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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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/

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.

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.

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.

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.

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.

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.

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

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.

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.

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.

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.

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.

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.

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.

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.

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/.

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.

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.

This technical report introduces a Named Clinical Entity Recognition Benchmark for evaluating language models in healthcare, addressing the crucial natural language processing (NLP) task of extracting structured information from clinical narratives to support applications like automated coding, clinical trial cohort identification, and clinical decision support. The leaderboard provides a standardized platform for assessing diverse language models, including encoder and decoder architectures, on their ability to identify and classify clinical entities across multiple medical domains. A curated collection of openly available clinical datasets is utilized, encompassing entities such as diseases, symptoms, medications, procedures, and laboratory measurements. Importantly, these entities are standardized according to the Observational Medical Outcomes Partnership (OMOP) Common Data Model, ensuring consistency and interoperability across different healthcare systems and datasets, and a comprehensive evaluation of model performance. Performance of models is primarily assessed using the F1-score, and it is complemented by various assessment modes to provide comprehensive insights into model performance. The report also includes a brief analysis of models evaluated to date, highlighting observed trends and limitations. By establishing this benchmarking framework, the leaderboard aims to promote transparency, facilitate comparative analyses, and drive innovation in clinical entity recognition tasks, addressing the need for robust evaluation methods in healthcare NLP.

Data visualizations are common in the real-world. We often use them in data sources such as scientific documents, news articles, textbooks, and social media to summarize key information in a visual form. Charts can also mislead its audience by communicating false information or biasing them towards a specific agenda. Verifying claims against charts is not a straightforward process. It requires analyzing both the text and visual components of the chart, considering characteristics such as colors, positions, and orientations. Moreover, to determine if a claim is supported by the chart content often requires different types of reasoning. To address this challenge, we introduce ChartCheck, a novel dataset for fact-checking against chart images. ChartCheck is the first large-scale dataset with 1.7k real-world charts and 10.5k human-written claims and explanations. We evaluated the dataset on state-of-the-art models and achieved an accuracy of 73.9 in the finetuned setting. Additionally, we identified chart characteristics and reasoning types that challenge the models.

Finding relevant literature underpins the practice of evidence-based medicine. From 2014 to 2016, TREC conducted a clinical decision support track, wherein participants were tasked with finding articles relevant to clinical questions posed by physicians. In total, 87 teams have participated over the past three years, generating 395 runs. During this period, each team has trialled a variety of methods. While there was significant overlap in the methods employed by different teams, the results were varied. Due to the diversity of the platforms used, the results arising from the different techniques are not directly comparable, reducing the ability to build on previous work. By using a stable platform, we have been able to compare different document and query processing techniques, allowing us to experiment with different search parameters. We have used our system to reproduce leading teams runs, and compare the results obtained. By benchmarking our indexing and search techniques, we can statistically test a variety of hypotheses, paving the way for further research.

The pervasiveness of large language models and generative AI in online media has amplified the need for effective automated fact-checking to assist fact-checkers in tackling the increasing volume and sophistication of misinformation. The complex nature of fact-checking demands that automated fact-checking systems provide explanations that enable fact-checkers to scrutinise their outputs. However, it is unclear how these explanations should align with the decision-making and reasoning processes of fact-checkers to be effectively integrated into their workflows. Through semi-structured interviews with fact-checking professionals, we bridge this gap by: (i) providing an account of how fact-checkers assess evidence, make decisions, and explain their processes; (ii) examining how fact-checkers use automated tools in practice; and (iii) identifying fact-checker explanation requirements for automated fact-checking tools. The findings show unmet explanation needs and identify important criteria for replicable fact-checking explanations that trace the model's reasoning path, reference specific evidence, and highlight uncertainty and information gaps.

Clinical diagnosis prediction models, when provided with a patient's medical history, aim to detect potential diseases early, facilitating timely intervention and improving prognostic outcomes. However, the inherent scarcity of patient data and large disease candidate space often pose challenges in developing satisfactory models for this intricate task. The exploration of leveraging Large Language Models (LLMs) for encapsulating clinical decision processes has been limited. We introduce MERA, a clinical diagnosis prediction model that bridges pertaining natural language knowledge with medical practice. We apply hierarchical contrastive learning on a disease candidate ranking list to alleviate the large decision space issue. With concept memorization through fine-tuning, we bridge the natural language clinical knowledge with medical codes. Experimental results on MIMIC-III and IV datasets show that MERA achieves the state-of-the-art diagnosis prediction performance and dramatically elevates the diagnosis prediction capabilities of generative LMs.

Artificial intelligence has advanced in Medical Visual Question Answering (Med-VQA), but prevalent research tends to focus on the accuracy of the answers, often overlooking the reasoning paths and interpretability, which are crucial in clinical settings. Besides, current Med-VQA algorithms, typically reliant on singular models, lack the robustness needed for real-world medical diagnostics which usually require collaborative expert evaluation. To address these shortcomings, this paper presents MedCoT, a novel hierarchical expert verification reasoning chain method designed to enhance interpretability and accuracy in biomedical imaging inquiries. MedCoT is predicated on two principles: The necessity for explicit reasoning paths in Med-VQA and the requirement for multi-expert review to formulate accurate conclusions. The methodology involves an Initial Specialist proposing diagnostic rationales, followed by a Follow-up Specialist who validates these rationales, and finally, a consensus is reached through a vote among a sparse Mixture of Experts within the locally deployed Diagnostic Specialist, which then provides the definitive diagnosis. Experimental evaluations on four standard Med-VQA datasets demonstrate that MedCoT surpasses existing state-of-the-art approaches, providing significant improvements in performance and interpretability.

Despite the potential of Large Language Models (LLMs) in medicine, they may generate responses lacking supporting evidence or based on hallucinated evidence. While Retrieval Augment Generation (RAG) is popular to address this issue, few studies implemented and evaluated RAG in downstream domain-specific applications. We developed a RAG pipeline with 70,000 ophthalmology-specific documents that retrieve relevant documents to augment LLMs during inference time. In a case study on long-form consumer health questions, we systematically evaluated the responses including over 500 references of LLMs with and without RAG on 100 questions with 10 healthcare professionals. The evaluation focuses on factuality of evidence, selection and ranking of evidence, attribution of evidence, and answer accuracy and completeness. LLMs without RAG provided 252 references in total. Of which, 45.3% hallucinated, 34.1% consisted of minor errors, and 20.6% were correct. In contrast, LLMs with RAG significantly improved accuracy (54.5% being correct) and reduced error rates (18.8% with minor hallucinations and 26.7% with errors). 62.5% of the top 10 documents retrieved by RAG were selected as the top references in the LLM response, with an average ranking of 4.9. The use of RAG also improved evidence attribution (increasing from 1.85 to 2.49 on a 5-point scale, P<0.001), albeit with slight decreases in accuracy (from 3.52 to 3.23, P=0.03) and completeness (from 3.47 to 3.27, P=0.17). The results demonstrate that LLMs frequently exhibited hallucinated and erroneous evidence in the responses, raising concerns for downstream applications in the medical domain. RAG substantially reduced the proportion of such evidence but encountered challenges.

This paper describes our participant system for the multi-modal fact verification (Factify) challenge at AAAI 2022. Despite the recent advance in text based verification techniques and large pre-trained multimodal models cross vision and language, very limited work has been done in applying multimodal techniques to automate fact checking process, particularly considering the increasing prevalence of claims and fake news about images and videos on social media. In our work, the challenge is treated as multimodal entailment task and framed as multi-class classification. Two baseline approaches are proposed and explored including an ensemble model (combining two uni-modal models) and a multi-modal attention network (modeling the interaction between image and text pair from claim and evidence document). We conduct several experiments investigating and benchmarking different SoTA pre-trained transformers and vision models in this work. Our best model is ranked first in leaderboard which obtains a weighted average F-measure of 0.77 on both validation and test set. Exploratory analysis of dataset is also carried out on the Factify data set and uncovers salient patterns and issues (e.g., word overlapping, visual entailment correlation, source bias) that motivates our hypothesis. Finally, we highlight challenges of the task and multimodal dataset for future research.

In this paper, we examine several methods of acquiring Czech data for automated fact-checking, which is a task commonly modeled as a classification of textual claim veracity w.r.t. a corpus of trusted ground truths. We attempt to collect sets of data in form of a factual claim, evidence within the ground truth corpus, and its veracity label (supported, refuted or not enough info). As a first attempt, we generate a Czech version of the large-scale FEVER dataset built on top of Wikipedia corpus. We take a hybrid approach of machine translation and document alignment; the approach and the tools we provide can be easily applied to other languages. We discuss its weaknesses and inaccuracies, propose a future approach for their cleaning and publish the 127k resulting translations, as well as a version of such dataset reliably applicable for the Natural Language Inference task - the CsFEVER-NLI. Furthermore, we collect a novel dataset of 3,097 claims, which is annotated using the corpus of 2.2M articles of Czech News Agency. We present its extended annotation methodology based on the FEVER approach, and, as the underlying corpus is kept a trade secret, we also publish a standalone version of the dataset for the task of Natural Language Inference we call CTKFactsNLI. We analyze both acquired datasets for spurious cues - annotation patterns leading to model overfitting. CTKFacts is further examined for inter-annotator agreement, thoroughly cleaned, and a typology of common annotator errors is extracted. Finally, we provide baseline models for all stages of the fact-checking pipeline and publish the NLI datasets, as well as our annotation platform and other experimental data.

Combating disinformation is one of the burning societal crises -- about 67% of the American population believes that disinformation produces a lot of uncertainty, and 10% of them knowingly propagate disinformation. Evidence shows that disinformation can manipulate democratic processes and public opinion, causing disruption in the share market, panic and anxiety in society, and even death during crises. Therefore, disinformation should be identified promptly and, if possible, mitigated. With approximately 3.2 billion images and 720,000 hours of video shared online daily on social media platforms, scalable detection of multimodal disinformation requires efficient fact verification. Despite progress in automatic text-based fact verification (e.g., FEVER, LIAR), the research community lacks substantial effort in multimodal fact verification. To address this gap, we introduce FACTIFY 3M, a dataset of 3 million samples that pushes the boundaries of the domain of fact verification via a multimodal fake news dataset, in addition to offering explainability through the concept of 5W question-answering. Salient features of the dataset include: (i) textual claims, (ii) ChatGPT-generated paraphrased claims, (iii) associated images, (iv) stable diffusion-generated additional images (i.e., visual paraphrases), (v) pixel-level image heatmap to foster image-text explainability of the claim, (vi) 5W QA pairs, and (vii) adversarial fake news stories.

Despite their impressive generative capabilities, LLMs are hindered by fact-conflicting hallucinations in real-world applications. The accurate identification of hallucinations in texts generated by LLMs, especially in complex inferential scenarios, is a relatively unexplored area. To address this gap, we present FactCHD, a dedicated benchmark designed for the detection of fact-conflicting hallucinations from LLMs. FactCHD features a diverse dataset that spans various factuality patterns, including vanilla, multi-hop, comparison, and set operation. A distinctive element of FactCHD is its integration of fact-based evidence chains, significantly enhancing the depth of evaluating the detectors' explanations. Experiments on different LLMs expose the shortcomings of current approaches in detecting factual errors accurately. Furthermore, we introduce Truth-Triangulator that synthesizes reflective considerations by tool-enhanced ChatGPT and LoRA-tuning based on Llama2, aiming to yield more credible detection through the amalgamation of predictive results and evidence. The benchmark dataset is available at https://github.com/zjunlp/FactCHD.

Clinical question answering systems have the potential to provide clinicians with relevant and timely answers to their questions. Nonetheless, despite the advances that have been made, adoption of these systems in clinical settings has been slow. One issue is a lack of question-answering datasets which reflect the real-world needs of health professionals. In this work, we present RealMedQA, a dataset of realistic clinical questions generated by humans and an LLM. We describe the process for generating and verifying the QA pairs and assess several QA models on BioASQ and RealMedQA to assess the relative difficulty of matching answers to questions. We show that the LLM is more cost-efficient for generating "ideal" QA pairs. Additionally, we achieve a lower lexical similarity between questions and answers than BioASQ which provides an additional challenge to the top two QA models, as per the results. We release our code and our dataset publicly to encourage further research.

The increased use of large language models (LLMs) across a variety of real-world applications calls for mechanisms to verify the factual accuracy of their outputs. In this work, we present a holistic end-to-end solution for annotating the factuality of LLM-generated responses, which encompasses a multi-stage annotation scheme designed to yield detailed labels concerning the verifiability and factual inconsistencies found in LLM outputs. We design and build an annotation tool to speed up the labelling procedure and ease the workload of raters. It allows flexible incorporation of automatic results in any stage, e.g. automatically-retrieved evidence. We further construct an open-domain document-level factuality benchmark in three-level granularity: claim, sentence and document. Preliminary experiments show that FacTool, FactScore and Perplexity.ai are struggling to identify false claims with the best F1=0.53. Annotation tool, benchmark and code are available at https://github.com/yuxiaw/Factcheck-GPT.

In response to the pressing need for advanced clinical problem-solving tools in healthcare, we introduce BooksMed, a novel framework based on a Large Language Model (LLM). BooksMed uniquely emulates human cognitive processes to deliver evidence-based and reliable responses, utilizing the GRADE (Grading of Recommendations, Assessment, Development, and Evaluations) framework to effectively quantify evidence strength. For clinical decision-making to be appropriately assessed, an evaluation metric that is clinically aligned and validated is required. As a solution, we present ExpertMedQA, a multispecialty clinical benchmark comprised of open-ended, expert-level clinical questions, and validated by a diverse group of medical professionals. By demanding an in-depth understanding and critical appraisal of up-to-date clinical literature, ExpertMedQA rigorously evaluates LLM performance. BooksMed outperforms existing state-of-the-art models Med-PaLM 2, Almanac, and ChatGPT in a variety of medical scenarios. Therefore, a framework that mimics human cognitive stages could be a useful tool for providing reliable and evidence-based responses to clinical inquiries.

Global healthcare providers are exploring use of large language models (LLMs) to provide medical advice to the public. LLMs now achieve nearly perfect scores on medical licensing exams, but this does not necessarily translate to accurate performance in real-world settings. We tested if LLMs can assist members of the public in identifying underlying conditions and choosing a course of action (disposition) in ten medical scenarios in a controlled study with 1,298 participants. Participants were randomly assigned to receive assistance from an LLM (GPT-4o, Llama 3, Command R+) or a source of their choice (control). Tested alone, LLMs complete the scenarios accurately, correctly identifying conditions in 94.9% of cases and disposition in 56.3% on average. However, participants using the same LLMs identified relevant conditions in less than 34.5% of cases and disposition in less than 44.2%, both no better than the control group. We identify user interactions as a challenge to the deployment of LLMs for medical advice. Standard benchmarks for medical knowledge and simulated patient interactions do not predict the failures we find with human participants. Moving forward, we recommend systematic human user testing to evaluate interactive capabilities prior to public deployments in healthcare.

Hallucinated outputs from language models pose risks in the medical domain, especially for lay audiences making health-related decisions. Existing factuality evaluation methods, such as entailment- and question-answering-based (QA), struggle with plain language summary (PLS) generation due to elaborative explanation phenomenon, which introduces external content (e.g., definitions, background, examples) absent from the source document to enhance comprehension. To address this, we introduce PlainQAFact, a framework trained on a fine-grained, human-annotated dataset PlainFact, to evaluate the factuality of both source-simplified and elaboratively explained sentences. PlainQAFact first classifies factuality type and then assesses factuality using a retrieval-augmented QA-based scoring method. Our approach is lightweight and computationally efficient. Empirical results show that existing factuality metrics fail to effectively evaluate factuality in PLS, especially for elaborative explanations, whereas PlainQAFact achieves state-of-the-art performance. We further analyze its effectiveness across external knowledge sources, answer extraction strategies, overlap measures, and document granularity levels, refining its overall factuality assessment.

Fact-checking is essential due to the explosion of misinformation in the media ecosystem. Although false information exists in every language and country, most research to solve the problem mainly concentrated on huge communities like English and Chinese. Low-resource languages like Vietnamese are necessary to explore corpora and models for fact verification. To bridge this gap, we construct ViWikiFC, the first manual annotated open-domain corpus for Vietnamese Wikipedia Fact Checking more than 20K claims generated by converting evidence sentences extracted from Wikipedia articles. We analyze our corpus through many linguistic aspects, from the new dependency rate, the new n-gram rate, and the new word rate. We conducted various experiments for Vietnamese fact-checking, including evidence retrieval and verdict prediction. BM25 and InfoXLM (Large) achieved the best results in two tasks, with BM25 achieving an accuracy of 88.30% for SUPPORTS, 86.93% for REFUTES, and only 56.67% for the NEI label in the evidence retrieval task, InfoXLM (Large) achieved an F1 score of 86.51%. Furthermore, we also conducted a pipeline approach, which only achieved a strict accuracy of 67.00% when using InfoXLM (Large) and BM25. These results demonstrate that our dataset is challenging for the Vietnamese language model in fact-checking tasks.

Recent research advances achieve human-level accuracy for de-identifying free-text clinical notes on research datasets, but gaps remain in reproducing this in large real-world settings. This paper summarizes lessons learned from building a system used to de-identify over one billion real clinical notes, in a fully automated way, that was independently certified by multiple organizations for production use. A fully automated solution requires a very high level of accuracy that does not require manual review. A hybrid context-based model architecture is described, which outperforms a Named Entity Recogniton (NER) - only model by 10% on the i2b2-2014 benchmark. The proposed system makes 50%, 475%, and 575% fewer errors than the comparable AWS, Azure, and GCP services respectively while also outperforming ChatGPT by 33%. It exceeds 98% coverage of sensitive data across 7 European languages, without a need for fine tuning. A second set of described models enable data obfuscation -- replacing sensitive data with random surrogates -- while retaining name, date, gender, clinical, and format consistency. Both the practical need and the solution architecture that provides for reliable & linked anonymized documents are described.

Large Language Models (LLMs) are at the forefront of NLP achievements but fall short in dealing with shortcut learning, factual inconsistency, and vulnerability to adversarial inputs.These shortcomings are especially critical in medical contexts, where they can misrepresent actual model capabilities. Addressing this, we present SemEval-2024 Task 2: Safe Biomedical Natural Language Inference for ClinicalTrials. Our contributions include the refined NLI4CT-P dataset (i.e., Natural Language Inference for Clinical Trials - Perturbed), designed to challenge LLMs with interventional and causal reasoning tasks, along with a comprehensive evaluation of methods and results for participant submissions. A total of 106 participants registered for the task contributing to over 1200 individual submissions and 25 system overview papers. This initiative aims to advance the robustness and applicability of NLI models in healthcare, ensuring safer and more dependable AI assistance in clinical decision-making. We anticipate that the dataset, models, and outcomes of this task can support future research in the field of biomedical NLI. The dataset, competition leaderboard, and website are publicly available.

Large language models have exhibited exceptional performance on various Natural Language Processing (NLP) tasks, leveraging techniques such as the pre-training, and instruction fine-tuning. Despite these advances, their effectiveness in medical applications is limited, due to challenges such as factual inaccuracies, reasoning abilities, and lack grounding in real-world experience. In this study, we present ClinicalGPT, a language model explicitly designed and optimized for clinical scenarios. By incorporating extensive and diverse real-world data, such as medical records, domain-specific knowledge, and multi-round dialogue consultations in the training process, ClinicalGPT is better prepared to handle multiple clinical task. Furthermore, we introduce a comprehensive evaluation framework that includes medical knowledge question-answering, medical exams, patient consultations, and diagnostic analysis of medical records. Our results demonstrate that ClinicalGPT significantly outperforms other models in these tasks, highlighting the effectiveness of our approach in adapting large language models to the critical domain of healthcare.

Although large language models (LLMs) have demonstrated impressive reasoning capabilities across general domains, their effectiveness in real-world clinical practice remains limited. This is likely due to their insufficient exposure to real-world clinical data during training, as such data is typically not included due to privacy concerns. To address this, we propose enhancing the clinical reasoning capabilities of LLMs by leveraging real-world clinical data. We constructed reasoning-intensive questions from a nationwide sepsis registry and fine-tuned Phi-4 on these questions using reinforcement learning, resulting in C-Reason. C-Reason exhibited strong clinical reasoning capabilities on the in-domain test set, as evidenced by both quantitative metrics and expert evaluations. Furthermore, its enhanced reasoning capabilities generalized to a sepsis dataset involving different tasks and patient cohorts, an open-ended consultations on antibiotics use task, and other diseases. Future research should focus on training LLMs with large-scale, multi-disease clinical datasets to develop more powerful, general-purpose clinical reasoning models.

The exponential surge in online health information, coupled with its increasing use by non-experts, highlights the pressing need for advanced Health Information Retrieval models that consider not only topical relevance but also the factual accuracy of the retrieved information, given the potential risks associated with health misinformation. To this aim, this paper introduces a solution driven by Retrieval-Augmented Generation (RAG), which leverages the capabilities of generative Large Language Models (LLMs) to enhance the retrieval of health-related documents grounded in scientific evidence. In particular, we propose a three-stage model: in the first stage, the user's query is employed to retrieve topically relevant passages with associated references from a knowledge base constituted by scientific literature. In the second stage, these passages, alongside the initial query, are processed by LLMs to generate a contextually relevant rich text (GenText). In the last stage, the documents to be retrieved are evaluated and ranked both from the point of view of topical relevance and factual accuracy by means of their comparison with GenText, either through stance detection or semantic similarity. In addition to calculating factual accuracy, GenText can offer a layer of explainability for it, aiding users in understanding the reasoning behind the retrieval. Experimental evaluation of our model on benchmark datasets and against baseline models demonstrates its effectiveness in enhancing the retrieval of both topically relevant and factually accurate health information, thus presenting a significant step forward in the health misinformation mitigation problem.

Our fight against false information is spearheaded by fact-checkers. They investigate the veracity of claims and document their findings as fact-checking reports. With the rapid increase in the amount of false information circulating online, the use of automation in fact-checking processes aims to strengthen this ecosystem by enhancing scalability. Datasets containing fact-checked claims play a key role in developing such automated solutions. However, to the best of our knowledge, there is no fact-checking dataset at the ecosystem level, covering claims from a sufficiently long period of time and sourced from a wide range of actors reflecting the entire ecosystem that admittedly follows widely-accepted codes and principles of fact-checking. We present a new dataset FACTors, the first to fill this gap by presenting ecosystem-level data on fact-checking. It contains 118,112 claims from 117,993 fact-checking reports in English (co-)authored by 1,953 individuals and published during the period of 1995-2025 by 39 fact-checking organisations that are active signatories of the IFCN (International Fact-Checking Network) and/or EFCSN (European Fact-Checking Standards Network). It contains 7,327 overlapping claims investigated by multiple fact-checking organisations, corresponding to 2,977 unique claims. It allows to conduct new ecosystem-level studies of the fact-checkers (organisations and individuals). To demonstrate the usefulness of FACTors, we present three example applications, including a first-of-its-kind statistical analysis of the fact-checking ecosystem, examining the political inclinations of the fact-checking organisations, and attempting to assign a credibility score to each organisation based on the findings of the statistical analysis and political leanings. Our methods for constructing FACTors are generic and can be used to maintain a live dataset that can be updated dynamically.

We introduce MedXpertQA, a highly challenging and comprehensive benchmark to evaluate expert-level medical knowledge and advanced reasoning. MedXpertQA includes 4,460 questions spanning 17 specialties and 11 body systems. It includes two subsets, Text for text evaluation and MM for multimodal evaluation. Notably, MM introduces expert-level exam questions with diverse images and rich clinical information, including patient records and examination results, setting it apart from traditional medical multimodal benchmarks with simple QA pairs generated from image captions. MedXpertQA applies rigorous filtering and augmentation to address the insufficient difficulty of existing benchmarks like MedQA, and incorporates specialty board questions to improve clinical relevance and comprehensiveness. We perform data synthesis to mitigate data leakage risk and conduct multiple rounds of expert reviews to ensure accuracy and reliability. We evaluate 16 leading models on MedXpertQA. Moreover, medicine is deeply connected to real-world decision-making, providing a rich and representative setting for assessing reasoning abilities beyond mathematics and code. To this end, we develop a reasoning-oriented subset to facilitate the assessment of o1-like models.

Misinformation threatens modern society by promoting distrust in science, changing narratives in public health, heightening social polarization, and disrupting democratic elections and financial markets, among a myriad of other societal harms. To address this, a growing cadre of professional fact-checkers and journalists provide high-quality investigations into purported facts. However, these largely manual efforts have struggled to match the enormous scale of the problem. In response, a growing body of Natural Language Processing (NLP) technologies have been proposed for more scalable fact-checking. Despite tremendous growth in such research, however, practical adoption of NLP technologies for fact-checking still remains in its infancy today. In this work, we review the capabilities and limitations of the current NLP technologies for fact-checking. Our particular focus is to further chart the design space for how these technologies can be harnessed and refined in order to better meet the needs of human fact-checkers. To do so, we review key aspects of NLP-based fact-checking: task formulation, dataset construction, modeling, and human-centered strategies, such as explainable models and human-in-the-loop approaches. Next, we review the efficacy of applying NLP-based fact-checking tools to assist human fact-checkers. We recommend that future research include collaboration with fact-checker stakeholders early on in NLP research, as well as incorporation of human-centered design practices in model development, in order to further guide technology development for human use and practical adoption. Finally, we advocate for more research on benchmark development supporting extrinsic evaluation of human-centered fact-checking technologies.

Given the widespread dissemination of misinformation on social media, implementing fact-checking mechanisms for online claims is essential. Manually verifying every claim is highly challenging, underscoring the need for an automated fact-checking system. This paper presents our system designed to address this issue. We utilize the Averitec dataset to assess the veracity of claims. In addition to veracity prediction, our system provides supporting evidence, which is extracted from the dataset. We develop a Retrieve and Generate (RAG) pipeline to extract relevant evidence sentences from a knowledge base, which are then inputted along with the claim into a large language model (LLM) for classification. We also evaluate the few-shot In-Context Learning (ICL) capabilities of multiple LLMs. Our system achieves an 'Averitec' score of 0.33, which is a 22% absolute improvement over the baseline. All code will be made available on All code will be made available on https://github.com/ronit-singhal/evidence-backed-fact-checking-using-rag-and-few-shot-in-context-learning-with-llms.

Faithfulness hallucinations are claims generated by a Large Language Model (LLM) not supported by contexts provided to the LLM. Lacking assessment standards, existing benchmarks focus on "factual statements" that rephrase source materials while overlooking "cognitive statements" that involve making inferences from the given context. Consequently, evaluating and detecting the hallucination of cognitive statements remains challenging. Inspired by how evidence is assessed in the legal domain, we design a rigorous framework to assess different levels of faithfulness of cognitive statements and introduce the CogniBench dataset where we reveal insightful statistics. To keep pace with rapidly evolving LLMs, we further develop an automatic annotation pipeline that scales easily across different models. This results in a large-scale CogniBench-L dataset, which facilitates training accurate detectors for both factual and cognitive hallucinations. We release our model and datasets at: https://github.com/FUTUREEEEEE/CogniBench

An accurate differential diagnosis (DDx) is a cornerstone of medical care, often reached through an iterative process of interpretation that combines clinical history, physical examination, investigations and procedures. Interactive interfaces powered by Large Language Models (LLMs) present new opportunities to both assist and automate aspects of this process. In this study, we introduce an LLM optimized for diagnostic reasoning, and evaluate its ability to generate a DDx alone or as an aid to clinicians. 20 clinicians evaluated 302 challenging, real-world medical cases sourced from the New England Journal of Medicine (NEJM) case reports. Each case report was read by two clinicians, who were randomized to one of two assistive conditions: either assistance from search engines and standard medical resources, or LLM assistance in addition to these tools. All clinicians provided a baseline, unassisted DDx prior to using the respective assistive tools. Our LLM for DDx exhibited standalone performance that exceeded that of unassisted clinicians (top-10 accuracy 59.1% vs 33.6%, [p = 0.04]). Comparing the two assisted study arms, the DDx quality score was higher for clinicians assisted by our LLM (top-10 accuracy 51.7%) compared to clinicians without its assistance (36.1%) (McNemar's Test: 45.7, p < 0.01) and clinicians with search (44.4%) (4.75, p = 0.03). Further, clinicians assisted by our LLM arrived at more comprehensive differential lists than those without its assistance. Our study suggests that our LLM for DDx has potential to improve clinicians' diagnostic reasoning and accuracy in challenging cases, meriting further real-world evaluation for its ability to empower physicians and widen patients' access to specialist-level expertise.

Summaries of medical text shall be faithful by being consistent and factual with source inputs, which is an important but understudied topic for safety and efficiency in healthcare. In this paper, we investigate and improve faithfulness in summarization on a broad range of medical summarization tasks. Our investigation reveals that current summarization models often produce unfaithful outputs for medical input text. We then introduce FaMeSumm, a framework to improve faithfulness by fine-tuning pre-trained language models based on medical knowledge. FaMeSumm performs contrastive learning on designed sets of faithful and unfaithful summaries, and it incorporates medical terms and their contexts to encourage faithful generation of medical terms. We conduct comprehensive experiments on three datasets in two languages: health question and radiology report summarization datasets in English, and a patient-doctor dialogue dataset in Chinese. Results demonstrate that FaMeSumm is flexible and effective by delivering consistent improvements over mainstream language models such as BART, T5, mT5, and PEGASUS, yielding state-of-the-art performances on metrics for faithfulness and general quality. Human evaluation by doctors also shows that FaMeSumm generates more faithful outputs. Our code is available at https://github.com/psunlpgroup/FaMeSumm .

The increasing concern with misinformation has stimulated research efforts on automatic fact checking. The recently-released FEVER dataset introduced a benchmark fact-verification task in which a system is asked to verify a claim using evidential sentences from Wikipedia documents. In this paper, we present a connected system consisting of three homogeneous neural semantic matching models that conduct document retrieval, sentence selection, and claim verification jointly for fact extraction and verification. For evidence retrieval (document retrieval and sentence selection), unlike traditional vector space IR models in which queries and sources are matched in some pre-designed term vector space, we develop neural models to perform deep semantic matching from raw textual input, assuming no intermediate term representation and no access to structured external knowledge bases. We also show that Pageview frequency can also help improve the performance of evidence retrieval results, that later can be matched by using our neural semantic matching network. For claim verification, unlike previous approaches that simply feed upstream retrieved evidence and the claim to a natural language inference (NLI) model, we further enhance the NLI model by providing it with internal semantic relatedness scores (hence integrating it with the evidence retrieval modules) and ontological WordNet features. Experiments on the FEVER dataset indicate that (1) our neural semantic matching method outperforms popular TF-IDF and encoder models, by significant margins on all evidence retrieval metrics, (2) the additional relatedness score and WordNet features improve the NLI model via better semantic awareness, and (3) by formalizing all three subtasks as a similar semantic matching problem and improving on all three stages, the complete model is able to achieve the state-of-the-art results on the FEVER test set.

Large Language Models (LLMs) hold great promise to revolutionize current clinical systems for their superior capacities on medical text processing tasks and medical licensing exams. Meanwhile, traditional ML models such as SVM and XGBoost have still been mainly adopted in clinical prediction tasks. An emerging question is Can LLMs beat traditional ML models in clinical prediction? Thus, we build a new benchmark ClinicalBench to comprehensively study the clinical predictive modeling capacities of both general-purpose and medical LLMs, and compare them with traditional ML models. ClinicalBench embraces three common clinical prediction tasks, two databases, 14 general-purpose LLMs, 8 medical LLMs, and 11 traditional ML models. Through extensive empirical investigation, we discover that both general-purpose and medical LLMs, even with different model scales, diverse prompting or fine-tuning strategies, still cannot beat traditional ML models in clinical prediction yet, shedding light on their potential deficiency in clinical reasoning and decision-making. We call for caution when practitioners adopt LLMs in clinical applications. ClinicalBench can be utilized to bridge the gap between LLMs' development for healthcare and real-world clinical practice.

Background: Recent advancements in large language models (LLMs) offer potential benefits in healthcare, particularly in processing extensive patient records. However, existing benchmarks do not fully assess LLMs' capability in handling real-world, lengthy clinical data. Methods: We present the LongHealth benchmark, comprising 20 detailed fictional patient cases across various diseases, with each case containing 5,090 to 6,754 words. The benchmark challenges LLMs with 400 multiple-choice questions in three categories: information extraction, negation, and sorting, challenging LLMs to extract and interpret information from large clinical documents. Results: We evaluated nine open-source LLMs with a minimum of 16,000 tokens and also included OpenAI's proprietary and cost-efficient GPT-3.5 Turbo for comparison. The highest accuracy was observed for Mixtral-8x7B-Instruct-v0.1, particularly in tasks focused on information retrieval from single and multiple patient documents. However, all models struggled significantly in tasks requiring the identification of missing information, highlighting a critical area for improvement in clinical data interpretation. Conclusion: While LLMs show considerable potential for processing long clinical documents, their current accuracy levels are insufficient for reliable clinical use, especially in scenarios requiring the identification of missing information. The LongHealth benchmark provides a more realistic assessment of LLMs in a healthcare setting and highlights the need for further model refinement for safe and effective clinical application. We make the benchmark and evaluation code publicly available.

The rapid spread of information in the digital age highlights the critical need for effective fact-checking tools, particularly for languages with limited resources, such as Vietnamese. In response to this challenge, we introduce ViFactCheck, the first publicly available benchmark dataset designed specifically for Vietnamese fact-checking across multiple online news domains. This dataset contains 7,232 human-annotated pairs of claim-evidence combinations sourced from reputable Vietnamese online news, covering 12 diverse topics. It has been subjected to a meticulous annotation process to ensure high quality and reliability, achieving a Fleiss Kappa inter-annotator agreement score of 0.83. Our evaluation leverages state-of-the-art pre-trained and large language models, employing fine-tuning and prompting techniques to assess performance. Notably, the Gemma model demonstrated superior effectiveness, with an impressive macro F1 score of 89.90%, thereby establishing a new standard for fact-checking benchmarks. This result highlights the robust capabilities of Gemma in accurately identifying and verifying facts in Vietnamese. To further promote advances in fact-checking technology and improve the reliability of digital media, we have made the ViFactCheck dataset, model checkpoints, fact-checking pipelines, and source code freely available on GitHub. This initiative aims to inspire further research and enhance the accuracy of information in low-resource languages.

Traditional Chinese Medicine (TCM) has seen increasing adoption in healthcare, with specialized Large Language Models (LLMs) emerging to support clinical applications. A fundamental requirement for these models is accurate identification of TCM drug ingredients. In this paper, we evaluate how general and TCM-specialized LLMs perform when identifying ingredients of Chinese drugs. Our systematic analysis reveals consistent failure patterns: models often interpret drug names literally, overuse common herbs regardless of relevance, and exhibit erratic behaviors when faced with unfamiliar formulations. LLMs also fail to understand the verification task. These findings demonstrate that current LLMs rely primarily on drug names rather than possessing systematic pharmacological knowledge. To address these limitations, we propose a Retrieval Augmented Generation (RAG) approach focused on ingredient names. Experiments across 220 TCM formulations show our method significantly improves accuracy from approximately 50% to 82% in ingredient verification tasks. Our work highlights critical weaknesses in current TCM-specific LLMs and offers a practical solution for enhancing their clinical reliability.

Since the COVID-19 pandemic, clinicians have seen a large and sustained influx in patient portal messages, significantly contributing to clinician burnout. To the best of our knowledge, there are no large-scale public patient portal messages corpora researchers can use to build tools to optimize clinician portal workflows. Informed by our ongoing work with a regional hospital, this study introduces an LLM-powered framework for configurable and realistic patient portal message generation. Our approach leverages few-shot grounded text generation, requiring only a small number of de-identified patient portal messages to help LLMs better match the true style and tone of real data. Clinical experts in our team deem this framework as HIPAA-friendly, unlike existing privacy-preserving approaches to synthetic text generation which cannot guarantee all sensitive attributes will be protected. Through extensive quantitative and human evaluation, we show that our framework produces data of higher quality than comparable generation methods as well as all related datasets. We believe this work provides a path forward for (i) the release of large-scale synthetic patient message datasets that are stylistically similar to ground-truth samples and (ii) HIPAA-friendly data generation which requires minimal human de-identification efforts.

Ensuring the accuracy of responses provided by large language models (LLMs) is crucial, particularly in clinical settings where incorrect information may directly impact patient health. To address this challenge, we construct K-QA, a dataset containing 1,212 patient questions originating from real-world conversations held on K Health (an AI-driven clinical platform). We employ a panel of in-house physicians to answer and manually decompose a subset of K-QA into self-contained statements. Additionally, we formulate two NLI-based evaluation metrics approximating recall and precision: (1) comprehensiveness, measuring the percentage of essential clinical information in the generated answer and (2) hallucination rate, measuring the number of statements from the physician-curated response contradicted by the LLM answer. Finally, we use K-QA along with these metrics to evaluate several state-of-the-art models, as well as the effect of in-context learning and medically-oriented augmented retrieval schemes developed by the authors. Our findings indicate that in-context learning improves the comprehensiveness of the models, and augmented retrieval is effective in reducing hallucinations. We make K-QA available to to the community to spur research into medically accurate NLP applications.

Clinical natural language processing requires methods that can address domain-specific challenges, such as complex medical terminology and clinical contexts. Recently, large language models (LLMs) have shown promise in this domain. Yet, their direct deployment can lead to privacy issues and are constrained by resources. To address this challenge, we delve into synthetic clinical text generation using LLMs for clinical NLP tasks. We propose an innovative, resource-efficient approach, ClinGen, which infuses knowledge into the process. Our model involves clinical knowledge extraction and context-informed LLM prompting. Both clinical topics and writing styles are drawn from external domain-specific knowledge graphs and LLMs to guide data generation. Our extensive empirical study across 7 clinical NLP tasks and 16 datasets reveals that ClinGen consistently enhances performance across various tasks, effectively aligning the distribution of real datasets and significantly enriching the diversity of generated training instances. We will publish our code and all the generated data in https://github.com/ritaranx/ClinGen.

As language models are adapted by a more sophisticated and diverse set of users, the importance of guaranteeing that they provide factually correct information supported by verifiable sources is critical across fields of study & professions. This is especially the case for high-stakes fields, such as medicine and law, where the risk of propagating false information is high and can lead to undesirable societal consequences. Previous work studying factuality and attribution has not focused on analyzing these characteristics of language model outputs in domain-specific scenarios. In this work, we present an evaluation study analyzing various axes of factuality and attribution provided in responses from a few systems, by bringing domain experts in the loop. Specifically, we first collect expert-curated questions from 484 participants across 32 fields of study, and then ask the same experts to evaluate generated responses to their own questions. We also ask experts to revise answers produced by language models, which leads to ExpertQA, a high-quality long-form QA dataset with 2177 questions spanning 32 fields, along with verified answers and attributions for claims in the answers.

Large language models (LLMs) offer a promising pre-screening tool, improving early disease detection and providing enhanced healthcare access for underprivileged communities. The early diagnosis of various diseases continues to be a significant challenge in healthcare, primarily due to the nonspecific nature of early symptoms, the shortage of expert medical practitioners, and the need for prolonged clinical evaluations, all of which can delay treatment and adversely affect patient outcomes. With impressive accuracy in prediction across a range of diseases, LLMs have the potential to revolutionize clinical pre-screening and decision-making for various medical conditions. In this work, we study the diagnostic capability of LLMs for Rheumatoid Arthritis (RA) with real world patients data. Patient data was collected alongside diagnoses from medical experts, and the performance of LLMs was evaluated in comparison to expert diagnoses for RA disease prediction. We notice an interesting pattern in disease diagnosis and find an unexpected misalignment between prediction and explanation. We conduct a series of multi-round analyses using different LLM agents. The best-performing model accurately predicts rheumatoid arthritis (RA) diseases approximately 95\% of the time. However, when medical experts evaluated the reasoning generated by the model, they found that nearly 68\% of the reasoning was incorrect. This study highlights a clear misalignment between LLMs high prediction accuracy and its flawed reasoning, raising important questions about relying on LLM explanations in clinical settings. LLMs provide incorrect reasoning to arrive at the correct answer for RA disease diagnosis.

Given a natural language statement, how to verify its veracity against a large-scale textual knowledge source like Wikipedia? Most existing neural models make predictions without giving clues about which part of a false claim goes wrong. In this paper, we propose LOREN, an approach for interpretable fact verification. We decompose the verification of the whole claim at phrase-level, where the veracity of the phrases serves as explanations and can be aggregated into the final verdict according to logical rules. The key insight of LOREN is to represent claim phrase veracity as three-valued latent variables, which are regularized by aggregation logical rules. The final claim verification is based on all latent variables. Thus, LOREN enjoys the additional benefit of interpretability -- it is easy to explain how it reaches certain results with claim phrase veracity. Experiments on a public fact verification benchmark show that LOREN is competitive against previous approaches while enjoying the merit of faithful and accurate interpretability. The resources of LOREN are available at: https://github.com/jiangjiechen/LOREN.

With the rise of generative AI, automated fact-checking methods to combat misinformation are becoming more and more important. However, factual claim detection, the first step in a fact-checking pipeline, suffers from two key issues that limit its scalability and generalizability: (1) inconsistency in definitions of the task and what a claim is, and (2) the high cost of manual annotation. To address (1), we review the definitions in related work and propose a unifying definition of factual claims that focuses on verifiability. To address (2), we introduce AFaCTA (Automatic Factual Claim deTection Annotator), a novel framework that assists in the annotation of factual claims with the help of large language models (LLMs). AFaCTA calibrates its annotation confidence with consistency along three predefined reasoning paths. Extensive evaluation and experiments in the domain of political speech reveal that AFaCTA can efficiently assist experts in annotating factual claims and training high-quality classifiers, and can work with or without expert supervision. Our analyses also result in PoliClaim, a comprehensive claim detection dataset spanning diverse political topics.

Several recent works seek to develop foundation models specifically for medical applications, adapting general-purpose large language models (LLMs) and vision-language models (VLMs) via continued pretraining on publicly available biomedical corpora. These works typically claim that such domain-adaptive pretraining (DAPT) improves performance on downstream medical tasks, such as answering medical licensing exam questions. In this paper, we compare seven public "medical" LLMs and two VLMs against their corresponding base models, arriving at a different conclusion: all medical VLMs and nearly all medical LLMs fail to consistently improve over their base models in the zero-/few-shot prompting regime for medical question-answering (QA) tasks. For instance, across the tasks and model pairs we consider in the 3-shot setting, medical LLMs only outperform their base models in 12.1% of cases, reach a (statistical) tie in 49.8% of cases, and are significantly worse than their base models in the remaining 38.2% of cases. Our conclusions are based on (i) comparing each medical model head-to-head, directly against the corresponding base model; (ii) optimizing the prompts for each model separately; and (iii) accounting for statistical uncertainty in comparisons. While these basic practices are not consistently adopted in the literature, our ablations show that they substantially impact conclusions. Our findings suggest that state-of-the-art general-domain models may already exhibit strong medical knowledge and reasoning capabilities, and offer recommendations to strengthen the conclusions of future studies.

The development of large language models tailored for handling patients' clinical notes is often hindered by the limited accessibility and usability of these notes due to strict privacy regulations. To address these challenges, we first create synthetic large-scale clinical notes using publicly available case reports extracted from biomedical literature. We then use these synthetic notes to train our specialized clinical large language model, Asclepius. While Asclepius is trained on synthetic data, we assess its potential performance in real-world applications by evaluating it using real clinical notes. We benchmark Asclepius against several other large language models, including GPT-3.5-turbo and other open-source alternatives. To further validate our approach using synthetic notes, we also compare Asclepius with its variants trained on real clinical notes. Our findings convincingly demonstrate that synthetic clinical notes can serve as viable substitutes for real ones when constructing high-performing clinical language models. This conclusion is supported by detailed evaluations conducted by both GPT-4 and medical professionals. All resources including weights, codes, and data used in the development of Asclepius are made publicly accessible for future research.

Given the growing influx of misinformation across news and social media, there is a critical need for systems that can provide effective real-time verification of news claims. Large language or multimodal model based verification has been proposed to scale up online policing mechanisms for mitigating spread of false and harmful content. While these can potentially reduce burden on human fact-checkers, such efforts may be hampered by foundation model training data becoming outdated. In this work, we test the limits of improving foundation model performance without continual updating through an initial study of knowledge transfer using either existing intra- and inter- domain benchmarks or explanations generated from large language models (LLMs). We evaluate on 12 public benchmarks for fact-checking and misinformation detection as well as two other tasks relevant to content moderation -- toxicity and stance detection. Our results on two recent multi-modal fact-checking benchmarks, Mocheg and Fakeddit, indicate that knowledge transfer strategies can improve Fakeddit performance over the state-of-the-art by up to 1.7% and Mocheg performance by up to 2.9%.

The pervasive influence of misinformation has far-reaching and detrimental effects on both individuals and society. The COVID-19 pandemic has witnessed an alarming surge in the dissemination of medical misinformation. However, existing datasets pertaining to misinformation predominantly focus on textual information, neglecting the inclusion of visual elements, and tend to center solely on COVID-19-related misinformation, overlooking misinformation surrounding other diseases. Furthermore, the potential of Large Language Models (LLMs), such as the ChatGPT developed in late 2022, in generating misinformation has been overlooked in previous works. To overcome these limitations, we present Med-MMHL, a novel multi-modal misinformation detection dataset in a general medical domain encompassing multiple diseases. Med-MMHL not only incorporates human-generated misinformation but also includes misinformation generated by LLMs like ChatGPT. Our dataset aims to facilitate comprehensive research and development of methodologies for detecting misinformation across diverse diseases and various scenarios, including human and LLM-generated misinformation detection at the sentence, document, and multi-modal levels. To access our dataset and code, visit our GitHub repository: https://github.com/styxsys0927/Med-MMHL.

Medical coding is the task of assigning medical codes to clinical free-text documentation. Healthcare professionals manually assign such codes to track patient diagnoses and treatments. Automated medical coding can considerably alleviate this administrative burden. In this paper, we reproduce, compare, and analyze state-of-the-art automated medical coding machine learning models. We show that several models underperform due to weak configurations, poorly sampled train-test splits, and insufficient evaluation. In previous work, the macro F1 score has been calculated sub-optimally, and our correction doubles it. We contribute a revised model comparison using stratified sampling and identical experimental setups, including hyperparameters and decision boundary tuning. We analyze prediction errors to validate and falsify assumptions of previous works. The analysis confirms that all models struggle with rare codes, while long documents only have a negligible impact. Finally, we present the first comprehensive results on the newly released MIMIC-IV dataset using the reproduced models. We release our code, model parameters, and new MIMIC-III and MIMIC-IV training and evaluation pipelines to accommodate fair future comparisons.

With the rapid development of artificial intelligence, large language models (LLMs) have shown promising capabilities in mimicking human-level language comprehension and reasoning. This has sparked significant interest in applying LLMs to enhance various aspects of healthcare, ranging from medical education to clinical decision support. However, medicine involves multifaceted data modalities and nuanced reasoning skills, presenting challenges for integrating LLMs. This paper provides a comprehensive review on the applications and implications of LLMs in medicine. It begins by examining the fundamental applications of general-purpose and specialized LLMs, demonstrating their utilities in knowledge retrieval, research support, clinical workflow automation, and diagnostic assistance. Recognizing the inherent multimodality of medicine, the review then focuses on multimodal LLMs, investigating their ability to process diverse data types like medical imaging and EHRs to augment diagnostic accuracy. To address LLMs' limitations regarding personalization and complex clinical reasoning, the paper explores the emerging development of LLM-powered autonomous agents for healthcare. Furthermore, it summarizes the evaluation methodologies for assessing LLMs' reliability and safety in medical contexts. Overall, this review offers an extensive analysis on the transformative potential of LLMs in modern medicine. It also highlights the pivotal need for continuous optimizations and ethical oversight before these models can be effectively integrated into clinical practice. Visit https://github.com/mingze-yuan/Awesome-LLM-Healthcare for an accompanying GitHub repository containing latest papers.

Metrics like FactScore and VeriScore that evaluate long-form factuality operate by decomposing an input response into atomic claims and then individually verifying each claim. While effective and interpretable, these methods incur numerous LLM calls and can take upwards of 100 seconds to evaluate a single response, limiting their practicality in large-scale evaluation and training scenarios. To address this, we propose VeriFastScore, which leverages synthetic data to fine-tune Llama3.1 8B for simultaneously extracting and verifying all verifiable claims within a given text based on evidence from Google Search. We show that this task cannot be solved via few-shot prompting with closed LLMs due to its complexity: the model receives ~4K tokens of evidence on average and needs to concurrently decompose claims, judge their verifiability, and verify them against noisy evidence. However, our fine-tuned VeriFastScore model demonstrates strong correlation with the original VeriScore pipeline at both the example level (r=0.80) and system level (r=0.94) while achieving an overall speedup of 6.6x (9.9x excluding evidence retrieval) over VeriScore. To facilitate future factuality research, we publicly release our VeriFastScore model and synthetic datasets.

Fact checking by professionals is viewed as a vital defense in the fight against misinformation.While fact checking is important and its impact has been significant, fact checks could have limited visibility and may not reach the intended audience, such as those deeply embedded in polarized communities. Concerned citizens (i.e., the crowd), who are users of the platforms where misinformation appears, can play a crucial role in disseminating fact-checking information and in countering the spread of misinformation. To explore if this is the case, we conduct a data-driven study of misinformation on the Twitter platform, focusing on tweets related to the COVID-19 pandemic, analyzing the spread of misinformation, professional fact checks, and the crowd response to popular misleading claims about COVID-19. In this work, we curate a dataset of false claims and statements that seek to challenge or refute them. We train a classifier to create a novel dataset of 155,468 COVID-19-related tweets, containing 33,237 false claims and 33,413 refuting arguments.Our findings show that professional fact-checking tweets have limited volume and reach. In contrast, we observe that the surge in misinformation tweets results in a quick response and a corresponding increase in tweets that refute such misinformation. More importantly, we find contrasting differences in the way the crowd refutes tweets, some tweets appear to be opinions, while others contain concrete evidence, such as a link to a reputed source. Our work provides insights into how misinformation is organically countered in social platforms by some of their users and the role they play in amplifying professional fact checks.These insights could lead to development of tools and mechanisms that can empower concerned citizens in combating misinformation. The code and data can be found in http://claws.cc.gatech.edu/covid_counter_misinformation.html.

The fluency and creativity of large pre-trained language models (LLMs) have led to their widespread use, sometimes even as a replacement for traditional search engines. Yet language models are prone to making convincing but factually inaccurate claims, often referred to as 'hallucinations.' These errors can inadvertently spread misinformation or harmfully perpetuate misconceptions. Further, manual fact-checking of model responses is a time-consuming process, making human factuality labels expensive to acquire. In this work, we fine-tune language models to be more factual, without human labeling and targeting more open-ended generation settings than past work. We leverage two key recent innovations in NLP to do so. First, several recent works have proposed methods for judging the factuality of open-ended text by measuring consistency with an external knowledge base or simply a large model's confidence scores. Second, the direct preference optimization algorithm enables straightforward fine-tuning of language models on objectives other than supervised imitation, using a preference ranking over possible model responses. We show that learning from automatically generated factuality preference rankings, generated either through existing retrieval systems or our novel retrieval-free approach, significantly improves the factuality (percent of generated claims that are correct) of Llama-2 on held-out topics compared with RLHF or decoding strategies targeted at factuality. At 7B scale, compared to Llama-2-chat, we observe 58% and 40% reduction in factual error rate when generating biographies and answering medical questions, respectively.

Current Large Language Models (LLMs) benchmarks are often based on open-ended or close-ended QA evaluations, avoiding the requirement of human labor. Close-ended measurements evaluate the factuality of responses but lack expressiveness. Open-ended capture the model's capacity to produce discourse responses but are harder to assess for correctness. These two approaches are commonly used, either independently or together, though their relationship remains poorly understood. This work is focused on the healthcare domain, where both factuality and discourse matter greatly. It introduces a comprehensive, multi-axis suite for healthcare LLM evaluation, exploring correlations between open and close benchmarks and metrics. Findings include blind spots and overlaps in current methodologies. As an updated sanity check, we release a new medical benchmark--CareQA--, with both open and closed variants. Finally, we propose a novel metric for open-ended evaluations --Relaxed Perplexity-- to mitigate the identified limitations.

Artificial intelligence holds great promise for expanding access to expert medical knowledge and reasoning. However, most evaluations of language models rely on static vignettes and multiple-choice questions that fail to reflect the complexity and nuance of evidence-based medicine in real-world settings. In clinical practice, physicians iteratively formulate and revise diagnostic hypotheses, adapting each subsequent question and test to what they've just learned, and weigh the evolving evidence before committing to a final diagnosis. To emulate this iterative process, we introduce the Sequential Diagnosis Benchmark, which transforms 304 diagnostically challenging New England Journal of Medicine clinicopathological conference (NEJM-CPC) cases into stepwise diagnostic encounters. A physician or AI begins with a short case abstract and must iteratively request additional details from a gatekeeper model that reveals findings only when explicitly queried. Performance is assessed not just by diagnostic accuracy but also by the cost of physician visits and tests performed. We also present the MAI Diagnostic Orchestrator (MAI-DxO), a model-agnostic orchestrator that simulates a panel of physicians, proposes likely differential diagnoses and strategically selects high-value, cost-effective tests. When paired with OpenAI's o3 model, MAI-DxO achieves 80% diagnostic accuracy--four times higher than the 20% average of generalist physicians. MAI-DxO also reduces diagnostic costs by 20% compared to physicians, and 70% compared to off-the-shelf o3. When configured for maximum accuracy, MAI-DxO achieves 85.5% accuracy. These performance gains with MAI-DxO generalize across models from the OpenAI, Gemini, Claude, Grok, DeepSeek, and Llama families. We highlight how AI systems, when guided to think iteratively and act judiciously, can advance diagnostic precision and cost-effectiveness in clinical care.

Synthesizing clinical evidence largely relies on systematic reviews of clinical trials and retrospective analyses from medical literature. However, the rapid expansion of publications presents challenges in efficiently identifying, summarizing, and updating clinical evidence. Here, we introduce TrialMind, a generative artificial intelligence (AI) pipeline for facilitating human-AI collaboration in three crucial tasks for evidence synthesis: study search, screening, and data extraction. To assess its performance, we chose published systematic reviews to build the benchmark dataset, named TrialReviewBench, which contains 100 systematic reviews and the associated 2,220 clinical studies. Our results show that TrialMind excels across all three tasks. In study search, it generates diverse and comprehensive search queries to achieve high recall rates (Ours 0.711-0.834 v.s. Human baseline 0.138-0.232). For study screening, TrialMind surpasses traditional embedding-based methods by 30% to 160%. In data extraction, it outperforms a GPT-4 baseline by 29.6% to 61.5%. We further conducted user studies to confirm its practical utility. Compared to manual efforts, human-AI collaboration using TrialMind yielded a 71.4% recall lift and 44.2% time savings in study screening and a 23.5% accuracy lift and 63.4% time savings in data extraction. Additionally, when comparing synthesized clinical evidence presented in forest plots, medical experts favored TrialMind's outputs over GPT-4's outputs in 62.5% to 100% of cases. These findings show the promise of LLM-based approaches like TrialMind to accelerate clinical evidence synthesis via streamlining study search, screening, and data extraction from medical literature, with exceptional performance improvement when working with human experts.

We consider the problem of automatically generating a narrative biomedical evidence summary from multiple trial reports. We evaluate modern neural models for abstractive summarization of relevant article abstracts from systematic reviews previously conducted by members of the Cochrane collaboration, using the authors conclusions section of the review abstract as our target. We enlist medical professionals to evaluate generated summaries, and we find that modern summarization systems yield consistently fluent and relevant synopses, but that they are not always factual. We propose new approaches that capitalize on domain-specific models to inform summarization, e.g., by explicitly demarcating snippets of inputs that convey key findings, and emphasizing the reports of large and high-quality trials. We find that these strategies modestly improve the factual accuracy of generated summaries. Finally, we propose a new method for automatically evaluating the factuality of generated narrative evidence syntheses using models that infer the directionality of reported findings.

Claims made by individuals or entities are oftentimes nuanced and cannot be clearly labeled as entirely "true" or "false" -- as is frequently the case with scientific and political claims. However, a claim (e.g., "vaccine A is better than vaccine B") can be dissected into its integral aspects and sub-aspects (e.g., efficacy, safety, distribution), which are individually easier to validate. This enables a more comprehensive, structured response that provides a well-rounded perspective on a given problem while also allowing the reader to prioritize specific angles of interest within the claim (e.g., safety towards children). Thus, we propose ClaimSpect, a retrieval-augmented generation-based framework for automatically constructing a hierarchy of aspects typically considered when addressing a claim and enriching them with corpus-specific perspectives. This structure hierarchically partitions an input corpus to retrieve relevant segments, which assist in discovering new sub-aspects. Moreover, these segments enable the discovery of varying perspectives towards an aspect of the claim (e.g., support, neutral, or oppose) and their respective prevalence (e.g., "how many biomedical papers believe vaccine A is more transportable than B?"). We apply ClaimSpect to a wide variety of real-world scientific and political claims featured in our constructed dataset, showcasing its robustness and accuracy in deconstructing a nuanced claim and representing perspectives within a corpus. Through real-world case studies and human evaluation, we validate its effectiveness over multiple baselines.