samyama-graph

KG grounding helps LLMs only for out-of-training knowledge: controlled clinical QA study

A new arXiv paper investigates when knowledge-graph (KG) grounding improves LLM performance on clinical question answering, finding that structured KG retrieval over the public biomedical graph PrimeKG provides no meaningful improvement on MedQA (all deltas ≤3.4) because the relevant facts are already in the model's training data. On synthetic counterfactual and hybrid benchmarks containing genuinely novel facts, the same pipeline lifts out-of-training accuracy from chance to ~100%. The paper also reproduces and partially corrects a recent Nature Medicine study on frontier LLMs vs. clinical RAG tools, flagging a score-deflating grader bug and clarifying that the reported ~88 HealthBench score reflects the Consensus variant, not full HealthBench (~46-47). The core finding — that RAG/KG grounding pays off only when the decisive fact is outside the model's training distribution — has direct implications for when retrieval augmentation is worth deploying.