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Future Querying: Can LLMs Serve as Implicit Medical World Models?

Research Medical/Healthcare AI

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TL;DR - This paper introduces “future querying,” which tests whether LLMs can act as implicit medical world models by answering time-indexed questions about patient trajectories from unstructured clinical notes. It could support flexible, privacy-preserving clinical prediction without separate pipelines for every endpoint.

  • Uses endpoint-agnostic training so one model can answer diverse future-oriented clinical queries without manual feature engineering or task-specific retraining.
  • Evaluates the approach on synthetic medical reports and real ICU notes from MIMIC-IV.
  • Finds that small, locally fine-tuned open-weight models can match or approach larger proprietary systems.
  • Results suggest LLMs can capture aspects of clinical dynamics while remaining suitable for on-premise deployment.

Sources (1)

Future Querying: Can LLMs Serve as Implicit Medical World Models?

arXiv cs.CL Siri Willems, James Butterworth, Lore Goetschalckx, Peter Vrancx, Philippe Modard, Elke Giets, Ludovic Denoyer 2026-08-24 arXiv:2608.23248
Public signals Semantic Scholar citations 0 · Semantic Scholar influential citations 0
Providers: Hugging Face · N/A OpenAlex · N/A Publisher · N/A Semantic Scholar · Citations 0 · Influential citations 0 X · N/A Fetched 2026-08-27 14:19:16.664449 UTC

TL;DR - This paper introduces “future querying,” which tests whether LLMs can act as implicit medical world models by answering time-indexed questions about patient trajectories from unstructured clinical notes. It could support flexible, privacy-preserving clinical prediction without separate pipelines for every endpoint.

  • Uses endpoint-agnostic training so one model can answer diverse future-oriented clinical queries without manual feature engineering or task-specific retraining.
  • Evaluates the approach on synthetic medical reports and real ICU notes from MIMIC-IV.
  • Finds that small, locally fine-tuned open-weight models can match or approach larger proprietary systems.
  • Results suggest LLMs can capture aspects of clinical dynamics while remaining suitable for on-premise deployment.
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