arXiv AI

Same Illness, Different Voice: Restating the Patient's Account Narrows Narrative Anchoring in Clinical Language Models

The study evaluates how clinical language models perform when patient narratives are presented in different voices—clinical, socioeconomic, and cultural—using 1,000 MedQA cases paired with three retellings each. All 12 tested models show a significant drop in accuracy (about 26% more errors) when the patient speaks in a marked voice, a penalty that persists even when the original vignette is included verbatim and is not explained by measured retelling properties. The authors find that rewriting the patient’s account into a clinical vignette before answering can halve this accuracy gap, though structured schema pipelines and additional reasoning tools offer limited improvements.

arXiv AI
Aug 25

SDoH-Aware Narrative Anchoring Bias in Medical LLMs for Trustworthy Clinical Decision Support

The paper investigates how medical large language models (LLMs) may exhibit narrative anchoring bias when presented with the same clinical case in different patient voices. Using the NarrativeShield SDoH MedQA dataset, the authors evaluate three Qwen2.5 instruction‑tuned LLMs (1.5B, 3B, 7B) on 300 clinical cases, reporting metrics such as persona‑level accuracy, counterfactual consistency, correct consistency, and narrative sensitivity error. The 7B model achieves the highest accuracy (56.33 %) and correct consistency (40.33 %), yet narrative sensitivity errors remain substantial (31.67 %).

By Ahnaf Atef Choudhury, Ramkrishna Saha
arXiv Machine Learning
Oct 5

Clinical Concept Centers in LLMs

The paper investigates whether clinical concepts are represented as distinct, causally influential centers within the latent space of large language models (LLMs). By evaluating eleven open-weight LLMs, the authors discover that each model contains dedicated clinical concept centers that are interpretable, activate only on relevant clinical narratives, and drive model behavior in both constrained and open-ended contexts. These centers can be leveraged for evaluation and performance improvement, as steering models along them enhances downstream clinical outcomes and aligns with clinician preferences.

By Aishik Nagar, Abhishek Vaidyanathan, Arun-Kumar Kaliya-Perumal, Elijah Tzen Hsuen Boey, Stefan Winkler
arXiv AI
Sep 25

IatroBench: A Pre-Registered Benchmark of Clinical Omission in Language Models

IatroBench is a pre‑registered benchmark that evaluates language models on clinical omission and commission harms across 60 scenarios and six models. Using a physician‑written rubric scored by Claude Opus 4.6, the study finds that models tend to withhold more information from patients than from doctors—a phenomenon termed framing‑contingent withholding—while also revealing varied patterns of omission across different models. The benchmark highlights how framing influences the amount of medical information shared by AI systems.

By David Gringras