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Large language models

Large language models (LLMs) are artificial-intelligence systems trained on very large collections of text to identify statistical relationships between language units and generate or transform text in response to prompts.

Where the papers sit

50 papers from the last 6 months study large language models directly · updated from PubMed 1 Nov 2026

  • Healthcare AI Safety and Equity

    Healthcare LLM work is shifting from headline accuracy toward bias, privacy, equity and oversight. Evaluations span prescription review, dermatology, MRI findings, EHR symptom extraction, spiritual pain and suicidal ideation, alongside education and therapy. Sensitivity, specificity and human agreement recur, but performance varies by domain and deployment setting. Local models and multidisciplinary or multimodal systems are being explored to protect sensitive data without losing clinical utility.

    13 papers · 26%

  • Clinical Education and Support

    Clinical education is moving from static text toward interactive virtual patients, 3D avatars, automated feedback and shared-decision training. LLMs are also being tested for readability, symptom assessment, treatment planning, radiology impressions and emergency recommendations. Early evaluations emphasize feasibility, acceptance and agreement with human supervisors, while cross-sectional designs dominate. Reliability, domain adaptation and safe integration into clinician and therapist workflows remain open questions.

    10 papers · 20%

  • Clinical Decision Support

    Clinical decision support is moving toward specialty-aware assistants that combine case reasoning, structured extraction and patient communication. Work spans hepatopancreatobiliary oncology, oncology nursing, rheumatic-disease infections, audiology, postoperative complications and cancer survivorship. Tool use for trial eligibility and coding aims to connect unstructured records with actionable decisions. Protocols and feasibility studies still predominate, leaving prospective validation, safety and effects on care unresolved.

    10 papers · 20%

  • Clinical Record Language Processing

    Clinical language processing is moving toward longitudinal, structured use of electronic health records rather than isolated text generation. Applications include chronic kidney disease diagnosis, infectious-disease extraction, anonymization, semantic interoperability and catheter-associated infection surveillance. Fine-tuning, rule-based hybrids and quantum-enhanced architectures are compared with clinician or specialist assessments using sensitivity, specificity and F1 score. The recurring goal is reliable data conversion for prevention and value-based care, with generalization and privacy still open.

    7 papers · 14%

  • Clinical Reliability and Safety

    Clinical evaluation is increasingly testing whether LLM answers are safe, complete, appropriate and calibrated for real patient-facing use. Applications include urological and andrological health management, rare-disease triage, reproductive counselling and drug-induced liver injury prognosis. High safety can coexist with missing information, and confidence does not always track accuracy. Clinician-centered frameworks and technology-acceptance measures point toward deployment decisions based on usability and evidence, not accuracy alone.

    6 papers · 12%

  • Research Analysis Automation

    LLMs are being tested as research co-pilots for statistical analysis, thematic coding and risk-of-bias assessment. The emphasis is shifting from effortless “vibe coding” toward benchmarking failures, reproducibility and explicit oversight. Prompt engineering changes performance, but it does not remove errors in code, interpretation or methodological judgment. Human review remains necessary before analyses or evidence assessments enter clinical research workflows.

    4 papers · 8%

PARADIGM SHIFT

Large language models should be bounded assistants rather than substitutes for clinical experts

Drug-induced liver injury prognostic prediction and German clinical-note code mapping were treated as tasks in which large language models might provide broadly useful clinical decision support and automation, but they instead exposed sharp limits to that assumption. In the multicenter drug-induced liver injury study, large language models were generally less accurate and specific than hepatologists, while in the German-note study, performance was very poor for diagnosis mapping, with F1 scores no higher than 0.12, despite better medication-name extraction 42757445Sep 42752481Sep. Across prognostic judgment and structured clinical interpretation, the result is that deployment should be restricted to bounded, task-specific assistance with expert oversight rather than treating fluent output as a replacement for clinical judgment.

NEW DIRECTION

Large language models become psychometric judges in examination standard setting

A basic medical science examination, rather than a clinical-care, documentation, or tutoring task, is the subject of the AI-Assisted Angoff Standard Setting paper; it uses large language models as judges who estimate the minimally competent candidate’s cutoff alongside faculty judges. The set otherwise presents LLMs as tools for generating or evaluating content, supporting clinical decisions, extracting information, or assisting analysis, not as participants in setting the pass standard itself. By applying the modified Angoff method and generalizability-theory analysis to LLM ratings, the paper gives LLMs a distinct psychometric role in constructing a high-stakes assessment. 42715553Sep

Papers

The 50 papers from the last 6 months that study large language models directly, newest first, by theme and by study type. Study types come from PubMed publication types and MeSH headings.

By theme

Healthcare AI Safety and Equity (13)
  1. Detecting spiritual pain in electronic medical records using large language models. Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 29 Oct 2026 PMID 42955097
  2. Ensemble of Domain-Specific Natural Language Processing and Large Language Models for Detecting Suicidal Ideation and Mental Health Conditions in Social Media Text: Development and Evaluation Study. JMIR mental health · 8 Oct 2026 PMID 42849899
  3. Psychological Therapy in the Age of Large Language Models: Framework for Therapist-Delivered and AI-Supported Functions. JMIR mental health · 16 Sept 2026 PMID 42748037
  4. Attitudes Toward Large Language Models in Health Care and Preferences for Their Adoption and Oversight Among Health Care Professionals: Cross-Sectional Survey. Journal of medical Internet research · 15 Sept 2026 PMID 42742517
  5. Locally Deployed Large Language Models for AI-Assisted Outpatient Prescription Review: Crossover Study. JMIR medical informatics · 14 Sept 2026 PMID 42735403
  6. Promise, Mimicry, and Surveillance: Responsibly Integrating Artificial Intelligence With Socratic Inquiry in Medical Education. JMIR medical education · 10 Sept 2026 PMID 42721480
  7. Exploring Bias in Medical Applications of Large Language Models: Protocol for a Systematic Review. JMIR research protocols · 10 Sept 2026 PMID 42721473
  8. AI-Assisted Angoff Standard Setting for Multiple-Choice Examinations in Medical Education: Comparative Study. JMIR medical education · 9 Sept 2026 PMID 42715553
  9. The Performance of Large Language Models in Extracting Intestinal Symptoms From Electronic Health Records: Retrospective Observational Study. Journal of medical Internet research · 26 Aug 2026 PMID 42647073
  10. Automating the Management of Extraspinal Findings in Magnetic Resonance Imaging Spine Studies Using a Privacy-Preserving Large Language Model: Retrospective Validation Study. Journal of medical Internet research · 26 Aug 2026 PMID 42647045
  11. Local Deployment of Open-Weight Language Models in Dermatology: Viewpoint on Privacy, Equity, and Practical Implementation. JMIR dermatology · 21 Aug 2026 PMID 42627943
  12. A Multidisciplinary Team-Based Large Language Model Framework for Predicting Postoperative Neurological Complications in Acute Type A Aortic Dissection: Model Development and Validation Study. Journal of medical Internet research · 18 Aug 2026 PMID 42611794
  13. Leveraging Multimodal Large Language Models for Fall Risk Reduction in Older Adults in the Home: Proposed Model Design. JMIR aging · 13 May 2026 PMID 42127229
Clinical Education and Support (10)
  1. Domain Adaptation of a Large Language Model for Radiology Impression Generation - Multi-Reader Evaluation. Journal of medical systems · 27 Oct 2026 PMID 42944792
  2. Large Language Model-Powered 3D Avatars to Train Shared Decision-Making in Undergraduate Medical Students: Design and Mixed Methods Acceptance Study. JMIR formative research · 27 Oct 2026 PMID 42944729
  3. Large Language Models as a New Tool for Therapists in Internet-Based Cognitive Behavioral Therapy: Blinded Clinician Rating Pilot Experiment. JMIR mental health · 26 Aug 2026 PMID 42647055
  4. Large Language Model Simplification of Open Access Pediatric Strabismus Literature: Cross-Sectional Validation of Readability and Clinical Fidelity. JMIR formative research · 14 Aug 2026 PMID 42600075
  5. Large language model use in dental education: a cross-sectional multi-country study. Medical education online · 6 Aug 2026 PMID 42559854
  6. A Multiagent Large Language Model Framework for Emergency Treatment Recommendation in Acute Ischemic Stroke: Development and Validation Study. Journal of medical Internet research · 30 Jul 2026 PMID 42531250
  7. Large Language Models for Endodontic Symptom Assessment and Treatment Planning Using Image-Free Clinical Records: Comparative Evaluation Study. JMIR medical informatics · 24 Jul 2026 PMID 42497401
  8. Understanding Public Awareness, Attitudes, Beliefs, and Perceptions About ChatGPT in Saudi Arabia: A Road Map for Digital Health. Medical science monitor : international medical journal of experimental and clinical research · 27 Jun 2026 PMID 42363582
  9. AI-Generated Versus Human Supervisor Feedback on Medical Students' Clinical Clerkship Logs: Cross-Sectional Convergent Mixed Methods Study. JMIR medical education · 16 Jun 2026 PMID 42302283
  10. Feasibility of Large Language Model-Based Standardized Virtual Patients to Support Clinical Decision-Making Training in Operative Dentistry: Mixed Methods Study. JMIR formative research · 19 May 2026 PMID 42155101
Clinical Decision Support (10)
  1. Large language models in the diagnosis and treatment of immunosuppression-related infections in rheumatic diseases: a comparative, vignette-based study. Rheumatology international · 9 Oct 2026 PMID 42853428
  2. Large Language Model Chatbot Responses to Cancer Survivorship Questions in Hong Kong: Bilingual Evaluation and Prompt Optimization Study. Journal of medical Internet research · 8 Oct 2026 PMID 42849027
  3. Large Language Models in Multidisciplinary Decision-Making for Hepatopancreatobiliary Oncology: Retrospective Comparative Feasibility Study. Journal of medical Internet research · 17 Sept 2026 PMID 42753242
  4. Clinical Code Mapping with LLM Tool Use: A Pilot for Automated Data Extraction of Medication and Diagnosis Information from Unstructured Clinical Notes. Studies in health technology and informatics · 17 Sept 2026 PMID 42752481
  5. Automated Extraction of Genetic Eligibility Criteria from Clinical Trial Records Using LLMs - A Technical Case Report. Studies in health technology and informatics · 17 Sept 2026 PMID 42752480
  6. Frameworks, Methodologies, and Tools for Evaluating Large Language Models in Digital Mental Health Interventions: Protocol for a Scoping Review. JMIR research protocols · 14 Sept 2026 PMID 42735424
  7. Evaluating Large Language Models in Clinical Audiology (AUDIOLOGYBENCH): Benchmark Development and Validation Study. Journal of medical Internet research · 11 Sept 2026 PMID 42727086
  8. A bimodal large language model reduces misalignment in patient education: A double-blinded randomized trial. Med (New York, N.Y.) · 17 Aug 2026 PMID 42607666
  9. Nurse-Led Large Language Model Chatbot for Predicting and Preventing Complications After Coronary Artery Bypass Grafting: Protocol for a Randomized Controlled Trial. JMIR research protocols · 4 Aug 2026 PMID 42550966
  10. Performance of Large Language Models for Oncology Nursing Decision Support: Cross-Sectional Study. Journal of medical Internet research · 24 Jul 2026 PMID 42497362
Clinical Record Language Processing (7)
  1. (AI)lephant in the Room: Utility of Generative AI to Develop Discussion Guides for Cardiac Surgery Morbidity and Mortality Conferences. Journal of surgical education · 13 Oct 2026 PMID 42868634
  2. Periodontitis Risk Assessment and Prevention Planning: Comparative Study of Multimodal Large Language Models and Periodontist Evaluations. Journal of medical Internet research · 2 Oct 2026 PMID 42826249
  3. Leveraging time-series electronic health records with large language models for chronic kidney disease diagnosis in primary care. BMJ health & care informatics · 18 Sept 2026 PMID 42759972
  4. Anonymization of Portuguese Clinical Notes Using Large Language Models and Quantum-Enhanced Hybrid Architectures: Comparative Evaluation Study. Journal of medical Internet research · 14 Sept 2026 PMID 42735382
  5. Fine-Tuning Large Language Models for Structured Extraction of Infectious Disease-Related Information From Clinical Notes in Japanese Primary Care: Development and Internal Validation Study. JMIR formative research · 10 Sept 2026 PMID 42721099
  6. Large Language Models for Semantic Interoperability in Value-Based Perioperative Care. Journal of medical systems · 14 May 2026 PMID 42133097
  7. The Best of Both Worlds: How Combining a Large Language Model and a Rule-Based Algorithm Makes Catheter-Associated Urinary Tract Infection Surveillance More Efficient. Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 14 May 2026 PMID 42132396
Clinical Reliability and Safety (6)
  1. A Clinician-Centered Evaluation Framework for Large Language Models in Patient Education: Integrating the Technology Acceptance Model and Medical Condition Regard Scale. JMIR formative research · 21 Sept 2026 PMID 42766478
  2. Multicenter Evaluation of Large Language Models Versus Hepatologists for Prognostic Prediction in Drug-Induced Liver Injury. Liver international : official journal of the International Association for the Study of the Liver · 18 Sept 2026 PMID 42757445
  3. Large language models show high clinical safety but differences in completeness for reproductive counselling in women with inflammatory rheumatic and musculoskeletal diseases: a comparative expert evaluation. Rheumatology international · 10 Sept 2026 PMID 42720754
  4. Initial-Visit Specialty Triage in Rare Diseases Using Large Language Models: Retrospective Benchmarking Study. Journal of medical Internet research · 23 Jul 2026 PMID 42490550
  5. Calibration of Self-Reported Confidence and Accuracy of Large Language Models in Medical Question Answering. Journal of medical systems · 26 Jun 2026 PMID 42360536
  6. Comparative study on the efficacy of large language models (LLMs) in health management for patients with urological and andrological diseases: a multidimensional quality evaluation and applicability analysis. World journal of urology · 16 May 2026 PMID 42142252
Research Analysis Automation (4)
  1. Benchmarking AI Vibe Coding for Clinical Statistical Analysis: A Structured Evaluation in Pulmonary Hypertension Research. Studies in health technology and informatics · 17 Sept 2026 PMID 42752488
  2. Performance, Failures, and Oversight of a Large Language Model Agent for Clinical Data Analysis: Evaluation Study. Journal of medical Internet research · 8 Sept 2026 PMID 42709964
  3. Large Language Model-Assisted Thematic Coding in Medical Education Research: Comparative Methodological Study. JMIR formative research · 25 Aug 2026 PMID 42641075
  4. Impact of prompt engineering on large language models for risk of bias assessment: a comparative study. BMJ evidence-based medicine · 17 May 2026 PMID 42144258

By study type

Clinical trials (2)
  1. A bimodal large language model reduces misalignment in patient education: A double-blinded randomized trial. Med (New York, N.Y.) · 17 Aug 2026 PMID 42607666
  2. Nurse-Led Large Language Model Chatbot for Predicting and Preventing Complications After Coronary Artery Bypass Grafting: Protocol for a Randomized Controlled Trial. JMIR research protocols · 4 Aug 2026 PMID 42550966
Observational studies and case reports (16)
  1. Domain Adaptation of a Large Language Model for Radiology Impression Generation - Multi-Reader Evaluation. Journal of medical systems · 27 Oct 2026 PMID 42944792
  2. Large Language Model-Powered 3D Avatars to Train Shared Decision-Making in Undergraduate Medical Students: Design and Mixed Methods Acceptance Study. JMIR formative research · 27 Oct 2026 PMID 42944729
  3. Large language models in the diagnosis and treatment of immunosuppression-related infections in rheumatic diseases: a comparative, vignette-based study. Rheumatology international · 9 Oct 2026 PMID 42853428
  4. Large Language Models in Multidisciplinary Decision-Making for Hepatopancreatobiliary Oncology: Retrospective Comparative Feasibility Study. Journal of medical Internet research · 17 Sept 2026 PMID 42753242
  5. Attitudes Toward Large Language Models in Health Care and Preferences for Their Adoption and Oversight Among Health Care Professionals: Cross-Sectional Survey. Journal of medical Internet research · 15 Sept 2026 PMID 42742517
  6. The Performance of Large Language Models in Extracting Intestinal Symptoms From Electronic Health Records: Retrospective Observational Study. Journal of medical Internet research · 26 Aug 2026 PMID 42647073
  7. Automating the Management of Extraspinal Findings in Magnetic Resonance Imaging Spine Studies Using a Privacy-Preserving Large Language Model: Retrospective Validation Study. Journal of medical Internet research · 26 Aug 2026 PMID 42647045
  8. A Multidisciplinary Team-Based Large Language Model Framework for Predicting Postoperative Neurological Complications in Acute Type A Aortic Dissection: Model Development and Validation Study. Journal of medical Internet research · 18 Aug 2026 PMID 42611794
  9. Large Language Model Simplification of Open Access Pediatric Strabismus Literature: Cross-Sectional Validation of Readability and Clinical Fidelity. JMIR formative research · 14 Aug 2026 PMID 42600075
  10. Large language model use in dental education: a cross-sectional multi-country study. Medical education online · 6 Aug 2026 PMID 42559854
  11. A Multiagent Large Language Model Framework for Emergency Treatment Recommendation in Acute Ischemic Stroke: Development and Validation Study. Journal of medical Internet research · 30 Jul 2026 PMID 42531250
  12. Performance of Large Language Models for Oncology Nursing Decision Support: Cross-Sectional Study. Journal of medical Internet research · 24 Jul 2026 PMID 42497362
  13. Initial-Visit Specialty Triage in Rare Diseases Using Large Language Models: Retrospective Benchmarking Study. Journal of medical Internet research · 23 Jul 2026 PMID 42490550
  14. Understanding Public Awareness, Attitudes, Beliefs, and Perceptions About ChatGPT in Saudi Arabia: A Road Map for Digital Health. Medical science monitor : international medical journal of experimental and clinical research · 27 Jun 2026 PMID 42363582
  15. AI-Generated Versus Human Supervisor Feedback on Medical Students' Clinical Clerkship Logs: Cross-Sectional Convergent Mixed Methods Study. JMIR medical education · 16 Jun 2026 PMID 42302283
  16. Feasibility of Large Language Model-Based Standardized Virtual Patients to Support Clinical Decision-Making Training in Operative Dentistry: Mixed Methods Study. JMIR formative research · 19 May 2026 PMID 42155101
Human data, design not indexed (32)
  1. Detecting spiritual pain in electronic medical records using large language models. Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 29 Oct 2026 PMID 42955097
  2. (AI)lephant in the Room: Utility of Generative AI to Develop Discussion Guides for Cardiac Surgery Morbidity and Mortality Conferences. Journal of surgical education · 13 Oct 2026 PMID 42868634
  3. Ensemble of Domain-Specific Natural Language Processing and Large Language Models for Detecting Suicidal Ideation and Mental Health Conditions in Social Media Text: Development and Evaluation Study. JMIR mental health · 8 Oct 2026 PMID 42849899
  4. Large Language Model Chatbot Responses to Cancer Survivorship Questions in Hong Kong: Bilingual Evaluation and Prompt Optimization Study. Journal of medical Internet research · 8 Oct 2026 PMID 42849027
  5. Periodontitis Risk Assessment and Prevention Planning: Comparative Study of Multimodal Large Language Models and Periodontist Evaluations. Journal of medical Internet research · 2 Oct 2026 PMID 42826249
  6. A Clinician-Centered Evaluation Framework for Large Language Models in Patient Education: Integrating the Technology Acceptance Model and Medical Condition Regard Scale. JMIR formative research · 21 Sept 2026 PMID 42766478
  7. Leveraging time-series electronic health records with large language models for chronic kidney disease diagnosis in primary care. BMJ health & care informatics · 18 Sept 2026 PMID 42759972
  8. Multicenter Evaluation of Large Language Models Versus Hepatologists for Prognostic Prediction in Drug-Induced Liver Injury. Liver international : official journal of the International Association for the Study of the Liver · 18 Sept 2026 PMID 42757445
  9. Benchmarking AI Vibe Coding for Clinical Statistical Analysis: A Structured Evaluation in Pulmonary Hypertension Research. Studies in health technology and informatics · 17 Sept 2026 PMID 42752488
  10. Clinical Code Mapping with LLM Tool Use: A Pilot for Automated Data Extraction of Medication and Diagnosis Information from Unstructured Clinical Notes. Studies in health technology and informatics · 17 Sept 2026 PMID 42752481
  11. Automated Extraction of Genetic Eligibility Criteria from Clinical Trial Records Using LLMs - A Technical Case Report. Studies in health technology and informatics · 17 Sept 2026 PMID 42752480
  12. Psychological Therapy in the Age of Large Language Models: Framework for Therapist-Delivered and AI-Supported Functions. JMIR mental health · 16 Sept 2026 PMID 42748037
  13. Frameworks, Methodologies, and Tools for Evaluating Large Language Models in Digital Mental Health Interventions: Protocol for a Scoping Review. JMIR research protocols · 14 Sept 2026 PMID 42735424
  14. Locally Deployed Large Language Models for AI-Assisted Outpatient Prescription Review: Crossover Study. JMIR medical informatics · 14 Sept 2026 PMID 42735403
  15. Anonymization of Portuguese Clinical Notes Using Large Language Models and Quantum-Enhanced Hybrid Architectures: Comparative Evaluation Study. Journal of medical Internet research · 14 Sept 2026 PMID 42735382
  16. Evaluating Large Language Models in Clinical Audiology (AUDIOLOGYBENCH): Benchmark Development and Validation Study. Journal of medical Internet research · 11 Sept 2026 PMID 42727086
  17. Promise, Mimicry, and Surveillance: Responsibly Integrating Artificial Intelligence With Socratic Inquiry in Medical Education. JMIR medical education · 10 Sept 2026 PMID 42721480
  18. Exploring Bias in Medical Applications of Large Language Models: Protocol for a Systematic Review. JMIR research protocols · 10 Sept 2026 PMID 42721473
  19. Fine-Tuning Large Language Models for Structured Extraction of Infectious Disease-Related Information From Clinical Notes in Japanese Primary Care: Development and Internal Validation Study. JMIR formative research · 10 Sept 2026 PMID 42721099
  20. Large language models show high clinical safety but differences in completeness for reproductive counselling in women with inflammatory rheumatic and musculoskeletal diseases: a comparative expert evaluation. Rheumatology international · 10 Sept 2026 PMID 42720754
  21. AI-Assisted Angoff Standard Setting for Multiple-Choice Examinations in Medical Education: Comparative Study. JMIR medical education · 9 Sept 2026 PMID 42715553
  22. Performance, Failures, and Oversight of a Large Language Model Agent for Clinical Data Analysis: Evaluation Study. Journal of medical Internet research · 8 Sept 2026 PMID 42709964
  23. Large Language Models as a New Tool for Therapists in Internet-Based Cognitive Behavioral Therapy: Blinded Clinician Rating Pilot Experiment. JMIR mental health · 26 Aug 2026 PMID 42647055
  24. Large Language Model-Assisted Thematic Coding in Medical Education Research: Comparative Methodological Study. JMIR formative research · 25 Aug 2026 PMID 42641075
  25. Local Deployment of Open-Weight Language Models in Dermatology: Viewpoint on Privacy, Equity, and Practical Implementation. JMIR dermatology · 21 Aug 2026 PMID 42627943
  26. Large Language Models for Endodontic Symptom Assessment and Treatment Planning Using Image-Free Clinical Records: Comparative Evaluation Study. JMIR medical informatics · 24 Jul 2026 PMID 42497401
  27. Calibration of Self-Reported Confidence and Accuracy of Large Language Models in Medical Question Answering. Journal of medical systems · 26 Jun 2026 PMID 42360536
  28. Impact of prompt engineering on large language models for risk of bias assessment: a comparative study. BMJ evidence-based medicine · 17 May 2026 PMID 42144258
  29. Comparative study on the efficacy of large language models (LLMs) in health management for patients with urological and andrological diseases: a multidimensional quality evaluation and applicability analysis. World journal of urology · 16 May 2026 PMID 42142252
  30. Large Language Models for Semantic Interoperability in Value-Based Perioperative Care. Journal of medical systems · 14 May 2026 PMID 42133097
  31. The Best of Both Worlds: How Combining a Large Language Model and a Rule-Based Algorithm Makes Catheter-Associated Urinary Tract Infection Surveillance More Efficient. Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 14 May 2026 PMID 42132396
  32. Leveraging Multimodal Large Language Models for Fall Risk Reduction in Older Adults in the Home: Proposed Model Design. JMIR aging · 13 May 2026 PMID 42127229