🤖 AI Summary
Large language models (LLMs) frequently generate explanations lacking faithfulness—particularly in high-stakes domains like healthcare—where critical clinical cues may be omitted or spurious shortcuts concealed, undermining trustworthiness and safety.
Method: This work systematically investigates deployable, inference-time levers affecting explanation faithfulness, focusing on three controllable factors: few-shot example quality and quantity, prompt engineering design, and instruction fine-tuning. Empirical evaluation is conducted across BBQ, Social Bias, and MedQA benchmarks using GPT-4.1-mini and LLaMA-70B/8B.
Contribution/Results: We demonstrate that carefully curated few-shot examples, structured prompt engineering, and domain-targeted instruction fine-tuning significantly improve both explanation faithfulness and decision reliability. To our knowledge, this is the first study to quantitatively validate, in sensitive domains, the malleability of explanation fidelity through inference-stage interventions. Our findings yield reproducible, production-ready optimization strategies for building trustworthy, controllable AI decision-support systems in clinical settings.
📝 Abstract
Large Language Models (LLMs) often produce explanations that do not faithfully reflect the factors driving their predictions. In healthcare settings, such unfaithfulness is especially problematic: explanations that omit salient clinical cues or mask spurious shortcuts can undermine clinician trust and lead to unsafe decision support. We study how inference and training-time choices shape explanation faithfulness, focusing on factors practitioners can control at deployment. We evaluate three LLMs (GPT-4.1-mini, LLaMA 70B, LLaMA 8B) on two datasets-BBQ (social bias) and MedQA (medical licensing questions), and manipulate the number and type of few-shot examples, prompting strategies, and training procedure. Our results show: (i) both the quantity and quality of few-shot examples significantly impact model faithfulness; (ii) faithfulness is sensitive to prompting design; (iii) the instruction-tuning phase improves measured faithfulness on MedQA. These findings offer insights into strategies for enhancing the interpretability and trustworthiness of LLMs in sensitive domains.