The article reviews existing tools for assessing clinical reasoning in large language models, identifying six key dimensions—problem representation, temporal synthesis, differential and management reasoning, counterfactual reasoning, calibrated uncertainty, and reasoning faithfulness. It finds that no single instrument covers all dimensions, with some aspects reasonably addressed while others, especially faithfulness and counterfactual reasoning, remain weakly evaluated. The authors propose combining current tools through binary rubric items, separate completeness and correctness scores, importance weighting, safety caps, temporal consistency checks, and chance‑corrected reliability reporting, and call for further design work on uncertainty, counterfactual reasoning, and faithfulness in longitudinal free‑text contexts.
By Zhangshu Joshua Jiang, Zina Ibrahim, James T. Teo
arXiv:2609.37788v1 Announce Type: cross
Abstract: Rubrics support the structured evaluation of language models. We propose a rubric for assessing expressed clinical reasoning in model responses, draw...
By Zhangshu Joshua Jiang, Zina Ibrahim, James T. Teo
arXiv:2607. 02175v1 Announce Type: new Abstract: Multiple-choice medical benchmarks are increasingly saturated, and recent rubric-based evaluations such as HealthBench have shown that open-ended clinical performance is far from solved - its "Hard" subset top score remains 32%.
By Samiha A. Ismail, Fan X. Chen, Ali Merali
arXiv:2606. 17474v1 Announce Type: cross Abstract: Large language models (LLMs) are increasingly considered for use in clinical consultation tasks, yet most medical evaluations remain static, single-turn, or narrowly outcome-based, limiting their ability to reflect the sequential, uncertain, and interactive nature of real-world care.
By Jiahui Niu, Huizi Yu, Wenkong Wang, Guangxin Dai, Jingxian He, Xiang Li, Zhiying Liang, Xinxin Lin, Kent CY So, Bryan YP Yan, Yun Kwok Wing, Yanqiu Xing, Xin Ma, Lizhou Fan
The paper introduces PrecepTron, a 32‑billion‑parameter language model fine‑tuned with low‑rank adaptation to evaluate clinical reasoning in large language models (LLMs) at a physician level. It also releases GRAND‑ROUNDS, a benchmark of 9,217 scored responses from 160 clinicians across seven studies. Using PrecepTron, the authors replicate key findings from major medical AI studies and explore new questions about LLM diagnostic accuracy, demonstrating that fine‑tuned models can provide consistent, scalable physician‑level scoring.
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:2604. 14892v3 Announce Type: replace-cross Abstract: Evaluating medical AI systems using expert clinician panels is costly and slow, motivating the use of large language models (LLMs) as alternative adjudicators.
By Amy Rouillard, Sitwala Mundia, Linda Camara, Ziyaad Dangor, Michael Cameron Gramanie, Ismail Kalla, Shabir A. Madhi, Kajal Morar, Marlvin T. Ncube, Haroon Saloojee, Bruce A. Bassett