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Dec 1

Addressing cognitive bias in medical language models

There is increasing interest in the application large language models (LLMs) to the medical field, in part because of their impressive performance on medical exam questions. While promising, exam questions do not reflect the complexity of real patient-doctor interactions. In reality, physicians' decisions are shaped by many complex factors, such as patient compliance, personal experience, ethical beliefs, and cognitive bias. Taking a step toward understanding this, our hypothesis posits that when LLMs are confronted with clinical questions containing cognitive biases, they will yield significantly less accurate responses compared to the same questions presented without such biases. In this study, we developed BiasMedQA, a benchmark for evaluating cognitive biases in LLMs applied to medical tasks. Using BiasMedQA we evaluated six LLMs, namely GPT-4, Mixtral-8x70B, GPT-3.5, PaLM-2, Llama 2 70B-chat, and the medically specialized PMC Llama 13B. We tested these models on 1,273 questions from the US Medical Licensing Exam (USMLE) Steps 1, 2, and 3, modified to replicate common clinically-relevant cognitive biases. Our analysis revealed varying effects for biases on these LLMs, with GPT-4 standing out for its resilience to bias, in contrast to Llama 2 70B-chat and PMC Llama 13B, which were disproportionately affected by cognitive bias. Our findings highlight the critical need for bias mitigation in the development of medical LLMs, pointing towards safer and more reliable applications in healthcare.

  • 10 authors
·
Feb 12, 2024

Explaining Large Language Models Decisions Using Shapley Values

The emergence of large language models (LLMs) has opened up exciting possibilities for simulating human behavior and cognitive processes, with potential applications in various domains, including marketing research and consumer behavior analysis. However, the validity of utilizing LLMs as stand-ins for human subjects remains uncertain due to glaring divergences that suggest fundamentally different underlying processes at play and the sensitivity of LLM responses to prompt variations. This paper presents a novel approach based on Shapley values from cooperative game theory to interpret LLM behavior and quantify the relative contribution of each prompt component to the model's output. Through two applications - a discrete choice experiment and an investigation of cognitive biases - we demonstrate how the Shapley value method can uncover what we term "token noise" effects, a phenomenon where LLM decisions are disproportionately influenced by tokens providing minimal informative content. This phenomenon raises concerns about the robustness and generalizability of insights obtained from LLMs in the context of human behavior simulation. Our model-agnostic approach extends its utility to proprietary LLMs, providing a valuable tool for practitioners and researchers to strategically optimize prompts and mitigate apparent cognitive biases. Our findings underscore the need for a more nuanced understanding of the factors driving LLM responses before relying on them as substitutes for human subjects in survey settings. We emphasize the importance of researchers reporting results conditioned on specific prompt templates and exercising caution when drawing parallels between human behavior and LLMs.

  • 1 authors
·
Mar 29, 2024

Making LLMs Reliable When It Matters Most: A Five-Layer Architecture for High-Stakes Decisions

Current large language models (LLMs) excel in verifiable domains where outputs can be checked before action but prove less reliable for high-stakes strategic decisions with uncertain outcomes. This gap, driven by mutually reinforcing cognitive biases in both humans and artificial intelligence (AI) systems, threatens the defensibility of valuations and sustainability of investments in the sector. This report describes a framework emerging from systematic qualitative assessment across 7 frontier-grade LLMs and 3 market-facing venture vignettes under time pressure. Detailed prompting specifying decision partnership and explicitly instructing avoidance of sycophancy, confabulation, solution drift, and nihilism achieved initial partnership state but failed to maintain it under operational pressure. Sustaining protective partnership state required an emergent 7-stage calibration sequence, built upon a 4-stage initialization process, within a 5-layer protection architecture enabling bias self-monitoring, human-AI adversarial challenge, partnership state verification, performance degradation detection, and stakeholder protection. Three discoveries resulted: partnership state is achievable through ordered calibration but requires emergent maintenance protocols; reliability degrades when architectural drift and context exhaustion align; and dissolution discipline prevents costly pursuit of fundamentally wrong directions. Cross-model validation revealed systematic performance differences across LLM architectures. This approach demonstrates that human-AI teams can achieve cognitive partnership capable of preventing avoidable regret in high-stakes decisions, addressing return-on-investment expectations that depend on AI systems supporting consequential decision-making without introducing preventable cognitive traps when verification arrives too late.

  • 1 authors
·
Nov 10

Human Decision-making is Susceptible to AI-driven Manipulation

Artificial Intelligence (AI) systems are increasingly intertwined with daily life, assisting users in executing various tasks and providing guidance on decision-making. This integration introduces risks of AI-driven manipulation, where such systems may exploit users' cognitive biases and emotional vulnerabilities to steer them toward harmful outcomes. Through a randomized controlled trial with 233 participants, we examined human susceptibility to such manipulation in financial (e.g., purchases) and emotional (e.g., conflict resolution) decision-making contexts. Participants interacted with one of three AI agents: a neutral agent (NA) optimizing for user benefit without explicit influence, a manipulative agent (MA) designed to covertly influence beliefs and behaviors, or a strategy-enhanced manipulative agent (SEMA) employing explicit psychological tactics to reach its hidden objectives. By analyzing participants' decision patterns and shifts in their preference ratings post-interaction, we found significant susceptibility to AI-driven manipulation. Particularly, across both decision-making domains, participants interacting with the manipulative agents shifted toward harmful options at substantially higher rates (financial, MA: 62.3%, SEMA: 59.6%; emotional, MA: 42.3%, SEMA: 41.5%) compared to the NA group (financial, 35.8%; emotional, 12.8%). Notably, our findings reveal that even subtle manipulative objectives (MA) can be as effective as employing explicit psychological strategies (SEMA) in swaying human decision-making. By revealing the potential for covert AI influence, this study highlights a critical vulnerability in human-AI interactions, emphasizing the need for ethical safeguards and regulatory frameworks to ensure responsible deployment of AI technologies and protect human autonomy.

  • 16 authors
·
Feb 11

DR.BENCH: Diagnostic Reasoning Benchmark for Clinical Natural Language Processing

The meaningful use of electronic health records (EHR) continues to progress in the digital era with clinical decision support systems augmented by artificial intelligence. A priority in improving provider experience is to overcome information overload and reduce the cognitive burden so fewer medical errors and cognitive biases are introduced during patient care. One major type of medical error is diagnostic error due to systematic or predictable errors in judgment that rely on heuristics. The potential for clinical natural language processing (cNLP) to model diagnostic reasoning in humans with forward reasoning from data to diagnosis and potentially reduce the cognitive burden and medical error has not been investigated. Existing tasks to advance the science in cNLP have largely focused on information extraction and named entity recognition through classification tasks. We introduce a novel suite of tasks coined as Diagnostic Reasoning Benchmarks, DR.BENCH, as a new benchmark for developing and evaluating cNLP models with clinical diagnostic reasoning ability. The suite includes six tasks from ten publicly available datasets addressing clinical text understanding, medical knowledge reasoning, and diagnosis generation. DR.BENCH is the first clinical suite of tasks designed to be a natural language generation framework to evaluate pre-trained language models. Experiments with state-of-the-art pre-trained generative language models using large general domain models and models that were continually trained on a medical corpus demonstrate opportunities for improvement when evaluated in DR. BENCH. We share DR. BENCH as a publicly available GitLab repository with a systematic approach to load and evaluate models for the cNLP community.

  • 7 authors
·
Sep 29, 2022

AgentClinic: a multimodal agent benchmark to evaluate AI in simulated clinical environments

Diagnosing and managing a patient is a complex, sequential decision making process that requires physicians to obtain information -- such as which tests to perform -- and to act upon it. Recent advances in artificial intelligence (AI) and large language models (LLMs) promise to profoundly impact clinical care. However, current evaluation schemes overrely on static medical question-answering benchmarks, falling short on interactive decision-making that is required in real-life clinical work. Here, we present AgentClinic: a multimodal benchmark to evaluate LLMs in their ability to operate as agents in simulated clinical environments. In our benchmark, the doctor agent must uncover the patient's diagnosis through dialogue and active data collection. We present two open medical agent benchmarks: a multimodal image and dialogue environment, AgentClinic-NEJM, and a dialogue-only environment, AgentClinic-MedQA. We embed cognitive and implicit biases both in patient and doctor agents to emulate realistic interactions between biased agents. We find that introducing bias leads to large reductions in diagnostic accuracy of the doctor agents, as well as reduced compliance, confidence, and follow-up consultation willingness in patient agents. Evaluating a suite of state-of-the-art LLMs, we find that several models that excel in benchmarks like MedQA are performing poorly in AgentClinic-MedQA. We find that the LLM used in the patient agent is an important factor for performance in the AgentClinic benchmark. We show that both having limited interactions as well as too many interaction reduces diagnostic accuracy in doctor agents. The code and data for this work is publicly available at https://AgentClinic.github.io.

  • 6 authors
·
May 13, 2024

Automatically Detecting Online Deceptive Patterns

Deceptive patterns in digital interfaces manipulate users into making unintended decisions, exploiting cognitive biases and psychological vulnerabilities. These patterns have become ubiquitous on various digital platforms. While efforts to mitigate deceptive patterns have emerged from legal and technical perspectives, a significant gap remains in creating usable and scalable solutions. We introduce our AutoBot framework to address this gap and help web stakeholders navigate and mitigate online deceptive patterns. AutoBot accurately identifies and localizes deceptive patterns from a screenshot of a website without relying on the underlying HTML code. AutoBot employs a two-stage pipeline that leverages the capabilities of specialized vision models to analyze website screenshots, identify interactive elements, and extract textual features. Next, using a large language model, AutoBot understands the context surrounding these elements to determine the presence of deceptive patterns. We also use AutoBot, to create a synthetic dataset to distill knowledge from 'teacher' LLMs to smaller language models. Through extensive evaluation, we demonstrate AutoBot's effectiveness in detecting deceptive patterns on the web, achieving an F1-score of 0.93 when detecting deceptive patterns, underscoring its potential as an essential tool for mitigating online deceptive patterns. We implement AutoBot, across three downstream applications targeting different web stakeholders: (1) a local browser extension providing users with real-time feedback, (2) a Lighthouse audit to inform developers of potential deceptive patterns on their sites, and (3) as a measurement tool designed for researchers and regulators.

  • 5 authors
·
Nov 11, 2024

In Search of the Long-Tail: Systematic Generation of Long-Tail Knowledge via Logical Rule Guided Search

Since large language models have approached human-level performance on many tasks, it has become increasingly harder for researchers to find tasks that are still challenging to the models. Failure cases usually come from the long-tail distribution - data that an oracle language model could assign a probability on the lower end of its distribution. Current methodology such as prompt engineering or crowdsourcing are insufficient for creating long-tail examples because humans are constrained by cognitive bias. We propose a Logic-Induced-Knowledge-Search (LINK) framework for systematically generating long-tail knowledge statements. Grounded by a symbolic rule, we search for long-tail values for each variable of the rule by first prompting a LLM, then verifying the correctness of the values with a critic, and lastly pushing for the long-tail distribution with a reranker. With this framework we construct a dataset, Logic-Induced-Long-Tail (LINT), consisting of 200 symbolic rules and 50K knowledge statements spanning across four domains. Human annotations find that 84% of the statements in LINT are factually correct. In contrast, ChatGPT and GPT4 struggle with directly generating long-tail statements under the guidance of logic rules, each only getting 56% and 78% of their statements correct. Moreover, their "long-tail" generations in fact fall into the higher likelihood range, and thus are not really long-tail. Our findings suggest that LINK is effective for generating data in the long-tail distribution while enforcing quality. LINT can be useful for systematically evaluating LLMs' capabilities in the long-tail distribution. We challenge the models with a simple entailment classification task using samples from LINT. We find that ChatGPT and GPT4's capability in identifying incorrect knowledge drop by ~3% in the long-tail distribution compared to head distribution.

  • 10 authors
·
Nov 13, 2023

Beyond Benchmarks: Dynamic, Automatic And Systematic Red-Teaming Agents For Trustworthy Medical Language Models

Ensuring the safety and reliability of large language models (LLMs) in clinical practice is critical to prevent patient harm and promote trustworthy healthcare applications of AI. However, LLMs are advancing so rapidly that static safety benchmarks often become obsolete upon publication, yielding only an incomplete and sometimes misleading picture of model trustworthiness. We demonstrate that a Dynamic, Automatic, and Systematic (DAS) red-teaming framework that continuously stress-tests LLMs can reveal significant weaknesses of current LLMs across four safety-critical domains: robustness, privacy, bias/fairness, and hallucination. A suite of adversarial agents is applied to autonomously mutate test cases, identify/evolve unsafe-triggering strategies, and evaluate responses, uncovering vulnerabilities in real time without human intervention. Applying DAS to 15 proprietary and open-source LLMs revealed a stark contrast between static benchmark performance and vulnerability under adversarial pressure. Despite a median MedQA accuracy exceeding 80\%, 94\% of previously correct answers failed our dynamic robustness tests. We observed similarly high failure rates across other domains: privacy leaks were elicited in 86\% of scenarios, cognitive-bias priming altered clinical recommendations in 81\% of fairness tests, and we identified hallucination rates exceeding 66\% in widely used models. Such profound residual risks are incompatible with routine clinical practice. By converting red-teaming from a static checklist into a dynamic stress-test audit, DAS red-teaming offers the surveillance that hospitals/regulators/technology vendors require as LLMs become embedded in patient chatbots, decision-support dashboards, and broader healthcare workflows. Our framework delivers an evolvable, scalable, and reliable safeguard for the next generation of medical AI.

  • 21 authors
·
Jul 30

Language Models And A Second Opinion Use Case: The Pocket Professional

This research tests the role of Large Language Models (LLMs) as formal second opinion tools in professional decision-making, particularly focusing on complex medical cases where even experienced physicians seek peer consultation. The work analyzed 183 challenging medical cases from Medscape over a 20-month period, testing multiple LLMs' performance against crowd-sourced physician responses. A key finding was the high overall score possible in the latest foundational models (>80% accuracy compared to consensus opinion), which exceeds most human metrics reported on the same clinical cases (450 pages of patient profiles, test results). The study rates the LLMs' performance disparity between straightforward cases (>81% accuracy) and complex scenarios (43% accuracy), particularly in these cases generating substantial debate among human physicians. The research demonstrates that LLMs may be valuable as generators of comprehensive differential diagnoses rather than as primary diagnostic tools, potentially helping to counter cognitive biases in clinical decision-making, reduce cognitive loads, and thus remove some sources of medical error. The inclusion of a second comparative legal dataset (Supreme Court cases, N=21) provides added empirical context to the AI use to foster second opinions, though these legal challenges proved considerably easier for LLMs to analyze. In addition to the original contributions of empirical evidence for LLM accuracy, the research aggregated a novel benchmark for others to score highly contested question and answer reliability between both LLMs and disagreeing human practitioners. These results suggest that the optimal deployment of LLMs in professional settings may differ substantially from current approaches that emphasize automation of routine tasks.

  • 1 authors
·
Oct 27, 2024 2

MOSSBench: Is Your Multimodal Language Model Oversensitive to Safe Queries?

Humans are prone to cognitive distortions -- biased thinking patterns that lead to exaggerated responses to specific stimuli, albeit in very different contexts. This paper demonstrates that advanced Multimodal Large Language Models (MLLMs) exhibit similar tendencies. While these models are designed to respond queries under safety mechanism, they sometimes reject harmless queries in the presence of certain visual stimuli, disregarding the benign nature of their contexts. As the initial step in investigating this behavior, we identify three types of stimuli that trigger the oversensitivity of existing MLLMs: Exaggerated Risk, Negated Harm, and Counterintuitive Interpretation. To systematically evaluate MLLMs' oversensitivity to these stimuli, we propose the Multimodal OverSenSitivity Benchmark (MOSSBench). This toolkit consists of 300 manually collected benign multimodal queries, cross-verified by third-party reviewers (AMT). Empirical studies using MOSSBench on 20 MLLMs reveal several insights: (1). Oversensitivity is prevalent among SOTA MLLMs, with refusal rates reaching up to 76% for harmless queries. (2). Safer models are more oversensitive: increasing safety may inadvertently raise caution and conservatism in the model's responses. (3). Different types of stimuli tend to cause errors at specific stages -- perception, intent reasoning, and safety judgement -- in the response process of MLLMs. These findings highlight the need for refined safety mechanisms that balance caution with contextually appropriate responses, improving the reliability of MLLMs in real-world applications. We make our project available at https://turningpoint-ai.github.io/MOSSBench/.

  • 6 authors
·
Jun 22, 2024

Evaluating Implicit Bias in Large Language Models by Attacking From a Psychometric Perspective

As large language models (LLMs) become an important way of information access, there have been increasing concerns that LLMs may intensify the spread of unethical content, including implicit bias that hurts certain populations without explicit harmful words. In this paper, we conduct a rigorous evaluation of LLMs' implicit bias towards certain demographics by attacking them from a psychometric perspective to elicit agreements to biased viewpoints. Inspired by psychometric principles in cognitive and social psychology, we propose three attack approaches, i.e., Disguise, Deception, and Teaching. Incorporating the corresponding attack instructions, we built two benchmarks: (1) a bilingual dataset with biased statements covering four bias types (2.7K instances) for extensive comparative analysis, and (2) BUMBLE, a larger benchmark spanning nine common bias types (12.7K instances) for comprehensive evaluation. Extensive evaluation of popular commercial and open-source LLMs shows that our methods can elicit LLMs' inner bias more effectively than competitive baselines. Our attack methodology and benchmarks offer an effective means of assessing the ethical risks of LLMs, driving progress toward greater accountability in their development. Our code, data and benchmarks are available at https://github.com/yuchenwen1/ImplicitBiasPsychometricEvaluation and https://github.com/yuchenwen1/BUMBLE.

  • 5 authors
·
Jun 20, 2024

It's All Connected: A Journey Through Test-Time Memorization, Attentional Bias, Retention, and Online Optimization

Designing efficient and effective architectural backbones has been in the core of research efforts to enhance the capability of foundation models. Inspired by the human cognitive phenomenon of attentional bias-the natural tendency to prioritize certain events or stimuli-we reconceptualize neural architectures, including Transformers, Titans, and modern linear recurrent neural networks as associative memory modules that learn a mapping of keys and values using an internal objective, referred to as attentional bias. Surprisingly, we observed that most existing sequence models leverage either (1) dot-product similarity, or (2) L2 regression objectives as their attentional bias. Going beyond these objectives, we present a set of alternative attentional bias configurations along with their effective approximations to stabilize their training procedure. We then reinterpret forgetting mechanisms in modern deep learning architectures as a form of retention regularization, providing a novel set of forget gates for sequence models. Building upon these insights, we present Miras, a general framework to design deep learning architectures based on four choices of: (i) associative memory architecture, (ii) attentional bias objective, (iii) retention gate, and (iv) memory learning algorithm. We present three novel sequence models-Moneta, Yaad, and Memora-that go beyond the power of existing linear RNNs while maintaining a fast parallelizable training process. Our experiments show different design choices in Miras yield models with varying strengths. For example, certain instances of Miras achieve exceptional performance in special tasks such as language modeling, commonsense reasoning, and recall intensive tasks, even outperforming Transformers and other modern linear recurrent models.

  • 4 authors
·
Apr 17 4

When Can We Trust LLMs in Mental Health? Large-Scale Benchmarks for Reliable LLM Evaluation

Evaluating Large Language Models (LLMs) for mental health support is challenging due to the emotionally and cognitively complex nature of therapeutic dialogue. Existing benchmarks are limited in scale, reliability, often relying on synthetic or social media data, and lack frameworks to assess when automated judges can be trusted. To address the need for large-scale dialogue datasets and judge reliability assessment, we introduce two benchmarks that provide a framework for generation and evaluation. MentalBench-100k consolidates 10,000 one-turn conversations from three real scenarios datasets, each paired with nine LLM-generated responses, yielding 100,000 response pairs. MentalAlign-70k}reframes evaluation by comparing four high-performing LLM judges with human experts across 70,000 ratings on seven attributes, grouped into Cognitive Support Score (CSS) and Affective Resonance Score (ARS). We then employ the Affective Cognitive Agreement Framework, a statistical methodology using intraclass correlation coefficients (ICC) with confidence intervals to quantify agreement, consistency, and bias between LLM judges and human experts. Our analysis reveals systematic inflation by LLM judges, strong reliability for cognitive attributes such as guidance and informativeness, reduced precision for empathy, and some unreliability in safety and relevance. Our contributions establish new methodological and empirical foundations for reliable, large-scale evaluation of LLMs in mental health. We release the benchmarks and codes at: https://github.com/abeerbadawi/MentalBench/

  • 9 authors
·
Oct 21

K-HATERS: A Hate Speech Detection Corpus in Korean with Target-Specific Ratings

Numerous datasets have been proposed to combat the spread of online hate. Despite these efforts, a majority of these resources are English-centric, primarily focusing on overt forms of hate. This research gap calls for developing high-quality corpora in diverse languages that also encapsulate more subtle hate expressions. This study introduces K-HATERS, a new corpus for hate speech detection in Korean, comprising approximately 192K news comments with target-specific offensiveness ratings. This resource is the largest offensive language corpus in Korean and is the first to offer target-specific ratings on a three-point Likert scale, enabling the detection of hate expressions in Korean across varying degrees of offensiveness. We conduct experiments showing the effectiveness of the proposed corpus, including a comparison with existing datasets. Additionally, to address potential noise and bias in human annotations, we explore a novel idea of adopting the Cognitive Reflection Test, which is widely used in social science for assessing an individual's cognitive ability, as a proxy of labeling quality. Findings indicate that annotations from individuals with the lowest test scores tend to yield detection models that make biased predictions toward specific target groups and are less accurate. This study contributes to the NLP research on hate speech detection and resource construction. The code and dataset can be accessed at https://github.com/ssu-humane/K-HATERS.

  • 4 authors
·
Oct 23, 2023

Verbalized Sampling: How to Mitigate Mode Collapse and Unlock LLM Diversity

Post-training alignment often reduces LLM diversity, leading to a phenomenon known as mode collapse. Unlike prior work that attributes this effect to algorithmic limitations, we identify a fundamental, pervasive data-level driver: typicality bias in preference data, whereby annotators systematically favor familiar text as a result of well-established findings in cognitive psychology. We formalize this bias theoretically, verify it on preference datasets empirically, and show that it plays a central role in mode collapse. Motivated by this analysis, we introduce Verbalized Sampling, a simple, training-free prompting strategy to circumvent mode collapse. VS prompts the model to verbalize a probability distribution over a set of responses (e.g., ``Generate 5 jokes about coffee and their corresponding probabilities''). Comprehensive experiments show that VS significantly improves performance across creative writing (poems, stories, jokes), dialogue simulation, open-ended QA, and synthetic data generation, without sacrificing factual accuracy and safety. For instance, in creative writing, VS increases diversity by 1.6-2.1x over direct prompting. We further observe an emergent trend that more capable models benefit more from VS. In sum, our work provides a new data-centric perspective on mode collapse and a practical inference-time remedy that helps unlock pre-trained generative diversity.

stanfordnlp Stanford NLP
·
Oct 1 3

On The Role of Pretrained Language Models in General-Purpose Text Embeddings: A Survey

Text embeddings have attracted growing interest due to their effectiveness across a wide range of natural language processing (NLP) tasks, such as retrieval, classification, clustering, bitext mining, and summarization. With the emergence of pretrained language models (PLMs), general-purpose text embeddings (GPTE) have gained significant traction for their ability to produce rich, transferable representations. The general architecture of GPTE typically leverages PLMs to derive dense text representations, which are then optimized through contrastive learning on large-scale pairwise datasets. In this survey, we provide a comprehensive overview of GPTE in the era of PLMs, focusing on the roles PLMs play in driving its development. We first examine the fundamental architecture and describe the basic roles of PLMs in GPTE, i.e., embedding extraction, expressivity enhancement, training strategies, learning objectives, and data construction. Then, we describe advanced roles enabled by PLMs, such as multilingual support, multimodal integration, code understanding, and scenario-specific adaptation. Finally, we highlight potential future research directions that move beyond traditional improvement goals, including ranking integration, safety considerations, bias mitigation, structural information incorporation, and the cognitive extension of embeddings. This survey aims to serve as a valuable reference for both newcomers and established researchers seeking to understand the current state and future potential of GPTE.

  • 6 authors
·
Jul 28