Can JEV Support Clinical Trial Criteria Assessment?

Patient-facing triage requires an appropriate care recommendation and recognition of when information is insufficient. We evaluate whether Jev, a decision model that returns probabilities over predefined actions, supports both judgments. Using CARE-Bench, we compare Jev with four general-purpose language models and three input-independent baselines across 925 decision points from 439 public cases. On the public test subset, Jev ranks fourth of five models by macro-F1 (0.461) but has the lowest observed multiclass Brier score (0.610), an 18.7% improvement over uniform prediction (case-bootstrap 95% interval, 4.9--31.1%). Noul has lower binary Brier than Choice (0.215 versus 0.276). A evaluation of 453 HealthBench conversations again gives Jev the lowest observed Brier score (0.299), but measures a distinct emergency-referral judgment. Jev combines lower probability error with missed clarification needs in the four-action task. Asking about information sufficiency separately increases recall but also produces frequent unnecessary clarification assignments.

Jev is a non-generative System One model that assigns probabilities to predefined answer options and cannot answer outside them. Its accuracy and calibration on medical question-answering and case-based diagnostic-reasoning tasks are unknown. We evaluated Jev 1.13 on four medical benchmarks: MetaMedQA, PubMedQA, DiagnosisArena-MCQ and the NEJM Case Challenges. GPT-6 Sol, with (medium) and without reasoning, was the reference. The primary outcome was top-1 accuracy; key secondary outcomes were calibration, selective prediction and recognition of unanswerable questions. All 8,469 requests returned a valid answer. Jev's accuracy was similar to that of GPT-6 Sol with medium reasoning on PubMedQA (78.4% vs 78.2%;), lower on MetaMedQA (74.8% vs 82.7%) and much lower on DiagnosisArena-MCQ (59.8% vs 82.4%;) and the NEJM cases (61.8% vs 82.4%). On MetaMedQA, Jev's probabilities were the best calibrated (expected calibration error 0.063 vs 0.146), and its answers with a probability of at least 0.9 (52.9% of questions) were 93.4% accurate, but GPT-6 Sol was as accurate when it accepted a similar proportion of questions. On DiagnosisArena-MCQ, Jev's probabilities discriminated poorly (AUROC 0.645 vs 0.768). Of the 162 questions whose correct answer was "I don't know or cannot answer", Jev chose that option for 10.5% (GPT-6 Sol, 8.6%). Median latency was 0.27-0.31 s; all 2,823 items cost USD 0.08. Jev was fast and inexpensive, and its accuracy was similar to that of a frontier LLM on research abstracts but lower on examination questions and much lower on complex diagnostic cases. Task-specific validation is required before clinical use.

Automated judges of clinical artificial intelligence (AI) outputs are necessary, but large language model (LLM) judges are costly and slow at scale. We compared Jev, a decision language model that returns structured judgments, with frontier and open-weight LLM judges in four use cases. On 118 pediatric answers, Jev's agreement with physicians' ordinal quality ratings (Gwet's AC2 0.50; expected score 0.53) matched or exceeded that of seven of 12 LLM judges, including frontier models, Claude Opus 5.5 (0.49) and GPT-6 (0.38). On physician-graded binary HealthBench criteria, Jev matched or exceeded four of six LLM judges. On MedHELM's open-ended tasks, Jev's agreement with a three-LLM jury approached or exceeded the jurors' internal agreement. On HealthBench Professional, Jev matched the benchmark's reference judge, GPT-5.4, on 91% of criteria (other judges, 91-93%). Frontier judges cost 73-294 times more than Jev and took 7-57 times longer. Jev may enable efficient clinical AI evaluation at scale.