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Hauptverfasser: Mutisya, Fred, Gitau, Shikoh, Ongoma, Nasubo, Mbae, Keith, Wamicha, Elizabeth
Format: Preprint
Veröffentlicht: 2025
Schlagworte:
Online-Zugang:https://arxiv.org/abs/2508.00081
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author Mutisya, Fred
Gitau, Shikoh
Ongoma, Nasubo
Mbae, Keith
Wamicha, Elizabeth
author_facet Mutisya, Fred
Gitau, Shikoh
Ongoma, Nasubo
Mbae, Keith
Wamicha, Elizabeth
contents HealthBench, a benchmark designed to measure the capabilities of AI systems for health better (Arora et al., 2025), has advanced medical language model evaluation through physician-crafted dialogues and transparent rubrics. However, its reliance on expert opinion, rather than high-tier clinical evidence, risks codifying regional biases and individual clinician idiosyncrasies, further compounded by potential biases in automated grading systems. These limitations are particularly magnified in low- and middle-income settings, where issues like sparse neglected tropical disease coverage and region-specific guideline mismatches are prevalent. The unique challenges of the African context, including data scarcity, inadequate infrastructure, and nascent regulatory frameworks, underscore the urgent need for more globally relevant and equitable benchmarks. To address these shortcomings, we propose anchoring reward functions in version-controlled Clinical Practice Guidelines (CPGs) that incorporate systematic reviews and GRADE evidence ratings. Our roadmap outlines "evidence-robust" reinforcement learning via rubric-to-guideline linkage, evidence-weighted scoring, and contextual override logic, complemented by a focus on ethical considerations and the integration of delayed outcome feedback. By re-grounding rewards in rigorously vetted CPGs, while preserving HealthBench's transparency and physician engagement, we aim to foster medical language models that are not only linguistically polished but also clinically trustworthy, ethically sound, and globally relevant.
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institution arXiv
publishDate 2025
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spellingShingle Rethinking Evidence Hierarchies in Medical Language Benchmarks: A Critical Evaluation of HealthBench
Mutisya, Fred
Gitau, Shikoh
Ongoma, Nasubo
Mbae, Keith
Wamicha, Elizabeth
Artificial Intelligence
HealthBench, a benchmark designed to measure the capabilities of AI systems for health better (Arora et al., 2025), has advanced medical language model evaluation through physician-crafted dialogues and transparent rubrics. However, its reliance on expert opinion, rather than high-tier clinical evidence, risks codifying regional biases and individual clinician idiosyncrasies, further compounded by potential biases in automated grading systems. These limitations are particularly magnified in low- and middle-income settings, where issues like sparse neglected tropical disease coverage and region-specific guideline mismatches are prevalent. The unique challenges of the African context, including data scarcity, inadequate infrastructure, and nascent regulatory frameworks, underscore the urgent need for more globally relevant and equitable benchmarks. To address these shortcomings, we propose anchoring reward functions in version-controlled Clinical Practice Guidelines (CPGs) that incorporate systematic reviews and GRADE evidence ratings. Our roadmap outlines "evidence-robust" reinforcement learning via rubric-to-guideline linkage, evidence-weighted scoring, and contextual override logic, complemented by a focus on ethical considerations and the integration of delayed outcome feedback. By re-grounding rewards in rigorously vetted CPGs, while preserving HealthBench's transparency and physician engagement, we aim to foster medical language models that are not only linguistically polished but also clinically trustworthy, ethically sound, and globally relevant.
title Rethinking Evidence Hierarchies in Medical Language Benchmarks: A Critical Evaluation of HealthBench
topic Artificial Intelligence
url https://arxiv.org/abs/2508.00081