Medical LLMs are often evaluated by whether they select the correct diagnosis, but diagnostic accuracy alone does not show whether the model used the case evidence appropriately. We present a behavioral audit of evidence use in medical diagnosis. For each case, we decompose patient information into evidence units, score candidate diagnoses under controlled evidence subsets, and mine low-order interactions in diagnostic margins. Because medical evidence is diagnosis-relative, the audit separates interaction discovery from failure assignment: large or negative interactions can reflect plausible differential diagnosis, while suspicious interactions require robustness checks and clinical review. We evaluate five open-weight LLMs on DDXPlus, CupCase, and MedCase. Across datasets, faithful support and differential conflict or cancellation account for most interaction strength, showing that many evidence interactions are clinically plausible rather than failures. In a DDXPlus-focused blinded five-reviewer 130-item enriched review sample, invalid or shortcut-like cases concentrate in negated or absent findings and clinically local evidence. These results show that accuracy can hide candidate evidence-use failures and motivate role-aware audits for medical LLM evaluation.
Using three support-annotated multi-hop QA benchmarks, this work compares matched adapted readers trained with raw context, retrieval windows, and gold-support diagnostic renderings to distinguish support-availability failures from remaining reader-interface effects.
Vision-language models can exhibit visual concept-conditioned divergence: given images containing demographic features, corporate logos, or ideological symbols, some models produce unusually uniform responses that differ from what peer models say about the same input. These behaviors evade text-only audits because visual concepts cannot be isolated or substituted the way text tokens can. We present VISTA (Visual Inconsistency Screening Through Analysis), a black-box cross-model audit that couples semantic entropy with distribution-based divergence to flag model-specific anomalies. In a controlled study, we implant concept-conditioned stances in three VLMs via fine-tuning on small biased datasets and confirm that VISTA detects them. Auditing six VLMs across 19 topics, VISTA surfaces 142 high-suspicion cases (1.2%) and identifies selective refusal as a previously unreported divergence pattern, where models refuse demographic queries at rates varying from 0 to 65% across groups.
This work introduces Code Monitor Red Teaming, a monitor-red-teaming protocol that fixes a public-check information boundary while varying generator pressure, verifier scaffolding, and weak-to-strong capability.
Jun-Hui Liao, Jiawen Deng, Fuji Ren et al.· 0 citations
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