HalluCXR: Benchmarking and Mitigating Hallucinations in Medical Vision-Language Models for Chest Radiograph Interpretation
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_ | 1866914581511667712 |
|---|---|
| author | Wang, Haoyu Li, Zitong |
| author_facet | Wang, Haoyu Li, Zitong |
| contents | Vision-language models (VLMs) are increasingly used for medical image interpretation, yet they frequently hallucinate, generating clinically plausible but factually incorrect findings that pose direct patient safety risks. We introduce HalluCXR, a benchmark evaluating six architecturally diverse VLMs across 856 stratified MIMIC-CXR chest radiographs and three query types, yielding 15,408 model evaluations. An eight-category hallucination taxonomy with clinical severity ratings and a two-layer detection pipeline are validated against 250 human annotations (auto-detection F1=0.959; LLM judge F1=0.907). We find that 61.9--82.3% of outputs contain hallucinations, with clinically dangerous errors in up to 80.2%. Three key patterns emerge: normal radiographs paradoxically attract the most severe hallucinations, common findings are systematically over-fabricated while rare findings go under-detected, and response length alone predicts hallucination risk (AUC up to 0.908). A six-model ensemble reduces fabrication by up to 84.8% at the cost of increased omission; a three-model subset retains comparable performance at half the cost. These results establish that hallucination auditing, verbosity-based risk monitoring, and ensemble-based safety layers are prerequisites for clinical deployment. |
| format | Preprint |
| id |
arxiv_https___arxiv_org_abs_2605_20469 |
| institution | arXiv |
| publishDate | 2026 |
| record_format | arxiv |
| spellingShingle | HalluCXR: Benchmarking and Mitigating Hallucinations in Medical Vision-Language Models for Chest Radiograph Interpretation Wang, Haoyu Li, Zitong Computer Vision and Pattern Recognition Vision-language models (VLMs) are increasingly used for medical image interpretation, yet they frequently hallucinate, generating clinically plausible but factually incorrect findings that pose direct patient safety risks. We introduce HalluCXR, a benchmark evaluating six architecturally diverse VLMs across 856 stratified MIMIC-CXR chest radiographs and three query types, yielding 15,408 model evaluations. An eight-category hallucination taxonomy with clinical severity ratings and a two-layer detection pipeline are validated against 250 human annotations (auto-detection F1=0.959; LLM judge F1=0.907). We find that 61.9--82.3% of outputs contain hallucinations, with clinically dangerous errors in up to 80.2%. Three key patterns emerge: normal radiographs paradoxically attract the most severe hallucinations, common findings are systematically over-fabricated while rare findings go under-detected, and response length alone predicts hallucination risk (AUC up to 0.908). A six-model ensemble reduces fabrication by up to 84.8% at the cost of increased omission; a three-model subset retains comparable performance at half the cost. These results establish that hallucination auditing, verbosity-based risk monitoring, and ensemble-based safety layers are prerequisites for clinical deployment. |
| title | HalluCXR: Benchmarking and Mitigating Hallucinations in Medical Vision-Language Models for Chest Radiograph Interpretation |
| topic | Computer Vision and Pattern Recognition |
| url | https://arxiv.org/abs/2605.20469 |