{"id":"https://openalex.org/W7225730148","doi":"https://doi.org/10.5281/zenodo.24117283","title":"Benchmarking Pharmacotherapeutic Hallucinations and Diagnostic Anchoring in Large Language Models Across High-Risk Primary Care and Renal Dosing Scenarios: A Clinical RLHF Audit","display_name":"Benchmarking Pharmacotherapeutic Hallucinations and Diagnostic Anchoring in Large Language Models Across High-Risk Primary Care and Renal Dosing Scenarios: A Clinical RLHF Audit","publication_year":2026,"publication_date":"2026-11-10","ids":{"openalex":"https://openalex.org/W7225730148","doi":"https://doi.org/10.5281/zenodo.24117283"},"language":"en","primary_location":{"id":"doi:10.5281/zenodo.24117283","doi":"https://doi.org/10.5281/zenodo.24117283","is_oa":true,"landing_page_url":"https://doi.org/10.5281/zenodo.24117283","pdf_url":null,"source":{"id":"https://openalex.org/S4306400562","display_name":"Zenodo (CERN European Organization for Nuclear Research)","issn_l":null,"issn":null,"is_oa":true,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I67311998","host_organization_name":"European Organization for Nuclear Research","host_organization_lineage":["https://openalex.org/I67311998"],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":null,"is_accepted":false,"is_published":false,"raw_source_name":null,"raw_type":"Preprint"},"volume":null,"type":"preprint","is_traditional":true,"indexed_in":["datacite"],"open_access":{"is_oa":true,"oa_status":"green","oa_url":"https://doi.org/10.5281/zenodo.24117283","any_repository_has_fulltext":true},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5161377328","display_name":"ibrahim Mohammed","orcid":null,"observed_orcids":[]},"institutions":[],"countries":[],"is_corresponding":true,"raw_author_name":"Mohammed, ibrahim","raw_affiliation_strings":["Clinical Informatics & Pharmacovigilance Alignment Research Unit"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Clinical Informatics & Pharmacovigilance Alignment Research Unit","institution_ids":[]}]}],"institutions":[],"countries_distinct_count":0,"institutions_distinct_count":0,"corresponding_author_ids":["https://openalex.org/A5161377328"],"corresponding_institution_ids":[],"apc_list":null,"apc_paid":null,"fwci":null,"has_fulltext":false,"cited_by_count":0,"citation_normalized_percentile":null,"cited_by_percentile_year":null,"biblio":{"volume":null,"issue":null,"first_page":null,"last_page":null},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T11636","display_name":"Artificial Intelligence in Healthcare and Education","score":0.9932000041007996,"subfield":{"id":"https://openalex.org/subfields/2718","display_name":"Health Informatics"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T11636","display_name":"Artificial Intelligence in Healthcare and Education","score":0.9932000041007996,"subfield":{"id":"https://openalex.org/subfields/2718","display_name":"Health Informatics"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T13702","display_name":"Machine Learning in Healthcare","score":0.0034000000450760126,"subfield":{"id":"https://openalex.org/subfields/1702","display_name":"Artificial Intelligence"},"field":{"id":"https://openalex.org/fields/17","display_name":"Computer Science"},"domain":{"id":"https://openalex.org/domains/3","display_name":"Physical Sciences"}},{"id":"https://openalex.org/T10350","display_name":"Electronic Health Records Systems","score":0.0010000000474974513,"subfield":{"id":"https://openalex.org/subfields/3605","display_name":"Health Information Management"},"field":{"id":"https://openalex.org/fields/36","display_name":"Health Professions"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[],"concepts":[{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.791700005531311},{"id":"https://openalex.org/C2776494729","wikidata":"https://www.wikidata.org/wiki/Q1848900","display_name":"Contraindication","level":3,"score":0.6772000193595886},{"id":"https://openalex.org/C86251818","wikidata":"https://www.wikidata.org/wiki/Q816754","display_name":"Benchmarking","level":2,"score":0.670799970626831},{"id":"https://openalex.org/C199521495","wikidata":"https://www.wikidata.org/wiki/Q181487","display_name":"Audit","level":2,"score":0.6075000166893005},{"id":"https://openalex.org/C177713679","wikidata":"https://www.wikidata.org/wiki/Q679690","display_name":"Intensive care medicine","level":1,"score":0.5360999703407288},{"id":"https://openalex.org/C2984752397","wikidata":"https://www.wikidata.org/wiki/Q3259956","display_name":"Primary care","level":2,"score":0.5040000081062317},{"id":"https://openalex.org/C545542383","wikidata":"https://www.wikidata.org/wiki/Q2751242","display_name":"Medical emergency","level":1,"score":0.4422000050544739},{"id":"https://openalex.org/C2777288759","wikidata":"https://www.wikidata.org/wiki/Q4164182","display_name":"Dosing","level":2,"score":0.4413999915122986},{"id":"https://openalex.org/C63527458","wikidata":"https://www.wikidata.org/wiki/Q5133829","display_name":"Clinical decision support system","level":3,"score":0.4228000044822693},{"id":"https://openalex.org/C2779328685","wikidata":"https://www.wikidata.org/wiki/Q1475557","display_name":"Patient safety","level":3,"score":0.39590001106262207},{"id":"https://openalex.org/C194828623","wikidata":"https://www.wikidata.org/wiki/Q2861470","display_name":"Emergency medicine","level":1,"score":0.3723999857902527},{"id":"https://openalex.org/C2779473830","wikidata":"https://www.wikidata.org/wiki/Q1540899","display_name":"MEDLINE","level":2,"score":0.36890000104904175},{"id":"https://openalex.org/C2777925291","wikidata":"https://www.wikidata.org/wiki/Q2581971","display_name":"Intensivist","level":3,"score":0.36469998955726624},{"id":"https://openalex.org/C160735492","wikidata":"https://www.wikidata.org/wiki/Q31207","display_name":"Health care","level":2,"score":0.3594000041484833},{"id":"https://openalex.org/C12174686","wikidata":"https://www.wikidata.org/wiki/Q1058438","display_name":"Risk assessment","level":2,"score":0.33320000767707825},{"id":"https://openalex.org/C45827449","wikidata":"https://www.wikidata.org/wiki/Q5270338","display_name":"Diagnosis code","level":3,"score":0.32839998602867126},{"id":"https://openalex.org/C185798385","wikidata":"https://www.wikidata.org/wiki/Q1161707","display_name":"Benchmark (surveying)","level":2,"score":0.325300008058548},{"id":"https://openalex.org/C534262118","wikidata":"https://www.wikidata.org/wiki/Q177719","display_name":"Medical diagnosis","level":2,"score":0.32260000705718994},{"id":"https://openalex.org/C107327155","wikidata":"https://www.wikidata.org/wiki/Q330268","display_name":"Decision support system","level":2,"score":0.31299999356269836},{"id":"https://openalex.org/C2776579137","wikidata":"https://www.wikidata.org/wiki/Q5133817","display_name":"Clinical audit","level":3,"score":0.31139999628067017},{"id":"https://openalex.org/C195910791","wikidata":"https://www.wikidata.org/wiki/Q1324077","display_name":"Medical record","level":2,"score":0.2883000075817108},{"id":"https://openalex.org/C2779974597","wikidata":"https://www.wikidata.org/wiki/Q28448986","display_name":"Clinical Practice","level":2,"score":0.259799987077713},{"id":"https://openalex.org/C32896092","wikidata":"https://www.wikidata.org/wiki/Q189447","display_name":"Risk management","level":2,"score":0.250900000333786}],"mesh":[],"locations_count":2,"locations":[{"id":"doi:10.5281/zenodo.24117283","doi":"https://doi.org/10.5281/zenodo.24117283","is_oa":true,"landing_page_url":"https://doi.org/10.5281/zenodo.24117283","pdf_url":null,"source":{"id":"https://openalex.org/S4306400562","display_name":"Zenodo (CERN European Organization for Nuclear Research)","issn_l":null,"issn":null,"is_oa":true,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I67311998","host_organization_name":"European Organization for Nuclear Research","host_organization_lineage":["https://openalex.org/I67311998"],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":null,"is_accepted":false,"is_published":false,"raw_source_name":null,"raw_type":"Preprint"},{"id":"doi:10.5281/zenodo.24117284","doi":"https://doi.org/10.5281/zenodo.24117284","is_oa":true,"landing_page_url":"https://doi.org/10.5281/zenodo.24117284","pdf_url":null,"source":{"id":"https://openalex.org/S4306400562","display_name":"Zenodo (CERN European Organization for Nuclear Research)","issn_l":null,"issn":null,"is_oa":true,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I67311998","host_organization_name":"European Organization for Nuclear Research","host_organization_lineage":["https://openalex.org/I67311998"],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":null,"is_accepted":false,"is_published":false,"raw_source_name":null,"raw_type":"Preprint"}],"best_oa_location":{"id":"doi:10.5281/zenodo.24117283","doi":"https://doi.org/10.5281/zenodo.24117283","is_oa":true,"landing_page_url":"https://doi.org/10.5281/zenodo.24117283","pdf_url":null,"source":{"id":"https://openalex.org/S4306400562","display_name":"Zenodo (CERN European Organization for Nuclear Research)","issn_l":null,"issn":null,"is_oa":true,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I67311998","host_organization_name":"European Organization for Nuclear Research","host_organization_lineage":["https://openalex.org/I67311998"],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":null,"is_accepted":false,"is_published":false,"raw_source_name":null,"raw_type":"Preprint"},"sustainable_development_goals":[],"study_designs":[],"awards":[],"funders":[],"has_content":{"grobid_xml":false,"pdf":false},"content_urls":null,"referenced_works_count":0,"referenced_works":[],"related_works":[],"abstract_inverted_index":{"Background:":[0],"Large":[1],"language":[2],"models":[3],"(LLMs)":[4],"embedded":[5],"within":[6],"electronic":[7],"health":[8],"record":[9],"(EHR)":[10],"clinical":[11,33],"decision":[12],"support":[13],"systems":[14],"risk":[15],"causing":[16],"fatal":[17],"pharmacotherapeutic":[18],"hallucinations":[19,110],"and":[20,46,52,93],"sycophantic":[21],"diagnostic":[22],"anchoring.":[23],"Objective:":[24],"To":[25],"quantify":[26],"these":[27],"failure":[28],"modes":[29],"across":[30],"50":[31],"adversarial":[32],"vignettes":[34],"spanning":[35],"KDIGO":[36],"2024":[37,40],"CKD,":[38],"ADA":[39],"euglycemic":[41],"DKA,":[42],"AHA":[43],"ACLS":[44],"WPW,":[45],"MGFA":[47],"2020":[48],"myasthenic":[49],"crisis":[50],"guidelines,":[51],"evaluate":[53],"Constraint-Guided":[54],"Chain-of-Thought":[55],"(CoT)":[56],"+":[57],"Ontology-Grounded":[58],"System":[59],"Prompts.":[60],"Methods:":[61],"The":[62],"ClinRLHF":[63],"Benchmark":[64],"evaluated":[65],"paired":[66],"zero-shot":[67],"versus":[68],"aligned":[69],"outputs":[70],"using":[71],"a":[72],"validated":[73],"5-point":[74],"Clinical":[75],"Safety":[76],"rubric.":[77],"Results:":[78],"Constraint-guided":[79],"alignment":[80],"significantly":[81],"improved":[82],"Contraindication":[83],"Detection":[84],"Rate":[85],"from":[86,96],"38.0%":[87],"to":[88,98],"96.0%":[89],"(p":[90,100],"<":[91,101],"0.0001)":[92],"Sycophancy":[94],"Resistance":[95],"26.0%":[97],"94.0%":[99],"0.0001).":[102],"Conclusions:":[103],"Ontology-grounded":[104],"deterministic":[105],"constraints":[106],"eliminate":[107],"catastrophic":[108],"prescribing":[109],"in":[111],"medical":[112],"LLMs.":[113]},"counts_by_year":[],"updated_date":"2026-11-11T12:16:26.678958","created_date":"2026-11-11T00:00:00"}
