It is shown that a simple, carefully conditioned probe can reliably detect hallucination, and the results suggest that hallucination mitigation is not simply a matter of identifying the right neurons, and point to a deeper separation between what representations reveal and what they allow us to change.
Abstract
Hallucination remains one of the central obstacles to deploying medical LLMs. Yet, even when hallucination can be detected, it is still unclear whether the internal representations associated with it can be used for control rather than detection alone. Using four open-source models across a suite of medical question-answering datasets, we show that a simple, carefully conditioned probe can reliably detect hallucination, with AUROC scores between 0.77 and 0.86 in our case. We further show that this signal is distributed and redundant rather than narrowly localized. Systematically selected neurons outperform random neurons only at very small subset sizes, whereas random subsets of a few hundred neurons recover nearly the full signal, and low-dimensional random projections preserve most of the detection performance. Beyond detection, we test whether this representation is causally actionable. Across 16 model--dataset combinations, our results reveal a sharp gap between decodability and controllability. The same internal structure that makes hallucination easy to detect does not translate into reliable neuron-level control. These findings show that medical hallucination seems to be readily visible in internal activations, but not easily corrected by steering the neurons most associated with it. More broadly, our results suggest that hallucination mitigation is not simply a matter of identifying the right neurons, and point to a deeper separation between what representations reveal and what they allow us to change.
The reliability of Large Language Models (LLMs) is often compromised by factual inconsistencies, including hallucinations---cases where generated content is not supported by the underlying source. We present HallDetect, a lightweight, reference-free, and black-box framework for hallucination detection that we evaluate not only on summarization but across a broader range of source-grounded generation settings. HallDetect builds on decomposition-based factuality evaluation: generated content is decomposed into atomic claims, each verified by a compact encoder-based entailment model through a contrastive formulation over a multi-scale library of source chunks, and aggregated with an asymmetric score in which a single confidently contradicted claim flags the response. Under a controlled protocol in which all methods share the same 4-bit quantized backbones and consumer-grade hardware budget, HallDetect outperforms comparably resourced generative and embedding-based baselines on three of four benchmarks while remaining stable across backbone families, and yields a claim-to-span audit trail that localizes each error.
Achir Oukelmoun, N. Semmar, Gäel de Chalendar· 0 citations
A lightweight linear detector is built on top of Role-Break that requires no fine-tuning of the VLM, whose feature dimension stays below 5,000 and reaches an average AUROC of 93.23 across six VLMs and four benchmarks.
Mingyu Wang, Weilin Jin, Wenbo Li et al.· 0 citations
Large vision-language models (LVLMs) are increasingly used for clinical image understanding, yet they remain vulnerable to \emph{hallucinations}--producing textual findings or attributes not supported by the image. We present a vision-traceable hallucination detection framework that audits arbitrary LVLM responses via visual evidence grounding, requiring neither modification nor internal access to the hidden states of LVLMs. Given an LVLM response, we extract visually verifiable entities and use a medical-domain-adapted Qwen-VL grounding verifier to localize each entity on the input image. To enhance the robustness of our detection method, we introduce a counterfactual entity perturbation method and estimate visual evidence uncertainty by contrasting factual and counterfactual grounding results. Specifically, we compute an entity-level uncertainty score from the positive confidence, counterfactual confidence, and their grounding overlap for binary hallucination decision-making. Experiments on multiple medical imaging modalities and LVLM backbones demonstrate that our method consistently improves hallucination detection performance over recent baselines, while providing interpretable localization evidence and strong cross-model transferability. Code and dataset are available at https://github.com/Agentic-CliniAI/CounterVHD.
Large vision--language models (LVLMs) demonstrate strong multimodal reasoning capabilities but remain prone to hallucination, where model predictions are not grounded in visual evidence, so a fully black-box framework that models hallucination as a structured uncertainty pattern is proposed.
Amir Mohammad Ezzati, Kiyan Rezaee, Bardiya Kariminia et al.· 0 citations
This work proposes AURORA, a novel hallucination detection framework that shifts the focus from static representations to the weight-gradient dynamics of LLMs, and achieves strong hallucination detection performance across four model families and four benchmark datasets.
Z. Zhang, Hainan Zhang, Zhiming Zheng· arXiv.org· 0 citations
Large Language Models can produce fluent text that is false, unsupported by the available evidence, or inconsistent with information that appears to be internally represented by the model. We study hallucination detection from the geometry of hidden activations and introduce the D-Score, a simple spectral statistic computed from a single forward pass. For a fixed model, layer, and tolerance parameter, the D-Score counts how many singular directions of the hidden activation matrix have singular values that remain close to the leading one. We use this quantity as a hallucination score, classifying an input text as hallucinated when its D-Score is larger than a pre-defined quantity. The motivation is that, when a model processes a text that conflicts with information available in its own internal state, the hidden representation may encode both the asserted content and some form of counter-evidence, uncertainty, correction, or lack of support; this can make the hidden trajectory spread across additional singular directions. We formalize this intuition through a lightweight spectral argument and evaluate the resulting detector on FAVA-Annotation and RAGTruth. The experiments indicate that the D-Score is a strong hidden-state signal for hallucination detection, while requiring no external verifier, no retrieval step, and no multiple generations.
Bianca Raimondi, Davide Evangelista, Maurizio Gabbrielli et al.· 0 citations