A framework to assess clinical safety and hallucination rates of LLMs for medical text summarisation

Integrating large language models (LLMs) into healthcare can enhance workflow efficiency and patient care by automating tasks such as summarising consultations. However, the fidelity between LLM outputs and ground truth information is vital to prevent miscommunication that could lead to compromise in patient safety. We propose a framework comprising (1) an error taxonomy for classifying LLM outputs, (2) an experimental structure for iterative comparisons in our LLM document generation pipeline, (3) a clinical safety framework to evaluate the harms of errors, and (4) a graphical user interface, CREOLA, to facilitate these processes. Our clinical error metrics were derived from 18 experimental configurations involving LLMs for clinical note generation, consisting of 12,999 clinician-annotated sentences. We observed a 1.47% hallucination rate and a 3.45% omission rate. By refining prompts and workflows, we successfully reduced major errors below previously reported human note-taking rates, highlighting the framework’s potential for safer clinical documentation.