Toward System One Clinical Intelligence: Parameter-Efficient Fine-Tuning and Counterfactual Explainability of Decision Foundation Models
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The paper evaluates whether a 9‑billion parameter decision foundation model, Clef‑Flash, is necessary for symptom‑to‑disease classification. Fine‑tuning the model on the 24‑class Symptom2Disease benchmark yields 95.42% accuracy, but simple TF‑IDF linear classifiers achieve higher accuracy (98.75%) with far faster inference. Ablation studies show that predictions can hinge on single descriptive clauses, indicating that the benchmark may not fully capture the model’s capabilities.
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