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  1. Home
  2. Increasing Large Language Model Accuracy For Care-seeking Advice Using Prompts Reflecting Human Reasoning Strategies In The Real World: Validation Study.
  1. Home
  2. Increasing Large Language Model Accuracy For Care-seeking Advice Using Prompts Reflecting Human Reasoning Strategies In The Real World: Validation Study.

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Increasing Large Language Model Accuracy for Care-Seeking Advice Using Prompts Reflecting Human Reasoning Strategies

Marvin Kopka1, Markus A Feufel1

  • 1Division of Ergonomics, Department of Psychology & Ergonomics (IPA), Technische Universität Berlin, Straße des 17. Juni 135, Berlin, State of Berlin, 10623, Germany, 49 31470806.

JMIR Biomedical Engineering
|April 8, 2026

View abstract on PubMed

Summary
This summary is machine-generated.
Keywords:
artificial intelligencebounded rationalitycare-seekingcognitive sciencedecision-makinghuman factorshuman-technology interactionnaturalistic decision supportnaturalistic decision-makingpromptingself-triage

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Naturalistic decision-making (NDM) inspired prompts enhance large language model (LLM) accuracy for uncertain care-seeking decisions, especially for self-care advice. This approach improves LLM performance in real-world scenarios without compromising emergency or non-emergency case recommendations.

Area of Science:

  • Artificial Intelligence
  • Cognitive Science
  • Human-Computer Interaction

Background:

  • Current large language model (LLM) prompting focuses on structured problems, neglecting high-uncertainty real-world tasks like care-seeking decisions.
  • Naturalistic decision-making (NDM) studies human reasoning in uncertain environments but hasn't been applied to LLM prompt engineering.

Purpose of the Study:

  • To investigate if NDM-inspired prompting strategies can enhance LLM performance on ambiguous care-seeking decisions.
  • To evaluate the effectiveness of recognition-primed decision-making and data-frame theory in LLM prompt design.

Main Methods:

  • Ten ChatGPT models were tested using default, recognition-primed, and data-frame prompts on 45 patient case vignettes across three urgency levels.
  • Each model-prompt combination was tested 10 times to assess accuracy and output variability.
  • Accuracy was analyzed using mixed-effects logistic regression.
  • Main Results:

    • NDM-inspired prompts improved overall LLM accuracy (recognition-primed: 67.6%; data-frame: 66.7%) compared to the default prompt (63.3%).
    • Significant accuracy gains were observed for self-care recommendations (default: 13.4% to NDM-inspired: 24.6%-29.8%).
    • NDM prompts enabled non-reasoning models to provide self-care advice, previously rare.

    Conclusions:

    • NDM-inspired prompts improve LLM accuracy in high-uncertainty care-seeking tasks, particularly for self-care advice.
    • These prompts enhance LLM utility for real-world decisions involving ambiguity without negatively impacting performance on emergency or non-emergency cases.
    • Future research should explore the impact of NDM-inspired LLM outputs on user decision-making.