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 15

Can LLMs Accurately Score Medical Diagnoses and Clinical Reasoning?

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
arXiv Machine Learning
Oct 23

The Value of System 1 Models in Medicine

The study evaluates four zero‑shot System 1 models on 86 public clinical tasks across 14 domains and 20 languages, measuring performance via AUROC. The best models achieved high AUROC scores—0.94 for medical knowledge, 0.93 for text understanding, 0.83 for clinical judgement from text, 0.89 for image perception, 0.84 for 2D image findings, and 0.69 for volumetric findings—yet performed worse on imaging tasks and varied significantly with language. System 1 models were fast (0.34–0.44 s) and energy‑efficient (24–81 J) but lagged behind clinicians on triage and were outperformed by generative models in some metrics.

By Xiufeng Yang, Konstantinos Vrettos, Zeineb Ben Chaaben, Fabian Drexel, Jannik L\"ubberstedt, Johannes Moll, Anirudh Narayanan, Frederike Stumpf, Cosmin I. Bercea, Jiawen Wang, Evangelia E. Vassalou, Krischan Braitsch, Sebastian Ziegelmayer, Markus Graf, Marcus R. Makowski, Lisa Adams, Nassir Navab, Michail E. Klontzas, Keno Bressem
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