Large language models exhibit unreliable updating of clinical judgment as patient evidence evolves
Mirrored from arXiv — NLP / Computation & Language for archival readability. Support the source by reading on the original site.
Computer Science > Artificial Intelligence
arXiv:2610.02684 (cs)
[Submitted on 2 Oct 2026]
Title:Large language models exhibit unreliable updating of clinical judgment as patient evidence evolves
View a PDF of the paper titled Large language models exhibit unreliable updating of clinical judgment as patient evidence evolves, by Min Zeng and 1 other authors
View PDF
HTML (experimental)
Abstract:Large language models (LLMs) are increasingly explored for clinical reasoning, but whether they appropriately revise judgments as patient evidence evolves remains unclear. We evaluated longitudinal belief updating using matched intensive-care trajectories from electronic health records. Across diverse LLMs, conditioning on a preceding judgment more often increased than reduced prediction error when estimates changed, replicated for a second endpoint. Controlled interventions revealed two failure modes. First, with preceding assessment fixed, models responded more strongly to worsening than matched improving respiratory evidence; this asymmetry persisted after headroom normalization at moderate and strong evidence levels. Second, with current evidence fixed, increasing prior risk from 10% to 90% shifted estimates by 26.2 percentage points, demonstrating causal influence of prior model beliefs. Prompting did not restore reliable updating. Evidence-Validated Longitudinal Update (EVLU) identified fewer, more reliable revisions, revealing a reliability-coverage trade-off. These findings establish longitudinal belief updating as a distinct dimension of LLM reliability.
| Subjects: | Artificial Intelligence (cs.AI); Computation and Language (cs.CL) |
| Cite as: | arXiv:2610.02684 [cs.AI] |
| (or arXiv:2610.02684v1 [cs.AI] for this version) | |
| https://doi.org/10.48550/arXiv.2610.02684
arXiv-issued DOI via DataCite (pending registration)
|
Full-text links:
Access Paper:
- View PDF
- HTML (experimental)
- TeX Source
View a PDF of the paper titled Large language models exhibit unreliable updating of clinical judgment as patient evidence evolves, by Min Zeng and 1 other authors
References & Citations
Loading...
Bookmark
Bibliographic Tools
Code, Data, Media
Demos
Related Papers
About arXivLabs
Bibliographic and Citation Tools
Bibliographic Explorer Toggle
Bibliographic Explorer (What is the Explorer?)
Connected Papers Toggle
Connected Papers (What is Connected Papers?)
Litmaps Toggle
Litmaps (What is Litmaps?)
scite.ai Toggle
scite Smart Citations (What are Smart Citations?)
Code, Data and Media Associated with this Article
alphaXiv Toggle
alphaXiv (What is alphaXiv?)
Links to Code Toggle
CatalyzeX Code Finder for Papers (What is CatalyzeX?)
DagsHub Toggle
DagsHub (What is DagsHub?)
GotitPub Toggle
Gotit.pub (What is GotitPub?)
Huggingface Toggle
Hugging Face (What is Huggingface?)
ScienceCast Toggle
ScienceCast (What is ScienceCast?)
Demos
Replicate Toggle
Replicate (What is Replicate?)
Spaces Toggle
Hugging Face Spaces (What is Spaces?)
Spaces Toggle
TXYZ.AI (What is TXYZ.AI?)
Recommenders and Search Tools
Link to Influence Flower
Influence Flower (What are Influence Flowers?)
Core recommender toggle
CORE Recommender (What is CORE?)
arXivLabs: experimental projects with community collaborators
arXivLabs is a framework that allows collaborators to develop and share new arXiv features directly on our website.
Both individuals and organizations that work with arXivLabs have embraced and accepted our values of openness, community, excellence, and user data privacy. arXiv is committed to these values and only works with partners that adhere to them.
Have an idea for a project that will add value for arXiv's community? Learn more about arXivLabs.
Discussion (0)
Sign in to join the discussion. Free account, 30 seconds — email code or GitHub.
Sign in →No comments yet. Sign in and be the first to say something.