Cited by 194Artificial Intelligence in Healthcare and EducationMachine Learning in HealthcareEthics and Social Impacts of AI

The clinicians’ guide to large language models: a general perspective with a focus on hallucinations

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Roustan, Dimitri, Bastardot, François·2025·Interactive Journal of Medical Research

Abstract

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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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
Published
2025-01-28
Volume
14
Pages
e59823
ISSN
1929-073X (ISSN-L)
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
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

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