通用大型语言模型能提高医生的临床推理能力吗？

Evidence and considerations for policy from a randomized trialin Indonesia, Kenya and the Netherlands Authors / Nicholas Rounding, Luthfi Saiful Arif, Janine Berg, Jochen Cals, Diederik De Boer,Eefje De Bont, Sander Dijksman, Ardi Findyartini, Didier Fouarge, Marie-Christine Fregin,Pawel Gmyrek, Nadia Greviana, Ralph Leijenaar, Soraiya Manji, Anastacia Mbithi,Norah Obungu, Arierta Pujitresnani, Roselyter Rianga, Diantha Soemantri,Sairabanu Mohamed Rashid Sokwalla, Sanne Steens, Lucia Velasco, Ardy Wildan,Prasandhya Astagiri Yusuf, Mark Levels © International Labour Organization 2026 Attribution 4.0 International (CC BY 4.0) creativecommons.org/licenses/by/4.0/. The user is allowed to reuse, share (copy and redistrib-ute), adapt (remix, transform and build upon the original work) as detailed in the licence. Theuser must clearly credit the ILO as the source of the material and indicate if changes were madeto the original content. Use of the emblem, name and logo of the ILO is not permitted in con-nection with translations, adaptations or other derivative works. Rounding, N., Arif, L., Berg, J., Cals, J., De Boer, D., De Bont, E., Dijksman, S., Findyartini, A., Fouarge, D., Fregin, M., Gmyrek, P., Greviana, N., Leijenaar, R., Manji, S., Mbithi, A., Obungu, N., Pujitresnani,A., Rianga, R., Soemantri, D., Sokwalla, S., Steens, S., Velasco, L., Wildan, A., Yusuf, P., Levels, M.Does a General-Purpose Large Language Model Improve Physicians’ Clinical Reasoning?: Evidenceand considerations for policy from a randomized trial in Indonesia, Kenya and the Netherlands. ILO Working Paper 175. Geneva: International Labour Office, 2026.© ILO. along with the attribution:This is a translation of a copyrighted work of the International Labour Organization (ILO). This translation has not been prepared, reviewed or endorsed by the ILO and shouldnot be considered an official ILO translation. The ILO disclaims all responsibility for its content and ac-curacy. Responsibility rests solely with the author(s) of the translation. along with the attribution:This is an adaptation of a copyrighted work of the International Labour Organization (ILO). This adaptation has not been prepared, reviewed or endorsed by the ILO and shouldnot be considered an official ILO adaptation. The ILO disclaims all responsibility for its content and ac-curacy. Responsibility rests solely with the author(s) of the adaptation. terials included in this publication. If the material is attributed to a third party, the user of such material is solely responsible for clearing the rights with the rights holder and for any claims ofinfringement. tion in accordance with the Arbitration Rules of the United Nations Commission on InternationalTrade Law (UNCITRAL). The parties shall be bound by any arbitration award rendered as a result digital products, visit:www.ilo.org/publns. 9789220435625 (html). ISSN 2708-3438 (print), ISSN 2708-3446 (digital)https://doi.org/10.54394/00033425 practice, and the presentation of material therein do not imply the expression of any opinionwhatsoever on the part of the ILO concerning the legal status of any country, area or territoryor of its authorities, or concerning the delimitation of its frontiers or boundaries. See:www.ilo. The opinions and views expressed in this publication are those of the author(s) and do not nec-essarily reflect the opinions, views or policies of the ILO. dorsement by the ILO, and any failure to mention a particular firm, commercial product or pro-cess is not a sign of disapproval. and-publications discussion of a range of issues related to the world of work. Comments on this ILO Working Paperare welcome and can be sent toberg@ilo.org. Authorization for publication: Caroline Fredrickson, Director, Research and Statistics department ILO Working Papers can be found at:www.ilo.org/research-and-publications/working-papers Suggested citation:Rounding, N., Arif, L., Berg, J., Cals, J., De Boer, D., De Bont, E., Dijksman, S., Findyartini, A., Fouarge, D., Fregin, M., Gmyrek, P., Greviana, N., Leijenaar, R., Manji, S., Mbithi, A., Obungu, N.,Pujitresnani, A., Rianga, R., Soemantri, D., Sokwalla, S., Steens, S., Velasco, L., Wildan, A., Yusuf,P., Levels, M. 2026.Does a General-Purpose Large Language Model Improve Physicians’ ClinicalReasoning?: Evidence and considerations for policy from a randomized trial in Indonesia, Kenyaand the Netherlands, ILO Working Paper 175 (Geneva, ILO).https://doi.org/10.54394/00033425 proves physicians’ clinical reasoning across diverse healthcare contexts, as well as the possibleimplications of using an LLM in healthcare settings. Using a randomized controlled trial with 249physicians in Indonesia, Kenya, and the Netherlands, the study finds that LLM access enhancesperformance on standardized clinical vignettes in all three countries. The magnitude of improve- some physicians with LLM access perform worse than those without, indicating that access alonedoes not g