# CLEAR: A Clinically-Grounded Tabular Framework for Radiology Report Evaluation

arXiv: https://arxiv.org/abs/2505.16325 · HTML: https://mlsanity.com/paper/2505.16325/

## Key facts

- Cited by 5 papers in the map (data through 14 Oct 2026).
- Builds on 12 of its 28 references that are in the map.
- First posted on arXiv 22 May 2025.

## Builds on (most cited first, 12 of 12)

- [Judging LLM-as-a-Judge with MT-Bench and Chatbot Arena](https://mlsanity.com/paper/2306.05685/) (2023)
- [Efficient Memory Management for Large Language Model Serving with PagedAttention](https://mlsanity.com/paper/2309.06180/) (2023)
- [BERTScore: Evaluating Text Generation with BERT](https://mlsanity.com/paper/1904.09675/) (2019)
- [LlamaFactory: Unified Efficient Fine-Tuning of 100+ Language Models](https://mlsanity.com/paper/2403.13372/) (2024)
- [CheXpert: A Large Chest Radiograph Dataset with Uncertainty Labels and Expert Comparison](https://mlsanity.com/paper/1901.07031/) (2019)
- [MIMIC-CXR-JPG, a large publicly available database of labeled chest radiographs](https://mlsanity.com/paper/1901.07042/) (2019)
- [CheXbert: Combining Automatic Labelers and Expert Annotations for Accurate Radiology Report Labeling Using BERT](https://mlsanity.com/paper/2004.09167/) (2020)
- [RadGraph: Extracting Clinical Entities and Relations from Radiology Reports](https://mlsanity.com/paper/2106.14463/) (2021)
- [GREEN: Generative Radiology Report Evaluation and Error Notation](https://mlsanity.com/paper/2405.03595/) (2024)
- [ACI-BENCH: a Novel Ambient Clinical Intelligence Dataset for Benchmarking Automatic Visit Note Generation](https://mlsanity.com/paper/2306.02022/) (2023)
- [FineRadScore: A Radiology Report Line-by-Line Evaluation Technique Generating Corrections with Severity Scores](https://mlsanity.com/paper/2405.20613/) (2024)
- [RadGraph2: Modeling Disease Progression in Radiology Reports via Hierarchical Information Extraction](https://mlsanity.com/paper/2308.05046/) (2023)

## Built on by (most cited first, 5 of 5)

- [CRIMSON: A Clinically-Grounded LLM-Based Metric for Generative Radiology Report Evaluation](https://mlsanity.com/paper/2603.06183/) (2026)
- [A Review of Longitudinal Radiology Report Generation: Dataset Composition, Methods, and Performance Evaluation](https://mlsanity.com/paper/2510.12444/) (2025)
- [MedPAO: A Protocol-Driven Agent for Structuring Medical Reports](https://mlsanity.com/paper/2510.04623/) (2025)
- [TSAssistant: A Human-in-the-Loop Agentic Framework for Automated Target Safety Assessment](https://mlsanity.com/paper/2604.23938/) (2026)
- [Beyond Scalar Scores: Exploring LLM-based Metrics for Clinical Significance Evaluation in Radiology Reports](https://mlsanity.com/paper/2606.18797/) (2026)

## Abstract (arXiv)

Existing metrics often lack the granularity and interpretability to capture nuanced clinical differences between candidate and ground-truth radiology reports, resulting in suboptimal evaluation. We introduce a Clinically-grounded tabular framework with Expert-curated labels and Attribute-level comparison for Radiology report evaluation (CLEAR). CLEAR not only examines whether a report can accurately identify the presence or absence of medical conditions, but also assesses whether it can precisely describe each positively identified condition across five key attributes: first occurrence, change, severity, descriptive location, and recommendation. Compared to prior works, CLEAR's multi-dimensional, attribute-level outputs enable a more comprehensive and clinically interpretable evaluation of report quality. Additionally, to measure the clinical alignment of CLEAR, we collaborate with five board-certified radiologists to develop CLEAR-Bench, a dataset of 100 chest X-ray reports from MIMIC-CXR, annotated across 6 curated attributes and 13 CheXpert conditions. Our experiments show that CLEAR achieves high accuracy in extracting clinical attributes and provides automated metrics that are strongly aligned with clinical judgment.