AI 服务暂时不可用，以下为来源正文，待恢复后补全翻译。
--> [Submitted on 25 May 2026] Title:Preferred, Not Safer: Pairwise Preference Is a Poor Proxy for Clinical Safety View a PDF of the paper titled Preferred, Not Safer: Pairwise Preference Is a Poor Proxy for Clinical Safety, by Fay Elhassan and 4 other authors View PDF HTML (experimental) Abstract:We evaluate whether clinician pairwise preferences provide a reliable signal of clinical safety in large language model (LLM) evaluation using expert feedback from MOOVE (Massive Open Online Validation and Evaluation), a clinician-led platform collecting blinded pairwise preferences alongside multi-criterion rubric ratings. Clinicians assign scores on a discrete $[-2, +2]$ scale, where negative values indicate clinically unsafe or misleading content. Using 26{,}804 pairwise judgments across outputs from 13 LLMs, contributed by more than 736 clinicians across 28+ countries, we find that clinician preference is a poor proxy for safety-critical performance. Models ranking highly under pairwise preference can still exhibit substantial rates of clinically meaningful failures ($\leq -1$) on dimensions such as \emph{Harmlessness} and \emph{Accuracy}. These failures are unevenly distributed across specialties, creating domain-specific ``no-go zones'' not visible in aggregate rankings or single-number leaderboards. We further analyze contributing factors including prompt length, refusal and escalation behavior, and the relative contributions of safety-critical versus surface-level features. A substantial fraction of preference votes carry no positive safety signal, while feature decomposition shows that surface-level characteristics explain slightly more preference variation than safety-critical rubric differences. Finally, we introduce a clinically adjusted preference ranking combining pairwise preference with rubric-derived feedback, producing a more safety-aware ordering than raw Bradley--Terry strength alone. Our findings support evaluation practices that separate preference from safety, report safety-critical failure rates directly, and incorporate clinically grounded adjustments when ranking LLMs for clinical decision making. Comments: 27 pages,10 figures Subjects: Computation and Language (cs.CL); Artificial Intelligence (cs.AI); Machine Learning (cs.LG) Cite as: arXiv:2608.02617 [cs.CL] (or arXiv:2608.02617v1 [cs.CL] for this version) https://doi.org/10.48550/arXiv.2608.02617 arXiv-issued DOI via DataCite Submission history From: Fay Majid Ahmed Elhassan Fay [view email] [v1] Mon, 25 May 2026 09:39:49 UTC (1,402 KB) Full-text links: Access Paper: View a PDF of the paper titled Preferred, Not Safer: Pairwise Preference Is a Poor Proxy for Clinical Safety, by Fay Elhassan and 4 other authors View PDF HTML (experimental) TeX Source view license Current browse context: cs.CL new | recent | 2026-08 Change to browse by: cs cs.AI cs.LG References & Citations NASA ADS Google Scholar Semantic Scholar Loading... Data provided by: Bibliographic Tools Bibliographic and Citation Tools Bibliographic Explorer Toggle Bibliographic Explorer (What is the Explorer?) Connected Papers Toggle Connected Papers (What is Connected Papers?) Litmaps Toggle Litmaps (What is Litmaps?) scite.ai Toggle scite Smart Citations (What are Smart Citations?) Code, Data, Media Code, Data and Media Associated with this Article alphaXiv Toggle alphaXiv (What is alphaXiv?) Links to Code Toggle CatalyzeX Code Finder for Papers (What is CatalyzeX?) DagsHub Toggle DagsHub (What is DagsHub?) GotitPub Toggle Gotit.pub (What is GotitPub?) Huggingface Toggle Hugging Face (What is Huggingface?) ScienceCast Toggle ScienceCast (What is ScienceCast?) Demos Demos Replicate Toggle Replicate (What is Replicate?) Spaces Toggle Hugging Face Spaces (What is Spaces?) Spaces Toggle TXYZ.AI (What is TXYZ.AI?) Related Papers Recommenders and Search Tools Link to Influence Flower Influence Flower (What are Influence Flowers?) Core recommender toggle CORE Recommender (What is CORE?) Author Venue Institution Topic About arXivLabs arXivLabs: experimental projects with community collaborators arXivLabs is a framework that allows collaborators to develop and share new arXiv features directly on our website. Both individuals and organizations that work with arXivLabs have embraced and accepted our values of openness, community, excellence, and user data privacy. arXiv is committed to these values and only works with partners that adhere to them. Have an idea for a project that will add value for arXiv's community? Learn more about arXivLabs. Which authors of this paper are endorsers? | Disable MathJax (What is MathJax?)