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 distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.006 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.002 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
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 teacher head, 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".