Background: Disease severity is a multidimensional construct difficult to capture with rule-based approaches in Electronic Healthcare Records (EHR). Agentic large language model (LLM) systems could synthesise clinical evidence and reason over EHRs, but remain unevaluated for this task.
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
The study evaluates whether large language models (LLMs) with in‑context learning can better identify institution‑specific protected health information (PHI) in electronic health records than existing de‑identification systems. Using 100 pediatric oncology notes from Texas Children’s Hospital, eight LLMs were compared to two purpose‑built systems and pattern‑based baselines under three progressively specific prompts. The best LLM achieved an F1 score of 0.918, recovering 79% of previously missed PHI categories and reaching a recall of 0.981 after iterative prompt refinement, demonstrating that calibrated single‑pass prompting can close the institutional PHI gap while balancing precision and recall.
By Daniel Palacios, Matthew Brady Neeley, Angel Adetomike Otto, Shalini Dhamodharan, John P. Woodhouse, Chi-fan Lin, Mark Zobeck, Zhandong Liu, Hyun-Hwan Jeong
The study evaluates large language models (LLMs) on sequential emergency department triage, where acuity labels are predicted from progressively longer nurse‑patient conversations. Six LLMs were tested at five checkpoints on simulated and physician‑authored dialogues, showing a decline from moderate‑to‑substantial agreement on full records to only fair‑to‑moderate agreement at each checkpoint. The models consistently anchor on chief complaint exchanges and fail to integrate later evidence, yielding low agreement with clinicians (QWK 0.295 vs. 0.887‑0.929) and concentrating predictions on ESI‑2 and ESI‑3.
whyItMatters":"The findings reveal that LLMs, despite strong offline performance, cannot reliably handle the sequential nature of real‑time triage, highlighting a critical gap for safe deployment in emergency settings."
By Dipankar Srirag, Haokai Zhao, Ashutosh Kumar, Eleanor Hopper, Michael Dalton, Quoc Dung Nguyen, Aditya Joshi, Salil S. Kanhere, Padmanesan Narasimhan
arXiv:2607. 24371v1 Announce Type: cross Abstract: Healthcare interoperability requires AI systems to produce structured outputs conforming to standardized schemas including ICD-10 for diagnostic coding, CPT for procedure billing, and HL7 FHIR for data exchange.
By Jianru Shen
arXiv:2606. 28362v1 Announce Type: cross Abstract: Systematic reviews and meta-analyses (SR/MA) remain the gold standard for evidence synthesis, yet completing one typically requires 67 weeks and substantial expert effort.
By Yen-Hsun Huang (Department of Education, Taipei Veterans General Hospital, Taipei, Taiwan), Yu-Shiou Lin (Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan)
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:2512.19735v4 Announce Type: replace
Abstract: Accurately predicting mortality risk in intensive care unit (ICU) patients is critical for clinical decision-making. Large language models (LLMs) a...
By Gangxiong Zhang, Yongchao Long, Yuxi Zhou, Yong Zhang, Shenda Hong
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
The study evaluates counterfactual bias in ten open‑source large language models (LLMs) for pediatric Emergency Severity Index (ESI) prediction. By creating paired clinical vignettes that differ only in demographic or socioeconomic variables, the authors measure shifts in acuity assignment, finding that counterfactual sensitivity varies widely across model families and sizes. A fine‑tuned Qwen2.5‑7B model exhibited the lowest sensitivity, while larger or medical‑domain models sometimes showed greater shifts, highlighting the need for fairness assessment before clinical deployment.
By Manar Aljohani, Brandon Ho, Kenneth McKinley, Dennis Ren, Xuan Wang
arXiv:2606. 19509v1 Announce Type: new Abstract: Large language models (LLMs) are increasingly applied to structured clinical data, yet whether they can recognize the limits of their own knowledge on such tasks remains unexplored.
By Akshat Dasula, Prasanna Desikan, Jaideep Srivastava
arXiv:2606. 19183v1 Announce Type: cross Abstract: Large language models (LLMs) can make clinical decision support more accessible by interpreting free-text documentation, but their direct use as diagnostic engines is limited by sensitivity to prompts, information order, and plausible but incorrect outputs.
By Soheyl Bateni, Maryam Abdolali