# RAmBLA: A Framework for Evaluating the Reliability of LLMs as Assistants in the Biomedical Domain

arXiv: https://arxiv.org/abs/2403.14578 · HTML: https://mlsanity.com/paper/2403.14578/

## Key facts

- Cited by 4 papers in the map (data through 14 Oct 2026).
- Builds on 29 of its 39 references that are in the map.
- First posted on arXiv 21 Mar 2024.

## Builds on (most cited first, 29 of 29)

- [Sentence-BERT: Sentence Embeddings using Siamese BERT-Networks](https://mlsanity.com/paper/1908.10084/) (2019)
- [BERTScore: Evaluating Text Generation with BERT](https://mlsanity.com/paper/1904.09675/) (2019)
- [Lost in the Middle: How Language Models Use Long Contexts](https://mlsanity.com/paper/2307.03172/) (2023)
- [DeBERTa: Decoding-enhanced BERT with Disentangled Attention](https://mlsanity.com/paper/2006.03654/) (2020)
- [Calibrate Before Use: Improving Few-Shot Performance of Language Models](https://mlsanity.com/paper/2102.09690/) (2021)
- [FEVER: a large-scale dataset for Fact Extraction and VERification](https://mlsanity.com/paper/1803.05355/) (2018)
- [PubMedQA: A Dataset for Biomedical Research Question Answering](https://mlsanity.com/paper/1909.06146/) (2019)
- [Can Large Language Models Be an Alternative to Human Evaluations?](https://mlsanity.com/paper/2305.01937/) (2023)
- [HaluEval: A Large-Scale Hallucination Evaluation Benchmark for Large Language Models](https://mlsanity.com/paper/2305.11747/) (2023)
- [All That's 'Human' Is Not Gold: Evaluating Human Evaluation of Generated Text](https://mlsanity.com/paper/2107.00061/) (2021)
- [TrustLLM: Trustworthiness in Large Language Models](https://mlsanity.com/paper/2401.05561/) (2024)
- [Adversarial GLUE: A Multi-Task Benchmark for Robustness Evaluation of Language Models](https://mlsanity.com/paper/2111.02840/) (2021)
- [On the Robustness of ChatGPT: An Adversarial and Out-of-distribution Perspective](https://mlsanity.com/paper/2302.12095/) (2023)
- [SafetyBench: Evaluating the Safety of Large Language Models](https://mlsanity.com/paper/2309.07045/) (2023)
- [A Survey of Large Language Models for Healthcare: from Data, Technology, and Applications to Accountability and Ethics](https://mlsanity.com/paper/2310.05694/) (2023)
- [Med-HALT: Medical Domain Hallucination Test for Large Language Models](https://mlsanity.com/paper/2307.15343/) (2023)
- [Benchmarking Cognitive Biases in Large Language Models as Evaluators](https://mlsanity.com/paper/2309.17012/) (2023)
- [FollowBench: A Multi-level Fine-grained Constraints Following Benchmark for Large Language Models](https://mlsanity.com/paper/2310.20410/) (2023)
- [Is ChatGPT Fair for Recommendation? Evaluating Fairness in Large Language Model Recommendation](https://mlsanity.com/paper/2305.07609/) (2023)
- [FaithDial: A Faithful Benchmark for Information-Seeking Dialogue](https://mlsanity.com/paper/2204.10757/) (2022)
- [DisentQA: Disentangling Parametric and Contextual Knowledge with Counterfactual Question Answering](https://mlsanity.com/paper/2211.05655/) (2022)
- [Small LLMs Are Weak Tool Learners: A Multi-LLM Agent](https://mlsanity.com/paper/2401.07324/) (2024)
- [Evaluating Human-Language Model Interaction](https://mlsanity.com/paper/2212.09746/) (2022)
- [Pre-trained Language Models in Biomedical Domain: A Systematic Survey](https://mlsanity.com/paper/2110.05006/) (2021)
- [Evaluating Attribution in Dialogue Systems: The BEGIN Benchmark](https://mlsanity.com/paper/2105.00071/) (2021)
- [Prompting is not a substitute for probability measurements in large language models](https://mlsanity.com/paper/2305.13264/) (2023)
- [A Comprehensive Evaluation of Large Language Models on Benchmark Biomedical Text Processing Tasks](https://mlsanity.com/paper/2310.04270/) (2023)
- [MedEval: A Multi-Level, Multi-Task, and Multi-Domain Medical Benchmark for Language Model Evaluation](https://mlsanity.com/paper/2310.14088/) (2023)
- [Benchmarking for Biomedical Natural Language Processing Tasks with a Domain Specific ALBERT](https://mlsanity.com/paper/2107.04374/) (2021)

## Built on by (most cited first, 4 of 4)

- [The Need for Guardrails with Large Language Models in Medical Safety-Critical Settings: An Artificial Intelligence Application in the Pharmacovigilance Ecosystem](https://mlsanity.com/paper/2407.18322/) (2024)
- [Towards Agents That Know When They Don't Know: Uncertainty as a Control Signal for Structured Reasoning](https://mlsanity.com/paper/2509.02401/) (2025)
- [Trusting CHATGPT: how minor tweaks in the prompts lead to major differences in sentiment classification](https://mlsanity.com/paper/2504.12180/) (2025)
- [When Large Language Models Fail in Healthcare: Evaluating Sensitivity to Prompt Variations](https://mlsanity.com/paper/2606.07237/) (2026)

## Abstract (arXiv)

Large Language Models (LLMs) increasingly support applications in a wide range of domains, some with potential high societal impact such as biomedicine, yet their reliability in realistic use cases is under-researched. In this work we introduce the Reliability AssesMent for Biomedical LLM Assistants (RAmBLA) framework and evaluate whether four state-of-the-art foundation LLMs can serve as reliable assistants in the biomedical domain. We identify prompt robustness, high recall, and a lack of hallucinations as necessary criteria for this use case. We design shortform tasks and tasks requiring LLM freeform responses mimicking real-world user interactions. We evaluate LLM performance using semantic similarity with a ground truth response, through an evaluator LLM.