Reasoning red teaming in healthcare not all paths to a desired outcome are desirable

Chang et al. showed that large language models can produce unsafe or biased outputs even when superficially accurate. We highlight that LLMs can hide harmful reasoning if only final responses are red-teamed. Monitoring intermediate inference steps, especially in ethically charged clinical scenarios, can reveal manipulative or unethical thought processes. We propose systematic testing of ethically sensitive prompts and thorough chain-of-thought analysis to ensure safe, trustworthy deployment in healthcare.

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Publication Details

Journal
npj Digital Medicine
Published
2025-11-12
DOI
https://doi.org/10.1038/s41746-025-02104-0
Primary Topic
Clinical Reasoning and Diagnostic Skills
Type
article
Field-Weighted Citation Impact
0.00
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article

Reasoning red teaming in healthcare not all paths to a desired outcome are desirable

Vera Sorin, Eyal Klang, Girish N. Nadkarni, Panagiotis Korfiatis
npj Digital Medicine
Clinical Reasoning and Diagnostic Skills
article

Reasoning red teaming in healthcare not all paths to a desired outcome are desirable

Vera Sorin, Eyal Klang, Girish N. Nadkarni, Panagiotis Korfiatis
article en

Abstract

Chang et al. showed that large language models can produce unsafe or biased outputs even when superficially accurate. We highlight that LLMs can hide harmful reasoning if only final responses are red-teamed. Monitoring intermediate inference steps, especially in ethically charged clinical scenarios, can reveal manipulative or unethical thought processes. We propose systematic testing of ethically sensitive prompts and thorough chain-of-thought analysis to ensure safe, trustworthy deployment in healthcare.

npj Digital MedicineVol. 8(1)
Mount Sinai Medical Center (US), Mayo Clinic in Arizona (US), Mayo Clinic in Florida (US), Icahn School of Medicine at Mount Sinai (US)
Openalex Percentile: Top 61%
Clinical Reasoning and Diagnostic Skills
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