# High Order Reasoning for Time Critical Recommendation in Evidence-based Medicine

arXiv: https://arxiv.org/abs/2405.03010 · HTML: https://mlsanity.com/paper/2405.03010/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Placed in Clinical and biomedical applications, one of 17 directions in LLM reasoning.
- Builds on 14 of its 46 references that are in the map.
- First posted on arXiv 5 May 2024.

## Placed in

- LLM reasoning / [Clinical and biomedical applications](https://mlsanity.com/lr/clinical-and-biomedical-applications/)

## Builds on (most cited first, 14 of 14)

- [Attention Is All You Need](https://mlsanity.com/paper/1706.03762/) (2017)
- [Language Models are Few-Shot Learners](https://mlsanity.com/paper/2005.14165/) (2020)
- [Llama 2: Open Foundation and Fine-Tuned Chat Models](https://mlsanity.com/paper/2307.09288/) (2023)
- [Large Language Models are Zero-Shot Reasoners](https://mlsanity.com/paper/2205.11916/) (2022)
- [Finetuned Language Models Are Zero-Shot Learners](https://mlsanity.com/paper/2109.01652/) (2021)
- [Pre-train, Prompt, and Predict: A Systematic Survey of Prompting Methods in Natural Language Processing](https://mlsanity.com/paper/2107.13586/) (2021)
- [Large Language Models Encode Clinical Knowledge](https://mlsanity.com/paper/2212.13138/) (2022)
- [Capabilities of GPT-4 on Medical Challenge Problems](https://mlsanity.com/paper/2303.13375/) (2023)
- [A Prompt Pattern Catalog to Enhance Prompt Engineering with ChatGPT](https://mlsanity.com/paper/2302.11382/) (2023)
- [True Few-Shot Learning with Language Models](https://mlsanity.com/paper/2105.11447/) (2021)
- [Better Zero-Shot Reasoning with Role-Play Prompting](https://mlsanity.com/paper/2308.07702/) (2023)
- [Regulating ChatGPT and other Large Generative AI Models](https://mlsanity.com/paper/2302.02337/) (2023)
- [HHH: An Online Medical Chatbot System based on Knowledge Graph and Hierarchical Bi-Directional Attention](https://mlsanity.com/paper/2002.03140/) (2020)
- [The Potential and Pitfalls of using a Large Language Model such as ChatGPT or GPT-4 as a Clinical Assistant](https://mlsanity.com/paper/2307.08152/) (2023)

## Abstract (arXiv)

In time-critical decisions, human decision-makers can interact with AI-enabled situation-aware software to evaluate many imminent and possible scenarios, retrieve billions of facts, and estimate different outcomes based on trillions of parameters in a fraction of a second. In high-order reasoning, "what-if" questions can be used to challenge the assumptions or pre-conditions of the reasoning, "why-not" questions can be used to challenge on the method applied in the reasoning, "so-what" questions can be used to challenge the purpose of the decision, and "how-about" questions can be used to challenge the applicability of the method. When above high-order reasoning questions are applied to assist human decision-making, it can help humans to make time-critical decisions and avoid false-negative or false-positive types of errors. In this paper, we present a model of high-order reasoning to offer recommendations in evidence-based medicine in a time-critical fashion for the applications in ICU. The Large Language Model (LLM) is used in our system. The experiments demonstrated the LLM exhibited optimal performance in the "What-if" scenario, achieving a similarity of 88.52% with the treatment plans of human doctors. In the "Why-not" scenario, the best-performing model tended to opt for alternative treatment plans in 70% of cases for patients who died after being discharged from the ICU. In the "So-what" scenario, the optimal model provided a detailed analysis of the motivation and significance of treatment plans for ICU patients, with its reasoning achieving a similarity of 55.6% with actual diagnostic information. In the "How-about" scenario, the top-performing LLM demonstrated a content similarity of 66.5% in designing treatment plans transferring for similar diseases. Meanwhile, LLMs managed to predict the life status of patients after their discharge from the ICU with an accuracy of 70%.