mlsanityData to 14 Oct 2026

Large Language Models are Clinical Reasoners: Reasoning-Aware Diagnosis Framework with Prompt-Generated Rationales

arXiv 2312.07399 ↗First posted 12 Dec 2023cs.CL cs.AIcited by 33

On the map: LLM reasoning → Clinical and biomedical applications

Abstract (arXiv)

Machine reasoning has made great progress in recent years owing to large language models (LLMs). In the clinical domain, however, most NLP-driven projects mainly focus on clinical classification or reading comprehension, and under-explore clinical reasoning for disease diagnosis due to the expensive rationale annotation with clinicians. In this work, we present a "reasoning-aware" diagnosis framework that rationalizes the diagnostic process via prompt-based learning in a time- and labor-efficient manner, and learns to reason over the prompt-generated rationales. Specifically, we address the clinical reasoning for disease diagnosis, where the LLM generates diagnostic rationales providing its insight on presented patient data and the reasoning path towards the diagnosis, namely Clinical Chain-of-Thought (Clinical CoT). We empirically demonstrate LLMs/LMs' ability of clinical reasoning via extensive experiments and analyses on both rationale generation and disease diagnosis in various settings. We further propose a novel set of criteria for evaluating machine-generated rationales' potential for real-world clinical settings, facilitating and benefiting future research in this area.

Key facts. Cited by 33 papers in the map (data through 14 Oct 2026). Placed in Clinical and biomedical applications, one of 17 directions in LLM reasoning. Builds on 17 of its 44 references that are in the map. First posted on arXiv 12 Dec 2023.

Builds on

17 of 44 references.

References · 17

  1. 2018BERT: Pre-training of Deep Bidirectional Transformers for Language Understandingcited by 40,399
  2. 2014Adam: A Method for Stochastic Optimizationcited by 37,240
  3. 2023Llama 2: Open Foundation and Fine-Tuned Chat Modelscited by 13,028
  4. 2015Distilling the Knowledge in a Neural Networkcited by 10,324
  5. 2022Large Language Models are Zero-Shot Reasonerscited by 4,374
  6. 2022OPT: Open Pre-trained Transformer Language Modelscited by 3,512
  7. 2023Lost in the Middle: How Language Models Use Long Contextscited by 3,455
  8. 2019BioBERT: a pre-trained biomedical language representation model for biomedical text miningcited by 1,947
  9. 2023Multimodal Chain-of-Thought Reasoning in Language Modelscited by 752
  10. 2023Distilling Step-by-Step! Outperforming Larger Language Models with Less Training Data and Smaller Model Sizescited by 737
  11. 2021Multimodal Few-Shot Learning with Frozen Language Modelscited by 661
  12. 2017Learning Spatio-Temporal Features with 3D Residual Networks for Action Recognitioncited by 178
5 more
  1. 2017What do we need to build explainable AI systems for the medical domain?cited by 129
  2. 2020Clinical Reading Comprehension: A Thorough Analysis of the emrQA Datasetcited by 23
  3. 2019How Additional Knowledge can Improve Natural Language Commonsense Question Answering?cited by 22
  4. 2023Chain of Thought Prompting Elicits Knowledge Augmentationcited by 21
  5. 2022CHARD: Clinical Health-Aware Reasoning Across Dimensions for Text Generation Modelscited by 7

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Cited by year (2026 to 14 Oct)

Citing papers per year: 2024: 9; 2025: 16; 2026: 8.

33 papers.

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  1. 2024Two Tales of Persona in LLMs: A Survey of Role-Playing and Personalizationcited by 208
  2. 2024Towards Lifelong Dialogue Agents via Timeline-based Memory Managementcited by 51
  3. 2025Limitations of Large Language Models in Clinical Problem-Solving Arising from Inflexible Reasoningcited by 31
  4. 2024Prompt engineering paradigms for medical applications: scoping review and recommendations for better practicescited by 14
  5. 2024Cross-Refine: Improving Natural Language Explanation Generation by Learning in Tandemcited by 9
  6. 2025Uncertainty-Aware Large Language Models for Explainable Disease Diagnosiscited by 9
  7. 2024CliBench: A Multifaceted and Multigranular Evaluation of Large Language Models for Clinical Decision Makingcited by 8
  8. 2025MedReflect: Teaching Medical LLMs to Self-Improve via Reflective Correctioncited by 8
  9. 2025MACD: Multi-Agent Clinical Diagnosis with Self-Learned Knowledge for LLMcited by 6
  10. 2025PersonaFuse: A Personality Activation-Driven Framework for Enhancing Human-LLM Interactionscited by 5
  11. 2024Interpretable Differential Diagnosis with Dual-Inference Large Language Modelscited by 4
  12. 2025Dialogue is Better Than Monologue: Instructing Medical LLMs via Strategical Conversationscited by 4
21 more
  1. 2025Large Language Models for Bioinformaticscited by 3
  2. 2025LLMs in Disease Diagnosis: A Comparative Study of DeepSeek-R1 and O3 Mini Across Chronic Health Conditionscited by 3
  3. 2025Can Reasoning LLMs Enhance Clinical Document Classification?cited by 3
  4. 2024Critique of Impure Reason: Unveiling the reasoning behaviour of medical Large Language Modelscited by 2
  5. 2025Integrating Large Language Models with Human Expertise for Disease Detection in Electronic Health Recordscited by 2
  6. 2025Learning to reason about rare diseases through retrieval-augmented agentscited by 2
  7. 2024Prompting Large Language Models for Supporting the Differential Diagnosis of Anemiacited by 1
  8. 2025MedCoAct: Confidence-Aware Multi-Agent Collaboration for Complete Clinical Decisioncited by 1
  9. 2026ReSS: Learning Reasoning Models for Tabular Data Prediction via Symbolic Scaffoldcited by 1
  10. 2026Improving Medical VQA through Trajectory-Aware Process Supervisioncited by 1
  11. 2024D-NLP at SemEval-2024 Task 2: Evaluating Clinical Inference Capabilities of Large Language Modelscited by 0
  12. 2025Can human clinical rationales improve the performance and explainability of clinical text classification models?cited by 0
  13. 2025Enhancing Trustworthy Clinical Diagnosis Decision-Making in Large Language Models via Etiology-Aware Attention Supervisioncited by 0
  14. 2025SwasthLLM: a Unified Cross-Lingual, Multi-Task, and Meta-Learning Zero-Shot Framework for Medical Diagnosis Using Contrastive Representationscited by 0
  15. 2025Leveraging Evidence-Guided LLMs to Enhance Trustworthy Depression Diagnosiscited by 0
  16. 2026Advances in LLM Reasoning Enable Flexibility in Clinical Problem-Solvingcited by 0
  17. 2026CONDESION-BENCH: Conditional Decision-Making of Large Language Models in Compositional Action Spacecited by 0
  18. 2026Surrogate modeling for interpreting black-box LLMs in medical predictionscited by 0
  19. 2026Reasoning4Sciences: Bridging Reasoning Language Models to All Scientific Branchescited by 0
  20. 2026Supervised Fine-tuning with Synthetic Rationale Data Hurts Real-World Disease Predictioncited by 0
  21. 2026Reinforcement Learning for Evidence-Seeking Diagnostic Reasoning with Large Language Modelscited by 0

Similar, not cited

Close in wording, no citation either way

  1. 2023Large Language Models Perform Diagnostic Reasoning
  2. 2023Diagnostic Reasoning Prompts Reveal the Potential for Large Language Model Interpretability in Medicine
  3. 2025ClinicalGPT-R1: Pushing reasoning capability of generalist disease diagnosis with large language model
  4. 2024Knowledge-Augmented Multimodal Clinical Rationale Generation for Disease Diagnosis with Small Language Models
  5. 2026Medical Reasoning with Large Language Models: A Survey and MR-Bench
  6. 2024Guiding Clinical Reasoning with Large Language Models via Knowledge Seeds
  7. 2025MedCaseReasoning: Evaluating and learning diagnostic reasoning from clinical case reports
  8. 2026Aligning Clinical Needs and AI Capabilities: A Survey on LLMs for Medical Reasoning