Xinwei Peng

Jinru Ding, Lu Lu, Chao Ding et al.

Recent advances in medical large language models (LLMs), multimodal models, and agents demand evaluation frameworks that reflect real clinical workflows and safety constraints. We present MedBench v4, a nationwide, cloud-based benchmarking infrastructure comprising over 700,000 expert-curated tasks spanning 24 primary and 91 secondary specialties, with dedicated tracks for LLMs, multimodal models, and agents. Items undergo multi-stage refinement and multi-round review by clinicians from more than 500 institutions, and open-ended responses are scored by an LLM-as-a-judge calibrated to human ratings. We evaluate 15 frontier models. Base LLMs reach a mean overall score of 54.1/100 (best: Claude Sonnet 4.5, 62.5/100), but safety and ethics remain low (18.4/100). Multimodal models perform worse overall (mean 47.5/100; best: GPT-5, 54.9/100), with solid perception yet weaker cross-modal reasoning. Agents built on the same backbones substantially improve end-to-end performance (mean 79.8/100), with Claude Sonnet 4.5-based agents achieving up to 85.3/100 overall and 88.9/100 on safety tasks. MedBench v4 thus reveals persisting gaps in multimodal reasoning and safety for base models, while showing that governance-aware agentic orchestration can markedly enhance benchmarked clinical readiness without sacrificing capability. By aligning tasks with Chinese clinical guidelines and regulatory priorities, the platform offers a practical reference for hospitals, developers, and policymakers auditing medical AI.

Jie Xu, Lu Lu, Sen Yang et al.

METHODS: First, a set of evaluation criteria is designed based on a comprehensive literature review. Second, existing candidate criteria are optimized for using a Delphi method by five experts in medicine and engineering. Third, three clinical experts design a set of medical datasets to interact with LLMs. Finally, benchmarking experiments are conducted on the datasets. The responses generated by chatbots based on LLMs are recorded for blind evaluations by five licensed medical experts. RESULTS: The obtained evaluation criteria cover medical professional capabilities, social comprehensive capabilities, contextual capabilities, and computational robustness, with sixteen detailed indicators. The medical datasets include twenty-seven medical dialogues and seven case reports in Chinese. Three chatbots are evaluated, ChatGPT by OpenAI, ERNIE Bot by Baidu Inc., and Doctor PuJiang (Dr. PJ) by Shanghai Artificial Intelligence Laboratory. Experimental results show that Dr. PJ outperforms ChatGPT and ERNIE Bot in both multiple-turn medical dialogue and case report scenarios.