Abstract:Existing medical AI benchmarks lack process visibility, atomic skill evaluation, and integrated hallucination detection. We introduce MedBench v5, a redesigned benchmark for clinical multimodal models (language, vision-language, and agent systems) that moves from static QA to dynamic, process-oriented evaluation. MedBench v5 features: (1) a dual-dimensional framework combining Clinical Cognitive Responsiveness (14 sub-dimensions) and Medical Atomic Skills (4 agent environments), covering 63 tasks; (2) three switchable information-flow stressors (omission, contradiction, evidence delay) for factorized degradation analysis; (3) a dynamic process audit protocol with five reasoning nodes that produces model-specific failure fingerprints; (4) hallucination propagation monitoring across initiation, propagation, anchoring, and contradiction interaction-capturing silent hallucination. Experiments on frontier models show that strong overall task performance does not guarantee process stability: stressors mainly disrupt contradiction detection, diagnosis updating, hallucination propagation, and contradiction-based self-correction, while final evidence grounding can remain superficially stable. MedBench v5 provides a unified infrastructure for capability profiling, controllable stress testing, process auditing, and hallucination trajectory analysis in clinical AI evaluation.
Abstract:Recent advances in medical large language models (LLMs), multimodal models, and agents demand evaluation frameworks that reflect real clinical workflows and safety constraints. We present MedBench v4, a nationwide, cloud-based benchmarking infrastructure comprising over 700,000 expert-curated tasks spanning 24 primary and 91 secondary specialties, with dedicated tracks for LLMs, multimodal models, and agents. Items undergo multi-stage refinement and multi-round review by clinicians from more than 500 institutions, and open-ended responses are scored by an LLM-as-a-judge calibrated to human ratings. We evaluate 15 frontier models. Base LLMs reach a mean overall score of 54.1/100 (best: Claude Sonnet 4.5, 62.5/100), but safety and ethics remain low (18.4/100). Multimodal models perform worse overall (mean 47.5/100; best: GPT-5, 54.9/100), with solid perception yet weaker cross-modal reasoning. Agents built on the same backbones substantially improve end-to-end performance (mean 79.8/100), with Claude Sonnet 4.5-based agents achieving up to 85.3/100 overall and 88.9/100 on safety tasks. MedBench v4 thus reveals persisting gaps in multimodal reasoning and safety for base models, while showing that governance-aware agentic orchestration can markedly enhance benchmarked clinical readiness without sacrificing capability. By aligning tasks with Chinese clinical guidelines and regulatory priorities, the platform offers a practical reference for hospitals, developers, and policymakers auditing medical AI.
Abstract:As large language models (LLMs) enter the medical domain, most benchmarks evaluate them on question answering or descriptive reasoning, overlooking quantitative reasoning critical to clinical decision-making. Existing datasets like MedCalc-Bench cover few calculation tasks and fail to reflect real-world computational scenarios. We introduce MedCalc-Eval, the largest benchmark for assessing LLMs' medical calculation abilities, comprising 700+ tasks across two types: equation-based (e.g., Cockcroft-Gault, BMI, BSA) and rule-based scoring systems (e.g., Apgar, Glasgow Coma Scale). These tasks span diverse specialties including internal medicine, surgery, pediatrics, and cardiology, offering a broader and more challenging evaluation setting. To improve performance, we further develop MedCalc-Env, a reinforcement learning environment built on the InternBootcamp framework, enabling multi-step clinical reasoning and planning. Fine-tuning a Qwen2.5-32B model within this environment achieves state-of-the-art results on MedCalc-Eval, with notable gains in numerical sensitivity, formula selection, and reasoning robustness. Remaining challenges include unit conversion, multi-condition logic, and contextual understanding. Code and datasets are available at https://github.com/maokangkun/MedCalc-Eval.