Large language models are vulnerable to incidental information in clinical documentation and reasoning

Large language models (LLMs) are increasingly relied upon to support ambient documentation and clinical reasoning. Here we examine the impact of a failure mode shared between these two applications by assessing their sensitivity to information incidental to the patient encounter. In 576 patient-clinician dialogues, we found that frontier models inserted small-talk exchanges into 35% of notes, while mean quality scores changed by at most 0.20 points on five-point scales. In 3.7% of frontier notes, models misattributed the asides or used them clinically. In 57 mock recorded consultations, background speech from a separate patient encounter at -10 dB leaked into 48.2% of transcripts, with co...

<iframe src="https://silytics.si/embed/item/262a4010-4c86-4988-9688-51663f24cabf" width="420" height="190" style="border:0" loading="lazy" title="Silytics entry"></iframe>

Silytics shows public metadata from arXiv and links to the original. Information may be incomplete or out of date. Last refreshed 16 October 2026. Licenses and terms of the original apply to the work itself. Not financial, legal or professional advice.