ClinDet-Bench: Beyond Abstention, Evaluating Judgment Determinability of LLMs in Clinical Decision-Making

Yusuke Watanabe, Yohei Kobashi, Takeshi Kojima, Yusuke Iwasawa, Yasushi Okuno, Yutaka Matsuo


Abstract
Clinical decisions are often required under incomplete information. Clinical experts must identify whether available information is sufficient for judgment, as both premature conclusions and unnecessary abstention can compromise patient safety. To evaluate this capability of large language models (LLMs), we developed ClinDet-Bench, a benchmark based on clinical scoring systems that decomposes incomplete-information scenarios into determinable and undeterminable conditions. Identifying determinability requires considering all hypotheses about missing information, including unlikely ones, and verifying whether the conclusion holds across them. We find that recent LLMs fail to identify determinability under incomplete information, producing both premature conclusions and excessive abstention, despite correctly explaining the underlying scoring knowledge and performing well under complete information. These findings suggest that existing benchmarks are insufficient to evaluate the safety of LLMs in clinical settings. ClinDet-Bench provides a framework for evaluating determinability recognition, leading to appropriate abstention, with potential applicability to medicine and other high-stakes domains, and is publicly available.
Anthology ID:
2026.acl-industry.47
Volume:
Proceedings of the 64th Annual Meeting of the Association for Computational Linguistics (ACL 2026)
Month:
July
Year:
2026
Address:
San Diego, California, USA
Editors:
Yunyao Li, Georg Rehm, Mei Tu
Venue:
ACL
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Publisher:
Association for Computational Linguistics
Note:
Pages:
681–703
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URL:
https://preview.aclanthology.org/ingest-acl/2026.acl-industry.47/
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Cite (ACL):
Yusuke Watanabe, Yohei Kobashi, Takeshi Kojima, Yusuke Iwasawa, Yasushi Okuno, and Yutaka Matsuo. 2026. ClinDet-Bench: Beyond Abstention, Evaluating Judgment Determinability of LLMs in Clinical Decision-Making. In Proceedings of the 64th Annual Meeting of the Association for Computational Linguistics (ACL 2026), pages 681–703, San Diego, California, USA. Association for Computational Linguistics.
Cite (Informal):
ClinDet-Bench: Beyond Abstention, Evaluating Judgment Determinability of LLMs in Clinical Decision-Making (Watanabe et al., ACL 2026)
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https://preview.aclanthology.org/ingest-acl/2026.acl-industry.47.pdf