LiveMedBench：基于自动化评分标准的无污染大型语言模型医学基准测试平台

LiveMedBench: A Contamination-Free Medical Benchmark for LLMs with Automated Rubric Evaluation

February 10, 2026

作者: Zhiling Yan, Dingjie Song, Zhe Fang, Yisheng Ji, Xiang Li, Quanzheng Li, Lichao Sun

cs.AI

摘要

在临床高风险场景中部署大语言模型（LLM）需要严格可靠的评估体系。然而现有医疗基准测试仍保持静态，存在两大关键局限：（1）数据污染，即测试集意外渗入训练语料库，导致性能评估虚高；（2）时间错位，无法捕捉医学知识的快速演进。此外，当前针对开放式临床推理的评估指标往往依赖浅层词汇重叠度（如ROUGE）或主观的"LLM即评判官"打分，二者均难以验证临床正确性。为弥补这些缺陷，我们推出LiveMedBench——一个基于标准化量规、持续更新且无数据污染的基准测试平台，每周从在线医疗社区采集真实临床病例，确保与模型训练数据严格时间隔离。我们提出多智能体临床筛选框架，可过滤原始数据噪声并依据循证医学原则验证临床完整性。在评估方面，我们开发了基于量规的自动化评估框架，将医师回答分解为细粒度的病例专属标准，其与专家医师的契合度显著优于"LLM即评判官"模式。截至目前，LiveMedBench已涵盖38个医学专科的2,756个真实病例（支持多语言），并配有16,702条独特评估标准。对38个LLM的大规模评估显示，即使最优模型准确率仅达39.2%，且84%的模型在截止日期后病例上表现退化，证实数据污染风险普遍存在。错误分析进一步指出语境应用能力（而非事实性知识）是主要瓶颈，35-48%的失败案例源于无法将医学知识适配到患者特定约束条件。

English

The deployment of Large Language Models (LLMs) in high-stakes clinical settings demands rigorous and reliable evaluation. However, existing medical benchmarks remain static, suffering from two critical limitations: (1) data contamination, where test sets inadvertently leak into training corpora, leading to inflated performance estimates; and (2) temporal misalignment, failing to capture the rapid evolution of medical knowledge. Furthermore, current evaluation metrics for open-ended clinical reasoning often rely on either shallow lexical overlap (e.g., ROUGE) or subjective LLM-as-a-Judge scoring, both inadequate for verifying clinical correctness. To bridge these gaps, we introduce LiveMedBench, a continuously updated, contamination-free, and rubric-based benchmark that weekly harvests real-world clinical cases from online medical communities, ensuring strict temporal separation from model training data. We propose a Multi-Agent Clinical Curation Framework that filters raw data noise and validates clinical integrity against evidence-based medical principles. For evaluation, we develop an Automated Rubric-based Evaluation Framework that decomposes physician responses into granular, case-specific criteria, achieving substantially stronger alignment with expert physicians than LLM-as-a-Judge. To date, LiveMedBench comprises 2,756 real-world cases spanning 38 medical specialties and multiple languages, paired with 16,702 unique evaluation criteria. Extensive evaluation of 38 LLMs reveals that even the best-performing model achieves only 39.2%, and 84% of models exhibit performance degradation on post-cutoff cases, confirming pervasive data contamination risks. Error analysis further identifies contextual application-not factual knowledge-as the dominant bottleneck, with 35-48% of failures stemming from the inability to tailor medical knowledge to patient-specific constraints.