Xuan Wang

Manar Aljohani, Jun Hou, Sindhura Kommu et al.

The application of large language models (LLMs) in healthcare holds significant promise for enhancing clinical decision-making, medical research, and patient care. However, their integration into real-world clinical settings raises critical concerns around trustworthiness, particularly around dimensions of truthfulness, privacy, safety, robustness, fairness, and explainability. These dimensions are essential for ensuring that LLMs generate reliable, unbiased, and ethically sound outputs. While researchers have recently begun developing benchmarks and evaluation frameworks to assess LLM trustworthiness, the trustworthiness of LLMs in healthcare remains underexplored, lacking a systematic review that provides a comprehensive understanding and future insights. This survey addresses that gap by providing a comprehensive review of current methodologies and solutions aimed at mitigating risks across key trust dimensions. We analyze how each dimension affects the reliability and ethical deployment of healthcare LLMs, synthesize ongoing research efforts, and identify critical gaps in existing approaches. We also identify emerging challenges posed by evolving paradigms, such as multi-agent collaboration, multi-modal reasoning, and the development of small open-source medical models. Our goal is to guide future research toward more trustworthy, transparent, and clinically viable LLMs.

Deyue Zhang, Dongdong Yang, Junjie Mu et al.

Multimodal large language models (MLLMs) exhibit remarkable capabilities but remain susceptible to jailbreak attacks exploiting cross-modal vulnerabilities. In this work, we introduce a novel method that leverages sequential comic-style visual narratives to circumvent safety alignments in state-of-the-art MLLMs. Our method decomposes malicious queries into visually innocuous storytelling elements using an auxiliary LLM, generates corresponding image sequences through diffusion models, and exploits the models' reliance on narrative coherence to elicit harmful outputs. Extensive experiments on harmful textual queries from established safety benchmarks show that our approach achieves an average attack success rate of 83.5\%, surpassing prior state-of-the-art by 46\%. Compared with existing visual jailbreak methods, our sequential narrative strategy demonstrates superior effectiveness across diverse categories of harmful content. We further analyze attack patterns, uncover key vulnerability factors in multimodal safety mechanisms, and evaluate the limitations of current defense strategies against narrative-driven attacks, revealing significant gaps in existing protections.