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:2609.01361v1 Announce Type: cross
Abstract: Linear classifiers trained on hidden states of a large language model (LLM), linear probes, can flag factual errors from a single forward pass. Geome...
By Nishant Mishra, Ameen Abu-Hanna, Iacer Calixto
arXiv:2607. 04223v1 Announce Type: cross Abstract: Retrieval-augmented generation (RAG) reduces but does not eliminate hallucination, and existing detectors return a single answer-level score that does not indicate which sentence is unsupported, or why.
By Mohamed Aly Bouke
arXiv:2608. 11922v1 Announce Type: cross Abstract: Predictive-distribution entropy makes a strong selection rule in retrieval-augmented question answering: across five QA benchmarks, keeping the candidate answer that a frozen respondent LLM produces with the lowest answer-token entropy lifts mean answer $F_1$ from 0.
By Po-Jen Ko, Che-Cheng Wu, Hung-Chun Hsu, Li-Yang Chang, Chuan-Ju Wang
The paper introduces Gated Activation Steering, an inference-time intervention that jointly mitigates hallucination and sycophancy in medical question answering. By learning separate steering directions from contrastive clinical pairs and applying them to specific attention heads, the method uses behavior‑specific gates to intervene only when needed. Experiments on EHR‑based clinical questions show that the 4‑billion‑parameter model with gated steering outperforms its unsteered counterpart and rivals larger models in resisting user pressure.
By Himanshu Tripathi, Subash Neupane, Shaswata Mitra, Sudip Mittal, Noorbakhsh Amiri Golilarz, Shahram Rahimi
arXiv:2608. 11922v2 Announce Type: replace-cross Abstract: Predictive-distribution entropy is a strong answer-selection rule in retrieval-augmented generation (RAG) for question answering: across five QA benchmarks, selecting the answer a frozen respondent LLM produces with the lowest answer-token entropy lifts mean $F_1$ from 0.
By Hung-Chun Hsu, Po-Jen Ko, Che-Cheng Wu, Li-Yang Chang, Chuan-Ju Wang
arXiv:2608. 12138v1 Announce Type: cross Abstract: General-purpose large language models (LLMs) have recently been reported to match or exceed specialized clinical AI tools on medical benchmarks, but such comparisons draw on a narrow set of systems and on benchmarks developed largely in high-income settings.
By Praveen Reddy, Charuta Mandke, Suvrankar Datta, Sarah Khan, Siddharth Reddy Anthireddy, Shitij Arora, Vishal Singh
arXiv:2608. 03854v1 Announce Type: new Abstract: When decoder language models are used as classifiers, predicted class probabilities depend on implementation choices, including the prompt template, verbalizer (label-to-token mapping), and scoring rule, that are rarely treated as experimental variables.
By Anton Rasmussen, Hong Qin
arXiv:2604. 08941v2 Announce Type: replace Abstract: Medical Vision-Language Models (VLMs) answering binary presence questions on chest radiographs can fail in two linked ways: they are confidently wrong, and they change answers when a clinically equivalent question is rephrased.
By Binesh Sadanandan, Vahid Behzadan
arXiv:2606. 08969v1 Announce Type: cross Abstract: Large language models (LLMs) are increasingly used for medical summarization, but their outputs can omit medically important information and introduce unsupported claims.
By Suhana Bedi, Bridget Lin, Anson Y. Zhou, Chloe O. Stanwyck, Jenelle A. Jindal, Sanmi Koyejo, David Stutz, Nigam H. Shah
arXiv:2409. 07314v3 Announce Type: replace-cross Abstract: While Large Language Models (LLMs) achieve superhuman performance on standardized medical licensing exams, these static benchmarks have become saturated and increasingly disconnected from the functional requirements of clinical workflows.
By Praveenkumar Kanithi, Cl\'ement Christophe, Marco AF Pimentel, Tathagata Raha, Prateek Munjal, Nada Saadi, Hamza A Javed, Svetlana Maslenkova, Nasir Hayat, Ronnie Rajan, Shadab Khan
The paper introduces a mixed-format medical visual question answering system that stabilizes both multiple-choice and free-text outputs. It employs an answer-text memory, a permutation-stabilized vision–language expert, and a sparse candidate-expanding router, extending the routable candidate set to include the expert’s top‑2 predictions. On a 1,403‑case retrospective analysis, this candidate expansion improves binary routing accuracy from 88.95% to 91.73%, rescues 56 errors, and achieves 92.23% overall performance, while ensuring all 475 open‑ended responses are schema‑valid without repair or retry.
By Hai-Dang Nguyen, Huy-Hieu Pham