VIHD: Visual Intervention-based Hallucination Detection for Medical Visual Question Answering

Fuente: arXiv
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Auteurs principaux: Chen, Jiayi, Ma, Benteng, Liao, Zehui, Chong, Winston, George, Yasmeen, Cai, Jianfei
Format: Preprint
Publié: 2026
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author Chen, Jiayi
Ma, Benteng
Liao, Zehui
Chong, Winston
George, Yasmeen
Cai, Jianfei
author_facet Chen, Jiayi
Ma, Benteng
Liao, Zehui
Chong, Winston
George, Yasmeen
Cai, Jianfei
contents While medical Multimodal Large Language Models (MLLMs) have shown promise in assisting diagnosis, they still frequently generate hallucinated responses that appear linguistically plausible but lack visual evidence. Such hallucinations pose risks to clinical decision-making and necessitate effective detection. Existing introspective detection methods primarily perform uncertainty estimation or logical verification by analyzing model responses conditioned on original or perturbed inputs. However, such external perturbations are often heuristic and context-agnostic, which overlooks the internal cross-modal dependency between generated tokens and related visual tokens during decoding. To address this issue, we propose VIHD, a Visual Intervention-based Hallucination Detection method that leverages targeted visual token masking to calibrate semantic entropy for more effective hallucination detection. VIHD locates visually dominant decoder layers via Visual Dependency Probing (VDP), executes Visual Intervention Decoding (VID) via token masking to calibrate the semantic distribution, and quantifies the resulting Calibrated Semantic Entropy (CSE) as a reliable hallucination signal. Extensive experiments on three medical VQA benchmarks with two medical MLLMs demonstrate that VIHD consistently outperforms state-of-the-art methods, underscoring the importance of fine-grained visual dependency for hallucination detection. The code will be available at https://github.com/Jiayi-Chen-AU/VIHD
format Preprint
id arxiv_https___arxiv_org_abs_2605_20772
institution arXiv
publishDate 2026
record_format arxiv
spellingShingle VIHD: Visual Intervention-based Hallucination Detection for Medical Visual Question Answering
Chen, Jiayi
Ma, Benteng
Liao, Zehui
Chong, Winston
George, Yasmeen
Cai, Jianfei
Computer Vision and Pattern Recognition
While medical Multimodal Large Language Models (MLLMs) have shown promise in assisting diagnosis, they still frequently generate hallucinated responses that appear linguistically plausible but lack visual evidence. Such hallucinations pose risks to clinical decision-making and necessitate effective detection. Existing introspective detection methods primarily perform uncertainty estimation or logical verification by analyzing model responses conditioned on original or perturbed inputs. However, such external perturbations are often heuristic and context-agnostic, which overlooks the internal cross-modal dependency between generated tokens and related visual tokens during decoding. To address this issue, we propose VIHD, a Visual Intervention-based Hallucination Detection method that leverages targeted visual token masking to calibrate semantic entropy for more effective hallucination detection. VIHD locates visually dominant decoder layers via Visual Dependency Probing (VDP), executes Visual Intervention Decoding (VID) via token masking to calibrate the semantic distribution, and quantifies the resulting Calibrated Semantic Entropy (CSE) as a reliable hallucination signal. Extensive experiments on three medical VQA benchmarks with two medical MLLMs demonstrate that VIHD consistently outperforms state-of-the-art methods, underscoring the importance of fine-grained visual dependency for hallucination detection. The code will be available at https://github.com/Jiayi-Chen-AU/VIHD
title VIHD: Visual Intervention-based Hallucination Detection for Medical Visual Question Answering
topic Computer Vision and Pattern Recognition
url https://arxiv.org/abs/2605.20772