A longitudinal analysis of declining medical safety messaging in generative AI models
Bibliographic record
Abstract
Generative AI models, including large language models (LLMs) and vision-language models (VLMs), are increasingly used to interpret medical images and answer clinical questions. However, their responses often include inaccuracies; therefore, safety measures like medical disclaimers are critical. In this study, we evaluated the presence of disclaimers in LLM and VLM outputs across model generations released from 2022 to 2025. Responses were generated from 500 mammograms, 500 chest X-rays, 500 dermatology images, and 500 medical questions drawn from a new dataset we introduced: TIMed-Q (Top Internet Medical Question Dataset). TIMed-Q captures the most frequently searched medical queries by patients, reflecting real-world health information-seeking behavior. Disclaimer presence in LLM outputs dropped from 26.3% in 2022 to 0.97% in 2025, while VLM disclaimer rates declined from 19.6% in 2023 to 1.05%. By 2025, most models displayed no disclaimers. As models gain further capability, disclaimers must function as adaptive safeguards tailored to clinical contexts.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.012 | 0.096 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.006 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".