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This paper introduces MIRA, a bilingual benchmark designed to detect Differential Information Dilution (DID) in large language models when responding to queries with varying levels of health literacy. The study reveals that mainstream models consistently omit critical medical details and actionable steps for users expressing questions with lower literacy signals, even when the core medical question remains unchanged. A proposed knowledge-guided mitigation strategy successfully reduces this underinformative simplification, particularly in Claude and Qwen models, offering a pathway to more equitable AI healthcare interactions.
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MIRA: A Bilingual Benchmark for Medical Information Response Audit

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arXiv:2605.28025v2 Announce Type: replace Abstract: Existing safety evaluations for large language models overlook whether responses preserve comparable medical information across different user phrasings of the same question. To address this, we introduce the Medical Information Response Audit (MIRA), a bilingual, controlled benchmark that assesses whether LLMs provide comparable medical information across user-side language, register, and health literacy signals. MIRA contains 4,320 prompts built from 60 medically reviewed, low-risk health questions. Across five mainstream LLMs, models answered all medical questions, but responses to low health-literacy signals consistently omitted more key information, provided fewer concrete next steps, and offered less support for independent judgment. We term this pattern Differential Information Dilution (DID). A comparison with 300 real-world health queries provides preliminary evidence of rank-order validity. A knowledge-guided mitigation prompt reduces information dilution for most models, with the largest reductions in underinformative simplification observed for Claude (~8%) and Qwen (~6%). Code and data are available at https://github.com/Rainxu09/MIRA.

Abstract:Existing safety evaluations for large language models overlook whether responses preserve comparable medical information across different user phrasings of the same question. To address this, we introduce the Medical Information Response Audit (MIRA), a bilingual, controlled benchmark that assesses whether LLMs provide comparable medical information across user-side language, register, and health literacy signals. MIRA contains 4,320 prompts built from 60 medically reviewed, low-risk health questions. Across five mainstream LLMs, models answered all medical questions, but responses to low health-literacy signals consistently omitted more key information, provided fewer concrete next steps, and offered less support for independent judgment. We term this pattern Differential Information Dilution (DID). A comparison with 300 real-world health queries provides preliminary evidence of rank-order validity. A knowledge-guided mitigation prompt reduces information dilution for most models, with the largest reductions in underinformative simplification observed for Claude (~8%) and Qwen (~6%). Code and data are available at this https URL.

Artificial Intelligence (cs.AI); Computation and Language (cs.CL); Computers and Society (cs.CY)

arXiv:2605.28025 [cs.AI]

(or arXiv:2605.28025v2 [cs.AI] for this version)

https://doi.org/10.48550/arXiv.2605.28025 Focus to learn more arXiv-issued DOI via DataCite

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