Jiawen Deng
Publications
Auditing Evidence Use in Medical LLM Diagnosis
Medical LLMs are often evaluated by whether they select the correct diagnosis, but diagnostic accuracy alone does not show whether the model used the case evidence appropriately. We present a behavioral audit of evidence use in medical diagnosis. For each case, we decompose patient information into evidence units, score candidate diagnoses under controlled evidence subsets, and mine low-order interactions in diagnostic margins. Because medical evidence is diagnosis-relative, the audit separates interaction discovery from failure assignment: large or negative interactions can reflect plausible differential diagnosis, while suspicious interactions require robustness checks and clinical review. We evaluate five open-weight LLMs on DDXPlus, CupCase, and MedCase. Across datasets, faithful support and differential conflict or cancellation account for most interaction strength, showing that many evidence interactions are clinically plausible rather than failures. In a DDXPlus-focused blinded five-reviewer 130-item enriched review sample, invalid or shortcut-like cases concentrate in negated or absent findings and clinically local evidence. These results show that accuracy can hide candidate evidence-use failures and motivate role-aware audits for medical LLM evaluation.
Beyond Explicit Refusals: Soft-Failure Attacks on Retrieval-Augmented Generation
Existing jamming attacks on Retrieval-Augmented Generation (RAG) systems typically induce explicit refusals or denial-of-service behaviors, which are conspicuous and easy to detect. In this work, we formalize a subtler availability threat, termed soft failure, which degrades system utility by inducing fluent and coherent yet non-informative responses rather than overt failures. We propose Deceptive Evolutionary Jamming Attack (DEJA), an automated black-box attack framework that generates adversarial documents to trigger such soft failures by exploiting safety-aligned behaviors of large language models. DEJA employs an evolutionary optimization process guided by a fine-grained Answer Utility Score (AUS), computed via an LLM-based evaluator, to systematically degrade the certainty of answers while maintaining high retrieval success. Extensive experiments across multiple RAG configurations and benchmark datasets show that DEJA consistently drives responses toward low-utility soft failures, achieving SASR above 79\% while keeping hard-failure rates below 15\%, significantly outperforming prior attacks. The resulting adversarial documents exhibit high stealth, evading perplexity-based detection and resisting query paraphrasing, and transfer across model families to proprietary systems without retargeting.