Large language model agents can use tools to perform clinical calculations

Abstract

Large language models (LLMs) can answer expert-level questions in medicine but are prone to hallucinations and arithmetic errors. Early evidence suggests LLMs cannot reliably perform clinical calculations, limiting their potential integration into clinical workflows. We evaluated ChatGPT’s performance across 48 medical calculation tasks, finding incorrect responses in one-third of trials (n = 212). We then assessed three forms of agentic augmentation: retrieval-augmented generation, a code interpreter tool, and a set of task-specific calculation tools (OpenMedCalc) across 10,000 trials. Models with access to task-specific tools showed the greatest improvement, with LLaMa and GPT-based models demonstrating a 5.5-fold (88% vs 16%) and 13-fold (64% vs 4.8%) reduction in incorrect responses, respectively, compared to the unimproved models. Our findings suggest that integration of machine-readable, task-specific tools may help overcome LLMs’ limitations in medical calculations.