The study evaluates counterfactual bias in ten open‑source large language models (LLMs) for pediatric Emergency Severity Index (ESI) prediction. By creating paired clinical vignettes that differ only in demographic or socioeconomic variables, the authors measure shifts in acuity assignment, finding that counterfactual sensitivity varies widely across model families and sizes. A fine‑tuned Qwen2.5‑7B model exhibited the lowest sensitivity, while larger or medical‑domain models sometimes showed greater shifts, highlighting the need for fairness assessment before clinical deployment.
arXiv:2604.26766v2 Announce Type: replace-cross Abstract: Accurate and consistent Emergency Severity Index (ESI) assignment remains a persistent challenge in emergency departments, where highly varia...
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."
arXiv:2512.19735v4 Announce Type: replace Abstract: Accurately predicting mortality risk in intensive care unit (ICU) patients is critical for clinical decision-making. Large language models (LLMs) a...
The study evaluates whether large language models (LLMs) with in‑context learning can better identify institution‑specific protected health information (PHI) in electronic health records than existing de‑identification systems. Using 100 pediatric oncology notes from Texas Children’s Hospital, eight LLMs were compared to two purpose‑built systems and pattern‑based baselines under three progressively specific prompts. The best LLM achieved an F1 score of 0.918, recovering 79% of previously missed PHI categories and reaching a recall of 0.981 after iterative prompt refinement, demonstrating that calibrated single‑pass prompting can close the institutional PHI gap while balancing precision and recall.
The paper reports that counterfactual fairness audits of clinical language‑model agents are unreliable without accounting for a per‑action instability floor. By repeatedly running identical vignettes, the authors found that actions changed 8.7% of the time, with instability varying eightfold across actions. A second model confirmed a pooled floor of 6.7%, showing that any reported fairness estimate lacking this floor cannot be interpreted as evidence of disparity.
arXiv:2605.01048v2 Announce Type: replace-cross Abstract: Counterfactual prompting (i.e., perturbing a single factor and measuring output change) is widely used to evaluate things like LLM bias and C...
arXiv:2607. 18828v1 Announce Type: new Abstract: Readiness stress-testing of medical AI has focused on closed-ended and multimodal benchmarks.
arXiv:2606. 16723v1 Announce Type: new Abstract: Large language model (LLM) agents increasingly take actions (screening applicants, recommending credit, triaging patients), yet fairness for LLMs is still measured by grading answers.
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.
arXiv:2607. 18086v1 Announce Type: new Abstract: Background: LLM judges increasingly score whether clinical language models give overconfident answers under incomplete evidence, yet whether a measured "safety gain" reflects real behavior change or the judge's calibration is unresolved.
arXiv:2608. 10273v1 Announce Type: cross Abstract: Deploying large language models (LLMs) for decision support in emergency departments (EDs) faces two major challenges: privacy risks of transmitting patient data to closed-source commercial LLMs and the lack of systematic evaluation of fine-tuning strategies for locally deployable open-source small language models (SLMs).
arXiv:2608. 03028v1 Announce Type: new Abstract: Applying a valid medication-safety rule when its patient-specific conditions are not met can produce an incorrect decision.