arXiv AI

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.

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 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 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 15

Can LLMs Accurately Score Medical Diagnoses and Clinical Reasoning?

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
arXiv Computation and Language
Sep 10

Auditable Emergency Triage for Maternal and Newborn Care in India

arXiv:2609.09356v1 Announce Type: new Abstract: At Noora Health, our nurses answer more than 50,000 medical queries per month on our WhatsApp-based service that provides caregivers with on-demand sup...

By Shobhit Jagga, Aman Dalmia, Niharika Priyadarshini, Neelima Devadas, Amrita K Prasen, Nikhil Nalin, Santhosh SJ, Sreeram Nurani Ramasubramanian, Muhammed Afeer K, Anubhav Arora
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
Jul 9

SycoEval-EM: Sycophancy Evaluation of Large Language Models in Simulated Clinical Encounters for Emergency Care

arXiv:2601. 16529v4 Announce Type: replace Abstract: Large language models (LLMs) deployed in clinical decision support may acquiesce to patient requests for care that conflicts with evidence-based guidelines.

By Dongshen Peng, Yi Wang, Austin Schoeffler, Sun-ha Hong, Brian Suffoletto, David Kim, Carl Preiksaitis, Christian Rose
arXiv AI
Aug 26

Right Diagnoses, Decorative Reasoning:A Perturbation Audit of Medical Chain-of-Thought

The study evaluates whether the chain-of-thought (CoT) rationales produced by medical language models truly influence their answers. Using a 30‑operator perturbation audit that modifies both the question and the CoT (e.g., severity reversal, negation flip, demographic swap, evidence ablation), the authors found that 72.9% of edits did not change the model’s answer—a high Chain‑Decoupling Rate (CDR). Across 14 large language models and four medical QA benchmarks, the CoT text had little impact on accuracy, and removing CoT prompting did not reduce performance. "whyItMatters":"The findings suggest that current medical CoT outputs may be more documentation than genuine reasoning, highlighting the need for better faithfulness checks in clinical AI systems."

By Mengzhu Xu, Jifan Gao, Xia Jiang, Yaoxin Wu, Xi Long