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HFEPX · Eval paper review

SemioLLM: Evaluating Large Language Models for Diagnostic Reasoning from Unstructured Clinical Narratives in Epilepsy

Meghal Dani, Muthu Jeyanthi Prakash, Filip Rosa, Zeynep Akata +1 more

Published

Jul 3, 2024

Citations

0

Trust level

Low

Usefulness score

40/100 (Low)

Extraction confidence

45% (Low)

Derived from extracted protocol signals and abstract evidence.

Rater population

Domain Experts

Signals refreshed

Mar 30, 2026

Should you rely on this paper?

This paper is adjacent to HFEPX scope and is best used for background context, not as a primary protocol reference.

Use this as background context only. Do not make protocol decisions from this page alone.

Best use

Background context only

Use if you need

Background context only.

What to verify

Read the full paper before copying any benchmark, metric, or protocol choices.

Main weakness

The available metadata is too thin to trust this as a primary source.

Human feedback signal
Detected
From extracted signals
Evaluation signal
Weak or implicit
Validate from full paper
Usefulness for eval research
40/100
Adjacent candidate

Treat as adjacent context, not a core eval-method reference.

Abstract

Large Language Models (LLMs) have been shown to encode clinical knowledge. Many evaluations, however, rely on structured question-answer benchmarks, overlooking critical challenges of interpreting and reasoning about unstructured clinical narratives in real-world settings. In this study we task eight Large Language models including two medical models (GPT-3.5, GPT-4, Mixtral-8x7B, Qwen-72B, LlaMa2, LlaMa3, OpenBioLLM, Med42) with a core diagnostic task in epilepsy: mapping seizure description phrases, after targeted filtering and standardization, to one of seven possible seizure onset zones using likelihood estimates. Most models yield results that often match the ground truth and even approach clinician-level performance after prompt engineering. Specifically, clinician-guided chain-of-thought reasoning leading to the most consistent improvements. Performance was further strongly modulated by clinical in-context impersonation, narrative length and language context (13.7%, 32.7% and 14.2% performance variation, respectively). However, expert analysis of reasoning outputs revealed that correct prediction can be based on hallucinated knowledge and inaccurate source citation, underscoring the need to improve interpretability of LLMs in clinical use. Overall, SemioLLM provides a scalable, domain-adaptable framework for evaluating LLMs in clinical disciplines where unstructured verbal descriptions encode diagnostic information. By identifying both the strengths and limitations of LLMs, our work contributes to testing the applicability of foundational AI systems for healthcare.

What we could verify

These are the protocol signals we could actually recover from the available paper metadata. Use them to decide whether this paper is worth deeper reading.

Human Feedback Types

partial

Expert Verification

Directly usable for protocol triage.

"Large Language Models (LLMs) have been shown to encode clinical knowledge."

Evaluation Modes

missing

None explicit

Validate eval design from full paper text.

"Large Language Models (LLMs) have been shown to encode clinical knowledge."

Quality Controls

missing

Not reported

No explicit QC controls found.

"Large Language Models (LLMs) have been shown to encode clinical knowledge."

Benchmarks / Datasets

missing

Not extracted

No benchmark anchors detected.

"Large Language Models (LLMs) have been shown to encode clinical knowledge."

Reported Metrics

missing

Not extracted

No metric anchors detected.

"Large Language Models (LLMs) have been shown to encode clinical knowledge."

Rater Population

partial

Domain Experts

Helpful for staffing comparability.

"However, expert analysis of reasoning outputs revealed that correct prediction can be based on hallucinated knowledge and inaccurate source citation, underscoring the need to improve interpretability of LLMs in clinical use."

Benchmarks and datasets

No benchmark or dataset names were extracted from the available abstract.

Reported metrics

No metric terms were extracted from the available abstract.

Human feedback details
Uses human feedback
Yes
Feedback types
Expert Verification
Rater population
Domain Experts
Expertise required
Medicine
Evaluation details
Evaluation modes
None
Agentic eval
None
Quality controls
Not reported
Evidence quality
Low
Use this page as
Background context only

Research brief

Metadata summary

Large Language Models (LLMs) have been shown to encode clinical knowledge.

Based on abstract + metadata only. Check the source paper before making high-confidence protocol decisions.

Key takeaways

  • Large Language Models (LLMs) have been shown to encode clinical knowledge.
  • Many evaluations, however, rely on structured question-answer benchmarks, overlooking critical challenges of interpreting and reasoning about unstructured clinical narratives in real-world settings.
  • In this study we task eight Large Language models including two medical models (GPT-3.5, GPT-4, Mixtral-8x7B, Qwen-72B, LlaMa2, LlaMa3, OpenBioLLM, Med42) with a core diagnostic task in epilepsy: mapping seizure description phrases, after targeted filtering and standardization, to one of seven possible seizure onset zones using likelihood estimates.

Researcher actions

  • Compare this paper against nearby papers in the same arXiv category before using it for protocol decisions.
  • Check the full text for explicit evaluation design choices (raters, protocol, and metrics).
  • Use related-paper links to find stronger protocol-specific references.

Caveats

  • Generated from abstract + metadata only; no PDF parsing.
  • Signals below are heuristic and may miss details reported outside the abstract.

Contribution summary

  • Many evaluations, however, rely on structured question-answer benchmarks, overlooking critical challenges of interpreting and reasoning about unstructured clinical narratives in real-world settings.
  • Performance was further strongly modulated by clinical in-context impersonation, narrative length and language context (13.7%, 32.7% and 14.2% performance variation, respectively).

Why it matters for eval

  • Many evaluations, however, rely on structured question-answer benchmarks, overlooking critical challenges of interpreting and reasoning about unstructured clinical narratives in real-world settings.

Researcher checklist

  • Human feedback protocol is explicit

    Detected: Expert Verification

  • Evaluation mode is explicit

    No clear evaluation mode extracted.

  • Quality control reporting appears

    No calibration/adjudication/IAA control explicitly detected.

  • Benchmark or dataset anchors are present

    No benchmark/dataset anchor extracted from abstract.

  • Metric reporting is present

    No metric terms extracted.