arXiv:2601. 17642v2 Announce Type: replace Abstract: Safety alignment in Large Language Models is critical for healthcare; however, reliance on binary refusal boundaries often results in over-refusal of benign queries or unsafe compliance with harmful ones.
By Zhihao Zhang, Liting Huang, Guanghao Wu, Preslav Nakov, Heng Ji, Usman Naseem
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: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: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:2608.29241v1 Announce Type: new
Abstract: Clinical voice agents are now deployed in routine care, where real patients do not wait their turn: they interrupt. These systems typically use a casca...
By Zachary Ellis, Spencer Hazel, Adam Brandt, Yajie Vera He, Ernest Lim, Jared Joselowitz
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
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:2608. 03731v1 Announce Type: new Abstract: Patient-facing medical LLMs and agents increasingly answer symptom questions before clinician contact, where the key safety question is what action the user should take next.
By Yining Hua, Hongbin Na, Cyrus Ayubcha
arXiv:2606. 28332v1 Announce Type: cross Abstract: Large language models (LLMs) are increasingly used for medical and health-related questions, yet their safety in high-risk medical scenarios remains poorly understood.
By Yige Li, Jun Sun, Wei Zhao, Zhe Li, Yutao Wu, Hanxun Huang, Xiang Zheng, Xingjun Ma
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: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: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