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Authors: Nancy F. Chen ×
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01.
arXiv (CS.AI) 2026-06-17

First, do NOHARM: towards clinically safe large language models

arXiv:2512.01241v3 Announce Type: replace-cross Abstract: Large language models (LLMs) are routinely used by physicians and patients for medical advice, yet their clinical safety profiles remain poorly characterized. We present NOHARM (Numerous Options Harm Assessment for Risk in Medicine), a 1,100-task benchmark of primary care-to-specialist consultation cases to measure the frequency and severity of harm from LLM-generated medical recommendations. NOHARM covers 10 specialties, with 12,747 expert annotations for 4,249 clinical management options. Across 28 LLMs, recommendations carried the potential for severe harm in up to 22.6% of cases, with errors of omission accounting for more than 80% of severe errors. In a randomized trial of 101 generalist physicians, human benchmark performance significantly improved with AI assistance, yet physicians remained far from realizing the potential of AI tools, frequently ignoring essential advice surfaced by AI. Safety performance tracked general-intelligence and medical-knowledge benchmarks across the full range of models but decoupled at the frontier. Despite strong performance on existing evaluations, widely used AI models can produce medical advice with the potential for severe harm at non-trivial rates, highlighting the importance of explicit measurement of clinical safety.

02.
arXiv (CS.CL) 2026-06-16

From ASR to ASP: Evaluating Prompt Attack Vulnerabilities Against Open-Source LLMs

Recent studies demonstrate that Large Language Models (LLMs) are vulnerable to attacks that generate harmful or sensitive outputs. As open-source LLMs are increasingly adopted in high-impact applications such as finance, law, and healthcare, systematically investigating their security risks is becoming increasingly important towards trustworthy LLM era. This paper comprehensively studies effective prompt injection attacks against 14 widely used open-source and three closed-source LLMs on five attack benchmarks. Moreover, existing evaluation metrics mostly only consider the attack success rate, overlooking uncertainty in model responses. Our proposed Attack Success Probability (ASP) additionally captures uncertain behaviors for evaluation, where the model may initially refuse a harmful request but subsequently provide harmful guidance or vice versa, reflecting inconsistency and ambiguity in attack feasibility. By systematically analyzing the effectiveness of prompt injection attacks, we propose a straightforward and effective hypnotism attack; results show that this attack causes aligned language models, including Stablelm2, Mistral, Openchat, and Vicuna, to generate objectionable behaviors, achieving around 90% ASP. They also indicate that ignore prefix attacks can break all 14 open-source LLMs, achieving over 60% ASP on a multi-categorical dataset. We find that moderately well-known LLMs exhibit higher vulnerability to prompt injection attacks, highlighting the need to raise public awareness and prioritize efficient mitigation strategies.