# Reliability Testing of Medical Model Performance under Distributed Deployment

arXiv: https://arxiv.org/abs/2609.36525 · HTML: https://mlsanity.com/paper/2609.36525/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 33 of its 58 references that are in the map.
- First posted on arXiv 29 Sep 2026.

## Builds on (most cited first, 30 of 33)

- [BERT: Pre-training of Deep Bidirectional Transformers for Language Understanding](https://mlsanity.com/paper/1810.04805/) (2018)
- [Learning Transferable Visual Models From Natural Language Supervision](https://mlsanity.com/paper/2103.00020/) (2021)
- [LLaMA: Open and Efficient Foundation Language Models](https://mlsanity.com/paper/2302.13971/) (2023)
- [Judging LLM-as-a-Judge with MT-Bench and Chatbot Arena](https://mlsanity.com/paper/2306.05685/) (2023)
- [Efficient Memory Management for Large Language Model Serving with PagedAttention](https://mlsanity.com/paper/2309.06180/) (2023)
- [FlashAttention: Fast and Memory-Efficient Exact Attention with IO-Awareness](https://mlsanity.com/paper/2205.14135/) (2022)
- [FlashAttention-2: Faster Attention with Better Parallelism and Work Partitioning](https://mlsanity.com/paper/2307.08691/) (2023)
- [BioBERT: a pre-trained biomedical language representation model for biomedical text mining](https://mlsanity.com/paper/1901.08746/) (2019)
- [Megatron-LM: Training Multi-Billion Parameter Language Models Using Model Parallelism](https://mlsanity.com/paper/1909.08053/) (2019)
- [Large Language Models Encode Clinical Knowledge](https://mlsanity.com/paper/2212.13138/) (2022)
- [Jailbroken: How Does LLM Safety Training Fail?](https://mlsanity.com/paper/2307.02483/) (2023)
- [LLaVA-Med: Training a Large Language-and-Vision Assistant for Biomedicine in One Day](https://mlsanity.com/paper/2306.00890/) (2023)
- [ZeRO: Memory Optimizations Toward Training Trillion Parameter Models](https://mlsanity.com/paper/1910.02054/) (2019)
- [PubMedQA: A Dataset for Biomedical Research Question Answering](https://mlsanity.com/paper/1909.06146/) (2019)
- [Mixed Precision Training](https://mlsanity.com/paper/1710.03740/) (2017)
- [Publicly Available Clinical BERT Embeddings](https://mlsanity.com/paper/1904.03323/) (2019)
- [Universal Adversarial Triggers for Attacking and Analyzing NLP](https://mlsanity.com/paper/1908.07125/) (2019)
- [BioGPT: Generative Pre-trained Transformer for Biomedical Text Generation and Mining](https://mlsanity.com/paper/2210.10341/) (2022)
- [DeepSpeed Inference: Enabling Efficient Inference of Transformer Models at Unprecedented Scale](https://mlsanity.com/paper/2207.00032/) (2022)
- [DeepXplore: Automated Whitebox Testing of Deep Learning Systems](https://mlsanity.com/paper/1705.06640/) (2017)
- [A Question-Entailment Approach to Question Answering](https://mlsanity.com/paper/1901.08079/) (2019)
- [HuatuoGPT-II, One-stage Training for Medical Adaption of LLMs](https://mlsanity.com/paper/2311.09774/) (2023)
- [Taxonomy of Real Faults in Deep Learning Systems](https://mlsanity.com/paper/1910.11015/) (2019)
- [TensorFuzz: Debugging Neural Networks with Coverage-Guided Fuzzing](https://mlsanity.com/paper/1807.10875/) (2018)
- [DeepMutation: Mutation Testing of Deep Learning Systems](https://mlsanity.com/paper/1805.05206/) (2018)
- [DLFuzz: Differential Fuzzing Testing of Deep Learning Systems](https://mlsanity.com/paper/1808.09413/) (2018)
- [ROCOv2: Radiology Objects in COntext Version 2, an Updated Multimodal Image Dataset](https://mlsanity.com/paper/2405.10004/) (2024)
- [An Empirical Study towards Characterizing Deep Learning Development and Deployment across Different Frameworks and Platforms](https://mlsanity.com/paper/1909.06727/) (2019)
- [Identifying Implementation Bugs in Machine Learning based Image Classifiers using Metamorphic Testing](https://mlsanity.com/paper/1808.05353/) (2018)
- [Your Compiler is Backdooring Your Model: Understanding and Exploiting Compilation Inconsistency Vulnerabilities in Deep Learning Compilers](https://mlsanity.com/paper/2509.11173/) (2025)

## Abstract (arXiv)

Distributed inference has become an indispensable part of deploying medical models under practical latency, memory, and throughput constraints. Although modern frameworks improve serving efficiency through tensor parallelism, mixed precision, kernel fusion, and multi-device communication, they are generally assumed to preserve the behavior observed during centralized HuggingFace evaluation. This assumption creates an evaluation-deployment mismatch: a model may pass offline evaluation but produce a different output after the execution stack changes. To address this mismatch, we propose a testing framework and an improved, distributed-execution-sensitive medical-model benchmark that evaluates the same checkpoint and input under a centralized HuggingFace reference and matched distributed deployments. Extensive experiments across language, vision, and multimodal medical models show that execution changes can produce measurable output disagreements. Across supported visual settings, the test success rate ranges from 0.21 to 0.43 for single-modality models and from 0.32 to 0.98 for multimodal models. The benchmark is aimed at extending medical-model evaluation from capability and security to evaluation-deployment consistency.