ClinDEF: A Dynamic Evaluation Framework for Large Language Models in Clinical Reasoning

• URL: http://arxiv.org/abs/2512.23440v1
• Date: Mon, 29 Dec 2025 12:58:58 GMT
• Title: ClinDEF: A Dynamic Evaluation Framework for Large Language Models in Clinical Reasoning
• Authors: Yuqi Tang, Jing Yu, Zichang Su, Kehua Feng, Zhihui Zhu, Libin Wang, Lei Liang, Qiang Zhang, Keyan Ding, Huajun Chen,
• Abstract summary: We propose ClinDEF, a dynamic framework for assessing clinical reasoning in LLMs through simulated diagnostic dialogues.<n>Our method generates patient cases and facilitates multi-turn interactions between an LLM-based doctor and an automated patient agent.<n>Experiments show that ClinDEF effectively exposes critical clinical reasoning gaps in state-of-the-art LLMs.
• Score: 58.01333341218153
• License: http://creativecommons.org/licenses/by/4.0/
• Abstract: Clinical diagnosis begins with doctor-patient interaction, during which physicians iteratively gather information, determine examination and refine differential diagnosis through patients' response. This dynamic clinical-reasoning process is poorly represented by existing LLM benchmarks that focus on static question-answering. To mitigate these gaps, recent methods explore dynamic medical frameworks involving interactive clinical dialogues. Although effective, they often rely on limited, contamination-prone datasets and lack granular, multi-level evaluation. In this work, we propose ClinDEF, a dynamic framework for assessing clinical reasoning in LLMs through simulated diagnostic dialogues. Grounded in a disease knowledge graph, our method dynamically generates patient cases and facilitates multi-turn interactions between an LLM-based doctor and an automated patient agent. Our evaluation protocol goes beyond diagnostic accuracy by incorporating fine-grained efficiency analysis and rubric-based assessment of diagnostic quality. Experiments show that ClinDEF effectively exposes critical clinical reasoning gaps in state-of-the-art LLMs, offering a more nuanced and clinically meaningful evaluation paradigm.

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