new

Get trending papers in your email inbox!

Subscribe

Daily Papers

byAK and the research community

Apr 21

MediQ: Question-Asking LLMs and a Benchmark for Reliable Interactive Clinical Reasoning

Users typically engage with LLMs interactively, yet most existing benchmarks evaluate them in a static, single-turn format, posing reliability concerns in interactive scenarios. We identify a key obstacle towards reliability: LLMs are trained to answer any question, even with incomplete context or insufficient knowledge. In this paper, we propose to change the static paradigm to an interactive one, develop systems that proactively ask questions to gather more information and respond reliably, and introduce an benchmark - MediQ - to evaluate question-asking ability in LLMs. MediQ simulates clinical interactions consisting of a Patient System and an adaptive Expert System; with potentially incomplete initial information, the Expert refrains from making diagnostic decisions when unconfident, and instead elicits missing details via follow-up questions. We provide a pipeline to convert single-turn medical benchmarks into an interactive format. Our results show that directly prompting state-of-the-art LLMs to ask questions degrades performance, indicating that adapting LLMs to proactive information-seeking settings is nontrivial. We experiment with abstention strategies to better estimate model confidence and decide when to ask questions, improving diagnostic accuracy by 22.3%; however, performance still lags compared to an (unrealistic in practice) upper bound with complete information upfront. Further analyses show improved interactive performance with filtering irrelevant contexts and reformatting conversations. Overall, we introduce a novel problem towards LLM reliability, an interactive MediQ benchmark and a novel question-asking system, and highlight directions to extend LLMs' information-seeking abilities in critical domains.

  • 7 authors
·
Jun 2, 2024

Do LLMs Know When to NOT Answer? Investigating Abstention Abilities of Large Language Models

Abstention Ability (AA) is a critical aspect of Large Language Model (LLM) reliability, referring to an LLM's capability to withhold responses when uncertain or lacking a definitive answer, without compromising performance. Although previous studies have attempted to improve AA, they lack a standardised evaluation method and remain unsuitable for black-box models where token prediction probabilities are inaccessible. This makes comparative analysis challenging, especially for state-of-the-art closed-source commercial LLMs. This paper bridges this gap by introducing a black-box evaluation approach and a new dataset, Abstain-QA, crafted to rigorously assess AA across varied question types (answerable and unanswerable), domains (well-represented and under-represented), and task types (fact centric and reasoning). We also propose a new confusion matrix, the ''Answerable-Unanswerable Confusion Matrix'' (AUCM) which serves as the basis for evaluating AA, by offering a structured and precise approach for assessment. Finally, we explore the impact of three prompting strategies-Strict Prompting, Verbal Confidence Thresholding, and Chain-of-Thought (CoT)-on improving AA. Our results indicate that even powerful models like GPT-4, Mixtral 8x22b encounter difficulties with abstention; however, strategic approaches such as Strict prompting and CoT can enhance this capability.

  • 4 authors
·
Jul 23, 2024

Pay-Per-Search Models are Abstention Models

LLMs cannot reliably recognize their parametric knowledge boundaries and often hallucinate answers to outside-of-boundary questions. In contrast, humans recognize their limitations and can either seek external help for such questions or abstain. In this paper, we introduce MASH (Modeling Abstention via Selective Help-seeking), a training framework that readily extracts abstentions from LLMs. Our key idea is that any external help-seeking by an LLM, i.e. search tool use, can serve as a proxy for abstention if the external help (search) is appropriately penalized while simultaneously rewarding answer accuracy. MASH operationalizes this idea using reinforcement learning with a pay-per-search reward. We run experiments on three knowledge-intensive QA datasets. Our results show that MASH substantially improves upon the selective help-seeking performance of prior efficient search approaches; on multi-hop datasets, MASH improves answer accuracy by 7.6%. Furthermore, MASH demonstrates strong off-the-shelf abstention -- it can distinguish between unanswerable/answerable questions and selectively generate responses for answerable questions -- showcasing behavior analogous to specialized abstention approaches. We emphasize that contrary to prior abstention methods, MASH does not require pre-determining knowledge boundaries to construct training data. Instead, MASH's abstentions are a by-product of training for the auxiliary selective help-seeking task. Overall, we show that MASH training effectively aligns search tool use with parametric knowledge, which can be successfully leveraged for making abstention decisions.

cornell Cornell University
·
Oct 1, 2025 2

Certifiers Make Neural Networks Vulnerable to Availability Attacks

To achieve reliable, robust, and safe AI systems, it is vital to implement fallback strategies when AI predictions cannot be trusted. Certifiers for neural networks are a reliable way to check the robustness of these predictions. They guarantee for some predictions that a certain class of manipulations or attacks could not have changed the outcome. For the remaining predictions without guarantees, the method abstains from making a prediction, and a fallback strategy needs to be invoked, which typically incurs additional costs, can require a human operator, or even fail to provide any prediction. While this is a key concept towards safe and secure AI, we show for the first time that this approach comes with its own security risks, as such fallback strategies can be deliberately triggered by an adversary. In addition to naturally occurring abstains for some inputs and perturbations, the adversary can use training-time attacks to deliberately trigger the fallback with high probability. This transfers the main system load onto the fallback, reducing the overall system's integrity and/or availability. We design two novel availability attacks, which show the practical relevance of these threats. For example, adding 1% poisoned data during training is sufficient to trigger the fallback and hence make the model unavailable for up to 100% of all inputs by inserting the trigger. Our extensive experiments across multiple datasets, model architectures, and certifiers demonstrate the broad applicability of these attacks. An initial investigation into potential defenses shows that current approaches are insufficient to mitigate the issue, highlighting the need for new, specific solutions.

  • 3 authors
·
Aug 25, 2021

The Impact of Medication Non-adherence on Adverse Outcomes: Evidence from Schizophrenia Patients via Survival Analysis

This study quantifies the association between non-adherence to antipsychotic medications and adverse outcomes in individuals with schizophrenia. We frame the problem using survival analysis, focusing on the time to the earliest of several adverse events (early death, involuntary hospitalization, jail booking). We extend standard causal inference methods (T-learner, S-learner, nearest neighbor matching) to utilize various survival models to estimate individual and average treatment effects, where treatment corresponds to medication non-adherence. Analyses are repeated using different amounts of longitudinal information (3, 6, 9, and 12 months). Using data from Allegheny County in western Pennsylvania, we find strong evidence that non-adherence advances adverse outcomes by approximately 1 to 4 months. Ablation studies confirm that county-provided risk scores adjust for key confounders, as their removal amplifies the estimated effects. Subgroup analyses by medication formulation (injectable vs. oral) and medication type consistently show that non-adherence is associated with earlier adverse events. These findings highlight the clinical importance of adherence in delaying psychiatric crises and show that integrating survival analysis with causal inference tools can yield policy-relevant insights. We caution that although we apply causal inference, we only make associative claims and discuss assumptions needed for causal interpretation.

Is Your Automated Software Engineer Trustworthy?

Large Language Models (LLMs) are being increasingly used in software engineering tasks, with an increased focus on bug report resolution over the past year. However, most proposed systems fail to properly handle uncertain or incorrect inputs and outputs. Existing LLM-based tools and coding agents respond to every issue and generate a patch for every case, even when the input is vague or their own output is incorrect. There are no mechanisms in place to abstain when confidence is low. This leads to unreliable behaviour, such as hallucinated code changes or responses based on vague issue reports. We introduce BouncerBench, a benchmark that evaluates whether LLM-based software agents can refuse to act when inputs are ill-defined or refuse to respond when their own outputs are likely to be incorrect. Unlike prior benchmarks that implicitly incentivize models to generate responses even when uncertain, BouncerBench aims to improve precision by targeting two overlooked failure points: (1) vague or underspecified issue descriptions in tickets and (2) logically or functionally incorrect code patches created by the system. It measures whether proposed systems can distinguish actionable issues from vague tickets and valid patches from untrustworthy ones. We also implement a basic input and output bouncer, evaluating how well current LLMs can abstain when needed. Our results show that most models fail to abstain from underspecified inputs or incorrect outputs. Hence, we conclude that there is significant room for improvement before LLMs can be trusted to make correct decisions and recommendations in real-world software engineering workflows. BouncerBench provides a first step toward evaluating and building more cautious, trustworthy code agents. The replication package, dataset, and leaderboard can be found at bouncerbench.com

  • 2 authors
·
Jun 21, 2025

Detection Is Cheap, Routing Is Learned: Why Refusal-Based Alignment Evaluation Fails

Current alignment evaluation mostly measures whether models encode dangerous concepts and whether they refuse harmful requests. Both miss the layer where alignment often operates: routing from concept detection to behavioral policy. We study political censorship in Chinese-origin language models as a natural experiment, using probes, surgical ablations, and behavioral tests across nine open-weight models from five labs. Three findings follow. First, probe accuracy alone is non-diagnostic: political probes, null controls, and permutation baselines can all reach 100%, so held-out category generalization is the informative test. Second, surgical ablation reveals lab-specific routing. Removing the political-sensitivity direction eliminates censorship and restores accurate factual output in most models tested, while one model confabulates because its architecture entangles factual knowledge with the censorship mechanism. Cross-model transfer fails, indicating that routing geometry is model- and lab-specific. Third, refusal is no longer the dominant censorship mechanism. Within one model family, hard refusal falls to zero while narrative steering rises to the maximum, making censorship invisible to refusal-only benchmarks. These results support a three-stage descriptive framework: detect, route, generate. Models often retain the relevant knowledge; alignment changes how that knowledge is expressed. Evaluations that audit only detection or refusal therefore miss the routing mechanism that most directly determines behavior.

  • 1 authors
·
Mar 18

Learning Conformal Abstention Policies for Adaptive Risk Management in Large Language and Vision-Language Models

Large Language and Vision-Language Models (LLMs/VLMs) are increasingly used in safety-critical applications, yet their opaque decision-making complicates risk assessment and reliability. Uncertainty quantification (UQ) helps assess prediction confidence and enables abstention when uncertainty is high. Conformal prediction (CP), a leading UQ method, provides statistical guarantees but relies on static thresholds, which fail to adapt to task complexity and evolving data distributions, leading to suboptimal trade-offs in accuracy, coverage, and informativeness. To address this, we propose learnable conformal abstention, integrating reinforcement learning (RL) with CP to optimize abstention thresholds dynamically. By treating CP thresholds as adaptive actions, our approach balances multiple objectives, minimizing prediction set size while maintaining reliable coverage. Extensive evaluations across diverse LLM/VLM benchmarks show our method outperforms Least Ambiguous Classifiers (LAC) and Adaptive Prediction Sets (APS), improving accuracy by up to 3.2%, boosting AUROC for hallucination detection by 22.19%, enhancing uncertainty-guided selective generation (AUARC) by 21.17%, and reducing calibration error by 70%-85%. These improvements hold across multiple models and datasets while consistently meeting the 90% coverage target, establishing our approach as a more effective and flexible solution for reliable decision-making in safety-critical applications. The code is available at: {https://github.com/sinatayebati/vlm-uncertainty}.

  • 6 authors
·
Feb 8, 2025 2