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Nevin Aresh

Publications and source records attributed to Nevin Aresh.

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"I Know Where to Look," But Does the LLM? Charting the Gaps Between Clinical Expert Needs and Unstructured Data Abstraction Tools

Clinical data abstraction, the process of distilling structured information from patient records, plays a key role in advancing knowledge about diseases such as cancer. Information extraction (IE) with large language models (LLMs) could accelerate this process, but it is unclear whether current frameworks effectively support clinical researchers without AI expertise. To address this, we co-designed an interactive LLM-based abstraction system called Libretto with seven cancer research teams, then evaluated the system's ability to help them answer real-world research questions. We found that while clinicians knew where and how to annotate complex concepts in patient notes, in twelve of fourteen tasks they faced barriers to replicating those intuitions with LLMs. Contextual note reliability judgments, difficulties in steering vibe-coded prompts, and inflexible evaluation strategies necessitated fundamental changes to the IE workflow. Our results highlight open problems for HCI research to bridge the gaps between AI data work tools and clinical users' needs.

cs.HC

Disentangling Reasoning and Knowledge in Medical Large Language Models

Medical reasoning in large language models (LLMs) aims to emulate clinicians' diagnostic thinking, but current benchmarks such as MedQA-USMLE, MedMCQA, and PubMedQA often mix reasoning with factual recall. We address this by separating 11 biomedical QA benchmarks into reasoning- and knowledge-focused subsets using a PubMedBERT classifier that reaches 81 percent accuracy, comparable to human performance. Our analysis shows that only 32.8 percent of questions require complex reasoning. We evaluate biomedical models (HuatuoGPT-o1, MedReason, m1) and general-domain models (DeepSeek-R1, o4-mini, Qwen3), finding consistent gaps between knowledge and reasoning performance. For example, HuatuoGPT-o1 scores 56.9 on knowledge but only 44.8 on reasoning. In adversarial tests where models are misled with incorrect initial reasoning, biomedical models degrade sharply, while larger or RL-trained general models show more robustness. To address this, we train BioMed-R1 using fine-tuning and reinforcement learning on reasoning-heavy examples. It achieves the strongest performance among similarly sized models. Further gains may come from incorporating clinical case reports and training with adversarial and backtracking scenarios.

cs.CL