Khurram Yamin

Khurram Yamin, Jingjing Tang, Santiago Cortes-Gomez et al.

Large language models (LLMs) are increasingly deployed as agents in high-stakes domains where optimal actions depend on both uncertainty about the world and consideration of utilities of different outcomes, yet their decision logic remains difficult to interpret. We study whether LLMs are rational utility maximizers with coherent beliefs and stable preferences. We consider behaviors of models for diagnosis challenge problems. The results provide insights about the relationship of LLM inferences to ideal Bayesian utility maximization for elicited probabilities and observed actions. Our approach provides falsifiable conditions under which the reported probabilities \emph{cannot} correspond to the true beliefs of any rational agent. We apply this methodology to multiple medical diagnostic domains with evaluations across several LLMs. We discuss implications of the results and directions forward for uses of LLMs in guiding high-stakes decisions.

Khurram Yamin, Jingjing Tang, Eric Horvitz et al.

LLMs are increasingly used to make or support high-stakes decisions under uncertainty, where alignment depends not only on factual accuracy but on how models weigh tradeoffs between different outcomes. We present an empirical pipeline for estimating the implied preferences that an LLM's observed choices optimize: we elicit the model's probability distribution over unknowns along with the choice it would make for the decision task and then fit a discrete choice model to recover the cost function that best rationalizes the model's decisions. We show how this revealed-preference description allows rigorous evaluation of whether models behave in a consistently goal-directed way, whether they can verbalize a description of their objectives which matches their revealed decision policy, and whether prompting can reliably steer those policies to implement a user-specified cost function. We apply this evaluation across four medical diagnosis domains and multiple frontier and open-source models. We find that while many models have a nontrivial degree of internal coherence, they also have significant weaknesses in faithfully reporting or adopting preferences in response to user direction.