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kierangilltoday at 5:18 PM1 replyview on HN

I work at a telemedicine company. We’ve benchmarked a few frontier LLMs on public medical imaging datasets. One test included high-quality and high-consensus otoscopic images. We didn’t anticipate the models to do well on something so niche, but what concerned us was how poorly calibrated the models were.

I know you can’t trust an LLM’s self-assessed “confidence” of a prediction, but I’ve found that confidence can at least be directionally correct for some tasks. For our benchmarks, however, confidence was poorly correlated. What’s worse is that binary classification models (“Do you see $diagnosis in this photo?”) highly influenced the LLM to confidently predict $diagnosis.

I’m concerned for those using LLMs for diagnostics, and getting confidently led to the wrong conclusion.


Replies

nostreboredtoday at 5:51 PM

But the binary classification models can be made ternary easily. RL on congruence plus penalty for misdiagnosis is easy to set up and gives great results.

What I’ve seen be the true bottleneck is people not setting up the structured data. But making a tiny reasoning model with OPSD -> GRPO is totally doable with a bit of money.