arXiv AI

TAF-MED: Multi-Turn Safety Refusal Collapse in LLMs Under Declared Self-Treatment Intent

arXiv:2608. 10258v1 Announce Type: cross Abstract: Large language models (LLMs) increasingly provide conversational health information that may influence treatment decisions, yet existing benchmarks do not isolate whether medication-safety boundaries persist across follow-ups after explicit self-treatment intent.

arXiv Computation and Language
Sep 22

LLMs Anchor on Chief Complaint and Fail to Integrate Evidence in Sequential Clinical Triage

The study evaluates large language models (LLMs) on sequential emergency department triage, where acuity labels are predicted from progressively longer nurse‑patient conversations. Six LLMs were tested at five checkpoints on simulated and physician‑authored dialogues, showing a decline from moderate‑to‑substantial agreement on full records to only fair‑to‑moderate agreement at each checkpoint. The models consistently anchor on chief complaint exchanges and fail to integrate later evidence, yielding low agreement with clinicians (QWK 0.295 vs. 0.887‑0.929) and concentrating predictions on ESI‑2 and ESI‑3. whyItMatters":"The findings reveal that LLMs, despite strong offline performance, cannot reliably handle the sequential nature of real‑time triage, highlighting a critical gap for safe deployment in emergency settings."

By Dipankar Srirag, Haokai Zhao, Ashutosh Kumar, Eleanor Hopper, Michael Dalton, Quoc Dung Nguyen, Aditya Joshi, Salil S. Kanhere, Padmanesan Narasimhan
arXiv AI
Jul 9

SycoEval-EM: Sycophancy Evaluation of Large Language Models in Simulated Clinical Encounters for Emergency Care

arXiv:2601. 16529v4 Announce Type: replace Abstract: Large language models (LLMs) deployed in clinical decision support may acquiesce to patient requests for care that conflicts with evidence-based guidelines.

By Dongshen Peng, Yi Wang, Austin Schoeffler, Sun-ha Hong, Brian Suffoletto, David Kim, Carl Preiksaitis, Christian Rose
arXiv AI
Sep 15

K-Bench: a clinically calibrated benchmark for evaluating large language models in high-risk mental health conversations

arXiv:2609.15855v1 Announce Type: cross Abstract: % !TEX root = ../main.tex People increasingly use large language models (LLMs) for mental health support, yet their safety in evolving, high-risk con...

By Laura M. Vowels, Matthew J. Vowels, Shivali Sharma, Apoorv Jha, Rehnuma Choudhury, Wasseem El Sarraj, Rachel Francois-Walcott, Aruba Hussain, Sarah Ingram, Angela Loulopoulou, Adva Segal, Elena Volkova
arXiv AI
Aug 5

Preferred, Not Safer: Pairwise Preference Is a Poor Proxy for Clinical Safety

arXiv:2608. 02617v1 Announce Type: cross Abstract: We evaluate whether clinician pairwise preferences provide a reliable signal of clinical safety in large language model (LLM) evaluation using expert feedback from MOOVE (Massive Open Online Validation and Evaluation), a clinician-led platform collecting blinded pairwise preferences alongside multi-criterion rubric ratings.

By Fay Elhassan, David Sasu, Alexandra Kulinkina, Lars Henning Klein, Mary-Anne Hartley
arXiv AI
Sep 15

Useless but Safe? Benchmarking Utility Recovery with User Intent Clarification in Multi-Turn Conversations

The paper introduces CarryOnBench, an interactive benchmark that tests whether large language models can revise their interpretation of user intent and recover utility while staying safe in multi‑turn conversations. Using 398 harmful‑looking queries with benign intents, the benchmark simulates 5,970 conversations across 14 models, evaluating both intent‑aligned utility and safety with a new metric called Ben‑Util. Results show that models often withhold information due to misinterpretation, but most can recover with clarifications, revealing failure modes such as unsafe and redundant recovery that single‑turn tests miss.

By Mingqian Zheng, Malia Morgan, Liwei Jiang, Carolyn Rose, Maarten Sap
arXiv AI
Aug 3

Reasoning in Real World Clinical Care: Why Large Language Models Are Not Yet Safe for Autonomous Clinical Decision Support

arXiv:2607. 28677v1 Announce Type: new Abstract: LLM now pass medical licensing examinations and, in curated cases, can rival physicians at diagnostic reasoning.

By Shayndhan Sivanathan, Shravan Nageswaran, Mehdi Zadem, Ryaan Sultan, Nicolas von Mallinckrodt, Max Solovyev, Alexey Matyushkin, Sumon Sadhu, Gabriele C DeLuca, Sanjeeva Jeyaretna, James Hillis, Manoj Ramachandran, Prakash Jayakumar
arXiv AI
Jun 17

First, do NOHARM: towards clinically safe large language models

arXiv:2512. 01241v3 Announce Type: replace-cross Abstract: Large language models (LLMs) are routinely used by physicians and patients for medical advice, yet their clinical safety profiles remain poorly characterized.

By David Wu, Fateme Nateghi Haredasht, Saloni Kumar Maharaj, Priyank Jain, Jessica Tran, Matthew Gwiazdon, Arjun Rustagi, Jenelle Jindal, Jacob M. Koshy, Vinay Kadiyala, Anup Agarwal, Bassman Tappuni, Brianna French, Sirus Jesudasen, Christopher V. Cosgriff, Rebanta Chakraborty, Jillian Caldwell, Susan Ziolkowski, David J. Iberri, Robert Diep, Rahul S. Dalal, Kira L. Newman, Kristin Galetta, J. Carl Pallais, Nancy Wei, Kathleen M. Buchheit, David I. Hong, Vartan Pahalyants, Ernest Y. Lee, Allen Shih, Tamara B. Kaplan, Vishnu Ravi, Sarita Khemani, Thomas A. Buckley, April S. Liang, Daniel Shirvani, Advait Patil, Nicholas Marshall, Kanav Chopra, Joel Koh, Adi Badhwar, Anastasia Perez, Austin J. Schoeffler, Mahbuba Tusty, Chase M. Walton, Liam G. McCoy, David J. H. Wu, Yingjie Weng, Sumant Ranji, Kevin Schulman, Nigam H. Shah, Jason Hom, Arnold Milstein, Arjun K. Manrai, Adam Rodman, Jonathan H. Chen, Ethan Goh
arXiv AI
Jul 16

Ask Before You Diagnose: Safe-Psych, a Sequential Evaluation Benchmark for LLMs in Psychiatry

arXiv:2607. 13036v1 Announce Type: cross Abstract: Large language models (LLMs) are increasingly used for decision support in healthcare, but clinical evidence is often incomplete or evolving.

By Oriana Presacan, Andreea Grama, Larisa Irimin\u{a}, Alireza Nik, Jaya Ojha, Vajira Thambawita, Ciprian I. B\u{a}cil\u{a}, Bogdan Ionescu, Michael A. Riegler