Language Models are Alignable Decision-Makers: Dataset and Application to the Medical Triage Domain
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Abstract (arXiv)
In difficult decision-making scenarios, it is common to have conflicting opinions among expert human decision-makers as there may not be a single right answer. Such decisions may be guided by different attributes that can be used to characterize an individual's decision. We introduce a novel dataset for medical triage decision-making, labeled with a set of decision-maker attributes (DMAs). This dataset consists of 62 scenarios, covering six different DMAs, including ethical principles such as fairness and moral desert. We present a novel software framework for human-aligned decision-making by utilizing these DMAs, paving the way for trustworthy AI with better guardrails. Specifically, we demonstrate how large language models (LLMs) can serve as ethical decision-makers, and how their decisions can be aligned to different DMAs using zero-shot prompting. Our experiments focus on different open-source models with varying sizes and training techniques, such as Falcon, Mistral, and Llama 2. Finally, we also introduce a new form of weighted self-consistency that improves the overall quantified performance. Our results provide new research directions in the use of LLMs as alignable decision-makers. The dataset and open-source software are publicly available at: https://github.com/ITM-Kitware/llm-alignable-dm.
Key facts. Cited by 14 papers in the map (data through 14 Oct 2026). Builds on 26 of its 50 references that are in the map. First posted on arXiv 10 Jun 2024.
Builds on
26 of 50 references.
References · 26
- 2020Language Models are Few-Shot Learnerscited by 32,419
- 2022Training language models to follow instructions with human feedbackcited by 15,971
- 2021LoRA: Low-Rank Adaptation of Large Language Modelscited by 14,380
- 2023Llama 2: Open Foundation and Fine-Tuned Chat Modelscited by 13,028
- 2021Training Verifiers to Solve Math Word Problemscited by 10,109
- 2020Retrieval-Augmented Generation for Knowledge-Intensive NLP Taskscited by 9,297
- 2020Measuring Massive Multitask Language Understandingcited by 7,963
- 2020Scaling Laws for Neural Language Modelscited by 6,586
- 2022Self-Consistency Improves Chain of Thought Reasoning in Language Modelscited by 5,708
- 2018Think you have Solved Question Answering? Try ARC, the AI2 Reasoning Challengecited by 4,886
- 2021Finetuned Language Models Are Zero-Shot Learnerscited by 3,780
- 2021TruthfulQA: Measuring How Models Mimic Human Falsehoodscited by 2,975
14 more
- 2022Large Language Models Encode Clinical Knowledgecited by 1,830
- 2020What Disease does this Patient Have? A Large-scale Open Domain Question Answering Dataset from Medical Examscited by 1,356
- 2023Whose Opinions Do Language Models Reflect?cited by 773
- 2020Aligning AI With Shared Human Valuescited by 723
- 2023The Falcon Series of Open Language Modelscited by 535
- 2023Fine-Grained Human Feedback Gives Better Rewards for Language Model Trainingcited by 401
- 2023Evaluating the Moral Beliefs Encoded in LLMscited by 215
- 2023Do the Rewards Justify the Means? Measuring Trade-Offs Between Rewards and Ethical Behavior in the MACHIAVELLI Benchmarkcited by 182
- 2022GitHub Copilot AI pair programmer: Asset or Liability?cited by 152
- 2021Can Machines Learn Morality? The Delphi Experimentcited by 141
- 2023SteerLM: Attribute Conditioned SFT as an (User-Steerable) Alternative to RLHFcited by 111
- 2023Aligning Language Models to User Opinionscited by 99
- 2023MoCa: Measuring Human-Language Model Alignment on Causal and Moral Judgment Taskscited by 44
- 2023The Behavior of Large Language Models When Prompted to Generate Code Explanationscited by 3
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Citing papers per year: 2025: 7; 2026: 7.
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- 2025DecisionFlow: Advancing Large Language Model as Principled Decision Makercited by 12
- 2025CLASH: Evaluating Language Models on Judging High-Stakes Dilemmas from Multiple Perspectivescited by 10
- 2025Tiered Agentic Oversight: A Hierarchical Multi-Agent System for Healthcare Safetycited by 8
- 2025ModelingAgent: Bridging LLMs and Mathematical Modeling for Real-World Challengescited by 5
- 2025ALIGN: Prompt-based Attribute Alignment for Reliable, Responsible, and Personalized LLM-based Decision-Makingcited by 2
- 2025Aligning Machiavellian Agents: Behavior Steering via Test-Time Policy Shapingcited by 2
- 2026Structuring the Space of Sociotechnical Alignmentcited by 2
- 2025Classical AI vs. LLMs for Decision-Maker Alignment in Health Insurance Choicescited by 1
- 2026CONDESION-BENCH: Conditional Decision-Making of Large Language Models in Compositional Action Spacecited by 0
- 2026Decisive: Guiding User Decisions with Optimal Preference Elicitation from Unstructured Documentscited by 0
- 2026REBAR: Reference Ethical Benchmark for Autonomy Readinesscited by 0
- 2026Framing Matters: Addressing Framing Sensitivity in Decision-Making through Behaviorally-Grounded Value Alignmentcited by 0
2 more
- 2026Auditing Alignment Controllability in LLMs via Political Axes26 Jul 2026
- 2026MET: Theory-Grounded and Culture-Aware Multilingual Moral Reasoning13 Jul 2026
- 2026Structuring the Space of Sociotechnical Alignment2 Jun 2026
- 2026Framing Matters: Addressing Framing Sensitivity in Decision-Making through Behaviorally-Grounded Value Alignment27 May 2026
- 2026REBAR: Reference Ethical Benchmark for Autonomy Readiness18 May 2026
- 2026Decisive: Guiding User Decisions with Optimal Preference Elicitation from Unstructured Documents20 Apr 2026
- 2026CONDESION-BENCH: Conditional Decision-Making of Large Language Models in Compositional Action Space10 Apr 2026
- 2025Aligning Machiavellian Agents: Behavior Steering via Test-Time Policy Shaping14 Nov 2025
- 2025Classical AI vs. LLMs for Decision-Maker Alignment in Health Insurance Choices7 Oct 2025
- 2025ALIGN: Prompt-based Attribute Alignment for Reliable, Responsible, and Personalized LLM-based Decision-Making11 Jul 2025
- 2025Tiered Agentic Oversight: A Hierarchical Multi-Agent System for Healthcare Safety14 Jun 2025
- 2025DecisionFlow: Advancing Large Language Model as Principled Decision Maker27 May 2025
- 2026REBAR: Reference Ethical Benchmark for Autonomy Readiness18 May 2026
- 2025DecisionFlow: Advancing Large Language Model as Principled Decision Makercited by 12
- 2025CLASH: Evaluating Language Models on Judging High-Stakes Dilemmas from Multiple Perspectivescited by 10
- 2025ModelingAgent: Bridging LLMs and Mathematical Modeling for Real-World Challengescited by 5
- 2025ALIGN: Prompt-based Attribute Alignment for Reliable, Responsible, and Personalized LLM-based Decision-Makingcited by 2
- 2026Structuring the Space of Sociotechnical Alignmentcited by 2
- 2025Classical AI vs. LLMs for Decision-Maker Alignment in Health Insurance Choicescited by 1
- 2026Decisive: Guiding User Decisions with Optimal Preference Elicitation from Unstructured Documentscited by 0
- 2026Framing Matters: Addressing Framing Sensitivity in Decision-Making through Behaviorally-Grounded Value Alignmentcited by 0
- 2026Auditing Alignment Controllability in LLMs via Political Axescited by 0
- 2026Auditing Alignment Controllability in LLMs via Political Axes26 Jul 2026
- 2026Structuring the Space of Sociotechnical Alignment2 Jun 2026
- 2026Framing Matters: Addressing Framing Sensitivity in Decision-Making through Behaviorally-Grounded Value Alignment27 May 2026
- 2026Decisive: Guiding User Decisions with Optimal Preference Elicitation from Unstructured Documents20 Apr 2026
- 2025Classical AI vs. LLMs for Decision-Maker Alignment in Health Insurance Choices7 Oct 2025
- 2025ALIGN: Prompt-based Attribute Alignment for Reliable, Responsible, and Personalized LLM-based Decision-Making11 Jul 2025
- 2025DecisionFlow: Advancing Large Language Model as Principled Decision Maker27 May 2025
- 2025ModelingAgent: Bridging LLMs and Mathematical Modeling for Real-World Challenges21 May 2025
- 2025CLASH: Evaluating Language Models on Judging High-Stakes Dilemmas from Multiple Perspectives15 Apr 2025
Similar, not cited
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- 2024Systematic Characterization of the Effectiveness of Alignment in Large Language Models for Categorical Decisions
- 2026A Human-Centric Pipeline for Aligning Large Language Models with Chinese Medical Ethics
- 2025Aligning Large Language Models with Healthcare Stakeholders: A Pathway to Trustworthy AI Integration
- 2024Aligning (Medical) LLMs for (Counterfactual) Fairness
- 2024TRIAGE: Ethical Benchmarking of AI Models Through Mass Casualty Simulations
- 2024Ensuring Safety and Trust: Analyzing the Risks of Large Language Models in Medicine
- 2025Small Language Models for Emergency Departments Decision Support: A Benchmark Study
- 2024MoralBench: Moral Evaluation of LLMs