arXiv:2511.20680v1 Announce Type: cross Abstract: Despite high performance on clinical benchmarks, large language models may reach correct conclusions through faulty reasoning, a failure mode with safety implications for oncology decision support that is not captured by accuracy-based evaluation. In this two-cohort retrospective study, we developed a hierarchical taxonomy of reasoning errors from GPT-4 chain-of-thought responses to real oncology notes and tested its clinical relevance. Using breast and pancreatic cancer notes from the CORAL dataset, we annotated 600 reasoning traces to define a three-tier taxonomy mapping computational failures to cognitive bias frameworks. We validated the taxonomy on 822 responses from prostate cancer consult notes spanning localized through metastatic disease, simulating extraction, analysis, and clinical recommendation tasks. Reasoning errors occurred in 23 percent of interpretations and dominated overall errors, with confirmation bias and anchoring bias most common. Reasoning failures were associated with guideline-discordant and potentially harmful recommendations, particularly in advanced disease management. Automated evaluators using state-of-the-art language models detected error presence but could not reliably classify subtypes. These findings show that large language models may provide fluent but clinically unsafe recommendations when reasoning is flawed. The taxonomy provides a generalizable framework for evaluating and improving reasoning fidelity before clinical deployment.

arXiv:2506.14652v2 Announce Type: replace-cross Abstract: In AI research and practice, rigor remains largely understood in terms of methodological rigor -- such as whether mathematical, statistical, or computational methods are correctly applied. We argue that this narrow conception of rigor has contributed to the concerns raised by the responsible AI community, including overblown claims about the capabilities of AI systems. Our position is that a broader conception of what rigorous AI research and practice should entail is needed. We believe such a conception -- in addition to a more expansive understanding of (1) methodological rigor -- should include aspects related to (2) what background knowledge informs what to work on (epistemic rigor); (3) how disciplinary, community, or personal norms, standards, or beliefs influence the work (normative rigor); (4) how clearly articulated the theoretical constructs under use are (conceptual rigor); (5) what is reported and how (reporting rigor); and (6) how well-supported the inferences from existing evidence are (interpretative rigor). In doing so, we also provide useful language and a framework for much-needed dialogue about the AI community's work by researchers, policymakers, journalists, and other stakeholders.

npj Digital Medicine, Published online: 25 November 2025; doi:10.1038/s41746-025-02096-x

Information content as a health system screening tool for rare diseases