ArticleResearch square2026
Deployment protocol and base model jointly determine residual risk in rule-based clinical LLM supervision.
Article in Research square, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Authors and funding
3 authors.
Funding
Abstract
Rule-based supervision can reduce unsafe clinical LLM outputs, but residual safety depends on deployment protocol and base model. We evaluated a five-gate sentinel across five models (Qwen 7B, Llama 8B, Meditron 7B, Gemma 4, Sonnet 4.5) on two clinical safety benchmarks under handoff-on and handoff-off protocols. Under handoff-on, all models achieved deploy violation rates at most 6%, though strict violation rates (counting blocked and escalated outputs) ranged from 1.5% to 49.5%, showing wide variation in how many outputs the sentinel blocks or escalates per model. Under handoff-off, residual risk stratified by base model (0.0-50%), driven by failure-mode profiles and repair conversion rate. A multisite extension (Llama 70B,
Identifiers
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.