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However, their utility in non-generative clinical prediction, often presumed inferior to specialized models, remains under-evaluated, leading to ongoing debate within the field and potential for misuse, misunderstanding, or over-reliance due to a lack of systematic benchmarking. Our ClinicRealm study addresses this by benchmarking 9 GPT-based LLMs, 5 BERT-based models, and 7 traditional methods on unstructured clinical notes and structured Electronic Health Records (EHR). Key findings reveal a significant shift: for clinical note predictions, leading LLMs (e.g., DeepSeek R1/V3, GPT o3-mini-high) in zero-shot settings now decisively outperform finetuned BERT models. On structured EHRs, while specialized models excel with ample data, advanced LLMs (e.g., GPT-4o, DeepSeek R1/V3) show potent zero-shot capabilities, often surpassing conventional models in data-scarce settings. Notably, leading open-source LLMs can match or exceed proprietary counterparts. These results establish modern LLMs as powerful non-generative clinical prediction tools, particularly with unstructured text and offering data-efficient structured data options, thus necessitating a re-evaluation of model selection strategies. This research should serve as an important insight for medical informaticists, AI developers, and clinical researchers, potentially prompting a reassessment of current assumptions and inspiring new approaches to LLM application in predictive healthcare.","url_abs":"https://arxiv.org/abs/2407.18525v2","url_pdf":"https://arxiv.org/pdf/2407.18525v2.pdf","source":{"archive":"pwc-archive (Hugging Face), CC BY-SA 4.0","snapshot":"2025-07-28","licence_url":"https://creativecommons.org/licenses/by-sa/4.0/legalcode","row_kind":"abstracts"},"code_links":[{"paper_slug":"is-larger-always-better-evaluating-and","repo_url":"https://github.com/yhzhu99/ehr-llm-benchmark","is_official":1,"mentioned_in_paper":1,"mentioned_in_github":1,"framework":"pytorch","reach":{"status":"ok"}}],"tasks":[{"task_slug":"benchmarking","task_name":"Benchmarking"},{"task_slug":"model-selection","task_name":"Model Selection"},{"task_slug":"readmission-prediction","task_name":"Readmission Prediction"},{"task_slug":"sentence","task_name":"Sentence"},{"task_slug":"zero-shot-learning","task_name":"Zero-Shot Learning"}],"methods":[{"method_slug":"adam","method_name":"Adam"},{"method_slug":"attention","method_name":"Attention"},{"method_slug":"attention-dropout","method_name":"Attention Dropout"},{"method_slug":"bert","method_name":"BERT"},{"method_slug":"bpe","method_name":"BPE"},{"method_slug":"cosine-annealing","method_name":"Cosine Annealing"},{"method_slug":"dense-connections","method_name":"Dense Connections"},{"method_slug":"discriminative-fine-tuning","method_name":"Discriminative Fine-Tuning"},{"method_slug":"dropout","method_name":"Dropout"},{"method_slug":"gpt","method_name":"GPT"},{"method_slug":"layer-normalization","method_name":"Layer Normalization"},{"method_slug":"linear-layer","method_name":"Linear Layer"},{"method_slug":"linear-warmup-with-cosine-annealing","method_name":"Linear Warmup With Cosine Annealing"},{"method_slug":"linear-warmup-with-linear-decay","method_name":"Linear Warmup With Linear Decay"},{"method_slug":"multi-head-attention","method_name":"Multi-Head Attention"},{"method_slug":"residual-connection","method_name":"Residual Connection"},{"method_slug":"softmax","method_name":"Softmax"},{"method_slug":"weight-decay","method_name":"Weight Decay"},{"method_slug":"wordpiece","method_name":"WordPiece"}],"datasets_introduced":[],"methods_introduced":[],"results":[],"syntology":{"atlas_url":"https://app.syntology.ai/?focus=2407.18525","mcp":{"get_harvested_code_for_paper":{"arxiv_id":"2407.18525"}},"developers":"https://syntology.ai/developers","read_at":"2026-09-24T18:15:14+00:00","read_at_is":"when the build read Syntology's graph, not when any sample ran","claim":"Per-sample execution status on synthesized fixtures; not a correctness claim about the paper. 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