arXiv Computation and Language

Trajectory-Guided Steering: Mitigating Spurious Feature Bias in Clinical Classification

arXiv AI
Aug 6

Memorization in Large Language Models in Medicine: Prevalence, Characteristics, and Implications

arXiv:2509. 08604v5 Announce Type: replace-cross Abstract: Large Language Models (LLMs) have demonstrated significant potential in medicine, with many studies adapting them through continued pre-training or fine-tuning on medical data to enhance domain-specific accuracy and safety.

By Anran Li, Lingfei Qian, Mengmeng Du, Yu Yin, Yan Hu, Zihao Sun, Yihang Fu, Hyunjae Kim, Erica Stutz, Xuguang Ai, Qianqian Xie, Rui Zhu, Jimin Huang, Yifan Yang, Siru Liu, Yih-Chung Tham, Lucila Ohno-Machado, Hyunghoon Cho, Zhiyong Lu, Hua Xu, Qingyu Chen
arXiv AI
Oct 1

Sense and Sensitivity: Benchmarking LLM Clinical Triage Recommendations with Physician Experts

The paper introduces a benchmark of over 6,000 clinical triage scenarios, 7,000 physician annotations, and 225,000 large language model (LLM) responses to assess how LLMs perform under realistic variations in clinical text. The study finds that LLMs tend to recommend unnecessary care more often than physicians, especially when the input text is perturbed, and that LLM recommendations are more sensitive to gender and tone changes than human recommendations. These findings underscore the importance of deployment‑oriented evaluations that reflect expert physician behavior.

By Abinitha Gourabathina, Haoran Zhang, Yuexing Hao, Walter Gerych, Marzyeh Ghassemi
arXiv Machine Learning
Oct 12

Hidden Data Challenges in Clinical Machine Learning

The paper highlights hidden data challenges in clinical machine learning, focusing on how commonly reused preprocessing pipelines for electronic health records embed assumptions about data availability, episode definitions, and missingness. Using MIMIC-IV, the authors identify violations in temporal, semantic, and population alignment—leading to temporal leakage, feature-task misalignment, and biased imputation—and show that these ambiguities can alter model signals without affecting overall predictive performance. They provide practical recommendations and open-source code for more temporally valid, clinically aligned, and reproducible preprocessing.

By Carolin Ciss\'ee, Dennis Fast, Raneen Younis, Alexander L\"oser, Wolfgang Nejdl, Zahra Ahmadi
arXiv AI
Aug 28

Making Clinical Language Models Auditable: Concept-Guided Fine-Tuning for Robust Prediction

The paper introduces CAST, a concept-guided artifact suppression tuning framework that uses sparse autoencoders to identify and suppress note-specific artifacts in clinical language models. CAST labels latent features with an LLM-assisted pipeline and ICD‑10 constraints, then fine‑tunes the model while providing post‑hoc per‑concept attributions for auditability. In experiments on MIMIC‑IV discharge‑note mortality prediction, CAST outperforms standard fine‑tuned encoders and competes with strong LLM baselines while offering a feature‑level audit trail of clinical concepts and suppressed artifacts.

By Jin Mu, Guanhua Chen
arXiv Machine Learning
Oct 5

Clinical Concept Centers in LLMs

The paper investigates whether clinical concepts are represented as distinct, causally influential centers within the latent space of large language models (LLMs). By evaluating eleven open-weight LLMs, the authors discover that each model contains dedicated clinical concept centers that are interpretable, activate only on relevant clinical narratives, and drive model behavior in both constrained and open-ended contexts. These centers can be leveraged for evaluation and performance improvement, as steering models along them enhances downstream clinical outcomes and aligns with clinician preferences.

By Aishik Nagar, Abhishek Vaidyanathan, Arun-Kumar Kaliya-Perumal, Elijah Tzen Hsuen Boey, Stefan Winkler
Hugging Face Trending Papers
Aug 17

Toward Better Assessment of LLMs' Performance in Clinical Error Detection

Automated detection of errors in clinical documentation is a promising application of large language models (LLMs), yet decisions to deploy such models rest on benchmarks that evaluate each clinical note in isolation. Error-detection benchmarks are typically constructed by injecting errors into notes, such that each erroneous note has a natural counterpart.