Detecting Unreliable Classifications from Quantized Models

Quantization enables deployment of large language models on resource-constrained clinical edge devices, but its effect on clinical accuracy and safety remains understudied. We evaluate five 7-8B parameter models at FP16, GPTQ-INT8, and GPTQ-INT4 precision across five benchmarks: MedQA, MedMCQA, Med-HALT, a risk-stratified sample of HealthBench, and MedSafetyBench. The study jointly varies quantization bit width, model family, and clinical task type, with explicit risk stratification and safety measures. INT8 GPTQ is universally safe (max. degradation -1.9%-1.9%), while INT4 degradation is substantial and model-dependent: BioMistral-7B, clinically fine-tuned, loses 19.7% on MedMCQA, more than any general-purpose model, showing clinical fine-tuning does not confer compression robustness. MedMCQA degrades more than MedQA under INT4; Med-HALT is largely unaffected. On HealthBench's emergency-risk subgroup, Qwen2.5-7B degrades by 26.8% under INT4, suggesting high-risk scenarios are disproportionately vulnerable to compression. On MedSafetyBench, the model family dominates over precision (refusal rates range 10.2%-74.9% at FP16), though Qwen2.5-7B (-17.8%) and Meditron-7B (-28.3%) show substantial INT4 safety degradation; notably, Qwen2.5-7B is simultaneously the most accuracy-robust model, demonstrating that accuracy and safety robustness are independent properties. We additionally test two recovery methods, clinical calibration substitution and QLoRA fine-tuning, both producing the same trade-off: MedMCQA recovers while MedQA further degrades, indicating recovery strategies require task-specific validation rather than being assumed universally beneficial. These findings indicate INT8 is broadly safe for clinical deployment, while INT4 safety must be assessed per-model and per-task, and that safety alignment is determined primarily by instruction tuning rather than clinical domain adaptation.

Post-training quantization (PTQ) has become a practical solution for deploying deep learning models on resource-constrained edge devices by compressing high-precision floating-point weights into low-precision representations without requiring retraining. Past research has demonstrated that quantization largely preserves classification accuracy; however, whether it also preserves the model's internal reasoning remains an open question. This study presents a systematic evaluation on how static PTQ affects the interpretability / explainability of five widely used CNN architectures: VGG19, ResNet18, EfficientNet-B0, DenseNet161, and MobileNetV2 at INT8 and INT4 precision. We employ a dual interpretability framework that combines Grad-CAM for spatial attention analysis with LIME for input-level feature attribution, and systematically compare full-precision and quantized models on two binary classification datasets. Interpretability is evaluated using three complementary metrics: the Pearson correlation coefficient, structural similarity index, and top-20% IoU to capture distributional and structural variations in model explanations, supplemented by deletion/insertion faithfulness analysis. The results show that classification accuracy is not a reliable indicator of interpretability stability under reduced precision. DenseNet161 maintains strong feature consistency across both precision levels, whereas EfficientNet-B0, despite achieving competitive spatial attention and classification accuracy at INT8 precision, exhibits a substantial degradation in input-level feature attribution. These findings have direct implications for the trustworthy deployment of quantized models in applications with high interpretability requirements, demonstrating that architecture selection is as important as the quantization strategy.

Post-training quantization is widely used to deploy large language models in resource-constrained settings, yet its evaluation relies almost exclusively on accuracy and perplexity. We show that these metrics fail to capture behavioral changes induced by quantization. We introduce correctness agreement, a decision-level metric that measures overlap in correct predictions between a base model and its quantized variants, independent of absolute accuracy. Across multiple models and quantization schemes from 8-bit to 2-bit, we find that behavioral divergence emerges under moderate quantization even when task performance appears preserved. To explain this effect, we analyze quantization as a structural operator on attention weights and quantify layer-wise distortions using statistical and distributional measures. Our results reveal non-linear breakpoints at low bit-widths and show that query and key projections are consistently more sensitive than value and output projections. These findings expose an illusion of equivalence between base and quantized models and motivate behavioral evaluation beyond conventional performance metrics.