LogiMed‑RoB is a new benchmark that tests large language models (LLMs) on hierarchical logical consistency in medical risk‑of‑bias assessments, using 860 randomized controlled trials and 14,820 queries based on Cochrane Risk of Bias 2.0 expert logic. The benchmark evaluates models across four dimensions—Atomic Consistency, Domain Consistency, Aggregation Consistency, and Evidential Faithfulness—revealing a catastrophic error‑compounding effect where high atomic accuracy does not translate to end‑to‑end consistency. Experiments on ten state‑of‑the‑art LLMs show that even top models can fail to deduce correct outcomes in a significant portion of cases, highlighting a gap between evidence retrieval and reasoning.
whyItMatters":"The study shows that high outcome accuracy can mask critical reasoning flaws, emphasizing the need for white‑box logical verification before deploying LLMs in clinical settings."
By Jiayu Huang, Zichen Tang, Qianhui Ling, Zemin Kuang, Haihong E
arXiv:2608.10725v2 Announce Type: replace
Abstract: Large language models (LLMs) often rely on shortcuts rather than systematic reasoning, raising safety concerns in medical applications. Allowing mo...
By Uma Ranjan, Kunal Tilaganji, Aditya Koul, Anurag Mahipal, Dashpreet Singh, Hriday Rana, Manan Jain, Sidharth Gupta, Ajo Babu George, Vineeth Balasubramanian, Nagarajan Natarajan, Amit Sharma
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. 10275v1 Announce Type: new Abstract: Large language models achieve high scores on medical knowledge assessments, yet clinical reasoning requires actively deciding what to investigate under uncertainty.
By Krischan Braitsch, Laura K. Schmalbrock, Theresa Weltermann, Andrew F. Berdel, Isabella Miller, Kai Tran, Michael Heider, Sabrina Kraus, Florian Bassermann, Jacqueline Lammert, Sebastian Ziegelmayer, Marcus Makowski, Lisa C. Adams, Keno K. Bressem
arXiv:2604. 14892v3 Announce Type: replace-cross Abstract: Evaluating medical AI systems using expert clinician panels is costly and slow, motivating the use of large language models (LLMs) as alternative adjudicators.
By Amy Rouillard, Sitwala Mundia, Linda Camara, Ziyaad Dangor, Michael Cameron Gramanie, Ismail Kalla, Shabir A. Madhi, Kajal Morar, Marlvin T. Ncube, Haroon Saloojee, Bruce A. Bassett
The paper introduces BAR, a Budget‑Aware LLM Reasoning framework that enhances post‑discharge risk prediction by integrating external medical knowledge graphs (KGs). BAR refines KGs into disease‑specific evidence graphs with support scores and provenance, then uses an LLM to plan, navigate, and verify evidence within a patient‑specific budget. Experiments on MIMIC‑III and MIMIC‑IV across eight diseases show BAR improves AUPRC by 3.4 points, raises citation precision from 59.8% to 77.9%, and uses only 62‑65% of the allotted budget.
By Chen Chen, Dongjie Wang, Mei Liu, Zijun Yao
The paper introduces three interpretable metrics—Explanation Stability Index (ESI), Causal Faithfulness Score (CFS), and Perturbation Stability Score (PSS)—to assess the faithfulness of large language models (LLMs) in clinical decision support. Evaluating six LLMs on 150 MedQA-USMLE questions, the study finds that only 23.3% of cited clinical concepts are causally necessary, and that correct answers often have lower CFS than incorrect ones, with answer consistency negatively predicting faithfulness. These findings suggest that accuracy, consistency, and consensus are incomplete safety signals for clinical decision-making support.
By Bharath Kumar Bolla, Chaitali Deb Purkayastha, Vishnu Surya Reddy Nandi
FD‑SCoPE is a language‑model framework that answers clinicians’ questions about systematic review evidence tables, exposing the underlying query, selected trials, and derivation rule for each answer. It handles both directly recorded attributes and derived attributes, achieving high accuracy on an oncology evidence table of 159 immune‑checkpoint inhibitor trials. After incorporating expert corrections, its performance on unseen questions improved from 77.9% to 84.9% F1.
By Manan Roy Choudhury, Suparno Roy Chowdhury, Swastik Sahoo, Muhammad Ali Khan, Kaneez Zahra Rubab Khakwani, Mohamad Bassam Sonbol, Irbaz Bin Riaz, Vivek Gupta
arXiv:2606.16149v5 Announce Type: replace
Abstract: Rare disease diagnosis depends on expert reasoning that is scarce and difficult to transfer. Large language models rank the correct disease first i...
By Minh-Ha Nguyen, Erica Gray, Bryce A. Schuler, Kevin W. Byram, Chih-Ting Yang, Fan Ma, Hua Xu, Wu-Chen Su, Chao Yan, Wei-Qi Wei, Adam Wright, Lisa Bastarache, Josh F. Peterson, Lingyao Li, Siyuan Ma, Undiagnosed Diseases Network, Rizwan Hamid, Thomas A. Cassini, Cathy Shyr
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: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