analiza aiqbench
This arXiv paper introduces a phase-aware benchmark that tests 30 general-purpose and medical LLMs across six stages of nasopharyngeal carcinoma care, from initial work-up to follow-up. Its main finding is that strong diagnostic accuracy does not carry over to later care stages, where failure modes shift from explicit decision errors to omissions. For AI readers, the notable points are that medically adapted models omitted more than general models and that prompt granularity trades decision quality against evidence faithfulness and safety.
Patient-specific rubric-based evaluation of large language models across longitudinal cancer care
arXiv:2610.35847v1 Announce Type: new Abstract: Large language models (LLMs) show promise in specialty medicine, yet existing evaluations largely focus on isolated clinical encounters rather than tracking how clinical responsibilities evolve across a longitudinal care pathway. Here we introduce NPC-RubricBench, a phase-aware benchmark for evaluating multistage clinical reasoning across the cancer care continuum, using nasopharyngeal carcinoma as a defined disease context. Curated from longitudinal records of 405 patients across two cancer centers, the benchmark comprises 941 patient-phase units across six sequential care phases and 17,688 patient-specific atomic criteria spanning five evaluation dimensions, with each assessment strictly restricted to decision-time clinical evidence. Evaluating 30 general-purpose and medical LLMs revealed that strong diagnostic performance does not carry over to downstream care. We evaluated 30 general-purpose and medical LLMs, showing that high diagnostic performance did not translate into improved downstream care. Instead, the dominant failure modes reversed across phases. Explicit decision errors dominated anatomical staging at 48.2%, whereas decision omissions dominated initial work-up and post-treatment follow-up at 33.4% and 30.4%, respectively. In the evaluated model set, medically adapted models showed higher omission rates than general-purpose models. Moreover, varying query granularity exposes a critical specification trade-off: broad open-ended requests degrade Decision Quality across all 30 models, while more detailed, checklist-like prompts raise Decision Quality but reduce Evidence Faithfulness and Safety Adherence. Furthermore, NPC-RubricBench demonstrates that static diagnostic benchmarks are insufficient to ensure consistent clinical reliability over time, highlighting the importance of phase-adaptive safeguards in multistage medical AI.
Abstract:Large language models (LLMs) show promise in specialty medicine, yet existing evaluations largely focus on isolated clinical encounters rather than tracking how clinical responsibilities evolve across a longitudinal care pathway. Here we introduce NPC-RubricBench, a phase-aware benchmark for evaluating multistage clinical reasoning across the cancer care continuum, using nasopharyngeal carcinoma as a defined disease context. Curated from longitudinal records of 405 patients across two cancer centers, the benchmark comprises 941 patient-phase units across six sequential care phases and 17,688 patient-specific atomic criteria spanning five evaluation dimensions, with each assessment strictly restricted to decision-time clinical evidence. Evaluating 30 general-purpose and medical LLMs revealed that strong diagnostic performance does not carry over to downstream care. We evaluated 30 general-purpose and medical LLMs, showing that high diagnostic performance did not translate into improved downstream care. Instead, the dominant failure modes reversed across phases. Explicit decision errors dominated anatomical staging at 48.2%, whereas decision omissions dominated initial work-up and post-treatment follow-up at 33.4% and 30.4%, respectively. In the evaluated model set, medically adapted models showed higher omission rates than general-purpose models. Moreover, varying query granularity exposes a critical specification trade-off: broad open-ended requests degrade Decision Quality across all 30 models, while more detailed, checklist-like prompts raise Decision Quality but reduce Evidence Faithfulness and Safety Adherence. Furthermore, NPC-RubricBench demonstrates that static diagnostic benchmarks are insufficient to ensure consistent clinical reliability over time, highlighting the importance of phase-adaptive safeguards in multistage medical AI.
Artificial Intelligence (cs.AI)
arXiv:2610.35847 [cs.AI]
(or arXiv:2610.35847v1 [cs.AI] for this version)
https://doi.org/10.48550/arXiv.2610.35847 Focus to learn more arXiv-issued DOI via DataCite (pending registration)
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