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A Survey on Medical Large Language Models: Technology, Application, Trustworthiness, and Future Directions

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arxiv 2406.03712 v2 pith:2XK3I3QU submitted 2024-06-06 cs.CL cs.LG

classification cs.CLcs.LG
keywords med-llmsmodelsmedicalhealthcarelanguagelargeapplicationsethical
verification ladder T0 review T1 audit T2 compute T3 formal

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With the advent of Large Language Models (LLMs), medical artificial intelligence (AI) has experienced substantial technological progress and paradigm shifts, highlighting the potential of LLMs to streamline healthcare delivery and improve patient outcomes. Considering this rapid technical progress, in this survey, we trace the recent advances of Medical Large Language Models (Med-LLMs), including the background, key findings, and mainstream techniques, especially for the evolution from general-purpose models to medical-specialized applications. Firstly, we delve into the foundational technology of Med-LLMs, indicating how general models can be progressively adapted and refined for the complicated medical tasks. Secondly, the wide-ranging applications of Med-LLMs are investigated across various healthcare domains, as well as an up-to-date review of existing Med-LLMs. The transformative impact of these models on daily medical practice is evident through their ability to assist clinicians, educators, and patients. Recognizing the importance of responsible innovation, we discuss the challenges associated with ensuring fairness, accountability, privacy, and robustness. Ethical considerations, rigorous evaluation methodologies, and the establishment of regulatory frameworks are crucial for building trustworthiness in the real-world system. We emphasize the need for ongoing scrutiny and development to maintain high standards of safety and reliability. Finally, we anticipate possible future trajectories for Med-LLMs, identifying key avenues for prudent expansion. By consolidating these insights, our review aims to provide professionals and researchers with a thorough understanding of the strengths and limitations of Med-LLMs, fostering a balanced and ethical approach to their integration into the healthcare ecosystem.

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Forward citations

Cited by 14 Pith papers

Reviewed papers in the Pith corpus that reference this work. Sorted by Pith novelty score. OpenAlex reports about 21 citations worldwide. Full citation record

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    cs.CL 2026-02 conditional novelty 6.0 of 10

    A patient simulator integrating medical, linguistic, and behavioral profiles exposes a monotonic performance decline in an antidepressant decision aid as simulated health literacy decreases.

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  4. MMInference: Accelerating Pre-filling for Long-Context VLMs via Modality-Aware Permutation Sparse Attention

    cs.CV 2025-04 conditional novelty 6.0 of 10

    MMInference speeds up long-context VLM prefill by up to 8.3x at 1M tokens using modality-aware permutation sparse attention while keeping accuracy close to full attention.

  5. CollabLLM: From Passive Responders to Active Collaborators

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    CollabLLM computes multiturn-aware rewards by forward-simulating future user turns, then fine-tunes the LLM with RL to ask clarifying questions and guide users to their goals.

  6. PIORS: Personalized Intelligent Outpatient Reception based on Large Language Model with Multi-Agents Medical Scenario Simulation

    cs.CL 2024-11 conditional novelty 6.0 of 10

    A fine-tuned LLM receptionist trained on simulated patient conversations outperformed GPT-4o and other baselines in virtual outpatient triage tests.

  7. From Interpretability to Control: Insights from Six Years of the TrustNLP Workshop

    cs.CL 2026-08 conditional novelty 5.0 of 10

    Truthfulness grew from zero papers in 2021-2022 to the largest topic by 2025-2026, while explainability declined and then resurged in 2026 through mechanistic interpretability.

  8. DiaLLMs: EHR Enhanced Clinical Conversational System for Clinical Test Recommendation and Diagnosis Prediction

    cs.AI 2025-06 conditional novelty 5.0 of 10

    DiaLLM is an EHR-grounded conversational system that translates clinical codes and test results into text and uses PPO with rejection sampling to recommend lab tests and predict diagnoses, reporting large gains over b...

  9. Knowledge-Augmented Language Models Interpreting Structured Chest X-Ray Findings

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    A text-only language model, fed structured text extracted from chest X-rays by an undisclosed vision pipeline, is reported to outperform multimodal baselines on the authors' new CXR-ClinEval benchmark.

  10. GovRelBench:A Benchmark for Government Domain Relevance

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    A new Chinese government-domain benchmark uses a ModernBERT model trained on subjectively assigned, Beta-diffused relevance labels to score LLM responses.

  11. A Comprehensive Survey of Electronic Health Record Modeling: From Deep Learning Approaches to Large Language Models

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    A survey that taxonomizes EHR modeling research into data-centric, architectural, learning-focused, multimodal, and LLM-based categories, with datasets and metrics.

  12. MedOrch: Medical Diagnosis with Tool-Augmented Reasoning Agents for Flexible Extensibility

    cs.CL 2025-05 reject novelty 4.0 of 10

    MedOrch is a modular framework in which LLMs call medical tools to answer clinical questions; its headline results on Alzheimer's, chest X-ray, and VQA benchmarks are weakened by best-of-five scoring.

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    A modular retrieval-augmented agent for emergency guidance is claimed to beat GPT-4o and GPT-3.5, but the supporting evaluation is automated, unaudited, and not released.

  14. Reasoning LLMs in the Medical Domain: A Literature Survey

    cs.AI 2025-08 reject

    A literature review of reasoning-LLM techniques for medicine, from CoT prompting to RL-trained medical models, with no new experiments and several placeholder citations.

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