arXiv Computation and Language

Auditable Emergency Triage for Maternal and Newborn Care in India

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 Computation and Language
Sep 22

LLMs Anchor on Chief Complaint and Fail to Integrate Evidence in Sequential Clinical Triage

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 AI
Jul 7

Medi-Gemma: A Hybrid Clinical Decision Support System Integrating Deterministic EMR Analytics and Retrieval-Augmented Generation

arXiv:2607. 04907v1 Announce Type: new Abstract: Deploying Large Language Models (LLMs) in high-stakes clinical settings remains limited by structural hallucinations, weak deterministic reasoning over tabular patient data, and omissions in vector retrieval.

By Mohammed Saim Ahmed Quadri, Yunzhe Xue, Justin W. Ady, Usman Roshan
arXiv AI
Sep 11

Emergency Department Revisit Quality Review Screening: Exploring Human Decision-Making and Artificial Intelligence Support

The study examined how clinicians and GPT‑4 evaluate emergency department revisit pairs to determine if further assessment is needed. GPT‑4 over‑identified nearly all pairs as requiring follow‑up, while clinicians used clinical gravity and differential diagnosis factors. An algorithm using a knowledge graph populated by an LLM achieved high positive predictive value for identifying pairs that clinicians deemed warranting review.

By Jonathan A. Handler, Marlene I. Robles-Granda, Jacob E. Mefford, Jeremy S. McGarvey, Gregory S. Podolej, Colleen J. Klein, Matthew D. Dalstrom, William F. Bond
arXiv AI
Jul 10

A safety-oriented hypothetico-deductive framework for AI-assisted differential diagnosis

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 AI
Jul 29

PatientAgentBench: A Benchmark Framework for Evaluating Patient-Facing Health AI Agents

arXiv:2607. 25485v1 Announce Type: new Abstract: Health AI is evolving from answering questions to agentic systems that converse with patients, reason about health records, and act on their behalf.

By Korosh Vatanparvar, Ashutosh Joshi, Maria Xenochristou, Mohammad Abuzar Hashemi, Prasad Kasu, Deepak Bansal, Daniel Lopez-Martinez, Anchal Nema, Ramya Ganesan, Will Kimbrough, Alex Woody, Yadunandana Rao, Dilek Hakkani-Tur, Wilko Schulz-Mahlendorf
arXiv AI
Jun 9

TRIAGE: Dialectical Reasoning for Explainable Risk Prediction on Irregularly Sampled Medical Time Series with LLMs

arXiv:2606. 09030v1 Announce Type: cross Abstract: Clinical early warning systems built on electronic health records, in which clinical observations are recorded as irregularly sampled medical time series (ISMTS), must deliver both calibrated risk scores for patient triage and interpretable rationales that clinicians can verify.

By Hyeongwon Jang, Gyouk Chu, Changhun Kim, Joonhyung Park, Hangyul Yoon, Eunho Yang
arXiv AI
Jun 6

PSEBench: A Controllable and Verifiable Benchmark for Evaluating LLMs in Patient Safety Event Triage

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
arXiv Computation and Language
Sep 1

CARE: Privacy-Compliant Agentic Reasoning with Evidence Discordance

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