CLIMB: A Benchmark of Clinical Bias in Large Language Models

Large language models (LLMs) are increasingly applied to clinical decision-making. However, their potential to exhibit bias poses significant risks to clinical equity. Currently, there is a lack of benchmarks that systematically evaluate such clinical bias in LLMs. While in downstream tasks, some biases of LLMs can be avoided such as by instructing the model to answer "I'm not sure...", the internal bias hidden within the model still lacks deep studies. We introduce CLIMB (shorthand for A Benchmark of Clinical Bias in Large Language Models), a pioneering comprehensive benchmark to evaluate both intrinsic (within LLMs) and extrinsic (on downstream tasks) bias in LLMs for clinical decision tasks. Notably, for intrinsic bias, we introduce a novel metric, AssocMAD, to assess the disparities of LLMs across multiple demographic groups. Additionally, we leverage counterfactual intervention to evaluate extrinsic bias in a task of clinical diagnosis prediction. Our experiments across popular and medically adapted LLMs, particularly from the Mistral and LLaMA families, unveil prevalent behaviors with both intrinsic and extrinsic bias. This work underscores the critical need to mitigate clinical bias and sets a new standard for future evaluations of LLMs' clinical bias.

Contrastive Bootstrapping for Label Refinement

Traditional text classification typically categorizes texts into pre-defined coarse-grained classes, from which the produced models cannot handle the real-world scenario where finer categories emerge periodically for accurate services. In this work, we investigate the setting where fine-grained classification is done only using the annotation of coarse-grained categories and the coarse-to-fine mapping. We propose a lightweight contrastive clustering-based bootstrapping method to iteratively refine the labels of passages. During clustering, it pulls away negative passage-prototype pairs under the guidance of the mapping from both global and local perspectives. Experiments on NYT and 20News show that our method outperforms the state-of-the-art methods by a large margin.