arXiv AI

A rubric landscape for evaluating clinical reasoning in large language models: what exists, what is missing, and what needs to be combined

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
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
Aug 26

STRIVE: Multi-Agent Structured Temporal Reasoning with Integrated Verification for Longitudinal Radiology Report Generation

STRIVE is a new framework for longitudinal radiology report generation that separates clinical reasoning into distinct Diagnosis, Attribute, and Temporal Change agents, each producing explicit evidence. The Temporal Change agent is refined with a Progression-Aware GRPO reward that differentiates direction-preserving errors from reversals. Verification occurs twice: a Consistency Gate aligns agent outputs before report generation, and a Validation Agent ensures the final report is supported by the aggregated evidence. On the Longitudinal-MIMIC dataset, STRIVE achieves superior clinical efficacy and more than doubles Longitudinal Change Concordance compared to the strongest baseline.

By Junyeong Maeng, Eunsong Kang, Heung-Il Suk
arXiv AI
Aug 25

Teaching LLMs How ICU Physicians Approach Clinical Reasoning Through OMOP-Aligned Retrieval Improves Reasoning Across Clinical Domains

arXiv:2608.22622v1 Announce Type: cross Abstract: Clinical decision-making relies on identifying relevant patient information to guide diagnosis and treatment, a challenge that is especially difficul...

By Miguel Contreras, Scott Siegel, Subhash Nerella, Jessica Sena, Jiaqing Zhang, Heng Sun, Hruday Tej Akkaladevi, Peiyu Lu, Jordan Rosen, Sumit Kapoor, Sasank Desaraju, Grace R. Thompson, Jacob Purcell, Michael Petrauskis, Philip KW. Hong, Meghan Brennan, Sarah Chrabaszcz, Tierra Smith, Ronnie Ren, Michel S. Kabbash, Ceyhun Haziroglu, Rushi Patel, Gabriel Gomez, Charlotte Chaiklin, Randy Leung, Kenneth N. John, Whitman Wiggins, Philip Kayser, Vincent Bird, Maria Bruzzone, Tyler J. Loftus, Azra Bihorac, Parisa Rashidi
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 AI
Jun 16

EHRNote-ChatQA: A Benchmark for Evidence-Grounded Multi-Turn Clinical Question Answering over Longitudinal Discharge Summaries

arXiv:2606. 15735v1 Announce Type: cross Abstract: Discharge summaries are crucial clinical documents containing the context of a patient's overall hospital stay, and are routinely reviewed by medical experts for patient readmission, ongoing care, and diagnostic decision-making.

By Jiyoun Kim, Muhan Yeo, Eunhye Jang, Jeewon Yang, Hangyul Yoon, Su Ji Lee, Hee Jo Han, Hee-Jae Jung, Doyun Kwon, Jun young Lee, Jaehun Lee, Jung-Oh Lee, Sunjun Kweon, Jong Hak Moon, Daseul Kim, Minjae Cho, Edward Choi
arXiv AI
Aug 11

CliniCARE-Bench: Clinical Calibrated Audit of Medical Reasoning in EHR

arXiv:2608. 07796v1 Announce Type: new Abstract: Large language models perform strongly on medical knowledge benchmarks, but reliable clinical deployment requires agents to conduct defensible investigations over heterogeneous, longitudinal records: determining what evidence is needed, retrieving and reconciling structured and free-text data, grounding conclusions in verifiable evidence, and deferring cases that cannot be resolved reliably.

By Veronica Chatrath, Bryan Zhu, George Pu, Jingxuan Fan, Apaar Shanker, Varun Ursekar, Anahita Sharma, Jason Qin, Keqi Han, Soham Dinesh Tiwari, Soham Dan, Vijay Kalmath, Yuan Li, Daniel Yue Zhang, Chenguang Wang, Zainab Doctor, Zhijun Yin, Nigam H. Shah, Yuan Xue
arXiv AI
1d 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 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 Computation and Language
Sep 11

Towards Reliable Medical LLMs: Benchmarking and Enhancing Confidence Estimation of Large Language Models in Medical Consultation

The paper introduces the first benchmark for evaluating confidence estimation in large language models during multi‑turn medical consultations, combining three types of medical data and an information sufficiency gradient to capture how confidence and correctness evolve as evidence accumulates. Experiments with 27 methods reveal that token‑level and consistency‑level confidence approaches are limited by medical data, and that medical reasoning must be judged on both diagnostic accuracy and information completeness. Building on these findings, the authors propose MedConf, a retrieval‑augmented, linguistically grounded self‑assessment framework that aligns patient information with supporting, missing, and contradictory relations, producing interpretable confidence estimates that outperform existing methods across multiple datasets and LLMs.

By Zhiyao Ren, Yibing Zhan, Siyuan Liang, Guozheng Ma, Baosheng Yu, Dacheng Tao