ArticleJAMIA open2025
A study of calibration as a measurement of trustworthiness of large language models in biomedical natural language processing.
Article in JAMIA open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed.
- Frailty prediction models in older adults with stroke in China: A systematic review and meta-analysis.International journal of nursing studies advances · 2026Review
- Calibration of Self-Reported Confidence and Accuracy of Large Language Models in Medical Question Answering.Journal of medical systems · 2026Article
- Confidence Measurement Metrics in Multimodal Large Language Models for Ultrasound-Based Radiology Cases: Comparative Evaluation Study of Self-Reported, Consistency-Based, and Hybrid Methods.Journal of medical Internet research · 2026Article
- Development and External Validation of a Large Language Model-Based Clinical Decision-Support System for Colonoscopy Surveillance Intervals.Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association · 2026Article
- Medical Feature Extraction From Clinical Examination Notes: Development and Evaluation of a Two-Phase Large Language Model Framework.JMIR medical informatics · 2025Article
- Will large language models transform clinical prediction?Diagnostic and prognostic research · 2025Article
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9 authors.
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Abstract
Objectives: To assess the calibration of 9 large language models (LLMs) within biomedical natural language processing (BioNLP) tasks, furthering understanding of trustworthiness and reliability in real-world settings. Materials and Methods: For each LLM, we collected responses and corresponding confidence scores for all 13 datasets (grouped into 6 tasks) of the Biomedical Language Understanding & Reasoning Benchmark (BLURB). Confidence scores were assigned using 3 strategies: Verbal, Self-consistency, and Hybrid. For evaluation, we introduced Flex-ECE (Flexible Expected Calibration Error), a novel adaptation of ECE that accounts for partial correctness in model responses, allowing for a more realistic assessment of calibration in language-based settings. Two post-hoc calibration techniques-isotonic regression and histogram binning-were evaluated. Results: Across tasks, mean calibration ranged from 23.9% (Population-Intervention-Comparison-Outcome extraction) to 46.6% (Relation Extraction). Across LLMs, Medicine-Llama3-8B had the best mean overall calibration (29.8%), and Flan-T5-XXL had the highest ranking on 5/13 datasets. Across strategies, Self-consistency (mean: 27.3%) had better calibration than Verbal (mean: 42.0%) and Hybrid (mean: 44.2%). Post-hoc methods substantially improved calibration, with best mean calibrated Flex-ECEs ranging from 0.1% to 4.1%. Discussion: The poor out-of-the-box calibration of LLMs poses a risk to trustworthy deployment of such models in real-world BioNLP applications. Calibration can be improved post-hoc and is a recommended practice. Non-binary metrics for LLM evaluation such as Flex-ECE provide a more realistic assessment of trustworthiness of LLMs, and indeed any model that can be partially right/wrong. Conclusion: This study shows that out-of-the-box calibration of LLMs is very poor, but traditional post-hoc calibration techniques are useful to calibrate LLMs.
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