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[Submitted on 11 Sep 2026] Title:Hindsight Bias in Clinical Temporal Reasoning: How Future Data Exposure Affects Large Language Model Judgment View a PDF of the paper titled Hindsight Bias in Clinical Temporal Reasoning: How Future Data Exposure Affects Large Language Model Judgment, by Misaki Matsuura and 2 other authors View PDF HTML (experimental) Abstract:Clinical decisions are prospective, but clinical language models are often evaluated on retrospective records that reveal the final diagnosis, treatment response, and outcome. Such evaluations may reward the use of future information rather than reasoning under the uncertainty present at the decision point. We introduce a paired benchmark for measuring outcome-conditioned shifts consistent with hindsight bias in clinical temporal reasoning. It contains 171 case reports from the PubMed Central Open Access Subset---40 sepsis and 131 GLP-1/diabetes cases---represented as both textual narratives and human-annotated and LLM-generated textual time series (TTS). For each case, questions are tied to a clinically meaningful cutoff and paired with a prospective reference answer and an outcome-consistent \emph{hindsight trap}. Models answer each question using either a TTS truncated at the cutoff or the complete timeline; additional conditions vary the narrative source (original or synthetic) and TTS annotation source (human or LLM). We evaluate accuracy (Acc), hindsight trap rate (HTR), answer instability rate (AIR), and hindsight bias rate (HBR), each of which captures different signals of hindsight bias. Across GPT 5.6 Sol, Gemma 4, GLM 5.2, and Opus 5, full timeline exposure produces consistent hindsight-sensitive shifts, while temporal masking reduces bias without lowering accuracy. Comments: Machine Learning for Health Symposium (ML4H 2026) Subjects: Computation and Language (cs.CL); Artificial Intelligence (cs.AI) Cite as: arXiv:2609.13454 [cs.CL] (or arXiv:2609.13454v1 [cs.CL] for this version) https://doi.org/10.48550/arXiv.2609.13454 arXiv-issued DOI via DataCite (pending registration) Submission history From: Sayantan Kumar [view email] [v1] Fri, 11 Sep 2026 19:15:20 UTC (2,209 KB) Full-text links: Access Paper: View a PDF of the paper titled Hindsight Bias in Clinical Temporal Reasoning: How Future Data Exposure Affects Large Language Model Judgment, by Misaki Matsuura and 2 other authors View PDF HTML (experimental) TeX Source view license Current browse context: cs.CL new | recent | 2026-09 Change to browse by: cs cs.AI 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?)