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
arXiv:2607. 20827v1 Announce Type: new Abstract: LLM agents choose tools and arguments from context that mixes user requests, tool outputs, retrieved records, memory, and untrusted text.
By Junchi Liao
The paper investigates why retrieval‑based open‑ended evaluation fails in medical fact verification. By creating two detailed taxonomies—one for retrieval‑stage errors across five quality dimensions and another for verifier‑reasoning errors across six steps—the authors automatically label evidence quality and reasoning errors using an LLM‑as‑Judge pipeline. Their large‑scale stress tests across multiple retrieval methods and verifier models show that increasing model size, reasoning effort, source breadth, or medical fine‑tuning does not eliminate these failure modes, indicating fundamental limits of the retrieve‑then‑verify paradigm in open‑ended medical contexts.
By Heyuan Huang, Jirui Dai, Alexandra DeLucia, Sonal Joshi, Mahsa Yarmohammadi, Jie Gao, Bernal Jim\'enez Guti\'errez, Mark Dredze
arXiv:2608. 05235v1 Announce Type: cross Abstract: Research agents increasingly conduct multi-round machine-learning experiments in industrial recommendation settings and retain the resulting trajectories to guide later decisions.
By Zijie Zhuang, Changxin Lao, Pengbo Xu, Hanwen Xu, Ruochen Yang, Yingzhi He, Peng Zhang, Jiangxia Cao, Yusheng Huang, Guohong Mu, Jian Liang, Ruiming Tang, Shuang Yang, Zhaojie Liu, Wenwu Ou, Kun Gai
OpenMTB‑Audit is an open‑source benchmark that tests large language models on 500 synthetic non‑small cell lung cancer cases, covering five adversarial error categories and four safety labels: Supported, Partially Supported, Unsupported, and Insufficient Information. The study found that all eight tested LLMs over‑refused Partially Supported recommendations, collapsing labels to achieve high safety scores. A deterministic seven‑module framework, MTB‑AuditAgent, was introduced to reduce over‑refusal to 6.7% and reach 91.2% accuracy, while an oncologist annotation study highlighted disagreement around the boundary between information sufficiency and treatment optimization.
By Negin Ashrafi, Jia Luo, Stacey M. Frumm, Roxana Daneshjou
The paper "Medical Causal Hypothesis Verification with Large Language Models" reports a small-scale study evaluating eight LLMs on 17 medical causal hypotheses. The authors introduce an evaluation framework and annotate 1,067 evidence points across six criteria, using nine metrics to assess performance. Results show that while LLMs have strong recall, they frequently fail to provide valid scientific articles, evidence, or reject unsupported hypotheses, revealing a critical limitation for their use in healthcare.
By Safiyyah Ahmed, Abrar Ansari, Md Aminul Islam, Elena Zheleva
The paper introduces a counterfactual evidence audit to assess how large language model agents respond to different sets of documents. By exposing agents to two mirrored sets of five documents and measuring changes in six downstream decisions, the authors predict how the agents will behave when presented with a full 45‑document context. Across multiple open‑weight model families and tasks, the five‑document audit accurately forecasts full‑context effects, reducing prediction error by 62% and correctly identifying the direction of most material effects.
By Rana Muhammad Usman
arXiv:2608.22062v1 Announce Type: new
Abstract: Longitudinal clinical event-relation verification determines whether a patient record supports a specified relation among two or more clinical events....
By Xingtao Lin, Yubo Feng, Weixin Liu, Hangqi Ren, Junchao Zhou, Caiwan Sun, You Chen
arXiv:2608.23397v1 Announce Type: new
Abstract: Interactive clinical agents must gather decisive evidence and convert it into grounded actions under partial observability. A correct final diagnosis a...
By Ruoyu Wu, Shenfu Xie, Yinqian Sun, Haibo Tong, Feifei Zhao
arXiv:2607. 18999v1 Announce Type: cross Abstract: Multi-turn medical consultation agents must decide what to ask, adapt to patient responses, and determine when the collected evidence is sufficient.
By Guofeng Zhang, Yizeng Quan, Huaiyi Fang, Jianwei Lv, Jinyao Liu, Xunxu Duan, Lening An, Yu Ouyang, Junfeng Wang
arXiv:2610.07843v1 Announce Type: cross
Abstract: In digital pathology, compact evidence is often used to explain or audit predictions made by whole-slide image multiple instance learning models. In...
By Hyun Do Jung, Jungwon Choi, Soojung Choi, Yujin Oh, Hwiyoung Kim
arXiv:2607. 28788v1 Announce Type: new Abstract: Clinical diagnosis at hospital admission must be made rapidly from limited, incomplete evidence.
By Jiahui Li, Ruili Fang, Zishuai Liu, Yutong Guo, Nan Yang, Wenzhan Song, Jin Lu, Fei Dou