The paper investigates how misleading context—specifically fabricated evidence and bare assertions—affects large language models’ medical question‑answering performance. Experiments on MedMisBench show that models are more prone to adopt answers based on assertions than fabricated evidence, and that these misleading cues are often disclosed in reasoning traces but rarely in final responses. A monitor that reads open reasoning traces can detect most corrupted decisions, whereas monitoring only responses is less effective.
By Robin Linzmayer, No\'emie Elhadad
arXiv:2611.00460v1 Announce Type: cross
Abstract: Large language models (LLMs) now answer medical exam questions at or above expert level, but it is unclear whether such scores reflect clinical compe...
By Navapat Nananukul, Mayank Kejriwal
The study evaluates how clinical language models perform when patient narratives are presented in different voices—clinical, socioeconomic, and cultural—using 1,000 MedQA cases paired with three retellings each. All 12 tested models show a significant drop in accuracy (about 26% more errors) when the patient speaks in a marked voice, a penalty that persists even when the original vignette is included verbatim and is not explained by measured retelling properties. The authors find that rewriting the patient’s account into a clinical vignette before answering can halve this accuracy gap, though structured schema pipelines and additional reasoning tools offer limited improvements.
By Prabhjot Singh, Pritam Deka, Vijay Chennareddy
RetiJev is a family of 0.8B‑9B decision models designed for ophthalmic clinical decision support, offering fast, accurate, and privacy‑preserving inference without autoregressive decoding. The authors created RetiJev‑Data, a source‑grounded corpus of 78,158 clinical‑decision and diagnosis questions, 50,074 guideline‑grading questions, and a 24,662‑question evaluation benchmark. RetiJev outperforms a 27B LLM and the commercial Jev 1.13 model on guideline grading and clinical decisions, achieving the highest accuracy while answering a case in 158 ms on a single GPU—3.5× faster than LLM generation and 470× faster than reasoning.
By Bo Liu, Lianyu Wang, Meng Wang, Ching-Yu Cheng, Huazhu Fu
The paper introduces MedQA-MM, a benchmark that exposes shortcut reasoning in medical multimodal multiple-choice questions. By auditing prompts, images, and modalities, the authors show that models often rely on textual cues rather than visual evidence, with full-input accuracy at 62.63% but only 5.21% when restricted to text. The study highlights the need for route-level evidence to validate true medical image reasoning.
By Benlu Wang, Yifan Zhang, Jiaqing Yu, Chin Siang Ong, Juncheng Huang, Zhuohao Li, Zhenyu Zhang, Arman Cohan, Hong Yu, Zonghai Yao
arXiv:2604. 04593v2 Announce Type: replace-cross Abstract: Retrieval-augmented generation (RAG) grounds large language models in external medical knowledge, yet standard retrievers frequently surface hard negatives that are semantically close to the query but describe clinically distinct conditions.
By Byeolhee Kim, Min-Kyung Kim, Young-Hak Kim, Tae-Joon Jeon
arXiv:2609.09684v1 Announce Type: new
Abstract: Medical question-answering datasets often contain answer labels, whereas high-quality rationales remain scarce, noisy, or costly to validate. This chan...
By Yuexin Wu, Dayou Yu, Vasile Rus
arXiv:2606. 07237v1 Announce Type: cross Abstract: Large Language Models (LLMs) are increasingly used in healthcare for tasks such as clinical question answering, diagnosis support, and report summarization.
By Mahdi Alkaeed
arXiv:2609.14825v1 Announce Type: cross
Abstract: Large language models (LLMs) are often deemed unsafe for clinical question answering because of their tendency to hallucinate. Retrieval augmentation...
By Zeyu Dong, Benjamin Wang, Joyee W. Jin
GLoC-EHR is a multimodal language model that processes electronic health records by combining a fixed-size global memory of the entire patient trajectory with a local memory of selected events. It generates hospital-course summaries and masked concept descriptions, then is fine‑tuned to cite evidence before answering clinical questions, using group relative policy optimization to reward correct, evidence‑supported responses. On MIMIC‑IV outcome tasks, GLoC‑EHR achieves the highest macro AUROC among compared models when answering directly, and maintains strong performance with evidence‑cited reasoning while adding distinct supported findings from the local memory.
By Chaiho Shin, Kwangsoo Kim
The paper identifies a new problem in clinical natural language processing called the clinical lost‑in‑the‑middle (CLitM) effect, where large language models perform poorly on information located near the center of long electronic health record (EHR) documents. Using the MedAlign dataset, the authors quantify a 21.9‑percentage‑point accuracy gap across 2,196 instruction‑response pairs and six models, showing that most critical facts lie in the CLitM trough. They propose Query‑Conditioned Clinical Suppression (QCCS), a lightweight context‑selection gate that outperforms traditional retrieval methods (BM25, dense retrieval, cross‑encoder reranking) on a held‑out set of 83 instructions, achieving up to 25.3% accuracy for middle‑position queries.
whyItMatters":"The study demonstrates that standard retrieval strategies fail to reliably surface central clinical information, and that a query‑aligned selection mechanism can substantially improve model performance on critical EHR data."
By Sanjay Basu
arXiv:2609.24799v1 Announce Type: new
Abstract: Post-training quantization (PTQ) enables efficient deployment of large language models, and PTQ methods are usually optimized and evaluated with generi...
By Yeji Kim, Mi-Young Kim, Randy Goebel