Expert-level validation of AI-generated medical text with scalable language models

• URL: http://arxiv.org/abs/2507.03152v2
• Date: Mon, 14 Jul 2025 17:51:35 GMT
• Title: Expert-level validation of AI-generated medical text with scalable language models
• Authors: Asad Aali, Vasiliki Bikia, Maya Varma, Nicole Chiou, Sophie Ostmeier, Arnav Singhvi, Magdalini Paschali, Ashwin Kumar, Andrew Johnston, Karimar Amador-Martinez, Eduardo Juan Perez Guerrero, Paola Naovi Cruz Rivera, Sergios Gatidis, Christian Bluethgen, Eduardo Pontes Reis, Eddy D. Zandee van Rilland, Poonam Laxmappa Hosamani, Kevin R Keet, Minjoung Go, Evelyn Ling, David B. Larson, Curtis Langlotz, Roxana Daneshjou, Jason Hom, Sanmi Koyejo, Emily Alsentzer, Akshay S. Chaudhari,
• Abstract summary: There is an immediate need to evaluate the accuracy and safety of LM-generated medical text.<n>Currently, such evaluation relies solely on manual physician review.<n>We propose MedVAL, a self-supervised framework that leverages synthetic data to train evaluator LMs.
• Score: 12.38276474827152
• License: http://creativecommons.org/licenses/by/4.0/
• Abstract: With the growing use of language models (LMs) in clinical environments, there is an immediate need to evaluate the accuracy and safety of LM-generated medical text. Currently, such evaluation relies solely on manual physician review. However, detecting errors in LM-generated text is challenging because 1) manual review is costly and 2) expert-composed reference outputs are often unavailable in real-world settings. While the "LM-as-judge" paradigm (a LM evaluating another LM) offers scalable evaluation, even frontier LMs can miss subtle but clinically significant errors. To address these challenges, we propose MedVAL, a self-supervised framework that leverages synthetic data to train evaluator LMs to assess whether LM-generated medical outputs are factually consistent with inputs, without requiring physician labels or reference outputs. To evaluate LM performance, we introduce MedVAL-Bench, a dataset containing 840 outputs annotated by physicians, following a physician-defined taxonomy of risk levels and error categories. Across 6 diverse medical tasks and 10 state-of-the-art LMs spanning open-source, proprietary, and medically adapted models, MedVAL fine-tuning significantly improves (p < 0.001) alignment with physicians on both seen and unseen tasks, increasing average F1 scores from 66% to 83%, with per-sample safety classification scores up to 86%. MedVAL improves the performance of even the best-performing proprietary LM (GPT-4o) by 8%. To support a scalable, risk-aware pathway towards clinical integration, we open-source the 1) codebase (https://github.com/StanfordMIMI/MedVAL), 2) MedVAL-Bench (https://huggingface.co/datasets/stanfordmimi/MedVAL-Bench), and 3) MedVAL-4B (https://huggingface.co/stanfordmimi/MedVAL-4B), the best-performing open-source LM. Our research provides the first evidence of LMs approaching expert-level validation ability for medical text.

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