LLMs for Medical Consultation Are Evaluated Too Late: The Preformulation Gap

arXiv cs.AIAugust 19, 2026en

arXiv:2608.17330v1 Announce Type: new Abstract: Large language models for medical consultation are often evaluated after a clinical problem has already been made clear, although real consultations may begin with a vague, minimized, or misframed concern. We evaluated three API models across four physician-authored, multi-turn vignettes under baseline and entry-to-care instruction conditions, yielding 24 fixed-script transcripts; two cases also used adaptive standardized-patient simulation, yielding 12 transcripts. Self-care or home-management advice before any patient answer appeared in 9 of 12 baseline case-model cells and 0 of 12 instruction cells, while structured handoff summaries appeare

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