Technological progress has led to concrete advancements in tasks that were regarded as challenging, such as automatic fact-checking. Interest in adopting these systems for public health and medicine has grown due to the high-stakes nature of medical decisions and challenges in critically appraising a vast and diverse medical literature. Evidence-based medicine connects to every individual, and yet the nature of it is highly technical, rendering the medical literacy of majority users inadequate to sufficiently navigate the domain. Such problems with medical communication ripens the ground for end-to-end fact-checking agents: check a claim against current medical literature and return with an evidence-backed verdict. And yet, such systems remain largely unused. In this position paper, developed with expert input, we present the first study examining how clinical experts verify real claims from social media by synthesizing medical evidence. In searching for this upper-bound, we reveal fundamental challenges in end-to-end fact-checking when applied to medicine: Difficulties connecting claims in the wild to scientific evidence in the form of clinical trials; ambiguities in underspecified claims mixed with mismatched intentions; and inherently subjective veracity labels. We argue that fact-checking should be approached and evaluated as an interactive communication problem, rather than an end-to-end process.

翻译：技术进步已在自动事实核查等曾被视作挑战性的任务中取得实质性进展。鉴于医疗决策的高风险性以及海量多元医学文献批判性评估的困难，在公共卫生与医学领域采用此类系统的兴趣日益增长。循证医学关乎每个个体，但其本质高度技术化，致使多数用户的医学素养不足以充分驾驭该领域。医学传播中的此类问题为端到端事实核查智能体创造了成熟条件：依据当前医学文献核查主张，并返回基于证据的判定。然而，此类系统至今仍未得到广泛应用。在这份吸纳专家意见撰写的立场文件中，我们首次通过临床专家综合医学证据验证社交媒体真实主张的过程展开研究。在探寻这一上限的过程中，我们揭示了端到端事实核查应用于医学领域的根本性挑战：将现实场景中的主张与临床试验形式的科学证据相关联的困难；未充分阐明的主张与错位意图交织产生的模糊性；以及本质上具有主观性的真实性标签。我们认为，事实核查应当作为交互式传播问题而非端到端流程来对待和评估。