用多智能体系统检测并阻止医疗大模型推荐已禁药品。
Trust but Verify: Mitigating Medical Hallucinations via Post-Hoc Adversarial Auditing and Multi-Agent Feedback Loops

- 设计五智能体系统,通过对抗性审计实时验证医疗建议合规性。
- 使幻觉率降低53%,安全拒绝率从-0.25提升至0.0。
- 适合医疗AI部署者与临床决策支持系统开发者参考。
大型语言模型在医疗场景中日益应用,但其生成错误信息(幻觉)的风险不容忽视。本研究检验了大模型在回答临床问题时是否仍会推荐已被禁用的药物,并测试了一种基于智能体的方法以减少此类错误。我们构建了一个包含103道临床多选题的对抗性数据集,其中历史正确答案对应已撤回药品,覆盖多种治疗类别,确保统计显著性。评估了三种开源模型家族(GPT-OSS、Llama-3、Falcon-3)在默认配置与智能体模式下的表现,采用点数得分、标签准确率、幻觉错误率(HER)及组件保真度(CF)评分。发现所有模型在默认设置下均表现出高幻觉率,持续推荐与训练数据模式匹配的禁用药物。提出的智能体架构使各模型的幻觉率平均降低约53%。点数得分从-0.25(不安全推荐)向0.0(适当拒绝)转变。安全审计机制即使在模型参数知识倾向禁用药物时仍能拦截危险输出。该多智能体框架为实现监管合规提供了模型无关的方法,优先保障患者安全。研究展示了如何将实时监管数据集成至大模型流程,支持临床决策。
原文摘要 · Abstract (English)
Large Language Models (LLMs) are increasingly deployed in healthcare settings, yet their tendency to hallucinate poses risks when clinical decisions are involved. This study examine whether LLMs recommend recently banned or withdrawn pharmaceuticals when answering clinical questions and tests an agent-based method for reducing such errors. We developed a five-agent "Trust but Verify" system using a single LLM backbone. To measure regulatory knowledge obsolescence, we created an adversarial dataset of 103 clinical MCQs where historically correct answers now refer to banned substances. This scale ensures statistical significance across various therapeutic classes. We evaluated three open-access model families (GPT-OSS, Llama-3, Falcon-3) under vanilla and agentic conditions. Performance was measured via pointwise score, label accuracy, Hallucination Error Rate (HER), and Component Fidelity (CF) score. We also observed clinical safety regression in proprietary models. In default configurations, all models showed high hallucination rates, consistently selecting banned drugs that matched training data patterns. Our proposed agentic architecture reduced HER by approximately 53% across models. Pointwise scores shifted from -0.25 (unsafe recommendation) toward 0.0 (appropriate refusal). The safety audit intercepted dangerous outputs even when models' parametric knowledge favored the banned substance. The proposed multi-agent framework offers a model-agnostic method for enforcing regulatory compliance that prioritizes patient safety over fluent text generation. Our work demonstrates a practical approach for deploying autonomous AI systems in safety-critical healthcare settings. It shows how real-time regulatory data can be integrated into LLM pipelines to support clinical decision-making.
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