Healthcare

Ask about this topic

Overview

Healthcare AI uses patient records, medical images, signals, and conversations to support tasks such as diagnosis, risk prediction, treatment planning, and care coordination. Common approaches include supervised learning, multimodal foundation models, retrieval-augmented generation, knowledge graphs, and reinforcement learning. Systems are tested on resources such as MIMIC-IV, MedQA, and CheXpert, as well as through clinician studies and workflow evaluations. A central challenge is that strong benchmark results do not guarantee safe, fair, reliable performance with incomplete information, changing clinical settings, or real patients, so prospective validation and careful governance remain essential.

Latest papers

CardsList

622 papers24 papers in the last four weeks, down 40% on the four weeks before. 0.1% of all new papers.

Jan 25, 2026

Health-ORSC-Bench: A Benchmark for Measuring Over-Refusal and Safety Completion in Health Context

Safety alignment in Large Language Models is critical for healthcare; however, reliance on binary refusal boundaries often results in over-refusal of benign queries or unsafe compliance with harmful ones. While existing benchmarks measure these extremes, they fail to evaluate Safe Completion: the model's ability to maximise helpfulness on dual-use or borderline queries by providing safe, high-level guidance without crossing into actionable harm. We introduce Health-ORSC-Bench, the first large-scale benchmark designed to systematically measure Over-Refusal and Safe Completion quality in healthcare. Comprising 31,920 benign boundary prompts across seven health categories (e.g., self-harm, medical misinformation), our framework uses an automated pipeline with human validation to test models at varying levels of intent ambiguity. We evaluate 30 state-of-the-art LLMs, including GPT-5 and Claude-4, revealing a significant tension: safety-optimised models frequently refuse up to 80% of "Hard" benign prompts, while domain-specific models often sacrifice safety for utility. Our findings demonstrate that model family and size significantly influence calibration: larger frontier models (e.g., GPT-5, Llama-4) exhibit "safety-pessimism" and higher over-refusal than smaller or MoE-based counterparts (e.g., Qwen-3-Next), highlighting that current LLMs struggle to balance refusal and compliance. Health-ORSC-Bench provides a rigorous standard for calibrating the next generation of medical AI assistants toward nuanced, safe, and helpful completions. Furthermore, our benchmark facilitates reproducible evaluation, encourages safety calibration, and supports development of clinically reliable, context-aware, human-aligned medical AI systems. Our code and data are available at: https://github.com/ZhihaoZhang97/Health-ORSC-Bench. Warning: Some contents may include toxic or undesired contents.

Zhihao Zhang, Liting Huang, Guanghao Wu +3

Macquarie University1 · UTS2 · MBZUAI3 +1

LLM Safety BenchmarksLanguage Model Safety EvaluationHealthcareLLM RefusalLLM Refusal BehaviorOver-Refusal+2
AskPDF
Jan 23, 2026

SycoEval-EM: Sycophancy Evaluation of Large Language Models in Simulated Clinical Encounters for Emergency Care

Large language models (LLMs) deployed in clinical decision support may acquiesce to patient requests for care that conflicts with evidence-based guidelines. We developed SycoEval-EM, a multi-agent simulation framework to evaluate LLM robustness to adversarial patient persuasion in emergency medicine. Across 19 contemporary LLMs and 1,425 simulated clinical encounters spanning three Choosing Wisely scenarios, acquiescence rates ranged from 0% to 100%, revealing a bimodal distribution. Seven models maintained near-perfect guideline adherence, while six acquiesced in the majority of encounters. Vulnerability varied substantially across clinical scenarios. Acquiescence was highest for CT imaging requests, intermediate for antibiotic prescriptions for sinusitis, and lowest for opioid prescriptions for acute back pain. Model scale, recency, and performance on static medical benchmarks did not consistently predict robustness. All five persuasion tactics produced similar acquiescence rates, with no statistically significant differences after correction for multiple comparisons, suggesting a generalized susceptibility rather than tactic-specific weaknesses. LLM-as-judge evaluation was validated against two independent physician raters across 95 matched conversations and demonstrated near-perfect agreement for the primary outcome of acquiescence (Cohens kappa = 0.957). These findings indicate that static medical benchmarks are insufficient to predict safety performance under sustained social pressure and support incorporating multi-turn adversarial testing into clinical AI evaluation. Notably, two models achieved perfect guideline adherence across all encounters, demonstrating that robustness to patient pressure is attainable without sacrificing effective clinical communication.

Dongshen Peng, Yi Wang, Austin Schoeffler +5

UNC Chapel Hill · University of Waterloo · Stanford University

LLM SycophancyLanguage Model Safety EvaluationHealthcareAdversarial Robustness of Language ModelsClinical Language Model EvaluationMedical LLMs
AskPDF
Jan 22, 2026

Towards Reliable Medical LLMs: Benchmarking and Enhancing Confidence Estimation of Large Language Models in Medical Consultation

Large-scale language models (LLMs) often offer clinical judgments based on incomplete information, increasing the risk of misdiagnosis. Existing studies have primarily evaluated confidence in single-turn, static settings, overlooking the coupling between confidence and correctness as clinical evidence accumulates during real consultations, which limits their support for reliable decision-making. We propose the first benchmark for assessing confidence in multi-turn interaction during realistic medical consultations. Our benchmark unifies three types of medical data for open-ended diagnostic generation and introduces an information sufficiency gradient to characterize the confidence-correctness dynamics as evidence increases. We implement and compare 27 representative methods on this benchmark; two key insights emerge: (1) medical data amplifies the inherent limitations of token-level and consistency-level confidence methods, and (2) medical reasoning must be evaluated for both diagnostic accuracy and information completeness. Based on these insights, we present MedConf, an evidence-grounded linguistic self-assessment framework that constructs symptom profiles via retrieval-augmented generation, aligns patient information with supporting, missing, and contradictory relations, and aggregates them into an interpretable confidence estimate through weighted integration. Across two LLMs and three medical datasets, MedConf consistently outperforms state-of-the-art methods on both AUROC and Pearson correlation coefficient metrics, maintaining stable performance under conditions of information insufficiency and multimorbidity. These results demonstrate that information adequacy is a key determinant of credible medical confidence modeling, providing a new pathway toward building more reliable and interpretable large medical models.

Zhiyao Ren, Yibing Zhan, Siyuan Liang +3

Nanyang Technological University, Singapore, Singapore. · Wuhan University, Wuhan, China.

HealthcareClinical ReasoningLLM Uncertainty EstimationClinical Language Model EvaluationMedical LLMs
AskPDF
Jan 20, 2026

LifeAgentBench: Benchmarking LLMs for Long-Horizon, Cross-Dimensional Lifestyle Health Reasoning

Personalized lifestyle health analysis requires long-horizon, multi-dimensional reasoning over heterogeneous lifestyle signals, and recent advances in mobile sensing and large language models (LLMs) make such support increasingly feasible. However, the capabilities of current LLMs in this setting remain insufficiently understood due to the lack of systematic benchmarks. In this paper, we introduce LifeAgentBench, a large-scale QA benchmark for long-horizon, cross-dimensional, and multi-user lifestyle health reasoning, containing 22,573 questions spanning from basic retrieval to complex reasoning. We release an extensible benchmark construction pipeline and a standardized evaluation protocol, deriving verifiable answers through executable queries and programs to support reliable assessment. We then systematically evaluate 13 representative LLMs on LifeAgentBench and identify key bottlenecks in long-horizon aggregation and cross-dimensional reasoning. Motivated by these findings, we propose LifeAgent, a tool-augmented reasoning baseline that decomposes complex queries, performs multi-step evidence retrieval, and invokes tools for deterministic aggregation. LifeAgent substantially enhances LLMs' capabilities on challenging reasoning tasks, achieving clear improvements over widely used baselines and showing potential for health reasoning in everyday scenarios. The benchmark is publicly available.

Ye Tian, Zihao Wang, Onat Gungor +2

University of California San Diego, La Jolla, CA, USA · Google Research, Mountain View, CA, USA

HealthcareLong-Horizon Agent EvaluationAI Agent BenchmarksLLM Tool Use
AskPDF
Jan 19, 2026

RubRIX: Rubric-Driven Risk Mitigation in Caregiver-AI Interactions

Caregivers seeking AI-mediated support express complex needs---information-seeking, emotional validation, and distress cues---that warrant careful evaluation of response safety and appropriateness. Existing AI evaluation frameworks, primarily focused on general risks (toxicity, hallucinations, policy violations, etc), may not adequately capture the nuanced risks of LLM-responses in caregiving-contexts. We introduce RubRIX (Rubric-based Risk Index), a theory-driven, clinician-validated framework for evaluating risks in LLM caregiving responses. Grounded in the Elements of an Ethic of Care, RubRIX operationalizes five empirically-derived risk dimensions: Inattention, Bias & Stigma, Information Inaccuracy, Uncritical Affirmation, and Epistemic Arrogance. We evaluate six state-of-the-art LLMs on over 20,000 caregiver queries from Reddit and ALZConnected. Rubric-guided refinement consistently reduced risk-components by 45-98% after one iteration across models. This work contributes a methodological approach for developing domain-sensitive, user-centered evaluation frameworks for high-burden contexts. Our findings highlight the importance of domain-sensitive, interactional risk evaluation for the responsible deployment of LLMs in caregiving support contexts. We release benchmark datasets to enable future research on contextual risk evaluation in AI-mediated support.

Drishti Goel, Jeongah Lee, Qiuyue Joy Zhong +5

University of Illinois Urbana-Champaign · University of Massachusetts Amherst · OSF HealthCare +1

Language Model Safety EvaluationLLM Safety EvaluationRubric-Based EvaluationLLM Safety BenchmarksHealthcare
AskPDF
Jan 10, 2026

Imaging-anchored multiomics in cardiovascular disease: integrating cardiac imaging, bulk, single-cell, and spatial transcriptomics

Cardiovascular disease arises from interactions between inherited risk, molecular programmes, and tissue-scale remodelling that are observed clinically through imaging. Cardiac MRI (CMR), computed tomography (CT), and echocardiography are integral to routine cardiovascular care, while bulk RNA sequencing, single-cell RNA sequencing, and spatial transcriptomics are providing increasingly detailed molecular characterization of cardiac tissue. Yet, these imaging and molecular data are still analysed in largely separate pipelines. This review examines joint representations that link cardiac imaging phenotypes to transcriptomic and spatially resolved molecular states. An imaging-anchored perspective is adopted in which echocardiography, CMR, and CT define a spatial phenotype of the heart, and bulk, single-cell and spatial transcriptomics provide cell-type- and location-specific molecular context. We define the representation requirements of each modality, compare multimodal fusion strategies, and synthesize integrative pipelines for radiogenomics, spatial alignment, and image-based gene-expression prediction, together with their validation requirements, limitations, and failure modes. Spatial multiomic maps of human myocardium and atherosclerotic plaque, together with single-cell, spatial, and multimodal medical foundation models, are advancing imaging-anchored multiomics; however, cost, scalability, and tissue availability remain substantial barriers to large-scale cardiovascular translation.

Minh H. N. Le, Thanh-Huy Nguyen, Tao Li +7

International Ph.D. Program in Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan · AIBioMed Research Group, Taipei Medical University, Taipei, Taiwan · Computational Biology Department, School of Computer Science, Carnegie Mellon University, Pittsburgh, PA, USA +6

Multimodal FusionSpatial TranscriptomicsHealthcare
AskPDF
Jan 6, 2026

EpiQAL: Benchmarking Large Language Models in Epidemiological Question Answering and Reasoning

Reliable epidemiological reasoning requires synthesizing study evidence to infer disease burden, transmission dynamics, and intervention effects at the population level. Existing medical question answering benchmarks primarily emphasize clinical knowledge or patient-level reasoning, yet few systematically evaluate evidence-grounded epidemiological inference. We present EpiQAL, to our knowledge the first diagnostic benchmark for epidemiological question answering over research literature, comprising three subsets built from open-access articles across diverse diseases. The three subsets progressively test factual recall, multi-step inference, and conclusion reconstruction under incomplete information, and are constructed through a quality-controlled pipeline combining taxonomy guidance, multi-model verification, and difficulty screening. Experiments on fifteen models spanning open-source and proprietary systems reveal that current LLMs show limited performance on epidemiological reasoning, with multi-step inference posing the greatest challenge. Model rankings shift across subsets, and scale alone does not predict success. Chain-of-Thought prompting benefits multi-step inference but yields mixed results elsewhere. EpiQAL provides fine-grained diagnostic signals for evidence-grounding, inferential reasoning, and conclusion reconstruction.

Mingyang Wei, Dehai Min, Zewen Liu +8

1Emory University · University of Illinois Chicago · 3Microsoft

LLM EvaluationHealthcareEvidence-Grounded ReasoningBiomedical QAMedical Reasoning
AskPDF
Jan 6, 2026

MAPLE: Medical Aspect-Based Summarization with Phrase-Level Evidence

Trustworthy clinical summarization requires every claim to be traceable to its evidence, yet existing attribution often resolves only to the sentence or document, leaving clinicians to scan surrounding text for the few words that matter. We argue that the unit of attribution should match the unit of verification: the precise phrase the reader's eye must land on. We present MAPLE (Medical Aspect-Based Summarization with Phrase-Level Evidence), a human-annotated benchmark that grounds each summarized claim in both cited sentences and contributory phrases within them. Spanning 152 randomized controlled trial (RCT) abstracts and 16 clinically motivated aspects, MAPLE comprises 1,799 aspect-based summaries with two-level evidence. We further introduce a decoupled evaluation framework that separately scores content, traceability, and locatability, together with a proxy for the amount of source text a clinician must inspect to verify a claim. Benchmarking eleven LLMs shows that sentence-level citation is consistently strong (C-F1 up to 90.9%), while phrase-level grounding remains less stable and the most discriminative axis across models (P-F1 66.1-84.5%). These results suggest that the key challenge is not only producing accurate summaries, but localizing their supporting evidence precisely enough for efficient clinical verification. Data and code are available at https://github.com/chubohao/maple.

Bohao Chu, Hendrik Damm, Tabea M. G. Pakull +5

University of Duisburg-Essen · University of Applied Sciences and Arts Dortmund · University Hospital Essen +1

HealthcareText SummarizationSummarization EvaluationEvidence-Grounded GenerationClinical Language Model Evaluation
AskPDF
Jan 5, 2026

ELF: A Family of Encoder-Free ECG-Language Models

ECG-Language Models (ELMs) extend recent advances in Multimodal Large Language Models (MLLMs) to automated ECG interpretation. However, most existing ELMs inherit Vision-Language Model (VLM) design choices and rely on pretrained ECG encoders, introducing substantial architectural and training complexity. Inspired by encoder-free VLMs, we introduce ELF, a family of three encoder-free ELMs that remain competitive with, and often outperform, prior state-of-the-art ELMs across two datasets despite substantially simpler architectures and training pipelines. All code and data are available at github.com/ELM-Research/ECG-Language-Models.

William Han, Tony Chen, Chaojing Duan +6

Carnegie Mellon University, USA · Allegheny Health Network, USA · University of California, Los Angeles, USA +1

HealthcareElectrocardiographyMultimodal Large Language ModelsElectrocardiogram InterpretationMultimodal Learning
AskPDF
Dec 26, 2025

Safety boundary maintenance in consumer AI systems responding to pediatric health queries: a cross-platform benchmark evaluation under naturalistic and adversarially pressured conditions

Consumer artificial intelligence chatbots are now accessed by hundreds of millions of users seeking health information, yet systematic evaluation of their safety boundary maintenance under real-world caregiver pressure remains scarce. We evaluated PediatricSafetyBench-v2, a benchmark of 600 pediatrics health queries comprising 300 authentic caregiver queries sourced from the HealthCareMagic-100k-en physician consultation corpus and 300 matched adversarial variants incorporating six operationalized caregiver pressure patterns, across four consumer AI systems (GPT-4o-mini, Gemini-2.0-Flash, Claude-3.5-Haiku, and Llama-3.1-8B). Safety boundary maintenance was assessed using a validated five-component Safety Composite Score (maximum 15 points; safety-appropriate threshold of 10 or above), validated against independent human raters prior to full-corpus application (mean weighted kappa 0.76; Pearson r = 0.88). The overall safety-appropriate rate was 95.5%. Safety-oriented system prompt deployment improved safety-appropriate rates by 5.9 percentage points across all four models. Counter-intuitively, adversarial caregiver pressure was associated with higher rather than lower Safety Composite Score values for all four models across all ten topic categories and severity levels. False expertise claims were the most vulnerability-inducing pressure pattern, whereas emotional escalation was associated with the highest scores. Consumer AI systems maintain safety boundaries in the large majority of pediatrics health interactions. PediatricSafetyBench-v2 is publicly released for longitudinal safety monitoring.

Vahideh Zolfaghari, Leila Mashhadi, Mitra Ahadi +2

Medical Sciences Education Research Center, Mashhad University of Medical Sciences, Mashhad, Iran. · Student Research Committee, Department of Health Information Technology and Management, Medical Informatics, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran. · Department of Anesthesiology and Intensive Care, Mashhad University of Medical Sciences, Mashhad, Iran. +2

HealthcareLLM SafetyMedical QAAdversarial Robustness of Language ModelsLLM Safety Evaluation
AskPDF
Dec 25, 2025

Context-Aware Classification and Grading of Sensitive Information in Online Conversational Health Data

Online medical consultations contain sensitive health information whose privacy implications depend not only on the entities mentioned but also on how those entities are described in context. Existing classification and grading approaches often map health-information entities directly to predefined sensitivity levels, potentially overlooking whether a condition is confirmed, suspected, negated, hypothetical, or merely planned for investigation. In this study, we formulate sensitive-information grading in online medical dialogues as a context-aware evaluation task. We develop a standard-informed operational framework that incorporates assertion status, experiencer, test-result status, and information granularity. We further design a naturalistic evaluation setting together with contrastive cases that minimally alter negation, uncertainty, experiencer, or granularity, and compare large language models under mention-only and full-context conditions. The study aims to quantify the contribution of contextual information to sensitivity grading and to characterize safety-critical over- and under-grading errors. Our framework provides a reproducible basis for evaluating whether LLMs can distinguish sensitive entity mentions from contextually established sensitive disclosures.

Yiwei Yan, Guanfeng Liu

School of Computing, Macquarie University, Australia

HealthcareText ClassificationLLM Safety EvaluationClinical Language Model Evaluation
AskPDF
Dec 16, 2025

Ophiuchus: Incentivizing Tool-augmented "Think with Images" for Joint Medical Segmentation, Understanding and Reasoning

Recent medical MLLMs have made significant progress in generating step-by-step textual reasoning chains. However, they still struggle with complex clinical tasks that necessitate dynamic and iterative focusing on fine-grained visual regions. To close this gap, we introduce Ophiuchus, a versatile, tool-augmented framework that equips an MLLM to (i) decide when fine-grained visual evidence is needed, (ii) determine where to probe and ground within the medical image, and (iii) seamlessly weave the relevant sub-image content back into an interleaved, multimodal chain of thought for precise segmentation and diagnosis. Ophiuchus moves beyond mere tool-calling by tightly fusing the MLLM's inherent grounding and reasoning capabilities with external tools, enabling more accurate and trustworthy decisions. The core of our method is a three-stage training strategy: cold-start SFT for basic tool selection; self-reflection fine-tuning to strengthen decision revision; and agentic tool reinforcement learning to elicit sophisticated, expert-like diagnostic behaviors. Extensive experiments show that Ophiuchus consistently outperforms both closed-source and open-source SOTA methods across diverse medical benchmarks, including VQA, detection, and reasoning-based segmentation. Our project code is available at https://github.com/SII-zyj/Ophiuchus.

Yankai Jiang, Yujie Zhang, Peng Zhang +5

Zhejiang University · Shanghai Artificial Intelligence Laboratory · Shanghai Innovation Institute +5

Image SegmentationTool Use in VLMsHealthcareMedical VQAMedical VLMsMedical Image Segmentation+2
AskPDF
Dec 9, 2025

An Agentic AI System for Multi-Framework Communication Coding

Clinical communication is central to patient outcomes, yet large-scale human annotation of patient-provider conversation remains labor-intensive, inconsistent, and difficult to scale. Existing approaches based on large language models typically rely on single-task models that lack adaptability, interpretability, and reliability, especially when applied across various communication frameworks and clinical domains. In this study, we developed a Multi-framework Structured Agentic AI system for Clinical Communication (MOSAIC), built on a LangGraph-based architecture that orchestrates four core agents, including a Plan Agent for codebook selection and workflow planning, an Update Agent for maintaining up-to-date retrieval databases, a set of Annotation Agents that applies codebook-guided retrieval-augmented generation (RAG) with dynamic few-shot prompting, and a Verification Agent that provides consistency checks and feedback. To evaluate performance, we compared MOSAIC outputs against gold-standard annotations created by trained human coders. We developed and evaluated MOSAIC using 26 gold standard annotated transcripts for training and 50 transcripts for testing, spanning rheumatology and OB/GYN domains. On the test set, MOSAIC achieved an overall F1 score of 0.928. Performance was highest in the Rheumatology subset (F1 = 0.962) and strongest for Patient Behavior (e.g., patients asking questions, expressing preferences, or showing assertiveness). Ablations revealed that MOSAIC outperforms baseline benchmarking.

Bohao Yang, Rui Yang, Joshua M. Biro +14

Department of Biostatistics and Bioinformatics, Duke School of Medicine, Durham, NC, USA · Centre for Quantitative Medicine, Duke-NUS Medical School, Singapore, Singapore · Medstar Health National Center for Human Factors in Healthcare, Washington, DC, USA +5

HealthcareClinical Information ExtractionMulti-Agent LLM SystemsAgentic RAGLLM Agent Orchestration
AskPDF
Dec 8, 2025

CLARITY: Medical World Model for Guiding Treatment Decisions by Modeling Context-Aware Disease Trajectories in Latent Space

Clinical decision-making in oncology requires predicting dynamic disease evolution, a task current static AI predictors cannot perform. While world models (WMs) offer a paradigm for generative prediction, existing medical applications remain limited. Existing methods often rely on stochastic diffusion models, focusing on visual reconstruction rather than causal, physiological transitions. Furthermore, in medical domain, models like MeWM typically ignore patient-specific temporal and clinical contexts and lack a feedback mechanism to link predictions to treatment decisions. To address these gaps, we introduce CLARITY, a medical world model that forecasts disease evolution directly within a structured latent space. It explicitly integrates time intervals (temporal context) and patient-specific data (clinical context) to model treatment-conditioned progression as a smooth, interpretable trajectory, and thus generate physiologically faithful, individualized treatment plans. Finally, CLARITY introduces a novel prediction-to-decision framework, translating latent rollouts into transparent, actionable recommendations. CLARITY demonstrates state-of-the-art performance in treatment planning. On the MU-Glioma-Post dataset, our approach outperforms recent MeWM by 12%, and significantly surpasses all other medical-specific large language models.

Tianxingjian Ding, Yuanhao Zou, Chen Chen +2

Institute of Artificial Intelligence, University of Central Florida

Disease Progression ModelingHealthcareClinical Decision SupportClinical Decision-MakingOncologyLatent World Models
AskPDF
Dec 6, 2025

JEEVHITAA -- An HCAI Ecosystem to Support Collective Care

Current mobile health platforms are predominantly individual-centric and lack the support for coordinated, auditable multi-actor workflows. However, in many settings worldwide, health decisions are enacted through multi-actor coordination rather than individual users. We present JEEVHITAA, a cross-platform mobile system enabling role-aware sharing and verifiable information flows within permissioned care circles. JEEVHITAA ingests platform and device data, builds layered profiles from sensors and tiered onboarding, and enforces fine-grained, time-bounded access control across care graphs. Data stays secure both within the application and the cloud. Integrated retrieval-augmented Large Language Models produce structured, role-targeted summaries and action plans, offer evidence-grounded verification with provenance and confidence scores, and support advanced insights on reports. We describe the architecture, connector abstractions, and security primitives, and report robustness evaluations using synthetic, ontology-driven data and findings from a feasibility study with real-life care circles across 9-14 weeks. We outline plans for larger multi-site evaluations focusing on operational alignment, longitudinal trust & literacy impact, and relational friction & efforts to sink into the daily infrastructure.

Shyama Sastha Krishnamoorthy Srinivasan, Harsh Pala, Mohan Kumar +1

IIIT-Delhi New Delhi, India · RIT, NY Rochester, New York, US

HealthcareClinical Decision SupportHuman-Centered AIAccess Control
AskPDF
Dec 5, 2025

Multilingual Medical Reasoning for Question Answering with Large Language Models

Large Language Models (LLMs) with reasoning capabilities have recently demonstrated strong potential in medical Question Answering (QA). Existing approaches are largely English-focused and primarily rely on distillation from general-purpose LLMs, raising concerns about the reliability of their medical knowledge. In this work, we present a method to generate multilingual reasoning traces based on medical knowledge extracted from Wikipedia. We produce 500k traces in English, Italian, and Spanish, using a retrieval-augmented generation approach over medical information from Wikipedia. The traces are generated to solve medical questions drawn from MedQA and MedMCQA, which we extend to Italian and Spanish. We test our pipeline in both in-domain and out-of-domain settings across Medical QA benchmarks, and demonstrate that our reasoning traces improve performance both when utilized via in-context learning (few-shot) and supervised fine-tuning, yielding state-of-the-art results among 8B-parameter LLMs. We believe that these resources can support the development of more transparent clinical decision-support tools in multilingual settings. We release the full suite of resources: reasoning traces, translated QA datasets, Medical-Wikipedia, and fine-tuned models.

Pietro Ferrazzi, Aitor Soroa, Rodrigo Agerri

Fondazione Bruno Kessler, Trento, Italy · HiTZ Center - Ixa, University of the Basque Country EHU, Spain

Knowledge Augmentation for Language ModelsHealthcareMedical QAMultilingual QAMedical ReasoningMedical LLMs
AskPDF
Dec 3, 2025

6 Fingers, 1 Kidney: Natural Adversarial Medical Images Reveal Critical Weaknesses of Vision-Language Models

Vision-language models (VLMs) are increasingly integrated into clinical workflows. However, existing benchmarks primarily assess performance on common anatomical presentations and fail to capture the challenges posed by rare variants. To address this gap, we introduce AdversarialAnatomyBench, the first benchmark comprising naturally occurring rare anatomical variants across diverse imaging modalities and anatomical regions. We call such variants that violate learned priors about "typical" human anatomy natural adversarial anatomy. Benchmarking 25 state-of-the-art VLMs with AdversarialAnatomyBench yielded three key insights. First, when queried with basic medical perception tasks, mean accuracy dropped from 71% on typical to 28% on atypical anatomy. Even the best-performing models, GPT-5, Gemini 2.5 Pro, and Llama 4 Maverick, showed performance drops of 41-51%. Second, model errors closely mirrored expected anatomical biases. Third, neither model scaling nor interventions, including bias-aware prompting and test-time reasoning, resolved these issues. These findings highlight a critical limitation in current VLMs: their poor generalization to rare anatomical presentations. AdversarialAnatomyBench provides a foundation for systematically measuring and mitigating anatomical bias in multimodal medical artificial intelligence (AI) systems.

Leon Mayer, Piotr Kalinowski, Caroline Ebersbach +6

German Cancer Research Center (DKFZ) Heidelberg, Division of Intelligent Medical Systems, Germany. · Medical Faculty, Heidelberg University, Germany. · Faculty of Mathematics and Computer Science, Heidelberg University, Germany. +9

VLM EvaluationVLM RobustnessHealthcareOOD GeneralizationMedical VLMsMedical Image Benchmarks
AskPDF
Dec 1, 2025

First, do NOHARM: a medical safety benchmark and randomized study of physician and AI teaming on clinical consultations

Large language models (LLMs) and medical AI tools are routinely used by physicians and patients for medical advice, yet their clinical safety profiles remain poorly characterized. We present NOHARM (Numerous Options Harm Assessment for Risk in Medicine), a 1,100-task benchmark of primary care-to-specialist consultation cases to measure the frequency and severity of potentially harmful errors from LLM-generated medical consultation recommendations. NOHARM covers 10 specialties, with 12,747 expert annotations for 4,249 clinical management options. Across 20 notable LLMs and 4 widely used retrieval-augmented generation (RAG) clinical AI tools, direct application of recommendations carried potential for severe harm in up to 24.6% of cases, with errors of omission accounting for more than 80% of severe errors. Harm potential was not uniform across systems, with clinical AI tools outperforming generalist LLMs, and multi-agent AI teaming further improving performance in generalist models. In a randomized study of 101 U.S.-licensed generalist physicians, AI assistance improved physician performance compared to conventional resources. However, AI-assisted physicians frequently omitted valuable AI-generated recommendations and still scored lower than many AI systems alone. Had those recommendations been incorporated, combined human-AI responses would have outperformed both the human and AI system as used, suggesting complementary strengths and unrealized potential in human-AI teaming. Collectively, these results show that despite strong performance on medical knowledge benchmarks, widely used AI tools can produce medical consultation advice with the potential for severe harm, and highlight the need for explicit measurement of clinical safety. The benchmark and leaderboard are publicly available to support ongoing evaluation and improvement of AI systems used for clinical care.

David Wu, Fateme Nateghi Haredasht, Saloni Kumar Maharaj +54

HealthcareClinical Decision SupportHuman-in-the-Loop AIAI Safety EvaluationClinical Language Model Evaluation
AskPDF
Nov 30, 2025

Generalised Medical Phrase Grounding

Medical phrase grounding (MPG) maps textual descriptions of radiological findings to corresponding image regions. These grounded reports are easier to interpret, especially for non-experts. Existing MPG systems mostly follow the referring expression comprehension (REC) paradigm and return exactly one bounding box per phrase. Real reports often violate this assumption. They contain multi-region findings, non-diagnostic text, and non-groundable phrases, such as negations or descriptions of normal anatomy. Motivated by this, we reformulate the task as generalised medical phrase grounding (GMPG), where each sentence is mapped to zero, one, or multiple scored regions. To realise this formulation, we introduce the first GMPG model: MedGrounder. We adopted a two-stage training regime: pre-training on report sentence--anatomy box alignment datasets and fine-tuning on report sentence--human annotated box datasets. Experiments on PadChest-GR and MS-CXR show that MedGrounder achieves strong zero-shot transfer and outperforms REC-style and grounded report generation baselines on multi-region and non-groundable phrases, while using far fewer human box annotations. Finally, we show that MedGrounder can be composed with existing report generators to produce grounded reports without retraining the generator.

Wenjun Zhang, Shekhar S. Chandra, Aaron Nicolson

The University of Queensland, Brisbane, Australia · Australian e-Health Research Centre, CSIRO Health and Biosecurity, Australia

Radiology VLMsHealthcareMedical Image Grounding
AskPDF
Nov 28, 2025

Auditable Context-Aware HFMD Forecasting with Structured LLM Agents

Effective HFMD surveillance requires forecasts capturing both time-series patterns and contextual drivers such as school calendars, weather, and policy or surveillance reports. In clinical settings, forecasts must be trusted and actionable; thus, beyond point accuracy, decision-makers require concise, auditable explanations of why risk is expected to rise or fall. Classical models (e.g., ARIMA and Prophet) and foundation models (e.g., Chronos, Moirai, and TimesFM) treat external covariates as numerical inputs, lacking semantic reasoning to reflect epidemiological mechanisms or resolve conflicting signals. We propose a two-agent neuro-symbolic framework that decouples contextual interpretation from probabilistic forecasting. An LLM-based Event Interpreter ingests heterogeneous signals -- school schedules, weather summaries, government reports, and clinical guidelines -- and outputs a scalar transmission-impact signal. A Forecast Generator combines this signal with historical case counts to produce point forecasts that are mapped to probabilistic predictions through Poisson/negative-binomial moment matching. We focus on one-week-ahead rolling forecasts, aligning with weekly hospital-capacity planning and the rapid, context-driven inflections typical of HFMD. We evaluate on two datasets: Hong Kong surveillance (90 target weeks in 2023--2024) and Lishui hospital visits (33 target weeks in 2024). Against traditional and foundation-model baselines, our approach achieves competitive point accuracy while providing robust 90% intervals (coverage approximately 0.85--1.00) and concise rationales. This demonstrates that integrating domain knowledge through LLM-based agents can match strong numerical forecasters while yielding interpretable, context-aware forecasts aligned with public-health decision-making.

Joongwon Chae, Runming Wang, Chen Xiong +5

Institute of Biomedicine and Health Engineering, Tsinghua Shenzhen International Graduate School (SIGS), Tsinghua University, Shenzhen, China · The First Hospital of Hebei Medical University, Shijiazhuang, China · The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui 323000, China +1

Epidemic ForecastingExplainable Time Series ForecastingHealthcareTime Series ForecastingLLM-Based Time Series ForecastingMulti-Agent LLMs+1
AskPDF
Nov 20, 2025

MedBayes-Lite: A Clinical Uncertainty Governance Layer for Risk-Aware Medical Decision Support

Clinical language models often assign high confidence to incorrect predictions, particularly in high-severity and out-of-distribution cases. We present MedBayes-Lite, a retraining-free uncertainty governance layer for transformer-based clinical predictors. It combines Monte Carlo dropout, predictive calibration, and confidence-guided abstention to defer low-confidence predictions for human review, adding no trainable parameters. Evaluated on MedMCQA and MedQA-USMLE, MedBayes-Lite reduces expected calibration error by 0.23 to 0.33 and drives harmful overconfident errors (confident, incorrect, high-severity predictions) toward zero. Under domain shift from MedMCQA to MedQA-USMLE, it reduces confident high-severity errors from about 21% to near zero while roughly halving calibration drift. We also introduce the Clinical Uncertainty Score (CUS), which strongly correlates with harmful overconfidence (r approximately 0.88). Although the framework does not improve risk-coverage ranking, and temperature scaling or deep ensembles may provide advantages in calibration cost or risk ranking, MedBayes-Lite offers a practical calibration-and-abstention layer that reduces confident high-severity errors in clinical question-answering benchmarks.

Elias Hossain, Md Mehedi Hasan Nipu, Maleeha Sheikh +5

College of Engineering and Computer Science, University of Central Florida, Orlando, FL 32816, USA · Department of Computer Science and Engineering, North South University, Dhaka 1229, Bangladesh · Department of Electrical and Computer Engineering, Purdue University Fort Wayne, Fort Wayne, IN 46805, USA +4

Selective PredictionHealthcareClinical Decision SupportLLM Uncertainty EstimationMedical LLMsUncertainty Calibration
AskPDF
Nov 17, 2025

MedGEN-Bench: A Contextually Entangled Benchmark for Open-ended Multimodal Medical Generation

Medical vision-language models (VLMs) are increasingly expected to support clinical workflows through diagnostic text and relevant medical images. However, current medical visual benchmarks have three recurring limitations: query-image misalignment from queries weakly grounded in specific image instances, closed-ended formats that narrow answer space and encourage shortcut-based prediction, and text-centric output paradigms that limit evaluation of image-generation and image-editing capabilities. We introduce MedGEN-Bench, a benchmark for open-ended multimodal medical generation. The evaluation snapshot reported in this manuscript comprises 6,422 image-text pairs reviewed by clinical experts and models, spanning 6 canonical imaging modalities, 15 clinical tasks, and 27 named subtasks. It includes 1,100 Visual Question Answering (VQA) pairs, 3,872 Image Editing pairs, and 1,450 Contextual Multimodal Generation pairs. MedGEN-Bench centers on contextual entanglement: dependence of an instruction's intended output on the particular image instance rather than on task wording alone. The benchmark operationalizes this concept through image-grounded instructions and extends evaluation to open-ended multimodal outputs. Its tiered evaluation protocol combines reproducible reference-based fidelity and similarity measures with a structured, checklist-guided assessment by a medical VLM judge. We evaluate 10 compositional frameworks, 2 dedicated image-editing models, 3 unified models, and 5 VLMs. The results show image-output tasks remain unsaturated. Contextual augmentation increases mean image-instruction similarity from 0.273 to 0.372, while a 1,000-case medical-expert audit shows moderate agreement between judge scores and clinician ratings. Source code and dataset are available at https://yangjj007.github.io/medgen.

Junjie Yang, Yuhao Yan, Gang Wu +12

South China University of Technology · Sun Yat-sen University · Hangzhou Dianzi University +10

HealthcareMultimodal GenerationImage Generation EvaluationImage EditingMultimodal Model EvaluationMedical Image Benchmarks
AskPDF
Nov 12, 2025

Generative AI Purpose-built for Social and Mental Health: A Real-World Pilot

Generative AI chatbots built for mental health could extend access to care, but evidence from real-world use is limited. We report a single-arm, naturalistic pilot of a foundation model trained for mental health, among 299 US adults with at least moderate depressive or anxiety symptoms who were followed for up to 12 months. Depression and anxiety symptoms fell by 10 weeks (Cohen's d 0.93 and 0.79), with loneliness, behavioral activation, and social interaction improving. Clinicians confirmed that automated safeguards were escalated appropriately. Participants fell into non-responding (57.2%), improving (37.1%) and rapidly improving (5.7%) trajectories. Early working alliance and greater engagement were associated with better outcomes. The AI deployed ten identified intervention families whose delivery varied with baseline anxiety and depression, with the overall ratio of clinical to non-clinical content increasing according to severity without survey information access. These findings support the feasibility of purpose-built AI for mental health.

Thomas D. Hull, Lizhe Zhang, Caitlin A. Stamatis +2

Slingshot AI · CREATIV Lab, Department of Psychiatry and Behavioral Sciences, University of Washington · Department of Psychiatry, NYU School of Medicine +1

HealthcareMental HealthMental Health Conversational AgentsConversational AgentsGenerative AI Evaluation
AskPDF
Nov 7, 2025

Towards Cellular-Scale Interpretability in Pathology Foundation Models for Biomarker Assessment

Molecular biomarker testing in pathology is often costly and tissue-consuming, limiting scalable clinical deployment. Artificial intelligence applied to hematoxylin and eosin (HE)-stained histology could enable rapid biomarker screening, but clinical translation requires models that are both accurate and interpretable. Here we introduce Hireca, a biomarker-focused pathology foundation model pretrained on more than 80,000 whole-slide images spanning 38 organ types from three medical centers, together with CytoMap, an interpretability module that localizes cellular-scale evidence underlying predictions. Across 10 biomarker tasks encompassing morphological, molecular, genetic, and spatial-transcriptomic-proxy readouts, Hireca ranked first in five tasks and outperformed comparable models overall. In evaluation by eight pathologists from two countries, CytoMap was consistently preferred over alternative visualization approaches and revealed error patterns in difficult cases. These results position Hireca and CytoMap as a transparent framework for clinically reviewable biomarker assessment directly from routine HE histology.

Jingsong Liu, Han Li, Zhengyang Xu +19

Institute of Pathology, Technical University of Munich, Munich, Germany · Munich Center for Machine Learning (MCML), Munich, Germany · Munich Data Science Institute (MDSI), Munich, Germany +6

Computational PathologyHealthcarePathology Foundation ModelsExplainable Medical Image AnalysisWhole-Slide Image Analysis
AskPDF
Nov 4, 2025

AyurParam: A State-of-the-Art Bilingual Language Model for Ayurveda

Current large language models excel at broad, general-purpose tasks, but consistently underperform when exposed to highly specialized domains that require deep cultural, linguistic, and subject-matter expertise. In particular, traditional medical systems such as Ayurveda embody centuries of nuanced textual and clinical knowledge that mainstream LLMs fail to accurately interpret or apply. We introduce AyurParam-2.9B, a domain-specialized, bilingual language model fine-tuned from Param-1-2.9B using an extensive, expertly curated Ayurveda dataset spanning classical texts and clinical guidance. AyurParam's dataset incorporates context-aware, reasoning, and objective-style Q&A in both English and Hindi, with rigorous annotation protocols for factual precision and instructional clarity. Benchmarked on BhashaBench-Ayur, AyurParam not only surpasses all open-source instruction-tuned models in its size class (1.5--3B parameters), but also demonstrates competitive or superior performance compared to much larger models. The results from AyurParam highlight the necessity for authentic domain adaptation and high-quality supervision in delivering reliable, culturally congruent AI for specialized medical knowledge.

Sravan Gorugantu, Mohd Nauman, Vijay Devane +7

BharatGen Team

Medical LLMsHealthcareDomain Adaptation for LLMsLLM Fine-TuningMultilingual Language Models
AskPDF
Nov 3, 2025

An Explanation-oriented Inquiry Dialogue Game for Expert Collaborative Recommendations

This work presents a requirement analysis for collaborative dialogues among medical experts and an inquiry dialogue game based on this analysis for incorporating explainability into multiagent system design. The game allows experts with different knowledge bases to collaboratively make recommendations while generating rich traces of the reasoning process through combining explanation-based illocutionary forces in an inquiry dialogue. The dialogue game was implemented as a prototype web-application and evaluated against the specification through a formative user study. The user study confirms that the dialogue game meets the needs for collaboration among medical experts. It also provides insights on the real-life value of dialogue-based communication tools for the medical community.

Qurat-ul-ain Shaheen, Katarzyna Budzynska, Carles Sierra

IIIA, CSIC, Barcelona, Spain · Software Competence Centre Hagenberg, Hagenberg, Austria · Laboratory of The New Ethos, Faculty of Administration and Social Sciences, Warsaw University of Technology, Warsaw, Poland

Explainable Artificial IntelligenceHealthcareMulti-Agent CollaborationClinical Decision-MakingMulti-Agent Communication
AskPDF
Nov 1, 2025

MedRECT: A Bilingual Medical Reasoning Benchmark for Error Correction in Clinical Texts

Large language models (LLMs) show promise in medical applications, but their ability to detect and correct errors in clinical texts remains under-evaluated, particularly beyond English. We introduce MedRECT, a bilingual benchmark for Japanese and English that formulates medical error handling as three subtasks: error detection, error sentence extraction, and error correction. MedRECT-ja contains 663 samples derived from the Japanese Medical Licensing Examinations, while the separately sourced MedRECT-en contains 458 samples curated from MEDEC. We evaluate 11 LLMs across 17 configurations that cover proprietary and open-weight models, medical-domain specialization, and multiple reasoning settings. Qwen3-32B scores higher in its thinking mode than in its non-thinking mode on error detection F1 and sentence extraction accuracy in both subsets, with sentence extraction accuracy higher by 24.5 percentage points on MedRECT-ja and 10.3 on MedRECT-en. Several leading general-purpose reasoning models outperform all three evaluated medical-domain models on these two subtasks. Most models have lower point estimates on the Japanese subset, although absolute scores are not directly comparable because the subsets differ in source material and error distributions. LoRA fine-tuning yields higher sentence extraction accuracy and higher point estimates on all three reference-based correction similarity metrics in both languages. MedRECT provides an open, reusable evaluation resource for studying medical error correction and reasoning across Japanese and English. Our dataset and code are available at https://github.com/pfnet-research/medrect.

Naoto Iwase, Hiroki Okuyama, Junichiro Iwasawa

Preferred Networks, Inc., Tokyo, Japan · School of Medicine, Nagoya University, Nagoya, Japan

Multilingual Language Model EvaluationHealthcareClinical Language Model EvaluationClinical NLPMedical LLMs
AskPDF
Oct 29, 2025

MedForj: An open, large-scale foundational generative prior for high-resolution 3D brain MRI

This work introduces MedForj, a suite of 3D foundational generative priors based on diffusion models. The MedForj models were trained on 72,65972{,}659 1~mm isotropic 3D T1T_1-weighted MRI human brain image volumes from 38,17438{,}174 subjects, drawn from a curated corpus of 80,67580{,}675 volumes from 42,50642{,}506 subjects spanning 3838 publicly available datasets. These training images were manually inspected to exclude those with poor quality and excessive pathology, and otherwise were minimally processed. The models include six different diffusion training strategies: rectified flow, latent diffusion rectified flow, flow matching, velocity prediction, clean prediction, and noise prediction. Image samples produced by each of these models were compared to each other and against real, ground truth data under downstream segmentation distributions, FID, five inverse problems, and blind human inspection in an observer study. Flow matching was the strongest strategy overall, achieving the best inverse problem solving results at 28.8028.80~dB PSNR and 0.8740.874 SSIM averaged over the five forward problems, the highest rate of reconstructions judged real by blind human raters at 72.6%72.6\%, and the closest per-structure match to real segmented anatomy in a permutation test. It was not best everywhere: rectified flow produced the most convincing unconditional samples in the observer study and the best FID, and the latent rectified-flow model achieved the smallest joint distributional distance to real anatomy. No other strategy, however, performed consistently well across all four evaluations. We therefore recommend flow matching as the default MedForj prior, while releasing every strategy so that the choice can be revisited per application. All model weights and corresponding code are publicly available at https://github.com/piksl-research/medforj.

Samuel W. Remedios, Aaron Carass, Jerry L. Prince +1

Image Analysis and Communications Laboratory, Johns Hopkins University · Department of Neurology, Johns Hopkins Hospital

Flow MatchingHealthcare3D Medical ImagingMedical Image SynthesisDiffusion-Based Inverse Problems3D Diffusion Models+1
AskPDF
Oct 20, 2025

Zoom In Disparities in Healthcare LLM Q&A

Equitable access to reliable health information is vital when integrating AI into healthcare. Yet, information quality varies across languages, raising concerns about the reliability and consistency of multilingual Large Language Models (LLMs). We systematically examine cross-lingual disparities in pre-training source and factuality alignment in LLM answers for multilingual healthcare Q&A across English, German, Turkish, Chinese (Mandarin), and Italian. We (i) constructed Multilingual Wiki Health Care (MultiWikiHealthCare), a multilingual dataset from Wikipedia; (ii) analyzed cross-lingual healthcare coverage; (iii) assessed LLM response alignment with these references; and (iv) conducted a case study on factual alignment through the use of contextual information and Retrieval-Augmented Generation (RAG). Our findings reveal substantial cross-lingual disparities in both Wikipedia coverage and LLM factual alignment. Across LLMs, responses align more with English Wikipedia, even when the prompts are non-English. Providing contextual excerpts from non-English Wikipedia at inference time effectively shifts factual alignment toward culturally relevant knowledge. These results highlight practical pathways for building more equitable, multilingual AI systems for healthcare.

Ipek Baris Schlicht, Burcu Sayin, Zhixue Zhao +5

Universitat Politècnica de València, Valencia, Spain · University of Trento, Trento, Italy · University of Sheffield, Sheffield, UK +5

Multilingual Language Model EvaluationKnowledge Augmentation for Language ModelsHealthcareMultilingual QAFactual Knowledge in Language ModelsClinical Language Model Evaluation
AskPDF
Oct 5, 2025

A global log for medical AI

Modern computer systems rely on syslog, a universal protocol that records critical events across heterogeneous infrastructure. Medicine's rapidly growing AI stack has no equivalent. As medicine deploys AI tools at scale, there is no standard way to record how, when, by whom, and for whom these models are used. Without such records, it is difficult to measure real-world performance and outcomes, detect adverse events, or identify bias and dataset drift. Here we introduce MedLog, a protocol for event-level logging of medical AI. Each time an AI model interacts with a human, another algorithm, or an automated workflow, MedLog creates a record. Each record contains nine core fields: header, model, user, target, inputs, artifacts, outputs, outcomes, and feedback. We apply MedLog across four deployments in the US, Switzerland, and Vietnam: ICU deterioration prediction, tetanus progression monitoring from wearable signals, automated sepsis quality reporting, and patient attendance prediction. MedLog records capture model behavior, workflow interactions, and downstream outcomes, including AI performance degradation during severe weather events in patient attendance prediction and increased laboratory testing after ICU deterioration alerts. MedLog limits the data footprint through risk-based sampling, lifecycle-aware retention policies, and write-behind caching, enabling deployment in low-resource settings. It also supports detailed traces for complex, agentic, or multi-stage workflows, creating a foundation for continuous monitoring, auditing, and improvement of medical AI.

Ayush Noori, Aaron E. Boussina, Hai Ho Bich +48

Algorithmic AuditingHealthcare
AskPDF