Mind the Gap: Benchmarking LLM Uncertainty and Calibration with Specialty-Aware Clinical QA and Reasoning-Based Behavioural Features

Alberto Testoni, Iacer Calixto


Abstract
Reliable uncertainty quantification (UQ) is essential when employing large language models (LLMs) in high-risk domains such as clinical question answering (QA). In this work, we evaluate uncertainty estimation methods for clinical QA focusing, for the first time, on eleven clinical specialties and six question types, and across ten open-source LLMs (general-purpose, biomedical, and reasoning models), alongside representative proprietary models. We analyze score-based UQ methods, present a case study introducing a novel lightweight method based on behavioral features derived from reasoning-oriented models, and examine conformal prediction as a complementary set-based approach. Our findings reveal that uncertainty reliability is not a monolithic property, but one that depends on clinical specialty and question type due to shifts in calibration and discrimination. Our results highlight the need to select or ensemble models based on their distinct, complementary strengths and clinical use.
Anthology ID:
2026.eacl-long.106
Volume:
Proceedings of the 19th Conference of the European Chapter of the Association for Computational Linguistics (Volume 1: Long Papers)
Month:
March
Year:
2026
Address:
Rabat, Morocco
Editors:
Vera Demberg, Kentaro Inui, Lluís Marquez
Venue:
EACL
SIG:
Publisher:
Association for Computational Linguistics
Note:
Pages:
2364–2382
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URL:
https://preview.aclanthology.org/ingest-eacl/2026.eacl-long.106/
DOI:
Bibkey:
Cite (ACL):
Alberto Testoni and Iacer Calixto. 2026. Mind the Gap: Benchmarking LLM Uncertainty and Calibration with Specialty-Aware Clinical QA and Reasoning-Based Behavioural Features. In Proceedings of the 19th Conference of the European Chapter of the Association for Computational Linguistics (Volume 1: Long Papers), pages 2364–2382, Rabat, Morocco. Association for Computational Linguistics.
Cite (Informal):
Mind the Gap: Benchmarking LLM Uncertainty and Calibration with Specialty-Aware Clinical QA and Reasoning-Based Behavioural Features (Testoni & Calixto, EACL 2026)
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https://preview.aclanthology.org/ingest-eacl/2026.eacl-long.106.pdf