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Decision language models as affordable and rapid alternatives to LLM judges of clinical generative AI

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arXiv:2610.28826v1 Announce Type: new Abstract: Automated judges of clinical artificial intelligence (AI) outputs are necessary, but large language model (LLM) judges are costly and slow at scale. We compared Jev, a decision language model that returns structured judgments, with frontier and open-weight LLM judges in four use cases. On 118 pediatric answers, Jev's agreement with physicians' ordinal quality ratings (Gwet's AC2 0.50; expected score 0.53) matched or exceeded that of seven of 12 LLM judges, including frontier models, Claude Opus 5.5 (0.49) and GPT-6 (0.38). On physician-graded binary HealthBench criteria, Jev matched or exceeded four of six LLM judges. On MedHELM's open-ended tasks, Jev's agreement with a three-LLM jury approached or exceeded the jurors' internal agreement. O…

SourcearXiv AIAuthor: Rotem Gershon, Seffi Cohen, Dean Ariel, Havatzelet Bilavsky-Yarden, Amiel Sberro, Shai Yitzhaki, Osnat Tausky, Naama Golan, Maayan Rabinovitch, Ariel Avraham Hasidim, Itay Arianu, Maya Dagan, Ran Balicer, Noa Dagan
Decision language models as affordable and rapid alternatives to LLM judges of clinical generative AI
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[Submitted on 20 Oct 2026]

Title:Decision language models as affordable and rapid alternatives to LLM judges of clinical generative AI

View a PDF of the paper titled Decision language models as affordable and rapid alternatives to LLM judges of clinical generative AI, by Rotem Gershon and 12 other authors

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Abstract:Automated judges of clinical artificial intelligence (AI) outputs are necessary, but large language model (LLM) judges are costly and slow at scale. We compared Jev, a decision language model that returns structured judgments, with frontier and open-weight LLM judges in four use cases. On 118 pediatric answers, Jev's agreement with physicians' ordinal quality ratings (Gwet's AC2 0.50; expected score 0.53) matched or exceeded that of seven of 12 LLM judges, including frontier models, Claude Opus 5.5 (0.49) and GPT-6 (0.38). On physician-graded binary HealthBench criteria, Jev matched or exceeded four of six LLM judges. On MedHELM's open-ended tasks, Jev's agreement with a three-LLM jury approached or exceeded the jurors' internal agreement. On HealthBench Professional, Jev matched the benchmark's reference judge, GPT-5.4, on 91% of criteria (other judges, 91-93%). Frontier judges cost 73-294 times more than Jev and took 7-57 times longer. Jev may enable efficient clinical AI evaluation at scale.

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Artificial Intelligence (cs.AI)

Cite as: arXiv:2610.28826 [cs.AI]

(or arXiv:2610.28826v1 [cs.AI] for this version)

https://doi.org/10.48550/arXiv.2610.28826

arXiv-issued DOI via DataCite (pending registration)

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From: Seffi Cohen [view email] [v1] Tue, 20 Oct 2026 18:46:47 UTC (2,804 KB)

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  • arXiv:2610.28826v1 Announce Type: new Abstract: Automated judges of clinical artificial intelligence (AI) outputs are necessary, but large language model (LLM) judges are costly a…

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