The clinicians’ guide to large language models: a general perspective with a focus on hallucinations
Open accessAbstract
Large language models (LLMs) are artificial intelligence tools that have the prospect of profoundly changing how we practice all aspects of medicine. Considering the incredible potential of LLMs in medicine and the interest of many health care stakeholders for implementation into routine practice, it is therefore essential that clinicians be aware of the basic risks associated with the use of these models. Namely, a significant risk associated with the use of LLMs is their potential to create hallucinations. Hallucinations (false information) generated by LLMs arise from a multitude of causes, including both factors related to the training dataset as well as their auto-regressive nature. The implications for clinical practice range from the generation of inaccurate diagnostic and therapeutic information to the reinforcement of flawed diagnostic reasoning pathways, as well as a lack of reliability if not used properly. To reduce this risk, we developed a general technical framework for approaching LLMs in general clinical practice, as well as for implementation on a larger institutional scale.
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Hallucination, in which LLMs generate confident but factually incorrect outputs, has been documented in clinical contexts with direct implications for patient safety.
“Hallucination, in which LLMs generate confident but factually incorrect outputs, has been documented in clinical contexts with direct implications for patient safety”
From A generative AI multi-agent framework with integrated XAI governance for cancer diagnostics: from multi-omics interpretation to lifestyle risk stratification (2026) · cites this paper as Roustan and Bastardot, 2025
Hallucinated content in clinical settings can vary in severity, ranging from minor factual inconsistencies to unsupported treatment recommendations that may directly harm patients.
“hallucinated content can vary in severity, ranging from minor factual inconsistencies to unsupported treatment recommendations that may directly harm patients”
From A generative AI multi-agent framework with integrated XAI governance for cancer diagnostics: from multi-omics interpretation to lifestyle risk stratification (2026) · cites this paper as Roustan and Bastardot, 2025
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- Authors
- Roustan, D., & Bastardot, F.
- Affiliations
- Cliniques Universitaires Saint-Luc (BE)
- Centre Hospitalier Universitaire Vaudois (CH)
- Corresponding author
- Roustan, Dimitri
- Venue
- Interactive Journal of Medical Research
- Publisher
- JMIR Publications Inc.
- Published
- 2025-01-28
- Volume
- 14
- Pages
- e59823
- ISSN
- 1929-073X (ISSN-L)
- PMC
- PMC11815294
- OpenAlex
- W4406887664
- Cited by
- 191
- References
- 23
- Citations by year
- 2026: 150 · 2025: 40 · 2024: 1
- FWCI
- 45.73
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by
- Locations
- Interactive Journal of Medical Research (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- SERVAL (Université de Lausanne) (submittedVersion, cc-by)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- IRIS (submittedVersion, cc-by)
- Topics
- Health Sciences › Medicine › Health Informatics › Artificial Intelligence in Healthcare and Education
- Physical Sciences › Computer Science › Artificial Intelligence › Machine Learning in Healthcare
- Social Sciences › Safety Research › Ethics and Social Impacts of AI
- Keywords
- large language models, hallucinations, clinical practice, diagnostic reasoning, training data quality, autoregressive generation
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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