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medRxiv

The Online Health Safety Gap: Consensus Alignment Does Not Imply Safety in Peer-to-Peer Health Narratives

This work identifies and empirically validates the Online Health Safety Gap: across 704 health narratives (699 classified), two scores computed from non-overlapping feature sets, Narrative Truth Distance for epistemic divergence and Narrative Risk Score for health risk potential, share only 4.9% of their variance (r=0.222, p<0.001), so 39.6% of narratives fall in the two off-diagonal quadrants that single-axis systems mishandle by construction (aligned-but-risky 25.2%, divergent-but-safe 14.4%), and on an expert-labeled misinformation benchmark of 437 posts containing 127 misinformation instances the highest discrimination is Youden J of 0.349, motivating a Classification Quadrant and a shift from fact-centric evaluation to risk-aware assessment.