Safety and security of large language models in healthcare

Publikation: Beitrag in Fachzeitschrift › Übersichtsartikel (Review) › Beigetragen › Begutachtung

Beitragende

Abstract

Integration of artificial intelligence methods into clinical care is proceeding rapidly, driven by advances in generative artificial intelligence, most notably large language models. Large language models trained on large amounts of text have shown potential across nearly every domain of healthcare. However, their broad applicability also comes with new responsibilities, vulnerabilities and threats. These need to be assessed and mitigated before widespread clinical adoption. Here we review the available literature on security and safety of large language models themselves as well as their integration with hospital workflows and interactions with human healthcare providers. We systematically map security hazards to development stages of clinical artificial intelligence systems (design, data, model, inference and environment), identify safety layers, from core optimization objectives, knowledge integrity and alignment, to interaction with humans and systems, and classify threats by their current clinical relevance. Finally, we provide a perspective on current mitigation techniques, illustrating respective stakeholders' responsibilities.

Details

OriginalspracheEnglisch
Seiten (von - bis)577-589
Seitenumfang13
FachzeitschriftNature
Jahrgang656
Ausgabenummer8128
PublikationsstatusVeröffentlicht - 20 Aug. 2026
Peer-Review-StatusJa

Externe IDs

ORCID /0000-0003-2265-4809/work/224858649
ORCID /0000-0002-3730-5348/work/224858755
ORCID /0000-0002-1997-1689/work/224858758
ORCID /0000-0003-3323-2492/work/224858813
ORCID /0009-0004-7808-2701/work/224858912
ORCID /0009-0001-9444-0730/work/224858950
Scopus 105047795437

Schlagworte

Ziele für nachhaltige Entwicklung

  • SDG 3 – Gute Gesundheit und Wohlergehen - Large Language Models, Humans, Generative Artificial Intelligence, Delivery of Health Care/standards, Workflow, Computer Security/standards, Artificial Intelligence

Schlagwörter

  • Large Language Models, Humans, Generative Artificial Intelligence, Delivery of Health Care/standards, Workflow, Computer Security/standards, Artificial Intelligence