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Mar 11

Evaluation of GPT-3.5 and GPT-4 for supporting real-world information needs in healthcare delivery

Despite growing interest in using large language models (LLMs) in healthcare, current explorations do not assess the real-world utility and safety of LLMs in clinical settings. Our objective was to determine whether two LLMs can serve information needs submitted by physicians as questions to an informatics consultation service in a safe and concordant manner. Sixty six questions from an informatics consult service were submitted to GPT-3.5 and GPT-4 via simple prompts. 12 physicians assessed the LLM responses' possibility of patient harm and concordance with existing reports from an informatics consultation service. Physician assessments were summarized based on majority vote. For no questions did a majority of physicians deem either LLM response as harmful. For GPT-3.5, responses to 8 questions were concordant with the informatics consult report, 20 discordant, and 9 were unable to be assessed. There were 29 responses with no majority on "Agree", "Disagree", and "Unable to assess". For GPT-4, responses to 13 questions were concordant, 15 discordant, and 3 were unable to be assessed. There were 35 responses with no majority. Responses from both LLMs were largely devoid of overt harm, but less than 20% of the responses agreed with an answer from an informatics consultation service, responses contained hallucinated references, and physicians were divided on what constitutes harm. These results suggest that while general purpose LLMs are able to provide safe and credible responses, they often do not meet the specific information need of a given question. A definitive evaluation of the usefulness of LLMs in healthcare settings will likely require additional research on prompt engineering, calibration, and custom-tailoring of general purpose models.

Disagreement as a way to study misinformation and its effects

Misinformation - false or misleading information - is considered a significant societal concern due to its associated "misinformation effects," such as political polarization, erosion of trust in institutions, problematic behavior, and public health challenges. However, the prevailing concept is misaligned with what is studied. While misinformation focuses on instances of information about factual matters, the broad spectrum of effects often manifests at a societal level and is shaped by a wide range of interdependent factors such as identity, values, opinions, epistemologies, and disagreements. Unsurprisingly, misinformation effects can occur without the prevalence of misinformation, and misinformation does not necessarily increase the effects studied. Here, we propose using disagreement - conflicting attitudes and beliefs between individuals and communities - as a way to study misinformation effects because it addresses the identified conceptual limitations of misinformation. Furthermore, unlike misinformation, disagreement does not require researchers to determine whether a given information is false or misleading. Thus, it can be studied and, more importantly, measured without the need to make a normative judgment about a given information, even when the specific topic is entirely removed, as we show in a longitudinal disagreement measurement. We demonstrate that disagreement, as a holistic concept, provides better explanations for the occurrence of misinformation effects, enhances precision in developing appropriate interventions, and offers a promising approach for evaluating them through quantification. Finally, we show how disagreement addresses current misinformation research questions and conclude with recommendations for research practice.

Beyond Preferences in AI Alignment

The dominant practice of AI alignment assumes (1) that preferences are an adequate representation of human values, (2) that human rationality can be understood in terms of maximizing the satisfaction of preferences, and (3) that AI systems should be aligned with the preferences of one or more humans to ensure that they behave safely and in accordance with our values. Whether implicitly followed or explicitly endorsed, these commitments constitute what we term a preferentist approach to AI alignment. In this paper, we characterize and challenge the preferentist approach, describing conceptual and technical alternatives that are ripe for further research. We first survey the limits of rational choice theory as a descriptive model, explaining how preferences fail to capture the thick semantic content of human values, and how utility representations neglect the possible incommensurability of those values. We then critique the normativity of expected utility theory (EUT) for humans and AI, drawing upon arguments showing how rational agents need not comply with EUT, while highlighting how EUT is silent on which preferences are normatively acceptable. Finally, we argue that these limitations motivate a reframing of the targets of AI alignment: Instead of alignment with the preferences of a human user, developer, or humanity-writ-large, AI systems should be aligned with normative standards appropriate to their social roles, such as the role of a general-purpose assistant. Furthermore, these standards should be negotiated and agreed upon by all relevant stakeholders. On this alternative conception of alignment, a multiplicity of AI systems will be able to serve diverse ends, aligned with normative standards that promote mutual benefit and limit harm despite our plural and divergent values.

This Thing Called Fairness: Disciplinary Confusion Realizing a Value in Technology

The explosion in the use of software in important sociotechnical systems has renewed focus on the study of the way technical constructs reflect policies, norms, and human values. This effort requires the engagement of scholars and practitioners from many disciplines. And yet, these disciplines often conceptualize the operative values very differently while referring to them using the same vocabulary. The resulting conflation of ideas confuses discussions about values in technology at disciplinary boundaries. In the service of improving this situation, this paper examines the value of shared vocabularies, analytics, and other tools that facilitate conversations about values in light of these disciplinary specific conceptualizations, the role such tools play in furthering research and practice, outlines different conceptions of "fairness" deployed in discussions about computer systems, and provides an analytic tool for interdisciplinary discussions and collaborations around the concept of fairness. We use a case study of risk assessments in criminal justice applications to both motivate our effort--describing how conflation of different concepts under the banner of "fairness" led to unproductive confusion--and illustrate the value of the fairness analytic by demonstrating how the rigorous analysis it enables can assist in identifying key areas of theoretical, political, and practical misunderstanding or disagreement, and where desired support alignment or collaboration in the absence of consensus.

What are human values, and how do we align AI to them?

There is an emerging consensus that we need to align AI systems with human values (Gabriel, 2020; Ji et al., 2024), but it remains unclear how to apply this to language models in practice. We split the problem of "aligning to human values" into three parts: first, eliciting values from people; second, reconciling those values into an alignment target for training ML models; and third, actually training the model. In this paper, we focus on the first two parts, and ask the question: what are "good" ways to synthesize diverse human inputs about values into a target for aligning language models? To answer this question, we first define a set of 6 criteria that we believe must be satisfied for an alignment target to shape model behavior in accordance with human values. We then propose a process for eliciting and reconciling values called Moral Graph Elicitation (MGE), which uses a large language model to interview participants about their values in particular contexts; our approach is inspired by the philosophy of values advanced by Taylor (1977), Chang (2004), and others. We trial MGE with a representative sample of 500 Americans, on 3 intentionally divisive prompts (e.g. advice about abortion). Our results demonstrate that MGE is promising for improving model alignment across all 6 criteria. For example, almost all participants (89.1%) felt well represented by the process, and (89%) thought the final moral graph was fair, even if their value wasn't voted as the wisest. Our process often results in "expert" values (e.g. values from women who have solicited abortion advice) rising to the top of the moral graph, without defining who is considered an expert in advance.