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Evaluating Large Language Models for Symptom-Based Medical Diagnosis: A Comparative Performance Analysis
This research undertook an assessment of Large Language Models (LLMs) within the domain of clinical diagnostics, specifically investigating their capacity to interpret symptom-centered inputs and generate precise clinical assessments. The investigation focused on evaluating several prominent architectures—including GPT-4, GPT-4o, Gemini, o1 Preview, and GPT-3.5—to gauge their proficiency in identifying clinical conditions solely from presented symptomatology. To guarantee clinical validity and appropriateness, symptom profiles were compiled from verified medical literature. Each architecture underwent testing within standardized environments to quantify diagnostic accuracy, precision, recall, and underlying logical processing. Specialized clinical scenarios were structured to examine performance boundaries across both routine and critical diagnostic conditions. The findings indicated that GPT-4 delivered the highest overall diagnostic accuracy, displaying a strong synergy with established medical logic. Conversely, Gemini demonstrated superior performance in high-stakes environments where exact decision-making is vital. Both GPT-4o and o1 Preview presented equitable metrics, maintaining a stable balance between precision and recall while managing real-time diagnostic scenarios. While possessing less advanced capabilities, GPT-3.5 remained functional for standard diagnostic duties. Ultimately, this investigation outlines the current capabilities and constraints of utilizing LLMs for clinical determination. Even though architectures like GPT-4 and Gemini show significant capability, critical barriers regarding data confidentiality, ethical protocols, and training bias correction must still be overcome. These insights offer strategic directions for the ethical incorporation of LLMs into diagnostic frameworks to optimize patient care outcomes.
Journal of Trustworthy and Explainable Intelligent Systems
Original Research | Open access | 15 September 2022 | Article: 19

Can Foundation Models Be Trusted? A Scoping Review of Interpretability, Hallucination, Uncertainty, Alignment, Evaluation, and Human Oversight
Foundation models have expanded the scope of artificial intelligence by supporting language generation, multimodal reasoning, knowledge-intensive assistance, decision support, and adaptable downstream applications. Their broad capabilities, however, do not establish that their outputs, explanations, internal processes, or deployment arrangements are trustworthy. This scoping review maps the research landscape concerning foundation-model trustworthiness across interpretability, explanation capabilities, hallucination, uncertainty, reliability, alignment, evaluation, and human oversight. The review uses structured search concepts, eligibility principles, evidence extraction, and dimension-based mapping to examine how peer-reviewed scholarship characterizes foundation models as general-purpose intelligent systems and how trustworthiness evidence is distributed across technical, human-centered, organizational, and governance domains. The synthesis indicates that interpretability methods can expose selected behavioral or representational features but do not independently demonstrate explanation fidelity, usefulness, or safety. Hallucination and factuality research identifies persistent risks involving fabrication, unsupported claims, weak grounding, and persuasive misinformation, while uncertainty methods remain constrained by calibration, context shift, and user-communication challenges. Alignment and post-training techniques may shape preferred behaviors but retain risks associated with proxy objectives, preference representation, and residual failure. Benchmarking, human evaluation, stress testing, and oversight provide partial evidence, yet their value depends on construct validity, domain relevance, intervention capacity, accountability, and lifecycle monitoring. The research landscape is therefore fragmented across disciplines and frequently model-centred rather than socio-technical. Key priorities include stronger foundation-model interpretability validation, consistent hallucination measurement, usable uncertainty communication, externally valid evaluation, meaningful oversight testing, multimodal analysis, and lifecycle governance. The review contributes an integrated evidence map while emphasizing that no single trustworthiness dimension certifies safety, reliability, accountability, or deployment readiness.
Journal of Trustworthy and Explainable Intelligent Systems
Review | Open access | 15 March 2026 | Article: 80