NurValues: 临床情境下大型语言模型护理价值观的现实评估
NurValues: Real-World Nursing Values Evaluation for Large Language Models in Clinical Context
AI总结：
NurValues通过首个护理价值对齐基准，评估LLMs在临床情境中是否符合护理核心价值观，发现通用LLMs在公正维度表现最差。
摘要：
尽管LLMs在医学知识和对话能力方面已有所展现，但其在临床实践中的应用带来了新的风险：患者可能比护士的专业判断更信任LLM生成的回应，这可能会加剧护患冲突。这些风险凸显了评估LLMs是否与人类护士所坚持的核心护理价值观一致的紧迫性。本工作引入了首个护理价值对齐基准，该基准由从国际护理代码中提炼出的五个核心价值维度组成：利他主义、人类尊严、诚信、公正和专业性。我们定义了基准上的两级任务，考虑到新兴护患冲突的两个特征。易级数据集包含2200个价值一致和价值违反的实例，这些实例通过为期五个月的纵向实地研究在三个不同层级的医院中收集；难级数据集由2200个基于对话的实例组成，这些实例嵌入了情境线索和微妙的误导信号，增加了对抗性复杂性，并更好地反映了新兴护患冲突情境中叙述者主观性和偏见。我们评估了23个最先进的LLMs在对齐护理价值观方面的能力，并发现通用LLMs优于医疗LLMs，而公正是最难对齐的价值维度。作为首个针对医疗价值对齐的现实基准，NurValues为LLMs在医患互动中如何应对伦理挑战提供了新的见解。
英文摘要：
While LLMs have demonstrated medical knowledge and conversational ability, their deployment in clinical practice raises new risks: patients may place greater trust in LLM-generated responses than in nurses' professional judgments, potentially intensifying nurse-patient conflicts. Such risks highlight the urgent need of evaluating whether LLMs align with the core nursing values upheld by human nurses. This work introduces the first benchmark for nursing value alignment, consisting of five core value dimensions distilled from international nursing codes: Altruism, Human Dignity, Integrity, Justice, and Professionalism. We define two-level tasks on the benchmark, considering the two characteristics of emerging nurse-patient conflicts. The Easy-Level dataset consists of 2,200 value-aligned and value-violating instances, which are collected through a five-month longitudinal field study across three hospitals of varying tiers; The Hard-Level dataset is comprised of 2,200 dialogue-based instances that embed contextual cues and subtle misleading signals, which increase adversarial complexity and better reflect the subjectivity and bias of narrators in the context of emerging nurse-patient conflicts. We evaluate a total of 23 SoTA LLMs on their ability to align with nursing values, and find that general LLMs outperform medical ones, and Justice is the hardest value dimension. As the first real-world benchmark for healthcare value alignment, NurValues provides novel insights into how LLMs navigate ethical challenges in clinician-patient interactions.
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