CardioBench: A Real-World Data Benchmark for Evaluating Large Language Models in Clinically Authentic Cardiovascular Care Scenarios
Authors: Xiao Li, Mouxiao Bian, Zhaodi Wu, Sijie Ren, Juechen Chen, Lu Lu, Jingru Ding, Yun Zhong, +3 more
Organizations: Department of Cardiology, Zhongshan Hospital Fudan University , Shanhai, China · Shanghai Institute of Cardiovascular Diseases, National Clinical , Shanghai, China · Research Center for Interventional Medicine , Shanghai, China · Shanghai Artificial Intelligence Laboratory, Shanghai, China · Minhang Hospital, Fudan University , Shanghai, China
Abstract
Background: Most medical large language model (LLM) benchmarks focus on examination knowledge or isolated tasks and may not reflect the longitudinal, multimodal, and safety-critical workflow of cardiovascular care. Objective: To develop CardioBench, a real-world benchmark spanning the cardiovascular care continuum, and assess LLM performance across clinical dimensions and specialist tasks. Methods: CardioBench includes 2,263 items from 13 task-specific datasets derived from de-identified cardiovascular records and examination data. Sixteen cardiology physicians conducted annotation and reference construction, followed by cross-review from two senior cardiologists. Seven LLMs generated 15,841 outputs under standardized zero-shot settings. Open-ended tasks were evaluated using key-point coverage and holistic clinical quality, while CardioEthics was scored by accuracy. Results: GPT-5.4 achieved the highest macro-average (62.55) and item-weighted mean (62.19), followed by Gemini 3.1 Pro (59.95) and Qwen 3.6 27B (59.72). GPT-5.4 ranked first in all three dimensions. CardioAuxReport performed best (86.38), whereas CardioECGRead (17.25) and CardioEthics (17.34) were lowest. The largest gaps between holistic clinical quality and key-point coverage occurred in CardioComm (52.71), CardioEmergRescue (52.05), and CardioTreatPlan (48.80). Conclusions: To our knowledge, CardioBench is the largest real-world, multi-task benchmark for LLM evaluation across the cardiovascular care continuum and offers the broadest coverage of clinically authentic cardiology scenarios reported to date. It provides a rigorous framework for identifying model strengths, clinically important omissions, and priorities for future development.
Multimodal Large Language Models (MLLMs) have shown strong performance on public medical benchmarks, yet existing evaluations often remain weak proxies for clinical use, relying on isolated inputs and simplified recognition-style tasks. We introduce CardioLens, a leakage-resistant evaluation testbed for multi-sequence Cardiovascular Magnetic Resonance (CMR), constructed from private hospital archives through a rigorous report-to-QA construction and verification pipeline. CardioLens contains 473,896 slices and 13,494 verified QA pairs across 4D Cine, LGE, perfusion, and T2-weighted imaging, and evaluates three stages of CMR interpretation: image understanding, report generation, and disease diagnosis. Across 24 state-of-the-art MLLMs, CardioLens reveals a substantial clinical reality gap: models perform poorly overall, with performance degrading along the real CMR workflow. Confusion analysis further shows a category-collapse failure mode, where models default to frequent abnormal categories rather than distinguishing clinically distinct findings. To rule out MLLM-compatible input construction as the primary cause, we compare random, clinically motivated, and data-driven slice selection protocols under different slice budgets; performance changes only marginally, typically by about 1%. Explicit reasoning prompts also fail to rescue performance, often making models more conservative rather than improving visual evidence use. These results show that current MLLMs remain far from reliable CMR interpretation, where clinical decisions require integrating distributed evidence across sequences, views, and temporal phases. CardioLens provides a clinically grounded testbed for developing next-generation MLLMs toward real-world clinical deployment.
Millions of clinicians use ChatGPT to support clinical care, but evaluations of the most common use cases in model-clinician conversations are limited. We introduce HealthBench Professional, an open benchmark for evaluating large language models on real tasks that clinicians bring to ChatGPT in the course of their work. The benchmark is organized around three common use cases central to clinical practice: care consult, writing and documentation, and medical research. Each example includes a physician-authored conversation with ChatGPT for Clinicians and is scored via rubrics written and iteratively adjudicated by three or more physicians across three phases. HealthBench Professional examples were carefully selected for quality, representativeness, and difficulty for OpenAI's current frontier models, to enable continued measurement of progress. Difficult examples for recent OpenAI models were enriched by roughly 3.5 times relative to the candidate pool of 15,079 examples. Additionally, about one-third of examples involve physicians conducting deliberate adversarial testing of models. As a strong baseline, we also collected human physician responses for all tasks (unbounded time, specialist-matched, web access). The best scoring system, GPT-5.4 in ChatGPT for Clinicians, outperforms base GPT-5.4, all other models, and human physicians. We hope HealthBench Professional provides the healthcare AI community a measure to track frontier model progress in real-world clinical tasks and build systems that clinicians can trust to improve care.
We introduce PhysicianBench, a benchmark for evaluating LLM agents on physician tasks grounded in real clinical setting within electronic health record (EHR) environments. Existing medical agent benchmarks primarily focus on static knowledge recall, single-step atomic actions, or action intent without verifiable execution against the environment. As a result, they fail to capture the long-horizon, composite workflows that characterize real clinical systems. PhysicianBench comprises 100 long-horizon tasks adapted from real consultation cases between primary care and subspecialty physicians, with each task independently reviewed by a separate panel of physicians. Tasks are instantiated in an EHR environment with real patient records and accessed through the same standard APIs used by commercial EHR vendors. Tasks span 21 specialties (e.g., cardiology, endocrinology, oncology, psychiatry) and diverse workflow types (e.g., diagnosis interpretation, medication prescribing, treatment planning), requiring an average of 27 tool calls per task. Solving each task requires retrieving data across encounters, reasoning over heterogeneous clinical information, executing consequential clinical actions, and producing clinical documentation. Each task is decomposed into structured checkpoints (670 in total across the benchmark) capturing distinct stages of completion graded by task-specific scripts with execution-grounded verification. Across 13 proprietary and open-source LLM agents, the best-performing model achieves only 46% success rate (pass@1), while open-source models reach at most 19%, revealing a substantial gap between current agent capabilities and the demands of real-world clinical workflows. PhysicianBench provides a realistic and execution-grounded benchmark for measuring progress toward autonomous clinical agents.
Ruoqi Liu, Imran Q. Mohiuddin, Austin J. Schoeffler +10