Med-VCD: Mitigating Hallucination for Medical Large Vision Language Models through Visual Contrastive Decoding

Fuente: arXiv
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Autori principali: Mahdavi, Zahra, Khodakaramimaghsoud, Zahra, Khaloo, Hooman, Taleshani, Sina Bakhshandeh, Hashemi, Erfan, Kaleybar, Javad Mirzapour, Manzari, Omid Nejati
Natura: Preprint
Pubblicazione: 2025
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author Mahdavi, Zahra
Khodakaramimaghsoud, Zahra
Khaloo, Hooman
Taleshani, Sina Bakhshandeh
Hashemi, Erfan
Kaleybar, Javad Mirzapour
Manzari, Omid Nejati
author_facet Mahdavi, Zahra
Khodakaramimaghsoud, Zahra
Khaloo, Hooman
Taleshani, Sina Bakhshandeh
Hashemi, Erfan
Kaleybar, Javad Mirzapour
Manzari, Omid Nejati
contents Large vision-language models (LVLMs) are now central to healthcare applications such as medical visual question answering and imaging report generation. Yet, these models remain vulnerable to hallucination outputs that appear plausible but are in fact incorrect. In the natural image domain, several decoding strategies have been proposed to mitigate hallucinations by reinforcing visual evidence, but most rely on secondary decoding or rollback procedures that substantially slow inference. Moreover, existing solutions are often domain-specific and may introduce misalignment between modalities or between generated and ground-truth content. We introduce Med-VCD, a sparse visual-contrastive decoding method that mitigates hallucinations in medical LVLMs without the time overhead of secondary decoding. Med-VCD incorporates a novel token-sparsification strategy that selects visually informed tokens on the fly, trimming redundancy while retaining critical visual context and thus balancing efficiency with reliability. Evaluations on eight medical datasets, spanning ophthalmology, radiology, and pathology tasks in visual question answering, report generation, and dedicated hallucination benchmarks, show that Med-VCD raises factual accuracy by an average of 13\% and improves hallucination accuracy by 6\% relative to baseline medical LVLMs.
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id arxiv_https___arxiv_org_abs_2512_01922
institution arXiv
publishDate 2025
record_format arxiv
spellingShingle Med-VCD: Mitigating Hallucination for Medical Large Vision Language Models through Visual Contrastive Decoding
Mahdavi, Zahra
Khodakaramimaghsoud, Zahra
Khaloo, Hooman
Taleshani, Sina Bakhshandeh
Hashemi, Erfan
Kaleybar, Javad Mirzapour
Manzari, Omid Nejati
Computer Vision and Pattern Recognition
Large vision-language models (LVLMs) are now central to healthcare applications such as medical visual question answering and imaging report generation. Yet, these models remain vulnerable to hallucination outputs that appear plausible but are in fact incorrect. In the natural image domain, several decoding strategies have been proposed to mitigate hallucinations by reinforcing visual evidence, but most rely on secondary decoding or rollback procedures that substantially slow inference. Moreover, existing solutions are often domain-specific and may introduce misalignment between modalities or between generated and ground-truth content. We introduce Med-VCD, a sparse visual-contrastive decoding method that mitigates hallucinations in medical LVLMs without the time overhead of secondary decoding. Med-VCD incorporates a novel token-sparsification strategy that selects visually informed tokens on the fly, trimming redundancy while retaining critical visual context and thus balancing efficiency with reliability. Evaluations on eight medical datasets, spanning ophthalmology, radiology, and pathology tasks in visual question answering, report generation, and dedicated hallucination benchmarks, show that Med-VCD raises factual accuracy by an average of 13\% and improves hallucination accuracy by 6\% relative to baseline medical LVLMs.
title Med-VCD: Mitigating Hallucination for Medical Large Vision Language Models through Visual Contrastive Decoding
topic Computer Vision and Pattern Recognition
url https://arxiv.org/abs/2512.01922