Large Language Models Lack Temporal Awareness of Medical Knowledge

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Hauptverfasser: Guan, Zihan, Jin, Qiao, Xiong, Guangzhi, Chen, Fangyuan, Hu, Mengxuan, Chen, Qingyu, Peng, Yifan, Lu, Zhiyong, Vullikanti, Anil
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Veröffentlicht: 2026
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author Guan, Zihan
Jin, Qiao
Xiong, Guangzhi
Chen, Fangyuan
Hu, Mengxuan
Chen, Qingyu
Peng, Yifan
Lu, Zhiyong
Vullikanti, Anil
author_facet Guan, Zihan
Jin, Qiao
Xiong, Guangzhi
Chen, Fangyuan
Hu, Mengxuan
Chen, Qingyu
Peng, Yifan
Lu, Zhiyong
Vullikanti, Anil
contents The existing methods for evaluating the medical knowledge of Large Language Models (LLMs) are largely based on atemporal examination-style benchmarks, while in reality, medical knowledge is inherently dynamic and continuously evolves as new evidence emerges and treatments are approved. Consequently, evaluating medical knowledge without a temporal context may provide an incomplete assessment of whether LLMs can accurately reason about time-specific medical knowledge. Moreover, most medical data are historical, requiring the models not only to recall the correct knowledge, but also to know when that knowledge is correct. To bridge the gap, we built TempoMed-Bench, the first-of-its-kind benchmark for evaluating the temporal awareness of the LLMs in the medical domain through evolving guideline knowledge. Based on the TempoMed-Bench, our evaluation analysis first reveals that LLMs lack temporal awareness in medical knowledge through the key findings: (1) model performance on up-to-date medical knowledge exhibits a gradual linear decline over time rather than a sharp knowledge-cutoff behavior, suggesting that parametric medical knowledge is not strictly bounded by knowledge cutoffs; (2) LLMs consistently struggle more with recalling outdated historical medical knowledge than with up-to-date recommendations: accuracy of historical knowledge is only 25.37%-53.89% of up-to-date knowledge, indicating potential knowledge forgetting effects during training; and (3) LLMs often exhibit temporally inconsistent behaviors, where predictions fluctuate irregularly across neighboring years. We also show that the temporal awareness problem is a challenge that cannot be easily solved when integrated with agentic search tools (-3.15%-14.14%). This work highlights an important yet underexplored challenge and motivates future research on developing LLMs that can better encode time-specific medical knowledge.
format Preprint
id arxiv_https___arxiv_org_abs_2605_13045
institution arXiv
publishDate 2026
record_format arxiv
spellingShingle Large Language Models Lack Temporal Awareness of Medical Knowledge
Guan, Zihan
Jin, Qiao
Xiong, Guangzhi
Chen, Fangyuan
Hu, Mengxuan
Chen, Qingyu
Peng, Yifan
Lu, Zhiyong
Vullikanti, Anil
Machine Learning
Computation and Language
The existing methods for evaluating the medical knowledge of Large Language Models (LLMs) are largely based on atemporal examination-style benchmarks, while in reality, medical knowledge is inherently dynamic and continuously evolves as new evidence emerges and treatments are approved. Consequently, evaluating medical knowledge without a temporal context may provide an incomplete assessment of whether LLMs can accurately reason about time-specific medical knowledge. Moreover, most medical data are historical, requiring the models not only to recall the correct knowledge, but also to know when that knowledge is correct. To bridge the gap, we built TempoMed-Bench, the first-of-its-kind benchmark for evaluating the temporal awareness of the LLMs in the medical domain through evolving guideline knowledge. Based on the TempoMed-Bench, our evaluation analysis first reveals that LLMs lack temporal awareness in medical knowledge through the key findings: (1) model performance on up-to-date medical knowledge exhibits a gradual linear decline over time rather than a sharp knowledge-cutoff behavior, suggesting that parametric medical knowledge is not strictly bounded by knowledge cutoffs; (2) LLMs consistently struggle more with recalling outdated historical medical knowledge than with up-to-date recommendations: accuracy of historical knowledge is only 25.37%-53.89% of up-to-date knowledge, indicating potential knowledge forgetting effects during training; and (3) LLMs often exhibit temporally inconsistent behaviors, where predictions fluctuate irregularly across neighboring years. We also show that the temporal awareness problem is a challenge that cannot be easily solved when integrated with agentic search tools (-3.15%-14.14%). This work highlights an important yet underexplored challenge and motivates future research on developing LLMs that can better encode time-specific medical knowledge.
title Large Language Models Lack Temporal Awareness of Medical Knowledge
topic Machine Learning
Computation and Language
url https://arxiv.org/abs/2605.13045