arXiv AI

TRIAGE: Dialectical LLM Reasoning for Explainable Risk Prediction on Irregularly Sampled Medical Time Series

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 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
Aug 3

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.

By Shayndhan Sivanathan, Shravan Nageswaran, Mehdi Zadem, Ryaan Sultan, Nicolas von Mallinckrodt, Max Solovyev, Alexey Matyushkin, Sumon Sadhu, Gabriele C DeLuca, Sanjeeva Jeyaretna, James Hillis, Manoj Ramachandran, Prakash Jayakumar
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 Machine Learning
Jun 2

OncoReason: Structuring Clinical Reasoning in LLMs for Robust and Interpretable Survival Prediction

arXiv:2510. 17532v2 Announce Type: replace-cross Abstract: Predicting cancer treatment outcomes requires models that are both accurate and interpretable, particularly in the presence of heterogeneous clinical data.

By Raghu Vamshi Hemadri, Geetha Krishna Guruju, Kristi Topollai, Anna Ewa Choromanska
arXiv AI
Sep 15

Hindsight Bias in Clinical Temporal Reasoning: How Future Data Exposure Affects Large Language Model Judgment

The paper introduces a paired benchmark to detect hindsight bias in clinical language models by comparing model responses to questions posed at a clinically relevant cutoff versus the full timeline. It uses 171 case reports (40 sepsis, 131 GLP‑1/diabetes) with both human‑annotated and LLM‑generated time‑series data, evaluating accuracy, hindsight trap rate, answer instability rate, and hindsight bias rate. Results show that exposing models to the full timeline consistently increases hindsight bias, while truncating the timeline mitigates bias without sacrificing accuracy.

By Misaki Matsuura, Sayantan Kumar, Ojas Kadam, Jeremy C. Weiss
arXiv AI
2d ago

Scaling Clinical Judgment to Evaluate Medical AI

arXiv:2609.12822v2 Announce Type: replace Abstract: Blinded physician evaluation has been considered by many to be the gold standard for assessing clinical reasoning in large language models (LLMs)....

By Thomas A. Buckley, Zahir Kanjee, Peter G. Brodeur, Byron Crowe, Anthony M. Pettinato, Aashna P. Shah, Adrian D. Haimovich, Liam G. McCoy, Daniel Restrepo, Jason A. Freed, Ethan Goh, Jonathan H. Chen, Laura Zwaan, Katherine E. Goodman, Daniel J. Morgan, Raja-Elie E. Abdulnour, Adam Rodman, Arjun K. Manrai
arXiv Computation and Language
Sep 23

Learning Diagnostic Reasoning for Decision Support in Toxicology

The paper introduces DeToxR, a reinforcement‑learning‑enhanced large language model designed to support decision making in acute toxicology cases. It fuses unstructured narratives from paramedics and patients with structured vital‑sign data to predict co‑ingested substances across 14 classes. In preliminary validation, DeToxR outperforms baseline models, achieving higher micro‑F1 and recall scores for poison identification.

By Nico Oberl\"ander, David Bani-Harouni, Tobias Zellner, Nassir Navab, Florian Eyer, Matthias Keicher