mlsanityData to 7 Oct 2026

Evaluating medical AI under missing information: same-provider judges and human raters change apparent safety

arXiv 2607.18828 ↗First posted 21 Jul 2026cs.AIcited by 0

Not on the map. Why?

Abstract (arXiv)

Readiness stress-testing of medical AI has focused on closed-ended and multimodal benchmarks. We extend it to open-ended clinical conversation under missing information, where safe behavior means recognizing absent information and qualifying, clarifying, or not over-committing - and where the evaluator becomes part of the measurement. We stress-test four models - three flagships (Claude Opus 4.8, GPT-5.5, Grok 4.3) and one mid-tier model (Gemini 3.5 Flash) - by deleting the latter half of the final user turn in HealthBench conversations, grading responses with a four-provider LLM-judge panel and a blinded clinician-anchored reference. Two evaluator-facing results are robust. First, judge choice materially changes apparent safety: inter-judge agreement is only moderate (Fleiss' kappa = 0.65), and after adjusting for each judge's general leniency (vote-level logistic regression), a positive same-provider association remains (exact permutation p = 0.04; GPT-5.5 ~ +0.10 on the probability scale) - large enough to change which model appears to over-commit least once its own-provider judge is excluded. Second, LLM judges are more permissive than clinicians on a blinded 50-item subsample: all four are significantly more lenient than the stricter independent clinician (crediting appropriate uncertainty on 66-84% of items vs 52%), and three of four than the author-influenced consensus (Grok directional only; judge-vs-consensus kappa = 0.20-0.43). On the author-audited clinical-underdetermined subset the permissiveness gap widened and the point-estimate model ordering held. A closed-ended MedQA anchor confirms accuracy is high and option-order effects are within a +/-5-point equivalence region for three of four models, so the safety gap is about calibration, not knowledge. We release the harness, prompts, per-item outputs, judge panel, perturbation audit, and human-annotation protocol.

Key facts. No citing papers in the map yet (data through 7 Oct 2026). Builds on 13 of its 22 references that are in the map. First posted on arXiv 21 Jul 2026.

Builds on

13 of 22 references.

References · 13

  1. 2023Judging LLM-as-a-Judge with MT-Bench and Chatbot Arenacited by 8,393
  2. 2022Large Language Models Encode Clinical Knowledgecited by 1,807
  3. 2022Language Models (Mostly) Know What They Knowcited by 1,783
  4. 2020What Disease does this Patient Have? A Large-scale Open Domain Question Answering Dataset from Medical Examscited by 1,324
  5. 2024LLM Evaluators Recognize and Favor Their Own Generationscited by 651
  6. 2023Large Language Models Are Not Robust Multiple Choice Selectorscited by 454
  7. 2025HealthBench: Evaluating Large Language Models Towards Improved Human Healthcited by 385
  8. 2023Large Language Models Sensitivity to The Order of Options in Multiple-Choice Questionscited by 249
  9. 2024Self-Preference Bias in LLM-as-a-Judgecited by 248
  10. 2024Uncertainty-Based Abstention in LLMs Improves Safety and Reduces Hallucinationscited by 51
  11. 2025Addressing Benchmarking Gaps in Large Language Models for Health and Medicine with Dynamic Red-Teamingcited by 10
  12. 2026Self-Preference Bias in Rubric-Based Evaluation of Large Language Modelscited by 9
1 more
  1. 2026Evaluating Large Language Model Raters for German Open-Response Clinical Questions: A Physician-Annotated Benchmark Study of Agreement, Evaluator Bias, and Abstentioncited by 2

Built on by

Not cited yet.