# Compartmentalised Agentic Reasoning for Clinical NLI

arXiv: https://arxiv.org/abs/2509.10222 · HTML: https://mlsanity.com/paper/2509.10222/

## 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 15 of its 47 references that are in the map.
- First posted on arXiv 12 Sep 2025.

## Placed in

- LLM reasoning / [Clinical and biomedical applications](https://mlsanity.com/lr/clinical-and-biomedical-applications/)
- LLM agents and tool use / [Medical and scientific domain agents](https://mlsanity.com/agents/medical-and-scientific-domain-agents/)

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

- [LLaMA: Open and Efficient Foundation Language Models](https://mlsanity.com/paper/2302.13971/) (2023)
- [Scaling Laws for Neural Language Models](https://mlsanity.com/paper/2001.08361/) (2020)
- [DeepSeek-R1: Incentivizing Reasoning Capability in LLMs via Reinforcement Learning](https://mlsanity.com/paper/2501.12948/) (2025)
- [GPT-4o System Card](https://mlsanity.com/paper/2410.21276/) (2024)
- [Training Compute-Optimal Large Language Models](https://mlsanity.com/paper/2203.15556/) (2022)
- [Sparks of Artificial General Intelligence: Early experiments with GPT-4](https://mlsanity.com/paper/2303.12712/) (2023)
- [Concrete Problems in AI Safety](https://mlsanity.com/paper/1606.06565/) (2016)
- [Annotation Artifacts in Natural Language Inference Data](https://mlsanity.com/paper/1803.02324/) (2018)
- [Hypothesis Only Baselines in Natural Language Inference](https://mlsanity.com/paper/1805.01042/) (2018)
- [Lessons from Natural Language Inference in the Clinical Domain](https://mlsanity.com/paper/1808.06752/) (2018)
- [SemEval-2024 Task 2: Safe Biomedical Natural Language Inference for Clinical Trials](https://mlsanity.com/paper/2404.04963/) (2024)
- [Large language models provide unsafe answers to patient-posed medical questions](https://mlsanity.com/paper/2507.18905/) (2025)
- [Enhancing Ethical Explanations of Large Language Models through Iterative Symbolic Refinement](https://mlsanity.com/paper/2402.00745/) (2024)
- [Preventing Another Tessa: Modular Safety Middleware For Health-Adjacent AI Assistants](https://mlsanity.com/paper/2509.07022/) (2025)
- [The Knowledge-Reasoning Dissociation: Fundamental Limitations of LLMs in Clinical Natural Language Inference](https://mlsanity.com/paper/2508.10777/) (2025)

## Abstract (arXiv)

Large language models can produce fluent judgments for clinical natural language inference, yet they frequently fail when the decision requires the correct inferential schema rather than surface matching. We introduce CARENLI, a compartmentalised agentic framework that routes each premise-statement pair to a reasoning family and then applies a specialised solver with explicit verification and targeted refinement. We evaluate on an expanded CTNLI benchmark of 200 instances spanning four reasoning families: Causal Attribution, Compositional Grounding, Epistemic Verification, and Risk State Abstraction. Across four contemporary backbone models, CARENLI improves mean accuracy from about 23% with direct prompting to about 57%, a gain of roughly 34 points, with the largest benefits on structurally demanding reasoning types. These results support compartmentalisation plus verification as a practical route to more reliable and auditable clinical inference.