In this work, we introduce LongMedBench, a real-world EHR-based benchmark for long-horizon clinical decision-making. Prior evaluations of LLM-based medical agents have largely emphasized short-context knowledge QA and tool use. However, real-world medical care is inherently longitudinal, and clinicians must aggregate evidence across repeated visits, tests, and evolving treatments. Therefore, long-horizon interaction is essential for realistic assessment. LongMedBench is constructed via a reproducible pipeline that integrates MIMIC-IV admission records and clinical notes into time-series event streams and long-context memory datasets, enabling long-horizon, multi-session interactions between agents and a clinical environment. It comprises 335 patients, with 19.72 inpatient visits per patient on average and 44.91 medical events per visit. Guided by the long-horizon decision process, we propose an evaluation taxonomy with three suites: fact-based QA, temporal reasoning, and long-horizon decision-making. This taxonomy measures how agents understand and leverage historical patient information over extended horizons. Our experiments show that while recent LLMs can make good use of explicit timestamps, they have challenges in implicit time inference; The RAG and agent memory system can improve the performance of information retrieval tasks, but the performance of decision-making tasks is highly dependent on the model's immediate context.
Zihan Xu, Yanzhen Chen, Xiaochen Zhang et al.· 0 citations
Large language models (LLMs) excel at answering pre-specified questions, yet their ability to navigate the open-ended, pre-conclusion stage of discovery remains largely unmeasured. We introduce Prospective Hypothesis Discovery (PHD), which asks models to autonomously construct grounded, discriminative, and testable hypothesis spaces from inconclusive evidence, including anomalous observations and fragmented records, to guide subsequent investigation. To evaluate this capability, we introduce HypoArena, comprising HypoData, a benchmark of 988 cases across six scientific and analytical domains, and HypoEval, an evaluation framework for open-ended hypothesis sets. To construct HypoData at scale, we propose Retrospective Context Regression, a Forge--Audit pipeline that reconstructs pre-conclusion contexts from completed expert documents by removing explicit conclusions, target hypotheses, and retrospective causal attributions while preserving the factual substrate. Because PHD admits multiple valid outputs, HypoEval combines bidirectional pairwise judgments with Bradley--Terry--Davidson aggregation for ranking and six-dimensional rubric scoring for diagnosis. Experiments on 15 frontier LLMs reveal clear capability stratification and model-dependent effects of structured analytical skills, with gains for several lower-performing models on HypoArena but regressions for other systems, including a top-performing model. Compared with absolute rubric scoring, arena evaluation resolves finer-grained differences among models, with aggregated rankings showing strong agreement with human experts and an independent judge. Together, these results support treating PHD as a distinct target for evaluating how LLMs formulate investigative directions when final conclusions are withheld. Our code and data are publicly available at github.com/SKYLENAGE-AI/HypoArena and github.com/SKYLENAGE-AI/HypoArena.
Tianyun Zhong, Wangyi Jiang, Wei Wang et al.· 0 citations
Evaluation of 19 multimodal large language models shows that current MLLMs still cannot reliably make justified and evidence-bounded inferences from experimental results, which is an essential capability in real scientific discovery.
Tao Han, Yucheng Zhang, Jinghang Wang et al.· 0 citations
Scientific reasoning benchmarks typically evaluate large language models (LLMs) using final-answer accuracy. However, a correct answer does not necessarily demonstrate the reasoning capability targeted by the problem. We identify Solution Hacking, a failure mode in which an LLM reaches the correct answer through invalid shortcuts, such as numerical search, enumeration, guessing, or answer-first verification, without providing a valid task-targeted derivation. We systematically analyze this phenomenon across difficulty levels, scientific domains, and frontier models. Solution hacking increases sharply with benchmark difficulty, from 2.2\% on common problems to 28.3\% on Olympiad-level problems and 37.4\% on HLE. Moreover, 8.2\%-44.1\% of answers credited as correct across frontier models are identified as hacked solutions. We further develop expert-inspired anti-hacking strategies, including an automatic judge and a test-time instruction. The results show that suppressing shortcut behavior substantially reduces reported accuracy while having a smaller effect on correct and non-hacked accuracy. These findings reveal that answer-only evaluation can overestimate the scientific reasoning capabilities of frontier LLMs.
Xuanhua Ren, Weiqi Zhai, Tianle Pu et al.· 0 citations