Trustworthy Agents for Electronic Health Records through Confidence Estimation

Fuente: arXiv
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Main Authors: Song, Yongwoo, Jeong, Minbyul, Sung, Mujeen
Format: Preprint
Published: 2025
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author Song, Yongwoo
Jeong, Minbyul
Sung, Mujeen
author_facet Song, Yongwoo
Jeong, Minbyul
Sung, Mujeen
contents Large language models (LLMs) show promise for extracting information from Electronic Health Records (EHR) and supporting clinical decisions. However, deployment in clinical settings faces challenges due to hallucination risks. We propose Hallucination Controlled Accuracy at k% (HCAcc@k%), a novel metric quantifying the accuracy-reliability trade-off at varying confidence thresholds. We introduce TrustEHRAgent, a confidence-aware agent incorporating stepwise confidence estimation for clinical question answering. Experiments on MIMIC-III and eICU datasets show TrustEHRAgent outperforms baselines under strict reliability constraints, achieving improvements of 44.23%p and 25.34%p at HCAcc@70% while baseline methods fail at these thresholds. These results highlight limitations of traditional accuracy metrics in evaluating healthcare AI agents. Our work contributes to developing trustworthy clinical agents that deliver accurate information or transparently express uncertainty when confidence is low.
format Preprint
id arxiv_https___arxiv_org_abs_2508_19096
institution arXiv
publishDate 2025
record_format arxiv
spellingShingle Trustworthy Agents for Electronic Health Records through Confidence Estimation
Song, Yongwoo
Jeong, Minbyul
Sung, Mujeen
Artificial Intelligence
Large language models (LLMs) show promise for extracting information from Electronic Health Records (EHR) and supporting clinical decisions. However, deployment in clinical settings faces challenges due to hallucination risks. We propose Hallucination Controlled Accuracy at k% (HCAcc@k%), a novel metric quantifying the accuracy-reliability trade-off at varying confidence thresholds. We introduce TrustEHRAgent, a confidence-aware agent incorporating stepwise confidence estimation for clinical question answering. Experiments on MIMIC-III and eICU datasets show TrustEHRAgent outperforms baselines under strict reliability constraints, achieving improvements of 44.23%p and 25.34%p at HCAcc@70% while baseline methods fail at these thresholds. These results highlight limitations of traditional accuracy metrics in evaluating healthcare AI agents. Our work contributes to developing trustworthy clinical agents that deliver accurate information or transparently express uncertainty when confidence is low.
title Trustworthy Agents for Electronic Health Records through Confidence Estimation
topic Artificial Intelligence
url https://arxiv.org/abs/2508.19096