Daily Papers

Medical quality control indicators are essential to assess the qualifications of healthcare institutions for medical services. With the impressive performance of large language models (LLMs) like GPT-4 in the medical field, leveraging these technologies for the Medical Quality Control Indicator Calculation (MQCIC) presents a promising approach. In this work, (1) we introduce a real-world task MQCIC and propose an open-source Chinese electronic medical records (EMRs)-based dataset (CMQCIC-Bench) comprising 785 instances and 76 indicators. (2) We propose a semi-automatic method to enhance the rule representation. Then we propose the Clinical Facts-based Inferential Rule (CF-IR) method that disentangles the clinical fact verification and inferential rule reasoning actions. (3) We conduct comprehensive experiments on 20 representative LLMs, covering general and medical models. Our findings reveal that CF-IR outperforms Chain-of-Thought methods in MQCIC tasks. (4) We conduct an error analysis and investigate the capabilities of clinical fact verification and inferential rule reasoning, providing insights to improve performance in the MQCIC further. The dataset and code is available in this repository https://github.com/YuY-2001/C-MQCIC.

With the emergence of large-scale vision language models (VLM), it is now possible to produce realistic-looking radiology reports for chest X-ray images. However, their clinical translation has been hampered by the factual errors and hallucinations in the produced descriptions during inference. In this paper, we present a novel phrase-grounded fact-checking model (FC model) that detects errors in findings and their indicated locations in automatically generated chest radiology reports. Specifically, we simulate the errors in reports through a large synthetic dataset derived by perturbing findings and their locations in ground truth reports to form real and fake findings-location pairs with images. A new multi-label cross-modal contrastive regression network is then trained on this dataset. We present results demonstrating the robustness of our method in terms of accuracy of finding veracity prediction and localization on multiple X-ray datasets. We also show its effectiveness for error detection in reports of SOTA report generators on multiple datasets achieving a concordance correlation coefficient of 0.997 with ground truth-based verification, thus pointing to its utility during clinical inference in radiology workflows.

Seeking health-related advice on the internet has become a common practice in the digital era. Determining the trustworthiness of medical claims found online and finding appropriate evidence for this information is increasingly challenging. Fact-checking has emerged as an approach to assess the veracity of factual claims using evidence from credible knowledge sources. To help advance the automation of this task, in this paper, we introduce a novel dataset of 750 health-related claims, labeled for veracity by medical experts and backed with evidence from appropriate clinical studies. We provide an analysis of the dataset, highlighting its characteristics and challenges. The dataset can be used for Machine Learning tasks related to automated fact-checking such as evidence retrieval, veracity prediction, and explanation generation. For this purpose, we provide baseline models based on different approaches, examine their performance, and discuss the findings.

Fact-checking is the task of verifying the veracity of claims by assessing their assertions against credible evidence. The vast majority of fact-checking studies focus exclusively on political claims. Very little research explores fact-checking for other topics, specifically subject matters for which expertise is required. We present the first study of explainable fact-checking for claims which require specific expertise. For our case study we choose the setting of public health. To support this case study we construct a new dataset PUBHEALTH of 11.8K claims accompanied by journalist crafted, gold standard explanations (i.e., judgments) to support the fact-check labels for claims. We explore two tasks: veracity prediction and explanation generation. We also define and evaluate, with humans and computationally, three coherence properties of explanation quality. Our results indicate that, by training on in-domain data, gains can be made in explainable, automated fact-checking for claims which require specific expertise.

While Large Language Models (LLMs) can generate fluent and convincing responses, they are not necessarily correct. This is especially apparent in the popular decompose-then-verify factuality evaluation pipeline, where LLMs evaluate generations by decomposing the generations into individual, valid claims. Factuality evaluation is especially important for medical answers, since incorrect medical information could seriously harm the patient. However, existing factuality systems are a poor match for the medical domain, as they are typically only evaluated on objective, entity-centric, formulaic texts such as biographies and historical topics. This differs from condition-dependent, conversational, hypothetical, sentence-structure diverse, and subjective medical answers, which makes decomposition into valid facts challenging. We propose MedScore, a new pipeline to decompose medical answers into condition-aware valid facts and verify against in-domain corpora. Our method extracts up to three times more valid facts than existing methods, reducing hallucination and vague references, and retaining condition-dependency in facts. The resulting factuality score substantially varies by decomposition method, verification corpus, and used backbone LLM, highlighting the importance of customizing each step for reliable factuality evaluation by using our generalizable and modularized pipeline for domain adaptation.

We introduce scientific claim verification, a new task to select abstracts from the research literature containing evidence that SUPPORTS or REFUTES a given scientific claim, and to identify rationales justifying each decision. To study this task, we construct SciFact, a dataset of 1.4K expert-written scientific claims paired with evidence-containing abstracts annotated with labels and rationales. We develop baseline models for SciFact, and demonstrate that simple domain adaptation techniques substantially improve performance compared to models trained on Wikipedia or political news. We show that our system is able to verify claims related to COVID-19 by identifying evidence from the CORD-19 corpus. Our experiments indicate that SciFact will provide a challenging testbed for the development of new systems designed to retrieve and reason over corpora containing specialized domain knowledge. Data and code for this new task are publicly available at https://github.com/allenai/scifact. A leaderboard and COVID-19 fact-checking demo are available at https://scifact.apps.allenai.org.

Doctors and patients alike increasingly use Large Language Models (LLMs) to diagnose clinical cases. However, unlike domains such as math or coding, where correctness can be objectively defined by the final answer, medical diagnosis requires both the outcome and the reasoning process to be accurate. Currently, widely used medical benchmarks like MedQA and MMLU assess only accuracy in the final answer, overlooking the quality and faithfulness of the clinical reasoning process. To address this limitation, we introduce MedCaseReasoning, the first open-access dataset for evaluating LLMs on their ability to align with clinician-authored diagnostic reasoning. The dataset includes 14,489 diagnostic question-and-answer cases, each paired with detailed reasoning statements derived from open-access medical case reports. We evaluate state-of-the-art reasoning LLMs on MedCaseReasoning and find significant shortcomings in their diagnoses and reasoning: for instance, the top-performing open-source model, DeepSeek-R1, achieves only 48% 10-shot diagnostic accuracy and mentions only 64% of the clinician reasoning statements (recall). However, we demonstrate that fine-tuning LLMs on the reasoning traces derived from MedCaseReasoning significantly improves diagnostic accuracy and clinical reasoning recall by an average relative gain of 29% and 41%, respectively. The open-source dataset, code, and models are available at https://github.com/kevinwu23/Stanford-MedCaseReasoning.

Claim verification can be a challenging task. In this paper, we present a method to enhance the robustness and reasoning capabilities of automated claim verification through the extraction of short facts from evidence. Our novel approach, FactDetect, leverages Large Language Models (LLMs) to generate concise factual statements from evidence and label these facts based on their semantic relevance to the claim and evidence. The generated facts are then combined with the claim and evidence. To train a lightweight supervised model, we incorporate a fact-detection task into the claim verification process as a multitasking approach to improve both performance and explainability. We also show that augmenting FactDetect in the claim verification prompt enhances performance in zero-shot claim verification using LLMs. Our method demonstrates competitive results in the supervised claim verification model by 15% on the F1 score when evaluated for challenging scientific claim verification datasets. We also demonstrate that FactDetect can be augmented with claim and evidence for zero-shot prompting (AugFactDetect) in LLMs for verdict prediction. We show that AugFactDetect outperforms the baseline with statistical significance on three challenging scientific claim verification datasets with an average of 17.3% performance gain compared to the best performing baselines.

Fact verification aims to automatically probe the veracity of a claim based on several pieces of evidence. Existing works are always engaging in the accuracy improvement, let alone the explainability, a critical capability of fact verification system. Constructing an explainable fact verification system in a complex multi-hop scenario is consistently impeded by the absence of a relevant high-quality dataset. Previous dataset either suffer from excessive simplification or fail to incorporate essential considerations for explainability. To address this, we present EX-FEVER, a pioneering dataset for multi-hop explainable fact verification. With over 60,000 claims involving 2-hop and 3-hop reasoning, each is created by summarizing and modifying information from hyperlinked Wikipedia documents. Each instance is accompanied by a veracity label and an explanation that outlines the reasoning path supporting the veracity classification. Additionally, we demonstrate a novel baseline system on our EX-FEVER dataset, showcasing document retrieval, explanation generation, and claim verification and observe that existing fact verification models trained on previous datasets struggle to perform well on our dataset. Furthermore, we highlight the potential of utilizing Large Language Models in the fact verification task. We hope our dataset could make a significant contribution by providing ample opportunities to explore the integration of natural language explanations in the domain of fact verification.

Factuality can play an important role when automatically processing clinical text, as it makes a difference if particular symptoms are explicitly not present, possibly present, not mentioned, or affirmed. In most cases, a sufficient number of examples is necessary to handle such phenomena in a supervised machine learning setting. However, as clinical text might contain sensitive information, data cannot be easily shared. In the context of factuality detection, this work presents a simple solution using machine translation to translate English data to German to train a transformer-based factuality detection model.

Recent advancements in reasoning-enhanced large language models (LLMs), such as DeepSeek-R1 and OpenAI-o3, have demonstrated significant progress. However, their application in professional medical contexts remains underexplored, particularly in evaluating the quality of their reasoning processes alongside final outputs. Here, we introduce MedR-Bench, a benchmarking dataset of 1,453 structured patient cases, annotated with reasoning references derived from clinical case reports. Spanning 13 body systems and 10 specialties, it includes both common and rare diseases. To comprehensively evaluate LLM performance, we propose a framework encompassing three critical examination recommendation, diagnostic decision-making, and treatment planning, simulating the entire patient care journey. To assess reasoning quality, we present the Reasoning Evaluator, a novel automated system that objectively scores free-text reasoning responses based on efficiency, actuality, and completeness using dynamic cross-referencing and evidence checks. Using this benchmark, we evaluate five state-of-the-art reasoning LLMs, including DeepSeek-R1, OpenAI-o3-mini, and Gemini-2.0-Flash Thinking, etc. Our results show that current LLMs achieve over 85% accuracy in relatively simple diagnostic tasks when provided with sufficient examination results. However, performance declines in more complex tasks, such as examination recommendation and treatment planning. While reasoning outputs are generally reliable, with factuality scores exceeding 90%, critical reasoning steps are frequently missed. These findings underscore both the progress and limitations of clinical LLMs. Notably, open-source models like DeepSeek-R1 are narrowing the gap with proprietary systems, highlighting their potential to drive accessible and equitable advancements in healthcare.

Automatic fact verification has received significant attention recently. Contemporary automatic fact-checking systems focus on estimating truthfulness using numerical scores which are not human-interpretable. A human fact-checker generally follows several logical steps to verify a verisimilitude claim and conclude whether its truthful or a mere masquerade. Popular fact-checking websites follow a common structure for fact categorization such as half true, half false, false, pants on fire, etc. Therefore, it is necessary to have an aspect-based (delineating which part(s) are true and which are false) explainable system that can assist human fact-checkers in asking relevant questions related to a fact, which can then be validated separately to reach a final verdict. In this paper, we propose a 5W framework (who, what, when, where, and why) for question-answer-based fact explainability. To that end, we present a semi-automatically generated dataset called FACTIFY-5WQA, which consists of 391, 041 facts along with relevant 5W QAs - underscoring our major contribution to this paper. A semantic role labeling system has been utilized to locate 5Ws, which generates QA pairs for claims using a masked language model. Finally, we report a baseline QA system to automatically locate those answers from evidence documents, which can serve as a baseline for future research in the field. Lastly, we propose a robust fact verification system that takes paraphrased claims and automatically validates them. The dataset and the baseline model are available at https: //github.com/ankuranii/acl-5W-QA

Language models (LMs) are widely used by an increasing number of users, underscoring the challenge of maintaining factuality across a broad range of topics. We first present VERIFY (Verification and Evidence RetrIeval for FactualitY evaluation), a pipeline to evaluate LMs' factuality in real-world user interactions. VERIFY considers the verifiability of LM-generated content and categorizes content units as supported, unsupported, or undecidable based on the retrieved evidence from the Web. Importantly, factuality judgment by VERIFY correlates better with human evaluations than existing methods. Using VERIFY, we identify "hallucination prompts" across diverse topics, i.e., those eliciting the highest rates of incorrect and inconclusive LM responses. These prompts form FactBench, a dataset of 1K prompts across 150 fine-grained topics. Our dataset captures emerging factuality challenges in real-world LM interactions and can be regularly updated with new prompts. We benchmark widely-used LMs from GPT, Gemini, and Llama3.1 family on FactBench, yielding the following key findings: (i) Proprietary models exhibit better factuality, with performance declining from Easy to Hard hallucination prompts. (ii) Llama3.1-405B-Instruct shows comparable or lower factual accuracy than Llama3.1-70B-Instruct across all evaluation methods due to its higher subjectivity that leads to more content labeled as undecidable. (iii) Gemini1.5-Pro shows a significantly higher refusal rate, with over-refusal in 25% of cases. Our code and data are publicly available at https://huggingface.co/spaces/launch/factbench.

Fact verification has attracted a lot of attention in the machine learning and natural language processing communities, as it is one of the key methods for detecting misinformation. Existing large-scale benchmarks for this task have focused mostly on textual sources, i.e. unstructured information, and thus ignored the wealth of information available in structured formats, such as tables. In this paper we introduce a novel dataset and benchmark, Fact Extraction and VERification Over Unstructured and Structured information (FEVEROUS), which consists of 87,026 verified claims. Each claim is annotated with evidence in the form of sentences and/or cells from tables in Wikipedia, as well as a label indicating whether this evidence supports, refutes, or does not provide enough information to reach a verdict. Furthermore, we detail our efforts to track and minimize the biases present in the dataset and could be exploited by models, e.g. being able to predict the label without using evidence. Finally, we develop a baseline for verifying claims against text and tables which predicts both the correct evidence and verdict for 18% of the claims.

Extracting patient information from unstructured text is a critical task in health decision-support and clinical research. Large language models (LLMs) have shown the potential to accelerate clinical curation via few-shot in-context learning, in contrast to supervised learning which requires much more costly human annotations. However, despite drastic advances in modern LLMs such as GPT-4, they still struggle with issues regarding accuracy and interpretability, especially in mission-critical domains such as health. Here, we explore a general mitigation framework using self-verification, which leverages the LLM to provide provenance for its own extraction and check its own outputs. This is made possible by the asymmetry between verification and generation, where the latter is often much easier than the former. Experimental results show that our method consistently improves accuracy for various LLMs in standard clinical information extraction tasks. Additionally, self-verification yields interpretations in the form of a short text span corresponding to each output, which makes it very efficient for human experts to audit the results, paving the way towards trustworthy extraction of clinical information in resource-constrained scenarios. To facilitate future research in this direction, we release our code and prompts.

In this paper we introduce a new publicly available dataset for verification against textual sources, FEVER: Fact Extraction and VERification. It consists of 185,445 claims generated by altering sentences extracted from Wikipedia and subsequently verified without knowledge of the sentence they were derived from. The claims are classified as Supported, Refuted or NotEnoughInfo by annotators achieving 0.6841 in Fleiss kappa. For the first two classes, the annotators also recorded the sentence(s) forming the necessary evidence for their judgment. To characterize the challenge of the dataset presented, we develop a pipeline approach and compare it to suitably designed oracles. The best accuracy we achieve on labeling a claim accompanied by the correct evidence is 31.87%, while if we ignore the evidence we achieve 50.91%. Thus we believe that FEVER is a challenging testbed that will help stimulate progress on claim verification against textual sources.

Large-language models have recently demonstrated impressive zero-shot capabilities in a variety of natural language tasks such as summarization, dialogue generation, and question-answering. Despite many promising applications in clinical medicine, adoption of these models in real-world settings has been largely limited by their tendency to generate incorrect and sometimes even toxic statements. In this study, we develop Almanac, a large language model framework augmented with retrieval capabilities for medical guideline and treatment recommendations. Performance on a novel dataset of clinical scenarios (n = 130) evaluated by a panel of 5 board-certified and resident physicians demonstrates significant increases in factuality (mean of 18% at p-value < 0.05) across all specialties, with improvements in completeness and safety. Our results demonstrate the potential for large language models to be effective tools in the clinical decision-making process, while also emphasizing the importance of careful testing and deployment to mitigate their shortcomings.

Large language models have achieved strong performance on medical reasoning benchmarks, yet their deployment in clinical settings demands rigorous verification to ensure factual accuracy. While reward models offer a scalable approach for reasoning trace verification, existing methods face two limitations: they produce only scalar reward values without explicit justification, and they rely on single-pass retrieval that precludes adaptive knowledge access as verification unfolds. We introduce method, an agentic framework that addresses these limitations by training medical reasoning verifiers to iteratively query external medical corpora during evaluation. Our approach combines tool-augmented verification with an iterative reinforcement learning paradigm that requires only trace-level supervision, alongside an adaptive curriculum mechanism that dynamically adjusts training data distribution. Across four medical reasoning benchmarks, method achieves substantial gains over existing methods, improving MedQA accuracy by 23.5% and MedXpertQA by 32.0% relative to the base generator in particular. Crucially, method demonstrates an 8times reduction in sampling budget requirement compared to prior reward model baselines. These findings establish that grounding verification in dynamically retrieved evidence offers a principled path toward more reliable medical reasoning systems.

Typical fact verification models use retrieved written evidence to verify claims. Evidence sources, however, often change over time as more information is gathered and revised. In order to adapt, models must be sensitive to subtle differences in supporting evidence. We present VitaminC, a benchmark infused with challenging cases that require fact verification models to discern and adjust to slight factual changes. We collect over 100,000 Wikipedia revisions that modify an underlying fact, and leverage these revisions, together with additional synthetically constructed ones, to create a total of over 400,000 claim-evidence pairs. Unlike previous resources, the examples in VitaminC are contrastive, i.e., they contain evidence pairs that are nearly identical in language and content, with the exception that one supports a given claim while the other does not. We show that training using this design increases robustness -- improving accuracy by 10% on adversarial fact verification and 6% on adversarial natural language inference (NLI). Moreover, the structure of VitaminC leads us to define additional tasks for fact-checking resources: tagging relevant words in the evidence for verifying the claim, identifying factual revisions, and providing automatic edits via factually consistent text generation.

Assessing whether an article supports an assertion is essential for hallucination detection and claim verification. While large language models (LLMs) have the potential to automate this task, achieving strong performance requires frontier models such as GPT-5 that are prohibitively expensive to deploy at scale. To efficiently perform biomedical evidence attribution, we present Med-V1, a family of small language models with only three billion parameters. Trained on high-quality synthetic data newly developed in this study, Med-V1 substantially outperforms (+27.0% to +71.3%) its base models on five biomedical benchmarks unified into a verification format. Despite its smaller size, Med-V1 performs comparably to frontier LLMs such as GPT-5, along with high-quality explanations for its predictions. We use Med-V1 to conduct a first-of-its-kind use case study that quantifies hallucinations in LLM-generated answers under different citation instructions. Results show that the format instruction strongly affects citation validity and hallucination, with GPT-5 generating more claims but exhibiting hallucination rates similar to GPT-4o. Additionally, we present a second use case showing that Med-V1 can automatically identify high-stakes evidence misattributions in clinical practice guidelines, revealing potentially negative public health impacts that are otherwise challenging to identify at scale. Overall, Med-V1 provides an efficient and accurate lightweight alternative to frontier LLMs for practical and real-world applications in biomedical evidence attribution and verification tasks. Med-V1 is available at https://github.com/ncbi-nlp/Med-V1.

Cancer patients are increasingly turning to large language models (LLMs) as a new form of internet search for medical information, making it critical to assess how well these models handle complex, personalized questions. However, current medical benchmarks focus on medical exams or consumer-searched questions and do not evaluate LLMs on real patient questions with detailed clinical contexts. In this paper, we first evaluate LLMs on cancer-related questions drawn from real patients, reviewed by three hematology oncology physicians. While responses are generally accurate, with GPT-4-Turbo scoring 4.13 out of 5, the models frequently fail to recognize or address false presuppositions in the questions-posing risks to safe medical decision-making. To study this limitation systematically, we introduce Cancer-Myth, an expert-verified adversarial dataset of 585 cancer-related questions with false presuppositions. On this benchmark, no frontier LLM -- including GPT-4o, Gemini-1.Pro, and Claude-3.5-Sonnet -- corrects these false presuppositions more than 30% of the time. Even advanced medical agentic methods do not prevent LLMs from ignoring false presuppositions. These findings expose a critical gap in the clinical reliability of LLMs and underscore the need for more robust safeguards in medical AI systems.

Misinformation and disinformation demand fact checking that goes beyond simple evidence-based reasoning. Existing benchmarks fall short: they are largely single modality (text-only), span short time horizons, use shallow evidence, cover domains unevenly, and often omit full articles -- obscuring models' real-world capability. We present MMM-Fact, a large-scale benchmark of 125,449 fact-checked statements (1995--2025) across multiple domains, each paired with the full fact-check article and multimodal evidence (text, images, videos, tables) from four fact-checking sites and one news outlet. To reflect verification effort, each statement is tagged with a retrieval-difficulty tier -- Basic (1--5 sources), Intermediate (6--10), and Advanced (>10) -- supporting fairness-aware evaluation for multi-step, cross-modal reasoning. The dataset adopts a three-class veracity scheme (true/false/not enough information) and enables tasks in veracity prediction, explainable fact-checking, complex evidence aggregation, and longitudinal analysis. Baselines with mainstream LLMs show MMM-Fact is markedly harder than prior resources, with performance degrading as evidence complexity rises. MMM-Fact offers a realistic, scalable benchmark for transparent, reliable, multimodal fact-checking.

Despite substantial progress in fact-verification benchmarks, claims grounded in large-scale structured data remain underexplored. In this work, we introduce ClaimDB, the first fact-verification benchmark where the evidence for claims is derived from compositions of millions of records and multiple tables. ClaimDB consists of 80 unique real-life databases covering a wide range of domains, from governance and healthcare to media, education and the natural sciences. At this scale, verification approaches that rely on "reading" the evidence break down, forcing a timely shift toward reasoning in executable programs. We conduct extensive experiments with 30 state-of-the-art proprietary and open-source (below 70B) LLMs and find that none exceed 83% accuracy, with more than half below 55%. Our analysis also reveals that both closed- and open-source models struggle with abstention -- the ability to admit that there is no evidence to decide -- raising doubts about their reliability in high-stakes data analysis. We release the benchmark, code, and the LLM leaderboard at https://claimdb.github.io .

Plain language summarization with LLMs can be useful for improving textual accessibility of technical content. But how factual are these summaries in a high-stakes domain like medicine? This paper presents FactPICO, a factuality benchmark for plain language summarization of medical texts describing randomized controlled trials (RCTs), which are the basis of evidence-based medicine and can directly inform patient treatment. FactPICO consists of 345 plain language summaries of RCT abstracts generated from three LLMs (i.e., GPT-4, Llama-2, and Alpaca), with fine-grained evaluation and natural language rationales from experts. We assess the factuality of critical elements of RCTs in those summaries: Populations, Interventions, Comparators, Outcomes (PICO), as well as the reported findings concerning these. We also evaluate the correctness of the extra information (e.g., explanations) added by LLMs. Using FactPICO, we benchmark a range of existing factuality metrics, including the newly devised ones based on LLMs. We find that plain language summarization of medical evidence is still challenging, especially when balancing between simplicity and factuality, and that existing metrics correlate poorly with expert judgments on the instance level.

With the proliferation of Large Language Models (LLMs) in diverse domains, there is a particular need for unified evaluation standards in clinical medical scenarios, where models need to be examined very thoroughly. We present CliMedBench, a comprehensive benchmark with 14 expert-guided core clinical scenarios specifically designed to assess the medical ability of LLMs across 7 pivot dimensions. It comprises 33,735 questions derived from real-world medical reports of top-tier tertiary hospitals and authentic examination exercises. The reliability of this benchmark has been confirmed in several ways. Subsequent experiments with existing LLMs have led to the following findings: (i) Chinese medical LLMs underperform on this benchmark, especially where medical reasoning and factual consistency are vital, underscoring the need for advances in clinical knowledge and diagnostic accuracy. (ii) Several general-domain LLMs demonstrate substantial potential in medical clinics, while the limited input capacity of many medical LLMs hinders their practical use. These findings reveal both the strengths and limitations of LLMs in clinical scenarios and offer critical insights for medical research.

The meaningful use of electronic health records (EHR) continues to progress in the digital era with clinical decision support systems augmented by artificial intelligence. A priority in improving provider experience is to overcome information overload and reduce the cognitive burden so fewer medical errors and cognitive biases are introduced during patient care. One major type of medical error is diagnostic error due to systematic or predictable errors in judgment that rely on heuristics. The potential for clinical natural language processing (cNLP) to model diagnostic reasoning in humans with forward reasoning from data to diagnosis and potentially reduce the cognitive burden and medical error has not been investigated. Existing tasks to advance the science in cNLP have largely focused on information extraction and named entity recognition through classification tasks. We introduce a novel suite of tasks coined as Diagnostic Reasoning Benchmarks, DR.BENCH, as a new benchmark for developing and evaluating cNLP models with clinical diagnostic reasoning ability. The suite includes six tasks from ten publicly available datasets addressing clinical text understanding, medical knowledge reasoning, and diagnosis generation. DR.BENCH is the first clinical suite of tasks designed to be a natural language generation framework to evaluate pre-trained language models. Experiments with state-of-the-art pre-trained generative language models using large general domain models and models that were continually trained on a medical corpus demonstrate opportunities for improvement when evaluated in DR. BENCH. We share DR. BENCH as a publicly available GitLab repository with a systematic approach to load and evaluate models for the cNLP community.

Large language models (LLMs) are increasingly used in healthcare, but their reliability is heavily influenced by user-driven factors such as question phrasing and the completeness of clinical information. In this study, we examined how misinformation framing, source authority, model persona, and omission of key clinical details affect the diagnostic accuracy and reliability of LLM outputs. We conducted two experiments: one introducing misleading external opinions with varying assertiveness (perturbation test), and another removing specific categories of patient information (ablation test). Using public datasets (MedQA and Medbullets), we evaluated proprietary models (GPT-4o, Claude 3.5 Sonnet, Claude 3.5 Haiku, Gemini 1.5 Pro, Gemini 1.5 Flash) and open-source models (LLaMA 3 8B, LLaMA 3 Med42 8B, DeepSeek R1 8B). All models were vulnerable to user-driven misinformation, with proprietary models especially affected by definitive and authoritative language. Assertive tone had the greatest negative impact on accuracy. In the ablation test, omitting physical exam findings and lab results caused the most significant performance drop. Although proprietary models had higher baseline accuracy, their performance declined sharply under misinformation. These results highlight the need for well-structured prompts and complete clinical context. Users should avoid authoritative framing of misinformation and provide full clinical details, especially for complex cases.

We contribute the largest publicly available dataset of naturally occurring factual claims for the purpose of automatic claim verification. It is collected from 26 fact checking websites in English, paired with textual sources and rich metadata, and labelled for veracity by human expert journalists. We present an in-depth analysis of the dataset, highlighting characteristics and challenges. Further, we present results for automatic veracity prediction, both with established baselines and with a novel method for joint ranking of evidence pages and predicting veracity that outperforms all baselines. Significant performance increases are achieved by encoding evidence, and by modelling metadata. Our best-performing model achieves a Macro F1 of 49.2%, showing that this is a challenging testbed for claim veracity prediction.

The internet gives the world an open platform to express their views and share their stories. While this is very valuable, it makes fake news one of our society's most pressing problems. Manual fact checking process is time consuming, which makes it challenging to disprove misleading assertions before they cause significant harm. This is he driving interest in automatic fact or claim verification. Some of the existing datasets aim to support development of automating fact-checking techniques, however, most of them are text based. Multi-modal fact verification has received relatively scant attention. In this paper, we provide a multi-modal fact-checking dataset called FACTIFY 2, improving Factify 1 by using new data sources and adding satire articles. Factify 2 has 50,000 new data instances. Similar to FACTIFY 1.0, we have three broad categories - support, no-evidence, and refute, with sub-categories based on the entailment of visual and textual data. We also provide a BERT and Vison Transformer based baseline, which achieves 65% F1 score in the test set. The baseline codes and the dataset will be made available at https://github.com/surya1701/Factify-2.0.

We present SciClaimEval, a new scientific dataset for the claim verification task. Unlike existing resources, SciClaimEval features authentic claims, including refuted ones, directly extracted from published papers. To create refuted claims, we introduce a novel approach that modifies the supporting evidence (figures and tables), rather than altering the claims or relying on large language models (LLMs) to fabricate contradictions. The dataset provides cross-modal evidence with diverse representations: figures are available as images, while tables are provided in multiple formats, including images, LaTeX source, HTML, and JSON. SciClaimEval contains 1,664 annotated samples from 180 papers across three domains, machine learning, natural language processing, and medicine, validated through expert annotation. We benchmark 11 multimodal foundation models, both open-source and proprietary, across the dataset. Results show that figure-based verification remains particularly challenging for all models, as a substantial performance gap remains between the best system and human baseline.

Verifying scientific claims presents a significantly greater challenge than verifying political or news-related claims. Unlike the relatively broad audience for political claims, the users of scientific claim verification systems can vary widely, ranging from researchers testing specific hypotheses to everyday users seeking information on a medication. Additionally, the evidence for scientific claims is often highly complex, involving technical terminology and intricate domain-specific concepts that require specialized models for accurate verification. Despite considerable interest from the research community, there is a noticeable lack of large-scale scientific claim verification datasets to benchmark and train effective models. To bridge this gap, we introduce two large-scale datasets, SciClaimHunt and SciClaimHunt_Num, derived from scientific research papers. We propose several baseline models tailored for scientific claim verification to assess the effectiveness of these datasets. Additionally, we evaluate models trained on SciClaimHunt and SciClaimHunt_Num against existing scientific claim verification datasets to gauge their quality and reliability. Furthermore, we conduct human evaluations of the claims in proposed datasets and perform error analysis to assess the effectiveness of the proposed baseline models. Our findings indicate that SciClaimHunt and SciClaimHunt_Num serve as highly reliable resources for training models in scientific claim verification.

Our society is facing rampant misinformation harming public health and trust. To address the societal challenge, we introduce FACT-GPT, a system leveraging Large Language Models (LLMs) to automate the claim matching stage of fact-checking. FACT-GPT, trained on a synthetic dataset, identifies social media content that aligns with, contradicts, or is irrelevant to previously debunked claims. Our evaluation shows that our specialized LLMs can match the accuracy of larger models in identifying related claims, closely mirroring human judgment. This research provides an automated solution for efficient claim matching, demonstrates the potential of LLMs in supporting fact-checkers, and offers valuable resources for further research in the field.

Following the global COVID-19 pandemic, the number of scientific papers studying the virus has grown massively, leading to increased interest in automated literate review. We present a clinical text mining system that improves on previous efforts in three ways. First, it can recognize over 100 different entity types including social determinants of health, anatomy, risk factors, and adverse events in addition to other commonly used clinical and biomedical entities. Second, the text processing pipeline includes assertion status detection, to distinguish between clinical facts that are present, absent, conditional, or about someone other than the patient. Third, the deep learning models used are more accurate than previously available, leveraging an integrated pipeline of state-of-the-art pretrained named entity recognition models, and improving on the previous best performing benchmarks for assertion status detection. We illustrate extracting trends and insights, e.g. most frequent disorders and symptoms, and most common vital signs and EKG findings, from the COVID-19 Open Research Dataset (CORD-19). The system is built using the Spark NLP library which natively supports scaling to use distributed clusters, leveraging GPUs, configurable and reusable NLP pipelines, healthcare specific embeddings, and the ability to train models to support new entity types or human languages with no code changes.

With the explosive growth of scientific publications, making the synthesis of scientific knowledge and fact checking becomes an increasingly complex task. In this paper, we propose a multi-task approach for verifying the scientific questions based on a joint reasoning from facts and evidence in research articles. We propose an intelligent combination of (1) an automatic information summarization and (2) a Boolean Question Answering which allows to generate an answer to a scientific question from only extracts obtained after summarization. Thus on a given topic, our proposed approach conducts structured content modeling based on paper abstracts to answer a scientific question while highlighting texts from paper that discuss the topic. We based our final system on an end-to-end Extractive Question Answering (EQA) combined with a three outputs classification model to perform in-depth semantic understanding of a question to illustrate the aggregation of multiple responses. With our light and fast proposed architecture, we achieved an average error rate of 4% and a F1-score of 95.6%. Our results are supported via experiments with two QA models (BERT, RoBERTa) over 3 Million Open Access (OA) articles in the medical and health domains on Europe PMC.

Several studies showed that Large Language Models (LLMs) can answer medical questions correctly, even outperforming the average human score in some medical exams. However, to our knowledge, no study has been conducted to assess the ability of language models to validate existing or generated medical text for correctness and consistency. In this paper, we introduce MEDEC (https://github.com/abachaa/MEDEC), the first publicly available benchmark for medical error detection and correction in clinical notes, covering five types of errors (Diagnosis, Management, Treatment, Pharmacotherapy, and Causal Organism). MEDEC consists of 3,848 clinical texts, including 488 clinical notes from three US hospital systems that were not previously seen by any LLM. The dataset has been used for the MEDIQA-CORR shared task to evaluate seventeen participating systems [Ben Abacha et al., 2024]. In this paper, we describe the data creation methods and we evaluate recent LLMs (e.g., o1-preview, GPT-4, Claude 3.5 Sonnet, and Gemini 2.0 Flash) for the tasks of detecting and correcting medical errors requiring both medical knowledge and reasoning capabilities. We also conducted a comparative study where two medical doctors performed the same task on the MEDEC test set. The results showed that MEDEC is a sufficiently challenging benchmark to assess the ability of models to validate existing or generated notes and to correct medical errors. We also found that although recent LLMs have a good performance in error detection and correction, they are still outperformed by medical doctors in these tasks. We discuss the potential factors behind this gap, the insights from our experiments, the limitations of current evaluation metrics, and share potential pointers for future research.

The deployment of Large Language Models (LLMs) in high-stakes clinical settings demands rigorous and reliable evaluation. However, existing medical benchmarks remain static, suffering from two critical limitations: (1) data contamination, where test sets inadvertently leak into training corpora, leading to inflated performance estimates; and (2) temporal misalignment, failing to capture the rapid evolution of medical knowledge. Furthermore, current evaluation metrics for open-ended clinical reasoning often rely on either shallow lexical overlap (e.g., ROUGE) or subjective LLM-as-a-Judge scoring, both inadequate for verifying clinical correctness. To bridge these gaps, we introduce LiveMedBench, a continuously updated, contamination-free, and rubric-based benchmark that weekly harvests real-world clinical cases from online medical communities, ensuring strict temporal separation from model training data. We propose a Multi-Agent Clinical Curation Framework that filters raw data noise and validates clinical integrity against evidence-based medical principles. For evaluation, we develop an Automated Rubric-based Evaluation Framework that decomposes physician responses into granular, case-specific criteria, achieving substantially stronger alignment with expert physicians than LLM-as-a-Judge. To date, LiveMedBench comprises 2,756 real-world cases spanning 38 medical specialties and multiple languages, paired with 16,702 unique evaluation criteria. Extensive evaluation of 38 LLMs reveals that even the best-performing model achieves only 39.2%, and 84% of models exhibit performance degradation on post-cutoff cases, confirming pervasive data contamination risks. Error analysis further identifies contextual application-not factual knowledge-as the dominant bottleneck, with 35-48% of failures stemming from the inability to tailor medical knowledge to patient-specific constraints.

Understanding the prevalence of misinformation in health topics online can inform public health policies and interventions. However, measuring such misinformation at scale remains a challenge, particularly for high-stakes but understudied topics like opioid-use disorder (OUD)--a leading cause of death in the U.S. We present the first large-scale study of OUD-related myths on YouTube, a widely-used platform for health information. With clinical experts, we validate 8 pervasive myths and release an expert-labeled video dataset. To scale labeling, we introduce MythTriage, an efficient triage pipeline that uses a lightweight model for routine cases and defers harder ones to a high-performing, but costlier, large language model (LLM). MythTriage achieves up to 0.86 macro F1-score while estimated to reduce annotation time and financial cost by over 76% compared to experts and full LLM labeling. We analyze 2.9K search results and 343K recommendations, uncovering how myths persist on YouTube and offering actionable insights for public health and platform moderation.

Large language models (LLMs) have achieved strong performance on medical exam-style tasks, motivating growing interest in their deployment in real-world clinical settings. However, clinical decision-making is inherently safety-critical, context-dependent, and conducted under evolving evidence. In such situations, reliable LLM performance depends not on factual recall alone, but on robust medical reasoning. In this work, we present a comprehensive review of medical reasoning with LLMs. Grounded in cognitive theories of clinical reasoning, we conceptualize medical reasoning as an iterative process of abduction, deduction, and induction, and organize existing methods into seven major technical routes spanning training-based and training-free approaches. We further conduct a unified cross-benchmark evaluation of representative medical reasoning models under a consistent experimental setting, enabling a more systematic and comparable assessment of the empirical impact of existing methods. To better assess clinically grounded reasoning, we introduce MR-Bench, a benchmark derived from real-world hospital data. Evaluations on MR-Bench expose a pronounced gap between exam-level performance and accuracy on authentic clinical decision tasks. Overall, this survey provides a unified view of existing medical reasoning methods, benchmarks, and evaluation practices, and highlights key gaps between current model performance and the requirements of real-world clinical reasoning.

Foundation Models that are capable of processing and generating multi-modal data have transformed AI's role in medicine. However, a key limitation of their reliability is hallucination, where inaccurate or fabricated information can impact clinical decisions and patient safety. We define medical hallucination as any instance in which a model generates misleading medical content. This paper examines the unique characteristics, causes, and implications of medical hallucinations, with a particular focus on how these errors manifest themselves in real-world clinical scenarios. Our contributions include (1) a taxonomy for understanding and addressing medical hallucinations, (2) benchmarking models using medical hallucination dataset and physician-annotated LLM responses to real medical cases, providing direct insight into the clinical impact of hallucinations, and (3) a multi-national clinician survey on their experiences with medical hallucinations. Our results reveal that inference techniques such as Chain-of-Thought (CoT) and Search Augmented Generation can effectively reduce hallucination rates. However, despite these improvements, non-trivial levels of hallucination persist. These findings underscore the ethical and practical imperative for robust detection and mitigation strategies, establishing a foundation for regulatory policies that prioritize patient safety and maintain clinical integrity as AI becomes more integrated into healthcare. The feedback from clinicians highlights the urgent need for not only technical advances but also for clearer ethical and regulatory guidelines to ensure patient safety. A repository organizing the paper resources, summaries, and additional information is available at https://github.com/mitmedialab/medical hallucination.

Fact verification is essential for ensuring the reliability of LLM applications. In this study, we evaluate 12 pre-trained LLMs and one specialized fact-verifier, including frontier LLMs and open-weight reasoning LLMs, using a collection of examples from 14 fact-checking benchmarks. We share three findings intended to guide future development of more robust fact verifiers. First, we highlight the importance of addressing annotation errors and ambiguity in datasets, demonstrating that approximately 16\% of ambiguous or incorrectly labeled data substantially influences model rankings. Neglecting this issue may result in misleading conclusions during comparative evaluations, and we suggest using a systematic pipeline utilizing LLM-as-a-judge to help identify these issues at scale. Second, we discover that frontier LLMs with few-shot in-context examples, often overlooked in previous works, achieve top-tier performance. We therefore recommend future studies include comparisons with these simple yet highly effective baselines. Lastly, despite their effectiveness, frontier LLMs incur substantial costs, motivating the development of small, fine-tuned fact verifiers. We show that these small models still have room for improvement, particularly on instances that require complex reasoning. Encouragingly, we demonstrate that augmenting training with synthetic multi-hop reasoning data significantly enhances their capabilities in such instances. We release our code, model, and dataset at https://github.com/just1nseo/verifying-the-verifiers

Factual recall from a reference source is crucial for evaluating the performance of Retrieval Augmented Generation (RAG) systems, as it directly probes into the quality of both retrieval and generation. However, it still remains a challenge to perform this evaluation reliably and efficiently. Recent work has focused on fact verification via prompting language model (LM) evaluators, however we demonstrate that these methods are unreliable in the presence of incomplete or inaccurate information. We introduce Facts as a Function (FaaF), a new approach to fact verification that utilizes the function calling abilities of LMs and a framework for RAG factual recall evaluation. FaaF substantially improves the ability of LMs to identify unsupported facts in text with incomplete information whilst improving efficiency and lowering cost by several times, compared to prompt-based approaches.

In the medical domain, numerous scenarios necessitate the long-form generation ability of large language models (LLMs). Specifically, when addressing patients' questions, it is essential that the model's response conveys factual claims, highlighting the need for an automated method to evaluate those claims. Thus, we introduce MedLFQA, a benchmark dataset reconstructed using long-form question-answering datasets related to the biomedical domain. We use MedLFQA to facilitate the automatic evaluations of factuality. We also propose OLAPH, a simple and novel framework that enables the improvement of factuality through automatic evaluations. The OLAPH framework iteratively trains LLMs to mitigate hallucinations using sampling predictions and preference optimization. In other words, we iteratively set the highest-scoring response as a preferred response derived from sampling predictions and train LLMs to align with the preferred response that improves factuality. We highlight that, even on evaluation metrics not used during training, LLMs trained with our OLAPH framework demonstrate significant performance improvement in factuality. Our findings reveal that a 7B LLM trained with our OLAPH framework can provide long answers comparable to the medical experts' answers in terms of factuality. We believe that our work could shed light on gauging the long-text generation ability of LLMs in the medical domain. Our code and datasets are available at https://github.com/dmis-lab/OLAPH}{https://github.com/dmis-lab/OLAPH.

Clinical evidence, derived from rigorous research and data analysis, provides healthcare professionals with reliable scientific foundations for informed decision-making. Integrating clinical evidence into real-time practice is challenging due to the enormous workload, complex professional processes, and time constraints. This highlights the need for tools that automate evidence synthesis to support more efficient and accurate decision making in clinical settings. This study introduces Quicker, an evidence-based clinical decision support system powered by large language models (LLMs), designed to automate evidence synthesis and generate clinical recommendations modeled after standard clinical guideline development processes. Quicker implements a fully automated chain that covers all phases, from questions to clinical recommendations, and further enables customized decision-making through integrated tools and interactive user interfaces. To evaluate Quicker's capabilities, we developed the Q2CRBench-3 benchmark dataset, based on clinical guideline development records for three different diseases. Experimental results highlighted Quicker's strong performance, with fine-grained question decomposition tailored to user preferences, retrieval sensitivities comparable to human experts, and literature screening performance approaching comprehensive inclusion of relevant studies. In addition, Quicker-assisted evidence assessment effectively supported human reviewers, while Quicker's recommendations were more comprehensive and logically coherent than those of clinicians. In system-level testing, collaboration between a single reviewer and Quicker reduced the time required for recommendation development to 20-40 minutes. In general, our findings affirm the potential of Quicker to help physicians make quicker and more reliable evidence-based clinical decisions.

Large language models have shown promise in clinical decision making, but current approaches struggle to localize and correct errors at specific steps of the reasoning process. This limitation is critical in medicine, where identifying and addressing reasoning errors is essential for accurate diagnosis and effective patient care. We introduce Med-PRM, a process reward modeling framework that leverages retrieval-augmented generation to verify each reasoning step against established medical knowledge bases. By verifying intermediate reasoning steps with evidence retrieved from clinical guidelines and literature, our model can precisely assess the reasoning quality in a fine-grained manner. Evaluations on five medical QA benchmarks and two open-ended diagnostic tasks demonstrate that Med-PRM achieves state-of-the-art performance, with improving the performance of base models by up to 13.50% using Med-PRM. Moreover, we demonstrate the generality of Med-PRM by integrating it in a plug-and-play fashion with strong policy models such as Meerkat, achieving over 80\% accuracy on MedQA for the first time using small-scale models of 8 billion parameters. Our code and data are available at: https://med-prm.github.io/

Medical large language models (LLMs) research often makes bold claims, from encoding clinical knowledge to reasoning like a physician. These claims are usually backed by evaluation on competitive benchmarks; a tradition inherited from mainstream machine learning. But how do we separate real progress from a leaderboard flex? Medical LLM benchmarks, much like those in other fields, are arbitrarily constructed using medical licensing exam questions. For these benchmarks to truly measure progress, they must accurately capture the real-world tasks they aim to represent. In this position paper, we argue that medical LLM benchmarks should (and indeed can) be empirically evaluated for their construct validity. In the psychological testing literature, "construct validity" refers to the ability of a test to measure an underlying "construct", that is the actual conceptual target of evaluation. By drawing an analogy between LLM benchmarks and psychological tests, we explain how frameworks from this field can provide empirical foundations for validating benchmarks. To put these ideas into practice, we use real-world clinical data in proof-of-concept experiments to evaluate popular medical LLM benchmarks and report significant gaps in their construct validity. Finally, we outline a vision for a new ecosystem of medical LLM evaluation centered around the creation of valid benchmarks.

Over the course of the COVID-19 pandemic, large volumes of biomedical information concerning this new disease have been published on social media. Some of this information can pose a real danger to people's health, particularly when false information is shared, for instance recommendations on how to treat diseases without professional medical advice. Therefore, automatic fact-checking resources and systems developed specifically for the medical domain are crucial. While existing fact-checking resources cover COVID-19-related information in news or quantify the amount of misinformation in tweets, there is no dataset providing fact-checked COVID-19-related Twitter posts with detailed annotations for biomedical entities, relations and relevant evidence. We contribute CoVERT, a fact-checked corpus of tweets with a focus on the domain of biomedicine and COVID-19-related (mis)information. The corpus consists of 300 tweets, each annotated with medical named entities and relations. We employ a novel crowdsourcing methodology to annotate all tweets with fact-checking labels and supporting evidence, which crowdworkers search for online. This methodology results in moderate inter-annotator agreement. Furthermore, we use the retrieved evidence extracts as part of a fact-checking pipeline, finding that the real-world evidence is more useful than the knowledge indirectly available in pretrained language models.

Large language models (LLMs) are increasingly envisioned as decision-support tools in clinical practice, yet safe clinical reasoning demands integrating heterogeneous knowledge bases -- trials, primary studies, regulatory documents, and cost data -- under strict accuracy constraints. Existing evaluations often rely on synthetic prompts, reduce the task to single-hop factoid queries, or conflate reasoning with open-ended generation, leaving their real-world utility unclear. To close this gap, we present MedBrowseComp, the first benchmark that systematically tests an agent's ability to reliably retrieve and synthesize multi-hop medical facts from live, domain-specific knowledge bases. MedBrowseComp contains more than 1,000 human-curated questions that mirror clinical scenarios where practitioners must reconcile fragmented or conflicting information to reach an up-to-date conclusion. Applying MedBrowseComp to frontier agentic systems reveals performance shortfalls as low as ten percent, exposing a critical gap between current LLM capabilities and the rigor demanded in clinical settings. MedBrowseComp therefore offers a clear testbed for reliable medical information seeking and sets concrete goals for future model and toolchain upgrades. You can visit our project page at: https://moreirap12.github.io/mbc-browse-app/

Large Language Models (LLMs) are increasingly being explored for clinical question answering and decision support, yet safe deployment critically requires reliable handling of patient measurements in heterogeneous clinical notes. Existing evaluations of LLMs for clinical numerical reasoning provide limited operation-level coverage, restricted primarily to arithmetic computation, and rarely assess the robustness of numerical understanding across clinical note formats. We introduce ClinicNumRobBench, a benchmark of 1,624 context-question instances with ground-truth answers that evaluates four main types of clinical numeracy: value retrieval, arithmetic computation, relational comparison, and aggregation. To stress-test robustness, ClinicNumRobBench presents longitudinal MIMIC-IV vital-sign records in three semantically equivalent representations, including a real-world note-style variant derived from the Open Patients dataset, and instantiates queries using 42 question templates. Experiments on 14 LLMs show that value retrieval is generally strong, with most models exceeding 85% accuracy, while relational comparison and aggregation remain challenging, with some models scoring below 15%. Fine-tuning on medical data can reduce numeracy relative to base models by over 30%, and performance drops under note-style variation indicate LLM sensitivity to format. ClinicNumRobBench offers a rigorous testbed for clinically reliable numerical reasoning. Code and data URL are available on https://github.com/MinhVuong2000/ClinicNumRobBench.

In this work, we introduce X-FACT: the largest publicly available multilingual dataset for factual verification of naturally existing real-world claims. The dataset contains short statements in 25 languages and is labeled for veracity by expert fact-checkers. The dataset includes a multilingual evaluation benchmark that measures both out-of-domain generalization, and zero-shot capabilities of the multilingual models. Using state-of-the-art multilingual transformer-based models, we develop several automated fact-checking models that, along with textual claims, make use of additional metadata and evidence from news stories retrieved using a search engine. Empirically, our best model attains an F-score of around 40%, suggesting that our dataset is a challenging benchmark for evaluation of multilingual fact-checking models.

Clinical trial matching is the task of identifying trials for which patients may be potentially eligible. Typically, this task is labor-intensive and requires detailed verification of patient electronic health records (EHRs) against the stringent inclusion and exclusion criteria of clinical trials. This process is manual, time-intensive, and challenging to scale up, resulting in many patients missing out on potential therapeutic options. Recent advancements in Large Language Models (LLMs) have made automating patient-trial matching possible, as shown in multiple concurrent research studies. However, the current approaches are confined to constrained, often synthetic datasets that do not adequately mirror the complexities encountered in real-world medical data. In this study, we present the first, end-to-end large-scale empirical evaluation of clinical trial matching using real-world EHRs. Our study showcases the capability of LLMs to accurately match patients with appropriate clinical trials. We perform experiments with proprietary LLMs, including GPT-4 and GPT-3.5, as well as our custom fine-tuned model called OncoLLM and show that OncoLLM, despite its significantly smaller size, not only outperforms GPT-3.5 but also matches the performance of qualified medical doctors. All experiments were carried out on real-world EHRs that include clinical notes and available clinical trials from a single cancer center in the United States.

In real world applications, knowledge graphs (KG) are widely used in various domains (e.g. medical applications and dialogue agents). However, for fact verification, KGs have not been adequately utilized as a knowledge source. KGs can be a valuable knowledge source in fact verification due to their reliability and broad applicability. A KG consists of nodes and edges which makes it clear how concepts are linked together, allowing machines to reason over chains of topics. However, there are many challenges in understanding how these machine-readable concepts map to information in text. To enable the community to better use KGs, we introduce a new dataset, FactKG: Fact Verification via Reasoning on Knowledge Graphs. It consists of 108k natural language claims with five types of reasoning: One-hop, Conjunction, Existence, Multi-hop, and Negation. Furthermore, FactKG contains various linguistic patterns, including colloquial style claims as well as written style claims to increase practicality. Lastly, we develop a baseline approach and analyze FactKG over these reasoning types. We believe FactKG can advance both reliability and practicality in KG-based fact verification.

Medical question-answering (QA) is a critical task for evaluating how effectively large language models (LLMs) encode clinical knowledge and assessing their potential applications in medicine. Despite showing promise on multiple-choice tests, LLMs frequently struggle with open-ended medical questions, producing responses with dangerous hallucinations or lacking comprehensive coverage of critical aspects. Existing approaches attempt to address these challenges through domain-specific fine-tuning, but this proves resource-intensive and difficult to scale across models. To improve the comprehensiveness and factuality of medical responses, we propose a novel approach utilizing structured medical reasoning. Our method guides LLMs through an seven-step cognitive process inspired by clinical diagnosis, enabling more accurate and complete answers without additional training. Experiments on the MedLFQA benchmark demonstrate that our approach achieves the highest Factuality Score of 85.8, surpassing fine-tuned models. Notably, this improvement transfers to smaller models, highlighting the method's efficiency and scalability. Our code and datasets are available.

Recent progress in multimodal large language models (MLLMs) has demonstrated promising performance on medical benchmarks and in preliminary trials as clinical assistants. Yet, our pilot audit of diagnostic cases uncovers a critical failure mode: instability in early evidence interpretation precedes hallucination, creating branching reasoning trajectories that cascade into globally inconsistent conclusions. This highlights the need for clinical reasoning agents that constrain stochasticity and hallucination while producing auditable decision flows. We introduce MedMMV, a controllable multimodal multi-agent framework for reliable and verifiable clinical reasoning. MedMMV stabilizes reasoning through diversified short rollouts, grounds intermediate steps in a structured evidence graph under the supervision of a Hallucination Detector, and aggregates candidate paths with a Combined Uncertainty scorer. On six medical benchmarks, MedMMV improves accuracy by up to 12.7% and, more critically, demonstrates superior reliability. Blind physician evaluations confirm that MedMMV substantially increases reasoning truthfulness without sacrificing informational content. By controlling instability through a verifiable, multi-agent process, our framework provides a robust path toward deploying trustworthy AI systems in high-stakes domains like clinical decision support.

As opposed to evaluating computation and logic-based reasoning, current benchmarks for evaluating large language models (LLMs) in medicine are primarily focused on question-answering involving domain knowledge and descriptive reasoning. While such qualitative capabilities are vital to medical diagnosis, in real-world scenarios, doctors frequently use clinical calculators that follow quantitative equations and rule-based reasoning paradigms for evidence-based decision support. To this end, we propose MedCalc-Bench, a first-of-its-kind dataset focused on evaluating the medical calculation capability of LLMs. MedCalc-Bench contains an evaluation set of over 1000 manually reviewed instances from 55 different medical calculation tasks. Each instance in MedCalc-Bench consists of a patient note, a question requesting to compute a specific medical value, a ground truth answer, and a step-by-step explanation showing how the answer is obtained. While our evaluation results show the potential of LLMs in this area, none of them are effective enough for clinical settings. Common issues include extracting the incorrect entities, not using the correct equation or rules for a calculation task, or incorrectly performing the arithmetic for the computation. We hope our study highlights the quantitative knowledge and reasoning gaps in LLMs within medical settings, encouraging future improvements of LLMs for various clinical calculation tasks.

Medical conversational AI (AI) plays a pivotal role in the development of safer and more effective medical dialogue systems. However, existing benchmarks and evaluation frameworks for assessing the information-gathering and diagnostic reasoning abilities of medical large language models (LLMs) have not been rigorously evaluated. To address these gaps, we present MedDialogRubrics, a novel benchmark comprising 5,200 synthetically constructed patient cases and over 60,000 fine-grained evaluation rubrics generated by LLMs and subsequently refined by clinical experts, specifically designed to assess the multi-turn diagnostic capabilities of LLM. Our framework employs a multi-agent system to synthesize realistic patient records and chief complaints from underlying disease knowledge without accessing real-world electronic health records, thereby mitigating privacy and data-governance concerns. We design a robust Patient Agent that is limited to a set of atomic medical facts and augmented with a dynamic guidance mechanism that continuously detects and corrects hallucinations throughout the dialogue, ensuring internal coherence and clinical plausibility of the simulated cases. Furthermore, we propose a structured LLM-based and expert-annotated rubric-generation pipeline that retrieves Evidence-Based Medicine (EBM) guidelines and utilizes the reject sampling to derive a prioritized set of rubric items ("must-ask" items) for each case. We perform a comprehensive evaluation of state-of-the-art models and demonstrate that, across multiple assessment dimensions, current models face substantial challenges. Our results indicate that improving medical dialogue will require advances in dialogue management architectures, not just incremental tuning of the base-model.

The breakthrough of OpenAI o1 highlights the potential of enhancing reasoning to improve LLM. Yet, most research in reasoning has focused on mathematical tasks, leaving domains like medicine underexplored. The medical domain, though distinct from mathematics, also demands robust reasoning to provide reliable answers, given the high standards of healthcare. However, verifying medical reasoning is challenging, unlike those in mathematics. To address this, we propose verifiable medical problems with a medical verifier to check the correctness of model outputs. This verifiable nature enables advancements in medical reasoning through a two-stage approach: (1) using the verifier to guide the search for a complex reasoning trajectory for fine-tuning LLMs, (2) applying reinforcement learning (RL) with verifier-based rewards to enhance complex reasoning further. Finally, we introduce HuatuoGPT-o1, a medical LLM capable of complex reasoning, which outperforms general and medical-specific baselines using only 40K verifiable problems. Experiments show complex reasoning improves medical problem-solving and benefits more from RL. We hope our approach inspires advancements in reasoning across medical and other specialized domains.

The proliferation of Large Language Models (LLMs) in medicine has enabled impressive capabilities, yet a critical gap remains in their ability to perform systematic, transparent, and verifiable reasoning, a cornerstone of clinical practice. This has catalyzed a shift from single-step answer generation to the development of LLMs explicitly designed for medical reasoning. This paper provides the first systematic review of this emerging field. We propose a taxonomy of reasoning enhancement techniques, categorized into training-time strategies (e.g., supervised fine-tuning, reinforcement learning) and test-time mechanisms (e.g., prompt engineering, multi-agent systems). We analyze how these techniques are applied across different data modalities (text, image, code) and in key clinical applications such as diagnosis, education, and treatment planning. Furthermore, we survey the evolution of evaluation benchmarks from simple accuracy metrics to sophisticated assessments of reasoning quality and visual interpretability. Based on an analysis of 60 seminal studies from 2022-2025, we conclude by identifying critical challenges, including the faithfulness-plausibility gap and the need for native multimodal reasoning, and outlining future directions toward building efficient, robust, and sociotechnically responsible medical AI.

Fact verification aims to verify a claim using evidence from a trustworthy knowledge base. To address this challenge, algorithms must produce features for every claim that are both semantically meaningful, and compact enough to find a semantic alignment with the source information. In contrast to previous work, which tackled the alignment problem by learning over annotated corpora of claims and their corresponding labels, we propose SFAVEL (Self-supervised Fact Verification via Language Model Distillation), a novel unsupervised pretraining framework that leverages pre-trained language models to distil self-supervised features into high-quality claim-fact alignments without the need for annotations. This is enabled by a novel contrastive loss function that encourages features to attain high-quality claim and evidence alignments whilst preserving the semantic relationships across the corpora. Notably, we present results that achieve a new state-of-the-art on FB15k-237 (+5.3% Hits@1) and FEVER (+8% accuracy) with linear evaluation.

Assessing the veracity of a claim made online is a complex and important task with real-world implications. When these claims are directed at communities with limited access to information and the content concerns issues such as healthcare and culture, the consequences intensify, especially in low-resource languages. In this work, we introduce AfrIFact, a dataset that covers the necessary steps for automatic fact-checking (i.e., information retrieval, evidence extraction, and fact checking), in ten African languages and English. Our evaluation results show that even the best embedding models lack cross-lingual retrieval capabilities, and that cultural and news documents are easier to retrieve than healthcare-domain documents, both in large corpora and in single documents. We show that LLMs lack robust multilingual fact-verification capabilities in African languages, while few-shot prompting improves performance by up to 43% in AfriqueQwen-14B, and task-specific fine-tuning further improves fact-checking accuracy by up to 26%. These findings, along with our release of the AfrIFact dataset, encourage work on low-resource information retrieval, evidence retrieval, and fact checking.

The potential of Multimodal Large Language Models (MLLMs) in domain of medical imaging raise the demands of systematic and rigorous evaluation frameworks that are aligned with the real-world medical imaging practice. Existing practices that report single or coarse-grained metrics are lack the granularity required for specialized clinical support and fail to assess the reliability of reasoning mechanisms. To address this, we propose a paradigm shift toward multidimensional, fine-grained and in-depth evaluation. Based on a two-stage systematic construction pipeline designed for this paradigm, we instantiate it with MedRCube. We benchmark 33 MLLMs, Lingshu-32B achieve top-tier performance. Crucially, MedRCube exposes a series of pronounced insights inaccessible under prior evaluation settings. Furthermore, we introduce a credibility evaluation subset to quantify reasoning credibility, uncover a highly significant positive association between shortcut behavior and diagnostic task performance, raising concerns for clinically trustworthy deployment. The resources of this work can be found at https://github.com/F1mc/MedRCube.

The goal of automated summarization techniques (Paice, 1990; Kupiec et al, 1995) is to condense text by focusing on the most critical information. Generative large language models (LLMs) have shown to be robust summarizers, yet traditional metrics struggle to capture resulting performance (Goyal et al, 2022) in more powerful LLMs. In safety-critical domains such as medicine, more rigorous evaluation is required, especially given the potential for LLMs to omit important information in the resulting summary. We propose MED-OMIT, a new omission benchmark for medical summarization. Given a doctor-patient conversation and a generated summary, MED-OMIT categorizes the chat into a set of facts and identifies which are omitted from the summary. We further propose to determine fact importance by simulating the impact of each fact on a downstream clinical task: differential diagnosis (DDx) generation. MED-OMIT leverages LLM prompt-based approaches which categorize the importance of facts and cluster them as supporting or negating evidence to the diagnosis. We evaluate MED-OMIT on a publicly-released dataset of patient-doctor conversations and find that MED-OMIT captures omissions better than alternative metrics.

Medical vision-language models often struggle with generating accurate quantitative measurements in radiology reports, leading to hallucinations that undermine clinical reliability. We introduce FactCheXcker, a modular framework that de-hallucinates radiology report measurements by leveraging an improved query-code-update paradigm. Specifically, FactCheXcker employs specialized modules and the code generation capabilities of large language models to solve measurement queries generated based on the original report. After extracting measurable findings, the results are incorporated into an updated report. We evaluate FactCheXcker on endotracheal tube placement, which accounts for an average of 78% of report measurements, using the MIMIC-CXR dataset and 11 medical report-generation models. Our results show that FactCheXcker significantly reduces hallucinations, improves measurement precision, and maintains the quality of the original reports. Specifically, FactCheXcker improves the performance of 10/11 models and achieves an average improvement of 135.0% in reducing measurement hallucinations measured by mean absolute error. Code is available at https://github.com/rajpurkarlab/FactCheXcker.

Large-scale clinical databases offer opportunities for medical research, but their complexity creates barriers to effective use. The Medical Information Mart for Intensive Care (MIMIC-IV), one of the world's largest open-source electronic health record databases, traditionally requires both SQL proficiency and clinical domain expertise. We introduce M3, a system that enables natural language querying of MIMIC-IV data through the Model Context Protocol. With a single command, M3 retrieves MIMIC-IV from PhysioNet, launches a local SQLite instance or connects to hosted BigQuery, and allows researchers to pose clinical questions in plain English. We evaluated M3 using one hundred questions from the EHRSQL 2024 benchmark with two language models: the proprietary Claude Sonnet 4 achieved 94% accuracy, while the open-source gpt-oss-20B (deployable locally on consumer hardware) achieved 93% accuracy. Both models translate natural language into SQL, execute queries against MIMIC-IV, and return structured results alongside the underlying query for verification. Error analysis revealed that most failures stemmed from complex temporal reasoning or ambiguous question phrasing rather than fundamental architectural limitations. The comparable performance of a smaller open-source model demonstrates that privacy-preserving local deployment is viable for sensitive clinical data analysis. M3 lowers technical barriers to critical care data analysis while maintaining security through OAuth2 authentication, query validation, and comprehensive audit logging.

Medical tasks such as diagnosis and treatment planning require precise and complex reasoning, particularly in life-critical domains. Unlike mathematical reasoning, medical reasoning demands meticulous, verifiable thought processes to ensure reliability and accuracy. However, there is a notable lack of datasets that provide transparent, step-by-step reasoning to validate and enhance the medical reasoning ability of AI models. To bridge this gap, we introduce MedReason, a large-scale high-quality medical reasoning dataset designed to enable faithful and explainable medical problem-solving in large language models (LLMs). We utilize a structured medical knowledge graph (KG) to convert clinical QA pairs into logical chains of reasoning, or ``thinking paths'', which trace connections from question elements to answers via relevant KG entities. Each path is validated for consistency with clinical logic and evidence-based medicine. Our pipeline generates detailed reasoning for various medical questions from 7 medical datasets, resulting in a dataset of 32,682 question-answer pairs, each with detailed, step-by-step explanations. Experiments demonstrate that fine-tuning with our dataset consistently boosts medical problem-solving capabilities, achieving significant gains of up to 7.7% for DeepSeek-Ditill-8B. Our top-performing model, MedReason-8B, outperforms the Huatuo-o1-8B, a state-of-the-art medical reasoning model, by up to 4.2% on the clinical benchmark MedBullets. We also engage medical professionals from diverse specialties to assess our dataset's quality, ensuring MedReason offers accurate and coherent medical reasoning. Our data, models, and code will be publicly available.

Knowledge Graphs (KGs) store structured factual knowledge by linking entities through relationships, crucial for many applications. These applications depend on the KG's factual accuracy, so verifying facts is essential, yet challenging. Expert manual verification is ideal but impractical on a large scale. Automated methods show promise but are not ready for real-world KGs. Large Language Models (LLMs) offer potential with their semantic understanding and knowledge access, yet their suitability and effectiveness for KG fact validation remain largely unexplored. In this paper, we introduce FactCheck, a benchmark designed to evaluate LLMs for KG fact validation across three key dimensions: (1) LLMs internal knowledge; (2) external evidence via Retrieval-Augmented Generation (RAG); and (3) aggregated knowledge employing a multi-model consensus strategy. We evaluated open-source and commercial LLMs on three diverse real-world KGs. FactCheck also includes a RAG dataset with 2+ million documents tailored for KG fact validation. Additionally, we offer an interactive exploration platform for analyzing verification decisions. The experimental analyses demonstrate that while LLMs yield promising results, they are still not sufficiently stable and reliable to be used in real-world KG validation scenarios. Integrating external evidence through RAG methods yields fluctuating performance, providing inconsistent improvements over more streamlined approaches -- at higher computational costs. Similarly, strategies based on multi-model consensus do not consistently outperform individual models, underscoring the lack of a one-fits-all solution. These findings further emphasize the need for a benchmark like FactCheck to systematically evaluate and drive progress on this difficult yet crucial task.

Clinical diagnosis is critical in medical practice, typically requiring a continuous and evolving process that includes primary diagnosis, differential diagnosis, and final diagnosis. However, most existing clinical diagnostic tasks are single-step processes, which does not align with the complex multi-step diagnostic procedures found in real-world clinical settings. In this paper, we propose a multi-step diagnostic task and annotate a clinical diagnostic dataset (MSDiagnosis). This dataset includes primary diagnosis, differential diagnosis, and final diagnosis questions. Additionally, we propose a novel and effective framework. This framework combines forward inference, backward inference, reflection, and refinement, enabling the LLM to self-evaluate and adjust its diagnostic results. To assess the effectiveness of our proposed method, we design and conduct extensive experiments. The experimental results demonstrate the effectiveness of the proposed method. We also provide a comprehensive experimental analysis and suggest future research directions for this task.

LLMs have demonstrated impressive performance in answering medical questions, such as passing scores on medical licensing examinations. However, medical board exam questions or general clinical questions do not capture the complexity of realistic clinical cases. Moreover, the lack of reference explanations means we cannot easily evaluate the reasoning of model decisions, a crucial component of supporting doctors in making complex medical decisions. To address these challenges, we construct two new datasets: JAMA Clinical Challenge and Medbullets. JAMA Clinical Challenge consists of questions based on challenging clinical cases, while Medbullets comprises USMLE Step 2&3 style clinical questions. Both datasets are structured as multiple-choice question-answering tasks, where each question is accompanied by an expert-written explanation. We evaluate four LLMs on the two datasets using various prompts. Experiments demonstrate that our datasets are harder than previous benchmarks. The inconsistency between automatic and human evaluations of model-generated explanations highlights the need to develop new metrics to support future research on explainable medical QA.

Large language models (LLMs) have shown significant potential in scientific disciplines such as biomedicine, particularly in hypothesis generation, where they can analyze vast literature, identify patterns, and suggest research directions. However, a key challenge lies in evaluating the truthfulness of generated hypotheses, as verifying their accuracy often requires substantial time and resources. Additionally, the hallucination problem in LLMs can lead to the generation of hypotheses that appear plausible but are ultimately incorrect, undermining their reliability. To facilitate the systematic study of these challenges, we introduce TruthHypo, a benchmark for assessing the capabilities of LLMs in generating truthful biomedical hypotheses, and KnowHD, a knowledge-based hallucination detector to evaluate how well hypotheses are grounded in existing knowledge. Our results show that LLMs struggle to generate truthful hypotheses. By analyzing hallucinations in reasoning steps, we demonstrate that the groundedness scores provided by KnowHD serve as an effective metric for filtering truthful hypotheses from the diverse outputs of LLMs. Human evaluations further validate the utility of KnowHD in identifying truthful hypotheses and accelerating scientific discovery. Our data and source code are available at https://github.com/Teddy-XiongGZ/TruthHypo.

The problem of verifying whether a textual hypothesis holds based on the given evidence, also known as fact verification, plays an important role in the study of natural language understanding and semantic representation. However, existing studies are mainly restricted to dealing with unstructured evidence (e.g., natural language sentences and documents, news, etc), while verification under structured evidence, such as tables, graphs, and databases, remains under-explored. This paper specifically aims to study the fact verification given semi-structured data as evidence. To this end, we construct a large-scale dataset called TabFact with 16k Wikipedia tables as the evidence for 118k human-annotated natural language statements, which are labeled as either ENTAILED or REFUTED. TabFact is challenging since it involves both soft linguistic reasoning and hard symbolic reasoning. To address these reasoning challenges, we design two different models: Table-BERT and Latent Program Algorithm (LPA). Table-BERT leverages the state-of-the-art pre-trained language model to encode the linearized tables and statements into continuous vectors for verification. LPA parses statements into programs and executes them against the tables to obtain the returned binary value for verification. Both methods achieve similar accuracy but still lag far behind human performance. We also perform a comprehensive analysis to demonstrate great future opportunities. The data and code of the dataset are provided in https://github.com/wenhuchen/Table-Fact-Checking.

With the growing importance of detecting misinformation, many studies have focused on verifying factual claims by retrieving evidence. However, canonical fact verification tasks do not apply to catching subtle differences in factually consistent claims, which might still bias the readers, especially on contentious political or economic issues. Our underlying assumption is that among the trusted sources, one's argument is not necessarily more true than the other, requiring comparison rather than verification. In this study, we propose ClaimDiff, a novel dataset that primarily focuses on comparing the nuance between claim pairs. In ClaimDiff, we provide 2,941 annotated claim pairs from 268 news articles. We observe that while humans are capable of detecting the nuances between claims, strong baselines struggle to detect them, showing over a 19% absolute gap with the humans. We hope this initial study could help readers to gain an unbiased grasp of contentious issues through machine-aided comparison.

Current medical retrieval benchmarks primarily emphasize lexical or shallow semantic similarity, overlooking the reasoning-intensive demands that are central to clinical decision-making. In practice, physicians often retrieve authoritative medical evidence to support diagnostic hypotheses. Such evidence typically aligns with an inferred diagnosis rather than the surface form of a patient's symptoms, leading to low lexical or semantic overlap between queries and relevant documents. To address this gap, we introduce R2MED, the first benchmark explicitly designed for reasoning-driven medical retrieval. It comprises 876 queries spanning three tasks: Q&A reference retrieval, clinical evidence retrieval, and clinical case retrieval. These tasks are drawn from five representative medical scenarios and twelve body systems, capturing the complexity and diversity of real-world medical information needs. We evaluate 15 widely-used retrieval systems on R2MED and find that even the best model achieves only 31.4 nDCG@10, demonstrating the benchmark's difficulty. Classical re-ranking and generation-augmented retrieval methods offer only modest improvements. Although large reasoning models improve performance via intermediate inference generation, the best results still peak at 41.4 nDCG@10. These findings underscore a substantial gap between current retrieval techniques and the reasoning demands of real clinical tasks. We release R2MED as a challenging benchmark to foster the development of next-generation medical retrieval systems with enhanced reasoning capabilities. Data and code are available at https://github.com/R2MED/R2MED

The emergence of advanced reasoning capabilities in Large Language Models (LLMs) marks a transformative development in healthcare applications. Beyond merely expanding functional capabilities, these reasoning mechanisms enhance decision transparency and explainability-critical requirements in medical contexts. This survey examines the transformation of medical LLMs from basic information retrieval tools to sophisticated clinical reasoning systems capable of supporting complex healthcare decisions. We provide a thorough analysis of the enabling technological foundations, with a particular focus on specialized prompting techniques like Chain-of-Thought and recent breakthroughs in Reinforcement Learning exemplified by DeepSeek-R1. Our investigation evaluates purpose-built medical frameworks while also examining emerging paradigms such as multi-agent collaborative systems and innovative prompting architectures. The survey critically assesses current evaluation methodologies for medical validation and addresses persistent challenges in field interpretation limitations, bias mitigation strategies, patient safety frameworks, and integration of multimodal clinical data. Through this survey, we seek to establish a roadmap for developing reliable LLMs that can serve as effective partners in clinical practice and medical research.

Assessing scientific claims requires identifying, extracting, and reasoning with multimodal data expressed in information-rich figures in scientific literature. Despite the large body of work in scientific QA, figure captioning, and other multimodal reasoning tasks over chart-based data, there are no readily usable multimodal benchmarks that directly test claim verification abilities. To remedy this gap, we introduce a new benchmark MuSciClaims accompanied by diagnostics tasks. We automatically extract supported claims from scientific articles, which we manually perturb to produce contradicted claims. The perturbations are designed to test for a specific set of claim verification capabilities. We also introduce a suite of diagnostic tasks that help understand model failures. Our results show most vision-language models are poor (~0.3-0.5 F1), with even the best model only achieving 0.72 F1. They are also biased towards judging claims as supported, likely misunderstanding nuanced perturbations within the claims. Our diagnostics show models are bad at localizing correct evidence within figures, struggle with aggregating information across modalities, and often fail to understand basic components of the figure.

Large Language Models (LLMs) are increasingly used for clinical decision support, where hallucinations and unsafe suggestions may pose direct risks to patient safety. These risks are particularly challenging as they often manifest as subtle clinical errors that evade detection by generic metrics, while expert-authored fine-grained rubrics remain costly to construct and difficult to scale. In this paper, we propose a retrieval-augmented multi-agent framework designed to automate the generation of instance-specific evaluation rubrics. Our approach grounds evaluation in authoritative medical evidence by decomposing retrieved content into atomic facts and synthesizing them with user interaction constraints to form verifiable, fine-grained evaluation criteria. Evaluated on HealthBench, our framework achieves a Clinical Intent Alignment (CIA) score of 60.12%, a statistically significant improvement over the GPT-4o baseline (55.16%). In discriminative tests, our rubrics yield a mean score delta (μ_Δ = 8.658) and an AUROC of 0.977, nearly doubling the quality separation achieved by GPT-4o baseline (4.972). Beyond evaluation, our rubrics effectively guide response refinement, improving quality by 9.2% (from 59.0% to 68.2%). This provides a scalable and transparent foundation for both evaluating and improving medical LLMs. The code is available at https://anonymous.4open.science/r/Automated-Rubric-Generation-AF3C/.

Verifying complex political claims is a challenging task, especially when politicians use various tactics to subtly misrepresent the facts. Automatic fact-checking systems fall short here, and their predictions like "half-true" are not very useful in isolation, since we have no idea which parts of the claim are true and which are not. In this work, we focus on decomposing a complex claim into a comprehensive set of yes-no subquestions whose answers influence the veracity of the claim. We present ClaimDecomp, a dataset of decompositions for over 1000 claims. Given a claim and its verification paragraph written by fact-checkers, our trained annotators write subquestions covering both explicit propositions of the original claim and its implicit facets, such as asking about additional political context that changes our view of the claim's veracity. We study whether state-of-the-art models can generate such subquestions, showing that these models generate reasonable questions to ask, but predicting the comprehensive set of subquestions from the original claim without evidence remains challenging. We further show that these subquestions can help identify relevant evidence to fact-check the full claim and derive the veracity through their answers, suggesting that they can be useful pieces of a fact-checking pipeline.

Integrating large language models (LLMs) like DeepSeek R1 into healthcare requires rigorous evaluation of their reasoning alignment with clinical expertise. This study assesses DeepSeek R1's medical reasoning against expert patterns using 100 MedQA clinical cases. The model achieved 93% diagnostic accuracy, demonstrating systematic clinical judgment through differential diagnosis, guideline-based treatment selection, and integration of patient-specific factors. However, error analysis of seven incorrect cases revealed persistent limitations: anchoring bias, challenges reconciling conflicting data, insufficient exploration of alternatives, overthinking, knowledge gaps, and premature prioritization of definitive treatment over intermediate care. Crucially, reasoning length correlated with accuracy - shorter responses (<5,000 characters) were more reliable, suggesting extended explanations may signal uncertainty or rationalization of errors. While DeepSeek R1 exhibits foundational clinical reasoning capabilities, recurring flaws highlight critical areas for refinement, including bias mitigation, knowledge updates, and structured reasoning frameworks. These findings underscore LLMs' potential to augment medical decision-making through artificial reasoning but emphasize the need for domain-specific validation, interpretability safeguards, and confidence metrics (e.g., response length thresholds) to ensure reliability in real-world applications.

Recognizing if LLM output can be grounded in evidence is central to many tasks in NLP: retrieval-augmented generation, summarization, document-grounded dialogue, and more. Current approaches to this kind of "fact-checking" are based on verifying each piece of a model generation against potential evidence using an LLM. However, this process can be very computationally expensive, requiring many calls to LLMs to check a single response. In this work, we show how to build small models that have GPT-4-level performance but for 400x lower cost. We do this by constructing synthetic training data with GPT-4, which involves creating realistic yet challenging instances of factual errors via a structured generation procedure. Training on this data teaches models to check each fact in the claim and recognize synthesis of information across sentences. For evaluation, we unify pre-existing datasets into a benchmark LLM-AggreFact, collected from recent work on fact-checking and grounding LLM generations. Our best system MiniCheck-FT5 (770M parameters) outperforms all systems of comparable size and reaches GPT-4 accuracy. We release LLM-AggreFact, code for data synthesis, and models.

Recent advancements in Large Language Models (LLMs) have demonstrated significant promise in clinical diagnosis. However, current models struggle to emulate the iterative, diagnostic hypothesis-driven reasoning of real clinical scenarios. Specifically, current LLMs suffer from three critical limitations: (1) generating hallucinated medical content due to weak grounding in verified knowledge, (2) asking redundant or inefficient questions rather than discriminative ones that hinder diagnostic progress, and (3) losing coherence over multi-turn dialogues, leading to contradictory or inconsistent conclusions. To address these challenges, we propose MedKGI, a diagnostic framework grounded in clinical practices. MedKGI integrates a medical knowledge graph (KG) to constrain reasoning to validated medical ontologies, selects questions based on information gain to maximize diagnostic efficiency, and adopts an OSCE-format structured state to maintain consistent evidence tracking across turns. Experiments on clinical benchmarks show that MedKGI outperforms strong LLM baselines in both diagnostic accuracy and inquiry efficiency, improving dialogue efficiency by 30% on average while maintaining state-of-the-art accuracy.

Medical reasoning in large language models (LLMs) aims to emulate clinicians' diagnostic thinking, but current benchmarks such as MedQA-USMLE, MedMCQA, and PubMedQA often mix reasoning with factual recall. We address this by separating 11 biomedical QA benchmarks into reasoning- and knowledge-focused subsets using a PubMedBERT classifier that reaches 81 percent accuracy, comparable to human performance. Our analysis shows that only 32.8 percent of questions require complex reasoning. We evaluate biomedical models (HuatuoGPT-o1, MedReason, m1) and general-domain models (DeepSeek-R1, o4-mini, Qwen3), finding consistent gaps between knowledge and reasoning performance. For example, m1 scores 60.5 on knowledge but only 47.1 on reasoning. In adversarial tests where models are misled with incorrect initial reasoning, biomedical models degrade sharply, while larger or RL-trained general models show more robustness. To address this, we train BioMed-R1 using fine-tuning and reinforcement learning on reasoning-heavy examples. It achieves the strongest performance among similarly sized models. Further gains may come from incorporating clinical case reports and training with adversarial and backtracking scenarios.

The emergence of groundbreaking large language models capable of performing complex reasoning tasks holds significant promise for addressing various scientific challenges, including those arising in complex clinical scenarios. To enable their safe and effective deployment in real-world healthcare settings, it is urgently necessary to benchmark the diagnostic capabilities of current models systematically. Given the limitations of existing medical benchmarks in evaluating advanced diagnostic reasoning, we present DiagnosisArena, a comprehensive and challenging benchmark designed to rigorously assess professional-level diagnostic competence. DiagnosisArena consists of 1,113 pairs of segmented patient cases and corresponding diagnoses, spanning 28 medical specialties, deriving from clinical case reports published in 10 top-tier medical journals. The benchmark is developed through a meticulous construction pipeline, involving multiple rounds of screening and review by both AI systems and human experts, with thorough checks conducted to prevent data leakage. Our study reveals that even the most advanced reasoning models, o3-mini, o1, and DeepSeek-R1, achieve only 45.82%, 31.09%, and 17.79% accuracy, respectively. This finding highlights a significant generalization bottleneck in current large language models when faced with clinical diagnostic reasoning challenges. Through DiagnosisArena, we aim to drive further advancements in AIs diagnostic reasoning capabilities, enabling more effective solutions for real-world clinical diagnostic challenges. We provide the benchmark and evaluation tools for further research and development https://github.com/SPIRAL-MED/DiagnosisArena.

Large Language Models (LLMs) such as GPT & Llama have demonstrated significant achievements in summarization tasks but struggle with factual inaccuracies, a critical issue in clinical NLP applications where errors could lead to serious consequences. To counter the high costs and limited availability of expert-annotated data for factual alignment, this study introduces an innovative pipeline that utilizes >100B parameter GPT variants like GPT-3.5 & GPT-4 to act as synthetic experts to generate high-quality synthetics feedback aimed at enhancing factual consistency in clinical note summarization. Our research primarily focuses on edit feedback generated by these synthetic feedback experts without additional human annotations, mirroring and optimizing the practical scenario in which medical professionals refine AI system outputs. Although such 100B+ parameter GPT variants have proven to demonstrate expertise in various clinical NLP tasks, such as the Medical Licensing Examination, there is scant research on their capacity to act as synthetic feedback experts and deliver expert-level edit feedback for improving the generation quality of weaker (<10B parameter) LLMs like GPT-2 (1.5B) & Llama 2 (7B) in clinical domain. So in this work, we leverage 100B+ GPT variants to act as synthetic feedback experts offering expert-level edit feedback, that is used to reduce hallucinations and align weaker (<10B parameter) LLMs with medical facts using two distinct alignment algorithms (DPO & SALT), endeavoring to narrow the divide between AI-generated content and factual accuracy. This highlights the substantial potential of LLM-based synthetic edits in enhancing the alignment of clinical factuality.

Ensuring factuality is essential for the safe use of Large Language Models (LLMs) in high-stakes domains such as medicine and law. Conformal inference provides distribution-free guarantees, but existing approaches are either overly conservative, discarding many true-claims, or rely on adaptive error rates and simple linear models that fail to capture complex group structures. To address these challenges, we reformulate conformal inference in a multiplicative filtering setting, modeling factuality as a product of claim-level scores. Our method, Multi-LLM Adaptive Conformal Inference (MACI), leverages ensembles to produce more accurate factuality-scores, which in our experiments led to higher retention, while validity is preserved through group-conditional calibration. Experiments show that MACI consistently achieves user-specified coverage with substantially higher retention and lower time cost than baselines. Our repository is available at https://github.com/MLAI-Yonsei/MACI

Large language models (LLMs) have shown substantial capacity for generating fluent, contextually appropriate responses. However, they can produce hallucinated outputs, especially when a user query includes one or more false premises-claims that contradict established facts. Such premises can mislead LLMs into offering fabricated or misleading details. Existing approaches include pretraining, fine-tuning, and inference-time techniques that often rely on access to logits or address hallucinations after they occur. These methods tend to be computationally expensive, require extensive training data, or lack proactive mechanisms to prevent hallucination before generation, limiting their efficiency in real-time applications. We propose a retrieval-based framework that identifies and addresses false premises before generation. Our method first transforms a user's query into a logical representation, then applies retrieval-augmented generation (RAG) to assess the validity of each premise using factual sources. Finally, we incorporate the verification results into the LLM's prompt to maintain factual consistency in the final output. Experiments show that this approach effectively reduces hallucinations, improves factual accuracy, and does not require access to model logits or large-scale fine-tuning.

This article presents a pipeline for automated fact-checking leveraging publicly available Language Models and data. The objective is to assess the accuracy of textual claims using evidence from a ground-truth evidence corpus. The pipeline consists of two main modules -- the evidence retrieval and the claim veracity evaluation. Our primary focus is on the ease of deployment in various languages that remain unexplored in the field of automated fact-checking. Unlike most similar pipelines, which work with evidence sentences, our pipeline processes data on a paragraph level, simplifying the overall architecture and data requirements. Given the high cost of annotating language-specific fact-checking training data, our solution builds on the Question Answering for Claim Generation (QACG) method, which we adapt and use to generate the data for all models of the pipeline. Our strategy enables the introduction of new languages through machine translation of only two fixed datasets of moderate size. Subsequently, any number of training samples can be generated based on an evidence corpus in the target language. We provide open access to all data and fine-tuned models for Czech, English, Polish, and Slovak pipelines, as well as to our codebase that may be used to reproduce the results.We comprehensively evaluate the pipelines for all four languages, including human annotations and per-sample difficulty assessment using Pointwise V-information. The presented experiments are based on full Wikipedia snapshots to promote reproducibility. To facilitate implementation and user interaction, we develop the FactSearch application featuring the proposed pipeline and the preliminary feedback on its performance.

Traditionally, AI research in medical diagnosis has largely centered on image analysis. While this has led to notable advancements, the absence of patient-reported symptoms continues to hinder diagnostic accuracy. To address this, we propose a Pre-Consultation Dialogue Framework (PCDF) that mimics real-world diagnostic procedures, where doctors iteratively query patients before reaching a conclusion. Specifically, we simulate diagnostic dialogues between two vision-language models (VLMs): a DocVLM, which generates follow-up questions based on the image and dialogue history, and a PatientVLM, which responds using a symptom profile derived from the ground-truth diagnosis. We additionally conducted a small-scale clinical validation of the synthetic symptoms generated by our framework, with licensed clinicians confirming their clinical relevance, symptom coverage, and overall realism. These findings indicate that the resulting DocVLM-PatientVLM interactions form coherent, multi-turn consultations paired with images and diagnoses, which we then use to fine-tune the DocVLM. This dialogue-based supervision leads to substantial gains over image-only training, highlighting the value of realistic symptom elicitation for diagnosis.

Large Language Models (LLMs) are increasingly deployed in real-world fact-checking systems, yet existing evaluations focus predominantly on claim verification and overlook the broader fact-checking workflow, including claim extraction and evidence retrieval. This narrow focus prevents current benchmarks from revealing systematic reasoning failures, factual blind spots, and robustness limitations of modern LLMs. To bridge this gap, we present FactArena, a fully automated arena-style evaluation framework that conducts comprehensive, stage-wise benchmarking of LLMs across the complete fact-checking pipeline. FactArena integrates three key components: (i) an LLM-driven fact-checking process that standardizes claim decomposition, evidence retrieval via tool-augmented interactions, and justification-based verdict prediction; (ii) an arena-styled judgment mechanism guided by consolidated reference guidelines to ensure unbiased and consistent pairwise comparisons across heterogeneous judge agents; and (iii) an arena-driven claim-evolution module that adaptively generates more challenging and semantically controlled claims to probe LLMs' factual robustness beyond fixed seed data. Across 16 state-of-the-art LLMs spanning seven model families, FactArena produces stable and interpretable rankings. Our analyses further reveal significant discrepancies between static claim-verification accuracy and end-to-end fact-checking competence, highlighting the necessity of holistic evaluation. The proposed framework offers a scalable and trustworthy paradigm for diagnosing LLMs' factual reasoning, guiding future model development, and advancing the reliable deployment of LLMs in safety-critical fact-checking applications.

Online medical consultation (OMC) restricts doctors to gathering patient information solely through inquiries, making the already complex sequential decision-making process of diagnosis even more challenging. Recently, the rapid advancement of large language models has demonstrated a significant potential to transform OMC. However, most studies have primarily focused on improving diagnostic accuracy under conditions of relatively sufficient information, while paying limited attention to the "inquiry" phase of the consultation process. This lack of focus has left the relationship between "inquiry" and "diagnosis" insufficiently explored. In this paper, we first extract real patient interaction strategies from authentic doctor-patient conversations and use these strategies to guide the training of a patient simulator that closely mirrors real-world behavior. By inputting medical records into our patient simulator to simulate patient responses, we conduct extensive experiments to explore the relationship between "inquiry" and "diagnosis" in the consultation process. Experimental results demonstrate that inquiry and diagnosis adhere to the Liebig's law: poor inquiry quality limits the effectiveness of diagnosis, regardless of diagnostic capability, and vice versa. Furthermore, the experiments reveal significant differences in the inquiry performance of various models. To investigate this phenomenon, we categorize the inquiry process into four types: (1) chief complaint inquiry; (2) specification of known symptoms; (3) inquiry about accompanying symptoms; and (4) gathering family or medical history. We analyze the distribution of inquiries across the four types for different models to explore the reasons behind their significant performance differences. We plan to open-source the weights and related code of our patient simulator at https://github.com/LIO-H-ZEN/PatientSimulator.

As large language models (LLMs) advance in conversational and reasoning capabilities, their practical application in healthcare has become a critical research focus. However, there is a notable gap between the performance of medical LLMs on static benchmarks such as USMLE and their utility in real-world clinical decision-making. This discrepancy arises because traditional exams fail to capture the dynamic, interactive nature of medical consultations. To address this challenge, we introduce a novel dynamic verification framework that moves beyond static answer verifier, establishing a large-scale, high-fidelity interactive reinforcement learning system. Our framework comprises two key components: a Patient Simulator that creates realistic clinical environments using de-identified medical records, and a Clinical Rubrics Generator that dynamically produces multi-dimensional evaluation metrics. Building on this foundation, we develop Baichuan-M2, a 32B-parameter medical augmented reasoning model trained through a multi-stage reinforcement learning strategy with an improved Group Relative Policy Optimization (GRPO) algorithm. Evaluated on HealthBench, Baichuan-M2 outperforms all other open-source models and most advanced closed-source counterparts, achieving a score above 32 on the challenging HealthBench Hard benchmark-previously exceeded only by GPT-5. Our work demonstrates that robust dynamic verifier system is essential for aligning LLM capabilities with practical clinical applications, establishing a new Pareto front in the performance-parameter trade-off for medical AI deployment.

Large language models (LLMs) excel at generating long-form responses, but evaluating their factuality remains challenging due to complex inter-sentence dependencies within the generated facts. Prior solutions predominantly follow a decompose-decontextualize-verify pipeline but often fail to capture essential context and miss key relational facts. In this paper, we introduce VeriFact, a factuality evaluation framework designed to enhance fact extraction by identifying and resolving incomplete and missing facts to support more accurate verification results. Moreover, we introduce FactRBench , a benchmark that evaluates both precision and recall in long-form model responses, whereas prior work primarily focuses on precision. FactRBench provides reference fact sets from advanced LLMs and human-written answers, enabling recall assessment. Empirical evaluations show that VeriFact significantly enhances fact completeness and preserves complex facts with critical relational information, resulting in more accurate factuality evaluation. Benchmarking various open- and close-weight LLMs on FactRBench indicate that larger models within same model family improve precision and recall, but high precision does not always correlate with high recall, underscoring the importance of comprehensive factuality assessment.

The integration of Artificial Intelligence (AI), especially Large Language Models (LLMs), into the clinical diagnosis process offers significant potential to improve the efficiency and accessibility of medical care. While LLMs have shown some promise in the medical domain, their application in clinical diagnosis remains underexplored, especially in real-world clinical practice, where highly sophisticated, patient-specific decisions need to be made. Current evaluations of LLMs in this field are often narrow in scope, focusing on specific diseases or specialties and employing simplified diagnostic tasks. To bridge this gap, we introduce CliBench, a novel benchmark developed from the MIMIC IV dataset, offering a comprehensive and realistic assessment of LLMs' capabilities in clinical diagnosis. This benchmark not only covers diagnoses from a diverse range of medical cases across various specialties but also incorporates tasks of clinical significance: treatment procedure identification, lab test ordering and medication prescriptions. Supported by structured output ontologies, CliBench enables a precise and multi-granular evaluation, offering an in-depth understanding of LLM's capability on diverse clinical tasks of desired granularity. We conduct a zero-shot evaluation of leading LLMs to assess their proficiency in clinical decision-making. Our preliminary results shed light on the potential and limitations of current LLMs in clinical settings, providing valuable insights for future advancements in LLM-powered healthcare.

The recent emergence of Medical Large Vision Language Models (Med-LVLMs) has enhanced medical diagnosis. However, current Med-LVLMs frequently encounter factual issues, often generating responses that do not align with established medical facts. Retrieval-Augmented Generation (RAG), which utilizes external knowledge, can improve the factual accuracy of these models but introduces two major challenges. First, limited retrieved contexts might not cover all necessary information, while excessive retrieval can introduce irrelevant and inaccurate references, interfering with the model's generation. Second, in cases where the model originally responds correctly, applying RAG can lead to an over-reliance on retrieved contexts, resulting in incorrect answers. To address these issues, we propose RULE, which consists of two components. First, we introduce a provably effective strategy for controlling factuality risk through the calibrated selection of the number of retrieved contexts. Second, based on samples where over-reliance on retrieved contexts led to errors, we curate a preference dataset to fine-tune the model, balancing its dependence on inherent knowledge and retrieved contexts for generation. We demonstrate the effectiveness of RULE on three medical VQA datasets, achieving an average improvement of 20.8% in factual accuracy. We publicly release our benchmark and code in https://github.com/richard-peng-xia/RULE.

As corporations rush to integrate large language models (LLMs) to their search offerings, it is critical that they provide factually accurate information that is robust to any presuppositions that a user may express. In this work, we introduce UPHILL, a dataset consisting of health-related queries with varying degrees of presuppositions. Using UPHILL, we evaluate the factual accuracy and consistency of InstructGPT, ChatGPT, and BingChat models. We find that while model responses rarely disagree with true health claims (posed as questions), they often fail to challenge false claims: responses from InstructGPT agree with 32% of the false claims, ChatGPT 26% and BingChat 23%. As we increase the extent of presupposition in input queries, the responses from InstructGPT and ChatGPT agree with the claim considerably more often, regardless of its veracity. Responses from BingChat, which rely on retrieved webpages, are not as susceptible. Given the moderate factual accuracy, and the inability of models to consistently correct false assumptions, our work calls for a careful assessment of current LLMs for use in high-stakes scenarios.

With the rapid development of large language models (LLMs), assessing their performance on health-related inquiries has become increasingly essential. It is critical that these models provide accurate and trustworthy health information, as their application in real-world contexts--where misinformation can have serious consequences for individuals seeking medical advice and support--depends on their reliability. In this work, we present CHBench, the first comprehensive Chinese Health-related Benchmark designed to evaluate LLMs' capabilities in understanding physical and mental health across diverse scenarios. CHBench includes 6,493 entries related to mental health and 2,999 entries focused on physical health, covering a broad spectrum of topics. This dataset serves as a foundation for evaluating Chinese LLMs' capacity to comprehend and generate accurate health-related information. Our extensive evaluations of four popular Chinese LLMs demonstrate that there remains considerable room for improvement in their understanding of health-related information. The code is available at https://github.com/TracyGuo2001/CHBench.

Recent advances in generative models, including large language models (LLMs), vision language models (VLMs), and diffusion models, have accelerated the field of natural language and image processing in medicine and marked a significant paradigm shift in how biomedical models can be developed and deployed. While these models are highly adaptable to new tasks, scaling and evaluating their usage presents new challenges not addressed in previous frameworks. In particular, the ability of these models to produce useful outputs with little to no specialized training data ("zero-" or "few-shot" approaches), as well as the open-ended nature of their outputs, necessitate the development of new guidelines for robust reporting of clinical generative model research. In response to gaps in standards and best practices for the development of clinical AI tools identified by US Executive Order 141103 and several emerging national networks for clinical AI evaluation, we begin to formalize some of these guidelines by building on the original MI-CLAIM checklist. The new checklist, MI-CLAIM-GEN (Table 1), aims to address differences in training, evaluation, interpretability, and reproducibility of new generative models compared to non-generative ("predictive") AI models. This MI-CLAIM-GEN checklist also seeks to clarify cohort selection reporting with unstructured clinical data and adds additional items on alignment with ethical standards for clinical AI research.

Large Language Models (LLMs) have attained human-level accuracy on medical question-answer (QA) benchmarks. However, their limitations in navigating open-ended clinical scenarios have recently been shown, raising concerns about the robustness and generalizability of LLM reasoning across diverse, real-world medical tasks. To probe potential LLM failure modes in clinical problem-solving, we present the medical abstraction and reasoning corpus (M-ARC). M-ARC assesses clinical reasoning through scenarios designed to exploit the Einstellung effect -- the fixation of thought arising from prior experience, targeting LLM inductive biases toward inflexible pattern matching from their training data rather than engaging in flexible reasoning. We find that LLMs, including current state-of-the-art o1 and Gemini models, perform poorly compared to physicians on M-ARC, often demonstrating lack of commonsense medical reasoning and a propensity to hallucinate. In addition, uncertainty estimation analyses indicate that LLMs exhibit overconfidence in their answers, despite their limited accuracy. The failure modes revealed by M-ARC in LLM medical reasoning underscore the need to exercise caution when deploying these models in clinical settings.

Access to the right evidence does not guarantee that large language models (LLMs) will reason with it correctly. This gap between retrieval and reasoning is especially concerning in clinical settings, where outputs must align with structured protocols. We study this gap using Written Exposure Therapy (WET) guidelines as a testbed. In evaluating model responses to curated clinician-vetted questions, we find that errors persist even when authoritative passages are provided. To address this, we propose an evaluation framework that measures accuracy, consistency, and fidelity of reasoning. Our results highlight both the potential and the risks: retrieval-augmented generation (RAG) can constrain outputs, but safe deployment requires assessing reasoning as rigorously as retrieval.

Infodemics and health misinformation have significant negative impact on individuals and society, exacerbating confusion and increasing hesitancy in adopting recommended health measures. Recent advancements in generative AI, capable of producing realistic, human like text and images, have significantly accelerated the spread and expanded the reach of health misinformation, resulting in an alarming surge in its dissemination. To combat the infodemics, most existing work has focused on developing misinformation datasets from social media and fact checking platforms, but has faced limitations in topical coverage, inclusion of AI generation, and accessibility of raw content. To address these issues, we present MM Health, a large scale multimodal misinformation dataset in the health domain consisting of 34,746 news article encompassing both textual and visual information. MM Health includes human-generated multimodal information (5,776 articles) and AI generated multimodal information (28,880 articles) from various SOTA generative AI models. Additionally, We benchmarked our dataset against three tasks (reliability checks, originality checks, and fine-grained AI detection) demonstrating that existing SOTA models struggle to accurately distinguish the reliability and origin of information. Our dataset aims to support the development of misinformation detection across various health scenarios, facilitating the detection of human and machine generated content at multimodal levels.

This research tests the role of Large Language Models (LLMs) as formal second opinion tools in professional decision-making, particularly focusing on complex medical cases where even experienced physicians seek peer consultation. The work analyzed 183 challenging medical cases from Medscape over a 20-month period, testing multiple LLMs' performance against crowd-sourced physician responses. A key finding was the high overall score possible in the latest foundational models (>80% accuracy compared to consensus opinion), which exceeds most human metrics reported on the same clinical cases (450 pages of patient profiles, test results). The study rates the LLMs' performance disparity between straightforward cases (>81% accuracy) and complex scenarios (43% accuracy), particularly in these cases generating substantial debate among human physicians. The research demonstrates that LLMs may be valuable as generators of comprehensive differential diagnoses rather than as primary diagnostic tools, potentially helping to counter cognitive biases in clinical decision-making, reduce cognitive loads, and thus remove some sources of medical error. The inclusion of a second comparative legal dataset (Supreme Court cases, N=21) provides added empirical context to the AI use to foster second opinions, though these legal challenges proved considerably easier for LLMs to analyze. In addition to the original contributions of empirical evidence for LLM accuracy, the research aggregated a novel benchmark for others to score highly contested question and answer reliability between both LLMs and disagreeing human practitioners. These results suggest that the optimal deployment of LLMs in professional settings may differ substantially from current approaches that emphasize automation of routine tasks.

The rise of misinformation, exacerbated by Large Language Models (LLMs) like GPT and Gemini, demands robust fact-checking solutions, especially for low-resource languages like Vietnamese. Existing methods struggle with semantic ambiguity, homonyms, and complex linguistic structures, often trading accuracy for efficiency. We introduce SemViQA, a novel Vietnamese fact-checking framework integrating Semantic-based Evidence Retrieval (SER) and Two-step Verdict Classification (TVC). Our approach balances precision and speed, achieving state-of-the-art results with 78.97\% strict accuracy on ISE-DSC01 and 80.82\% on ViWikiFC, securing 1st place in the UIT Data Science Challenge. Additionally, SemViQA Faster improves inference speed 7x while maintaining competitive accuracy. SemViQA sets a new benchmark for Vietnamese fact verification, advancing the fight against misinformation. The source code is available at: https://github.com/DAVID-NGUYEN-S16/SemViQA.

Despite achieving high accuracy on medical benchmarks, LLMs exhibit the Einstellung Effect in clinical diagnosis--relying on statistical shortcuts rather than patient-specific evidence, causing misdiagnosis in atypical cases. Existing benchmarks fail to detect this critical failure mode. We introduce MedEinst, a counterfactual benchmark with 5,383 paired clinical cases across 49 diseases. Each pair contains a control case and a "trap" case with altered discriminative evidence that flips the diagnosis. We measure susceptibility via Bias Trap Rate--probability of misdiagnosing traps despite correctly diagnosing controls. Extensive Evaluation of 17 LLMs shows frontier models achieve high baseline accuracy but severe bias trap rates. Thus, we propose ECR-Agent, aligning LLM reasoning with Evidence-Based Medicine standard via two components: (1) Dynamic Causal Inference (DCI) performs structured reasoning through dual-pathway perception, dynamic causal graph reasoning across three levels (association, intervention, counterfactual), and evidence audit for final diagnosis; (2) Critic-Driven Graph and Memory Evolution (CGME) iteratively refines the system by storing validated reasoning paths in an exemplar base and consolidating disease-specific knowledge into evolving illness graphs. Source code is to be released.

Generative Large Language Models (LLMs) such as GPT-3 are capable of generating highly fluent responses to a wide variety of user prompts. However, LLMs are known to hallucinate facts and make non-factual statements which can undermine trust in their output. Existing fact-checking approaches either require access to token-level output probability distribution (which may not be available for systems such as ChatGPT) or external databases that are interfaced via separate, often complex, modules. In this work, we propose "SelfCheckGPT", a simple sampling-based approach that can be used to fact-check black-box models in a zero-resource fashion, i.e. without an external database. SelfCheckGPT leverages the simple idea that if a LLM has knowledge of a given concept, sampled responses are likely to be similar and contain consistent facts. However, for hallucinated facts, stochastically sampled responses are likely to diverge and contradict one another. We investigate this approach by using GPT-3 to generate passages about individuals from the WikiBio dataset, and manually annotate the factuality of the generated passages. We demonstrate that SelfCheckGPT can: i) detect non-factual and factual sentences; and ii) rank passages in terms of factuality. We compare our approach to several existing baselines and show that in sentence hallucination detection, our approach has AUC-PR scores comparable to grey-box methods, while SelfCheckGPT is best at passage factuality assessment.

This paper describes the results of SemEval 2023 task 7 -- Multi-Evidence Natural Language Inference for Clinical Trial Data (NLI4CT) -- consisting of 2 tasks, a Natural Language Inference (NLI) task, and an evidence selection task on clinical trial data. The proposed challenges require multi-hop biomedical and numerical reasoning, which are of significant importance to the development of systems capable of large-scale interpretation and retrieval of medical evidence, to provide personalized evidence-based care. Task 1, the entailment task, received 643 submissions from 40 participants, and Task 2, the evidence selection task, received 364 submissions from 23 participants. The tasks are challenging, with the majority of submitted systems failing to significantly outperform the majority class baseline on the entailment task, and we observe significantly better performance on the evidence selection task than on the entailment task. Increasing the number of model parameters leads to a direct increase in performance, far more significant than the effect of biomedical pre-training. Future works could explore the limitations of large models for generalization and numerical inference, and investigate methods to augment clinical datasets to allow for more rigorous testing and to facilitate fine-tuning. We envisage that the dataset, models, and results of this task will be useful to the biomedical NLI and evidence retrieval communities. The dataset, competition leaderboard, and website are publicly available.

As language models (LMs) become integral to fields like healthcare, law, and journalism, their ability to differentiate between fact, belief, and knowledge is essential for reliable decision-making. Failure to grasp these distinctions can lead to significant consequences in areas such as medical diagnosis, legal judgments, and dissemination of fake news. Despite this, current literature has largely focused on more complex issues such as theory of mind, overlooking more fundamental epistemic challenges. This study systematically evaluates the epistemic reasoning capabilities of modern LMs, including GPT-4, Claude-3, and Llama-3, using a new dataset, KaBLE, consisting of 13,000 questions across 13 tasks. Our results reveal key limitations. First, while LMs achieve 86% accuracy on factual scenarios, their performance drops significantly with false scenarios, particularly in belief-related tasks. Second, LMs struggle with recognizing and affirming personal beliefs, especially when those beliefs contradict factual data, which raises concerns for applications in healthcare and counseling, where engaging with a person's beliefs is critical. Third, we identify a salient bias in how LMs process first-person versus third-person beliefs, performing better on third-person tasks (80.7%) compared to first-person tasks (54.4%). Fourth, LMs lack a robust understanding of the factive nature of knowledge, namely, that knowledge inherently requires truth. Fifth, LMs rely on linguistic cues for fact-checking and sometimes bypass the deeper reasoning. These findings highlight significant concerns about current LMs' ability to reason about truth, belief, and knowledge while emphasizing the need for advancements in these areas before broad deployment in critical sectors.

Fact-checking requires retrieving evidence related to a claim under investigation. The task can be formulated as question generation based on a claim, followed by question answering. However, recent question generation approaches assume that the answer is known and typically contained in a passage given as input, whereas such passages are what is being sought when verifying a claim. In this paper, we present {\it Varifocal}, a method that generates questions based on different focal points within a given claim, i.e.\ different spans of the claim and its metadata, such as its source and date. Our method outperforms previous work on a fact-checking question generation dataset on a wide range of automatic evaluation metrics. These results are corroborated by our manual evaluation, which indicates that our method generates more relevant and informative questions. We further demonstrate the potential of focal points in generating sets of clarification questions for product descriptions.

Factual hallucination remains a central challenge for large language models (LLMs). Existing mitigation approaches primarily rely on either external post-hoc verification or mapping uncertainty directly to abstention during fine-tuning, often resulting in overly conservative behavior. We propose VeriFY, a training-time framework that teaches LLMs to reason about factual uncertainty through consistency-based self-verification. VeriFY augments training with structured verification traces that guide the model to produce an initial answer, generate and answer a probing verification query, issue a consistency judgment, and then decide whether to answer or abstain. To address the risk of reinforcing hallucinated content when training on augmented traces, we introduce a stage-level loss masking approach that excludes hallucinated answer stages from the training objective while preserving supervision over verification behavior. Across multiple model families and scales, VeriFY reduces factual hallucination rates by 9.7 to 53.3 percent, with only modest reductions in recall (0.4 to 5.7 percent), and generalizes across datasets when trained on a single source. The source code, training data, and trained model checkpoints will be released upon acceptance.

Background: Large language models (LLMs) are trained to follow directions, but this introduces a vulnerability to blindly comply with user requests even if they generate wrong information. In medicine, this could accelerate the generation of misinformation that impacts human well-being. Objectives/Methods: We analyzed compliance to requests to generate misleading content about medications in settings where models know the request is illogical. We investigated whether in-context directions and instruction-tuning of LLMs to prioritize logical reasoning over compliance reduced misinformation risk. Results: While all frontier LLMs complied with misinformation requests, both prompt-based and parameter-based approaches can improve the detection of logic flaws in requests and prevent the dissemination of medical misinformation. Conclusion: Shifting LLMs to prioritize logic over compliance could reduce risks of exploitation for medical misinformation.

How do we most effectively treat a disease or condition? Ideally, we could consult a database of evidence gleaned from clinical trials to answer such questions. Unfortunately, no such database exists; clinical trial results are instead disseminated primarily via lengthy natural language articles. Perusing all such articles would be prohibitively time-consuming for healthcare practitioners; they instead tend to depend on manually compiled systematic reviews of medical literature to inform care. NLP may speed this process up, and eventually facilitate immediate consult of published evidence. The Evidence Inference dataset was recently released to facilitate research toward this end. This task entails inferring the comparative performance of two treatments, with respect to a given outcome, from a particular article (describing a clinical trial) and identifying supporting evidence. For instance: Does this article report that chemotherapy performed better than surgery for five-year survival rates of operable cancers? In this paper, we collect additional annotations to expand the Evidence Inference dataset by 25\%, provide stronger baseline models, systematically inspect the errors that these make, and probe dataset quality. We also release an abstract only (as opposed to full-texts) version of the task for rapid model prototyping. The updated corpus, documentation, and code for new baselines and evaluations are available at http://evidence-inference.ebm-nlp.com/.

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 grounded in factual medical knowledge. We produce 500k traces in English, Italian, and Spanish, using a retrievalaugmented 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 outof-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 safer, 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.

Fact verification systems typically assess whether a claim is supported by retrieved evidence, assuming that truthfulness depends solely on what is stated. However, many real-world claims are half-truths, factually correct yet misleading due to the omission of critical context. Existing models struggle with such cases, as they are not designed to reason about what is left unsaid. We introduce the task of half-truth detection, and propose PolitiFact-Hidden, a new benchmark with 15k political claims annotated with sentence-level evidence alignment and inferred claim intent. To address this challenge, we present TRACER, a modular re-assessment framework that identifies omission-based misinformation by aligning evidence, inferring implied intent, and estimating the causal impact of hidden content. TRACER can be integrated into existing fact-checking pipelines and consistently improves performance across multiple strong baselines. Notably, it boosts Half-True classification F1 by up to 16 points, highlighting the importance of modeling omissions for trustworthy fact verification.

A key component of fact verification is thevevidence retrieval, often from multiple documents. Recent approaches use dense representations and condition the retrieval of each document on the previously retrieved ones. The latter step is performed over all the documents in the collection, requiring storing their dense representations in an index, thus incurring a high memory footprint. An alternative paradigm is retrieve-and-rerank, where documents are retrieved using methods such as BM25, their sentences are reranked, and further documents are retrieved conditioned on these sentences, reducing the memory requirements. However, such approaches can be brittle as they rely on heuristics and assume hyperlinks between documents. We propose a novel retrieve-and-rerank method for multi-hop retrieval, that consists of a retriever that jointly scores documents in the knowledge source and sentences from previously retrieved documents using an autoregressive formulation and is guided by a proof system based on natural logic that dynamically terminates the retrieval process if the evidence is deemed sufficient. This method is competitive with current state-of-the-art methods on FEVER, HoVer and FEVEROUS-S, while using 5 to 10 times less memory than competing systems. Evaluation on an adversarial dataset indicates improved stability of our approach compared to commonly deployed threshold-based methods. Finally, the proof system helps humans predict model decisions correctly more often than using the evidence alone.

We introduce RJUA-QA, a novel medical dataset for question answering (QA) and reasoning with clinical evidence, contributing to bridge the gap between general large language models (LLMs) and medical-specific LLM applications. RJUA-QA is derived from realistic clinical scenarios and aims to facilitate LLMs in generating reliable diagnostic and advice. The dataset contains 2,132 curated Question-Context-Answer pairs, corresponding about 25,000 diagnostic records and clinical cases. The dataset covers 67 common urological disease categories, where the disease coverage exceeds 97.6\% of the population seeking medical services in urology. Each data instance in RJUA-QA comprises: (1) a question mirroring real patient to inquiry about clinical symptoms and medical conditions, (2) a context including comprehensive expert knowledge, serving as a reference for medical examination and diagnosis, (3) a doctor response offering the diagnostic conclusion and suggested examination guidance, (4) a diagnosed clinical disease as the recommended diagnostic outcome, and (5) clinical advice providing recommendations for medical examination. RJUA-QA is the first medical QA dataset for clinical reasoning over the patient inquiries, where expert-level knowledge and experience are required for yielding diagnostic conclusions and medical examination advice. A comprehensive evaluation is conducted to evaluate the performance of both medical-specific and general LLMs on the RJUA-QA dataset.

The rapid propagation of misinformation poses substantial risks to public interest. To combat misinformation, large language models (LLMs) are adapted to automatically verify claim credibility. Nevertheless, existing methods heavily rely on the embedded knowledge within LLMs and / or black-box APIs for evidence collection, leading to subpar performance with smaller LLMs or upon unreliable context. In this paper, we propose retrieval augmented fact verification through the synthesis of contrasting arguments (RAFTS). Upon input claims, RAFTS starts with evidence retrieval, where we design a retrieval pipeline to collect and re-rank relevant documents from verifiable sources. Then, RAFTS forms contrastive arguments (i.e., supporting or refuting) conditioned on the retrieved evidence. In addition, RAFTS leverages an embedding model to identify informative demonstrations, followed by in-context prompting to generate the prediction and explanation. Our method effectively retrieves relevant documents as evidence and evaluates arguments from varying perspectives, incorporating nuanced information for fine-grained decision-making. Combined with informative in-context examples as prior, RAFTS achieves significant improvements to supervised and LLM baselines without complex prompts. We demonstrate the effectiveness of our method through extensive experiments, where RAFTS can outperform GPT-based methods with a significantly smaller 7B LLM.

Automatic fact verification has become an increasingly popular topic in recent years and among datasets the Fact Extraction and VERification (FEVER) dataset is one of the most popular. In this work we present BEVERS, a tuned baseline system for the FEVER dataset. Our pipeline uses standard approaches for document retrieval, sentence selection, and final claim classification, however, we spend considerable effort ensuring optimal performance for each component. The results are that BEVERS achieves the highest FEVER score and label accuracy among all systems, published or unpublished. We also apply this pipeline to another fact verification dataset, Scifact, and achieve the highest label accuracy among all systems on that dataset as well. We also make our full code available.

Health-related misinformation is very prevalent and potentially harmful. It is difficult to identify, especially when claims distort or misinterpret scientific findings. We investigate the impact of synthetic data generation and lightweight fine-tuning techniques on the ability of large language models (LLMs) to recognize fallacious arguments using the MISSCI dataset and framework. In this work, we propose MisSynth, a pipeline that applies retrieval-augmented generation (RAG) to produce synthetic fallacy samples, which are then used to fine-tune an LLM model. Our results show substantial accuracy gains with fine-tuned models compared to vanilla baselines. For instance, the LLaMA 3.1 8B fine-tuned model achieved an over 35% F1-score absolute improvement on the MISSCI test split over its vanilla baseline. We demonstrate that introducing synthetic fallacy data to augment limited annotated resources can significantly enhance zero-shot LLM classification performance on real-world scientific misinformation tasks, even with limited computational resources. The code and synthetic dataset are available on https://github.com/mxpoliakov/MisSynth.

Researchers have found that fake news spreads much times faster than real news. This is a major problem, especially in today's world where social media is the key source of news for many among the younger population. Fact verification, thus, becomes an important task and many media sites contribute to the cause. Manual fact verification is a tedious task, given the volume of fake news online. The Factify5WQA shared task aims to increase research towards automated fake news detection by providing a dataset with an aspect-based question answering based fact verification method. Each claim and its supporting document is associated with 5W questions that help compare the two information sources. The objective performance measure in the task is done by comparing answers using BLEU score to measure the accuracy of the answers, followed by an accuracy measure of the classification. The task had submissions using custom training setup and pre-trained language-models among others. The best performing team posted an accuracy of 69.56%, which is a near 35% improvement over the baseline.

While there are numerous benchmarks comparing the performance of modern language models (LMs), end-task evaluations often conflate notions of *factual accuracy* ("truth") and *reasoning ability* ("rationality", or "honesty" in the sense of correctly reporting implications of beliefs). Our goal is a dataset that clearly distinguishes these two notions. Our approach is to leverage and extend a collection of human-annotated *entailment trees*, engineered to express both good and bad chains of reasoning, and using a mixture of true and false facts, in particular including counterfactual examples, to avoid belief bias (also known as the "content effect"). The resulting dataset, called BaRDa, contains 3000 entailments (1787 valid, 1213 invalid), using 6681 true and 2319 false statements. Testing on four GPT-series models, GPT3(curie)/GPT3(davinici)/3.5/4, we find factual accuracy (truth) scores of 74.1/80.6/82.6/87.1 and reasoning accuracy scores of 63.1/78.0/71.8/79.2. This shows the clear progression of models towards improved factual accuracy and entailment reasoning, and the dataset provides a new benchmark that more cleanly separates and quantifies these two notions.

Recent advances in reasoning with large language models (LLMs)has shown remarkable reasoning capabilities in domains such as mathematics and coding, yet their application to clinical diagnosis remains underexplored. Here, we introduce ClinicalGPT-R1, a reasoning enhanced generalist large language model for disease diagnosis. Trained on a dataset of 20,000 real-world clinical records, ClinicalGPT-R1 leverages diverse training strategies to enhance diagnostic reasoning. To benchmark performance, we curated MedBench-Hard, a challenging dataset spanning seven major medical specialties and representative diseases. Experimental results demonstrate that ClinicalGPT-R1 outperforms GPT-4o in Chinese diagnostic tasks and achieves comparable performance to GPT-4 in English settings. This comparative study effectively validates the superior performance of ClinicalGPT-R1 in disease diagnosis tasks. Resources are available at https://github.com/medfound/medfound.

Current Large Language Models (LLMs) exhibit significant limitations, notably in structured, interpretable, and verifiable medical reasoning, alongside practical deployment challenges related to computational resources and data privacy. This report focused on the development of WiNGPT-3.0, the 32-billion parameter LLMs, engineered with the objective of enhancing its capacity for medical reasoning and exploring its potential for effective integration within healthcare IT infrastructures. The broader aim is to advance towards clinically applicable models. The approach involved a multi-stage training pipeline tailored for general, medical, and clinical reasoning. This pipeline incorporated supervised fine-tuning (SFT) and reinforcement learning (RL), leveraging curated Long Chain-of-Thought (CoT) datasets, auxiliary reward models, and an evidence-based diagnostic chain simulation. WiNGPT-3.0 demonstrated strong performance: specific model variants achieved scores of 66.6 on MedCalc and 87.1 on MedQA-USMLE. Furthermore, targeted training improved performance on a clinical reasoning task from a baseline score of 58.1 to 62.5. These findings suggest that reinforcement learning, even when applied with a limited dataset of only a few thousand examples, can enhance medical reasoning accuracy. Crucially, this demonstration of RL's efficacy with limited data and computation paves the way for more trustworthy and practically deployable LLMs within clinical workflows and health information infrastructures.

Fact-checking is an important way to combat misinformation on social media, especially during significant social events such as the COVID-19 pandemic and the U.S. presidential elections. In this study, we thoroughly evaluated the performance of Google Fact Check, a search engine specifically for fact-checking results, by analyzing the results returned from Google Fact Check regarding 1,000 false claims about COVID-19. We found that Google Fact Check could not provide sufficient fact-checking information for most false claims, even though the results provided are relatively reliable and helpful. We also found that claims getting different fact-checking verdicts tend to contain different emotional tones, and different sources tend to check claims using dictionary words to different extents and at different lengths. Claims in different descriptions are likely to get different fact-checking results. We aimed to bring up the best practice of fact-checking for the general people based on our analyses.

Recent benchmarks have probed factual consistency and rhetorical robustness in Large Language Models (LLMs). However, a knowledge gap exists regarding how directional framing of factually true statements influences model agreement, a common scenario for LLM users. AssertBench addresses this by sampling evidence-supported facts from FEVEROUS, a fact verification dataset. For each (evidence-backed) fact, we construct two framing prompts: one where the user claims the statement is factually correct, and another where the user claims it is incorrect. We then record the model's agreement and reasoning. The desired outcome is that the model asserts itself, maintaining consistent truth evaluation across both framings, rather than switching its evaluation to agree with the user. AssertBench isolates framing-induced variability from the model's underlying factual knowledge by stratifying results based on the model's accuracy on the same claims when presented neutrally. In doing so, this benchmark aims to measure an LLM's ability to "stick to its guns" when presented with contradictory user assertions about the same fact. The complete source code is available at https://github.com/achowd32/assert-bench.