Can LLMs Follow Medical Expert Logic? A Benchmark for Hierarchical Logical Consistency in Risk-of-Bias Assessment

📅 2026-09-10
📈 Citations: 0
Influential: 0
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🤖 AI Summary
论文针对医学评估中逻辑一致性问题,通过建立LogiMed-RoB基准测试来评估大型语言模型的逻辑推理能力,揭示了现有模型在深层逻辑推理上的不足。
📝 Abstract
Evidence-based medicine demands strict logical consistency, yet current evaluations of large language models (LLMs) prioritize superficial label matching over genuine reasoning. We introduce LogiMed-RoB, a benchmark grounded in Cochrane Risk of Bias (RoB) 2.0 expert logic, comprising 860 randomized controlled trials (RCTs) and 14,820 queries. It evaluates models under the Hierarchical Logical Consistency (HLC) framework across four dimensions: Atomic Consistency, Domain Consistency, Aggregation Consistency, and Evidential Faithfulness. Experiments on 10 state-of-the-art LLMs reveal a catastrophic Error Compounding Effect: despite the top model reaching 98.88% Atomic Consistency, its end-to-end consistency collapses to 45.13%, with several open-weight architectures plummeting to nearly 0%. We further uncover a systematic evidence-reasoning gap: even when models retrieve high-quality evidence, they fail to deduce correct outcomes in 18.63-40.05% of cases, while Blind Guess Rates reach 48.28%. LogiMed-RoB demonstrates that high outcome accuracy can conceal critical reasoning flaws, underscoring the necessity of white-box logical verification for clinical deployment.
Problem

Research questions and friction points this paper is trying to address.

Logical Consistency
Risk of Bias
Large Language Models
Evidence-based Medicine
Hierarchical Logical Consistency
Innovation

Methods, ideas, or system contributions that make the work stand out.

Hierarchical Logical Consistency
LogiMed-RoB
Risk of Bias Assessment
Error Compounding Effect
Evidence-reasoning Gap
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