Decide, Ask, or Defer: Clinical LLMs under Incomplete Evidence

arXiv:2610.04542v3 Announce Type: replace Abstract: Clinical LLMs must decide not only what diagnosis to produce, but also whether the available evidence is sufficient for autonomous decision making. Binary DECIDE/ABSTAIN formulations merge distinct non decision states and do not explicitly evaluate information acquisition. We introduce a DECIDE/ASK/DEFER formulation together with a blinded protocol that prevents models from using evidence completeness metadata. We evaluate Qwen, Gemini, and GPT on 200 matched clinical evidence states constructed from DDXPlus. The models show substantial diffe

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