From Retinal Evidence to Safe Decisions: RETINA-SAFE and ECRT for Hallucination Risk Triage in Medical LLMs
Fuente:
arXiv
Saved in:
| Main Authors: | , , |
|---|---|
| Format: | Preprint |
| Published: |
2026
|
| Subjects: | |
| Online Access: | |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1866910107468562432 |
|---|---|
| author | Yu, Zhe Xing, Wenpeng Han, Meng |
| author_facet | Yu, Zhe Xing, Wenpeng Han, Meng |
| contents | Hallucinations in medical large language models (LLMs) remain a safety-critical issue, particularly when available evidence is insufficient or conflicting. We study this problem in diabetic retinopathy (DR) decision settings and introduce RETINA-SAFE, an evidence-grounded benchmark aligned with retinal grading records, comprising 12,522 samples. RETINA-SAFE is organized into three evidence-relation tasks: E-Align (evidence-consistent), E-Conflict (evidence-conflicting), and E-Gap (evidence-insufficient). We further propose ECRT (Evidence-Conditioned Risk Triage), a two-stage white-box detection framework: Stage 1 performs Safe/Unsafe risk triage, and Stage 2 refines unsafe cases into contradiction-driven versus evidence-gap risks. ECRT leverages internal representation and logit shifts under CTX/NOCTX conditions, with class-balanced training for robust learning. Under evidence-grouped (not patient-disjoint) splits across multiple backbones, ECRT provides strong Stage-1 risk triage and explicit subtype attribution, improves Stage-1 balanced accuracy by +0.15 to +0.19 over external uncertainty and self-consistency baselines and by +0.02 to +0.07 over the strongest adapted supervised baseline, and consistently exceeds a single-stage white-box ablation on Stage-1 balanced accuracy. These findings support white-box internal signals grounded in retinal evidence as a practical route to interpretable medical LLM risk triage. |
| format | Preprint |
| id |
arxiv_https___arxiv_org_abs_2604_05348 |
| institution | arXiv |
| publishDate | 2026 |
| record_format | arxiv |
| spellingShingle | From Retinal Evidence to Safe Decisions: RETINA-SAFE and ECRT for Hallucination Risk Triage in Medical LLMs Yu, Zhe Xing, Wenpeng Han, Meng Artificial Intelligence Hallucinations in medical large language models (LLMs) remain a safety-critical issue, particularly when available evidence is insufficient or conflicting. We study this problem in diabetic retinopathy (DR) decision settings and introduce RETINA-SAFE, an evidence-grounded benchmark aligned with retinal grading records, comprising 12,522 samples. RETINA-SAFE is organized into three evidence-relation tasks: E-Align (evidence-consistent), E-Conflict (evidence-conflicting), and E-Gap (evidence-insufficient). We further propose ECRT (Evidence-Conditioned Risk Triage), a two-stage white-box detection framework: Stage 1 performs Safe/Unsafe risk triage, and Stage 2 refines unsafe cases into contradiction-driven versus evidence-gap risks. ECRT leverages internal representation and logit shifts under CTX/NOCTX conditions, with class-balanced training for robust learning. Under evidence-grouped (not patient-disjoint) splits across multiple backbones, ECRT provides strong Stage-1 risk triage and explicit subtype attribution, improves Stage-1 balanced accuracy by +0.15 to +0.19 over external uncertainty and self-consistency baselines and by +0.02 to +0.07 over the strongest adapted supervised baseline, and consistently exceeds a single-stage white-box ablation on Stage-1 balanced accuracy. These findings support white-box internal signals grounded in retinal evidence as a practical route to interpretable medical LLM risk triage. |
| title | From Retinal Evidence to Safe Decisions: RETINA-SAFE and ECRT for Hallucination Risk Triage in Medical LLMs |
| topic | Artificial Intelligence |
| url | https://arxiv.org/abs/2604.05348 |