Machine learning models are often designed to maximize a primary goal, such as accuracy. However, as these models are increasingly used to inform decisions that affect people's lives or well-being, it is often unclear what the real-world repercussions of their deployment might be--making it crucial to understand and manage such repercussions effectively. Models maximizing user engagement on social media platforms, e.g., may inadvertently contribute to the spread of misinformation and content that deepens political polarization. This issue is not limited to social media--it extends to other applications where machine learning-informed decisions can have real-world repercussions, such as education, employment, and lending. Existing methods addressing this issue require prior knowledge or estimates of analytical models describing the relationship between a classifier's predictions and their corresponding repercussions. We introduce THEIA, a novel classification algorithm capable of optimizing a primary objective, such as accuracy, while providing high-confidence guarantees about its potential repercussions. Importantly, THEIA solves the open problem of providing such guarantees based solely on existing data with observations of previous repercussions. We prove that it satisfies constraints on a model's repercussions with high confidence and that it is guaranteed to identify a solution, if one exists, given sufficient data. We empirically demonstrate, using real-life data, that THEIA can identify models that achieve high accuracy while ensuring, with high confidence, that constraints on their repercussions are satisfied.

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We propose a Level Set Traversal algorithm that iteratively explores regions of high confidence with respect to the input space using orthogonal components of the local gradients.

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Multimodal large language models (MLLMs) hold considerable promise for applications in healthcare. However, their deployment in safety-critical settings is hindered by two key limitations: (i) sensitivity to prompt design, and (ii) a tendency to generate incorrect responses with high confidence. As clinicians may rely on a model's stated confidence to gauge the reliability of its predictions, it is especially important that when a model expresses high confidence, it is also highly accurate. We introduce Prompt4Trust, the first reinforcement learning (RL) framework for prompt augmentation targeting confidence calibration in MLLMs. A lightweight LLM is trained to produce context-aware auxiliary prompts that guide a downstream task MLLM to generate responses in which the expressed confidence more accurately reflects predictive accuracy. Unlike conventional calibration techniques, Prompt4Trust specifically prioritizes aspects of calibration most critical for safe and trustworthy clinical decision-making. Beyond improvements driven by this clinically motivated calibration objective, our proposed method also improves task accuracy, achieving state-of-the-art medical visual question answering (VQA) performance on the PMC-VQA benchmark, which is composed of multiple-choice questions spanning diverse medical imaging modalities. Moreover, our framework trained with a small downstream task MLLM showed promising zero-shot generalization to larger MLLMs in our experiments, suggesting the potential for scalable calibration without the associated computational costs. This work demonstrates the potential of automated yet human-aligned prompt engineering for improving the the trustworthiness of MLLMs in safety critical settings. Our codebase can be found at https://github.com/xingbpshen/prompt4trust.