Right Diagnoses, Decorative Reasoning:A Perturbation Audit of Medical Chain-of-Thought
Clinicians read chain-of-thought (CoT) rationales as evidence of medical reasoning, but whether the visible chain plays that role is rarely tested. General-domain CoT-faithfulness probes ignore clinical cost, and medical LLM evaluations treat the chain as a black box. We close this gap with a medical perturbation audit: a 30-operator battery edits both the chain and the question with clinically motivated operators (severity reversal, negation flip, demographic swap, evidence ablation), paired with a chain-update times answer-flip joint analysis that classifies each model by its failure mode. A
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- PossiblePossibly related (embedding) · 47%Chain of Thought is a scaling trap. the next wave is latent reasoning (Coconut / HRM / RecrusiveMAS)... but then we hit the black box wall. Where does BDH fit? [D] →
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- PossiblePossibly related (embedding) · 45%The AI Validation Gap: Decision Support Tools Are Outrunning Their Own Evidence - The Clinical Trial Vanguard →
- LinkedLinked via arxiv author · 85%Mengzhu Xu →
“Right Diagnoses, Decorative Reasoning:A Perturbation Audit of Medical Chain-of-Thought”
- LinkedLinked via arxiv author · 85%Jifan Gao →
“Right Diagnoses, Decorative Reasoning:A Perturbation Audit of Medical Chain-of-Thought”
- LinkedLinked via arxiv author · 85%Xia Jiang →
“Right Diagnoses, Decorative Reasoning:A Perturbation Audit of Medical Chain-of-Thought”