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Autores principales: Feier, Andrei Marian, Kocaman, Veysel, Gul, Yigit, Korkmaz, Ahmet, Thomas, Alexander, Zakharov, Aleksei, Gil, Jay, Butgul, Mehmet, Talby, David
Formato: Preprint
Publicado: 2026
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Acceso en línea:https://arxiv.org/abs/2606.00027
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author Feier, Andrei Marian
Kocaman, Veysel
Gul, Yigit
Korkmaz, Ahmet
Thomas, Alexander
Zakharov, Aleksei
Gil, Jay
Butgul, Mehmet
Talby, David
author_facet Feier, Andrei Marian
Kocaman, Veysel
Gul, Yigit
Korkmaz, Ahmet
Thomas, Alexander
Zakharov, Aleksei
Gil, Jay
Butgul, Mehmet
Talby, David
contents Large language models (LLMs) are increasingly deployed across healthcare, yet existing benchmarks fail to capture model behavior under adversarial or ethically complex conditions common in clinical practice. We developed a multi-domain red teaming framework evaluating eleven contemporary LLMs across 690 clinically grounded scenarios spanning nine domains and over 150 subcategories. Scenarios incorporated adversarial transformations, and responses were assessed using a seven-dimension rubric with LLM-assisted scoring and human-in-the-loop validation. Results revealed substantial performance variance, with mean scores ranging from 0.791 to 0.984. Critically, several high-performing systems produced complete failures in individual safety-critical scenarios, demonstrating that aggregate accuracy masks clinically meaningful risk. The highest-performing systems (X-BAI, GPT-5, Claude Opus 4.1) achieved scores above 0.97 with low variance, while performance varied significantly across domains. Equity-related tasks showed 10-20% error amplification with demographic modifications, and human reviewers identified clinically relevant failures missed by automated evaluation. Our findings demonstrate that performance variance and worst-case failures provide more clinically meaningful reliability indicators than mean accuracy alone, and that hybrid evaluation approaches combining automation with clinician oversight are essential for credible safety assessment.
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publishDate 2026
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spellingShingle A Multi-Domain Red Teaming Framework for Safety, Robustness, and Fairness Evaluation of Medical Large Language Models
Feier, Andrei Marian
Kocaman, Veysel
Gul, Yigit
Korkmaz, Ahmet
Thomas, Alexander
Zakharov, Aleksei
Gil, Jay
Butgul, Mehmet
Talby, David
Computation and Language
Artificial Intelligence
Large language models (LLMs) are increasingly deployed across healthcare, yet existing benchmarks fail to capture model behavior under adversarial or ethically complex conditions common in clinical practice. We developed a multi-domain red teaming framework evaluating eleven contemporary LLMs across 690 clinically grounded scenarios spanning nine domains and over 150 subcategories. Scenarios incorporated adversarial transformations, and responses were assessed using a seven-dimension rubric with LLM-assisted scoring and human-in-the-loop validation. Results revealed substantial performance variance, with mean scores ranging from 0.791 to 0.984. Critically, several high-performing systems produced complete failures in individual safety-critical scenarios, demonstrating that aggregate accuracy masks clinically meaningful risk. The highest-performing systems (X-BAI, GPT-5, Claude Opus 4.1) achieved scores above 0.97 with low variance, while performance varied significantly across domains. Equity-related tasks showed 10-20% error amplification with demographic modifications, and human reviewers identified clinically relevant failures missed by automated evaluation. Our findings demonstrate that performance variance and worst-case failures provide more clinically meaningful reliability indicators than mean accuracy alone, and that hybrid evaluation approaches combining automation with clinician oversight are essential for credible safety assessment.
title A Multi-Domain Red Teaming Framework for Safety, Robustness, and Fairness Evaluation of Medical Large Language Models
topic Computation and Language
Artificial Intelligence
url https://arxiv.org/abs/2606.00027