CLAIOct 5, 2025

Small Language Models for Emergency Departments Decision Support: A Benchmark Study

arXiv:2510.04032v1h-index: 42025 IEEE Smart World Congress (SWC)
Originality Synthesis-oriented
AI Analysis

This addresses the need for efficient and practical AI tools to assist physicians in high-stakes emergency departments, though it is incremental as it focuses on benchmarking existing models rather than introducing new methods.

The study tackled the problem of identifying suitable small language models (SLMs) for emergency department decision support by benchmarking them on medical datasets, and found that general-domain SLMs outperformed medically fine-tuned ones, suggesting specialized fine-tuning may not be necessary.

Large language models (LLMs) have become increasingly popular in medical domains to assist physicians with a variety of clinical and operational tasks. Given the fast-paced and high-stakes environment of emergency departments (EDs), small language models (SLMs), characterized by a reduction in parameter count compared to LLMs, offer significant potential due to their inherent reasoning capability and efficient performance. This enables SLMs to support physicians by providing timely and accurate information synthesis, thereby improving clinical decision-making and workflow efficiency. In this paper, we present a comprehensive benchmark designed to identify SLMs suited for ED decision support, taking into account both specialized medical expertise and broad general problem-solving capabilities. In our evaluations, we focus on SLMs that have been trained on a mixture of general-domain and medical corpora. A key motivation for emphasizing SLMs is the practical hardware limitations, operational cost constraints, and privacy concerns in the typical real-world deployments. Our benchmark datasets include MedMCQA, MedQA-4Options, and PubMedQA, with the medical abstracts dataset emulating tasks aligned with real ED physicians' daily tasks. Experimental results reveal that general-domain SLMs surprisingly outperform their medically fine-tuned counterparts across these diverse benchmarks for ED. This indicates that for ED, specialized medical fine-tuning of the model may not be required.

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