When Reasoning Hurts: Source-Aware Evaluation of Frontier LLMs for Clinical SOAP Note Generation
arXiv cs.AI 18 hours ago
Researchers tested reasoning-enabled large language models on clinical SOAP note generation from patient dialogue using benchmarks spanning multiple datasets, finding that enabling reasoning actually degraded GPT-5.4 performance across all three datasets while providing only modest improvements from retrieval-augmented generation. The evaluation used seven automatic metrics and two LLM judges to assess outputs from GPT-5.4, DeepSeek-V4-Flash, and Gemma-4-E4B across a controlled 2x2 design. The results show that advanced reasoning capabilities do not automatically improve performance on fidelity-sensitive clinical documentation tasks, suggesting the need for task-specific evaluation rather than assuming stronger models will transfer better to structured medical writing.