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HFEPX · Eval paper review

MedCase-Structured: A Text-to-FHIR Dataset for Benchmarking Diagnostic Reasoning in Clinically Realistic EHR Settings

Valentina Bui Muti, Eugénie Dulout, Ziquan Fu

Published

May 28, 2026

Citations

0

Trust level

Moderate

Usefulness score

65/100 (Medium)

Extraction confidence

70% (Moderate)

Derived from extracted protocol signals and abstract evidence.

Rater population

Domain Experts

Signals refreshed

Jul 1, 2026

Should you rely on this paper?

This paper has useful evaluation signal, but protocol completeness is partial; pair it with related papers before deciding implementation strategy.

Use this for comparison and orientation, not as your only source.

Best use

Secondary protocol comparison source

Use if you need

A secondary eval reference to pair with stronger protocol papers.

What to verify

Validate the evaluation procedure and quality controls in the full paper before operational use.

Main weakness

No major weakness surfaced.

Human feedback signal
Detected
From extracted signals
Evaluation signal
Detected
Eval setup described
Usefulness for eval research
65/100
Moderate-confidence candidate

Useful as a secondary reference; validate protocol details against neighboring papers.

Abstract

Large language models (LLMs) show promise for clinical reasoning and decision support, but evaluation in structured, electronic health record-congruent settings remains limited. Existing benchmarks often rely on static datasets or unstructured inputs that do not reflect the interoperable data formats used in clinical systems. We introduce a reusable pipeline for generating terminology-grounded HL7 FHIR R4 bundles from unstructured text, enabling controllable evaluation of clinical decision support systems over structured inputs. The pipeline combines staged LLM generation with terminology-grounded validation and repair to eliminate hallucinated codes and enforce structural and semantic consistency. Applying this approach to MedCaseReasoning, we construct MedCase-Structured, a synthetic dataset of 1,732 FHIR bundles derived from clinician-authored diagnostic cases, producing complete, valid bundles for 97.1% of attempted cases. Evaluation on MedCase-Structured reveals consistently lower diagnostic accuracy for LLMs on structured FHIR inputs than with plain text, highlighting the importance of deployment-aligned benchmarking.

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

strong

Expert Verification

Directly usable for protocol triage.

"Large language models (LLMs) show promise for clinical reasoning and decision support, but evaluation in structured, electronic health record-congruent settings remains limited."

Evaluation Modes

strong

Automatic Metrics

Includes extracted eval setup.

"Large language models (LLMs) show promise for clinical reasoning and decision support, but evaluation in structured, electronic health record-congruent settings remains limited."

Quality Controls

missing

Not reported

No explicit QC controls found.

"Large language models (LLMs) show promise for clinical reasoning and decision support, but evaluation in structured, electronic health record-congruent settings remains limited."

Benchmarks / Datasets

missing

Not extracted

No benchmark anchors detected.

"Large language models (LLMs) show promise for clinical reasoning and decision support, but evaluation in structured, electronic health record-congruent settings remains limited."

Reported Metrics

strong

Accuracy

Useful for evaluation criteria comparison.

"Evaluation on MedCase-Structured reveals consistently lower diagnostic accuracy for LLMs on structured FHIR inputs than with plain text, highlighting the importance of deployment-aligned benchmarking."

Rater Population

strong

Domain Experts

Helpful for staffing comparability.

"Large language models (LLMs) show promise for clinical reasoning and decision support, but evaluation in structured, electronic health record-congruent settings remains limited."

Benchmarks and datasets

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

Reported metrics

accuracy
Human feedback details
Uses human feedback
Yes
Feedback types
Expert Verification
Rater population
Domain Experts
Expertise required
Medicine
Evaluation details
Evaluation modes
Automatic Metrics
Agentic eval
None
Quality controls
Not reported
Evidence quality
Moderate
Use this page as
Secondary protocol comparison source

Research brief

Metadata summary

Large language models (LLMs) show promise for clinical reasoning and decision support, but evaluation in structured, electronic health record-congruent settings remains limited.

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

Key takeaways

  • Large language models (LLMs) show promise for clinical reasoning and decision support, but evaluation in structured, electronic health record-congruent settings remains limited.
  • Existing benchmarks often rely on static datasets or unstructured inputs that do not reflect the interoperable data formats used in clinical systems.
  • We introduce a reusable pipeline for generating terminology-grounded HL7 FHIR R4 bundles from unstructured text, enabling controllable evaluation of clinical decision support systems over structured inputs.

Researcher actions

  • Compare this paper against nearby papers in the same arXiv category before using it for protocol decisions.
  • Validate inferred eval signals (Automatic metrics) against the full paper.
  • 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.

Recommended queries

Contribution summary

  • Large language models (LLMs) show promise for clinical reasoning and decision support, but evaluation in structured, electronic health record-congruent settings remains limited.
  • We introduce a reusable pipeline for generating terminology-grounded HL7 FHIR R4 bundles from unstructured text, enabling controllable evaluation of clinical decision support systems over structured inputs.
  • Evaluation on MedCase-Structured reveals consistently lower diagnostic accuracy for LLMs on structured FHIR inputs than with plain text, highlighting the importance of deployment-aligned benchmarking.

Why it matters for eval

  • We introduce a reusable pipeline for generating terminology-grounded HL7 FHIR R4 bundles from unstructured text, enabling controllable evaluation of clinical decision support systems over structured inputs.
  • Evaluation on MedCase-Structured reveals consistently lower diagnostic accuracy for LLMs on structured FHIR inputs than with plain text, highlighting the importance of deployment-aligned benchmarking.

Researcher checklist

  • Human feedback protocol is explicit

    Detected: Expert Verification

  • Evaluation mode is explicit

    Detected: Automatic Metrics

  • 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

    Detected: accuracy