# Humans and Large Language Models in Clinical Decision Support: A Study with Medical Calculators

arXiv: https://arxiv.org/abs/2411.05897 · HTML: https://mlsanity.com/paper/2411.05897/

## Key facts

- Cited by 1 papers in the map (data through 14 Oct 2026).
- Builds on 15 of its 27 references that are in the map.
- First posted on arXiv 8 Nov 2024.

## Builds on (most cited first, 15 of 15)

- [Language Models are Few-Shot Learners](https://mlsanity.com/paper/2005.14165/) (2020)
- [Measuring Massive Multitask Language Understanding](https://mlsanity.com/paper/2009.03300/) (2020)
- [Large Language Models Encode Clinical Knowledge](https://mlsanity.com/paper/2212.13138/) (2022)
- [What Disease does this Patient Have? A Large-scale Open Domain Question Answering Dataset from Medical Exams](https://mlsanity.com/paper/2009.13081/) (2020)
- [PubMedQA: A Dataset for Biomedical Research Question Answering](https://mlsanity.com/paper/1909.06146/) (2019)
- [Capabilities of GPT-4 on Medical Challenge Problems](https://mlsanity.com/paper/2303.13375/) (2023)
- [MedMCQA : A Large-scale Multi-Subject Multi-Choice Dataset for Medical domain Question Answering](https://mlsanity.com/paper/2203.14371/) (2022)
- [A Survey on RAG Meeting LLMs: Towards Retrieval-Augmented Large Language Models](https://mlsanity.com/paper/2405.06211/) (2024)
- [Cognitive Architectures for Language Agents](https://mlsanity.com/paper/2309.02427/) (2023)
- [Can Generalist Foundation Models Outcompete Special-Purpose Tuning? Case Study in Medicine](https://mlsanity.com/paper/2311.16452/) (2023)
- [Tool Learning with Foundation Models](https://mlsanity.com/paper/2304.08354/) (2023)
- [Investigating Data Contamination in Modern Benchmarks for Large Language Models](https://mlsanity.com/paper/2311.09783/) (2023)
- [Opportunities and Challenges for ChatGPT and Large Language Models in Biomedicine and Health](https://mlsanity.com/paper/2306.10070/) (2023)
- [MedCalc-Bench: Evaluating Large Language Models for Medical Calculations](https://mlsanity.com/paper/2406.12036/) (2024)
- [AgentMD: Empowering Language Agents for Risk Prediction with Large-Scale Clinical Tool Learning](https://mlsanity.com/paper/2402.13225/) (2024)

## Built on by (most cited first, 1 of 1)

- [Towards a Deterministic Math Solver for Clinical Language Models](https://mlsanity.com/paper/2609.10728/) (2026)

## Abstract (arXiv)

Although large language models (LLMs) have been assessed for general medical knowledge using licensing exams, their ability to support clinical decision-making, such as selecting medical calculators, remains uncertain. We assessed nine LLMs, including open-source, proprietary, and domain-specific models, with 1,009 multiple-choice question-answer pairs across 35 clinical calculators and compared LLMs to humans on a subset of questions. While the highest-performing LLM, OpenAI o1, provided an answer accuracy of 66.0% (CI: 56.7-75.3%) on the subset of 100 questions, two human annotators nominally outperformed LLMs with an average answer accuracy of 79.5% (CI: 73.5-85.0%). Ultimately, we evaluated medical trainees and LLMs in recommending medical calculators across clinical scenarios like risk stratification and diagnosis. With error analysis showing that the highest-performing LLMs continue to make mistakes in comprehension (49.3% of errors) and calculator knowledge (7.1% of errors), our findings highlight that LLMs are not superior to humans in calculator recommendation.