arXiv — Machine Learning · · 3 min read

RxEval: A Prescription-Level Benchmark for Evaluating LLM Medication Recommendation

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Computer Science > Machine Learning

arXiv:2605.14543 (cs)
[Submitted on 14 May 2026]

Title:RxEval: A Prescription-Level Benchmark for Evaluating LLM Medication Recommendation

View a PDF of the paper titled RxEval: A Prescription-Level Benchmark for Evaluating LLM Medication Recommendation, by Shuhao Chen and 6 other authors
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Abstract:Inpatient medication recommendation requires clinicians to repeatedly select specific medications, doses, and routes as a patient's condition evolves. Existing benchmarks formulate this task as admission-level prediction over coarse drug codes with multi-hot diagnostic and procedure code inputs, failing to capture the per-timepoint, information-rich nature of real prescribing. We propose RxEval, a prescription-level benchmark that evaluates LLM prescribing capability by multiple-choice questions: each question presents a detailed patient profile and time-ordered clinical trajectory, requiring selection of specific medication-dose-route triples from real prescriptions and patient-specific distractors generated via reasoning-chain perturbation. RxEval comprises 1,547 questions spanning 584 patients, 18 diagnostic categories, and 969 unique medications. Evaluation of 16 LLMs shows that RxEval is both challenging and discriminative: F1 ranges from 45.18 to 77.10 across models, and the best Exact Match is only 46.10%. Error analysis reveals that even frontier models may overlook stated patient information and fail to derive clinical conclusions.
Subjects: Machine Learning (cs.LG); Artificial Intelligence (cs.AI)
Cite as: arXiv:2605.14543 [cs.LG]
  (or arXiv:2605.14543v1 [cs.LG] for this version)
  https://doi.org/10.48550/arXiv.2605.14543
arXiv-issued DOI via DataCite (pending registration)

Submission history

From: Shuhao Chen [view email]
[v1] Thu, 14 May 2026 08:24:03 UTC (688 KB)
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