Zhihui Tang

Shirui Wang, Zhihui Tang, Huaxia Yang et al.

Large language models (LLMs) hold promise in clinical decision support but face major challenges in safety evaluation and effectiveness validation. We developed the Clinical Safety-Effectiveness Dual-Track Benchmark (CSEDB), a multidimensional framework built on clinical expert consensus, encompassing 30 criteria covering critical areas like critical illness recognition, guideline adherence, and medication safety, with weighted consequence measures. Thirty-two specialist physicians developed and reviewed 2,069 open-ended Q&A items aligned with these criteria, spanning 26 clinical departments to simulate real-world scenarios. Benchmark testing of six LLMs revealed moderate overall performance (average total score 57.2%, safety 54.7%, effectiveness 62.3%), with a significant 13.3% performance drop in high-risk scenarios (p < 0.0001). Domain-specific medical LLMs showed consistent performance advantages over general-purpose models, with relatively higher top scores in safety (0.912) and effectiveness (0.861). The findings of this study not only provide a standardized metric for evaluating the clinical application of medical LLMs, facilitating comparative analyses, risk exposure identification, and improvement directions across different scenarios, but also hold the potential to promote safer and more effective deployment of large language models in healthcare environments.

Hongyang Ma, Tiantian Gu, Huaiyuan Sun et al.

The transition of Large Language Models (LLMs) from passive knowledge retrievers to autonomous clinical agents demands a shift in evaluation-from static accuracy to dynamic behavioral reliability. To explore this boundary in dentistry, a domain where high-quality AI advice uniquely empowers patient-participatory decision-making, we present the Standardized Clinical Management & Performance Evaluation (SCMPE) benchmark, which comprehensively assesses performance from knowledge-oriented evaluations (static objective tasks) to workflow-based simulations (multi-turn simulated patient interactions). Our analysis reveals that while models demonstrate high proficiency in static objective tasks, their performance precipitates in dynamic clinical dialogues, identifying that the primary bottleneck lies not in knowledge retention, but in the critical challenges of active information gathering and dynamic state tracking. Mapping "Guideline Adherence" versus "Decision Quality" reveals a prevalent "High Efficacy, Low Safety" risk in general models. Furthermore, we quantify the impact of Retrieval-Augmented Generation (RAG). While RAG mitigates hallucinations in static tasks, its efficacy in dynamic workflows is limited and heterogeneous, sometimes causing degradation. This underscores that external knowledge alone cannot bridge the reasoning gap without domain-adaptive pre-training. This study empirically charts the capability boundaries of dental LLMs, providing a roadmap for bridging the gap between standardized knowledge and safe, autonomous clinical practice.