Large language models show systematic failures in incorporating evolving medical knowledge

arXiv cs.AIOctober 23, 2026en

arXiv:2610.30631v1 Announce Type: new Abstract: Medical knowledge evolves as clinical guidelines revise recommendations, yet whether large language models (LLMs) faithfully incorporate such changes remains unclear. We introduce ChronoEvo, comprising 1,709 recommendation-level revisions across 12 forms of medical knowledge change, to distinguish recognition of revised guidance from incorporation into clinical recommendations. In the primary model, 90.8% of responses recognized revisions and 80.2% were clinically correct, but only 58.5% fully incorporated guidance, yielding a 32.3-percentage-point recognition-incorporation gap. This dissociation persisted across 14 models and was corroborated

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