arXiv:2505.07205cs.CL2025-05被引 2

构建医疗大模型伦理安全评估基准,揭示其决策短板并提出治理框架。

Benchmarking Ethical and Safety Risks of Healthcare LLMs in China-Toward Systemic Governance under Healthy China 2030

  • 建立1.2万条医疗伦理与安全问答数据集,覆盖20个维度。
  • 主流中文医疗大模型平均准确率仅42.7%,微调后提升至50.8%。
  • 适合医院AI治理团队、政策制定者及医疗AI研发人员参考。

大型语言模型(LLMs)正推动中国“健康中国2030”战略下的医疗变革,但带来新的伦理与患者安全挑战。本文构建了一个包含12,000项问答的基准测试,涵盖11个伦理与9个安全维度,用于量化评估医疗场景中的风险。基于该数据集,我们评估了当前主流中文医疗LLM(如Qwen 2.5-32B、DeepSeek),发现其基础性能中等(Qwen 2.5-32B准确率为42.7%),在本数据集上微调后准确率最高达50.8%。结果表明,大模型在伦理与安全决策方面存在显著差距,反映制度监管不足。进一步分析发现系统性治理短板:缺乏细粒度伦理审计流程、医院IRB响应迟缓、评估工具匮乏。最后,我们提出一套适用于医疗机构的治理框架,包括设立大模型审计团队、制定数据伦理指南、部署安全模拟流水线,以主动管理风险。研究强调中国医疗领域亟需强化大模型治理,确保人工智能创新与患者安全、伦理标准同步推进。

原文摘要 · Abstract (English)

Large Language Models (LLMs) are poised to transform healthcare under China's Healthy China 2030 initiative, yet they introduce new ethical and patient-safety challenges. We present a novel 12,000-item Q&A benchmark covering 11 ethics and 9 safety dimensions in medical contexts, to quantitatively evaluate these risks. Using this dataset, we assess state-of-the-art Chinese medical LLMs (e.g., Qwen 2.5-32B, DeepSeek), revealing moderate baseline performance (accuracy 42.7% for Qwen 2.5-32B) and significant improvements after fine-tuning on our data (up to 50.8% accuracy). Results show notable gaps in LLM decision-making on ethics and safety scenarios, reflecting insufficient institutional oversight. We then identify systemic governance shortfalls-including the lack of fine-grained ethical audit protocols, slow adaptation by hospital IRBs, and insufficient evaluation tools-that currently hinder safe LLM deployment. Finally, we propose a practical governance framework for healthcare institutions (embedding LLM auditing teams, enacting data ethics guidelines, and implementing safety simulation pipelines) to proactively manage LLM risks. Our study highlights the urgent need for robust LLM governance in Chinese healthcare, aligning AI innovation with patient safety and ethical standards.

医疗AI伦理安全大模型治理健康中国

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