How do large language models (LLMs) generate human-like text?

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Last updated: August 29, 2025View editorial policy

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Large Language Models Generate Text by Predicting the Next Word in a Sequence Based on Context

Large language models (LLMs) generate human-like text by predicting the next word in a sequence based on context, using an autoregressive approach that builds text one token at a time. 1

How LLMs Generate Text

LLMs operate using a fundamental mechanism called autoregressive prediction, which involves several key components:

Autoregressive Prediction Process

  • LLMs are transformer-based neural networks with billions of parameters trained on vast text corpora from diverse sources 1
  • They predict each subsequent word (or token) based on all previous words in the sequence 1
  • This prediction is probability-based, with the model calculating the most likely continuation of text given what came before 1

Key Technical Components

  • Tokenization: Text is broken down into smaller units (words, subwords, or characters) for processing 1
  • Attention mechanisms: Allow the model to focus on different parts of the input when producing each part of the output 1
  • Transformer architecture: Processes sequences of data in parallel using self-attention mechanisms, improving efficiency and capturing complex text dependencies 1
  • Decoder: Converts vectorized input data back into a text sequence 1

Why This Matters in Clinical Practice

Understanding how LLMs generate text is important for pharmacy and medical professionals because:

  • LLMs don't simply retrieve pre-written responses but generate novel text based on patterns learned during training
  • Their autoregressive nature explains both their strengths (coherent, contextually appropriate responses) and limitations (potential for hallucinations when making low-probability predictions) 2
  • The quality of responses depends on the context provided and how well the prompt guides the prediction process 1

Common Misconceptions About LLMs

It's important to clarify that LLMs do NOT:

  • Cut and paste text from the internet (they generate new text)
  • Use pre-programmed responses (they dynamically create responses)
  • Simply translate between languages (though they can perform translation as a task)

Clinical Applications and Limitations

LLMs can support clinical practice through:

  • Clinical documentation assistance
  • Medical question answering
  • Patient education material generation
  • Literature summarization

However, healthcare professionals should be aware that:

  • LLMs may produce hallucinations (fabricated information) when operating outside their training distribution 1
  • Their accuracy in medical contexts varies widely (25-90%) 1
  • They lack standardized accuracy metrics crucial for safe deployment in healthcare 1

Understanding the fundamental next-word prediction mechanism helps pharmacy students recognize both the potential and limitations of these tools in clinical settings.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Embers of autoregression show how large language models are shaped by the problem they are trained to solve.

Proceedings of the National Academy of Sciences of the United States of America, 2024

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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