Evidence map›Paper›PMID 41881991›Full record

ArticleNature communications2026

Grounding large language models in clinical diagnostics.

Xi Chen, Hanyu Zhou, Huahui Yi, Mingke You, WeiZhi Liu, Li Wang, Ziyuan Qin, Hairui Li, Xue Zhang, Yingman Guo and 9 more

Abstract read
In one paragraph

Article in Nature communications, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

19 authors.

Xi Chen *Sports Medicine Center, Department of Orthopedics and Orthopedic Research Institute, West China Hospital, Sichuan University, Chngdu, China.
Hanyu Zhou *School of Computer Science, Carnegie Mellon University, Pittsburgh, PA, USA.
Huahui Yi *West China Biomedical Big Data Center, Med-X Center for Informatics, Sichuan University, Chengdu, China.
Mingke YouSports Medicine Center, Department of Orthopedics and Orthopedic Research Institute, West China Hospital, Sichuan University, Chngdu, China.
WeiZhi LiuWest China School of Medicine, Sichuan University, Chengdu, China.
Li WangWest China School of Medicine, Sichuan University, Chengdu, China.ORCID http://orcid.org/0000-0003-3260-5998
Ziyuan QinDepartment of Mathematics and Computer Science, Laney Graduate School, Emory University, Atlanta, GA, USA.ORCID http://orcid.org/0009-0001-1013-4622
Hairui LiDepartment of Plastic Surgery, West China Tianfu Hospital, West China Hospital, Chengdu, China.
Xue ZhangWest China School of Medicine, Sichuan University, Chengdu, China.
Yingman GuoKidney Disease Center, First Affiliated Hospital, College of Medicine, Zhejiang University, Key Laboratory of Kidney Disease, Hangzhou, China.
Songlin LiDepartment of Orthopedics, Qilu Hospital of Shandong University, Jinan, China.
Yunan HuSports Medicine Center, Department of Orthopedics and Orthopedic Research Institute, West China Hospital, Sichuan University, Chngdu, China.
Qianjiang XiongSports Medicine Center, Department of Orthopedics and Orthopedic Research Institute, West China Hospital, Sichuan University, Chngdu, China.
Rongxiao LiSports Medicine Center, Department of Orthopedics and Orthopedic Research Institute, West China Hospital, Sichuan University, Chngdu, China.
Lei FanSports Medicine Center, Department of Orthopedics and Orthopedic Research Institute, West China Hospital, Sichuan University, Chngdu, China.
Qicheng LaoDepartment of Orthopedics, Qilu Hospital of Shandong University, Jinan, China.
Weili FuSports Medicine Center, Department of Orthopedics and Orthopedic Research Institute, West China Hospital, Sichuan University, Chngdu, China. foxwin2008@163.com.ORCID http://orcid.org/0000-0003-4438-2760
Jian LiSports Medicine Center, Department of Orthopedics and Orthopedic Research Institute, West China Hospital, Sichuan University, Chngdu, China. lijian_sportsmed@163.com.ORCID http://orcid.org/0009-0005-2666-6219
Kang LiWest China Biomedical Big Data Center, Med-X Center for Informatics, Sichuan University, Chengdu, China. likang@wchscu.cn.ORCID http://orcid.org/0000-0002-8136-9816

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Although Large Language Models (LLMs) possess extensive medical knowledge, they often struggle to emulate the complex, iterative process of real-world clinical diagnosis. To address this limitation, we present ClinDiag-GPT, a specialized LLM fine-tuned to execute full diagnostic procedures, supported by the ClinDiag-Framework evaluation system and ClinDiag-Benchmark, a dataset comprising 4,421 real-world cases. Our evaluation shows that existing LLMs, including GPT-4o-mini, GPT-4o, Claude-3-Haiku, Qwen2.5-72b, Qwen2.5-32b, and Qwen2.5-14b, while proficient in static tasks, fall short in dynamic diagnostic workflows and frequently commit clinical errors. In contrast, ClinDiag-GPT, trained on clinical cases, outperforms all baseline models in both diagnostic accuracy and procedural performance. Furthermore, a comparative analysis reveals that collaboration between physicians and ClinDiag-GPT yields higher diagnostic accuracy and efficiency compared to either working alone, demonstrating the utility of ClinDiag-GPT as a clinical assistant.

Indexed as

Large Language ModelsGenerative Artificial IntelligenceHumans

Identifiers

PMID41881991
PMCPMC13181090

What OpenQuestion holds

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LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.