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Paper · arXiv

Do Clinical Models Change Treatment Decisions?

Clinical foundation models are evaluated with factual or exam-style medical QA, but treatment decisions must change when patient context changes. We introduce ClinPivot, an auditable treatment-decision benchmark built from biomedical relations and pivoted patient contexts. ClinPivot asks whether models change treatment choices when new clinical constraints shift the action space. We find that strong medical QA performance does not reliably predict decision-making performance: frontier models and task-adapted Qwen variants often fail to change decisions correctly, and model rankings shift across evaluation regimes. Decision-structured supervision improves pivot-sensitive decision-making an...

AuthorsDongkyu Cho, Miao Zhang, Rumi Chunara
Primary categorycs.AI
Published27 May 2026
Last updated at source27 May 2026
cs.AI
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