This is a paper review. i need you to reformat the text, making it discursive and fluent. the text must be very very clear and must present all the aspects of the review. please be academic but not pompous.  explain with rigor the flaws and the positive aspects.

# Review

While the manuscript titled "*A Reproducibility Study on Consistent LLM Reasoning for Natural Language Inference over Clinical Trials*"
 presents a commendable effort in exploring the reproducibility of 
Natural Language Inference (NLI) methods within the clinical domain, 
several significant shortcomings and areas for improvement warrant 
attention. This detailed critique addresses the primary negative aspects
 and identifies key elements that the paper is missing, hindering its 
potential impact and scholarly rigor.

### **1. Content Accuracy and Relevance**

**a. Insufficient Dataset Characterization:**

- **Lack of Detailed Dataset Analysis:** The manuscript
briefly describes the SemEval-2024 NLI4CT dataset but fails to provide
an in-depth analysis of its composition. Details such as the
distribution of classes beyond the high-level percentages, potential
biases in the data (e.g., class imbalance, demographic representation),
and the rationale behind selecting breast cancer-focused CTRs are
notably absent.
- **Bias and Limitations:** There is no discussion on
possible inherent biases within the dataset or how these might affect
model performance. Understanding the dataset's limitations is crucial
for interpreting the results and ensuring the generalizability of the
findings.

**b. Limited Contextualization within the Field:**

- **Comparative Context Missing:** The paper does not
adequately position its contributions relative to existing
reproducibility studies in related domains. Without comparing with
similar efforts, it is challenging to assess the novelty and
significance of the current study.
- **Absence of Theoretical Framework:** The manuscript
lacks a robust theoretical underpinning that explains why certain models or techniques are expected to perform better in the clinical NLI
context. Incorporating relevant theories or models from computational
linguistics or clinical informatics could strengthen the study’s
foundation.

### **2. Argumentation and Analysis**

**a. Superficial Performance Discussion:**

- **Shallow Interpretation of Results:** While the
results are presented comprehensively in tables, the analysis remains
superficial. The manuscript does not delve into the underlying reasons
for why specific models outperform others or why certain prompting
strategies yield better consistency and faithfulness.
- **Lack of Insight into Failure Modes:** The paper does
not explore or hypothesize why models like BioMistral-7B exhibit high
faithfulness scores yet poor F1-scores. Understanding these
contradictions is essential for advancing model development and
addressing specific weaknesses.

**b. Absence of Statistical Validation:**

- **No Statistical Significance Testing:** The results
are reported in terms of average scores, but the manuscript does not
include any statistical tests to determine the significance of observed
differences between models or configurations. Without such analysis, it
is difficult to ascertain whether the performance improvements are
meaningful or due to random variation.

### **3. Methodology**

**a. Incomplete Replication of Original Methods:**

- **Partial Reproduction of Techniques:** The study
mentions reproducing methods from various authors but admits to not
fully replicating all preliminary experiments due to resource
constraints (e.g., not re-implementing Lee et al.’s work). This
incomplete replication undermines the study’s reproducibility objective
and limits the ability to draw comprehensive comparisons.
- **Modification Without Justification:** Changes made
during reproduction, such as altering response label extraction methods
or adjusting hyperparameters, are not sufficiently justified. The
rationale behind these modifications is unclear, making it difficult to
assess their impact on the results.

**b. Lack of Detailed Hyperparameter Documentation:**

- **Opaque Hyperparameter Adjustments:** The manuscript
states that hyperparameters were adjusted slightly but does not provide
detailed information on the specific values used or the criteria for
their selection. Transparency in hyperparameter settings is vital for
reproducibility and for other researchers to build upon the work.

**c. Limited Exploration of Advanced Techniques:**

- **Exclusion of Certain Prompting Strategies:** Although the study emphasizes zero-shot performance, it excludes the application of In-Context Learning (ICL), Chain-of-Thought (CoT), and
Self-Consistency techniques in the baseline evaluations. Given the
importance of these strategies in enhancing model reasoning, their
omission limits the comprehensiveness of the evaluation.

### **4. Organization and Structure**

**a. Inconsistent Section Transitions:**

- **Abrupt Section Changes:** Transitions between
sections, particularly between Related Work and Methodology, are abrupt
and lack seamless integration. This disrupts the flow of the narrative
and makes it harder for readers to follow the logical progression of the study.

**b. Misplacement of Supplementary Materials:**

- **Embedded Figures and Tables:** Critical figures and
tables are interspersed within the text in a manner that interrupts the
reading flow. Consolidating these supplementary materials into
designated sections or appendices would enhance readability and maintain the manuscript’s structural integrity.

### **5. Writing Quality and Clarity**

**a. Formatting and Typographical Errors:**

- **Hyphenation and Line Breaks:** The manuscript
contains numerous formatting issues, such as inappropriate hyphenations
(e.g., "repro - du - ce") and line breaks within paragraphs that disrupt the text flow. These errors detract from the professionalism and
readability of the paper.

**b. Dense and Complex Sentences:**

- **Overly Complex Explanations:** Certain sections,
especially the Experimental Results, are written in a densely packed
manner with complex sentence structures. This can obscure key points and make it challenging for readers to grasp the essential findings.
Simplifying sentence constructions and breaking down complex ideas into
clearer, more concise segments would improve comprehension.

**c. Lack of Clarity in Method Descriptions:**

- **Ambiguous Descriptions:** Some methodological steps,
such as the exact nature of 'small modifications' made during
reproduction or the specific 'response label extraction methods'
employed, are described ambiguously. Clear, detailed explanations are
necessary to ensure that other researchers can accurately replicate the
study.

### **6. References and Citations**

**a. Absence of a Comprehensive Reference List:**

- **Missing Bibliography:** The manuscript fails to
include a formal reference list or bibliography. All in-text citations
are presented with placeholders (e.g., "[10 Anonymous Author(s)]"),
making it impossible to verify sources or consult the referenced works. A complete and properly formatted bibliography is essential for academic
credibility and facilitating further research.

**b. Inconsistent Citation Formatting:**

- **Variations in Citation Style:** There are
inconsistencies in how citations are formatted within the text,
including spacing, use of brackets, and ordering. Maintaining a
consistent citation style (e.g., APA, MLA, Chicago) is crucial for
readability and adherence to academic standards.

### **7. Methodological Justifications and Transparency**

**a. Limited Rationale for Model Selection:**

- **Unclear Selection Criteria:** The paper lists several models (e.g., Mistral-7B, LLaMa3.1-8B-Instruct, Gemini) but does not
clearly articulate the criteria for choosing these specific models over
others. Providing a justification based on model performance,
availability, or relevance to the clinical domain would strengthen the
methodological transparency.

**b. Insufficient Description of Experimental Setup:**

- **Details on Computational Resources:** There is no
mention of the computational resources used (e.g., hardware
specifications, training times), which is important for assessing the
feasibility and scalability of the experiments.
- **Reproducibility Enhancements:** While the authors
state that implementations are publicly available, specific details on
how to access and utilize these resources (e.g., exact URLs, version
control information) are sparse. Ensuring that all necessary information is accessible is key to facilitating true reproducibility.

### **8. Lack of Comprehensive Error and Sensitivity Analyses**

**a. No Error Analysis Section:**

- **Missing Identification of Common Errors:** The
manuscript does not include a dedicated error analysis section that
identifies and categorizes the common types of mistakes made by the
models. Such an analysis is essential for understanding model
limitations and guiding future improvements.

**b. Sensitivity to Hyperparameters:**

- **Impact of Hyperparameter Choices Not Explored:** The
study does not investigate how sensitive model performances are to
different hyperparameter settings. Understanding this sensitivity can
inform the robustness and reliability of the models under varying
conditions.

### **9. Generalizability and Applicability Concerns**

**a. Narrow Focus on Breast Cancer CTRs:**

- **Limited Scope:** The study exclusively focuses on
breast cancer-related clinical trials, which may limit the
generalizability of the findings to other medical domains or conditions. Expanding the dataset to include a broader range of clinical trials
would enhance the applicability of the results.

**b. Lack of Cross-Domain Validation:**

- **Single Domain Evaluation:** There is no evaluation of how well the models and methods perform across different medical
domains or in real-world clinical settings. Incorporating cross-domain
validation would provide insights into the models’ versatility and
adaptability.

### **10. Ethical Considerations and Implications**

**a. No Discussion on Ethical Implications:**

- **Ethical Concerns Unaddressed:** The manuscript does
not address potential ethical implications of deploying LLMs in clinical settings, such as issues related to data privacy, informed consent, or
the consequences of erroneous inferences. Including an ethical analysis
would demonstrate a comprehensive understanding of the broader impacts
of the research.

**b. Absence of Bias Mitigation Strategies:**

- **Bias Handling Not Discussed:** There is no mention of strategies employed to identify or mitigate biases in the models or
datasets. Addressing bias is crucial, especially in the clinical domain
where biased inferences can have significant real-world consequences.

### **11. Future Work and Limitations**

**a. Vague Future Directions:**

- **Lack of Specificity in Suggestions:** While the
conclusion mentions expanding to other datasets and domains, it lacks
specific, actionable recommendations for future research. Providing
detailed proposals for subsequent studies would offer clearer guidance
to researchers looking to build upon this work.

**b. Inadequate Discussion of Limitations:**

- **Understated Limitations:** The manuscript briefly
acknowledges some limitations, such as not replicating all original
methods, but fails to comprehensively discuss how these limitations
affect the study’s findings and interpretations. A more thorough
discussion of limitations would enhance the transparency and credibility of the research.

### **12. Technical Rigor and Completeness**

**a. Incomplete Methodological Reporting:**

- **Omission of Certain Details:** Key methodological
details, such as the exact configurations used for Parameter-Efficient
Fine-Tuning (PEFT) or the specific nature of "small modifications"
during reproduction, are insufficiently reported. Complete
methodological transparency is necessary to ensure replicability and
validate the study’s claims.

**b. Lack of Comprehensive Performance Metrics:**

- **Limited Evaluation Metrics:** The study focuses on
Macro F1-Score, Faithfulness, and Consistency but does not incorporate
other relevant metrics such as Precision, Recall, AUC-ROC, or area under the precision-recall curve, which could provide a more nuanced
understanding of model performance.

**c. Absence of Baseline Comparisons:**

- **No Traditional Baselines:** Besides the models
evaluated, the study does not compare the LLMs’ performance against
traditional NLI approaches or simpler baseline models. Including such
comparisons would contextualize the LLMs' performance within the broader landscape of NLI methodologies.

### **13. Clarity in Reproduction Versus Replication Distinction**

**a. Ambiguity in Reproduction Goals:**

- **Replication vs. Reproduction Confusion:** The
manuscript states its aim to reproduce rather than replicate original
studies, yet it does not clearly define the distinction or explain the
implications of this choice. Clarifying this distinction would help
readers understand the study’s scope and limitations better.

**b. Impact of Reproduction Choices:**

- **Effects of Methodological Deviations:** The paper
mentions deviations from original pre-processing and label extraction
methods but does not sufficiently analyze how these choices impact the
results. Evaluating the consequences of such deviations is essential for assessing the fidelity of the reproduction efforts.

---

### **Conclusion**

In summary, while the manuscript makes a valuable contribution by 
addressing the reproducibility of NLI methods in the clinical domain, it
 suffers from numerous critical flaws that undermine its academic rigor 
and practical utility. The absence of a comprehensive reference list, 
insufficient methodological transparency, superficial analysis of 
results, and lack of detailed error and bias assessments are among the 
most pressing issues. Additionally, the narrow focus on breast cancer 
CTRs and the omission of ethical considerations limit the study's 
broader applicability and societal relevance.

**Recommendation:** **Reject**

**Rationale:** The manuscript, in its current form, does
 not meet the necessary standards of academic thoroughness and 
transparency required for publication. The significant gaps in 
methodological detail, analysis depth, and scholarly rigor necessitate 
substantial revisions before the work can be considered for inclusion in
 a reputable academic venue. Addressing the identified negative aspects 
comprehensively would not only strengthen the study’s validity but also 
enhance its contribution to the field of AI in healthcare.

---

**Suggestions for Improvement:**

1. **Comprehensive Reference List:** Include a complete
and properly formatted bibliography to ensure all cited works are
verifiable and to enhance the manuscript’s credibility.
2. **Detailed Dataset Analysis:** Provide an in-depth examination of the dataset's characteristics, potential biases, and limitations.
3. **Enhanced Methodological Transparency:** Clearly
document all methodological choices, including hyperparameter settings,
model configurations, and the rationale behind modifications made during reproduction.
4. **Incorporate Error and Bias Analysis:** Add dedicated sections analyzing common errors, model biases, and their implications for clinical applications.
5. **Statistical Significance Testing:** Implement statistical tests to validate the significance of performance differences observed between models and configurations.
6. **Expanded Discussion on Limitations and Ethical Implications:** Thoroughly discuss the study’s limitations and the ethical considerations of deploying LLMs in clinical settings.
7. **Broaden Scope for Generalizability:** Extend the
evaluation to include a wider range of clinical domains and incorporate
cross-domain validation to enhance the generalizability of the findings.
8. **Improve Writing Quality:** Address formatting errors, simplify complex sentences, and ensure clarity and conciseness throughout the manuscript.

By systematically addressing these areas, the authors can 
significantly improve the manuscript’s quality, making it a robust and 
valuable contribution to the academic discourse on AI and clinical 
reasoning.

# PROS

While the manuscript 
presents several areas needing improvement, it also possesses notable 
strengths that contribute positively to the field of Artificial 
Intelligence (AI) in healthcare, particularly in the domain of Natural 
Language Inference (NLI) applied to Clinical Trial Reports (CTRs). The 
following outlines the primary positive aspects of the study:

### **1. Relevance and Timeliness**

**Significant Contribution to AI in Healthcare:**

- **Critical Intersection:** The study addresses a
crucial intersection between AI and healthcare by focusing on the
application of Large Language Models (LLMs) in interpreting and
reasoning over Clinical Trial Reports. This is particularly pertinent
given the increasing reliance on AI for augmenting clinical
decision-making processes.
- **Timely Exploration:** With the rapid expansion of AI
technologies in medical domains, evaluating the consistency and
reliability of LLMs in clinical reasoning is both timely and necessary.
The study responds to current demands for robust and trustworthy AI
systems in healthcare settings.

### **2. Comprehensive Evaluation Framework**

**Diverse Model and Technique Assessment:**

- **Wide Range of Models:** The study evaluates a diverse set of models, including both open-source (e.g., Mistral-7B,
LLaMa3.1-8B-Instruct) and commercial (Gemini) LLMs. This comprehensive
approach provides a broad perspective on how different architectures and training backgrounds influence performance in clinical NLI tasks.
- **Variety of Prompting and Decoding Strategies:** By
experimenting with multiple prompting techniques (short vs. long
prompts) and decoding strategies (greedy vs. sampling), the study
thoroughly explores the factors that affect model performance and
consistency. This detailed assessment helps in understanding the nuanced ways in which prompting and decoding impact the reasoning capabilities
of LLMs.

### **3. Emphasis on Reproducibility**

**Transparent Methodological Approach:**

- **Detailed Methodology:** The authors meticulously
outline their methodological steps, including dataset descriptions,
model configurations, prompting strategies, and evaluation metrics. This transparency is essential for reproducibility, allowing other
researchers to replicate the study and validate its findings.
- **Public Availability of Implementations:** By making
their implementations publicly available, the authors enhance the
study’s transparency and facilitate further research. This commitment to open science strengthens the credibility and utility of their work
within the academic community.

### **4. Robust Empirical Insights**

**In-Depth Performance Analysis:**

- **Performance Benchmarks:** The study establishes
baseline scores across multiple models, providing valuable benchmark
data for future research. These benchmarks serve as reference points for evaluating new models and techniques in the domain of clinical NLI.
- **Identification of Model Vulnerabilities:** The
authors highlight specific weaknesses of various models, such as
BioMistral-7B’s tendency to default to the "contradiction" label, which
undermines faithfulness. Identifying these vulnerabilities is critical
for guiding future improvements and ensuring the reliability of LLMs in
clinical applications.

### **5. Structured and Clear Presentation**

**Well-Organized Manuscript:**

- **Logical Flow:** The paper follows a clear and logical structure, progressing systematically from the introduction and related work to methodology, results, discussion, and conclusions. This
organization aids in the reader’s comprehension and facilitates a
coherent understanding of the study’s objectives and findings.
- **Effective Use of Visual Aids:** Figures and tables
are effectively utilized to illustrate key points, present empirical
data, and compare model performances. For instance, Figure 1 and Figure 2 provide visual examples of entailment/contradiction queries and
statement variations, respectively, enhancing the reader’s grasp of the
task and evaluation process.
- **Detailed Tables:** Tables 2, 3, and 4 offer
comprehensive performance metrics across different models and
techniques, enabling a straightforward comparison of results. These
tables are essential for summarizing complex data in an accessible
format.

### **6. Methodological Innovation and Extension**

**Extending Existing Methods:**

- **Beyond Reproduction:** In addition to reproducing
existing methods, the authors extend the study by exploring a broader
set of techniques and establishing new baselines. This extension not
only validates previous findings but also contributes additional
knowledge to the field.
- **Parameter-Efficient Fine-Tuning (PEFT):** The
incorporation of PEFT techniques to fine-tune models demonstrates an
innovative approach to improving model performance without extensive
computational resources. This is particularly relevant for practitioners with limited access to high-performance computing infrastructure.

### **7. Clear Articulation of Challenges and Goals**

**Focused Research Objectives:**

- **Addressing Specific Challenges:** The manuscript
clearly identifies and articulates the challenges of consistent
reasoning in the context of clinical NLI, such as handling syntactic
alterations and semantic shifts. By focusing on these specific
challenges, the study maintains a targeted and relevant scope.
- **Well-Defined Objectives:** The primary objectives of
reproducing state-of-the-art methods, extending methodologies, and
establishing baseline scores are clearly stated. This clarity helps in
setting reader expectations and provides a clear framework for
evaluating the study’s success in meeting its goals.

### **8. Practical Implications and Future Directions**

**Foundation for Future Research:**

- **Empirical Lessons:** The study concludes with an
analysis that highlights key insights and empirical lessons learned,
which are valuable for guiding future research in the domain. These
lessons can inform the development of more robust and reliable clinical
reasoning models.
- **Expanded Research Opportunities:** By suggesting the
expansion of benchmarking efforts to other clinical datasets and
exploring generalization to other specialized fields, the authors lay
the groundwork for continued advancements and diversification of
research in NLI and LLM applications.

---

**Summary**

The manuscript exhibits several strengths, including its relevance to
 a critical and timely intersection of AI and healthcare, comprehensive 
evaluation of diverse models and techniques, strong emphasis on 
reproducibility, and structured presentation. Additionally, the study 
provides robust empirical insights, methodological innovations, and 
clear articulation of research challenges and objectives. These positive
 aspects collectively contribute valuable knowledge and resources to the
 field, supporting ongoing efforts to enhance the reliability and 
consistency of LLMs in clinical applications.