# CLEAR: Cross-Source Evidence Adjudication for Large Language Models in Medicine

arXiv: https://arxiv.org/abs/2609.16301 · HTML: https://mlsanity.com/paper/2609.16301/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 39 of its 57 references that are in the map.
- First posted on arXiv 14 Sep 2026.

## Builds on (most cited first, 30 of 39)

- [Language Models are Few-Shot Learners](https://mlsanity.com/paper/2005.14165/) (2020)
- [GPT-4 Technical Report](https://mlsanity.com/paper/2303.08774/) (2023)
- [Retrieval-Augmented Generation for Knowledge-Intensive NLP Tasks](https://mlsanity.com/paper/2005.11401/) (2020)
- [Measuring Massive Multitask Language Understanding](https://mlsanity.com/paper/2009.03300/) (2020)
- [PaLM: Scaling Language Modeling with Pathways](https://mlsanity.com/paper/2204.02311/) (2022)
- [MMLU-Pro: A More Robust and Challenging Multi-Task Language Understanding Benchmark](https://mlsanity.com/paper/2406.01574/) (2024)
- [Self-RAG: Learning to Retrieve, Generate, and Critique through Self-Reflection](https://mlsanity.com/paper/2310.11511/) (2023)
- [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)
- [Active Retrieval Augmented Generation](https://mlsanity.com/paper/2305.06983/) (2023)
- [Adaptive-RAG: Learning to Adapt Retrieval-Augmented Large Language Models through Question Complexity](https://mlsanity.com/paper/2403.14403/) (2024)
- [HealthBench: Evaluating Large Language Models Towards Improved Human Health](https://mlsanity.com/paper/2505.08775/) (2025)
- [Benchmarking Retrieval-Augmented Generation for Medicine](https://mlsanity.com/paper/2402.13178/) (2024)
- [Time-Aware Language Models as Temporal Knowledge Bases](https://mlsanity.com/paper/2106.15110/) (2021)
- [MEDITRON-70B: Scaling Medical Pretraining for Large Language Models](https://mlsanity.com/paper/2311.16079/) (2023)
- [Almanac: Retrieval-Augmented Language Models for Clinical Medicine](https://mlsanity.com/paper/2303.01229/) (2023)
- [Opportunities and Challenges for ChatGPT and Large Language Models in Biomedicine and Health](https://mlsanity.com/paper/2306.10070/) (2023)
- [BioMedLM: A 2.7B Parameter Language Model Trained On Biomedical Text](https://mlsanity.com/paper/2403.18421/) (2024)
- [Benchmarking large language models for biomedical natural language processing applications and recommendations](https://mlsanity.com/paper/2305.16326/) (2023)
- [MedExQA: Medical Question Answering Benchmark with Multiple Explanations](https://mlsanity.com/paper/2406.06331/) (2024)
- [Astute RAG: Overcoming Imperfect Retrieval Augmentation and Knowledge Conflicts for Large Language Models](https://mlsanity.com/paper/2410.07176/) (2024)
- [Improving Retrieval-Augmented Generation in Medicine with Iterative Follow-up Questions](https://mlsanity.com/paper/2408.00727/) (2024)
- [Baichuan-M1: Pushing the Medical Capability of Large Language Models](https://mlsanity.com/paper/2502.12671/) (2025)
- [Rationale-Guided Retrieval Augmented Generation for Medical Question Answering](https://mlsanity.com/paper/2411.00300/) (2024)
- [Improving Medical Reasoning through Retrieval and Self-Reflection with Retrieval-Augmented Large Language Models](https://mlsanity.com/paper/2401.15269/) (2024)
- [How Do Large Language Models Capture the Ever-changing World Knowledge? A Review of Recent Advances](https://mlsanity.com/paper/2310.07343/) (2023)
- [AfriMed-QA: A Pan-African, Multi-Specialty, Medical Question-Answering Benchmark Dataset](https://mlsanity.com/paper/2411.15640/) (2024)
- [Dynamic Parametric Retrieval Augmented Generation for Test-time Knowledge Enhancement](https://mlsanity.com/paper/2503.23895/) (2025)
- [Enhancing Retrieval and Managing Retrieval: A Four-Module Synergy for Improved Quality and Efficiency in RAG Systems](https://mlsanity.com/paper/2407.10670/) (2024)

## Abstract (arXiv)

Medical knowledge evolves continuously, whereas the parametric knowledge encoded in large language models (LLMs) is fixed at training time. External retrieval, including retrieval-augmented generation (RAG), can provide access to newly available evidence, but retrieved information may be irrelevant, incomplete, or conflicting. As a result, external retrieval can in turn degrade the factual accuracy and evidence grounding of LLM outputs. To address this challenge, we propose CLEAR, an agentic framework for cross-source evidence adjudication in LLMs in medicine. CLEAR independently generates candidate answers from three complementary pathways---parametric knowledge, locally curated corpora, and dynamically retrieved evidence---reflecting three common sources of information available to LLMs. An aggregation verifier jointly evaluates the candidates, supporting evidence, provenance, and source-quality information to identify agreement and conflict across sources. An adjudication module then determines whether the current conclusion should be preserved or revised through complementary override-guard and challenge-audit mechanisms, while unresolved conflicts trigger targeted follow-up search and re-adjudication.