Red teaming ChatGPT in medicine to yield real-world insights on model behavior

Red teaming, the practice of adversarially exposing unexpected or undesired model behaviors, is critical towards improving equity and accuracy of large language models, but non-model creator-affiliated red teaming is scant in healthcare. We convened teams of clinicians, medical and engineering students, and technical professionals (80 participants total) to stress-test models with real-world clinical cases and categorize inappropriate responses along axes of safety, privacy, hallucinations/accuracy, and bias. Six medically-trained reviewers re-analyzed prompt-response pairs and added qualitative annotations. Of 376 unique prompts (1504 responses), 20.1% were inappropriate (GPT-3.5: 25.8%; GPT-4.0: 16%; GPT-4.0 with Internet: 17.8%). Subsequently, we show the utility of our benchmark by testing GPT-4o, a model released after our event (20.4% inappropriate). 21.5% of responses appropriate with GPT-3.5 were inappropriate in updated models. We share insights for constructing red teaming prompts, and present our benchmark for iterative model assessments.