Daily Papers

Foundation Models that are capable of processing and generating multi-modal data have transformed AI's role in medicine. However, a key limitation of their reliability is hallucination, where inaccurate or fabricated information can impact clinical decisions and patient safety. We define medical hallucination as any instance in which a model generates misleading medical content. This paper examines the unique characteristics, causes, and implications of medical hallucinations, with a particular focus on how these errors manifest themselves in real-world clinical scenarios. Our contributions include (1) a taxonomy for understanding and addressing medical hallucinations, (2) benchmarking models using medical hallucination dataset and physician-annotated LLM responses to real medical cases, providing direct insight into the clinical impact of hallucinations, and (3) a multi-national clinician survey on their experiences with medical hallucinations. Our results reveal that inference techniques such as Chain-of-Thought (CoT) and Search Augmented Generation can effectively reduce hallucination rates. However, despite these improvements, non-trivial levels of hallucination persist. These findings underscore the ethical and practical imperative for robust detection and mitigation strategies, establishing a foundation for regulatory policies that prioritize patient safety and maintain clinical integrity as AI becomes more integrated into healthcare. The feedback from clinicians highlights the urgent need for not only technical advances but also for clearer ethical and regulatory guidelines to ensure patient safety. A repository organizing the paper resources, summaries, and additional information is available at https://github.com/mitmedialab/medical hallucination.

Large Vision Language Models (LVLMs) are increasingly integral to healthcare applications, including medical visual question answering and imaging report generation. While these models inherit the robust capabilities of foundational Large Language Models (LLMs), they also inherit susceptibility to hallucinations-a significant concern in high-stakes medical contexts where the margin for error is minimal. However, currently, there are no dedicated methods or benchmarks for hallucination detection and evaluation in the medical field. To bridge this gap, we introduce Med-HallMark, the first benchmark specifically designed for hallucination detection and evaluation within the medical multimodal domain. This benchmark provides multi-tasking hallucination support, multifaceted hallucination data, and hierarchical hallucination categorization. Furthermore, we propose the MediHall Score, a new medical evaluative metric designed to assess LVLMs' hallucinations through a hierarchical scoring system that considers the severity and type of hallucination, thereby enabling a granular assessment of potential clinical impacts. We also present MediHallDetector, a novel Medical LVLM engineered for precise hallucination detection, which employs multitask training for hallucination detection. Through extensive experimental evaluations, we establish baselines for popular LVLMs using our benchmark. The findings indicate that MediHall Score provides a more nuanced understanding of hallucination impacts compared to traditional metrics and demonstrate the enhanced performance of MediHallDetector. We hope this work can significantly improve the reliability of LVLMs in medical applications. All resources of this work will be released soon.

Advancements in Large Language Models (LLMs) and their increasing use in medical question-answering necessitate rigorous evaluation of their reliability. A critical challenge lies in hallucination, where models generate plausible yet factually incorrect outputs. In the medical domain, this poses serious risks to patient safety and clinical decision-making. To address this, we introduce MedHallu, the first benchmark specifically designed for medical hallucination detection. MedHallu comprises 10,000 high-quality question-answer pairs derived from PubMedQA, with hallucinated answers systematically generated through a controlled pipeline. Our experiments show that state-of-the-art LLMs, including GPT-4o, Llama-3.1, and the medically fine-tuned UltraMedical, struggle with this binary hallucination detection task, with the best model achieving an F1 score as low as 0.625 for detecting "hard" category hallucinations. Using bidirectional entailment clustering, we show that harder-to-detect hallucinations are semantically closer to ground truth. Through experiments, we also show incorporating domain-specific knowledge and introducing a "not sure" category as one of the answer categories improves the precision and F1 scores by up to 38% relative to baselines.

The remarkable capabilities of large language models (LLMs) in language understanding and generation have not rendered them immune to hallucinations. LLMs can still generate plausible-sounding but factually incorrect or fabricated information. As LLM-empowered chatbots become popular, laypeople may frequently ask health-related queries and risk falling victim to these LLM hallucinations, resulting in various societal and healthcare implications. In this work, we conduct a pioneering study of hallucinations in LLM-generated responses to real-world healthcare queries from patients. We propose MedHalu, a carefully crafted first-of-its-kind medical hallucination dataset with a diverse range of health-related topics and the corresponding hallucinated responses from LLMs with labeled hallucination types and hallucinated text spans. We also introduce MedHaluDetect framework to evaluate capabilities of various LLMs in detecting hallucinations. We also employ three groups of evaluators -- medical experts, LLMs, and laypeople -- to study who are more vulnerable to these medical hallucinations. We find that LLMs are much worse than the experts. They also perform no better than laypeople and even worse in few cases in detecting hallucinations. To fill this gap, we propose expert-in-the-loop approach to improve hallucination detection through LLMs by infusing expert reasoning. We observe significant performance gains for all the LLMs with an average macro-F1 improvement of 6.3 percentage points for GPT-4.

Multimodal large language models (MLLMs) have recently achieved remarkable progress in radiology by integrating visual perception with natural language understanding. However, they often generate clinically unsupported descriptions, known as medical hallucinations, which pose serious risks in medical applications that demand accuracy and image-grounded outputs. Through empirical analysis, we find that prompt-induced hallucinations remain prevalent in radiology MLLMs, largely due to over-sensitivity to clinical sections. To address this, we introduce Clinical Contrastive Cecoding (CCD), a training-free and retrieval-free inference framework that integrates structured clinical signals from task-specific radiology expert models. CCD introduces a dual-stage contrastive mechanism to refine token-level logits during generation, thereby enhancing clinical fidelity without modifying the base MLLM. Experiments on three datasets and multiple models demonstrate that CCD consistently improves overall performance on radiology report generation (RRG). On the MIMIC-CXR dataset, it yields up to a 17% improvement in RadGraph-F1 when applied to state-of-the-art RRG models. Our approach provides a lightweight and generalisable solution for mitigating medical hallucinations, effectively bridging expert models and MLLMs in radiology.

LLMs are bound to transform healthcare with advanced decision support and flexible chat assistants. However, LLMs are prone to generate inaccurate medical content. To ground LLMs in high-quality medical knowledge, LLMs have been equipped with external knowledge via RAG, where unstructured medical knowledge is split into small text chunks that can be selectively retrieved and integrated into the LLMs context. Yet, existing RAG pipelines rely on raw, unstructured medical text, which can be noisy, uncurated and difficult for LLMs to effectively leverage. Systematic approaches to organize medical knowledge to best surface it to LLMs are generally lacking. To address these challenges, we introduce MIRIAD, a large-scale, curated corpus of 5,821,948 medical QA pairs, each rephrased from and grounded in a passage from peer-reviewed medical literature using a semi-automated pipeline combining LLM generation, filtering, grounding, and human annotation. Unlike prior medical corpora, which rely on unstructured text, MIRIAD encapsulates web-scale medical knowledge in an operationalized query-response format, which enables more targeted retrieval. Experiments on challenging medical QA benchmarks show that augmenting LLMs with MIRIAD improves accuracy up to 6.7% compared to unstructured RAG baselines with the same source corpus and with the same amount of retrieved text. Moreover, MIRIAD improved the ability of LLMs to detect medical hallucinations by 22.5 to 37% (increase in F1 score). We further introduce MIRIAD-Atlas, an interactive map of MIRIAD spanning 56 medical disciplines, enabling clinical users to visually explore, search, and refine medical knowledge. MIRIAD promises to unlock a wealth of down-stream applications, including medical information retrievers, enhanced RAG applications, and knowledge-grounded chat interfaces, which ultimately enables more reliable LLM applications in healthcare.

Hallucinations in large language models (LLMs) during summarization of patient-clinician dialogues pose significant risks to patient care and clinical decision-making. However, the phenomenon remains understudied in the clinical domain, with uncertainty surrounding the applicability of general-domain hallucination detectors. The rarity and randomness of hallucinations further complicate their investigation. In this paper, we conduct an evaluation of hallucination detection methods in the medical domain, and construct two datasets for the purpose: A fact-controlled Leave-N-out dataset -- generated by systematically removing facts from source dialogues to induce hallucinated content in summaries; and a natural hallucination dataset -- arising organically during LLM-based medical summarization. We show that general-domain detectors struggle to detect clinical hallucinations, and that performance on fact-controlled hallucinations does not reliably predict effectiveness on natural hallucinations. We then develop fact-based approaches that count hallucinations, offering explainability not available with existing methods. Notably, our LLM-based detectors, which we developed using fact-controlled hallucinations, generalize well to detecting real-world clinical hallucinations. This research contributes a suite of specialized metrics supported by expert-annotated datasets to advance faithful clinical summarization systems.

Large language models have the potential to be valuable in the healthcare industry, but it's crucial to verify their safety and effectiveness through rigorous evaluation. For this purpose, we comprehensively evaluated both open-source LLMs and Google's new multimodal LLM called Gemini across Medical reasoning, hallucination detection, and Medical Visual Question Answering tasks. While Gemini showed competence, it lagged behind state-of-the-art models like MedPaLM 2 and GPT-4 in diagnostic accuracy. Additionally, Gemini achieved an accuracy of 61.45\% on the medical VQA dataset, significantly lower than GPT-4V's score of 88\%. Our analysis revealed that Gemini is highly susceptible to hallucinations, overconfidence, and knowledge gaps, which indicate risks if deployed uncritically. We also performed a detailed analysis by medical subject and test type, providing actionable feedback for developers and clinicians. To mitigate risks, we applied prompting strategies that improved performance. Additionally, we facilitated future research and development by releasing a Python module for medical LLM evaluation and establishing a dedicated leaderboard on Hugging Face for medical domain LLMs. Python module can be found at https://github.com/promptslab/RosettaEval

Automatic medical report generation (MRG), which possesses significant research value as it can aid radiologists in clinical diagnosis and report composition, has garnered increasing attention. Despite recent progress, generating accurate reports remains arduous due to the requirement for precise clinical comprehension and disease diagnosis inference. Furthermore, owing to the limited accessibility of medical data and the imbalanced distribution of diseases, the underrepresentation of rare diseases in training data makes large-scale medical visual language models (LVLMs) prone to hallucinations, such as omissions or fabrications, severely undermining diagnostic performance and further intensifying the challenges for MRG in practice. In this study, to effectively mitigate hallucinations in medical report generation, we propose a chain-of-medical-thought approach (CoMT), which intends to imitate the cognitive process of human doctors by decomposing diagnostic procedures. The radiological features with different importance are structured into fine-grained medical thought chains to enhance the inferential ability during diagnosis, thereby alleviating hallucination problems and enhancing the diagnostic accuracy of MRG. The code and dataset have been released at https://github.com/FRENKIE-CHIANG/CoMT.

We present MedHal, a novel large-scale dataset specifically designed to evaluate if models can detect hallucinations in medical texts. Current hallucination detection methods face significant limitations when applied to specialized domains like medicine, where they can have disastrous consequences. Existing medical datasets are either too small, containing only a few hundred samples, or focus on a single task like Question Answering or Natural Language Inference. MedHal addresses these gaps by: (1) incorporating diverse medical text sources and tasks; (2) providing a substantial volume of annotated samples suitable for training medical hallucination detection models; and (3) including explanations for factual inconsistencies to guide model learning. We demonstrate MedHal's utility by training and evaluating a baseline medical hallucination detection model, showing improvements over general-purpose hallucination detection approaches. This resource enables more efficient evaluation of medical text generation systems while reducing reliance on costly expert review, potentially accelerating the development of medical AI research.

Large language models (LLMs) have significantly advanced natural language processing tasks, yet they are susceptible to generating inaccurate or unreliable responses, a phenomenon known as hallucination. In critical domains such as health and medicine, these hallucinations can pose serious risks. This paper introduces HALO, a novel framework designed to enhance the accuracy and reliability of medical question-answering (QA) systems by focusing on the detection and mitigation of hallucinations. Our approach generates multiple variations of a given query using LLMs and retrieves relevant information from external open knowledge bases to enrich the context. We utilize maximum marginal relevance scoring to prioritize the retrieved context, which is then provided to LLMs for answer generation, thereby reducing the risk of hallucinations. The integration of LangChain further streamlines this process, resulting in a notable and robust increase in the accuracy of both open-source and commercial LLMs, such as Llama-3.1 (from 44% to 65%) and ChatGPT (from 56% to 70%). This framework underscores the critical importance of addressing hallucinations in medical QA systems, ultimately improving clinical decision-making and patient care. The open-source HALO is available at: https://github.com/ResponsibleAILab/HALO.

The rapid advancement of large language models (LLMs) has significantly impacted various domains, including healthcare and biomedicine. However, the phenomenon of hallucination, where LLMs generate outputs that deviate from factual accuracy or context, poses a critical challenge, especially in high-stakes domains. This paper conducts a scoping study of existing techniques for mitigating hallucinations in knowledge-based task in general and especially for medical domains. Key methods covered in the paper include Retrieval-Augmented Generation (RAG)-based techniques, iterative feedback loops, supervised fine-tuning, and prompt engineering. These techniques, while promising in general contexts, require further adaptation and optimization for the medical domain due to its unique demands for up-to-date, specialized knowledge and strict adherence to medical guidelines. Addressing these challenges is crucial for developing trustworthy AI systems that enhance clinical decision-making and patient safety as well as accuracy of biomedical scientific research.

Medical vision-language models often struggle with generating accurate quantitative measurements in radiology reports, leading to hallucinations that undermine clinical reliability. We introduce FactCheXcker, a modular framework that de-hallucinates radiology report measurements by leveraging an improved query-code-update paradigm. Specifically, FactCheXcker employs specialized modules and the code generation capabilities of large language models to solve measurement queries generated based on the original report. After extracting measurable findings, the results are incorporated into an updated report. We evaluate FactCheXcker on endotracheal tube placement, which accounts for an average of 78% of report measurements, using the MIMIC-CXR dataset and 11 medical report-generation models. Our results show that FactCheXcker significantly reduces hallucinations, improves measurement precision, and maintains the quality of the original reports. Specifically, FactCheXcker improves the performance of 10/11 models and achieves an average improvement of 135.0% in reducing measurement hallucinations measured by mean absolute error. Code is available at https://github.com/rajpurkarlab/FactCheXcker.

Large Vision Language Models (LVLMs) have recently achieved superior performance in various tasks on natural image and text data, which inspires a large amount of studies for LVLMs fine-tuning and training. Despite their advancements, there has been scant research on the robustness of these models against hallucination when fine-tuned on smaller datasets. In this study, we introduce a new benchmark dataset, the Medical Visual Hallucination Test (MedVH), to evaluate the hallucination of domain-specific LVLMs. MedVH comprises five tasks to evaluate hallucinations in LVLMs within the medical context, which includes tasks for comprehensive understanding of textual and visual input, as well as long textual response generation. Our extensive experiments with both general and medical LVLMs reveal that, although medical LVLMs demonstrate promising performance on standard medical tasks, they are particularly susceptible to hallucinations, often more so than the general models, raising significant concerns about the reliability of these domain-specific models. For medical LVLMs to be truly valuable in real-world applications, they must not only accurately integrate medical knowledge but also maintain robust reasoning abilities to prevent hallucination. Our work paves the way for future evaluations of these studies.

This research paper focuses on the challenges posed by hallucinations in large language models (LLMs), particularly in the context of the medical domain. Hallucination, wherein these models generate plausible yet unverified or incorrect information, can have serious consequences in healthcare applications. We propose a new benchmark and dataset, Med-HALT (Medical Domain Hallucination Test), designed specifically to evaluate and reduce hallucinations. Med-HALT provides a diverse multinational dataset derived from medical examinations across various countries and includes multiple innovative testing modalities. Med-HALT includes two categories of tests reasoning and memory-based hallucination tests, designed to assess LLMs's problem-solving and information retrieval abilities. Our study evaluated leading LLMs, including Text Davinci, GPT-3.5, LlaMa-2, MPT, and Falcon, revealing significant differences in their performance. The paper provides detailed insights into the dataset, promoting transparency and reproducibility. Through this work, we aim to contribute to the development of safer and more reliable language models in healthcare. Our benchmark can be found at medhalt.github.io

Large Language Models (LLMs) have demonstrated a remarkable potential in medical knowledge acquisition and question-answering. However, LLMs can potentially hallucinate and yield factually incorrect outcomes, even with domain-specific pretraining. Previously, retrieval augmented generation (RAG) has limited success in addressing hallucinations. Unlike previous methods in RAG where the retrieval model was trained separately from the LLM, we introduce JMLR (for Jointly trains LLM and information Retrieval) during the fine-tuning phase. The synchronized training mechanism enhances JMLR's ability to retrieve clinical guidelines and leverage medical knowledge to reason and answer questions and reduces the demand for computational resources. We evaluated JMLR on the important medical question-answering application. Our experimental results demonstrate that JMLR-13B (70.5%) outperforms a previous state-of-the-art open-source model using conventional pre-training and fine-tuning Meditron-70B (68.9%) and Llama2-13B with RAG (67.7%) on a medical question-answering dataset. Comprehensive evaluations reveal JMLR-13B enhances reasoning quality and reduces hallucinations better than Claude3-Opus. Additionally, JMLR-13B (148 GPU hours) also trains much faster than Meditron-70B (42630 GPU hours). Through this work, we provide a new and efficient knowledge enhancement method for healthcare, demonstrating the potential of integrating retrieval and LLM training for medical question-answering systems.

Visual Information Extraction (VIE) converts unstructured document images into structured formats like JSON, critical for medical applications such as report analysis and online consultations. Traditional methods rely on OCR and language models, while end-to-end multimodal models offer direct JSON generation. However, domain-specific schemas and high annotation costs limit their effectiveness in medical VIE. We base our approach on the Reinforcement Learning with Verifiable Rewards (RLVR) framework to address these challenges using only 100 annotated samples. Our approach ensures dataset diversity, a balanced precision-recall reward mechanism to reduce hallucinations and improve field coverage, and innovative sampling strategies to enhance reasoning capabilities. Fine-tuning Qwen2.5-VL-7B with our RLVR method, we achieve state-of-the-art performance on medical VIE tasks, significantly improving F1, precision, and recall. While our models excel on tasks similar to medical datasets, performance drops on dissimilar tasks, highlighting the need for domain-specific optimization. Case studies further demonstrate the value of reasoning during training and inference for VIE.

Developing reliable AI systems to assist human clinicians in multi-modal medical diagnosis has long been a key objective for researchers. Recently, Multi-modal Large Language Models (MLLMs) have gained significant attention and achieved success across various domains. With strong reasoning capabilities and the ability to perform diverse tasks based on user instructions, they hold great potential for enhancing medical diagnosis. However, directly applying MLLMs to the medical domain still presents challenges. They lack detailed perception of visual inputs, limiting their ability to perform quantitative image analysis, which is crucial for medical diagnostics. Additionally, MLLMs often exhibit hallucinations and inconsistencies in reasoning, whereas clinical diagnoses must adhere strictly to established criteria. To address these challenges, we propose MedAgent-Pro, an evidence-based reasoning agentic system designed to achieve reliable, explainable, and precise medical diagnoses. This is accomplished through a hierarchical workflow: at the task level, knowledge-based reasoning generate reliable diagnostic plans for specific diseases following retrieved clinical criteria. While at the case level, multiple tool agents process multi-modal inputs, analyze different indicators according to the plan, and provide a final diagnosis based on both quantitative and qualitative evidence. Comprehensive experiments on both 2D and 3D medical diagnosis tasks demonstrate the superiority and effectiveness of MedAgent-Pro, while case studies further highlight its reliability and interpretability. The code is available at https://github.com/jinlab-imvr/MedAgent-Pro.

Large Language Models (LLMs) present immense potential in the medical field, yet concerns over data privacy, regulatory compliance, and model stability restrict their widespread adoption. Although the distillation of high-performing closed-source LLMs has proven effective for general tasks, their application in healthcare is limited due to reduced domain knowledge and remnants of alignment behavior hindering clinical tasks. To address these challenges, we propose Dialogue-Based Knowledge Encoding (DBKE). DBKE enhances models' implicit knowledge base and primes them for conversational recall, augmenting their conversational capabilities and enabling a soft alignment for subsequent use cases. By transforming dense academic source text into synthetic dialogue, DBKE broadens the model's knowledge base and enables a soft alignment that guides downstream behaviours. We present Clinical Camel, an open-source, healthcare-focused conversational model, to showcase the effectiveness of DBKE. Clinical Camel outperforms GPT-3.5 on the United States Medical Licensing Examination (USMLE) Step 1 and Step 3 with scores of 53.2 % and 58.2 %, respectively, compared to GPT-3.5's scores of 36.1 % and 55.7 %. Clinical Camel adeptly handles multi-stage clinical case problems, provides adaptive counseling, and generates clinical notes. However, it is prone to hallucinations, which pose a significant obstacle in safety-critical settings. The performance of Clinical Camel underscores the importance of continued research and development of open-source models for the safe and effective integration of LLMs in healthcare settings.

Large language models (LLMs) have transformed various sectors, including education, finance, and medicine, by enhancing content generation and decision-making processes. However, their integration into the medical field is cautious due to hallucinations, instances where generated content deviates from factual accuracy, potentially leading to adverse outcomes. To address this, we introduce Hyper-RAG, a hypergraph-driven Retrieval-Augmented Generation method that comprehensively captures both pairwise and beyond-pairwise correlations in domain-specific knowledge, thereby mitigating hallucinations. Experiments on the NeurologyCrop dataset with six prominent LLMs demonstrated that Hyper-RAG improves accuracy by an average of 12.3% over direct LLM use and outperforms Graph RAG and Light RAG by 6.3% and 6.0%, respectively. Additionally, Hyper-RAG maintained stable performance with increasing query complexity, unlike existing methods which declined. Further validation across nine diverse datasets showed a 35.5% performance improvement over Light RAG using a selection-based assessment. The lightweight variant, Hyper-RAG-Lite, achieved twice the retrieval speed and a 3.3% performance boost compared with Light RAG. These results confirm Hyper-RAG's effectiveness in enhancing LLM reliability and reducing hallucinations, making it a robust solution for high-stakes applications like medical diagnostics.

The advancement of Large Vision-Language Models (LVLMs) has propelled their application in the medical field. However, Medical LVLMs (Med-LVLMs) encounter factuality challenges due to modality misalignment, where the models prioritize textual knowledge over visual input, leading to hallucinations that contradict information in medical images. Previous attempts to enhance modality alignment in Med-LVLMs through preference optimization have inadequately mitigated clinical relevance in preference data, making these samples easily distinguishable and reducing alignment effectiveness. To address this challenge, we propose MMedPO, a novel multimodal medical preference optimization approach that considers the clinical relevance of preference samples to enhance Med-LVLM alignment. MMedPO curates multimodal preference data by introducing two types of dispreference: (1) plausible hallucinations injected through target Med-LVLMs or GPT-4o to produce medically inaccurate responses, and (2) lesion region neglect achieved through local lesion-noising, disrupting visual understanding of critical areas. We then calculate clinical relevance for each sample based on scores from multiple Med-LLMs and visual tools, and integrate these scores into the preference optimization process as weights, enabling effective alignment. Our experiments demonstrate that MMedPO significantly enhances factual accuracy in Med-LVLMs, achieving substantial improvements over existing preference optimization methods by averaging 14.2% and 51.7% across the Med-VQA and report generation tasks. Our code are available in https://github.com/aiming-lab/MMedPO.

The advancement in healthcare has shifted focus toward patient-centric approaches, particularly in self-care and patient education, facilitated by access to Electronic Health Records (EHR). However, medical jargon in EHRs poses significant challenges in patient comprehension. To address this, we introduce a new task of automatically generating lay definitions, aiming to simplify complex medical terms into patient-friendly lay language. We first created the README dataset, an extensive collection of over 50,000 unique (medical term, lay definition) pairs and 300,000 mentions, each offering context-aware lay definitions manually annotated by domain experts. We have also engineered a data-centric Human-AI pipeline that synergizes data filtering, augmentation, and selection to improve data quality. We then used README as the training data for models and leveraged a Retrieval-Augmented Generation method to reduce hallucinations and improve the quality of model outputs. Our extensive automatic and human evaluations demonstrate that open-source mobile-friendly models, when fine-tuned with high-quality data, are capable of matching or even surpassing the performance of state-of-the-art closed-source large language models like ChatGPT. This research represents a significant stride in closing the knowledge gap in patient education and advancing patient-centric healthcare solutions.

Large language models (LLMs) have shown promise in medical question answering but often struggle with hallucinations and shallow reasoning, particularly in tasks requiring nuanced clinical understanding. Retrieval-augmented generation (RAG) offers a practical and privacy-preserving way to enhance LLMs with external medical knowledge. However, most existing approaches rely on surface-level semantic retrieval and lack the structured reasoning needed for clinical decision support. We introduce MedCoT-RAG, a domain-specific framework that combines causal-aware document retrieval with structured chain-of-thought prompting tailored to medical workflows. This design enables models to retrieve evidence aligned with diagnostic logic and generate step-by-step causal reasoning reflective of real-world clinical practice. Experiments on three diverse medical QA benchmarks show that MedCoT-RAG outperforms strong baselines by up to 10.3% over vanilla RAG and 6.4% over advanced domain-adapted methods, improving accuracy, interpretability, and consistency in complex medical tasks.

Large Language Models (LLMs) are increasingly used for clinical decision support, where hallucinations and unsafe suggestions may pose direct risks to patient safety. These risks are particularly challenging as they often manifest as subtle clinical errors that evade detection by generic metrics, while expert-authored fine-grained rubrics remain costly to construct and difficult to scale. In this paper, we propose a retrieval-augmented multi-agent framework designed to automate the generation of instance-specific evaluation rubrics. Our approach grounds evaluation in authoritative medical evidence by decomposing retrieved content into atomic facts and synthesizing them with user interaction constraints to form verifiable, fine-grained evaluation criteria. Evaluated on HealthBench, our framework achieves a Clinical Intent Alignment (CIA) score of 60.12%, a statistically significant improvement over the GPT-4o baseline (55.16%). In discriminative tests, our rubrics yield a mean score delta (μ_Δ = 8.658) and an AUROC of 0.977, nearly doubling the quality separation achieved by GPT-4o baseline (4.972). Beyond evaluation, our rubrics effectively guide response refinement, improving quality by 9.2% (from 59.0% to 68.2%). This provides a scalable and transparent foundation for both evaluating and improving medical LLMs. The code is available at https://anonymous.4open.science/r/Automated-Rubric-Generation-AF3C/.

Large language models (LLM) hold significant potential for applications in biomedicine, but they struggle with hallucinations and outdated knowledge. While retrieval-augmented generation (RAG) is generally employed to address these issues, it also has its own set of challenges: (1) LLMs are vulnerable to irrelevant or incorrect context, (2) medical queries are often not well-targeted for helpful information, and (3) retrievers are prone to bias toward the specific source corpus they were trained on. In this study, we present RAG^2 (RAtionale-Guided RAG), a new framework for enhancing the reliability of RAG in biomedical contexts. RAG^2 incorporates three key innovations: a small filtering model trained on perplexity-based labels of rationales, which selectively augments informative snippets of documents while filtering out distractors; LLM-generated rationales as queries to improve the utility of retrieved snippets; a structure designed to retrieve snippets evenly from a comprehensive set of four biomedical corpora, effectively mitigating retriever bias. Our experiments demonstrate that RAG^2 improves the state-of-the-art LLMs of varying sizes, with improvements of up to 6.1\%, and it outperforms the previous best medical RAG model by up to 5.6\% across three medical question-answering benchmarks. Our code is available at https://github.com/dmis-lab/RAG2.

Text-guided image editors can now manipulate authentic medical scans with high fidelity, enabling lesion implantation/removal that threatens clinical trust and safety. Existing defenses are inadequate for healthcare. Medical detectors are largely black-box, while MLLM-based explainers are typically post-hoc, lack medical expertise, and may hallucinate evidence on ambiguous cases. We present MedForge, a data-and-method solution for pre-hoc, evidence-grounded medical forgery detection. We introduce MedForge-90K, a large-scale benchmark of realistic lesion edits across 19 pathologies with expert-guided reasoning supervision via doctor inspection guidelines and gold edit locations. Building on it, MedForge-Reasoner performs localize-then-analyze reasoning, predicting suspicious regions before producing a verdict, and is further aligned with Forgery-aware GSPO to strengthen grounding and reduce hallucinations. Experiments demonstrate state-of-the-art detection accuracy and trustworthy, expert-aligned explanations.

Retrieval-augmented question answering (QA) integrates external information and thereby increases the QA accuracy of reader models that lack domain knowledge. However, documents retrieved for closed domains require high expertise, so the reader model may have difficulty fully comprehending the text. Moreover, the retrieved documents contain thousands of tokens, some unrelated to the question. As a result, the documents include some inaccurate information, which could lead the reader model to mistrust the passages and could result in hallucinations. To solve these problems, we propose K-comp (Knowledge-injected compressor) which provides the knowledge required to answer correctly. The compressor automatically generates the prior knowledge necessary to facilitate the answer process prior to compression of the retrieved passages. Subsequently, the passages are compressed autoregressively, with the generated knowledge being integrated into the compression process. This process ensures alignment between the question intent and the compressed context. By augmenting this prior knowledge and concise context, the reader models are guided toward relevant answers and trust the context.

Background: Clinical documentation represents a significant burden for healthcare providers, with physicians spending up to 2 hours daily on administrative tasks. Recent advances in large language models (LLMs) offer promising solutions, but privacy concerns and computational requirements limit their adoption in healthcare settings. Objective: To develop and evaluate a privacy-preserving, on-device medical transcription system using a fine-tuned Llama 3.2 1B model capable of generating structured medical notes from medical transcriptions while maintaining complete data sovereignty entirely in the browser. Methods: We fine-tuned a Llama 3.2 1B model using Parameter-Efficient Fine-Tuning (PEFT) with LoRA on 1,500 synthetic medical transcription-to-structured note pairs. The model was evaluated against the base Llama 3.2 1B on two datasets: 100 endocrinology transcripts and 140 modified ACI benchmark cases. Evaluation employed both statistical metrics (ROUGE, BERTScore, BLEURT) and LLM-as-judge assessments across multiple clinical quality dimensions. Results: The fine-tuned OnDevice model demonstrated substantial improvements over the base model. On the ACI benchmark, ROUGE-1 scores increased from 0.346 to 0.496, while BERTScore F1 improved from 0.832 to 0.866. Clinical quality assessments showed marked reduction in major hallucinations (from 85 to 35 cases) and enhanced factual correctness (2.81 to 3.54 on 5-point scale). Similar improvements were observed on the internal evaluation dataset, with composite scores increasing from 3.13 to 4.43 (+41.5%). Conclusions: Fine-tuning compact LLMs for medical transcription yields clinically meaningful improvements while enabling complete on-device browser deployment. This approach addresses key barriers to AI adoption in healthcare: privacy preservation, cost reduction, and accessibility for resource-constrained environments.

Ensuring the accuracy of responses provided by large language models (LLMs) is crucial, particularly in clinical settings where incorrect information may directly impact patient health. To address this challenge, we construct K-QA, a dataset containing 1,212 patient questions originating from real-world conversations held on K Health (an AI-driven clinical platform). We employ a panel of in-house physicians to answer and manually decompose a subset of K-QA into self-contained statements. Additionally, we formulate two NLI-based evaluation metrics approximating recall and precision: (1) comprehensiveness, measuring the percentage of essential clinical information in the generated answer and (2) hallucination rate, measuring the number of statements from the physician-curated response contradicted by the LLM answer. Finally, we use K-QA along with these metrics to evaluate several state-of-the-art models, as well as the effect of in-context learning and medically-oriented augmented retrieval schemes developed by the authors. Our findings indicate that in-context learning improves the comprehensiveness of the models, and augmented retrieval is effective in reducing hallucinations. We make K-QA available to to the community to spur research into medically accurate NLP applications.

We study extractive question-answering in the medical domain (Medical-EQA). This problem has two main challenges: (i) domain specificity, as most AI models lack necessary domain knowledge, and (ii) extraction-based answering style, which restricts most autoregressive LLMs due to potential hallucinations. To handle those challenges, we propose TOP-Training, a target-oriented pre-training paradigm that stands out among all domain adaptation techniques with two desirable features: (i) TOP-Training moves one step further than popular domain-oriented fine-tuning since it not only moves closer to the target domain, but also familiarizes itself with the target dataset, and (ii) it does not assume the existence of a large set of unlabeled instances from the target domain. Specifically, for a target Medical-EQA dataset, we extract its entities and leverage large language models (LLMs) to generate synthetic texts containing those entities; we then demonstrate that pretraining on this synthetic text data yields better performance on the target Medical-EQA benchmarks. Overall, our contributions are threefold: (i) TOP-Training, a new pretraining technique to effectively adapt LLMs to better solve a target problem, (ii) TOP-Training has a wide application scope because it does not require the target problem to have a large set of unlabeled data, and (iii) our experiments highlight the limitations of autoregressive LLMs, emphasizing TOP-Training as a means to unlock the true potential of bidirectional LLMs.

Multimodal Large Language Models (MLLMs) have demonstrated impressive capabilities in understanding common visual elements, largely due to their large-scale datasets and advanced training strategies. However, their effectiveness in medical applications remains limited due to the inherent discrepancies between data and tasks in medical scenarios and those in the general domain. Concretely, existing medical MLLMs face the following critical limitations: (1) limited coverage of medical knowledge beyond imaging, (2) heightened susceptibility to hallucinations due to suboptimal data curation processes, (3) lack of reasoning capabilities tailored for complex medical scenarios. To address these challenges, we first propose a comprehensive data curation procedure that (1) efficiently acquires rich medical knowledge data not only from medical imaging but also from extensive medical texts and general-domain data; and (2) synthesizes accurate medical captions, visual question answering (VQA), and reasoning samples. As a result, we build a multimodal dataset enriched with extensive medical knowledge. Building on the curated data, we introduce our medical-specialized MLLM: Lingshu. Lingshu undergoes multi-stage training to embed medical expertise and enhance its task-solving capabilities progressively. Besides, we preliminarily explore the potential of applying reinforcement learning with verifiable rewards paradigm to enhance Lingshu's medical reasoning ability. Additionally, we develop MedEvalKit, a unified evaluation framework that consolidates leading multimodal and textual medical benchmarks for standardized, fair, and efficient model assessment. We evaluate the performance of Lingshu on three fundamental medical tasks, multimodal QA, text-based QA, and medical report generation. The results show that Lingshu consistently outperforms the existing open-source multimodal models on most tasks ...

Medical conversational AI (AI) plays a pivotal role in the development of safer and more effective medical dialogue systems. However, existing benchmarks and evaluation frameworks for assessing the information-gathering and diagnostic reasoning abilities of medical large language models (LLMs) have not been rigorously evaluated. To address these gaps, we present MedDialogRubrics, a novel benchmark comprising 5,200 synthetically constructed patient cases and over 60,000 fine-grained evaluation rubrics generated by LLMs and subsequently refined by clinical experts, specifically designed to assess the multi-turn diagnostic capabilities of LLM. Our framework employs a multi-agent system to synthesize realistic patient records and chief complaints from underlying disease knowledge without accessing real-world electronic health records, thereby mitigating privacy and data-governance concerns. We design a robust Patient Agent that is limited to a set of atomic medical facts and augmented with a dynamic guidance mechanism that continuously detects and corrects hallucinations throughout the dialogue, ensuring internal coherence and clinical plausibility of the simulated cases. Furthermore, we propose a structured LLM-based and expert-annotated rubric-generation pipeline that retrieves Evidence-Based Medicine (EBM) guidelines and utilizes the reject sampling to derive a prioritized set of rubric items ("must-ask" items) for each case. We perform a comprehensive evaluation of state-of-the-art models and demonstrate that, across multiple assessment dimensions, current models face substantial challenges. Our results indicate that improving medical dialogue will require advances in dialogue management architectures, not just incremental tuning of the base-model.

Medical question-answering (QA) is a critical task for evaluating how effectively large language models (LLMs) encode clinical knowledge and assessing their potential applications in medicine. Despite showing promise on multiple-choice tests, LLMs frequently struggle with open-ended medical questions, producing responses with dangerous hallucinations or lacking comprehensive coverage of critical aspects. Existing approaches attempt to address these challenges through domain-specific fine-tuning, but this proves resource-intensive and difficult to scale across models. To improve the comprehensiveness and factuality of medical responses, we propose a novel approach utilizing structured medical reasoning. Our method guides LLMs through an seven-step cognitive process inspired by clinical diagnosis, enabling more accurate and complete answers without additional training. Experiments on the MedLFQA benchmark demonstrate that our approach achieves the highest Factuality Score of 85.8, surpassing fine-tuned models. Notably, this improvement transfers to smaller models, highlighting the method's efficiency and scalability. Our code and datasets are available.

Retrieval augmented generation (RAG) provides the capability to constrain generative model outputs, and mitigate the possibility of hallucination, by providing relevant in-context text. The number of tokens a generative large language model (LLM) can incorporate as context is finite, thus limiting the volume of knowledge from which to generate an answer. We propose a two-layer RAG framework for query-focused answer generation and evaluate a proof-of-concept for this framework in the context of query-focused summary generation from social media forums, focusing on emerging drug-related information. The evaluations demonstrate the effectiveness of the two-layer framework in resource constrained settings to enable researchers in obtaining near real-time data from users.

Medical Vision-Language Models (VLMs) are prone to hallucinations, compromising clinical reliability. While reinforcement learning methods like Group Relative Policy Optimization (GRPO) offer a low-cost alignment solution, their reliance on sparse, outcome-based rewards inadvertently encourages models to "overthink" -- generating verbose, convoluted, and unverifiable Chain-of-Thought reasoning to justify answers. This focus on outcomes obscures factual errors and poses significant safety risks. To address this, we propose CheXPO-v2, a novel alignment framework that shifts from outcome to process supervision. Our core innovation is a Knowledge Graph Consistency Reward mechanism driven by Entity-Relation Matching. By explicitly parsing reasoning steps into structured "Disease, Relation, Anatomy" triplets, we provide fine-grained supervision that penalizes incoherent logic and hallucinations at the atomic level. Integrating this with a hard-example mining strategy, our approach significantly outperforms GRPO and state-of-the-art models on benchmarks like MIMIC-CXR-VQA. Crucially, CheXPO-v2 achieves new state-of-the-art accuracy using only 5k samples, demonstrating exceptional data efficiency while producing clinically sound and verifiable reasoning. The project source code is publicly available at: https://github.com/ecoxial2007/CheX-Phi4MM.

Accurate diagnosis with medical large language models is hindered by knowledge gaps and hallucinations. Retrieval and tool-augmented methods help, but their impact is limited by weak use of external knowledge and poor feedback-reasoning traceability. To address these challenges, We introduce Deep-DxSearch, an agentic RAG system trained end-to-end with reinforcement learning (RL) that enables steer tracebale retrieval-augmented reasoning for medical diagnosis. In Deep-DxSearch, we first construct a large-scale medical retrieval corpus comprising patient records and reliable medical knowledge sources to support retrieval-aware reasoning across diagnostic scenarios. More crutially, we frame the LLM as the core agent and the retrieval corpus as its environment, using tailored rewards on format, retrieval, reasoning structure, and diagnostic accuracy, thereby evolving the agentic RAG policy from large-scale data through RL. Experiments demonstrate that our end-to-end agentic RL training framework consistently outperforms prompt-engineering and training-free RAG approaches across multiple data centers. After training, Deep-DxSearch achieves substantial gains in diagnostic accuracy, surpassing strong diagnostic baselines such as GPT-4o, DeepSeek-R1, and other medical-specific frameworks for both common and rare disease diagnosis under in-distribution and out-of-distribution settings. Moreover, ablation studies on reward design and retrieval corpus components confirm their critical roles, underscoring the uniqueness and effectiveness of our approach compared with traditional implementations. Finally, case studies and interpretability analyses highlight improvements in Deep-DxSearch's diagnostic policy, providing deeper insight into its performance gains and supporting clinicians in delivering more reliable and precise preliminary diagnoses. See https://github.com/MAGIC-AI4Med/Deep-DxSearch.

Machine unlearning is a promising paradigm for removing unwanted data samples from a trained model, towards ensuring compliance with privacy regulations and limiting harmful biases. Although unlearning has been shown in, e.g., classification and recommendation systems, its potential in medical image-to-image translation, specifically in image recon-struction, has not been thoroughly investigated. This paper shows that machine unlearning is possible in MRI tasks and has the potential to benefit for bias removal. We set up a protocol to study how much shared knowledge exists between datasets of different organs, allowing us to effectively quantify the effect of unlearning. Our study reveals that combining training data can lead to hallucinations and reduced image quality in the reconstructed data. We use unlearning to remove hallucinations as a proxy exemplar of undesired data removal. Indeed, we show that machine unlearning is possible without full retraining. Furthermore, our observations indicate that maintaining high performance is feasible even when using only a subset of retain data. We have made our code publicly accessible.

Large language models are now routinely used in high-stakes applications where hallucinations can cause serious harm, such as medical consultations or legal advice. Existing hallucination detection methods, however, are impractical for real-world use, as they are either limited to short factual queries or require costly external verification. We present a cheap, scalable method for real-time identification of hallucinated tokens in long-form generations, and scale it effectively to 70B parameter models. Our approach targets entity-level hallucinations -- e.g., fabricated names, dates, citations -- rather than claim-level, thereby naturally mapping to token-level labels and enabling streaming detection. We develop an annotation methodology that leverages web search to annotate model responses with grounded labels indicating which tokens correspond to fabricated entities. This dataset enables us to train effective hallucination classifiers with simple and efficient methods such as linear probes. Evaluating across four model families, our classifiers consistently outperform baselines on long-form responses, including more expensive methods such as semantic entropy (e.g., AUC 0.90 vs 0.71 for Llama-3.3-70B), and are also an improvement in short-form question-answering settings. Moreover, despite being trained only with entity-level labels, our probes effectively detect incorrect answers in mathematical reasoning tasks, indicating generalization beyond entities. While our annotation methodology is expensive, we find that annotated responses from one model can be used to train effective classifiers on other models; accordingly, we publicly release our datasets to facilitate reuse. Overall, our work suggests a promising new approach for scalable, real-world hallucination detection.

While large language models (LLMs) have achieved state-of-the-art performance on a wide range of medical question answering (QA) tasks, they still face challenges with hallucinations and outdated knowledge. Retrieval-augmented generation (RAG) is a promising solution and has been widely adopted. However, a RAG system can involve multiple flexible components, and there is a lack of best practices regarding the optimal RAG setting for various medical purposes. To systematically evaluate such systems, we propose the Medical Information Retrieval-Augmented Generation Evaluation (MIRAGE), a first-of-its-kind benchmark including 7,663 questions from five medical QA datasets. Using MIRAGE, we conducted large-scale experiments with over 1.8 trillion prompt tokens on 41 combinations of different corpora, retrievers, and backbone LLMs through the MedRAG toolkit introduced in this work. Overall, MedRAG improves the accuracy of six different LLMs by up to 18% over chain-of-thought prompting, elevating the performance of GPT-3.5 and Mixtral to GPT-4-level. Our results show that the combination of various medical corpora and retrievers achieves the best performance. In addition, we discovered a log-linear scaling property and the "lost-in-the-middle" effects in medical RAG. We believe our comprehensive evaluations can serve as practical guidelines for implementing RAG systems for medicine.

Patients often face difficulties in understanding their hospitalizations, while healthcare workers have limited resources to provide explanations. In this work, we investigate the potential of large language models to generate patient summaries based on doctors' notes and study the effect of training data on the faithfulness and quality of the generated summaries. To this end, we release (i) a rigorous labeling protocol for errors in medical texts and (ii) a publicly available dataset of annotated hallucinations in 100 doctor-written and 100 generated summaries. We show that fine-tuning on hallucination-free data effectively reduces hallucinations from 2.60 to 1.55 per summary for Llama 2, while preserving relevant information. We observe a similar effect on GPT-4 (0.70 to 0.40), when the few-shot examples are hallucination-free. We also conduct a qualitative evaluation using hallucination-free and improved training data. We find that common quantitative metrics do not correlate well with faithfulness and quality. Finally, we test GPT-4 for automatic hallucination detection, which clearly outperforms common baselines.

Rare diseases affect hundreds of millions worldwide, yet diagnosis often spans years. Convectional pipelines decouple noisy evidence extraction from downstream inferential diagnosis, and general/medical large language models (LLMs) face scarce real world electronic health records (EHRs), stale domain knowledge, and hallucinations. We assemble a large, domain specialized clinical corpus and a clinician validated reasoning set, and develop RareSeek R1 via staged instruction tuning, chain of thought learning, and graph grounded retrieval. Across multicenter EHR narratives and public benchmarks, RareSeek R1 attains state of the art accuracy, robust generalization, and stability under noisy or overlapping phenotypes. Augmented retrieval yields the largest gains when narratives pair with prioritized variants by resolving ambiguity and aligning candidates to mechanisms. Human studies show performance on par with experienced physicians and consistent gains in assistive use. Notably, transparent reasoning highlights decisive non phenotypic evidence (median 23.1%, such as imaging, interventions, functional tests) underpinning many correct diagnoses. This work advances a narrative first, knowledge integrated reasoning paradigm that shortens the diagnostic odyssey and enables auditable, clinically translatable decision support.

Electrocardiography (ECG) serves as an indispensable diagnostic tool in clinical practice, yet existing multimodal large language models (MLLMs) remain unreliable for ECG interpretation, often producing plausible but clinically incorrect analyses. To address this, we propose ECG-R1, the first reasoning MLLM designed for reliable ECG interpretation via three innovations. First, we construct the interpretation corpus using Protocol-Guided Instruction Data Generation, grounding interpretation in measurable ECG features and monograph-defined quantitative thresholds and diagnostic logic. Second, we present a modality-decoupled architecture with Interleaved Modality Dropout to improve robustness and cross-modal consistency when either the ECG signal or ECG image is missing. Third, we present Reinforcement Learning with ECG Diagnostic Evidence Rewards to strengthen evidence-grounded ECG interpretation. Additionally, we systematically evaluate the ECG interpretation capabilities of proprietary, open-source, and medical MLLMs, and provide the first quantitative evidence that severe hallucinations are widespread, suggesting that the public should not directly trust these outputs without independent verification. Code and data are publicly available at https://github.com/PKUDigitalHealth/ECG-R1{here}, and an online platform can be accessed at http://ai.heartvoice.com.cn/ECG-R1/{here}.

Large Language Models (LLMs) such as GPT & Llama have demonstrated significant achievements in summarization tasks but struggle with factual inaccuracies, a critical issue in clinical NLP applications where errors could lead to serious consequences. To counter the high costs and limited availability of expert-annotated data for factual alignment, this study introduces an innovative pipeline that utilizes >100B parameter GPT variants like GPT-3.5 & GPT-4 to act as synthetic experts to generate high-quality synthetics feedback aimed at enhancing factual consistency in clinical note summarization. Our research primarily focuses on edit feedback generated by these synthetic feedback experts without additional human annotations, mirroring and optimizing the practical scenario in which medical professionals refine AI system outputs. Although such 100B+ parameter GPT variants have proven to demonstrate expertise in various clinical NLP tasks, such as the Medical Licensing Examination, there is scant research on their capacity to act as synthetic feedback experts and deliver expert-level edit feedback for improving the generation quality of weaker (<10B parameter) LLMs like GPT-2 (1.5B) & Llama 2 (7B) in clinical domain. So in this work, we leverage 100B+ GPT variants to act as synthetic feedback experts offering expert-level edit feedback, that is used to reduce hallucinations and align weaker (<10B parameter) LLMs with medical facts using two distinct alignment algorithms (DPO & SALT), endeavoring to narrow the divide between AI-generated content and factual accuracy. This highlights the substantial potential of LLM-based synthetic edits in enhancing the alignment of clinical factuality.

Large language models (LLMs) have shown promise for generative and knowledge-intensive tasks including question-answering (QA) tasks. However, the practical deployment still faces challenges, notably the issue of "hallucination", where models generate plausible-sounding but unfaithful or nonsensical information. This issue becomes particularly critical in the medical domain due to the uncommon professional concepts and potential social risks involved. This paper analyses the phenomenon of hallucination in medical generative QA systems using widely adopted LLMs and datasets. Our investigation centers on the identification and comprehension of common problematic answers, with a specific emphasis on hallucination. To tackle this challenge, we present an interactive self-reflection methodology that incorporates knowledge acquisition and answer generation. Through this feedback process, our approach steadily enhances the factuality, consistency, and entailment of the generated answers. Consequently, we harness the interactivity and multitasking ability of LLMs and produce progressively more precise and accurate answers. Experimental results on both automatic and human evaluation demonstrate the superiority of our approach in hallucination reduction compared to baselines.

Hallucination is a well-known phenomenon in text generated by large language models (LLMs). The existence of hallucinatory responses is found in almost all application scenarios e.g., summarization, question-answering (QA) etc. For applications requiring high reliability (e.g., customer-facing assistants), the potential existence of hallucination in LLM-generated text is a critical problem. The amount of hallucination can be reduced by leveraging information retrieval to provide relevant background information to the LLM. However, LLMs can still generate hallucinatory content for various reasons (e.g., prioritizing its parametric knowledge over the context, failure to capture the relevant information from the context, etc.). Detecting hallucinations through automated methods is thus paramount. To facilitate research in this direction, we introduce a sophisticated dataset, DelucionQA, that captures hallucinations made by retrieval-augmented LLMs for a domain-specific QA task. Furthermore, we propose a set of hallucination detection methods to serve as baselines for future works from the research community. Analysis and case study are also provided to share valuable insights on hallucination phenomena in the target scenario.

Large-scale multilingual machine translation systems have demonstrated remarkable ability to translate directly between numerous languages, making them increasingly appealing for real-world applications. However, when deployed in the wild, these models may generate hallucinated translations which have the potential to severely undermine user trust and raise safety concerns. Existing research on hallucinations has primarily focused on small bilingual models trained on high-resource languages, leaving a gap in our understanding of hallucinations in massively multilingual models across diverse translation scenarios. In this work, we fill this gap by conducting a comprehensive analysis on both the M2M family of conventional neural machine translation models and ChatGPT, a general-purpose large language model~(LLM) that can be prompted for translation. Our investigation covers a broad spectrum of conditions, spanning over 100 translation directions across various resource levels and going beyond English-centric language pairs. We provide key insights regarding the prevalence, properties, and mitigation of hallucinations, paving the way towards more responsible and reliable machine translation systems.

Hallucination is a common problem for Large Vision-Language Models (LVLMs) with long generations which is difficult to eradicate. The generation with hallucinations is partially inconsistent with the image content. To mitigate hallucination, current studies either focus on the process of model inference or the results of model generation, but the solutions they design sometimes do not deal appropriately with various types of queries and the hallucinations of the generations about these queries. To accurately deal with various hallucinations, we present a unified framework, Dentist, for hallucination mitigation. The core step is to first classify the queries, then perform different processes of hallucination mitigation based on the classification result, just like a dentist first observes the teeth and then makes a plan. In a simple deployment, Dentist can classify queries as perception or reasoning and easily mitigate potential hallucinations in answers which has been demonstrated in our experiments. On MMbench, we achieve a 13.44%/10.2%/15.8% improvement in accuracy on Image Quality, a Coarse Perception visual question answering (VQA) task, over the baseline InstructBLIP/LLaVA/VisualGLM.

As large language models continue to develop in the field of AI, text generation systems are susceptible to a worrisome phenomenon known as hallucination. In this study, we summarize recent compelling insights into hallucinations in LLMs. We present a novel taxonomy of hallucinations from various text generation tasks, thus provide theoretical insights, detection methods and improvement approaches. Based on this, future research directions are proposed. Our contribution are threefold: (1) We provide a detailed and complete taxonomy for hallucinations appearing in text generation tasks; (2) We provide theoretical analyses of hallucinations in LLMs and provide existing detection and improvement methods; (3) We propose several research directions that can be developed in the future. As hallucinations garner significant attention from the community, we will maintain updates on relevant research progress.

Hallucinations in large language models (LLMs) are commonly regarded as errors to be minimized. However, recent perspectives suggest that some hallucinations may encode creative or epistemically valuable content, a dimension that remains underquantified in current literature. Existing hallucination detection methods primarily focus on factual consistency, struggling to handle heterogeneous scientific tasks and balance creativity with accuracy. To address these challenges, we propose HIC-Bench, a novel evaluation framework that categorizes hallucinations into Intelligent Hallucinations (IH) and Defective Hallucinations (DH), enabling systematic investigation of their interplay in LLM creativity. HIC-Bench features three core characteristics: (1) Structured IH/DH Assessment. using a multi-dimensional metric matrix integrating Torrance Tests of Creative Thinking (TTCT) metrics (Originality, Feasibility, Value) with hallucination-specific dimensions (scientific plausibility, factual deviation); (2) Cross-Domain Applicability. spanning ten scientific domains with open-ended innovation tasks; and (3) Dynamic Prompt Optimization. leveraging the Dynamic Hallucination Prompt (DHP) to guide models toward creative and reliable outputs. The evaluation process employs multiple LLM judges, averaging scores to mitigate bias, with human annotators verifying IH/DH classifications. Experimental results reveal a nonlinear relationship between IH and DH, demonstrating that creativity and correctness can be jointly optimized. These insights position IH as a catalyst for creativity and reveal the ability of LLM hallucinations to drive scientific innovation.Additionally, the HIC-Bench offers a valuable platform for advancing research into the creative intelligence of LLM hallucinations.

Large Language Models (LLMs) have demonstrated remarkable proficiency in generating text that closely resemble human writing. However, they often generate factually incorrect statements, a problem typically referred to as 'hallucination'. Addressing hallucination is crucial for enhancing the reliability and effectiveness of LLMs. While much research has focused on hallucinations in English, our study extends this investigation to conversational data in three languages: Hindi, Farsi, and Mandarin. We offer a comprehensive analysis of a dataset to examine both factual and linguistic errors in these languages for GPT-3.5, GPT-4o, Llama-3.1, Gemma-2.0, DeepSeek-R1 and Qwen-3. We found that LLMs produce very few hallucinated responses in Mandarin but generate a significantly higher number of hallucinations in Hindi and Farsi.

As Large Language Models (LLMs) continue to advance in their ability to write human-like text, a key challenge remains around their tendency to hallucinate generating content that appears factual but is ungrounded. This issue of hallucination is arguably the biggest hindrance to safely deploying these powerful LLMs into real-world production systems that impact people's lives. The journey toward widespread adoption of LLMs in practical settings heavily relies on addressing and mitigating hallucinations. Unlike traditional AI systems focused on limited tasks, LLMs have been exposed to vast amounts of online text data during training. While this allows them to display impressive language fluency, it also means they are capable of extrapolating information from the biases in training data, misinterpreting ambiguous prompts, or modifying the information to align superficially with the input. This becomes hugely alarming when we rely on language generation capabilities for sensitive applications, such as summarizing medical records, financial analysis reports, etc. This paper presents a comprehensive survey of over 32 techniques developed to mitigate hallucination in LLMs. Notable among these are Retrieval Augmented Generation (Lewis et al, 2021), Knowledge Retrieval (Varshney et al,2023), CoNLI (Lei et al, 2023), and CoVe (Dhuliawala et al, 2023). Furthermore, we introduce a detailed taxonomy categorizing these methods based on various parameters, such as dataset utilization, common tasks, feedback mechanisms, and retriever types. This classification helps distinguish the diverse approaches specifically designed to tackle hallucination issues in LLMs. Additionally, we analyze the challenges and limitations inherent in these techniques, providing a solid foundation for future research in addressing hallucinations and related phenomena within the realm of LLMs.

Although the problem of hallucinations in neural machine translation (NMT) has received some attention, research on this highly pathological phenomenon lacks solid ground. Previous work has been limited in several ways: it often resorts to artificial settings where the problem is amplified, it disregards some (common) types of hallucinations, and it does not validate adequacy of detection heuristics. In this paper, we set foundations for the study of NMT hallucinations. First, we work in a natural setting, i.e., in-domain data without artificial noise neither in training nor in inference. Next, we annotate a dataset of over 3.4k sentences indicating different kinds of critical errors and hallucinations. Then, we turn to detection methods and both revisit methods used previously and propose using glass-box uncertainty-based detectors. Overall, we show that for preventive settings, (i) previously used methods are largely inadequate, (ii) sequence log-probability works best and performs on par with reference-based methods. Finally, we propose DeHallucinator, a simple method for alleviating hallucinations at test time that significantly reduces the hallucinatory rate. To ease future research, we release our annotated dataset for WMT18 German-English data, along with the model, training data, and code.

While the problem of hallucinations in neural machine translation has long been recognized, so far the progress on its alleviation is very little. Indeed, recently it turned out that without artificially encouraging models to hallucinate, previously existing methods fall short and even the standard sequence log-probability is more informative. It means that characteristics internal to the model can give much more information than we expect, and before using external models and measures, we first need to ask: how far can we go if we use nothing but the translation model itself ? We propose to use a method that evaluates the percentage of the source contribution to a generated translation. Intuitively, hallucinations are translations "detached" from the source, hence they can be identified by low source contribution. This method improves detection accuracy for the most severe hallucinations by a factor of 2 and is able to alleviate hallucinations at test time on par with the previous best approach that relies on external models. Next, if we move away from internal model characteristics and allow external tools, we show that using sentence similarity from cross-lingual embeddings further improves these results.

Large Language Models (LLMs) are increasingly used in various contexts, yet remain prone to generating non-factual content, commonly referred to as "hallucinations". The literature categorizes hallucinations into several types, including entity-level, relation-level, and sentence-level hallucinations. However, existing hallucination datasets often fail to capture fine-grained hallucinations in multilingual settings. In this work, we introduce HalluVerse25, a multilingual LLM hallucination dataset that categorizes fine-grained hallucinations in English, Arabic, and Turkish. Our dataset construction pipeline uses an LLM to inject hallucinations into factual biographical sentences, followed by a rigorous human annotation process to ensure data quality. We evaluate several LLMs on HalluVerse25, providing valuable insights into how proprietary models perform in detecting LLM-generated hallucinations across different contexts.

While many capabilities of language models (LMs) improve with increased training budget, the influence of scale on hallucinations is not yet fully understood. Hallucinations come in many forms, and there is no universally accepted definition. We thus focus on studying only those hallucinations where a correct answer appears verbatim in the training set. To fully control the training data content, we construct a knowledge graph (KG)-based dataset, and use it to train a set of increasingly large LMs. We find that for a fixed dataset, larger and longer-trained LMs hallucinate less. However, hallucinating on leq5% of the training data requires an order of magnitude larger model, and thus an order of magnitude more compute, than Hoffmann et al. (2022) reported was optimal. Given this costliness, we study how hallucination detectors depend on scale. While we see detector size improves performance on fixed LM's outputs, we find an inverse relationship between the scale of the LM and the detectability of its hallucinations.

Concerns about hallucinations in Large Language Models (LLMs) have been raised by researchers, yet their potential in areas where creativity is vital, such as drug discovery, merits exploration. In this paper, we come up with the hypothesis that hallucinations can improve LLMs in drug discovery. To verify this hypothesis, we use LLMs to describe the SMILES string of molecules in natural language and then incorporate these descriptions as part of the prompt to address specific tasks in drug discovery. Evaluated on seven LLMs and five classification tasks, our findings confirm the hypothesis: LLMs can achieve better performance with text containing hallucinations. Notably, Llama-3.1-8B achieves an 18.35% gain in ROC-AUC compared to the baseline without hallucination. Furthermore, hallucinations generated by GPT-4o provide the most consistent improvements across models. Additionally, we conduct empirical analyses and a case study to investigate key factors affecting performance and the underlying reasons. Our research sheds light on the potential use of hallucinations for LLMs and offers new perspectives for future research leveraging LLMs in drug discovery.

This survey presents a comprehensive analysis of the phenomenon of hallucination in multimodal large language models (MLLMs), also known as Large Vision-Language Models (LVLMs), which have demonstrated significant advancements and remarkable abilities in multimodal tasks. Despite these promising developments, MLLMs often generate outputs that are inconsistent with the visual content, a challenge known as hallucination, which poses substantial obstacles to their practical deployment and raises concerns regarding their reliability in real-world applications. This problem has attracted increasing attention, prompting efforts to detect and mitigate such inaccuracies. We review recent advances in identifying, evaluating, and mitigating these hallucinations, offering a detailed overview of the underlying causes, evaluation benchmarks, metrics, and strategies developed to address this issue. Additionally, we analyze the current challenges and limitations, formulating open questions that delineate potential pathways for future research. By drawing the granular classification and landscapes of hallucination causes, evaluation benchmarks, and mitigation methods, this survey aims to deepen the understanding of hallucinations in MLLMs and inspire further advancements in the field. Through our thorough and in-depth review, we contribute to the ongoing dialogue on enhancing the robustness and reliability of MLLMs, providing valuable insights and resources for researchers and practitioners alike. Resources are available at: https://github.com/showlab/Awesome-MLLM-Hallucination.

Hallucinations of deep neural models are amongst key challenges in automatic speech recognition (ASR). In this paper, we investigate hallucinations of the Whisper ASR model induced by non-speech audio segments present during inference. By inducting hallucinations with various types of sounds, we show that there exists a set of hallucinations that appear frequently. We then study hallucinations caused by the augmentation of speech with such sounds. Finally, we describe the creation of a bag of hallucinations (BoH) that allows to remove the effect of hallucinations through the post-processing of text transcriptions. The results of our experiments show that such post-processing is capable of reducing word error rate (WER) and acts as a good safeguard against problematic hallucinations.

A major risk of using language models in practical applications is their tendency to hallucinate incorrect statements. Hallucinations are often attributed to knowledge gaps in LMs, but we hypothesize that in some cases, when justifying previously generated hallucinations, LMs output false claims that they can separately recognize as incorrect. We construct three question-answering datasets where ChatGPT and GPT-4 often state an incorrect answer and offer an explanation with at least one incorrect claim. Crucially, we find that ChatGPT and GPT-4 can identify 67% and 87% of their own mistakes, respectively. We refer to this phenomenon as hallucination snowballing: an LM over-commits to early mistakes, leading to more mistakes that it otherwise would not make.

Recently, multimodal large language models (MLLMs) have demonstrated remarkable performance in visual-language tasks. However, the authenticity of the responses generated by MLLMs is often compromised by object hallucinations. We identify that a key cause of these hallucinations is the model's over-susceptibility to specific image frequency features in detecting objects. In this paper, we introduce Multi-Frequency Perturbations (MFP), a simple, cost-effective, and pluggable method that leverages both low-frequency and high-frequency features of images to perturb visual feature representations and explicitly suppress redundant frequency-domain features during inference, thereby mitigating hallucinations. Experimental results demonstrate that our method significantly mitigates object hallucinations across various model architectures. Furthermore, as a training-time method, MFP can be combined with inference-time methods to achieve state-of-the-art performance on the CHAIR benchmark.

As Large Language Models become more ubiquitous across domains, it becomes important to examine their inherent limitations critically. This work argues that hallucinations in language models are not just occasional errors but an inevitable feature of these systems. We demonstrate that hallucinations stem from the fundamental mathematical and logical structure of LLMs. It is, therefore, impossible to eliminate them through architectural improvements, dataset enhancements, or fact-checking mechanisms. Our analysis draws on computational theory and Godel's First Incompleteness Theorem, which references the undecidability of problems like the Halting, Emptiness, and Acceptance Problems. We demonstrate that every stage of the LLM process-from training data compilation to fact retrieval, intent classification, and text generation-will have a non-zero probability of producing hallucinations. This work introduces the concept of Structural Hallucination as an intrinsic nature of these systems. By establishing the mathematical certainty of hallucinations, we challenge the prevailing notion that they can be fully mitigated.

Detecting hallucinations in large language models (LLMs) is critical for enhancing their reliability and trustworthiness. Most research focuses on hallucinations as deviations from information seen during training. However, the opaque nature of an LLM's parametric knowledge complicates the understanding of why generated texts appear ungrounded: The LLM might not have picked up the necessary knowledge from large and often inaccessible datasets, or the information might have been changed or contradicted during further training. Our focus is on hallucinations involving information not used in training, which we determine by using recency to ensure the information emerged after a cut-off date. This study investigates these hallucinations by detecting them at sentence level using different internal states of various LLMs. We present HalluRAG, a dataset designed to train classifiers on these hallucinations. Depending on the model and quantization, MLPs trained on HalluRAG detect hallucinations with test accuracies ranging up to 75 %, with Mistral-7B-Instruct-v0.1 achieving the highest test accuracies. Our results show that IAVs detect hallucinations as effectively as CEVs and reveal that answerable and unanswerable prompts are encoded differently as separate classifiers for these categories improved accuracy. However, HalluRAG showed some limited generalizability, advocating for more diversity in datasets on hallucinations.

AI applications driven by multimodal large language models (MLLMs) are prone to hallucinations and pose considerable risks to human users. Crucially, such hallucinations are not equally problematic: some hallucination contents could be detected by human users(i.e., obvious hallucinations), while others are often missed or require more verification effort(i.e., elusive hallucinations). This indicates that multimodal AI hallucinations vary significantly in their verifiability. Yet, little research has explored how to control this property for AI applications with diverse security and usability demands. To address this gap, we construct a dataset from 4,470 human responses to AI-generated hallucinations and categorize these hallucinations into obvious and elusive types based on their verifiability by human users. Further, we propose an activation-space intervention method that learns separate probes for obvious and elusive hallucinations. We reveal that obvious and elusive hallucinations elicit different intervention probes, allowing for fine-grained control over the model's verifiability. Empirical results demonstrate the efficacy of this approach and show that targeted interventions yield superior performance in regulating corresponding verifiability. Moreover, simply mixing these interventions enables flexible control over the verifiability required for different scenarios.

Vision-language models (VLMs) adapted to the medical domain have shown strong performance on visual question answering benchmarks, yet their robustness against two critical failure modes, hallucination and sycophancy, remains poorly understood, particularly in combination. We evaluate six VLMs (three general-purpose, three medical-specialist) on three medical VQA datasets and uncover a grounding-sycophancy tradeoff: models with the lowest hallucination propensity are the most sycophantic, while the most pressure-resistant model hallucinates more than all medical-specialist models. To characterize this tradeoff, we propose three metrics: L-VASE, a logit-space reformulation of VASE that avoids its double-normalization; CCS, a confidence-calibrated sycophancy score that penalizes high-confidence capitulation; and Clinical Safety Index (CSI), a unified safety index that combines grounding, autonomy, and calibration via a geometric mean. Across 1,151 test cases, no model achieves a CSI above 0.35, indicating that none of the evaluated 7-8B parameter VLMs is simultaneously well-grounded and robust to social pressure. Our findings suggest that joint evaluation of both properties is necessary before these models can be considered for clinical use. Code is available at https://github.com/UTSA-VIRLab/AgreeOrRight

Recent advancements in large multimodal models (LMMs) have significantly enhanced performance across diverse tasks, with ongoing efforts to further integrate additional modalities such as video and audio. However, most existing LMMs remain vulnerable to hallucinations, the discrepancy between the factual multimodal input and the generated textual output, which has limited their applicability in various real-world scenarios. This paper presents the first systematic investigation of hallucinations in LMMs involving the three most common modalities: language, visual, and audio. Our study reveals two key contributors to hallucinations: overreliance on unimodal priors and spurious inter-modality correlations. To address these challenges, we introduce the benchmark The Curse of Multi-Modalities (CMM), which comprehensively evaluates hallucinations in LMMs, providing a detailed analysis of their underlying issues. Our findings highlight key vulnerabilities, including imbalances in modality integration and biases from training data, underscoring the need for balanced cross-modal learning and enhanced hallucination mitigation strategies. Based on our observations and findings, we suggest potential research directions that could enhance the reliability of LMMs.

Large language models (LLMs), including ChatGPT, Bard, and Llama, have achieved remarkable successes over the last two years in a range of different applications. In spite of these successes, there exist concerns that limit the wide application of LLMs. A key problem is the problem of hallucination. Hallucination refers to the fact that in addition to correct responses, LLMs can also generate seemingly correct but factually incorrect responses. This report aims to present a comprehensive review of the current literature on both hallucination detection and hallucination mitigation. We hope that this report can serve as a good reference for both engineers and researchers who are interested in LLMs and applying them to real world tasks.

Large Vision-Language Models (LVLMs) have demonstrated remarkable performance in performing complex multimodal tasks. However, they are still plagued by object hallucination: the misidentification or misclassification of objects present in images. To this end, we propose HALLUCINOGEN, a novel visual question answering (VQA) object hallucination attack benchmark that utilizes diverse contextual reasoning prompts to evaluate object hallucination in state-of-the-art LVLMs. We design a series of contextual reasoning hallucination prompts to evaluate LVLMs' ability to accurately identify objects in a target image while asking them to perform diverse visual-language tasks such as identifying, locating or performing visual reasoning around specific objects. Further, we extend our benchmark to high-stakes medical applications and introduce MED-HALLUCINOGEN, hallucination attacks tailored to the biomedical domain, and evaluate the hallucination performance of LVLMs on medical images, a critical area where precision is crucial. Finally, we conduct extensive evaluations of eight LVLMs and two hallucination mitigation strategies across multiple datasets to show that current generic and medical LVLMs remain susceptible to hallucination attacks.

Aligning large language models (LLMs) to accurately detect hallucinations remains a significant challenge due to the sophisticated nature of hallucinated text. Recognizing that hallucinated samples typically exhibit higher deceptive quality than traditional negative samples, we use these carefully engineered hallucinations as negative examples in the DPO alignment procedure. Our method incorporates a curriculum learning strategy, gradually transitioning the training from easier samples, identified based on the greatest reduction in probability scores from independent fact checking models, to progressively harder ones. This structured difficulty scaling ensures stable and incremental learning. Experimental evaluation demonstrates that our HaluCheck models, trained with curriculum DPO approach and high quality negative samples, significantly improves model performance across various metrics, achieving improvements of upto 24% on difficult benchmarks like MedHallu and HaluEval. Additionally, HaluCheck models demonstrate robustness in zero-shot settings, significantly outperforming larger state-of-the-art models across various benchmarks.

Hallucination poses a challenge to the deployment of large vision-language models (LVLMs) in applications. Unlike in large language models (LLMs), hallucination in LVLMs often arises from misalignments between visual inputs and textual outputs. This paper investigates the underlying mechanisms of hallucination, focusing on the unique structure of LVLMs that distinguishes them from large language models (LLMs). We identify that hallucinations often arise from the sensitivity of text decoders to vision inputs, a natural phenomenon when image encoders and text decoders are pre-trained separately. Inspired by this, we introduce Visual and Textual Intervention (VTI), a novel technique designed to reduce hallucinations by steering latent space representations during inference to enhance the stability of vision features. As a task-agnostic test-time intervention, VTI can be easily applied to any problem without additional cost. Extensive experiments demonstrate that it can effectively reduce hallucinations and outperform baseline methods across multiple metrics, highlighting the critical role of vision feature stability in LVLMs.

The emergence of large language models (LLMs) has marked a significant breakthrough in natural language processing (NLP), leading to remarkable advancements in text understanding and generation. Nevertheless, alongside these strides, LLMs exhibit a critical tendency to produce hallucinations, resulting in content that is inconsistent with real-world facts or user inputs. This phenomenon poses substantial challenges to their practical deployment and raises concerns over the reliability of LLMs in real-world scenarios, which attracts increasing attention to detect and mitigate these hallucinations. In this survey, we aim to provide a thorough and in-depth overview of recent advances in the field of LLM hallucinations. We begin with an innovative taxonomy of LLM hallucinations, then delve into the factors contributing to hallucinations. Subsequently, we present a comprehensive overview of hallucination detection methods and benchmarks. Additionally, representative approaches designed to mitigate hallucinations are introduced accordingly. Finally, we analyze the challenges that highlight the current limitations and formulate open questions, aiming to delineate pathways for future research on hallucinations in LLMs.

Multimodal hallucination in multimodal large language models (MLLMs) restricts the correctness of MLLMs. However, multimodal hallucinations are multi-sourced and arise from diverse causes. Existing benchmarks fail to adequately distinguish between perception-induced hallucinations and reasoning-induced hallucinations. This failure constitutes a significant issue and hinders the diagnosis of multimodal reasoning failures within MLLMs. To address this, we propose the {\dataset} benchmark, which isolates reasoning hallucinations by constructing questions where input images are correctly perceived by MLLMs yet reasoning errors persist. {\dataset} introduces multi-granular evaluation metrics: accuracy, factuality, and LLMs hallucination score for hallucination quantification. Our analysis reveals that (1) the model scale, data scale, and training stages significantly affect the degree of logical, fabrication, and factual hallucinations; (2) current MLLMs show no effective improvement on spatial hallucinations caused by misinterpreted spatial relationships, indicating their limited visual reasoning capabilities; and (3) question types correlate with distinct hallucination patterns, highlighting targeted challenges and potential mitigation strategies. To address these challenges, we propose {\method}, a method that combines curriculum reinforcement fine-tuning to encourage models to generate logic-consistent reasoning chains by stepwise reducing learning difficulty, and collaborative hint inference to reduce reasoning complexity. {\method} establishes a baseline on {\dataset}, and reduces the logical hallucinations in original base models.

Despite their powerful chat, coding, and reasoning abilities, Large Language Models (LLMs) frequently hallucinate. Conventional wisdom suggests that hallucinations are a consequence of a balance between creativity and factuality, which can be mitigated, but not eliminated, by grounding the LLM in external knowledge sources. Through extensive systematic experiments, we show that these traditional approaches fail to explain why LLMs hallucinate in practice. Specifically, we show that LLMs augmented with a massive Mixture of Memory Experts (MoME) can easily memorize large datasets of random numbers. We corroborate these experimental findings with a theoretical construction showing that simple neural networks trained to predict the next token hallucinate when the training loss is above a threshold as it usually does in practice when training on internet scale data. We interpret our findings by comparing against traditional retrieval methods for mitigating hallucinations. We use our findings to design a first generation model for removing hallucinations -- Lamini-1 -- that stores facts in a massive mixture of millions of memory experts that are retrieved dynamically.

While hallucinations of large language models (LLMs) prevail as a major challenge, existing evaluation benchmarks on factuality do not cover the diverse domains of knowledge that the real-world users of LLMs seek information about. To bridge this gap, we introduce WildHallucinations, a benchmark that evaluates factuality. It does so by prompting LLMs to generate information about entities mined from user-chatbot conversations in the wild. These generations are then automatically fact-checked against a systematically curated knowledge source collected from web search. Notably, half of these real-world entities do not have associated Wikipedia pages. We evaluate 118,785 generations from 15 LLMs on 7,919 entities. We find that LLMs consistently hallucinate more on entities without Wikipedia pages and exhibit varying hallucination rates across different domains. Finally, given the same base models, adding a retrieval component only slightly reduces hallucinations but does not eliminate hallucinations.

Large Language Models (LLMs) have transformed the Natural Language Processing (NLP) landscape with their remarkable ability to understand and generate human-like text. However, these models are prone to ``hallucinations'' -- outputs that do not align with factual reality or the input context. This paper introduces the Hallucinations Leaderboard, an open initiative to quantitatively measure and compare the tendency of each model to produce hallucinations. The leaderboard uses a comprehensive set of benchmarks focusing on different aspects of hallucinations, such as factuality and faithfulness, across various tasks, including question-answering, summarisation, and reading comprehension. Our analysis provides insights into the performance of different models, guiding researchers and practitioners in choosing the most reliable models for their applications.

Large language models (LLMs) have transformed natural language processing, achieving remarkable performance across diverse tasks. However, their impressive fluency often comes at the cost of producing false or fabricated information, a phenomenon known as hallucination. Hallucination refers to the generation of content by an LLM that is fluent and syntactically correct but factually inaccurate or unsupported by external evidence. Hallucinations undermine the reliability and trustworthiness of LLMs, especially in domains requiring factual accuracy. This survey provides a comprehensive review of research on hallucination in LLMs, with a focus on causes, detection, and mitigation. We first present a taxonomy of hallucination types and analyze their root causes across the entire LLM development lifecycle, from data collection and architecture design to inference. We further examine how hallucinations emerge in key natural language generation tasks. Building on this foundation, we introduce a structured taxonomy of detection approaches and another taxonomy of mitigation strategies. We also analyze the strengths and limitations of current detection and mitigation approaches and review existing evaluation benchmarks and metrics used to quantify LLMs hallucinations. Finally, we outline key open challenges and promising directions for future research, providing a foundation for the development of more truthful and trustworthy LLMs.

Recent advances in generative vision-language models (VLMs) have exciting potential implications for AI in radiology, yet VLMs are also known to produce hallucinations, nonsensical text, and other unwanted behaviors that can waste clinicians' time and cause patient harm. Drawing on recent work on direct preference optimization (DPO), we propose a simple method for modifying the behavior of pretrained VLMs performing radiology report generation by suppressing unwanted types of generations. We apply our method to the prevention of hallucinations of prior exams, addressing a long-established problem behavior in models performing chest X-ray report generation. Across our experiments, we find that DPO fine-tuning achieves a 3.2-4.8x reduction in lines hallucinating prior exams while maintaining model performance on clinical accuracy metrics. Our work is, to the best of our knowledge, the first work to apply DPO to medical VLMs, providing a data- and compute- efficient way to suppress problem behaviors while maintaining overall clinical accuracy.

Large Language Models (LLMs) often generate hallucinations, producing outputs that are contextually inaccurate or factually incorrect. We introduce HICD, a novel method designed to induce hallucinations for contrastive decoding to mitigate hallucinations. Unlike existing contrastive decoding methods, HICD selects attention heads crucial to the model's prediction as inducing heads, then induces hallucinations by dispersing attention of these inducing heads and compares the hallucinated outputs with the original outputs to obtain the final result. Our approach significantly improves performance on tasks requiring contextual faithfulness, such as context completion, reading comprehension, and question answering. It also improves factuality in tasks requiring accurate knowledge recall. We demonstrate that our inducing heads selection and attention dispersion method leads to more "contrast-effective" hallucinations for contrastive decoding, outperforming other hallucination-inducing methods. Our findings provide a promising strategy for reducing hallucinations by inducing hallucinations in a controlled manner, enhancing the performance of LLMs in a wide range of tasks.

Stroboscopic light stimulation (SLS) on closed eyes typically induces simple visual hallucinations (VHs), characterised by vivid, geometric and colourful patterns. A dataset of 862 sentences, extracted from 422 open subjective reports, was recently compiled as part of the Dreamachine programme (Collective Act, 2022), an immersive multisensory experience that combines SLS and spatial sound in a collective setting. Although open reports extend the range of reportable phenomenology, their analysis presents significant challenges, particularly in systematically identifying patterns. To address this challenge, we implemented a data-driven approach leveraging Large Language Models and Topic Modelling to uncover and interpret latent experiential topics directly from the Dreamachine's text-based reports. Our analysis confirmed the presence of simple VHs typically documented in scientific studies of SLS, while also revealing experiences of altered states of consciousness and complex hallucinations. Building on these findings, our computational approach expands the systematic study of subjective experience by enabling data-driven analyses of open-ended phenomenological reports, capturing experiences not readily identified through standard questionnaires. By revealing rich and multifaceted aspects of experiences, our study broadens our understanding of stroboscopically-induced phenomena while highlighting the potential of Natural Language Processing and Large Language Models in the emerging field of computational (neuro)phenomenology. More generally, this approach provides a practically applicable methodology for uncovering subtle hidden patterns of subjective experience across diverse research domains.

Hallucinations, defined as instances where Large Language Models (LLMs) generate false or misleading content, pose a significant challenge that impacts the safety and trust of downstream applications. We introduce UQLM, a Python package for LLM hallucination detection using state-of-the-art uncertainty quantification (UQ) techniques. This toolkit offers a suite of UQ-based scorers that compute response-level confidence scores ranging from 0 to 1. This library provides an off-the-shelf solution for UQ-based hallucination detection that can be easily integrated to enhance the reliability of LLM outputs.

The rapid development of Large Multimodal Models (LMMs) has significantly advanced multimodal understanding by harnessing the language abilities of Large Language Models (LLMs) and integrating modality-specific encoders. However, LMMs are plagued by hallucinations that limit their reliability and adoption. While traditional methods to detect and mitigate these hallucinations often involve costly training or rely heavily on external models, recent approaches utilizing internal model features present a promising alternative. In this paper, we critically assess the limitations of the state-of-the-art training-free technique, the logit lens, in handling generalized visual hallucinations. We introduce a refined method that leverages contextual token embeddings from middle layers of LMMs. This approach significantly improves hallucination detection and grounding across diverse categories, including actions and OCR, while also excelling in tasks requiring contextual understanding, such as spatial relations and attribute comparison. Our novel grounding technique yields highly precise bounding boxes, facilitating a transition from Zero-Shot Object Segmentation to Grounded Visual Question Answering. Our contributions pave the way for more reliable and interpretable multimodal models.

While large language models (LLMs) have demonstrated remarkable capabilities across a range of downstream tasks, a significant concern revolves around their propensity to exhibit hallucinations: LLMs occasionally generate content that diverges from the user input, contradicts previously generated context, or misaligns with established world knowledge. This phenomenon poses a substantial challenge to the reliability of LLMs in real-world scenarios. In this paper, we survey recent efforts on the detection, explanation, and mitigation of hallucination, with an emphasis on the unique challenges posed by LLMs. We present taxonomies of the LLM hallucination phenomena and evaluation benchmarks, analyze existing approaches aiming at mitigating LLM hallucination, and discuss potential directions for future research.

Large-scale Text-to-Image (TTI) models have become a common approach for generating training data in various generative fields. However, visual hallucinations, which contain perceptually critical defects, remain a concern, especially in non-photorealistic styles like cartoon characters. We propose a novel visual hallucination detection system for cartoon character images generated by TTI models. Our approach leverages pose-aware in-context visual learning (PA-ICVL) with Vision-Language Models (VLMs), utilizing both RGB images and pose information. By incorporating pose guidance from a fine-tuned pose estimator, we enable VLMs to make more accurate decisions. Experimental results demonstrate significant improvements in identifying visual hallucinations compared to baseline methods relying solely on RGB images. This research advances TTI models by mitigating visual hallucinations, expanding their potential in non-photorealistic domains.

Large vision-language models (LVLMs) hallucinate: certain context cues in an image may trigger the language module's overconfident and incorrect reasoning on abnormal or hypothetical objects. Though a few benchmarks have been developed to investigate LVLM hallucinations, they mainly rely on hand-crafted corner cases whose fail patterns may hardly generalize, and finetuning on them could undermine their validity. These motivate us to develop the first automatic benchmark generation approach, AUTOHALLUSION, that harnesses a few principal strategies to create diverse hallucination examples. It probes the language modules in LVLMs for context cues and uses them to synthesize images by: (1) adding objects abnormal to the context cues; (2) for two co-occurring objects, keeping one and excluding the other; or (3) removing objects closely tied to the context cues. It then generates image-based questions whose ground-truth answers contradict the language module's prior. A model has to overcome contextual biases and distractions to reach correct answers, while incorrect or inconsistent answers indicate hallucinations. AUTOHALLUSION enables us to create new benchmarks at the minimum cost and thus overcomes the fragility of hand-crafted benchmarks. It also reveals common failure patterns and reasons, providing key insights to detect, avoid, or control hallucinations. Comprehensive evaluations of top-tier LVLMs, e.g., GPT-4V(ision), Gemini Pro Vision, Claude 3, and LLaVA-1.5, show a 97.7% and 98.7% success rate of hallucination induction on synthetic and real-world datasets of AUTOHALLUSION, paving the way for a long battle against hallucinations.

Memory systems are key components that enable AI systems such as LLMs and AI agents to achieve long-term learning and sustained interaction. However, during memory storage and retrieval, these systems frequently exhibit memory hallucinations, including fabrication, errors, conflicts, and omissions. Existing evaluations of memory hallucinations are primarily end-to-end question answering, which makes it difficult to localize the operational stage within the memory system where hallucinations arise. To address this, we introduce the Hallucination in Memory Benchmark (HaluMem), the first operation level hallucination evaluation benchmark tailored to memory systems. HaluMem defines three evaluation tasks (memory extraction, memory updating, and memory question answering) to comprehensively reveal hallucination behaviors across different operational stages of interaction. To support evaluation, we construct user-centric, multi-turn human-AI interaction datasets, HaluMem-Medium and HaluMem-Long. Both include about 15k memory points and 3.5k multi-type questions. The average dialogue length per user reaches 1.5k and 2.6k turns, with context lengths exceeding 1M tokens, enabling evaluation of hallucinations across different context scales and task complexities. Empirical studies based on HaluMem show that existing memory systems tend to generate and accumulate hallucinations during the extraction and updating stages, which subsequently propagate errors to the question answering stage. Future research should focus on developing interpretable and constrained memory operation mechanisms that systematically suppress hallucinations and improve memory reliability.

Machine Translation (MT) is undergoing a paradigm shift, with systems based on fine-tuned large language models (LLM) becoming increasingly competitive with traditional encoder-decoder models trained specifically for translation tasks. However, LLM-based systems are at a higher risk of generating hallucinations, which can severely undermine user's trust and safety. Most prior research on hallucination mitigation focuses on traditional MT models, with solutions that involve post-hoc mitigation - detecting hallucinated translations and re-translating them. While effective, this approach introduces additional complexity in deploying extra tools in production and also increases latency. To address these limitations, we propose a method that intrinsically learns to mitigate hallucinations during the model training phase. Specifically, we introduce a data creation framework to generate hallucination focused preference datasets. Fine-tuning LLMs on these preference datasets reduces the hallucination rate by an average of 96% across five language pairs, while preserving overall translation quality. In a zero-shot setting our approach reduces hallucinations by 89% on an average across three unseen target languages.

Hallucinations in Large Language Model (LLM) outputs for Question Answering (QA) tasks can critically undermine their real-world reliability. This paper introduces a methodology for robust, one-shot hallucination detection, specifically designed for scenarios with limited data access, such as interacting with black-box LLM APIs that typically expose only a few top candidate log-probabilities per token. Our approach derives uncertainty indicators directly from these readily available log-probabilities generated during non-greedy decoding. We first derive an Entropy Production Rate (EPR) that offers baseline performance, later augmented with supervised learning. Our learned model leverages the entropic contributions of the accessible top-ranked tokens within a single generated sequence, without multiple re-runs per query. Evaluated across diverse QA datasets and multiple LLMs, this estimator significantly improves token-level hallucination detection over state-of-the-art methods. Crucially, high performance is demonstrated using only the typically small set of available log-probabilities (e.g., top-10 per token), confirming its practical efficiency and suitability for API-constrained deployments. This work provides a lightweight technique to enhance the trustworthiness of LLM responses, at the token level, after a single generation pass, for QA and Retrieval-Augmented Generation (RAG) systems. Our experiments confirmed the performance of our method against existing approaches on public dataset as well as for a financial framework analyzing annual company reports.

Large language models (LLMs) have the potential to transform the practice of law, but this potential is threatened by the presence of legal hallucinations -- responses from these models that are not consistent with legal facts. We investigate the extent of these hallucinations using an original suite of legal queries, comparing LLMs' responses to structured legal metadata and examining their consistency. Our work makes four key contributions: (1) We develop a typology of legal hallucinations, providing a conceptual framework for future research in this area. (2) We find that legal hallucinations are alarmingly prevalent, occurring between 69% of the time with ChatGPT 3.5 and 88% with Llama 2, when these models are asked specific, verifiable questions about random federal court cases. (3) We illustrate that LLMs often fail to correct a user's incorrect legal assumptions in a contra-factual question setup. (4) We provide evidence that LLMs cannot always predict, or do not always know, when they are producing legal hallucinations. Taken together, these findings caution against the rapid and unsupervised integration of popular LLMs into legal tasks. Even experienced lawyers must remain wary of legal hallucinations, and the risks are highest for those who stand to benefit from LLMs the most -- pro se litigants or those without access to traditional legal resources.

Recent progress in multimodal large language models (MLLMs) has demonstrated promising performance on medical benchmarks and in preliminary trials as clinical assistants. Yet, our pilot audit of diagnostic cases uncovers a critical failure mode: instability in early evidence interpretation precedes hallucination, creating branching reasoning trajectories that cascade into globally inconsistent conclusions. This highlights the need for clinical reasoning agents that constrain stochasticity and hallucination while producing auditable decision flows. We introduce MedMMV, a controllable multimodal multi-agent framework for reliable and verifiable clinical reasoning. MedMMV stabilizes reasoning through diversified short rollouts, grounds intermediate steps in a structured evidence graph under the supervision of a Hallucination Detector, and aggregates candidate paths with a Combined Uncertainty scorer. On six medical benchmarks, MedMMV improves accuracy by up to 12.7% and, more critically, demonstrates superior reliability. Blind physician evaluations confirm that MedMMV substantially increases reasoning truthfulness without sacrificing informational content. By controlling instability through a verifiable, multi-agent process, our framework provides a robust path toward deploying trustworthy AI systems in high-stakes domains like clinical decision support.

Large Language Models (LLMs) have significantly advanced the field of Natural Language Processing (NLP), achieving remarkable performance across diverse tasks and enabling widespread real-world applications. However, LLMs are prone to hallucination, generating content that either conflicts with established knowledge or is unfaithful to the original sources. Existing hallucination benchmarks primarily focus on sentence- or passage-level hallucination detection, neglecting dialogue-level evaluation, hallucination localization, and rationale provision. They also predominantly target factuality hallucinations while underestimating faithfulness hallucinations, often relying on labor-intensive or non-specialized evaluators. To address these limitations, we propose HalluDial, the first comprehensive large-scale benchmark for automatic dialogue-level hallucination evaluation. HalluDial encompasses both spontaneous and induced hallucination scenarios, covering factuality and faithfulness hallucinations. The benchmark includes 4,094 dialogues with a total of 146,856 samples. Leveraging HalluDial, we conduct a comprehensive meta-evaluation of LLMs' hallucination evaluation capabilities in information-seeking dialogues and introduce a specialized judge language model, HalluJudge. The high data quality of HalluDial enables HalluJudge to achieve superior or competitive performance in hallucination evaluation, facilitating the automatic assessment of dialogue-level hallucinations in LLMs and providing valuable insights into this phenomenon. The dataset and the code are available at https://github.com/FlagOpen/HalluDial.

The present study introduces the knowledge-augmented generator, which is specifically designed to produce information that remains grounded in contextual knowledge, regardless of alterations in the context. Previous research has predominantly focused on examining hallucinations stemming from static input, such as in the domains of summarization or machine translation. However, our investigation delves into the faithfulness of generative question answering in the presence of dynamic knowledge. Our objective is to explore the existence of hallucinations arising from parametric memory when contextual knowledge undergoes changes, while also analyzing the underlying causes for their occurrence. In order to efficiently address this issue, we propose a straightforward yet effective measure for detecting such hallucinations. Intriguingly, our investigation uncovers that all models exhibit a tendency to generate previous answers as hallucinations. To gain deeper insights into the underlying causes of this phenomenon, we conduct a series of experiments that verify the critical role played by context in hallucination, both during training and testing, from various perspectives.

Recent development of Large Vision-Language Models (LVLMs) has attracted growing attention within the AI landscape for its practical implementation potential. However, ``hallucination'', or more specifically, the misalignment between factual visual content and corresponding textual generation, poses a significant challenge of utilizing LVLMs. In this comprehensive survey, we dissect LVLM-related hallucinations in an attempt to establish an overview and facilitate future mitigation. Our scrutiny starts with a clarification of the concept of hallucinations in LVLMs, presenting a variety of hallucination symptoms and highlighting the unique challenges inherent in LVLM hallucinations. Subsequently, we outline the benchmarks and methodologies tailored specifically for evaluating hallucinations unique to LVLMs. Additionally, we delve into an investigation of the root causes of these hallucinations, encompassing insights from the training data and model components. We also critically review existing methods for mitigating hallucinations. The open questions and future directions pertaining to hallucinations within LVLMs are discussed to conclude this survey.

Despite significant strides in multimodal tasks, Multimodal Large Language Models (MLLMs) are plagued by the critical issue of hallucination. The reliable detection of such hallucinations in MLLMs has, therefore, become a vital aspect of model evaluation and the safeguarding of practical application deployment. Prior research in this domain has been constrained by a narrow focus on singular tasks, an inadequate range of hallucination categories addressed, and a lack of detailed granularity. In response to these challenges, our work expands the investigative horizons of hallucination detection. We present a novel meta-evaluation benchmark, MHaluBench, meticulously crafted to facilitate the evaluation of advancements in hallucination detection methods. Additionally, we unveil a novel unified multimodal hallucination detection framework, UNIHD, which leverages a suite of auxiliary tools to validate the occurrence of hallucinations robustly. We demonstrate the effectiveness of UNIHD through meticulous evaluation and comprehensive analysis. We also provide strategic insights on the application of specific tools for addressing various categories of hallucinations.

The emergence of Large Language Models (LLMs) has revolutionized how users access information, shifting from traditional search engines to direct question-and-answer interactions with LLMs. However, the widespread adoption of LLMs has revealed a significant challenge known as hallucination, wherein LLMs generate coherent yet factually inaccurate responses. This hallucination phenomenon has led to users' distrust in information retrieval systems based on LLMs. To tackle this challenge, this paper proposes Dynamic Retrieval Augmentation based on hallucination Detection (DRAD) as a novel method to detect and mitigate hallucinations in LLMs. DRAD improves upon traditional retrieval augmentation by dynamically adapting the retrieval process based on real-time hallucination detection. It features two main components: Real-time Hallucination Detection (RHD) for identifying potential hallucinations without external models, and Self-correction based on External Knowledge (SEK) for correcting these errors using external knowledge. Experiment results show that DRAD demonstrates superior performance in both detecting and mitigating hallucinations in LLMs. All of our code and data are open-sourced at https://github.com/oneal2000/EntityHallucination.

Large audio-video language models can generate descriptions for both video and audio. However, they sometimes ignore audio content, producing audio descriptions solely reliant on visual information. This paper refers to this as audio hallucinations and analyzes them in large audio-video language models. We gather 1,000 sentences by inquiring about audio information and annotate them whether they contain hallucinations. If a sentence is hallucinated, we also categorize the type of hallucination. The results reveal that 332 sentences are hallucinated with distinct trends observed in nouns and verbs for each hallucination type. Based on this, we tackle a task of audio hallucination classification using pre-trained audio-text models in the zero-shot and fine-tuning settings. Our experimental results reveal that the zero-shot models achieve higher performance (52.2% in F1) than the random (40.3%) and the fine-tuning models achieve 87.9%, outperforming the zero-shot models.

Hallucination is a big shadow hanging over the rapidly evolving Multimodal Large Language Models (MLLMs), referring to the phenomenon that the generated text is inconsistent with the image content. In order to mitigate hallucinations, existing studies mainly resort to an instruction-tuning manner that requires retraining the models with specific data. In this paper, we pave a different way, introducing a training-free method named Woodpecker. Like a woodpecker heals trees, it picks out and corrects hallucinations from the generated text. Concretely, Woodpecker consists of five stages: key concept extraction, question formulation, visual knowledge validation, visual claim generation, and hallucination correction. Implemented in a post-remedy manner, Woodpecker can easily serve different MLLMs, while being interpretable by accessing intermediate outputs of the five stages. We evaluate Woodpecker both quantitatively and qualitatively and show the huge potential of this new paradigm. On the POPE benchmark, our method obtains a 30.66%/24.33% improvement in accuracy over the baseline MiniGPT-4/mPLUG-Owl. The source code is released at https://github.com/BradyFU/Woodpecker.

The prevalent use of large language models (LLMs) in various domains has drawn attention to the issue of "hallucination," which refers to instances where LLMs generate factually inaccurate or ungrounded information. Existing techniques for hallucination detection in language assistants rely on intricate fuzzy, specific free-language-based chain of thought (CoT) techniques or parameter-based methods that suffer from interpretability issues. Additionally, the methods that identify hallucinations post-generation could not prevent their occurrence and suffer from inconsistent performance due to the influence of the instruction format and model style. In this paper, we introduce a novel pre-detection self-evaluation technique, referred to as SELF-FAMILIARITY, which focuses on evaluating the model's familiarity with the concepts present in the input instruction and withholding the generation of response in case of unfamiliar concepts. This approach emulates the human ability to refrain from responding to unfamiliar topics, thus reducing hallucinations. We validate SELF-FAMILIARITY across four different large language models, demonstrating consistently superior performance compared to existing techniques. Our findings propose a significant shift towards preemptive strategies for hallucination mitigation in LLM assistants, promising improvements in reliability, applicability, and interpretability.

Hallucinations pose a significant challenge to the reliability and alignment of Large Language Models (LLMs), limiting their widespread acceptance beyond chatbot applications. Despite ongoing efforts, hallucinations remain a prevalent challenge in LLMs. The detection of hallucinations itself is also a formidable task, frequently requiring manual labeling or constrained evaluations. This paper introduces an automated scalable framework that combines benchmarking LLMs' hallucination tendencies with efficient hallucination detection. We leverage LLMs to generate challenging tasks related to hypothetical phenomena, subsequently employing them as agents for efficient hallucination detection. The framework is domain-agnostic, allowing the use of any language model for benchmark creation or evaluation in any domain. We introduce the publicly available HypoTermQA Benchmarking Dataset, on which state-of-the-art models' performance ranged between 3% and 11%, and evaluator agents demonstrated a 6% error rate in hallucination prediction. The proposed framework provides opportunities to test and improve LLMs. Additionally, it has the potential to generate benchmarking datasets tailored to specific domains, such as law, health, and finance.

Large Vision-Language Models (LVLMs) have recently demonstrated remarkable progress, yet hallucination remains a critical barrier, particularly in chart understanding, which requires sophisticated perceptual and cognitive abilities as well as rigorous factual accuracy. While prior work has investigated hallucinations and chart comprehension independently, their intersection remains largely unexplored. To address this gap, we present ChartHal, a benchmark that features a fine-grained taxonomy of hallucination scenarios in chart understanding, along with a human-validated dataset of 1,062 samples. Our evaluation shows that state-of-the-art LVLMs suffer from severe hallucinations on ChartHal, including proprietary models such as GPT-5 and o4-mini, which achieve only 34.46% and 22.79% accuracy, respectively. Further analysis reveals that questions involving information absent from or contradictory to charts are especially likely to trigger hallucinations, underscoring the urgent need for more robust mitigation strategies. Code and data are available at https://github.com/ymcui/ChartHal .

Large Language Models (LLMs) often generate outputs that lack grounding in real-world facts, a phenomenon known as hallucinations. Prior research has associated hallucinations with model uncertainty, leveraging this relationship for hallucination detection and mitigation. In this paper, we challenge the underlying assumption that all hallucinations are associated with uncertainty. Using knowledge detection and uncertainty measurement methods, we demonstrate that models can hallucinate with high certainty even when they have the correct knowledge. We further show that high-certainty hallucinations are consistent across models and datasets, distinctive enough to be singled out, and challenge existing mitigation methods. Our findings reveal an overlooked aspect of hallucinations, emphasizing the need to understand their origins and improve mitigation strategies to enhance LLM safety. The code is available at https://github.com/technion-cs-nlp/Trust_me_Im_wrong .

The recent advancements in Large Language Models (LLMs) have garnered widespread acclaim for their remarkable emerging capabilities. However, the issue of hallucination has parallelly emerged as a by-product, posing significant concerns. While some recent endeavors have been made to identify and mitigate different types of hallucination, there has been a limited emphasis on the nuanced categorization of hallucination and associated mitigation methods. To address this gap, we offer a fine-grained discourse on profiling hallucination based on its degree, orientation, and category, along with offering strategies for alleviation. As such, we define two overarching orientations of hallucination: (i) factual mirage (FM) and (ii) silver lining (SL). To provide a more comprehensive understanding, both orientations are further sub-categorized into intrinsic and extrinsic, with three degrees of severity - (i) mild, (ii) moderate, and (iii) alarming. We also meticulously categorize hallucination into six types: (i) acronym ambiguity, (ii) numeric nuisance, (iii) generated golem, (iv) virtual voice, (v) geographic erratum, and (vi) time wrap. Furthermore, we curate HallucInation eLiciTation (HILT), a publicly available dataset comprising of 75,000 samples generated using 15 contemporary LLMs along with human annotations for the aforementioned categories. Finally, to establish a method for quantifying and to offer a comparative spectrum that allows us to evaluate and rank LLMs based on their vulnerability to producing hallucinations, we propose Hallucination Vulnerability Index (HVI). We firmly believe that HVI holds significant value as a tool for the wider NLP community, with the potential to serve as a rubric in AI-related policy-making. In conclusion, we propose two solution strategies for mitigating hallucinations.

Like students facing hard exam questions, large language models sometimes guess when uncertain, producing plausible yet incorrect statements instead of admitting uncertainty. Such "hallucinations" persist even in state-of-the-art systems and undermine trust. We argue that language models hallucinate because the training and evaluation procedures reward guessing over acknowledging uncertainty, and we analyze the statistical causes of hallucinations in the modern training pipeline. Hallucinations need not be mysterious -- they originate simply as errors in binary classification. If incorrect statements cannot be distinguished from facts, then hallucinations in pretrained language models will arise through natural statistical pressures. We then argue that hallucinations persist due to the way most evaluations are graded -- language models are optimized to be good test-takers, and guessing when uncertain improves test performance. This "epidemic" of penalizing uncertain responses can only be addressed through a socio-technical mitigation: modifying the scoring of existing benchmarks that are misaligned but dominate leaderboards, rather than introducing additional hallucination evaluations. This change may steer the field toward more trustworthy AI systems.

Hallucinations are a type of output error produced by deep neural networks. While this has been studied in natural language processing, they have not been researched previously in automatic speech recognition. Here, we define hallucinations in ASR as transcriptions generated by a model that are semantically unrelated to the source utterance, yet still fluent and coherent. The similarity of hallucinations to probable natural language outputs of the model creates a danger of deception and impacts the credibility of the system. We show that commonly used metrics, such as word error rates, cannot differentiate between hallucinatory and non-hallucinatory models. To address this, we propose a perturbation-based method for assessing the susceptibility of an automatic speech recognition (ASR) model to hallucination at test time, which does not require access to the training dataset. We demonstrate that this method helps to distinguish between hallucinatory and non-hallucinatory models that have similar baseline word error rates. We further explore the relationship between the types of ASR errors and the types of dataset noise to determine what types of noise are most likely to create hallucinatory outputs. We devise a framework for identifying hallucinations by analysing their semantic connection with the ground truth and their fluency. Finally, we discover how to induce hallucinations with a random noise injection to the utterance.

Hallucination plagues even frontier LLMs--but how bad is it really for summarizing academic papers? We evaluate Factored Verification, a simple automated method for detecting hallucinations in abstractive summaries. This method sets a new SotA on hallucination detection in the summarization task of the HaluEval benchmark, achieving 76.2% accuracy. We then use this method to estimate how often language models hallucinate when summarizing across multiple academic papers and find 0.62 hallucinations in the average ChatGPT (16k) summary, 0.84 for GPT-4, and 1.55 for Claude 2. We ask models to self-correct using Factored Critiques and find that this lowers the number of hallucinations to 0.49 for ChatGPT, 0.46 for GPT-4, and 0.95 for Claude 2. The hallucinations we find are often subtle, so we advise caution when using models to synthesize academic papers.

Large vision-language models (LVLMs) have demonstrated exceptional performance on complex multimodal tasks. However, they continue to suffer from significant hallucination issues, including object, attribute, and relational hallucinations. To accurately detect these hallucinations, we investigated the variations in cross-modal attention patterns between hallucination and non-hallucination states. Leveraging these distinctions, we developed a lightweight detector capable of identifying hallucinations. Our proposed method, Detecting Hallucinations by Cross-modal Attention Patterns (DHCP), is straightforward and does not require additional LVLM training or extra LVLM inference steps. Experimental results show that DHCP achieves remarkable performance in hallucination detection. By offering novel insights into the identification and analysis of hallucinations in LVLMs, DHCP contributes to advancing the reliability and trustworthiness of these models.

Background: Emerging reports of "AI psychosis" are on the rise, where user-LLM interactions may exacerbate or induce psychosis or adverse psychological symptoms. Whilst the sycophantic and agreeable nature of LLMs can be beneficial, it becomes a vector for harm by reinforcing delusional beliefs in vulnerable users. Methods: Psychosis-bench is a novel benchmark designed to systematically evaluate the psychogenicity of LLMs comprises 16 structured, 12-turn conversational scenarios simulating the progression of delusional themes(Erotic Delusions, Grandiose/Messianic Delusions, Referential Delusions) and potential harms. We evaluated eight prominent LLMs for Delusion Confirmation (DCS), Harm Enablement (HES), and Safety Intervention(SIS) across explicit and implicit conversational contexts. Findings: Across 1,536 simulated conversation turns, all LLMs demonstrated psychogenic potential, showing a strong tendency to perpetuate rather than challenge delusions (mean DCS of 0.91 pm0.88). Models frequently enabled harmful user requests (mean HES of 0.69 pm0.84) and offered safety interventions in only roughly a third of applicable turns (mean SIS of 0.37 pm0.48). 51 / 128 (39.8%) of scenarios had no safety interventions offered. Performance was significantly worse in implicit scenarios, models were more likely to confirm delusions and enable harm while offering fewer interventions (p < .001). A strong correlation was found between DCS and HES (rs = .77). Model performance varied widely, indicating that safety is not an emergent property of scale alone. Conclusion: This study establishes LLM psychogenicity as a quantifiable risk and underscores the urgent need for re-thinking how we train LLMs. We frame this issue not merely as a technical challenge but as a public health imperative requiring collaboration between developers, policymakers, and healthcare professionals.

Large Language Models (LLMs) are adept at text manipulation -- tasks such as machine translation and text summarization. However, these models can also be prone to hallucination, which can be detrimental to the faithfulness of any answers that the model provides. Recent works in combating hallucinations in LLMs deal with identifying hallucinated sentences and categorizing the different ways in which models hallucinate. This paper takes a deep dive into LLM behavior with respect to hallucinations, defines a token-level approach to identifying different kinds of hallucinations, and further utilizes this token-level tagging to improve the interpretability and faithfulness of LLMs in dialogue summarization tasks. Through this, the paper presents a new, enhanced dataset and a new training paradigm.

Neural sequence models can generate highly fluent sentences, but recent studies have also shown that they are also prone to hallucinate additional content not supported by the input. These variety of fluent but wrong outputs are particularly problematic, as it will not be possible for users to tell they are being presented incorrect content. To detect these errors, we propose a task to predict whether each token in the output sequence is hallucinated (not contained in the input) and collect new manually annotated evaluation sets for this task. We also introduce a method for learning to detect hallucinations using pretrained language models fine tuned on synthetic data that includes automatically inserted hallucinations Experiments on machine translation (MT) and abstractive summarization demonstrate that our proposed approach consistently outperforms strong baselines on all benchmark datasets. We further demonstrate how to use the token-level hallucination labels to define a fine-grained loss over the target sequence in low-resource MT and achieve significant improvements over strong baseline methods. We also apply our method to word-level quality estimation for MT and show its effectiveness in both supervised and unsupervised settings. Codes and data available at https://github.com/violet-zct/fairseq-detect-hallucination.

Large language models (LLMs) frequently generate non-factual content, known as hallucinations. Existing retrieval-augmented-based hallucination detection approaches typically address this by framing it as a classification task, evaluating hallucinations based on their consistency with retrieved evidence. However, this approach usually lacks detailed explanations for these evaluations and does not assess the reliability of these explanations. Furthermore, deficiencies in retrieval systems can lead to irrelevant or partially relevant evidence retrieval, impairing the detection process. Moreover, while real-world hallucination detection requires analyzing multiple pieces of evidence, current systems usually treat all evidence uniformly without considering its relevance to the content. To address these challenges, we introduce Halu-J, a critique-based hallucination judge with 7 billion parameters. Halu-J enhances hallucination detection by selecting pertinent evidence and providing detailed critiques. Our experiments indicate that Halu-J outperforms GPT-4o in multiple-evidence hallucination detection and matches its capability in critique generation and evidence selection. We also introduce ME-FEVER, a new dataset designed for multiple-evidence hallucination detection. Our code and dataset can be found in https://github.com/GAIR-NLP/factool .

Recent advancements in massively multilingual machine translation systems have significantly enhanced translation accuracy; however, even the best performing systems still generate hallucinations, severely impacting user trust. Detecting hallucinations in Machine Translation (MT) remains a critical challenge, particularly since existing methods excel with High-Resource Languages (HRLs) but exhibit substantial limitations when applied to Low-Resource Languages (LRLs). This paper evaluates sentence-level hallucination detection approaches using Large Language Models (LLMs) and semantic similarity within massively multilingual embeddings. Our study spans 16 language directions, covering HRLs, LRLs, with diverse scripts. We find that the choice of model is essential for performance. On average, for HRLs, Llama3-70B outperforms the previous state of the art by as much as 0.16 MCC (Matthews Correlation Coefficient). However, for LRLs we observe that Claude Sonnet outperforms other LLMs on average by 0.03 MCC. The key takeaway from our study is that LLMs can achieve performance comparable or even better than previously proposed models, despite not being explicitly trained for any machine translation task. However, their advantage is less significant for LRLs.

Hallucinations in large language model (LLM) outputs severely limit their reliability in knowledge-intensive tasks such as question answering. To address this challenge, we introduce REFIND (Retrieval-augmented Factuality hallucINation Detection), a novel framework that detects hallucinated spans within LLM outputs by directly leveraging retrieved documents. As part of the REFIND, we propose the Context Sensitivity Ratio (CSR), a novel metric that quantifies the sensitivity of LLM outputs to retrieved evidence. This innovative approach enables REFIND to efficiently and accurately detect hallucinations, setting it apart from existing methods. In the evaluation, REFIND demonstrated robustness across nine languages, including low-resource settings, and significantly outperformed baseline models, achieving superior IoU scores in identifying hallucinated spans. This work highlights the effectiveness of quantifying context sensitivity for hallucination detection, thereby paving the way for more reliable and trustworthy LLM applications across diverse languages.

Retrieval-Augmented Generation (RAG) systems have gained widespread adoption by application builders because they leverage sources of truth to enable Large Language Models (LLMs) to generate more factually sound responses. However, hallucinations, instances of LLM responses that are unfaithful to the provided context, often prevent these systems from being deployed in production environments. Current hallucination detection methods typically involve human evaluation or the use of closed-source models to review RAG system outputs for hallucinations. Both human evaluators and closed-source models suffer from scaling issues due to their high costs and slow inference speeds. In this work, we introduce a perturbed multi-hop QA dataset with induced hallucinations. Via supervised fine-tuning on our dataset, we achieve better recall with a 7B model than GPT-4o on the RAGTruth hallucination detection benchmark and offer competitive performance on precision and accuracy, all while using a fraction of the parameters. Code is released at our repository.

The detection of hallucinations in multilingual scientific text generated by Large Language Models (LLMs) presents significant challenges for reliable AI systems. This paper describes our submission to the SHROOM-CAP 2025 shared task on scientific hallucination detection across 9 languages. Unlike most approaches that focus primarily on model architecture, we adopted a data-centric strategy that addressed the critical issue of training data scarcity and imbalance. We unify and balance five existing datasets to create a comprehensive training corpus of 124,821 samples (50% correct, 50% hallucinated), representing a 172x increase over the original SHROOM training data. Our approach fine-tuned XLM-RoBERTa-Large with 560 million parameters on this enhanced dataset, achieves competitive performance across all languages, including 2nd place in Gujarati (zero-shot language) with Factuality F1 of 0.5107, and rankings between 4th-6th place across the remaining 8 languages. Our results demonstrate that systematic data curation can significantly outperform architectural innovations alone, particularly for low-resource languages in zero-shot settings.

Large language models (LLMs), such as ChatGPT, are prone to generate hallucinations, i.e., content that conflicts with the source or cannot be verified by the factual knowledge. To understand what types of content and to which extent LLMs are apt to hallucinate, we introduce the Hallucination Evaluation benchmark for Large Language Models (HaluEval), a large collection of generated and human-annotated hallucinated samples for evaluating the performance of LLMs in recognizing hallucination. To generate these samples, we propose a ChatGPT-based two-step framework, i.e., sampling-then-filtering. Besides, we also hire some human labelers to annotate the hallucinations in ChatGPT responses. The empirical results suggest that ChatGPT is likely to generate hallucinated content in specific topics by fabricating unverifiable information (i.e., about 19.5% responses). Moreover, existing LLMs face great challenges in recognizing the hallucinations in texts. However, our experiments also prove that providing external knowledge or adding reasoning steps can help LLMs recognize hallucinations. Our benchmark can be accessed at https://github.com/RUCAIBox/HaluEval.

Large Language Models (LLMs) excel in various language tasks but they often generate incorrect information, a phenomenon known as "hallucinations". Retrieval-Augmented Generation (RAG) aims to mitigate this by using document retrieval for accurate responses. However, RAG still faces hallucinations due to vague queries. This study aims to improve RAG by optimizing query generation with a query-document alignment score, refining queries using LLMs for better precision and efficiency of document retrieval. Experiments have shown that our approach improves document retrieval, resulting in an average accuracy gain of 1.6%.

Large Multi-modal Models (LMMs) have recently demonstrated remarkable abilities in visual context understanding and coherent response generation. However, alongside these advancements, the issue of hallucinations has emerged as a significant challenge, producing erroneous responses that are unrelated to the visual contents. In this paper, we introduce a novel contrastive-based decoding method, COuntering DEscription Contrastive Decoding (CODE), which leverages self-generated descriptions as contrasting references during the decoding phase of LMMs to address hallucination issues. CODE utilizes the comprehensive descriptions from model itself as visual counterpart to correct and improve response alignment with actual visual content. By dynamically adjusting the information flow and distribution of next-token predictions in the LMM's vocabulary, CODE enhances the coherence and informativeness of generated responses. Extensive experiments demonstrate that our method significantly reduces hallucinations and improves cross-modal consistency across various benchmarks and cutting-edge LMMs. Our method provides a simple yet effective decoding strategy that can be integrated to existing LMM frameworks without additional training.

Despite their impressive capabilities, large language models (LLMs) have been observed to generate responses that include inaccurate or fabricated information, a phenomenon commonly known as ``hallucination''. In this work, we propose a simple Induce-then-Contrast Decoding (ICD) strategy to alleviate hallucinations. We first construct a factually weak LLM by inducing hallucinations from the original LLMs. Then, we penalize these induced hallucinations during decoding to enhance the factuality of the generated content. Concretely, we determine the final next-token predictions by amplifying the predictions from the original model and downplaying the induced untruthful predictions via contrastive decoding. Experimental results on both discrimination-based and generation-based hallucination evaluation benchmarks, such as TruthfulQA and FActScore, demonstrate that our proposed ICD methods can effectively enhance the factuality of LLMs across various model sizes and families. For example, when equipped with ICD, Llama2-7B-Chat and Mistral-7B-Instruct achieve performance comparable to ChatGPT and GPT4 on TruthfulQA, respectively.

Large language models are extensively applied across a wide range of tasks, such as customer support, content creation, educational tutoring, and providing financial guidance. However, a well-known drawback is their predisposition to generate hallucinations. This damages the trustworthiness of the information these models provide, impacting decision-making and user confidence. We propose a method to detect hallucinations by looking at the structure of the latent space and finding associations within hallucinated and non-hallucinated generations. We create a graph structure that connects generations that lie closely in the embedding space. Moreover, we employ a Graph Attention Network which utilizes message passing to aggregate information from neighboring nodes and assigns varying degrees of importance to each neighbor based on their relevance. Our findings show that 1) there exists a structure in the latent space that differentiates between hallucinated and non-hallucinated generations, 2) Graph Attention Networks can learn this structure and generalize it to unseen generations, and 3) the robustness of our method is enhanced when incorporating contrastive learning. When evaluated against evidence-based benchmarks, our model performs similarly without access to search-based methods.

Although many studies have investigated and reduced hallucinations in large language models (LLMs) for single-document tasks, research on hallucination in multi-document summarization (MDS) tasks remains largely unexplored. Specifically, it is unclear how the challenges arising from handling multiple documents (e.g., repetition and diversity of information) affect models outputs. In this work, we investigate how hallucinations manifest in LLMs when summarizing topic-specific information from multiple documents. Since no benchmarks exist for investigating hallucinations in MDS, we use existing news and conversation datasets, annotated with topic-specific insights, to create two novel multi-document benchmarks. When evaluating 5 LLMs on our benchmarks, we observe that on average, up to 75% of the content in LLM-generated summary is hallucinated, with hallucinations more likely to occur towards the end of the summaries. Moreover, when summarizing non-existent topic-related information, gpt-3.5-turbo and GPT-4o still generate summaries about 79.35% and 44% of the time, raising concerns about their tendency to fabricate content. To understand the characteristics of these hallucinations, we manually evaluate 700+ insights and find that most errors stem from either failing to follow instructions or producing overly generic insights. Motivated by these observations, we investigate the efficacy of simple post-hoc baselines in mitigating hallucinations but find them only moderately effective. Our results underscore the need for more effective approaches to systematically mitigate hallucinations in MDS. We release our dataset and code at github.com/megagonlabs/Hallucination_MDS.

Faithfulness hallucinations are claims generated by a Large Language Model (LLM) not supported by contexts provided to the LLM. Lacking assessment standards, existing benchmarks focus on "factual statements" that rephrase source materials while overlooking "cognitive statements" that involve making inferences from the given context. Consequently, evaluating and detecting the hallucination of cognitive statements remains challenging. Inspired by how evidence is assessed in the legal domain, we design a rigorous framework to assess different levels of faithfulness of cognitive statements and introduce the CogniBench dataset where we reveal insightful statistics. To keep pace with rapidly evolving LLMs, we further develop an automatic annotation pipeline that scales easily across different models. This results in a large-scale CogniBench-L dataset, which facilitates training accurate detectors for both factual and cognitive hallucinations. We release our model and datasets at: https://github.com/FUTUREEEEEE/CogniBench

Large Multimodal Models (LMMs) often suffer from multimodal hallucinations, wherein they may create content that is not present in the visual inputs. In this paper, we explore a new angle of this issue: overly detailed training data hinders the model's ability to timely terminate generation, leading to continued outputs beyond visual perception limits. By investigating how the model decides to terminate generation with EOS, the special end-of-sentence token, we find that the model assesses the completeness of the entire sequence by comparing the generated text with the image. This observation suggests that the model possesses an inherent potential of making proper EOS decisions based on its visual perception to avoid overly lengthy outputs. To take advantage of such potential, we explore two methods to mitigate multimodal hallucinations: a training objective that enables the model to reduce hallucinations by learning from regular instruction data, and a data filtering strategy to prevent harmful training data from exacerbating model hallucinations. Both methods significantly improve the hallucination performance of LMMs, without requiring any additional data or knowledge.