arXiv Computation and Language By Ali H. Lazem, William Teahan

Do We Need the Largest LLMs for Every Clinical Decision?

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The paper introduces CERTA, a decision‑level statistical certificate that decides when a quantized clinical language model can replace its native BF16 reference and escalates uncertain decisions to the reference model. Across eleven instruction‑tuned models (7‑72 B parameters) and 2,500 clinical‑verification decisions from 2,484 de‑identified patients, 8‑bit quantization achieved 99.8‑100% coverage, while 4‑bit configurations cut deployment costs to roughly 26–28% of the BF16 baseline with peak memory below a 48 GB accelerator. On external named‑entity benchmarks, the chosen NF4 settings showed only a 0.045 mean absolute F1 change, indicating minimal performance loss. whyItMatters":"CERTA enables risk‑controlled deployment of smaller, cheaper models for clinical decision support, potentially making advanced language models more accessible in resource‑constrained healthcare settings."

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