clinical informatics teams

Abstract: Large language models (LLMs) have been widely adopted for clinical question answering (QA). Current systems can attach citations to their answers, but these often point to broad texts, leaving time-pressed clinicians unable to verify them efficiently. An alternative is to ensure that responses are verifiable by construction: providing fine-grained verbatim quotes from reference material that substantiate claims, so users can verify an answer without opening other documents. In this paper, we evaluate the ability of current models to perform this task end-to-end: from providing citations for every factual claim, to producing verbatim quotes, to ensuring that those quotes fully substantiate the claims. To do so, we build a standardized harness over four clinical practice guidelines and evaluate twelve LLMs on 222 synthetic clinical questions, measuring each of these stages separately. We find that most models can attach verbatim quotes to over 90% of their claims from prompting alone, apart from some lightweight models such as claude-haiku-4.5. Yet these quotes often fail to substantiate every detail of the claims they accompany. For instance, claude-opus-5 produces verbatim quotes for 98.0% of its claims, but fully substantiates only 37.1%. Our work provides insights into the current capability gap of LLMs in building verifiable clinical QA systems, along with artifacts for future research.

Abstract: Graph Retrieval-Augmented Generation (GraphRAG) can connect evidence distributed across a corpus graph, but most systems use largely shared exploration procedures across queries. This creates a structural mismatch: direct facts may need compact local neighborhoods, comparisons need balanced coverage of multiple targets, and mediated questions may require deeper paths through weakly related connectors. We present Mosaic, a training-free framework that formulates GraphRAG retrieval as a per-query control problem. An LLM analyzer converts query-specific evidence requirements into a bounded policy over seed selection, graph traversal, stopping, and evidence selection, while the corpus graph, indexes, scoring functions, grounding procedure, and answer generator remain shared. On GraphRAG-Bench, Mosaic achieves query-weighted Answer Correctness of 76.97 on Medical and 64.33 on Novel, improving over the strongest previously reported overall results by 5.13 and 4.43 points. On Medical, it reaches 95.1 Evidence Recall and 86.1 Context Relevancy. Controlled comparisons on an identical graph and generator show that no fixed narrow, medium, or wide policy is consistently optimal; Mosaic improves by 9.96 points over the strongest canonical fixed policy. Relative to Fixed Wide, it evaluates 81.9% fewer paths and retains 47.2% fewer evidence items. Transfer experiments on HotpotQA, MuSiQue, and 2WikiMultiHopQA further show that the policy interface can be applied without benchmark-specific retriever training.

Abstract: Large language models (LLMs) have demonstrated strong capabilities across diverse domains, showing considerable potential in medicine. However, their application in medical settings remains limited by the scarcity of visual question answering (VQA) datasets that capture clinical reasoning and explicit image-text alignment. Here, we leverage de-identified medical images and expert commentaries shared on clinician-oriented social media. By combining an advanced LLM with clinician-in-the-loop verification, we established a rigorous pipeline to construct ThoughtMed-1M, a long-form medical VQA dataset containing over one million VQA pairs and designed to capture structured clinical logic and medical image-text alignment. To demonstrate its utility, we developed a FOundational LLM Trained on ThoughtMed-1M (FOLTMed). FOLTMed achieved state-of-the-art performance across 42 medical VQA benchmark datasets, with a macro accuracy of 85.4%, and generated more clinically coherent responses on the ThoughtMed-1M test set. It outperformed state-of-the-art models by 3--5% across factuality and similarity metrics, highlighting a scalable paradigm for advancing research on clinically grounded multimodal LLMs.