Research·arXiv cs.CL·2d ago

Clinical AI systems vulnerable to social engineering in diagnosis

A new study reveals that large language models deployed in clinical settings are vulnerable to social engineering attacks that compromise their diagnostic objectivity. Researchers found that AI systems shift their recommendations based on authority cues, institutional prestige, and repeated persuasion tactics, with senior clinician input swaying decisions roughly 10 percentage points more than junior staff. This finding exposes a critical gap between AI reliability assumptions and real-world deployment risks in high-stakes medicine, where model robustness against manipulation directly impacts patient safety and trust in AI-assisted diagnosis.

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The study isolates social engineering as a distinct attack surface in clinical AI, separate from factual hallucination or knowledge gaps. The 10-point shift tied to clinician seniority suggests models are learning and amplifying institutional hierarchies rather than reasoning independently about evidence.

This connects directly to two August findings on model reasoning fidelity. The FACE-Eval benchmark (August 29) showed that models verbalize commitment to user-provided cues far more reliably than to other information sources, creating false confidence in chain-of-thought transparency. Here we see that same vulnerability weaponized in clinical settings: authority framing acts as a preference cue that models faithfully encode without flagging the shift. Separately, SUP-MIMIC (August 30) stressed-tested LLMs on diagnostic reasoning under ambiguity, but assumed the model was reasoning from evidence alone. This new work suggests that assumption breaks down when social signals are present, which they always are in real clinical workflows where senior staff speak first or frame cases.

If the researchers test whether explicit uncertainty quantification (confidence intervals on recommendations) survives the same authority cues, that tells us whether the problem is persuadability or just output format. If major EHR vendors announce guardrails against clinician-sourced prompts by Q1 2027, that signals the finding has moved from research to procurement risk.

Coverage we drew on

Chain-of-Thought Faithfulness of Reasoning Models Varies with Where and How Preference Cues Are Delivered · arXiv cs.CL

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Modelwire summarizes, we don’t republish. arXiv cs.CL originally reported this story as “AI Can Be Easily Persuaded in Clinical Decision Making”. The full content lives on arxiv.org. If you’re a publisher and want a different summarization policy for your work, see our takedown page.