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When Metrics Disagree: Automatic Similarity vs. LLM-as-a-Judge for Clinical Dialogue Evaluation

arXiv:2603.00314v2 Announce Type: replace-cross Abstract: As Large Language Models (LLMs) are increasingly integrated into healthcare to address complex inquiries, ensuring their reliability remains a critical challenge. Recent studies have highlighted that generic LLMs often struggle in clinical contexts, occasionally producing misleading guidance. To mitigate these risks, this research focuses on the domain-specific adaptation of \textbf{Llama-2-7B} using the \textbf{Low-Rank Adaptation (LoRA)} technique. By injecting trainable low-rank matrices into the Transformer layers, we efficiently adapted the model using authentic patient-physician transcripts while preserving the foundational knowledge of the base model. Our objective was to enhance precision and contextual relevance in responding to medical queries by capturing the specialized nuances of clinical discourse. Due to the resource-intensive nature of large-scale human validation, the model's performance was evaluated through a dual-track framework: \textbf{Track A} utilized traditional lexical similarity metrics (e.g., BLEU, ROUGE), while \textbf{Track B} employed an "LLM-as-a-Judge" paradigm using GPT-4 for semantic assessment. Our results demonstrate that while the LoRA-enhanced model achieved significant improvements across all quantitative lexical dimensions, a profound disagreement surfaced in the GPT-4 evaluation, which marginally favored the baseline model's conversational flow. This metric divergence underscores a pivotal finding: traditional automated scores may not fully reflect clinical utility. Consequently, we propose that while automated metrics and LLM judges serve as valuable developmental proxies, rigorous validation by human medical experts remains an indispensable requirement for the safe deployment of LLMs in healthcare settings.

Building evidence-based knowledge graphs from full-text literature for disease-specific biomedical reasoning

arXiv:2603.28325v2 Announce Type: replace-cross Abstract: Biomedical knowledge resources often either preserve evidence as unstructured text or compress it into flat triples that omit study design, provenance, and quantitative support. Here we present EvidenceNet, a framework and dataset for building disease-specific knowledge graphs from full-text biomedical literature. EvidenceNet uses a large language model (LLM)-assisted pipeline to extract experimentally grounded findings as structured evidence nodes, normalize biomedical entities, score evidence quality, and connect evidence records through typed semantic relations. We release two resources: EvidenceNet-HCC with 7,872 evidence records, 10,328 graph nodes, and 49,756 edges, and EvidenceNet-CRC with 6,622 records, 8,795 nodes, and 39,361 edges. Technical validation shows high component fidelity, including 98.3% field-level extraction accuracy, 100.0% high-confidence entity-link accuracy, 87.5% fusion integrity, and 90.0% semantic relation-type accuracy. In downstream evaluation, EvidenceNet improves internal and external retrieval-augmented question answering and retains structural signal for future link prediction and target prioritization. These results establish EvidenceNet as a disease-specific resource for evidence-aware biomedical reasoning and hypothesis generation.
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