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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 View PDF 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. Subjects: 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) Submission history From: Seffi Cohen [view email] [v1] Tue, 20 Oct 2026 18:46:47 UTC (2,804 KB) Full-text links: Access Paper: 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 View PDF view license Additional Features Audio Summary Current browse context: cs.AI new | recent | 2026-10 Change to browse by: cs References & Citations SciX 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?)