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待翻译:A collective capability boundary in frontier large language models on guideline-conformant and case-specific oncology decision-making

AI 服务暂时不可用,以下为来源摘要,待恢复后补全翻译:arXiv:2608.28592v1 Announce Type: new Abstract: Large language models (LLMs) achieve high scores on medical knowledge examinations, yet real-world oncology is not a knowledge test--it is a sequence of guideline-pathway choices, escalation judgments, and commitments under uncertainty. Existing benchmarks largely measure factual recall, leaving open whether frontier LLMs share decision-path blind spots that combining models cannot fix. We built the Oncology Decision Boundary Benchmark (ODBB)--2,005 oncology decision points across NCCN guidelines and colorectal cancer cases--and evaluated nine frontier LLMs (four closed-source, five open-weight families) released between June 2025 and April 2026. A fully deterministic scorer (zero LLM inference) classified outputs into 14 failure types, independently validated by two oncologists (Cohen's weighted $\kappa$ = 0.939 and 0.790) on a 225-item stratified sample. Treating the nine as a pooled super-model, 42.1% (Wilson 95% CI 40.0--44.3%) of all items--35.7% of the 1,586 NCCN items and 66.4% of the 419 colorectal-cancer cases--were answered correctly by none, with failures concentrated in choosing between guideline pathways before reasoning within any: a consistent blind spot in clinical meta-judgment that likely requires architectural intervention rather than more training data. Two models tuned for decisiveness (GPT-5.5, Gemini 3.1 Pro Preview) made unsafe commitments three to five times more often than the seven cautious models without scoring higher. In 3--9% of items, models stated the correct next clinical step yet did not commit to it--failures of decision, not knowledge. Model quality is no longer the primary bottleneck for clinical LLM deployment; the binding constraint is the assumption that any single model can be the sole basis for a clinical decision. Progress requires architectures that detect when a model reaches its competence boundary and route the decision to a clinician.

来源arXiv AI作者: Zhang Sheng, Jinming Li, Wangyang Chen, Zhiwei Bao, Yu YoSean Wang

AI 服务暂时不可用,以下为来源正文,待恢复后补全翻译。

--> [Submitted on 8 Jun 2026] Title:A collective capability boundary in frontier large language models on guideline-conformant and case-specific oncology decision-making View a PDF of the paper titled A collective capability boundary in frontier large language models on guideline-conformant and case-specific oncology decision-making, by Zhang Sheng and 4 other authors View PDF HTML (experimental) Abstract:Large language models (LLMs) achieve high scores on medical knowledge examinations, yet real-world oncology is not a knowledge test--it is a sequence of guideline-pathway choices, escalation judgments, and commitments under uncertainty. Existing benchmarks largely measure factual recall, leaving open whether frontier LLMs share decision-path blind spots that combining models cannot fix. We built the Oncology Decision Boundary Benchmark (ODBB)--2,005 oncology decision points across NCCN guidelines and colorectal cancer cases--and evaluated nine frontier LLMs (four closed-source, five open-weight families) released between June 2025 and April 2026. A fully deterministic scorer (zero LLM inference) classified outputs into 14 failure types, independently validated by two oncologists (Cohen's weighted $\kappa$ = 0.939 and 0.790) on a 225-item stratified sample. Treating the nine as a pooled super-model, 42.1% (Wilson 95% CI 40.0--44.3%) of all items--35.7% of the 1,586 NCCN items and 66.4% of the 419 colorectal-cancer cases--were answered correctly by none, with failures concentrated in choosing between guideline pathways before reasoning within any: a consistent blind spot in clinical meta-judgment that likely requires architectural intervention rather than more training data. Two models tuned for decisiveness (GPT-5.5, Gemini 3.1 Pro Preview) made unsafe commitments three to five times more often than the seven cautious models without scoring higher. In 3--9% of items, models stated the correct next clinical step yet did not commit to it--failures of decision, not knowledge. Model quality is no longer the primary bottleneck for clinical LLM deployment; the binding constraint is the assumption that any single model can be the sole basis for a clinical decision. Progress requires architectures that detect when a model reaches its competence boundary and route the decision to a clinician. Subjects: Artificial Intelligence (cs.AI) Cite as: arXiv:2608.28592 [cs.AI] (or arXiv:2608.28592v1 [cs.AI] for this version) https://doi.org/10.48550/arXiv.2608.28592 arXiv-issued DOI via DataCite Submission history From: Zhang Sheng [view email] [v1] Mon, 8 Jun 2026 02:24:59 UTC (23,153 KB) Full-text links: Access Paper: View a PDF of the paper titled A collective capability boundary in frontier large language models on guideline-conformant and case-specific oncology decision-making, by Zhang Sheng and 4 other authors View PDF HTML (experimental) TeX Source view license Current browse context: cs.AI new | recent | 2026-08 Change to browse by: cs References & Citations NASA ADS Google Scholar Semantic Scholar Loading... Data provided by: Bibliographic Tools Bibliographic and Citation Tools Bibliographic Explorer Toggle Bibliographic Explorer (What is the Explorer?) Connected Papers Toggle Connected Papers (What is Connected Papers?) Litmaps Toggle Litmaps (What is Litmaps?) scite.ai Toggle scite Smart Citations (What are Smart Citations?) Code, Data, Media Code, Data and Media Associated with this Article alphaXiv Toggle alphaXiv (What is alphaXiv?) Links to Code Toggle CatalyzeX Code Finder for Papers (What is CatalyzeX?) DagsHub Toggle DagsHub (What is DagsHub?) GotitPub Toggle Gotit.pub (What is GotitPub?) Huggingface Toggle Hugging Face (What is Huggingface?) ScienceCast Toggle ScienceCast (What is ScienceCast?) Demos Demos Replicate Toggle Replicate (What is Replicate?) Spaces Toggle Hugging Face Spaces (What is Spaces?) Spaces Toggle TXYZ.AI (What is TXYZ.AI?) Related Papers Recommenders and Search Tools Link to Influence Flower Influence Flower (What are Influence Flowers?) Core recommender toggle CORE Recommender (What is CORE?) Author Venue Institution Topic About arXivLabs arXivLabs: experimental projects with community collaborators arXivLabs is a framework that allows collaborators to develop and share new arXiv features directly on our website. Both individuals and organizations that work with arXivLabs have embraced and accepted our values of openness, community, excellence, and user data privacy. arXiv is committed to these values and only works with partners that adhere to them. Have an idea for a project that will add value for arXiv's community? Learn more about arXivLabs. Which authors of this paper are endorsers? | Disable MathJax (What is MathJax?)