Skip to content
naulon

No retraction, correction or concern found when last checked on Oct 20, 2026.

Can large language models reason about medical questions?

Valentin Liévin, Christoffer Egeberg Hother, Andreas Geert Motzfeldt and 1 more

Patterns · 2024 · CC BY

doi:10.1016/j.patter.2024.100943

Abstract

Although large language models often produce impressive outputs, it remains unclear how they perform in real-world scenarios requiring strong reasoning skills and expert domain knowledge. We set out to investigate whether closed- and open-source models (GPT-3.5, Llama 2, etc.) can be applied to answer and reason about difficult real-world-based questions. We focus on three popular medical benchmarks (MedQA-US Medical Licensing Examination [USMLE], MedMCQA, and PubMedQA) and multiple prompting scenarios: chain of thought (CoT; think step by step), few shot, and retrieval augmentation. Based on an expert annotation of the generated CoTs, we found that InstructGPT can often read, reason, and recall expert knowledge. Last, by leveraging advances in prompt engineering (few-shot and ensemble methods), we demonstrated that GPT-3.5 not only yields calibrated predictive distributions but also reaches the passing score on three datasets: MedQA-USMLE (60.2%), MedMCQA (62.7%), and PubMedQA (78.2%). Open-source models are closing the gap: Llama 2 70B also passed the MedQA-USMLE with 62.5% accuracy.

Full text

Its licence does not allow us to show the full text. Read it at PubMed Central:

Read at PubMed Central

References 63

  1. 1.

    Mikolov T., Sutskever I., Chen K., Corrado G.S., Dean J. Distributed representations of words and phrases and their compositionality. Adv. Neural Inf. Process. Syst. 2013;26.

    Not in our library

  2. 2.

    Pennington J., Socher R., Manning C. Proceedings of the 2014 Conference on Empirical Methods in Natural Language Processing (EMNLP). 2014;1532-1543.

    Not in our library10.3115/v1/d14-1162

  3. 3.

    Peters M.E., Neumann M., Iyyer M., Gardner M., Clark C., Lee K., Zettlemoyer L. Deep contextualized word representations. arXiv. 2018.

    Not in our library10.48550/arxiv.1802.05365

  4. 4.

    Vaswani A., Shazeer N., Parmar N., Uszkoreit J., Jones L., Gomez A.N., Kaiser Ł., Polosukhin I. Attention is all you need. Adv. Neural Inf. Process. Syst. 2017;30.

    Not in our library

  5. 5.

    Devlin J., Chang M., Lee K., Toutanova K. BERT: Pre-training of Deep Bidirectional Transformers for Language Understanding. arXiv. 2018.

    Not in our library10.04805/arxiv.1810.04805

  6. 6.

    Radford A., Narasimhan K., Salimans T., Sutskever I. 2018.

    Not in our library

  7. 7.

    Brown T., Mann B., Ryder N., Subbiah M., Kaplan J.D., Dhariwal P., Neelakantan A., Shyam P., Sastry G., Askell A., Agarwal S., et al. Language models are few-shot learners. Adv. Neural Inf. Process. Syst. 2020;33.

    Not in our library

  8. 8.

    Rae J.W., Borgeaud S., Cai T., Millican K., Hoffmann J., Song H.F., Aslanides J., Henderson S., Ring R., Young S., Rutherford E., et al. Scaling Language Models: Methods, Analysis & Insights from Training Gopher. arXiv. 2021.

    Not in our library10.48550/arxiv.2112.11446

  9. 9.

    Chowdhery A., Narang S., Devlin J., Bosma M., Mishra G., Roberts A., Barham P., Chung H.W., Sutton C., Gehrmann S., et al. Palm: Scaling language modeling with pathways. J. Mach. Learn. Res. 2023;24:1-113.

    Not in our library

  10. 10.

    Thoppilan R., Freitas D.D., Hall J., Shazeer N., Kulshreshtha A., Cheng H., Jin A., Bos T., Baker L., Du Y., et al. LaMDA: Language Models for Dialog Applications. arXiv. 2022.

    Not in our library10.48550/arxiv.2201.08239

  11. 11.

    Hoffmann J., Borgeaud S., Mensch A., Buchatskaya E., Cai T., Rutherford E., Casas D.D.L., Hendricks L.A., Welbl J., Clark A., et al. Training Compute-optimal Large Language Models. arXiv. 2022.

    Not in our library10.48550/arxiv.2203.15556

  12. 12.

    Smith S., Patwary M., Norick B., LeGresley P., Rajbhandari S., Casper J., Liu Z., Prabhumoye S., Zerveas G., Korthikanti V., et al. Using DeepSpeed and Megatron to Train Megatron-turing NLG 530B, A Large-scale Generative Language Model. arXiv. 2022.

    Not in our library10.48550/arxiv.2201.11990

  13. 13.

    Zhang S., Roller S., Goyal N., Artetxe M., Chen M., Chen S., Dewan C., Diab M., Li X., Lin X.V., et al. OPT: Open Pre-trained Transformer Language Models. arXiv. 2022.

    Not in our library10.48550/arxiv.2205.01068

  14. 14.

    Lieber O., Sharir O., Lenz B., Shoham Y. Jurassic-1: Technical details and evaluation. White Paper AI21 Labs. 2021;1:9.

    Not in our library

  15. 15.

    Fedus W., Zoph B., Shazeer N. Switch transformers: Scaling to trillion parameter models with simple and efficient sparsity. J. Mach. Learn. Res. 2022;23:5232-5270.

    Not in our library

  16. 16.

    Laurençon H., Saulnier L., Wang T., Akiki C., Villanova del Moral A., Le Scao T., Von Werra L., Mou C., González Ponferrada E., Nguyen H., et al. The BigScience ROOTS Corpus: A 1.6TB composite multilingual dataset. Adv. Neural Inf. Process. Syst. 2022;35:31809-31826.

    Not in our library

  17. 17.

    Kaplan J., McCandlish S., Henighan T., Brown T.B., Chess B., Child R., Gray S., Radford A., Wu J., et al. Scaling Laws for Neural Language Models. arXiv. 2020.

    Not in our library10.48550/arxiv.2001.08361

  18. 18.

    Srivastava A., Rastogi A., Rao A., Shoeb A.A.M., Abid A., Fisch A., Brown A.R., Santoro A., Gupta A., Garriga-Alonso A., et al. Beyond the Imitation Game: Quantifying and extrapolating the capabilities of language models. arXiv. 2022.

    Not in our library10.48550/arxiv.2206.04615

  19. 19.

    Liu P., Yuan W., Fu J., Jiang Z., Hayashi H., Neubig G. Pre-train, prompt, and predict: A systematic survey of prompting methods in natural language processing. ACM Comput. Surv. 2023;55:1-35.

    Not in our library

  20. 20.

    Wei J., Wang X., Schuurmans D., Bosma M., Xia F., Chi E., Le Q.V., Zhou D. Chain-of-thought prompting elicits reasoning in large language models. Adv. Neural Inf. Process. Syst. 2022;35:24824-24837.

    Not in our library

  21. 21.

    Zhou D., Schärli N., Hou L., Wei J., Scales N., Wang X., Schuurmans D., Cui C., Bousquet O., Le Q., Chi E. Least-to-most Prompting Enables Complex Reasoning in Large Language Models. arXiv. 2022.

    Not in our library10.48550/arxiv.2205.10625

  22. 22.

    Drozdov A., Schärli N., Akyürek E., Scales N., Song X., Chen X., Bousquet O., Zhou D. Compositional Semantic Parsing with Large Language Models. arXiv. 2022.

    Not in our library10.48550/arxiv.2209.15003

  23. 23.

    Nye M.I., Andreassen A.J., Gur-Ari G., Michalewski H., Austin J., Bieber D., Dohan D., Lewkowycz A., Bosma M., Luan D., et al. Show Your Work: Scratchpads for Intermediate Computation with Language Models. arXiv. 2021.

    Not in our library10.48550/arxiv.2112.00114

  24. 24.

    Suzgun M., Scales N., Schärli N., Gehrmann S., Tay Y., Chung H.W., Chowdhery A., Le Q.V., Chi E.H., Zhou D., Wei J. Challenging BIG-bench Tasks and Whether Chain-of-thought Can Solve Them. arXiv. 2022.

    Not in our library10.48550/arxiv.2210.09261

  25. 25.

    Kojima T., Gu S.S., Reid M., Matsuo Y., Iwasawa Y. Large language models are zero-shot reasoners. Adv. Neural Inf. Process. Syst. 2022;35:22199-22213.

    Not in our library

  26. 26.

    Ouyang L., Wu J., Jiang X., Almeida D., Wainwright C., Mishkin P., Zhang C., Agarwal S., Slama K., Ray A., Schulman J., et al. Training language models to follow instructions with human feedback. Adv. Neural Inf. Process. Syst. 2022;35:27730-27744.

    Not in our library

  27. 27.

    Bender E.M., Gebru T., McMillan-Major A., Shmitchell S. Proceedings of the 2021 ACM conference on fairness, accountability, and transparency. 2021;610-623.

    Not in our library

  28. 28.

    Wang B., Xu C., Wang S., Gan Z., Cheng Y., Gao J., Awadallah A.H., Li B. Adversarial GLUE: A Multi-task Benchmark for Robustness Evaluation of Language Models. arXiv. 2021.

    Not in our library10.48550/arxiv.2111.02840

  29. 29.
  30. 30.

    Sezgin E., Sirrianni J., Linwood S.L. Operationalizing and Implementing Pretrained, Large Artificial Intelligence Linguistic Models in the US Health Care System: Outlook of Generative Pretrained Transformer 3 (GPT-3) as a Service Model. JMIR medical informatics. 2022;10.

    Not in our library10.2196/32875

  31. 31.

    Hendrycks D., Burns C., Basart S., Zou A., Mazeika M., Song D., Steinhardt J. Measuring Massive Multitask Language Understanding. arXiv. 2020.

    Not in our library10.48550/arxiv.2009.03300

  32. 32.

    Jin D., Pan E., Oufattole N., Weng W.H., Fang H., Szolovits P. What disease does this patient have? a large-scale open domain question answering dataset from medical exams. Appl. Sci. 2021;11:6421.

    Not in our library

  33. 33.
  34. 34.

    Singhal K., Tu T., Gottweis J., Sayres R., Wulczyn E., Hou L., Clark K., Pfohl S., Cole-Lewis H., Neal D., et al. Towards Expert-level Medical Question Answering with Large Language Models. arXiv. 2023.

    Not in our library10.48550/arxiv.2305.09617

  35. 35.

    Nori H., King N., McKinney S.M., Carignan D., Horvitz E. Capabilities of GPT-4 on Medical Challenge Problems. arXiv. 2023.

    Not in our library10.48550/arxiv.2303.13375

  36. 36.
  37. 37.
  38. 38.

    Touvron H., Martin L., Stone K., Albert P., Almahairi A., Babaei Y., Bashlykov N., Batra S., Bhargava P., Bhosale S., et al. Llama 2: Open Foundation and Fine-tuned Chat Models. arXiv. 2023.

    Not in our library10.48550/arxiv.2307.09288

  39. 39.

    Chen Z., Hernández-Cano A., Romanou A., Bonnet A., Matoba K., Salvi F., Pagliardini M., Fan S., Köpf A., Mohtashami A., et al. MEDITRON-70B: Scaling Medical Pretraining for Large Language Models. arXiv. 2023.

    Not in our library10.48550/arxiv.2311.16079

  40. 40.

    Wang Y., Ma X., Chen W. Augmenting Black-box LLMs with Medical Textbooks for Clinical Question Answering. arXiv. 2023.

    Not in our library10.48550/arxiv.2309.02233

All 63 references

Cited by papers we hold 5

Reads

Read by people on this page

None yet.

Checked or read by AI through naulon

None yet.

A person counts once a day per paper. We keep no cookie and no address: a reader is a hash that changes every day. Any month under five reads shows no number.

Are you an author?

Is this your paper?

Claim it to add your note and be paid when agents cite it. Free.