MedDialBench: Benchmarking LLM Diagnostic Robustness under Parametric Adversarial Patient Behaviors

Interactive medical dialogue benchmarks have shown that LLM diagnostic accuracy degrades significantly when interacting with non-cooperative patients, yet existing approaches either apply adversarial behaviors without graded severity or case-specific grounding, or reduce patient non-cooperation to a single ungraded axis, and none analyze cross-dimension interactions. We introduce MedDialBench, a benchmark enabling controlled, dose-response characterization of how individual patient behavior dimensions affect LLM diagnostic robustness. It decomposes patient behavior into five dimensions -- Logic Consistency, Health Cognition, Expression Style, Disclosure, and Attitude -- each with graded severity levels and case-specific behavioral scripts. This controlled factorial design enables graded sensitivity analysis, dose-response profiling, and cross-dimension interaction detection. Evaluating five frontier LLMs across 7,225 dialogues (85 cases x 17 configurations x 5 models), we find a fundamental asymmetry: information pollution (fabricating symptoms) produces 1.7-3.4x larger accuracy drops than information deficit (withholding information), and fabricating is the only configuration achieving statistical significance across all five models (McNemar p < 0.05). Among six dimension combinations, fabricating is the sole driver of super-additive interaction: all three fabricating-involving pairs produce O/E ratios of 0.70-0.81 (35-44% of eligible cases fail under the combination despite succeeding under each dimension alone), while all non-fabricating pairs show purely additive effects (O/E ~ 1.0). Inquiry strategy moderates deficit but not pollution: exhaustive questioning recovers withheld information, but cannot compensate for fabricated inputs. Models exhibit distinct vulnerability profiles, with worst-case drops ranging from 38.8 to 54.1 percentage points.

Recurrent Attention Networks for Long-text Modeling

Self-attention-based models have achieved remarkable progress in short-text mining. However, the quadratic computational complexities restrict their application in long text processing. Prior works have adopted the chunking strategy to divide long documents into chunks and stack a self-attention backbone with the recurrent structure to extract semantic representation. Such an approach disables parallelization of the attention mechanism, significantly increasing the training cost and raising hardware requirements. Revisiting the self-attention mechanism and the recurrent structure, this paper proposes a novel long-document encoding model, Recurrent Attention Network (RAN), to enable the recurrent operation of self-attention. Combining the advantages from both sides, the well-designed RAN is capable of extracting global semantics in both token-level and document-level representations, making it inherently compatible with both sequential and classification tasks, respectively. Furthermore, RAN is computationally scalable as it supports parallelization on long document processing. Extensive experiments demonstrate the long-text encoding ability of the proposed RAN model on both classification and sequential tasks, showing its potential for a wide range of applications.