# Same Facts, Different Updates: Inference Setup Shapes LLM Behavior in Medical Allocation

arXiv: https://arxiv.org/abs/2608.18108 · HTML: https://mlsanity.com/paper/2608.18108/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 25 of its 32 references that are in the map.
- First posted on arXiv 10 Jun 2026.

## Builds on (most cited first, 25 of 25)

- [Training language models to follow instructions with human feedback](https://mlsanity.com/paper/2203.02155/) (2022)
- [Retrieval-Augmented Generation for Knowledge-Intensive NLP Tasks](https://mlsanity.com/paper/2005.11401/) (2020)
- [Judging LLM-as-a-Judge with MT-Bench and Chatbot Arena](https://mlsanity.com/paper/2306.05685/) (2023)
- [Lost in the Middle: How Language Models Use Long Contexts](https://mlsanity.com/paper/2307.03172/) (2023)
- [Rethinking the Role of Demonstrations: What Makes In-Context Learning Work?](https://mlsanity.com/paper/2202.12837/) (2022)
- [Fantastically Ordered Prompts and Where to Find Them: Overcoming Few-Shot Prompt Order Sensitivity](https://mlsanity.com/paper/2104.08786/) (2021)
- [Language Models Don't Always Say What They Think: Unfaithful Explanations in Chain-of-Thought Prompting](https://mlsanity.com/paper/2305.04388/) (2023)
- [Towards Understanding Sycophancy in Language Models](https://mlsanity.com/paper/2310.13548/) (2023)
- [Language (Technology) is Power: A Critical Survey of "Bias" in NLP](https://mlsanity.com/paper/2005.14050/) (2020)
- [StereoSet: Measuring stereotypical bias in pretrained language models](https://mlsanity.com/paper/2004.09456/) (2020)
- [Large Language Models Can Be Easily Distracted by Irrelevant Context](https://mlsanity.com/paper/2302.00093/) (2023)
- [Quantifying Language Models' Sensitivity to Spurious Features in Prompt Design or: How I learned to start worrying about prompt formatting](https://mlsanity.com/paper/2310.11324/) (2023)
- [Open Problems and Fundamental Limitations of Reinforcement Learning from Human Feedback](https://mlsanity.com/paper/2307.15217/) (2023)
- [CrowS-Pairs: A Challenge Dataset for Measuring Social Biases in Masked Language Models](https://mlsanity.com/paper/2010.00133/) (2020)
- [Bias and Fairness in Large Language Models: A Survey](https://mlsanity.com/paper/2309.00770/) (2023)
- [Large Language Models Are Not Robust Multiple Choice Selectors](https://mlsanity.com/paper/2309.03882/) (2023)
- [State of What Art? A Call for Multi-Prompt LLM Evaluation](https://mlsanity.com/paper/2401.00595/) (2023)
- [Large Language Models Sensitivity to The Order of Options in Multiple-Choice Questions](https://mlsanity.com/paper/2308.11483/) (2023)
- [ProSA: Assessing and Understanding the Prompt Sensitivity of LLMs](https://mlsanity.com/paper/2410.12405/) (2024)
- [MT-Eval: A Multi-Turn Capabilities Evaluation Benchmark for Large Language Models](https://mlsanity.com/paper/2401.16745/) (2024)
- [Large Language Models to Identify Social Determinants of Health in Electronic Health Records](https://mlsanity.com/paper/2308.06354/) (2023)
- [Unmasking and Quantifying Racial Bias of Large Language Models in Medical Report Generation](https://mlsanity.com/paper/2401.13867/) (2024)
- [Better than Average: Paired Evaluation of NLP Systems](https://mlsanity.com/paper/2110.10746/) (2021)
- [Inherited Goal Drift: Contextual Pressure Can Undermine Agentic Goals](https://mlsanity.com/paper/2603.03258/) (2026)
- [Asymmetric Goal Drift in Coding Agents Under Value Conflict](https://mlsanity.com/paper/2603.03456/) (2026)

## Abstract (arXiv)

Large language models are being incorporated into sensitive and important decision-making processes across nearly all fields. While prior work studies model bias around inputs and scenario framing, models can also behave in unexpected and undesirable ways due to context accumulated over their deployment. In this work, we study a medical example in which a model is asked to assign resource-allocation probabilities to two people given brief clinical context, and then sees the same scenario with a single extra sentence containing contrasting patient information, either with or without its previous response in context. Across three of four tested models, the paired-context and independent-inference experiments have different probability shifts, often in opposite directions (in favor of Person B vs. in favor of Person A) when new information is provided. We include additional paired-context experiments to show the effect of varying attributes across scenario axes. Our findings show the context-dependent effect of patient information in a sensitive medical use case. More broadly, our work shows the importance of carefully incorporating LLM-based systems into decision-making processes, context engineering, and further model behavioral studies.