysis of Training-Free Self-Reported Confidence in Language Models

The paper investigates whether language models’ self-reported confidence is meaningful without additional training. By evaluating three training‑free signals—direct verbalization, post‑hoc probability estimates, and agreement across multiple generations—on 100 TriviaQA questions, the authors find that direct verbalization alone achieves high AUROC scores (0.956 and 0.937) for correctness prediction, while agreement-based methods perform noticeably worse. Re‑eliciting confidence for the same answers shows modest score shifts and occasional decision flips, and an audit of biography claims reveals only a small confidence gap between supported and contradicted statements.

By Lukas Meyer, Sofia Rossi, Wei Chen, Thomas Laurent, Yiming Li
arXiv AI
Sep 28

AcuityBench: Evaluating Clinical Acuity Identification and Uncertainty Alignment

AcuityBench is a new benchmark that tests whether language models can correctly identify the urgency of medical care needed from user presentations. It unifies five public datasets—user conversations, online forum posts, clinical vignettes, and patient portal messages—under a shared four-level acuity framework, providing 914 cases for evaluation. The benchmark supports both explicit four-way classification and free-form conversational responses, revealing that models vary widely in accuracy and that conversational formats reduce over-triage but increase under-triage, especially for high-acuity cases.

By Robin Linzmayer (Department of Computer Science, Columbia University, Department of Biomedical Informatics, Columbia University), Georgianna Lin (Department of Biomedical Informatics, Columbia University), Di Coneybeare (Department of Emergency Medicine, Columbia University Irving Medical Center), Jason Chu (Department of Emergency Medicine, Columbia University Irving Medical Center), Trudi Cloyd (Department of Emergency Medicine, Columbia University Irving Medical Center), Manish Garg (Department of Emergency Medicine, Columbia University Irving Medical Center), Miles Gordon (Department of Emergency Medicine, Columbia University Irving Medical Center), Elizabeth Hartofilis (Department of Emergency Medicine, Columbia University Irving Medical Center), Benjamin Hong (Department of Emergency Medicine, Columbia University Irving Medical Center), Ashraf Hussain (Department of Emergency Medicine, Columbia University Irving Medical Center), Eugene Y. Kim (Department of Emergency Medicine, Columbia University Irving Medical Center), Oluchi Iheagwara King (Department of Emergency Medicine, Columbia University Irving Medical Center), Ross McCormack (Department of Emergency Medicine, Columbia University Irving Medical Center), Erica Olsen (Department of Emergency Medicine, Columbia University Irving Medical Center), John K. Riggins Jr (Department of Emergency Medicine, Columbia University Irving Medical Center), Mustafa N. Rasheed (Department of Emergency Medicine, Columbia University Irving Medical Center), Dana L. Sacco (Department of Emergency Medicine, Columbia University Irving Medical Center), Vinay Saggar (Department of Emergency Medicine, Columbia University Irving Medical Center), Osman R. Sayan (Department of Emergency Medicine, Columbia University Irving Medical Center), Amit Shembekar (Department of Emergency Medicine, Columbia University Irving Medical Center), Janice Shin-Kim (Department of Emergency Medicine, Columbia University Irving Medical Center), Wendy W. Sun (Department of Emergency Medicine, Columbia University Irving Medical Center), Bernard P. Chang (Department of Emergency Medicine, Columbia University Irving Medical Center), David Kessler (Department of Emergency Medicine, Columbia University Irving Medical Center), No\'emie Elhadad (Department of Computer Science, Columbia University, Department of Biomedical Informatics, Columbia University)
arXiv AI
Oct 2

A rubric landscape for evaluating clinical reasoning in large language models: what exists, what is missing, and what needs to be combined

The article reviews existing tools for assessing clinical reasoning in large language models, identifying six key dimensions—problem representation, temporal synthesis, differential and management reasoning, counterfactual reasoning, calibrated uncertainty, and reasoning faithfulness. It finds that no single instrument covers all dimensions, with some aspects reasonably addressed while others, especially faithfulness and counterfactual reasoning, remain weakly evaluated. The authors propose combining current tools through binary rubric items, separate completeness and correctness scores, importance weighting, safety caps, temporal consistency checks, and chance‑corrected reliability reporting, and call for further design work on uncertainty, counterfactual reasoning, and faithfulness in longitudinal free‑text contexts.

By Zhangshu Joshua Jiang, Zina Ibrahim, James T. Teo
arXiv AI
Oct 16

AI Consilium: a Benchmark of LLM Clinical Multidisciplinary Second Opinions

The paper introduces AI Consilium, a benchmark for evaluating large language models (LLMs) on providing clinically grounded, coherent, actionable, and safe second opinions in multidisciplinary settings. Using 300 NEJM–MedQA cases, the study compares eight single-model pipelines that generate role-specific opinions and interactive-consilium reports under free-form and structured conditions. Results show that structured final reports generally score higher, especially in management, and that GPT‑5.6‑Sol outperforms other models across all evaluated components, demonstrating the benchmark’s ability to differentiate model capabilities and the impact of response structure.

By Alexey A. Bokov, Ivan I. Panin, Nikolay B. Nechaev, Mikhail Yu. Valkov, Valeria Yu. Chernina, Natalia Gombolevskaya, Ayyaz Hussain, Vladimir M. Agafonov, Victor A. Gombolevskiy, Aleksandr V. Nesterov, Iaroslav R. Bespalov, Ivan V. Oseledets, Dmitry V. Dylov