The perils of politeness: how large language models may amplify medical misinformation.

Rosen, Kyra L; Sui, Margaret; Heydari, Kimia; Enichen, Elizabeth J; Kvedar, Joseph C · NPJ Digit Med · 2025

review · Level V

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Abstract

Chen et al. demonstrate that large language models (LLMs) frequently prioritize agreement over accuracy when responding to illogical medical prompts, a behavior known as sycophancy. By reinforcing user assumptions, this tendency may amplify misinformation and bias in clinical contexts. The authors find that simple prompting strategies and LLM fine-tuning can markedly reduce sycophancy without impairing performance, highlighting a path toward safer, more trustworthy applications of LLMs in medicine.