Reinforcement Learning Towards Broadly and Persistently Beneficial Models

As AI systems are deployed across increasingly diverse and high-stakes settings, model alignment must generalize beyond the tasks and domains seen during training. This is especially important for reinforcement learning (RL), which can introduce unexpected misalignment through reward hacking, deception, or other unintended strategies. We study whether RL on beneficial behavior, instantiated in realistic domains, can produce broad and persistent alignment generalization beyond the training distribution. We construct a dataset of realistic situations designed to measure and train beneficial traits, such as truthfulness, fairness, risk awareness, and corrigibility, spanning varied domains, including health, science, and education. We then train models with RL on this dataset and evaluate them on more than 50 independent benchmarks of alignment and beneficial behavior. Compared to a compute-matched baseline, beneficial trait RL improves performance on over 80% of these out-of-distribution benchmarks. We observe substantial out-of-distribution alignment transfer: a beneficial-behavior RL intervention entirely limited to one domain, health, produces broad improvements on non-health alignment evaluations, including reduced reward hacking, deception, and general misalignment. Finally, we study alignment persistence: whether behavior remains robustly aligned under attempts to steer models towards misalignment. Models trained with beneficial trait RL show improved persistence, including greater resistance to adversarial prompting and harmful finetuning; further work is required to isolate the sources of these effects. These results suggest that RL to reinforce beneficial behavior in realistic domains can produce models that are more robustly aligned with human flourishing.

AI-based Clinical Decision Support for Primary Care: A Real-World Study

We evaluate the impact of large language model-based clinical decision support in live care. In partnership with Penda Health, a network of primary care clinics in Nairobi, Kenya, we studied AI Consult, a tool that serves as a safety net for clinicians by identifying potential documentation and clinical decision-making errors. AI Consult integrates into clinician workflows, activating only when needed and preserving clinician autonomy. We conducted a quality improvement study, comparing outcomes for 39,849 patient visits performed by clinicians with or without access to AI Consult across 15 clinics. Visits were rated by independent physicians to identify clinical errors. Clinicians with access to AI Consult made relatively fewer errors: 16% fewer diagnostic errors and 13% fewer treatment errors. In absolute terms, the introduction of AI Consult would avert diagnostic errors in 22,000 visits and treatment errors in 29,000 visits annually at Penda alone. In a survey of clinicians with AI Consult, all clinicians said that AI Consult improved the quality of care they delivered, with 75% saying the effect was "substantial". These results required a clinical workflow-aligned AI Consult implementation and active deployment to encourage clinician uptake. We hope this study demonstrates the potential for LLM-based clinical decision support tools to reduce errors in real-world settings and provides a practical framework for advancing responsible adoption.

HealthBench: Evaluating Large Language Models Towards Improved Human Health

We present HealthBench, an open-source benchmark measuring the performance and safety of large language models in healthcare. HealthBench consists of 5,000 multi-turn conversations between a model and an individual user or healthcare professional. Responses are evaluated using conversation-specific rubrics created by 262 physicians. Unlike previous multiple-choice or short-answer benchmarks, HealthBench enables realistic, open-ended evaluation through 48,562 unique rubric criteria spanning several health contexts (e.g., emergencies, transforming clinical data, global health) and behavioral dimensions (e.g., accuracy, instruction following, communication). HealthBench performance over the last two years reflects steady initial progress (compare GPT-3.5 Turbo's 16% to GPT-4o's 32%) and more rapid recent improvements (o3 scores 60%). Smaller models have especially improved: GPT-4.1 nano outperforms GPT-4o and is 25 times cheaper. We additionally release two HealthBench variations: HealthBench Consensus, which includes 34 particularly important dimensions of model behavior validated via physician consensus, and HealthBench Hard, where the current top score is 32%. We hope that HealthBench grounds progress towards model development and applications that benefit human health.