Real-world health questions from patients often unintentionally embed false assumptions or premises. In such cases, safe medical communication typically involves redirection: addressing the implicit misconception and then responding to the underlying patient context, rather than the original question. While large language models (LLMs) are increasingly being used by lay users for medical advice, they have not yet been tested for this crucial competency. Therefore, in this work, we investigate how LLMs react to false premises embedded within real-world health questions. We develop a semi-automated pipeline to curate MedRedFlag, a dataset of 1100+ questions sourced from Reddit that require redirection. We then systematically compare responses from state-of-the-art LLMs to those from clinicians. Our analysis reveals that LLMs often fail to redirect problematic questions, even when the problematic premise is detected, and provide answers that could lead to suboptimal medical decision making. Our benchmark and results reveal a novel and substantial gap in how LLMs perform under the conditions of real-world health communication, highlighting critical safety concerns for patient-facing medical AI systems. Code and data are available at https://github.com/srsambara-1/MedRedFlag.

How do people understand and evaluate claims about others’ beliefs, even though these beliefs cannot be directly observed? In this paper, we introduce a cognitive model of epistemic language interpretation, grounded in Bayesian inferences about other agents’ goals, beliefs, and intentions: a language-augmented Bayesian theory-of-mind (LaBToM). By translating natural language into an epistemic “language-of-thought” with grammar-constrained LLM decoding, then evaluating these translations against the inferences produced by inverting a generative model of rational action and perception, LaBToM captures graded plausibility judgments of epistemic claims. We validate our model in an experiment where participants watch an agent navigate a maze to find keys hidden in boxes needed to reach their goal, then rate sentences about the agent’s beliefs. In contrast with multimodal LLMs (GPT-4o, Gemini Pro) and ablated models, our model correlates highly with human judgments for a wide range of expressions, including modal language, uncertainty expressions, knowledge claims, likelihood comparisons, and attributions of false belief.

Drawing real world social inferences usually requires taking into account information from multiple modalities. Language is a particularly powerful source of information in social settings, especially in novel situations where language can provide both abstract information about the environment dynamics and concrete specifics about an agent that cannot be easily visually observed. In this paper, we propose Language-Informed Rational Agent Synthesis (LIRAS), a framework for drawing context-specific social inferences that integrate linguistic and visual inputs. LIRAS frames multimodal social reasoning as a process of constructing structured but situation-specific agent and environment representations – leveraging multimodal language models to parse language and visual inputs into unified symbolic representations, over which a Bayesian inverse planning engine can be run to produce granular probabilistic judgments. On a range of existing and new social reasoning tasks derived from cognitive science experiments, we find that our model (instantiated with a comparatively lightweight VLM) outperforms ablations and state-of-the-art models in capturing human judgments across all domains.