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Jan 7

Large Language Models Encode Clinical Knowledge

Large language models (LLMs) have demonstrated impressive capabilities in natural language understanding and generation, but the quality bar for medical and clinical applications is high. Today, attempts to assess models' clinical knowledge typically rely on automated evaluations on limited benchmarks. There is no standard to evaluate model predictions and reasoning across a breadth of tasks. To address this, we present MultiMedQA, a benchmark combining six existing open question answering datasets spanning professional medical exams, research, and consumer queries; and HealthSearchQA, a new free-response dataset of medical questions searched online. We propose a framework for human evaluation of model answers along multiple axes including factuality, precision, possible harm, and bias. In addition, we evaluate PaLM (a 540-billion parameter LLM) and its instruction-tuned variant, Flan-PaLM, on MultiMedQA. Using a combination of prompting strategies, Flan-PaLM achieves state-of-the-art accuracy on every MultiMedQA multiple-choice dataset (MedQA, MedMCQA, PubMedQA, MMLU clinical topics), including 67.6% accuracy on MedQA (US Medical License Exam questions), surpassing prior state-of-the-art by over 17%. However, human evaluation reveals key gaps in Flan-PaLM responses. To resolve this we introduce instruction prompt tuning, a parameter-efficient approach for aligning LLMs to new domains using a few exemplars. The resulting model, Med-PaLM, performs encouragingly, but remains inferior to clinicians. We show that comprehension, recall of knowledge, and medical reasoning improve with model scale and instruction prompt tuning, suggesting the potential utility of LLMs in medicine. Our human evaluations reveal important limitations of today's models, reinforcing the importance of both evaluation frameworks and method development in creating safe, helpful LLM models for clinical applications.

  • 30 authors
·
Dec 26, 2022

A Toolbox for Surfacing Health Equity Harms and Biases in Large Language Models

Large language models (LLMs) hold immense promise to serve complex health information needs but also have the potential to introduce harm and exacerbate health disparities. Reliably evaluating equity-related model failures is a critical step toward developing systems that promote health equity. In this work, we present resources and methodologies for surfacing biases with potential to precipitate equity-related harms in long-form, LLM-generated answers to medical questions and then conduct an empirical case study with Med-PaLM 2, resulting in the largest human evaluation study in this area to date. Our contributions include a multifactorial framework for human assessment of LLM-generated answers for biases, and EquityMedQA, a collection of seven newly-released datasets comprising both manually-curated and LLM-generated questions enriched for adversarial queries. Both our human assessment framework and dataset design process are grounded in an iterative participatory approach and review of possible biases in Med-PaLM 2 answers to adversarial queries. Through our empirical study, we find that the use of a collection of datasets curated through a variety of methodologies, coupled with a thorough evaluation protocol that leverages multiple assessment rubric designs and diverse rater groups, surfaces biases that may be missed via narrower evaluation approaches. Our experience underscores the importance of using diverse assessment methodologies and involving raters of varying backgrounds and expertise. We emphasize that while our framework can identify specific forms of bias, it is not sufficient to holistically assess whether the deployment of an AI system promotes equitable health outcomes. We hope the broader community leverages and builds on these tools and methods towards realizing a shared goal of LLMs that promote accessible and equitable healthcare for all.

  • 30 authors
·
Mar 18, 2024

A Forgotten Danger in DNN Supervision Testing: Generating and Detecting True Ambiguity

Deep Neural Networks (DNNs) are becoming a crucial component of modern software systems, but they are prone to fail under conditions that are different from the ones observed during training (out-of-distribution inputs) or on inputs that are truly ambiguous, i.e., inputs that admit multiple classes with nonzero probability in their ground truth labels. Recent work proposed DNN supervisors to detect high-uncertainty inputs before their possible misclassification leads to any harm. To test and compare the capabilities of DNN supervisors, researchers proposed test generation techniques, to focus the testing effort on high-uncertainty inputs that should be recognized as anomalous by supervisors. However, existing test generators can only produce out-of-distribution inputs. No existing model- and supervisor-independent technique supports the generation of truly ambiguous test inputs. In this paper, we propose a novel way to generate ambiguous inputs to test DNN supervisors and used it to empirically compare several existing supervisor techniques. In particular, we propose AmbiGuess to generate ambiguous samples for image classification problems. AmbiGuess is based on gradient-guided sampling in the latent space of a regularized adversarial autoencoder. Moreover, we conducted what is - to the best of our knowledge - the most extensive comparative study of DNN supervisors, considering their capabilities to detect 4 distinct types of high-uncertainty inputs, including truly ambiguous ones.

  • 3 authors
·
Jul 21, 2022

Model Tampering Attacks Enable More Rigorous Evaluations of LLM Capabilities

Evaluations of large language model (LLM) risks and capabilities are increasingly being incorporated into AI risk management and governance frameworks. Currently, most risk evaluations are conducted by designing inputs that elicit harmful behaviors from the system. However, a fundamental limitation of this approach is that the harmfulness of the behaviors identified during any particular evaluation can only lower bound the model's worst-possible-case behavior. As a complementary method for eliciting harmful behaviors, we propose evaluating LLMs with model tampering attacks which allow for modifications to latent activations or weights. We pit state-of-the-art techniques for removing harmful LLM capabilities against a suite of 5 input-space and 6 model tampering attacks. In addition to benchmarking these methods against each other, we show that (1) model resilience to capability elicitation attacks lies on a low-dimensional robustness subspace; (2) the attack success rate of model tampering attacks can empirically predict and offer conservative estimates for the success of held-out input-space attacks; and (3) state-of-the-art unlearning methods can easily be undone within 16 steps of fine-tuning. Together these results highlight the difficulty of removing harmful LLM capabilities and show that model tampering attacks enable substantially more rigorous evaluations than input-space attacks alone. We release models at https://huggingface.co/LLM-GAT

  • 15 authors
·
Feb 3, 2025

OutSafe-Bench: A Benchmark for Multimodal Offensive Content Detection in Large Language Models

Since Multimodal Large Language Models (MLLMs) are increasingly being integrated into everyday tools and intelligent agents, growing concerns have arisen regarding their possible output of unsafe contents, ranging from toxic language and biased imagery to privacy violations and harmful misinformation. Current safety benchmarks remain highly limited in both modality coverage and performance evaluations, often neglecting the extensive landscape of content safety. In this work, we introduce OutSafe-Bench, the first most comprehensive content safety evaluation test suite designed for the multimodal era. OutSafe-Bench includes a large-scale dataset that spans four modalities, featuring over 18,000 bilingual (Chinese and English) text prompts, 4,500 images, 450 audio clips and 450 videos, all systematically annotated across nine critical content risk categories. In addition to the dataset, we introduce a Multidimensional Cross Risk Score (MCRS), a novel metric designed to model and assess overlapping and correlated content risks across different categories. To ensure fair and robust evaluation, we propose FairScore, an explainable automated multi-reviewer weighted aggregation framework. FairScore selects top-performing models as adaptive juries, thereby mitigating biases from single-model judgments and enhancing overall evaluation reliability. Our evaluation of nine state-of-the-art MLLMs reveals persistent and substantial safety vulnerabilities, underscoring the pressing need for robust safeguards in MLLMs.

  • 6 authors
·
Nov 13, 2025