Science

Evaluation format, not only model capability, shapes measured triage failure in consumer health AI

A recent Nature Medicine study reported that ChatGPT Health under-triages 51.6% of emergencies and concluded that consumer-facing AI triage poses safety risks. Its protocol, however, was an exam-style scaffold (forced A/B/C/D output, knowledge suppression, no clarifying questions) unlike how consumers use health chatbots. We ask how much of the headline error rate is a property of the measurement rather than of the models. In a first, mechanistic study, five frontier LLMs on a 17-scenario bank scored 6.4 points higher under naturalistic patient-style messages than under the constrained scaffold (p=0.015). In a second, faithful replication we ran the authors' own 60 released vignettes through six frontier models under four matched formats, with clinician validation of the rewrites and a blinded clinician audit of the LLM adjudicators. Here the direction reversed: free-text rewrites scored slightly below the exact prompt (78.7% vs 81.8%, p=0.020), removing only the answer scaffold changed little (80.6% vs 81.4%, p=0.81), and naturalistic input with a forced categorical answer beat both the exact prompt (84.4%, p=0.023) and free text (p=0.0001). On the four vignettes defining the original emergency rate, under-triage was 17% with the exact scaffold, 50% in free text, and 21% with a forced letter on the same message; every free-text "under-triage" was a same-day recommendation scored C rather than D, and 60% made escalation conditional on information the patient was asked to check, behavior a single-turn benchmark cannot score. The headline rate did not reproduce as a stable cross-model finding; much of it depends on output format and on mapping prose onto a four-point scale. Each format elicits a separate response, so the design measures format sensitivity, not format versus capability. Safety claims should report sensitivity to input wording, output format and adjudication.

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An updated Model Spec for more capable and beneficial AI

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Understanding and Mitigating Role Spoofing in LLMs

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Aligning Autoresearch: Co-Improvement between Agents and Humans

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Efficient Scalable Oversight via Rewinding

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Beyond Binary Labels: Diagnostic Evaluation of LLM Safety with Prompt-Level Rubrics

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Plan R: AI Safety by ASICs

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StopLoss: Teaching Agents to Predict Failure and Stop Early

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Do Coding Agents Still Need a Debugger? Frontier-Model-Based Fault Localization at the Accuracy Ceiling

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InfraDev: Can Coding Agents Develop AI Infrastructure, and How Can We Tell?

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kw-bench: Breaking Frontier Harnesses on Real-World Tasks

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I Put a Bunch of AI Agents in Charge of a Fantasy Soccer Team. They’re Not Better Than Humans—Yet

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Recursive Self-Improvement on a Budget: Scoring Code Edits Before They Run

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ParetoRSI-Gym: Can AI Agents Improve Language Models Across Multiple Domains?

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