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MedDialBench: Benchmarking LLM Diagnostic Robustness under Parametric Adversarial Patient Behaviors

Xiaotian Luo, Xun Jiang, Jiangcheng Wu · Apr 8, 2026 · Citations: 0

Automatic Metrics
Open arXiv Find Implementation RSS feed Shortlist (0)

How to use this page

Low trust

Use this as background context only. Do not make protocol decisions from this page alone.

Best use

Background context only

What to verify

Validate the evaluation procedure and quality controls in the full paper before operational use.

Evidence quality

Low

Derived from extracted protocol signals and abstract evidence.

Abstract

Interactive medical dialogue benchmarks have shown that LLM diagnostic accuracy degrades significantly when interacting with non-cooperative patients, yet existing approaches either apply adversarial behaviors without graded severity or case-specific grounding, or reduce patient non-cooperation to a single ungraded axis, and none analyze cross-dimension interactions. We introduce MedDialBench, a benchmark enabling controlled, dose-response characterization of how individual patient behavior dimensions affect LLM diagnostic robustness. It decomposes patient behavior into five dimensions -- Logic Consistency, Health Cognition, Expression Style, Disclosure, and Attitude -- each with graded severity levels and case-specific behavioral scripts. This controlled factorial design enables graded sensitivity analysis, dose-response profiling, and cross-dimension interaction detection. Evaluating five frontier LLMs across 7,225 dialogues (85 cases x 17 configurations x 5 models), we find a fundamental asymmetry: information pollution (fabricating symptoms) produces 1.7-3.4x larger accuracy drops than information deficit (withholding information), and fabricating is the only configuration achieving statistical significance across all five models (McNemar p < 0.05). Among six dimension combinations, fabricating is the sole driver of super-additive interaction: all three fabricating-involving pairs produce O/E ratios of 0.70-0.81 (35-44% of eligible cases fail under the combination despite succeeding under each dimension alone), while all non-fabricating pairs show purely additive effects (O/E ~ 1.0). Inquiry strategy moderates deficit but not pollution: exhaustive questioning recovers withheld information, but cannot compensate for fabricated inputs. Models exhibit distinct vulnerability profiles, with worst-case drops ranging from 38.8 to 54.1 percentage points.

Abstract-only analysis — low confidence

All signals on this page are inferred from the abstract only and may be inaccurate. Do not use this page as a primary protocol reference.

  • This paper looks adjacent to evaluation work, but not like a strong protocol reference.
  • The available metadata is too thin to trust this as a primary source.
Human Eval Hub LLM-as-Judge Hub Pairwise Preference Hub

Should You Rely On This Paper?

This paper is adjacent to HFEPX scope and is best used for background context, not as a primary protocol reference.

Best use

Background context only

Use if you need

A benchmark-and-metrics comparison anchor.

Main weakness

This paper looks adjacent to evaluation work, but not like a strong protocol reference.

Trust level

Low

Usefulness score

5/100 • Low

Treat as adjacent context, not a core eval-method reference.

Human Feedback Signal

Not explicit in abstract metadata

Evaluation Signal

Detected

Usefulness for eval research

Adjacent candidate

Extraction confidence 45%

If you are doing eval pipeline work, start here:

Human Eval Hub LLM-as-Judge Hub Pairwise Preference Hub Tool-Use Eval Hub

What We Could Verify

These are the protocol signals we could actually recover from the available paper metadata. Use them to decide whether this paper is worth deeper reading.

Human Feedback Types

missing

None explicit

No explicit feedback protocol extracted.

"Interactive medical dialogue benchmarks have shown that LLM diagnostic accuracy degrades significantly when interacting with non-cooperative patients, yet existing approaches either apply adversarial behaviors without graded severity or case-specific grounding, or reduce patient non-cooperation to a single ungraded axis, and none analyze cross-dimension interactions."

Evaluation Modes

partial

Automatic Metrics

Includes extracted eval setup.

"Interactive medical dialogue benchmarks have shown that LLM diagnostic accuracy degrades significantly when interacting with non-cooperative patients, yet existing approaches either apply adversarial behaviors without graded severity or case-specific grounding, or reduce patient non-cooperation to a single ungraded axis, and none analyze cross-dimension interactions."

Quality Controls

missing

Not reported

No explicit QC controls found.

"Interactive medical dialogue benchmarks have shown that LLM diagnostic accuracy degrades significantly when interacting with non-cooperative patients, yet existing approaches either apply adversarial behaviors without graded severity or case-specific grounding, or reduce patient non-cooperation to a single ungraded axis, and none analyze cross-dimension interactions."

Benchmarks / Datasets

partial

Meddialbench

Useful for quick benchmark comparison.

"We introduce MedDialBench, a benchmark enabling controlled, dose-response characterization of how individual patient behavior dimensions affect LLM diagnostic robustness."

Reported Metrics

partial

Accuracy

Useful for evaluation criteria comparison.

"Interactive medical dialogue benchmarks have shown that LLM diagnostic accuracy degrades significantly when interacting with non-cooperative patients, yet existing approaches either apply adversarial behaviors without graded severity or case-specific grounding, or reduce patient non-cooperation to a single ungraded axis, and none analyze cross-dimension interactions."

Human Feedback Details

  • Uses human feedback: No
  • Feedback types: None
  • Rater population: Not reported
  • Expertise required: Medicine

Evaluation Details

  • Evaluation modes: Automatic Metrics
  • Agentic eval: None
  • Quality controls: Not reported
  • Evidence quality: Low
  • Use this page as: Background context only

Protocol And Measurement Signals

Benchmarks / Datasets

Meddialbench

Reported Metrics

accuracy

Research Brief

Metadata summary

Interactive medical dialogue benchmarks have shown that LLM diagnostic accuracy degrades significantly when interacting with non-cooperative patients, yet existing approaches either apply adversarial behaviors without graded severity or case-specific grounding, or reduce patient non-cooperation to a single ungraded axis, and none analyze cross-dimension interactions.

Based on abstract + metadata only. Check the source paper before making high-confidence protocol decisions.

Key Takeaways

  • Interactive medical dialogue benchmarks have shown that LLM diagnostic accuracy degrades significantly when interacting with non-cooperative patients, yet existing approaches either apply adversarial behaviors without graded severity or case-specific grounding, or reduce patient non-cooperation to a single ungraded axis, and none analyze cross-dimension interactions.
  • We introduce MedDialBench, a benchmark enabling controlled, dose-response characterization of how individual patient behavior dimensions affect LLM diagnostic robustness.
  • It decomposes patient behavior into five dimensions -- Logic Consistency, Health Cognition, Expression Style, Disclosure, and Attitude -- each with graded severity levels and case-specific behavioral scripts.

Researcher Actions

  • Compare this paper against nearby papers in the same arXiv category before using it for protocol decisions.
  • Validate inferred eval signals (Automatic metrics) against the full paper.
  • Use related-paper links to find stronger protocol-specific references.

Caveats

  • Generated from abstract + metadata only; no PDF parsing.
  • Signals below are heuristic and may miss details reported outside the abstract.

Recommended Queries

Accuracy

Research Summary

Contribution Summary

  • Interactive medical dialogue benchmarks have shown that LLM diagnostic accuracy degrades significantly when interacting with non-cooperative patients, yet existing approaches either apply adversarial behaviors without graded severity or…
  • We introduce MedDialBench, a benchmark enabling controlled, dose-response characterization of how individual patient behavior dimensions affect LLM diagnostic robustness.
  • Evaluating five frontier LLMs across 7,225 dialogues (85 cases x 17 configurations x 5 models), we find a fundamental asymmetry: information pollution (fabricating symptoms) produces 1.7-3.4x larger accuracy drops than information deficit…

Why It Matters For Eval

  • Interactive medical dialogue benchmarks have shown that LLM diagnostic accuracy degrades significantly when interacting with non-cooperative patients, yet existing approaches either apply adversarial behaviors without graded severity or…
  • We introduce MedDialBench, a benchmark enabling controlled, dose-response characterization of how individual patient behavior dimensions affect LLM diagnostic robustness.

Researcher Checklist

  • Gap: Human feedback protocol is explicit

    No explicit human feedback protocol detected.

  • Pass: Evaluation mode is explicit

    Detected: Automatic Metrics

  • Gap: Quality control reporting appears

    No calibration/adjudication/IAA control explicitly detected.

  • Pass: Benchmark or dataset anchors are present

    Detected: Meddialbench

  • Pass: Metric reporting is present

    Detected: accuracy

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Papers are ranked by protocol overlap, extraction signal alignment, and semantic proximity.

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