English

DiReCT: Diagnostic Reasoning for Clinical Notes via Large Language Models

Computation and Language 2025-07-02 v6 Artificial Intelligence

Abstract

Large language models (LLMs) have recently showcased remarkable capabilities, spanning a wide range of tasks and applications, including those in the medical domain. Models like GPT-4 excel in medical question answering but may face challenges in the lack of interpretability when handling complex tasks in real clinical settings. We thus introduce the diagnostic reasoning dataset for clinical notes (DiReCT), aiming at evaluating the reasoning ability and interpretability of LLMs compared to human doctors. It contains 511 clinical notes, each meticulously annotated by physicians, detailing the diagnostic reasoning process from observations in a clinical note to the final diagnosis. Additionally, a diagnostic knowledge graph is provided to offer essential knowledge for reasoning, which may not be covered in the training data of existing LLMs. Evaluations of leading LLMs on DiReCT bring out a significant gap between their reasoning ability and that of human doctors, highlighting the critical need for models that can reason effectively in real-world clinical scenarios.

Keywords

Cite

@article{arxiv.2408.01933,
  title  = {DiReCT: Diagnostic Reasoning for Clinical Notes via Large Language Models},
  author = {Bowen Wang and Jiuyang Chang and Yiming Qian and Guoxin Chen and Junhao Chen and Zhouqiang Jiang and Jiahao Zhang and Yuta Nakashima and Hajime Nagahara},
  journal= {arXiv preprint arXiv:2408.01933},
  year   = {2025}
}

Comments

Accepted by NeurIPS 2024 D&B Track

R2 v1 2026-06-28T18:03:20.212Z