AIarXiv
Ranked by formulaVerdict: NotableThe Value of System 1 Models in Medicine
Many clinical decisions are a choice among a few fixed options, taken quickly and in large numbers.
Key numbers
- 76 times slower
- 95% CI
Caveats
- Preprint; not yet peer reviewed.
VerdictWorth a reader's time today.
Abstract
Many clinical decisions are a choice among a few fixed options, taken quickly and in large numbers. Such decisions also need an uncertainty estimate to know when to defer to a clinician. Generative language models answer slowly in free text and state their confidence poorly. In contrast, System 1 models answer zero-shot with a probability for each answer. However, their performance across clinical tasks is unknown. Four System 1 models, two proprietary and two with open weights, were evaluated zero-shot on 86 public tasks from 14 clinical domains in 20 languages, spanning examination questions and medical imaging. Tasks were assigned to six capability tiers before analysis. The primary outcome was the area under the receiver-operating-characteristic curve (AUROC). Secondary outcomes included calibration, language effects and comparisons with published results and generative models. Across 179,111 cases, the mean AUROC of the best model per task was 0.94 for medical knowledge, 0.93 for text understanding, 0.83 for clinical judgement from text, 0.89 for image perception, 0.84 for 2D image findings and 0.69 for volumetric findings. Imaging tasks scored 0.09 (95% CI, 0.06 to 0.11) lower than text tasks (P < 0.001). The best model matched or exceeded the best published result on 13 of 26 text tasks and on 8 of 35 imaging tasks. Triage nurses outperformed the best model (accuracy, 0.85 vs. 0.56). One decision took 0.34 to 0.44 seconds and 24 to 81 joules on open-weight models run locally. Accuracy on identical questions fell by up to 39 percentage points from English to Yoruba. Generative models of the same family were 11 to 76 times slower, with 3 to 5 percentage points higher balanced accuracy. System 1 models decide quickly, cheaply and with usable confidence when the answer is stated in a text or recalled from medical knowledge, but not when it must be judged or read from an image.
The editor's rubric
- Leverage3 / 5
- A method or resource many groups across the field will adopt within a year.
- Magnitude4 / 5
- A qualitative jump: a capability or regime that did not exist before.
- Evidence4 / 5
- Strong: large scale, preregistered, independently replicated, or a well-powered randomized trial.
- Novelty2 / 5
- A new combination of known ideas.
- Trajectory3 / 5
- A clear path to scale.
- Stakes2 / 5
- Benefits a professional community (practitioners, clinicians, engineers).
Editor’s rationale
Heuristic triage from title and abstract text only, not a reading of the paper. Cues found: breadth (many tasks, zero/few-shot); gains (x-fold, versus baseline, state of the art); verification (confidence interval, p-value, error bars); stakes (general AI).
How the score was computed
Desks place stronger verdicts first, then use this score to order work within the same verdict.
- Merit
- 6.1 / 10
- Adjusted merit
- 5.1 / 10
- Attention
- 0%
- Freshness
- 86%