Medical large language models are easily distracted

Fuente: arXiv
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Autores principales: Vishwanath, Krithik, Alyakin, Anton, Alber, Daniel Alexander, Lee, Jin Vivian, Kondziolka, Douglas, Oermann, Eric Karl
Formato: Preprint
Publicado: 2025
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author Vishwanath, Krithik
Alyakin, Anton
Alber, Daniel Alexander
Lee, Jin Vivian
Kondziolka, Douglas
Oermann, Eric Karl
author_facet Vishwanath, Krithik
Alyakin, Anton
Alber, Daniel Alexander
Lee, Jin Vivian
Kondziolka, Douglas
Oermann, Eric Karl
contents Large language models (LLMs) have the potential to transform medicine, but real-world clinical scenarios contain extraneous information that can hinder performance. The rise of assistive technologies like ambient dictation, which automatically generates draft notes from live patient encounters, has the potential to introduce additional noise making it crucial to assess the ability of LLM's to filter relevant data. To investigate this, we developed MedDistractQA, a benchmark using USMLE-style questions embedded with simulated real-world distractions. Our findings show that distracting statements (polysemous words with clinical meanings used in a non-clinical context or references to unrelated health conditions) can reduce LLM accuracy by up to 17.9%. Commonly proposed solutions to improve model performance such as retrieval-augmented generation (RAG) and medical fine-tuning did not change this effect and in some cases introduced their own confounders and further degraded performance. Our findings suggest that LLMs natively lack the logical mechanisms necessary to distinguish relevant from irrelevant clinical information, posing challenges for real-world applications. MedDistractQA and our results highlights the need for robust mitigation strategies to enhance LLM resilience to extraneous information.
format Preprint
id arxiv_https___arxiv_org_abs_2504_01201
institution arXiv
publishDate 2025
record_format arxiv
spellingShingle Medical large language models are easily distracted
Vishwanath, Krithik
Alyakin, Anton
Alber, Daniel Alexander
Lee, Jin Vivian
Kondziolka, Douglas
Oermann, Eric Karl
Computation and Language
Artificial Intelligence
Human-Computer Interaction
Large language models (LLMs) have the potential to transform medicine, but real-world clinical scenarios contain extraneous information that can hinder performance. The rise of assistive technologies like ambient dictation, which automatically generates draft notes from live patient encounters, has the potential to introduce additional noise making it crucial to assess the ability of LLM's to filter relevant data. To investigate this, we developed MedDistractQA, a benchmark using USMLE-style questions embedded with simulated real-world distractions. Our findings show that distracting statements (polysemous words with clinical meanings used in a non-clinical context or references to unrelated health conditions) can reduce LLM accuracy by up to 17.9%. Commonly proposed solutions to improve model performance such as retrieval-augmented generation (RAG) and medical fine-tuning did not change this effect and in some cases introduced their own confounders and further degraded performance. Our findings suggest that LLMs natively lack the logical mechanisms necessary to distinguish relevant from irrelevant clinical information, posing challenges for real-world applications. MedDistractQA and our results highlights the need for robust mitigation strategies to enhance LLM resilience to extraneous information.
title Medical large language models are easily distracted
topic Computation and Language
Artificial Intelligence
Human-Computer Interaction
url https://arxiv.org/abs/2504.01201