Review
Open access
Aug 2026
Explainability of decoder-only clinical large language models: A scoping review.
Findings show that clinical LLM explainability has shifted toward fluent generative rationales, but evidence that such explanations reflect model reasoning remains limited, and three regulatory priorities are highlighted: prioritizing explanations that enable independent verification or logic auditing over plausibility-only rationales; preferring inspectable models where regulatory documentation is required; and prospectively validating explanations in clinical workflows before scaling.
Nishant Mishra, Ameen Abu-Hanna, Iacer Calixto
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