Daily Papers

Large Vision Language Models (LVLMs) have recently achieved superior performance in various tasks on natural image and text data, which inspires a large amount of studies for LVLMs fine-tuning and training. Despite their advancements, there has been scant research on the robustness of these models against hallucination when fine-tuned on smaller datasets. In this study, we introduce a new benchmark dataset, the Medical Visual Hallucination Test (MedVH), to evaluate the hallucination of domain-specific LVLMs. MedVH comprises five tasks to evaluate hallucinations in LVLMs within the medical context, which includes tasks for comprehensive understanding of textual and visual input, as well as long textual response generation. Our extensive experiments with both general and medical LVLMs reveal that, although medical LVLMs demonstrate promising performance on standard medical tasks, they are particularly susceptible to hallucinations, often more so than the general models, raising significant concerns about the reliability of these domain-specific models. For medical LVLMs to be truly valuable in real-world applications, they must not only accurately integrate medical knowledge but also maintain robust reasoning abilities to prevent hallucination. Our work paves the way for future evaluations of these studies.

Large Vision Language Models (LVLMs) are increasingly integral to healthcare applications, including medical visual question answering and imaging report generation. While these models inherit the robust capabilities of foundational Large Language Models (LLMs), they also inherit susceptibility to hallucinations-a significant concern in high-stakes medical contexts where the margin for error is minimal. However, currently, there are no dedicated methods or benchmarks for hallucination detection and evaluation in the medical field. To bridge this gap, we introduce Med-HallMark, the first benchmark specifically designed for hallucination detection and evaluation within the medical multimodal domain. This benchmark provides multi-tasking hallucination support, multifaceted hallucination data, and hierarchical hallucination categorization. Furthermore, we propose the MediHall Score, a new medical evaluative metric designed to assess LVLMs' hallucinations through a hierarchical scoring system that considers the severity and type of hallucination, thereby enabling a granular assessment of potential clinical impacts. We also present MediHallDetector, a novel Medical LVLM engineered for precise hallucination detection, which employs multitask training for hallucination detection. Through extensive experimental evaluations, we establish baselines for popular LVLMs using our benchmark. The findings indicate that MediHall Score provides a more nuanced understanding of hallucination impacts compared to traditional metrics and demonstrate the enhanced performance of MediHallDetector. We hope this work can significantly improve the reliability of LVLMs in medical applications. All resources of this work will be released soon.

This research paper focuses on the challenges posed by hallucinations in large language models (LLMs), particularly in the context of the medical domain. Hallucination, wherein these models generate plausible yet unverified or incorrect information, can have serious consequences in healthcare applications. We propose a new benchmark and dataset, Med-HALT (Medical Domain Hallucination Test), designed specifically to evaluate and reduce hallucinations. Med-HALT provides a diverse multinational dataset derived from medical examinations across various countries and includes multiple innovative testing modalities. Med-HALT includes two categories of tests reasoning and memory-based hallucination tests, designed to assess LLMs's problem-solving and information retrieval abilities. Our study evaluated leading LLMs, including Text Davinci, GPT-3.5, LlaMa-2, MPT, and Falcon, revealing significant differences in their performance. The paper provides detailed insights into the dataset, promoting transparency and reproducibility. Through this work, we aim to contribute to the development of safer and more reliable language models in healthcare. Our benchmark can be found at medhalt.github.io

Large Vision-Language Models (LVLMs) have demonstrated remarkable performance in performing complex multimodal tasks. However, they are still plagued by object hallucination: the misidentification or misclassification of objects present in images. To this end, we propose HALLUCINOGEN, a novel visual question answering (VQA) object hallucination attack benchmark that utilizes diverse contextual reasoning prompts to evaluate object hallucination in state-of-the-art LVLMs. We design a series of contextual reasoning hallucination prompts to evaluate LVLMs' ability to accurately identify objects in a target image while asking them to perform diverse visual-language tasks such as identifying, locating or performing visual reasoning around specific objects. Further, we extend our benchmark to high-stakes medical applications and introduce MED-HALLUCINOGEN, hallucination attacks tailored to the biomedical domain, and evaluate the hallucination performance of LVLMs on medical images, a critical area where precision is crucial. Finally, we conduct extensive evaluations of eight LVLMs and two hallucination mitigation strategies across multiple datasets to show that current generic and medical LVLMs remain susceptible to hallucination attacks.

Foundation Models that are capable of processing and generating multi-modal data have transformed AI's role in medicine. However, a key limitation of their reliability is hallucination, where inaccurate or fabricated information can impact clinical decisions and patient safety. We define medical hallucination as any instance in which a model generates misleading medical content. This paper examines the unique characteristics, causes, and implications of medical hallucinations, with a particular focus on how these errors manifest themselves in real-world clinical scenarios. Our contributions include (1) a taxonomy for understanding and addressing medical hallucinations, (2) benchmarking models using medical hallucination dataset and physician-annotated LLM responses to real medical cases, providing direct insight into the clinical impact of hallucinations, and (3) a multi-national clinician survey on their experiences with medical hallucinations. Our results reveal that inference techniques such as Chain-of-Thought (CoT) and Search Augmented Generation can effectively reduce hallucination rates. However, despite these improvements, non-trivial levels of hallucination persist. These findings underscore the ethical and practical imperative for robust detection and mitigation strategies, establishing a foundation for regulatory policies that prioritize patient safety and maintain clinical integrity as AI becomes more integrated into healthcare. The feedback from clinicians highlights the urgent need for not only technical advances but also for clearer ethical and regulatory guidelines to ensure patient safety. A repository organizing the paper resources, summaries, and additional information is available at https://github.com/mitmedialab/medical hallucination.

Automatic medical report generation (MRG), which possesses significant research value as it can aid radiologists in clinical diagnosis and report composition, has garnered increasing attention. Despite recent progress, generating accurate reports remains arduous due to the requirement for precise clinical comprehension and disease diagnosis inference. Furthermore, owing to the limited accessibility of medical data and the imbalanced distribution of diseases, the underrepresentation of rare diseases in training data makes large-scale medical visual language models (LVLMs) prone to hallucinations, such as omissions or fabrications, severely undermining diagnostic performance and further intensifying the challenges for MRG in practice. In this study, to effectively mitigate hallucinations in medical report generation, we propose a chain-of-medical-thought approach (CoMT), which intends to imitate the cognitive process of human doctors by decomposing diagnostic procedures. The radiological features with different importance are structured into fine-grained medical thought chains to enhance the inferential ability during diagnosis, thereby alleviating hallucination problems and enhancing the diagnostic accuracy of MRG. The code and dataset have been released at https://github.com/FRENKIE-CHIANG/CoMT.

We present MedHal, a novel large-scale dataset specifically designed to evaluate if models can detect hallucinations in medical texts. Current hallucination detection methods face significant limitations when applied to specialized domains like medicine, where they can have disastrous consequences. Existing medical datasets are either too small, containing only a few hundred samples, or focus on a single task like Question Answering or Natural Language Inference. MedHal addresses these gaps by: (1) incorporating diverse medical text sources and tasks; (2) providing a substantial volume of annotated samples suitable for training medical hallucination detection models; and (3) including explanations for factual inconsistencies to guide model learning. We demonstrate MedHal's utility by training and evaluating a baseline medical hallucination detection model, showing improvements over general-purpose hallucination detection approaches. This resource enables more efficient evaluation of medical text generation systems while reducing reliance on costly expert review, potentially accelerating the development of medical AI research.

Hallucination is a common problem for Large Vision-Language Models (LVLMs) with long generations which is difficult to eradicate. The generation with hallucinations is partially inconsistent with the image content. To mitigate hallucination, current studies either focus on the process of model inference or the results of model generation, but the solutions they design sometimes do not deal appropriately with various types of queries and the hallucinations of the generations about these queries. To accurately deal with various hallucinations, we present a unified framework, Dentist, for hallucination mitigation. The core step is to first classify the queries, then perform different processes of hallucination mitigation based on the classification result, just like a dentist first observes the teeth and then makes a plan. In a simple deployment, Dentist can classify queries as perception or reasoning and easily mitigate potential hallucinations in answers which has been demonstrated in our experiments. On MMbench, we achieve a 13.44%/10.2%/15.8% improvement in accuracy on Image Quality, a Coarse Perception visual question answering (VQA) task, over the baseline InstructBLIP/LLaVA/VisualGLM.

Recent advances in generative vision-language models (VLMs) have exciting potential implications for AI in radiology, yet VLMs are also known to produce hallucinations, nonsensical text, and other unwanted behaviors that can waste clinicians' time and cause patient harm. Drawing on recent work on direct preference optimization (DPO), we propose a simple method for modifying the behavior of pretrained VLMs performing radiology report generation by suppressing unwanted types of generations. We apply our method to the prevention of hallucinations of prior exams, addressing a long-established problem behavior in models performing chest X-ray report generation. Across our experiments, we find that DPO fine-tuning achieves a 3.2-4.8x reduction in lines hallucinating prior exams while maintaining model performance on clinical accuracy metrics. Our work is, to the best of our knowledge, the first work to apply DPO to medical VLMs, providing a data- and compute- efficient way to suppress problem behaviors while maintaining overall clinical accuracy.

Multimodal large language models (MLLMs) have recently achieved remarkable progress in radiology by integrating visual perception with natural language understanding. However, they often generate clinically unsupported descriptions, known as medical hallucinations, which pose serious risks in medical applications that demand accuracy and image-grounded outputs. Through empirical analysis, we find that prompt-induced hallucinations remain prevalent in radiology MLLMs, largely due to over-sensitivity to clinical sections. To address this, we introduce Clinical Contrastive Cecoding (CCD), a training-free and retrieval-free inference framework that integrates structured clinical signals from task-specific radiology expert models. CCD introduces a dual-stage contrastive mechanism to refine token-level logits during generation, thereby enhancing clinical fidelity without modifying the base MLLM. Experiments on three datasets and multiple models demonstrate that CCD consistently improves overall performance on radiology report generation (RRG). On the MIMIC-CXR dataset, it yields up to a 17% improvement in RadGraph-F1 when applied to state-of-the-art RRG models. Our approach provides a lightweight and generalisable solution for mitigating medical hallucinations, effectively bridging expert models and MLLMs in radiology.

Large vision-language models (LVLMs) hallucinate: certain context cues in an image may trigger the language module's overconfident and incorrect reasoning on abnormal or hypothetical objects. Though a few benchmarks have been developed to investigate LVLM hallucinations, they mainly rely on hand-crafted corner cases whose fail patterns may hardly generalize, and finetuning on them could undermine their validity. These motivate us to develop the first automatic benchmark generation approach, AUTOHALLUSION, that harnesses a few principal strategies to create diverse hallucination examples. It probes the language modules in LVLMs for context cues and uses them to synthesize images by: (1) adding objects abnormal to the context cues; (2) for two co-occurring objects, keeping one and excluding the other; or (3) removing objects closely tied to the context cues. It then generates image-based questions whose ground-truth answers contradict the language module's prior. A model has to overcome contextual biases and distractions to reach correct answers, while incorrect or inconsistent answers indicate hallucinations. AUTOHALLUSION enables us to create new benchmarks at the minimum cost and thus overcomes the fragility of hand-crafted benchmarks. It also reveals common failure patterns and reasons, providing key insights to detect, avoid, or control hallucinations. Comprehensive evaluations of top-tier LVLMs, e.g., GPT-4V(ision), Gemini Pro Vision, Claude 3, and LLaVA-1.5, show a 97.7% and 98.7% success rate of hallucination induction on synthetic and real-world datasets of AUTOHALLUSION, paving the way for a long battle against hallucinations.

Hallucination poses a challenge to the deployment of large vision-language models (LVLMs) in applications. Unlike in large language models (LLMs), hallucination in LVLMs often arises from misalignments between visual inputs and textual outputs. This paper investigates the underlying mechanisms of hallucination, focusing on the unique structure of LVLMs that distinguishes them from large language models (LLMs). We identify that hallucinations often arise from the sensitivity of text decoders to vision inputs, a natural phenomenon when image encoders and text decoders are pre-trained separately. Inspired by this, we introduce Visual and Textual Intervention (VTI), a novel technique designed to reduce hallucinations by steering latent space representations during inference to enhance the stability of vision features. As a task-agnostic test-time intervention, VTI can be easily applied to any problem without additional cost. Extensive experiments demonstrate that it can effectively reduce hallucinations and outperform baseline methods across multiple metrics, highlighting the critical role of vision feature stability in LVLMs.

Vision language models (VLMs) perceive the world through a combination of a visual encoder and a large language model (LLM). The visual encoder, pre-trained on large-scale vision-text datasets, provides zero-shot generalization to visual data, and the LLM endows its high reasoning ability to VLMs. It leads VLMs to achieve high performance on wide benchmarks without fine-tuning, exhibiting zero or few-shot capability. However, recent studies show that VLMs are vulnerable to hallucination. This undesirable behavior degrades reliability and credibility, thereby making users unable to fully trust the output from VLMs. To enhance trustworthiness and better tackle the hallucination of VLMs, we curate a new evaluation dataset, called the BEfore-AFter hallucination dataset (BEAF), and introduce new metrics: True Understanding (TU), IGnorance (IG), StuBbornness (SB), and InDecision (ID). Unlike prior works that focus only on constructing questions and answers, the key idea of our benchmark is to manipulate visual scene information by image editing models and to design the metrics based on scene changes. This allows us to clearly assess whether VLMs correctly understand a given scene by observing the ability to perceive changes. We also visualize image-wise object relationship by virtue of our two-axis view: vision and text. Upon evaluating VLMs with our dataset, we observed that our metrics reveal different aspects of VLM hallucination that have not been reported before. Project page: https://beafbench.github.io/

Large-scale Text-to-Image (TTI) models have become a common approach for generating training data in various generative fields. However, visual hallucinations, which contain perceptually critical defects, remain a concern, especially in non-photorealistic styles like cartoon characters. We propose a novel visual hallucination detection system for cartoon character images generated by TTI models. Our approach leverages pose-aware in-context visual learning (PA-ICVL) with Vision-Language Models (VLMs), utilizing both RGB images and pose information. By incorporating pose guidance from a fine-tuned pose estimator, we enable VLMs to make more accurate decisions. Experimental results demonstrate significant improvements in identifying visual hallucinations compared to baseline methods relying solely on RGB images. This research advances TTI models by mitigating visual hallucinations, expanding their potential in non-photorealistic domains.

Large vision-language models (LVLMs) have demonstrated exceptional performance on complex multimodal tasks. However, they continue to suffer from significant hallucination issues, including object, attribute, and relational hallucinations. To accurately detect these hallucinations, we investigated the variations in cross-modal attention patterns between hallucination and non-hallucination states. Leveraging these distinctions, we developed a lightweight detector capable of identifying hallucinations. Our proposed method, Detecting Hallucinations by Cross-modal Attention Patterns (DHCP), is straightforward and does not require additional LVLM training or extra LVLM inference steps. Experimental results show that DHCP achieves remarkable performance in hallucination detection. By offering novel insights into the identification and analysis of hallucinations in LVLMs, DHCP contributes to advancing the reliability and trustworthiness of these models.

Large language models (LLMs) have significantly advanced natural language processing tasks, yet they are susceptible to generating inaccurate or unreliable responses, a phenomenon known as hallucination. In critical domains such as health and medicine, these hallucinations can pose serious risks. This paper introduces HALO, a novel framework designed to enhance the accuracy and reliability of medical question-answering (QA) systems by focusing on the detection and mitigation of hallucinations. Our approach generates multiple variations of a given query using LLMs and retrieves relevant information from external open knowledge bases to enrich the context. We utilize maximum marginal relevance scoring to prioritize the retrieved context, which is then provided to LLMs for answer generation, thereby reducing the risk of hallucinations. The integration of LangChain further streamlines this process, resulting in a notable and robust increase in the accuracy of both open-source and commercial LLMs, such as Llama-3.1 (from 44% to 65%) and ChatGPT (from 56% to 70%). This framework underscores the critical importance of addressing hallucinations in medical QA systems, ultimately improving clinical decision-making and patient care. The open-source HALO is available at: https://github.com/ResponsibleAILab/HALO.

The rapid advancement of large language models (LLMs) has significantly impacted various domains, including healthcare and biomedicine. However, the phenomenon of hallucination, where LLMs generate outputs that deviate from factual accuracy or context, poses a critical challenge, especially in high-stakes domains. This paper conducts a scoping study of existing techniques for mitigating hallucinations in knowledge-based task in general and especially for medical domains. Key methods covered in the paper include Retrieval-Augmented Generation (RAG)-based techniques, iterative feedback loops, supervised fine-tuning, and prompt engineering. These techniques, while promising in general contexts, require further adaptation and optimization for the medical domain due to its unique demands for up-to-date, specialized knowledge and strict adherence to medical guidelines. Addressing these challenges is crucial for developing trustworthy AI systems that enhance clinical decision-making and patient safety as well as accuracy of biomedical scientific research.

The remarkable capabilities of large language models (LLMs) in language understanding and generation have not rendered them immune to hallucinations. LLMs can still generate plausible-sounding but factually incorrect or fabricated information. As LLM-empowered chatbots become popular, laypeople may frequently ask health-related queries and risk falling victim to these LLM hallucinations, resulting in various societal and healthcare implications. In this work, we conduct a pioneering study of hallucinations in LLM-generated responses to real-world healthcare queries from patients. We propose MedHalu, a carefully crafted first-of-its-kind medical hallucination dataset with a diverse range of health-related topics and the corresponding hallucinated responses from LLMs with labeled hallucination types and hallucinated text spans. We also introduce MedHaluDetect framework to evaluate capabilities of various LLMs in detecting hallucinations. We also employ three groups of evaluators -- medical experts, LLMs, and laypeople -- to study who are more vulnerable to these medical hallucinations. We find that LLMs are much worse than the experts. They also perform no better than laypeople and even worse in few cases in detecting hallucinations. To fill this gap, we propose expert-in-the-loop approach to improve hallucination detection through LLMs by infusing expert reasoning. We observe significant performance gains for all the LLMs with an average macro-F1 improvement of 6.3 percentage points for GPT-4.

Recent development of Large Vision-Language Models (LVLMs) has attracted growing attention within the AI landscape for its practical implementation potential. However, ``hallucination'', or more specifically, the misalignment between factual visual content and corresponding textual generation, poses a significant challenge of utilizing LVLMs. In this comprehensive survey, we dissect LVLM-related hallucinations in an attempt to establish an overview and facilitate future mitigation. Our scrutiny starts with a clarification of the concept of hallucinations in LVLMs, presenting a variety of hallucination symptoms and highlighting the unique challenges inherent in LVLM hallucinations. Subsequently, we outline the benchmarks and methodologies tailored specifically for evaluating hallucinations unique to LVLMs. Additionally, we delve into an investigation of the root causes of these hallucinations, encompassing insights from the training data and model components. We also critically review existing methods for mitigating hallucinations. The open questions and future directions pertaining to hallucinations within LVLMs are discussed to conclude this survey.

Recent interest in Large Vision-Language Models (LVLMs) for practical applications is moderated by the significant challenge of hallucination or the inconsistency between the factual information and the generated text. In this paper, we first perform an in-depth analysis of hallucinations and discover several novel insights about how and when LVLMs hallucinate. From our analysis, we show that: (1) The community's efforts have been primarily targeted towards reducing hallucinations related to visual recognition (VR) prompts (e.g., prompts that only require describing the image), thereby ignoring hallucinations for cognitive prompts (e.g., prompts that require additional skills like reasoning on contents of the image). (2) LVLMs lack visual perception, i.e., they can see but not necessarily understand or perceive the input image. We analyze responses to cognitive prompts and show that LVLMs hallucinate due to a perception gap: although LVLMs accurately recognize visual elements in the input image and possess sufficient cognitive skills, they struggle to respond accurately and hallucinate. To overcome this shortcoming, we propose Visual Description Grounded Decoding (VDGD), a simple, robust, and training-free method for alleviating hallucinations. Specifically, we first describe the image and add it as a prefix to the instruction. Next, during auto-regressive decoding, we sample from the plausible candidates according to their KL-Divergence (KLD) to the description, where lower KLD is given higher preference. Experimental results on several benchmarks and LVLMs show that VDGD improves significantly over other baselines in reducing hallucinations. We also propose VaLLu, a benchmark for the comprehensive evaluation of the cognitive capabilities of LVLMs.

Hallucination has been a major problem for large language models and remains a critical challenge when it comes to multimodality in which vision-language models (VLMs) have to deal with not just textual but also visual inputs. Despite rapid progress in VLMs, resources for evaluating and addressing multimodal hallucination are limited and mostly focused on evaluation. This work introduces HaloQuest, a novel visual question answering dataset that captures various aspects of multimodal hallucination such as false premises, insufficient contexts, and visual challenges. A novel idea from HaloQuest is to leverage synthetic images, apart from real ones, to enable dataset creation at scale. With over 7.7K examples spanning across a wide variety of categories, HaloQuest was designed to be both a challenging benchmark for VLMs and a fine-tuning dataset for advancing multimodal reasoning. Our experiments reveal that current models struggle with HaloQuest, with all open-source VLMs achieving below 36% accuracy. On the other hand, fine-tuning on HaloQuest significantly reduces hallucination rates while preserving performance on standard reasoning tasks. Our results discover that benchmarking with generated images is highly correlated (r=0.97) with real images. Last but not least, we propose a novel Auto-Eval mechanism that is highly correlated with human raters (r=0.99) for evaluating VLMs. In sum, this work makes concrete strides towards understanding, evaluating, and mitigating hallucination in VLMs, serving as an important step towards more reliable multimodal AI systems in the future.

Multimodal large language models (MLLMs) have recently shown significant advancements in video understanding, excelling in content reasoning and instruction-following tasks. However, hallucination, where models generate inaccurate or misleading content, remains underexplored in the video domain. Building on the observation that MLLM visual encoders often fail to distinguish visually different yet semantically similar video pairs, we introduce VidHalluc, the largest benchmark designed to examine hallucinations in MLLMs for video understanding. It consists of 5,002 videos, paired to highlight cases prone to hallucinations. VidHalluc assesses hallucinations across three critical dimensions: (1) action, (2) temporal sequence, and (3) scene transition. Comprehensive testing shows that most MLLMs are vulnerable to hallucinations across these dimensions. Furthermore, we propose DINO-HEAL, a training-free method that reduces hallucinations by incorporating spatial saliency from DINOv2 to reweight visual features during inference. Our results show that DINO-HEAL consistently improves performance on VidHalluc, achieving an average improvement of 3.02% in mitigating hallucinations across all tasks. Both the VidHalluc benchmark and DINO-HEAL code are available at https://people-robots.github.io/vidhalluc.

Advancements in Large Language Models (LLMs) and their increasing use in medical question-answering necessitate rigorous evaluation of their reliability. A critical challenge lies in hallucination, where models generate plausible yet factually incorrect outputs. In the medical domain, this poses serious risks to patient safety and clinical decision-making. To address this, we introduce MedHallu, the first benchmark specifically designed for medical hallucination detection. MedHallu comprises 10,000 high-quality question-answer pairs derived from PubMedQA, with hallucinated answers systematically generated through a controlled pipeline. Our experiments show that state-of-the-art LLMs, including GPT-4o, Llama-3.1, and the medically fine-tuned UltraMedical, struggle with this binary hallucination detection task, with the best model achieving an F1 score as low as 0.625 for detecting "hard" category hallucinations. Using bidirectional entailment clustering, we show that harder-to-detect hallucinations are semantically closer to ground truth. Through experiments, we also show incorporating domain-specific knowledge and introducing a "not sure" category as one of the answer categories improves the precision and F1 scores by up to 38% relative to baselines.

Large Vision-Language Models (LVLMs) have shown remarkable performance on many visual-language tasks. However, these models still suffer from multimodal hallucination, which means the generation of objects or content that violates the images. Many existing work detects hallucination by directly judging whether an object exists in an image, overlooking the association between the object and semantics. To address this issue, we propose Hierarchical Feedback Learning with Vision-enhanced Penalty Decoding (HELPD). This framework incorporates hallucination feedback at both object and sentence semantic levels. Remarkably, even with a marginal degree of training, this approach can alleviate over 15% of hallucination. Simultaneously, HELPD penalizes the output logits according to the image attention window to avoid being overly affected by generated text. HELPD can be seamlessly integrated with any LVLMs. Our experiments demonstrate that the proposed framework yields favorable results across multiple hallucination benchmarks. It effectively mitigates hallucination for different LVLMs and concurrently improves their text generation quality.

Multimodal foundation models are prone to hallucination, generating outputs that either contradict the input or are not grounded by factual information. Given the diversity in architectures, training data and instruction tuning techniques, there can be large variations in systems' susceptibility to hallucinations. To assess system hallucination robustness, hallucination ranking approaches have been developed for specific tasks such as image captioning, question answering, summarization, or biography generation. However, these approaches typically compare model outputs to gold-standard references or labels, limiting hallucination benchmarking for new domains. This work proposes "CrossCheckGPT", a reference-free universal hallucination ranking for multimodal foundation models. The core idea of CrossCheckGPT is that the same hallucinated content is unlikely to be generated by different independent systems, hence cross-system consistency can provide meaningful and accurate hallucination assessment scores. CrossCheckGPT can be applied to any model or task, provided that the information consistency between outputs can be measured through an appropriate distance metric. Focusing on multimodal large language models that generate text, we explore two information consistency measures: CrossCheck-explicit and CrossCheck-implicit. We showcase the applicability of our method for hallucination ranking across various modalities, namely the text, image, and audio-visual domains. Further, we propose the first audio-visual hallucination benchmark, "AVHalluBench", and illustrate the effectiveness of CrossCheckGPT, achieving correlations of 98% and 89% with human judgements on MHaluBench and AVHalluBench, respectively.

Vision language models (VLMs) often generate hallucination, i.e., content that cannot be substantiated by either textual or visual inputs. Prior work primarily attributes this to over-reliance on linguistic prior knowledge rather than visual inputs. Some methods attempt to mitigate hallucination by amplifying visual token attention proportionally to their attention scores. However, these methods overlook the visual attention sink problem, where attention is frequently misallocated to task-irrelevant visual regions, and neglect cross-modal fusion balance by enhancing only visual attention without adjusting attention to the user query. This can result in amplifying incorrect areas while failing to properly interpret the user query. To address these challenges, we propose a simple yet effective method called Gaze Shift-Guided Cross-modal Fusion Enhancement (GIFT). GIFT pre-computes a holistic visual saliency map by tracking positive changes in visual attention, or "gaze shifts", during user query comprehension, and leverages this map to amplify attention to both salient visual information and the user query at each decoding step. This reduces the impact of visual attention sink, as irrelevant tokens exhibit minimal shifts, while ensuring balanced cross-modal fusion for well-integrated representation. Extensive experiments show that GIFT effectively mitigates hallucination in VLMs across both generative and classification tasks, achieving up to 20.7% improvement over greedy decoding, while maintaining general vision-language performance with low computational overhead.

Vision-language models (VLMs) are prone to object hallucinations, where they erroneously indicate the presenceof certain objects in an image. Existing benchmarks quantify hallucinations using relatively small, labeled datasets. However, this approach is i) insufficient to assess hallucinations that arise in open-world settings, where VLMs are widely used, and ii) inadequate for detecting systematic errors in VLMs. We propose DASH (Detection and Assessment of Systematic Hallucinations), an automatic, large-scale pipeline designed to identify systematic hallucinations of VLMs on real-world images in an open-world setting. A key component is DASH-OPT for image-based retrieval, where we optimize over the ''natural image manifold'' to generate images that mislead the VLM. The output of DASH consists of clusters of real and semantically similar images for which the VLM hallucinates an object. We apply DASH to PaliGemma and two LLaVA-NeXT models across 380 object classes and, in total, find more than 19k clusters with 950k images. We study the transfer of the identified systematic hallucinations to other VLMs and show that fine-tuning PaliGemma with the model-specific images obtained with DASH mitigates object hallucinations. Code and data are available at https://YanNeu.github.io/DASH.

Vision-Language Models (VLMs) excel at visual understanding but often suffer from visual hallucinations, where they generate descriptions of nonexistent objects, actions, or concepts, posing significant risks in safety-critical applications. Existing hallucination mitigation methods typically follow one of two paradigms: generation adjustment, which modifies decoding behavior to align text with visual inputs, and post-hoc verification, where external models assess and correct outputs. While effective, generation adjustment methods often rely on heuristics and lack correction mechanisms, while post-hoc verification is complicated, typically requiring multiple models and tending to reject outputs rather than refine them. In this work, we introduce REVERSE, a unified framework that integrates hallucination-aware training with on-the-fly self-verification. By leveraging a new hallucination-verification dataset containing over 1.3M semi-synthetic samples, along with a novel inference-time retrospective resampling technique, our approach enables VLMs to both detect hallucinations during generation and dynamically revise those hallucinations. Our evaluations show that REVERSE achieves state-of-the-art hallucination reduction, outperforming the best existing methods by up to 12% on CHAIR-MSCOCO and 28% on HaloQuest. Our dataset, model, and code are available at: https://reverse-vlm.github.io.

This survey presents a comprehensive analysis of the phenomenon of hallucination in multimodal large language models (MLLMs), also known as Large Vision-Language Models (LVLMs), which have demonstrated significant advancements and remarkable abilities in multimodal tasks. Despite these promising developments, MLLMs often generate outputs that are inconsistent with the visual content, a challenge known as hallucination, which poses substantial obstacles to their practical deployment and raises concerns regarding their reliability in real-world applications. This problem has attracted increasing attention, prompting efforts to detect and mitigate such inaccuracies. We review recent advances in identifying, evaluating, and mitigating these hallucinations, offering a detailed overview of the underlying causes, evaluation benchmarks, metrics, and strategies developed to address this issue. Additionally, we analyze the current challenges and limitations, formulating open questions that delineate potential pathways for future research. By drawing the granular classification and landscapes of hallucination causes, evaluation benchmarks, and mitigation methods, this survey aims to deepen the understanding of hallucinations in MLLMs and inspire further advancements in the field. Through our thorough and in-depth review, we contribute to the ongoing dialogue on enhancing the robustness and reliability of MLLMs, providing valuable insights and resources for researchers and practitioners alike. Resources are available at: https://github.com/showlab/Awesome-MLLM-Hallucination.

Hallucinations pose a significant challenge to the reliability of large vision-language models, making their detection essential for ensuring accuracy in critical applications. Current detection methods often rely on computationally intensive models, leading to high latency and resource demands. Their definitive outcomes also fail to account for real-world scenarios where the line between hallucinated and truthful information is unclear. To address these issues, we propose HalLoc, a dataset designed for efficient, probabilistic hallucination detection. It features 150K token-level annotated samples, including hallucination types, across Visual Question Answering (VQA), instruction-following, and image captioning tasks. This dataset facilitates the development of models that detect hallucinations with graded confidence, enabling more informed user interactions. Additionally, we introduce a baseline model trained on HalLoc, offering low-overhead, concurrent hallucination detection during generation. The model can be seamlessly integrated into existing VLMs, improving reliability while preserving efficiency. The prospect of a robust plug-and-play hallucination detection module opens new avenues for enhancing the trustworthiness of vision-language models in real-world applications. The HalLoc dataset and code are publicly available at: https://github.com/dbsltm/cvpr25_halloc.

The advancement of Large Vision-Language Models (LVLMs) has increasingly highlighted the critical issue of their tendency to hallucinate non-existing objects in the images. To address this issue, previous works focused on using specially curated datasets or powerful LLMs (e.g., GPT-3.5) to rectify the outputs of LVLMs. However, these approaches require either expensive training/fine-tuning or API access to advanced LLMs to correct the model's output post-generation. In this paper, we tackle this challenge by introducing a framework called Mitigating hallucinAtion via classifieR-Free guIdaNcE (MARINE), which is both training-free and API-free, and can effectively and efficiently reduce object hallucinations during the generation process. Specifically, MARINE enriches the visual context of LVLMs by integrating existing open-source vision models, and employs classifier-free guidance to incorporate the additional object grounding features to improve the precision of LVLMs' generations. Through comprehensive evaluations across 6 popular LVLMs with diverse evaluation metrics, we demonstrate the effectiveness of MARINE, which even outperforms existing fine-tuning-based methods. Remarkably, it not only reduces hallucinations but also improves the detailedness of LVLMs' generations, as assessed by GPT-4V.

Hallucinations in large language models (LLMs) are commonly regarded as errors to be minimized. However, recent perspectives suggest that some hallucinations may encode creative or epistemically valuable content, a dimension that remains underquantified in current literature. Existing hallucination detection methods primarily focus on factual consistency, struggling to handle heterogeneous scientific tasks and balance creativity with accuracy. To address these challenges, we propose HIC-Bench, a novel evaluation framework that categorizes hallucinations into Intelligent Hallucinations (IH) and Defective Hallucinations (DH), enabling systematic investigation of their interplay in LLM creativity. HIC-Bench features three core characteristics: (1) Structured IH/DH Assessment. using a multi-dimensional metric matrix integrating Torrance Tests of Creative Thinking (TTCT) metrics (Originality, Feasibility, Value) with hallucination-specific dimensions (scientific plausibility, factual deviation); (2) Cross-Domain Applicability. spanning ten scientific domains with open-ended innovation tasks; and (3) Dynamic Prompt Optimization. leveraging the Dynamic Hallucination Prompt (DHP) to guide models toward creative and reliable outputs. The evaluation process employs multiple LLM judges, averaging scores to mitigate bias, with human annotators verifying IH/DH classifications. Experimental results reveal a nonlinear relationship between IH and DH, demonstrating that creativity and correctness can be jointly optimized. These insights position IH as a catalyst for creativity and reveal the ability of LLM hallucinations to drive scientific innovation.Additionally, the HIC-Bench offers a valuable platform for advancing research into the creative intelligence of LLM hallucinations.

Generative super-resolution (GSR) currently sets the state-of-the-art in terms of perceptual image quality, overcoming the "regression-to-the-mean" blur of prior non-generative models. However, from a human perspective, such models do not fully conform to the optimal balance between quality and fidelity. Instead, a different class of artifacts, in which generated details fail to perceptually match the low resolution image (LRI) or ground-truth image (GTI), is a critical but under studied issue in GSR, limiting its practical deployments. In this work, we focus on measuring, analyzing, and mitigating these artifacts (i.e., "hallucinations"). We observe that hallucinations are not well-characterized with existing image metrics or quality models, as they are orthogonal to both exact fidelity and no-reference quality. Instead, we take advantage of a multimodal large language model (MLLM) by constructing a prompt that assesses hallucinatory visual elements and generates a "Hallucination Score" (HS). We find that our HS is closely aligned with human evaluations, and also provides complementary insights to prior image metrics used for super-resolution (SR) models. In addition, we find certain deep feature distances have strong correlations with HS. We therefore propose to align the GSR models by using such features as differentiable reward functions to mitigate hallucinations.

The hallucination of large multimodal models (LMMs), providing responses that appear correct but are actually incorrect, limits their reliability and applicability. This paper aims to study the hallucination problem of LMMs in video modality, which is dynamic and more challenging compared to static modalities like images and text. From this motivation, we first present a comprehensive benchmark termed HAVEN for evaluating hallucinations of LMMs in video understanding tasks. It is built upon three dimensions, i.e., hallucination causes, hallucination aspects, and question formats, resulting in 6K questions. Then, we quantitatively study 7 influential factors on hallucinations, e.g., duration time of videos, model sizes, and model reasoning, via experiments of 16 LMMs on the presented benchmark. In addition, inspired by recent thinking models like OpenAI o1, we propose a video-thinking model to mitigate the hallucinations of LMMs via supervised reasoning fine-tuning (SRFT) and direct preference optimization (TDPO)-- where SRFT enhances reasoning capabilities while TDPO reduces hallucinations in the thinking process. Extensive experiments and analyses demonstrate the effectiveness. Remarkably, it improves the baseline by 7.65% in accuracy on hallucination evaluation and reduces the bias score by 4.5%. The code and data are public at https://github.com/Hongcheng-Gao/HAVEN.

Recent progress in multimodal large language models (MLLMs) has demonstrated promising performance on medical benchmarks and in preliminary trials as clinical assistants. Yet, our pilot audit of diagnostic cases uncovers a critical failure mode: instability in early evidence interpretation precedes hallucination, creating branching reasoning trajectories that cascade into globally inconsistent conclusions. This highlights the need for clinical reasoning agents that constrain stochasticity and hallucination while producing auditable decision flows. We introduce MedMMV, a controllable multimodal multi-agent framework for reliable and verifiable clinical reasoning. MedMMV stabilizes reasoning through diversified short rollouts, grounds intermediate steps in a structured evidence graph under the supervision of a Hallucination Detector, and aggregates candidate paths with a Combined Uncertainty scorer. On six medical benchmarks, MedMMV improves accuracy by up to 12.7% and, more critically, demonstrates superior reliability. Blind physician evaluations confirm that MedMMV substantially increases reasoning truthfulness without sacrificing informational content. By controlling instability through a verifiable, multi-agent process, our framework provides a robust path toward deploying trustworthy AI systems in high-stakes domains like clinical decision support.

Medical vision-language models often struggle with generating accurate quantitative measurements in radiology reports, leading to hallucinations that undermine clinical reliability. We introduce FactCheXcker, a modular framework that de-hallucinates radiology report measurements by leveraging an improved query-code-update paradigm. Specifically, FactCheXcker employs specialized modules and the code generation capabilities of large language models to solve measurement queries generated based on the original report. After extracting measurable findings, the results are incorporated into an updated report. We evaluate FactCheXcker on endotracheal tube placement, which accounts for an average of 78% of report measurements, using the MIMIC-CXR dataset and 11 medical report-generation models. Our results show that FactCheXcker significantly reduces hallucinations, improves measurement precision, and maintains the quality of the original reports. Specifically, FactCheXcker improves the performance of 10/11 models and achieves an average improvement of 135.0% in reducing measurement hallucinations measured by mean absolute error. Code is available at https://github.com/rajpurkarlab/FactCheXcker.

Although the problem of hallucinations in neural machine translation (NMT) has received some attention, research on this highly pathological phenomenon lacks solid ground. Previous work has been limited in several ways: it often resorts to artificial settings where the problem is amplified, it disregards some (common) types of hallucinations, and it does not validate adequacy of detection heuristics. In this paper, we set foundations for the study of NMT hallucinations. First, we work in a natural setting, i.e., in-domain data without artificial noise neither in training nor in inference. Next, we annotate a dataset of over 3.4k sentences indicating different kinds of critical errors and hallucinations. Then, we turn to detection methods and both revisit methods used previously and propose using glass-box uncertainty-based detectors. Overall, we show that for preventive settings, (i) previously used methods are largely inadequate, (ii) sequence log-probability works best and performs on par with reference-based methods. Finally, we propose DeHallucinator, a simple method for alleviating hallucinations at test time that significantly reduces the hallucinatory rate. To ease future research, we release our annotated dataset for WMT18 German-English data, along with the model, training data, and code.

Detecting hallucinations in large language models (LLMs) is critical for enhancing their reliability and trustworthiness. Most research focuses on hallucinations as deviations from information seen during training. However, the opaque nature of an LLM's parametric knowledge complicates the understanding of why generated texts appear ungrounded: The LLM might not have picked up the necessary knowledge from large and often inaccessible datasets, or the information might have been changed or contradicted during further training. Our focus is on hallucinations involving information not used in training, which we determine by using recency to ensure the information emerged after a cut-off date. This study investigates these hallucinations by detecting them at sentence level using different internal states of various LLMs. We present HalluRAG, a dataset designed to train classifiers on these hallucinations. Depending on the model and quantization, MLPs trained on HalluRAG detect hallucinations with test accuracies ranging up to 75 %, with Mistral-7B-Instruct-v0.1 achieving the highest test accuracies. Our results show that IAVs detect hallucinations as effectively as CEVs and reveal that answerable and unanswerable prompts are encoded differently as separate classifiers for these categories improved accuracy. However, HalluRAG showed some limited generalizability, advocating for more diversity in datasets on hallucinations.

Large language models (LLMs) have shown promise for generative and knowledge-intensive tasks including question-answering (QA) tasks. However, the practical deployment still faces challenges, notably the issue of "hallucination", where models generate plausible-sounding but unfaithful or nonsensical information. This issue becomes particularly critical in the medical domain due to the uncommon professional concepts and potential social risks involved. This paper analyses the phenomenon of hallucination in medical generative QA systems using widely adopted LLMs and datasets. Our investigation centers on the identification and comprehension of common problematic answers, with a specific emphasis on hallucination. To tackle this challenge, we present an interactive self-reflection methodology that incorporates knowledge acquisition and answer generation. Through this feedback process, our approach steadily enhances the factuality, consistency, and entailment of the generated answers. Consequently, we harness the interactivity and multitasking ability of LLMs and produce progressively more precise and accurate answers. Experimental results on both automatic and human evaluation demonstrate the superiority of our approach in hallucination reduction compared to baselines.

Large Vision-Language Models (LVLMs) have recently achieved remarkable success. However, LVLMs are still plagued by the hallucination problem, which limits the practicality in many scenarios. Hallucination refers to the information of LVLMs' responses that does not exist in the visual input, which poses potential risks of substantial consequences. There has been limited work studying hallucination evaluation in LVLMs. In this paper, we propose Hallucination Evaluation based on Large Language Models (HaELM), an LLM-based hallucination evaluation framework. HaELM achieves an approximate 95% performance comparable to ChatGPT and has additional advantages including low cost, reproducibility, privacy preservation and local deployment. Leveraging the HaELM, we evaluate the hallucination in current LVLMs. Furthermore, we analyze the factors contributing to hallucination in LVLMs and offer helpful suggestions to mitigate the hallucination problem. Our training data and human annotation hallucination data will be made public soon.

Despite great progress, existing multimodal large language models (MLLMs) are prone to visual hallucination, greatly impeding their trustworthy applications. In this paper, we study this problem from the perspective of visual-spatial reasoning, and propose a new learning task for MLLMs, termed Grounded Chain-of-Thought (GCoT). Different from recent visual CoT studies, which focus more on visual knowledge reasoning, GCoT is keen to helping MLLMs to recognize and ground the relevant visual cues step by step, thereby predicting the correct answer with grounding coordinates as the intuitive basis. To facilitate this task, we also carefully design and construct a dataset called multimodal grounded chain-of-thought (MM-GCoT) consisting of 24,022 GCoT examples for 5,033 images. Besides, a comprehensive consistency evaluation system is also introduced, including the metrics of answer accuracy, grounding accuracy and answer-grounding consistency. We further design and conduct a bunch of experiments on 12 advanced MLLMs, and reveal some notable findings: i. most MLLMs performs poorly on the consistency evaluation, indicating obvious visual hallucination; ii. visual hallucination is not directly related to the parameter size and general multimodal performance, i.e., a larger and stronger MLLM is not less affected by this issue. Lastly, we also demonstrate that the proposed dataset can help existing MLLMs to well cultivate their GCoT capability and reduce the inconsistent answering significantly. Moreover, their GCoT can be also generalized to exiting multimodal tasks, such as open-world QA and REC.

Vision-Language Models (VLMs) are increasingly used in safety-critical applications that require reliable visual grounding. However, these models often hallucinate details that are not present in the image to satisfy user prompts. While recent datasets and benchmarks have been introduced to evaluate systematic hallucinations in VLMs, many hallucination behaviors remain insufficiently characterized. In particular, prior work primarily focuses on object presence or absence, leaving it unclear how prompt phrasing and structural constraints can systematically induce hallucinations. In this paper, we investigate how different forms of prompt pressure influence hallucination behavior. We introduce Ghost-100, a procedurally generated dataset of synthetic scenes in which key visual details are deliberately removed, enabling controlled analysis of absence-based hallucinations. Using a structured 5-Level Prompt Intensity Framework, we vary prompts from neutral queries to toxic demands and rigid formatting constraints. We evaluate three representative open-weight VLMs: MiniCPM-V 2.6-8B, Qwen2-VL-7B, and Qwen3-VL-8B. Across all three models, hallucination rates do not increase monotonically with prompt intensity. All models exhibit reductions at higher intensity levels at different thresholds, though not all show sustained reduction under maximum coercion. These results suggest that current safety alignment is more effective at detecting semantic hostility than structural coercion, revealing model-specific limitations in handling compliance pressure. Our dataset is available at: https://github.com/bli1/tone-matters

Multimodal hallucination in multimodal large language models (MLLMs) restricts the correctness of MLLMs. However, multimodal hallucinations are multi-sourced and arise from diverse causes. Existing benchmarks fail to adequately distinguish between perception-induced hallucinations and reasoning-induced hallucinations. This failure constitutes a significant issue and hinders the diagnosis of multimodal reasoning failures within MLLMs. To address this, we propose the {\dataset} benchmark, which isolates reasoning hallucinations by constructing questions where input images are correctly perceived by MLLMs yet reasoning errors persist. {\dataset} introduces multi-granular evaluation metrics: accuracy, factuality, and LLMs hallucination score for hallucination quantification. Our analysis reveals that (1) the model scale, data scale, and training stages significantly affect the degree of logical, fabrication, and factual hallucinations; (2) current MLLMs show no effective improvement on spatial hallucinations caused by misinterpreted spatial relationships, indicating their limited visual reasoning capabilities; and (3) question types correlate with distinct hallucination patterns, highlighting targeted challenges and potential mitigation strategies. To address these challenges, we propose {\method}, a method that combines curriculum reinforcement fine-tuning to encourage models to generate logic-consistent reasoning chains by stepwise reducing learning difficulty, and collaborative hint inference to reduce reasoning complexity. {\method} establishes a baseline on {\dataset}, and reduces the logical hallucinations in original base models.

Hallucinations are a persistent problem with Large Language Models (LLMs). As these models become increasingly used in high-stakes domains, such as healthcare and finance, the need for effective hallucination detection is crucial. To this end, we propose a versatile framework for zero-resource hallucination detection that practitioners can apply to real-world use cases. To achieve this, we adapt a variety of existing uncertainty quantification (UQ) techniques, including black-box UQ, white-box UQ, and LLM-as-a-Judge, transforming them as necessary into standardized response-level confidence scores ranging from 0 to 1. To enhance flexibility, we introduce a tunable ensemble approach that incorporates any combination of the individual confidence scores. This approach enables practitioners to optimize the ensemble for a specific use case for improved performance. To streamline implementation, the full suite of scorers is offered in this paper's companion Python toolkit, UQLM. To evaluate the performance of the various scorers, we conduct an extensive set of experiments using several LLM question-answering benchmarks. We find that our tunable ensemble typically surpasses its individual components and outperforms existing hallucination detection methods. Our results demonstrate the benefits of customized hallucination detection strategies for improving the accuracy and reliability of LLMs.

Patients often face difficulties in understanding their hospitalizations, while healthcare workers have limited resources to provide explanations. In this work, we investigate the potential of large language models to generate patient summaries based on doctors' notes and study the effect of training data on the faithfulness and quality of the generated summaries. To this end, we release (i) a rigorous labeling protocol for errors in medical texts and (ii) a publicly available dataset of annotated hallucinations in 100 doctor-written and 100 generated summaries. We show that fine-tuning on hallucination-free data effectively reduces hallucinations from 2.60 to 1.55 per summary for Llama 2, while preserving relevant information. We observe a similar effect on GPT-4 (0.70 to 0.40), when the few-shot examples are hallucination-free. We also conduct a qualitative evaluation using hallucination-free and improved training data. We find that common quantitative metrics do not correlate well with faithfulness and quality. Finally, we test GPT-4 for automatic hallucination detection, which clearly outperforms common baselines.

Hallucination, where models generate fluent text unsupported by visual evidence, remains a major flaw in vision-language models and is particularly critical in sign language translation (SLT). In SLT, meaning depends on precise grounding in video, and gloss-free models are especially vulnerable because they map continuous signer movements directly into natural language without intermediate gloss supervision that serves as alignment. We argue that hallucinations arise when models rely on language priors rather than visual input. To capture this, we propose a token-level reliability measure that quantifies how much the decoder uses visual information. Our method combines feature-based sensitivity, which measures internal changes when video is masked, with counterfactual signals, which capture probability differences between clean and altered video inputs. These signals are aggregated into a sentence-level reliability score, providing a compact and interpretable measure of visual grounding. We evaluate the proposed measure on two SLT benchmarks (PHOENIX-2014T and CSL-Daily) with both gloss-based and gloss-free models. Our results show that reliability predicts hallucination rates, generalizes across datasets and architectures, and decreases under visual degradations. Beyond these quantitative trends, we also find that reliability distinguishes grounded tokens from guessed ones, allowing risk estimation without references; when combined with text-based signals (confidence, perplexity, or entropy), it further improves hallucination risk estimation. Qualitative analysis highlights why gloss-free models are more susceptible to hallucinations. Taken together, our findings establish reliability as a practical and reusable tool for diagnosing hallucinations in SLT, and lay the groundwork for more robust hallucination detection in multimodal generation.

Following the success of Large Language Models (LLMs), expanding their boundaries to new modalities represents a significant paradigm shift in multimodal understanding. Human perception is inherently multimodal, relying not only on text but also on auditory and visual cues for a complete understanding of the world. In recognition of this fact, audio-visual LLMs have recently emerged. Despite promising developments, the lack of dedicated benchmarks poses challenges for understanding and evaluating models. In this work, we show that audio-visual LLMs struggle to discern subtle relationships between audio and visual signals, leading to hallucinations, underscoring the need for reliable benchmarks. To address this, we introduce AVHBench, the first comprehensive benchmark specifically designed to evaluate the perception and comprehension capabilities of audio-visual LLMs. Our benchmark includes tests for assessing hallucinations, as well as the cross-modal matching and reasoning abilities of these models. Our results reveal that most existing audio-visual LLMs struggle with hallucinations caused by cross-interactions between modalities, due to their limited capacity to perceive complex multimodal signals and their relationships. Additionally, we demonstrate that simple training with our AVHBench improves robustness of audio-visual LLMs against hallucinations.

The rapid development of Large Multimodal Models (LMMs) has significantly advanced multimodal understanding by harnessing the language abilities of Large Language Models (LLMs) and integrating modality-specific encoders. However, LMMs are plagued by hallucinations that limit their reliability and adoption. While traditional methods to detect and mitigate these hallucinations often involve costly training or rely heavily on external models, recent approaches utilizing internal model features present a promising alternative. In this paper, we critically assess the limitations of the state-of-the-art training-free technique, the logit lens, in handling generalized visual hallucinations. We introduce a refined method that leverages contextual token embeddings from middle layers of LMMs. This approach significantly improves hallucination detection and grounding across diverse categories, including actions and OCR, while also excelling in tasks requiring contextual understanding, such as spatial relations and attribute comparison. Our novel grounding technique yields highly precise bounding boxes, facilitating a transition from Zero-Shot Object Segmentation to Grounded Visual Question Answering. Our contributions pave the way for more reliable and interpretable multimodal models.

Despite significant strides in multimodal tasks, Multimodal Large Language Models (MLLMs) are plagued by the critical issue of hallucination. The reliable detection of such hallucinations in MLLMs has, therefore, become a vital aspect of model evaluation and the safeguarding of practical application deployment. Prior research in this domain has been constrained by a narrow focus on singular tasks, an inadequate range of hallucination categories addressed, and a lack of detailed granularity. In response to these challenges, our work expands the investigative horizons of hallucination detection. We present a novel meta-evaluation benchmark, MHaluBench, meticulously crafted to facilitate the evaluation of advancements in hallucination detection methods. Additionally, we unveil a novel unified multimodal hallucination detection framework, UNIHD, which leverages a suite of auxiliary tools to validate the occurrence of hallucinations robustly. We demonstrate the effectiveness of UNIHD through meticulous evaluation and comprehensive analysis. We also provide strategic insights on the application of specific tools for addressing various categories of hallucinations.

Recent advancements in large multimodal models (LMMs) have significantly enhanced performance across diverse tasks, with ongoing efforts to further integrate additional modalities such as video and audio. However, most existing LMMs remain vulnerable to hallucinations, the discrepancy between the factual multimodal input and the generated textual output, which has limited their applicability in various real-world scenarios. This paper presents the first systematic investigation of hallucinations in LMMs involving the three most common modalities: language, visual, and audio. Our study reveals two key contributors to hallucinations: overreliance on unimodal priors and spurious inter-modality correlations. To address these challenges, we introduce the benchmark The Curse of Multi-Modalities (CMM), which comprehensively evaluates hallucinations in LMMs, providing a detailed analysis of their underlying issues. Our findings highlight key vulnerabilities, including imbalances in modality integration and biases from training data, underscoring the need for balanced cross-modal learning and enhanced hallucination mitigation strategies. Based on our observations and findings, we suggest potential research directions that could enhance the reliability of LMMs.

Vision-Language Models (VLM) can support clinicians by analyzing medical images and engaging in natural language interactions to assist in diagnostic and treatment tasks. However, VLMs often exhibit "hallucinogenic" behavior, generating textual outputs not grounded in contextual multimodal information. This challenge is particularly pronounced in the medical domain, where we do not only require VLM outputs to be accurate in single interactions but also to be consistent with clinical reasoning and diagnostic pathways throughout multi-turn conversations. For this purpose, we propose a new alignment algorithm that uses symbolic representations of clinical reasoning to ground VLMs in medical knowledge. These representations are utilized to (i) generate GPT-4-guided visual instruction tuning data at scale, simulating clinician-VLM conversations with demonstrations of clinical reasoning, and (ii) create an automatic reward function that evaluates the clinical validity of VLM generations throughout clinician-VLM interactions. Our algorithm eliminates the need for human involvement in training data generation or reward model construction, reducing costs compared to standard reinforcement learning with human feedback (RLHF). We apply our alignment algorithm to develop Dr-LLaVA, a conversational VLM finetuned for analyzing bone marrow pathology slides, demonstrating strong performance in multi-turn medical conversations.

Large Vision-Language Models (LVLMs) have shown strong performance across multimodal tasks. However, they often produce hallucinations -- text that is inconsistent with visual input, due to the limited ability to verify information in different regions of the image. To address this, we propose Multi-Region Fusion Decoding (MRFD), a training-free decoding method that improves factual grounding by modeling inter-region consistency. MRFD identifies salient regions using cross-attention, generates initial responses for each, and computes reliability weights based on Jensen-Shannon Divergence (JSD) among the responses. These weights guide a consistency-aware fusion of per-region predictions, using region-aware prompts inspired by Chain-of-Thought reasoning. Experiments across multiple LVLMs and benchmarks show that MRFD significantly reduces hallucinations and improves response factuality without requiring model updates.

In text-to-image (T2I) generation, a prevalent training technique involves utilizing Vision Language Models (VLMs) for image re-captioning. Even though VLMs are known to exhibit hallucination, generating descriptive content that deviates from the visual reality, the ramifications of such caption hallucinations on T2I generation performance remain under-explored. Through our empirical investigation, we first establish a comprehensive dataset comprising VLM-generated captions, and then systematically analyze how caption hallucination influences generation outcomes. Our findings reveal that (1) the disparities in caption quality persistently impact model outputs during fine-tuning. (2) VLMs confidence scores serve as reliable indicators for detecting and characterizing noise-related patterns in the data distribution. (3) even subtle variations in caption fidelity have significant effects on the quality of learned representations. These findings collectively emphasize the profound impact of caption quality on model performance and highlight the need for more sophisticated robust training algorithm in T2I. In response to these observations, we propose a approach leveraging VLM confidence score to mitigate caption noise, thereby enhancing the robustness of T2I models against hallucination in caption.

The advancement of Large Vision-Language Models (LVLMs) has propelled their application in the medical field. However, Medical LVLMs (Med-LVLMs) encounter factuality challenges due to modality misalignment, where the models prioritize textual knowledge over visual input, leading to hallucinations that contradict information in medical images. Previous attempts to enhance modality alignment in Med-LVLMs through preference optimization have inadequately mitigated clinical relevance in preference data, making these samples easily distinguishable and reducing alignment effectiveness. To address this challenge, we propose MMedPO, a novel multimodal medical preference optimization approach that considers the clinical relevance of preference samples to enhance Med-LVLM alignment. MMedPO curates multimodal preference data by introducing two types of dispreference: (1) plausible hallucinations injected through target Med-LVLMs or GPT-4o to produce medically inaccurate responses, and (2) lesion region neglect achieved through local lesion-noising, disrupting visual understanding of critical areas. We then calculate clinical relevance for each sample based on scores from multiple Med-LLMs and visual tools, and integrate these scores into the preference optimization process as weights, enabling effective alignment. Our experiments demonstrate that MMedPO significantly enhances factual accuracy in Med-LVLMs, achieving substantial improvements over existing preference optimization methods by averaging 14.2% and 51.7% across the Med-VQA and report generation tasks. Our code are available in https://github.com/aiming-lab/MMedPO.

Generative Vision-Language Models (VLMs) are prone to generate plausible-sounding textual answers that, however, are not always grounded in the input image. We investigate this phenomenon, usually referred to as "hallucination" and show that it stems from an excessive reliance on the language prior. In particular, we show that as more tokens are generated, the reliance on the visual prompt decreases, and this behavior strongly correlates with the emergence of hallucinations. To reduce hallucinations, we introduce Multi-Modal Mutual-Information Decoding (M3ID), a new sampling method for prompt amplification. M3ID amplifies the influence of the reference image over the language prior, hence favoring the generation of tokens with higher mutual information with the visual prompt. M3ID can be applied to any pre-trained autoregressive VLM at inference time without necessitating further training and with minimal computational overhead. If training is an option, we show that M3ID can be paired with Direct Preference Optimization (DPO) to improve the model's reliance on the prompt image without requiring any labels. Our empirical findings show that our algorithms maintain the fluency and linguistic capabilities of pre-trained VLMs while reducing hallucinations by mitigating visually ungrounded answers. Specifically, for the LLaVA 13B model, M3ID and M3ID+DPO reduce the percentage of hallucinated objects in captioning tasks by 25% and 28%, respectively, and improve the accuracy on VQA benchmarks such as POPE by 21% and 24%.

Large Vision-Language Models (LVLMs) have recently demonstrated remarkable progress, yet hallucination remains a critical barrier, particularly in chart understanding, which requires sophisticated perceptual and cognitive abilities as well as rigorous factual accuracy. While prior work has investigated hallucinations and chart comprehension independently, their intersection remains largely unexplored. To address this gap, we present ChartHal, a benchmark that features a fine-grained taxonomy of hallucination scenarios in chart understanding, along with a human-validated dataset of 1,062 samples. Our evaluation shows that state-of-the-art LVLMs suffer from severe hallucinations on ChartHal, including proprietary models such as GPT-5 and o4-mini, which achieve only 34.46% and 22.79% accuracy, respectively. Further analysis reveals that questions involving information absent from or contradictory to charts are especially likely to trigger hallucinations, underscoring the urgent need for more robust mitigation strategies. Code and data are available at https://github.com/ymcui/ChartHal .

Large vision-language models (LVLMs) have made substantial progress in integrating large language models (LLMs) with visual inputs, enabling advanced multimodal reasoning. Despite their success, a persistent challenge is hallucination-where generated text fails to accurately reflect visual content-undermining both accuracy and reliability. Existing methods focus on alignment training or decoding refinements but primarily address symptoms at the generation stage without probing the underlying causes. In this work, we investigate the internal mechanisms driving hallucination in LVLMs, with an emphasis on the multi-head attention module. Specifically, we introduce Vision-aware Head Divergence (VHD), a metric that quantifies the sensitivity of attention head outputs to visual context. Based on this, our findings reveal the presence of vision-aware attention heads that are more attuned to visual information; however, the model's overreliance on its prior language patterns is closely related to hallucinations. Building on these insights, we propose Vision-aware Head Reinforcement (VHR), a training-free approach to mitigate hallucination by enhancing the role of vision-aware attention heads. Extensive experiments demonstrate that our method achieves superior performance compared to state-of-the-art approaches in mitigating hallucinations, while maintaining high efficiency with negligible additional time overhead.

Object hallucination has been an Achilles' heel which hinders the broader applications of large vision-language models (LVLMs). Object hallucination refers to the phenomenon that the LVLMs claim non-existent objects in the image. To mitigate the object hallucinations, instruction tuning and external model-based detection methods have been proposed, which either require large-scare computational resources or depend on the detection result of external models. However, there remains an under-explored field to utilize the LVLM itself to alleviate object hallucinations. In this work, we adopt the intuition that the LVLM tends to respond logically consistently for existent objects but inconsistently for hallucinated objects. Therefore, we propose a Logical Closed Loop-based framework for Object Hallucination Detection and Mitigation, namely LogicCheckGPT. In specific, we devise logical consistency probing to raise questions with logical correlations, inquiring about attributes from objects and vice versa. Whether their responses can form a logical closed loop serves as an indicator of object hallucination. As a plug-and-play method, it can be seamlessly applied to all existing LVLMs. Comprehensive experiments conducted on three benchmarks across four LVLMs have demonstrated significant improvements brought by our method, indicating its effectiveness and generality.

Recent advancements in large video models (LVMs) have significantly enhance video understanding. However, these models continue to suffer from hallucinations, producing content that conflicts with input videos. To address this issue, we propose Dr.V, a hierarchical framework covering perceptive, temporal, and cognitive levels to diagnose video hallucination by fine-grained spatial-temporal grounding. Dr.V comprises of two key components: a benchmark dataset Dr.V-Bench and a satellite video agent Dr.V-Agent. Dr.V-Bench includes 10k instances drawn from 4,974 videos spanning diverse tasks, each enriched with detailed spatial-temporal annotation. Dr.V-Agent detects hallucinations in LVMs by systematically applying fine-grained spatial-temporal grounding at the perceptive and temporal levels, followed by cognitive level reasoning. This step-by-step pipeline mirrors human-like video comprehension and effectively identifies hallucinations. Extensive experiments demonstrate that Dr.V-Agent is effective in diagnosing hallucination while enhancing interpretability and reliability, offering a practical blueprint for robust video understanding in real-world scenarios. All our data and code are available at https://github.com/Eurekaleo/Dr.V.

Video large language models have not yet been widely deployed, largely due to their tendency to hallucinate. Typical benchmarks for Video-LLMs rely simply on multiple-choice questions. Unfortunately, VideoLLMs hallucinate far more aggressively on freeform text generation tasks like video captioning than they do on multiple choice verification tasks. To address this weakness, we propose ARGUS, a VideoLLM benchmark that measures freeform video captioning performance. By comparing VideoLLM outputs to human ground truth captions, ARGUS quantifies dual metrics. First, we measure the rate of hallucinations in the form of incorrect statements about video content or temporal relationships. Second, we measure the rate at which the model omits important descriptive details. Together, these dual metrics form a comprehensive view of video captioning performance.

Multimodal large language models have made significant advancements in recent years, yet they still suffer from a common issue known as the "hallucination problem" where the models generate textual descriptions that contain inaccurate or non-existent content from the image. To address this issue, this paper introduces a novel strategy: Hallucination-Aware Direct Preference Optimization (HA-DPO). Our approach treats the hallucination problem as a unique preference selection issue, where the model is trained to favor the non-hallucinating response when presented with two responses of the same image (one accurate and one hallucinating). This paper also presents an efficient process for constructing hallucination sample pairs to ensure high-quality, style-consistent pairs for stable HA-DPO training. We applied this strategy to two mainstream multimodal models, and the results showed a significant reduction in the hallucination problem and an enhancement in the models' generalization capabilities. With HA-DPO, the MiniGPT-4 model demonstrates significant advancements: POPE accuracy increases from 51.13% to 85.66% (34.5% absolute improvement), and the MME score escalates from 968.58 to 1365.76 (41% relative improvement). The code, models, and datasets will be made publicly available.

Clinicians spend a significant amount of time reviewing medical images and transcribing their findings regarding patient diagnosis, referral and treatment in text form. Vision-language models (VLMs), which automatically interpret images and summarize their findings as text, have enormous potential to alleviate clinical workloads and increase patient access to high-quality medical care. While foundational models have stirred considerable interest in the medical community, it is unclear whether their general capabilities translate to real-world clinical utility. In this work, we show that foundation VLMs markedly underperform compared to practicing ophthalmologists on specialist tasks crucial to the care of patients with age-related macular degeneration (AMD). To address this, we initially identified the essential capabilities required for image-based clinical decision-making, and then developed a curriculum to selectively train VLMs in these skills. The resulting model, RetinaVLM, can be instructed to write reports that significantly outperform those written by leading foundation medical VLMs in disease staging (F1 score of 0.63 vs. 0.11) and patient referral (0.67 vs. 0.39), and approaches the diagnostic performance of junior ophthalmologists (who achieve 0.77 and 0.78 on the respective tasks). Furthermore, in a reader study involving two senior ophthalmologists with up to 32 years of experience, RetinaVLM's reports were found to be similarly correct (78.6% vs. 82.1%) and complete (both 78.6%) as reports written by junior ophthalmologists with up to 10 years of experience. These results demonstrate that our curriculum-based approach provides a blueprint for specializing generalist foundation medical VLMs to handle real-world clinical tasks.

Medical Vision-Language Models (VLMs) are prone to hallucinations, compromising clinical reliability. While reinforcement learning methods like Group Relative Policy Optimization (GRPO) offer a low-cost alignment solution, their reliance on sparse, outcome-based rewards inadvertently encourages models to "overthink" -- generating verbose, convoluted, and unverifiable Chain-of-Thought reasoning to justify answers. This focus on outcomes obscures factual errors and poses significant safety risks. To address this, we propose CheXPO-v2, a novel alignment framework that shifts from outcome to process supervision. Our core innovation is a Knowledge Graph Consistency Reward mechanism driven by Entity-Relation Matching. By explicitly parsing reasoning steps into structured "Disease, Relation, Anatomy" triplets, we provide fine-grained supervision that penalizes incoherent logic and hallucinations at the atomic level. Integrating this with a hard-example mining strategy, our approach significantly outperforms GRPO and state-of-the-art models on benchmarks like MIMIC-CXR-VQA. Crucially, CheXPO-v2 achieves new state-of-the-art accuracy using only 5k samples, demonstrating exceptional data efficiency while producing clinically sound and verifiable reasoning. The project source code is publicly available at: https://github.com/ecoxial2007/CheX-Phi4MM.

We present VinDr-CXR-VQA, a large-scale chest X-ray dataset for explainable Medical Visual Question Answering (Med-VQA) with spatial grounding. The dataset contains 17,597 question-answer pairs across 4,394 images, each annotated with radiologist-verified bounding boxes and clinical reasoning explanations. Our question taxonomy spans six diagnostic types-Where, What, Is there, How many, Which, and Yes/No-capturing diverse clinical intents. To improve reliability, we construct a balanced distribution of 41.7% positive and 58.3% negative samples, mitigating hallucinations in normal cases. Benchmarking with MedGemma-4B-it demonstrates improved performance (F1 = 0.624, +11.8% over baseline) while enabling lesion localization. VinDr-CXR-VQA aims to advance reproducible and clinically grounded Med-VQA research. The dataset and evaluation tools are publicly available at huggingface.co/datasets/Dangindev/VinDR-CXR-VQA.

Recently, Large Vision-Language Models (LVLMs) have demonstrated impressive capabilities in multi-modal context comprehension. However, they still suffer from hallucination problems referring to generating inconsistent outputs with the image content. To mitigate hallucinations, previous studies mainly focus on retraining LVLMs with custom datasets. Although effective, they inherently come with additional computational costs. In this paper, we propose a training-free framework, MVP, that aims to reduce hallucinations by making the most of the innate capabilities of the LVLMs via Multi-View Multi-Path Reasoning. Specifically, we first devise a multi-view information-seeking strategy to thoroughly perceive the comprehensive information in the image, which enriches the general global information captured by the original vision encoder in LVLMs. Furthermore, during the answer decoding, we observe that the occurrence of hallucinations has a strong correlation with the certainty of the answer tokens. Thus, we propose multi-path reasoning for each information view to quantify and aggregate the certainty scores for each potential answer among multiple decoding paths and finally decide the output answer. By fully grasping the information in the image and carefully considering the certainty of the potential answers when decoding, our MVP can effectively reduce hallucinations in LVLMs.The extensive experiments verify that our proposed MVP significantly mitigates the hallucination problem across four well-known LVLMs. The source code is available at: https://github.com/GasolSun36/MVP.

Large vision-language models (LVMs) extend large language models (LLMs) with visual perception capabilities, enabling them to process and interpret visual information. A major challenge compromising their reliability is object hallucination that LVMs may generate plausible but factually inaccurate information. We propose a novel visual adversarial perturbation (VAP) method to mitigate this hallucination issue. VAP alleviates LVM hallucination by applying strategically optimized visual noise without altering the base model. Our approach formulates hallucination suppression as an optimization problem, leveraging adversarial strategies to generate beneficial visual perturbations that enhance the model's factual grounding and reduce parametric knowledge bias. Extensive experimental results demonstrate that our method consistently reduces object hallucinations across 8 state-of-the-art LVMs, validating its efficacy across diverse evaluations.

Nowadays, the research on Large Vision-Language Models (LVLMs) has been significantly promoted thanks to the success of Large Language Models (LLM). Nevertheless, these Vision-Language Models (VLMs) are suffering from the drawback of hallucination -- due to insufficient understanding of vision and language modalities, VLMs may generate incorrect perception information when doing downstream applications, for example, captioning a non-existent entity. To address the hallucination phenomenon, on the one hand, we introduce a Contrastive Instruction Evaluation Method (CIEM), which is an automatic pipeline that leverages an annotated image-text dataset coupled with an LLM to generate factual/contrastive question-answer pairs for the evaluation of the hallucination of VLMs. On the other hand, based on CIEM, we further propose a new instruction tuning method called CIT (the abbreviation of Contrastive Instruction Tuning) to alleviate the hallucination of VLMs by automatically producing high-quality factual/contrastive question-answer pairs and corresponding justifications for model tuning. Through extensive experiments on CIEM and CIT, we pinpoint the hallucination issues commonly present in existing VLMs, the disability of the current instruction-tuning dataset to handle the hallucination phenomenon and the superiority of CIT-tuned VLMs over both CIEM and public datasets.

While the problem of hallucinations in neural machine translation has long been recognized, so far the progress on its alleviation is very little. Indeed, recently it turned out that without artificially encouraging models to hallucinate, previously existing methods fall short and even the standard sequence log-probability is more informative. It means that characteristics internal to the model can give much more information than we expect, and before using external models and measures, we first need to ask: how far can we go if we use nothing but the translation model itself ? We propose to use a method that evaluates the percentage of the source contribution to a generated translation. Intuitively, hallucinations are translations "detached" from the source, hence they can be identified by low source contribution. This method improves detection accuracy for the most severe hallucinations by a factor of 2 and is able to alleviate hallucinations at test time on par with the previous best approach that relies on external models. Next, if we move away from internal model characteristics and allow external tools, we show that using sentence similarity from cross-lingual embeddings further improves these results.

Large Multimodal Models (LMMs) often suffer from multimodal hallucinations, wherein they may create content that is not present in the visual inputs. In this paper, we explore a new angle of this issue: overly detailed training data hinders the model's ability to timely terminate generation, leading to continued outputs beyond visual perception limits. By investigating how the model decides to terminate generation with EOS, the special end-of-sentence token, we find that the model assesses the completeness of the entire sequence by comparing the generated text with the image. This observation suggests that the model possesses an inherent potential of making proper EOS decisions based on its visual perception to avoid overly lengthy outputs. To take advantage of such potential, we explore two methods to mitigate multimodal hallucinations: a training objective that enables the model to reduce hallucinations by learning from regular instruction data, and a data filtering strategy to prevent harmful training data from exacerbating model hallucinations. Both methods significantly improve the hallucination performance of LMMs, without requiring any additional data or knowledge.

Large language models (LLMs), after being aligned with vision models and integrated into vision-language models (VLMs), can bring impressive improvement in image reasoning tasks. This was shown by the recently released GPT-4V(ison), LLaVA-1.5, etc. However, the strong language prior in these SOTA LVLMs can be a double-edged sword: they may ignore the image context and solely rely on the (even contradictory) language prior for reasoning. In contrast, the vision modules in VLMs are weaker than LLMs and may result in misleading visual representations, which are then translated to confident mistakes by LLMs. To study these two types of VLM mistakes, i.e., language hallucination and visual illusion, we curated HallusionBench, an image-context reasoning benchmark that is still challenging to even GPT-4V and LLaVA-1.5. We provide a detailed analysis of examples in HallusionBench, which sheds novel insights on the illusion or hallucination of VLMs and how to improve them in the future. The benchmark and codebase will be released at https://github.com/tianyi-lab/HallusionBench.

Large Vision-Language Models (LVLMs) have advanced considerably, intertwining visual recognition and language understanding to generate content that is not only coherent but also contextually attuned. Despite their success, LVLMs still suffer from the issue of object hallucinations, where models generate plausible yet incorrect outputs that include objects that do not exist in the images. To mitigate this issue, we introduce Visual Contrastive Decoding (VCD), a simple and training-free method that contrasts output distributions derived from original and distorted visual inputs. The proposed VCD effectively reduces the over-reliance on statistical bias and unimodal priors, two essential causes of object hallucinations. This adjustment ensures the generated content is closely grounded to visual inputs, resulting in contextually accurate outputs. Our experiments show that VCD, without either additional training or the usage of external tools, significantly mitigates the object hallucination issue across different LVLM families. Beyond mitigating object hallucinations, VCD also excels in general LVLM benchmarks, highlighting its wide-ranging applicability.

Large language models have the potential to be valuable in the healthcare industry, but it's crucial to verify their safety and effectiveness through rigorous evaluation. For this purpose, we comprehensively evaluated both open-source LLMs and Google's new multimodal LLM called Gemini across Medical reasoning, hallucination detection, and Medical Visual Question Answering tasks. While Gemini showed competence, it lagged behind state-of-the-art models like MedPaLM 2 and GPT-4 in diagnostic accuracy. Additionally, Gemini achieved an accuracy of 61.45\% on the medical VQA dataset, significantly lower than GPT-4V's score of 88\%. Our analysis revealed that Gemini is highly susceptible to hallucinations, overconfidence, and knowledge gaps, which indicate risks if deployed uncritically. We also performed a detailed analysis by medical subject and test type, providing actionable feedback for developers and clinicians. To mitigate risks, we applied prompting strategies that improved performance. Additionally, we facilitated future research and development by releasing a Python module for medical LLM evaluation and establishing a dedicated leaderboard on Hugging Face for medical domain LLMs. Python module can be found at https://github.com/promptslab/RosettaEval

Recently, multimodal large language models (MLLMs) have demonstrated remarkable performance in visual-language tasks. However, the authenticity of the responses generated by MLLMs is often compromised by object hallucinations. We identify that a key cause of these hallucinations is the model's over-susceptibility to specific image frequency features in detecting objects. In this paper, we introduce Multi-Frequency Perturbations (MFP), a simple, cost-effective, and pluggable method that leverages both low-frequency and high-frequency features of images to perturb visual feature representations and explicitly suppress redundant frequency-domain features during inference, thereby mitigating hallucinations. Experimental results demonstrate that our method significantly mitigates object hallucinations across various model architectures. Furthermore, as a training-time method, MFP can be combined with inference-time methods to achieve state-of-the-art performance on the CHAIR benchmark.

Hallucinations in large language models (LLMs) during summarization of patient-clinician dialogues pose significant risks to patient care and clinical decision-making. However, the phenomenon remains understudied in the clinical domain, with uncertainty surrounding the applicability of general-domain hallucination detectors. The rarity and randomness of hallucinations further complicate their investigation. In this paper, we conduct an evaluation of hallucination detection methods in the medical domain, and construct two datasets for the purpose: A fact-controlled Leave-N-out dataset -- generated by systematically removing facts from source dialogues to induce hallucinated content in summaries; and a natural hallucination dataset -- arising organically during LLM-based medical summarization. We show that general-domain detectors struggle to detect clinical hallucinations, and that performance on fact-controlled hallucinations does not reliably predict effectiveness on natural hallucinations. We then develop fact-based approaches that count hallucinations, offering explainability not available with existing methods. Notably, our LLM-based detectors, which we developed using fact-controlled hallucinations, generalize well to detecting real-world clinical hallucinations. This research contributes a suite of specialized metrics supported by expert-annotated datasets to advance faithful clinical summarization systems.

Multimodal Large Language Models (MLLMs) inherit the superior text understanding capabilities of LLMs and extend these capabilities to multimodal scenarios. These models achieve excellent results in the general domain of multimodal tasks. However, in the medical domain, the substantial training costs and the requirement for extensive medical data pose challenges to the development of medical MLLMs. Furthermore, due to the free-text form of answers, tasks such as visual grounding that need to produce output in a prescribed form become difficult for MLLMs. So far, there have been no medical MLLMs works in medical visual grounding area. For the medical vision grounding task, which involves identifying locations in medical images based on short text descriptions, we propose Parameter-efficient Fine-tuning medical multimodal large language models for Medcial Visual Grounding (PFMVG). To validate the performance of the model, we evaluate it on a public benchmark dataset for medical visual grounding, where it achieves competitive results, and significantly outperforming GPT-4v. Our code will be open sourced after peer review.

Multimodal language models (MLMs) show promise for clinical decision support and diagnostic reasoning, raising the prospect of end-to-end automated medical image interpretation. However, clinicians are highly selective in adopting AI tools; a model that makes errors on seemingly simple perception tasks such as determining image orientation or identifying whether a CT scan is contrast-enhance are unlikely to be adopted for clinical tasks. We introduce Medblink, a benchmark designed to probe these models for such perceptual abilities. Medblink spans eight clinically meaningful tasks across multiple imaging modalities and anatomical regions, totaling 1,429 multiple-choice questions over 1,605 images. We evaluate 19 state-of-the-art MLMs, including general purpose (GPT4o, Claude 3.5 Sonnet) and domain specific (Med Flamingo, LLaVA Med, RadFM) models. While human annotators achieve 96.4% accuracy, the best-performing model reaches only 65%. These results show that current MLMs frequently fail at routine perceptual checks, suggesting the need to strengthen their visual grounding to support clinical adoption. Data is available on our project page.

Stroboscopic light stimulation (SLS) on closed eyes typically induces simple visual hallucinations (VHs), characterised by vivid, geometric and colourful patterns. A dataset of 862 sentences, extracted from 422 open subjective reports, was recently compiled as part of the Dreamachine programme (Collective Act, 2022), an immersive multisensory experience that combines SLS and spatial sound in a collective setting. Although open reports extend the range of reportable phenomenology, their analysis presents significant challenges, particularly in systematically identifying patterns. To address this challenge, we implemented a data-driven approach leveraging Large Language Models and Topic Modelling to uncover and interpret latent experiential topics directly from the Dreamachine's text-based reports. Our analysis confirmed the presence of simple VHs typically documented in scientific studies of SLS, while also revealing experiences of altered states of consciousness and complex hallucinations. Building on these findings, our computational approach expands the systematic study of subjective experience by enabling data-driven analyses of open-ended phenomenological reports, capturing experiences not readily identified through standard questionnaires. By revealing rich and multifaceted aspects of experiences, our study broadens our understanding of stroboscopically-induced phenomena while highlighting the potential of Natural Language Processing and Large Language Models in the emerging field of computational (neuro)phenomenology. More generally, this approach provides a practically applicable methodology for uncovering subtle hidden patterns of subjective experience across diverse research domains.

Developing reliable AI systems to assist human clinicians in multi-modal medical diagnosis has long been a key objective for researchers. Recently, Multi-modal Large Language Models (MLLMs) have gained significant attention and achieved success across various domains. With strong reasoning capabilities and the ability to perform diverse tasks based on user instructions, they hold great potential for enhancing medical diagnosis. However, directly applying MLLMs to the medical domain still presents challenges. They lack detailed perception of visual inputs, limiting their ability to perform quantitative image analysis, which is crucial for medical diagnostics. Additionally, MLLMs often exhibit hallucinations and inconsistencies in reasoning, whereas clinical diagnoses must adhere strictly to established criteria. To address these challenges, we propose MedAgent-Pro, an evidence-based reasoning agentic system designed to achieve reliable, explainable, and precise medical diagnoses. This is accomplished through a hierarchical workflow: at the task level, knowledge-based reasoning generate reliable diagnostic plans for specific diseases following retrieved clinical criteria. While at the case level, multiple tool agents process multi-modal inputs, analyze different indicators according to the plan, and provide a final diagnosis based on both quantitative and qualitative evidence. Comprehensive experiments on both 2D and 3D medical diagnosis tasks demonstrate the superiority and effectiveness of MedAgent-Pro, while case studies further highlight its reliability and interpretability. The code is available at https://github.com/jinlab-imvr/MedAgent-Pro.

Inspired by the superior language abilities of large language models (LLM), large vision-language models (LVLM) have been recently explored by integrating powerful LLMs for improving the performance on complex multimodal tasks. Despite the promising progress on LVLMs, we find that LVLMs suffer from the hallucination problem, i.e. they tend to generate objects that are inconsistent with the target images in the descriptions. To investigate it, this work presents the first systematic study on object hallucination of LVLMs. We conduct the evaluation experiments on several representative LVLMs, and show that they mostly suffer from severe object hallucination issue. We further discuss that the visual instructions may influence the hallucination, and find that: objects that frequently occur in the visual instructions or co-occur with the image objects, are obviously prone to be hallucinated by LVLMs. Besides, we find that existing evaluation methods might be affected by the input instructions and generation styles of LVLMs. Thus, we further design an improved evaluation method for object hallucination by proposing a polling-based query method called POPE. Experiment results demonstrate that our POPE can evaluate the object hallucination in a more stable and flexible way. Our codes and data are publicly available at https://github.com/RUCAIBox/POPE.

Assessing whether an article supports an assertion is essential for hallucination detection and claim verification. While large language models (LLMs) have the potential to automate this task, achieving strong performance requires frontier models such as GPT-5 that are prohibitively expensive to deploy at scale. To efficiently perform biomedical evidence attribution, we present Med-V1, a family of small language models with only three billion parameters. Trained on high-quality synthetic data newly developed in this study, Med-V1 substantially outperforms (+27.0% to +71.3%) its base models on five biomedical benchmarks unified into a verification format. Despite its smaller size, Med-V1 performs comparably to frontier LLMs such as GPT-5, along with high-quality explanations for its predictions. We use Med-V1 to conduct a first-of-its-kind use case study that quantifies hallucinations in LLM-generated answers under different citation instructions. Results show that the format instruction strongly affects citation validity and hallucination, with GPT-5 generating more claims but exhibiting hallucination rates similar to GPT-4o. Additionally, we present a second use case showing that Med-V1 can automatically identify high-stakes evidence misattributions in clinical practice guidelines, revealing potentially negative public health impacts that are otherwise challenging to identify at scale. Overall, Med-V1 provides an efficient and accurate lightweight alternative to frontier LLMs for practical and real-world applications in biomedical evidence attribution and verification tasks. Med-V1 is available at https://github.com/ncbi-nlp/Med-V1.

Hallucinations in vision-language models pose a significant challenge to their reliability, particularly in the generation of long captions. Current methods fall short of accurately identifying and mitigating these hallucinations. To address this issue, we introduce ESREAL, a novel unsupervised learning framework designed to suppress the generation of hallucinations through accurate localization and penalization of hallucinated tokens. Initially, ESREAL creates a reconstructed image based on the generated caption and aligns its corresponding regions with those of the original image. This semantic reconstruction aids in identifying both the presence and type of token-level hallucinations within the generated caption. Subsequently, ESREAL computes token-level hallucination scores by assessing the semantic similarity of aligned regions based on the type of hallucination. Finally, ESREAL employs a proximal policy optimization algorithm, where it selectively penalizes hallucinated tokens according to their token-level hallucination scores. Our framework notably reduces hallucinations in LLaVA, InstructBLIP, and mPLUG-Owl2 by 32.81%, 27.08%, and 7.46% on the CHAIR metric. This improvement is achieved solely through signals derived from the image itself, without the need for any image-text pairs.

Despite the rapid success of Large Vision-Language Models (LVLMs), a persistent challenge is their tendency to generate hallucinated content, undermining reliability in real-world use. Existing training-free methods address hallucinations but face two limitations: (i) they rely on narrow assumptions about hallucination sources, and (ii) their effectiveness declines toward the end of generation, where hallucinations are most likely to occur. A common strategy is to build hallucinated models by completely or partially removing visual tokens and contrasting them with the original model. Yet, this alone proves insufficient, since visual information still propagates into generated text. Building on this insight, we propose a novel hallucinated model that captures hallucination effects by selectively removing key text tokens. We further introduce Generalized Contrastive Decoding, which integrates multiple hallucinated models to represent diverse hallucination sources. Together, these ideas form CRoPS, a training-free hallucination mitigation framework that improves CHAIR scores by 20% and achieves consistent gains across six benchmarks and three LVLM families, outperforming state-of-the-art training-free methods.

Large Vision-Language Models (LVLMs) are increasingly adept at generating contextually detailed and coherent responses from visual inputs. However, their application in multimodal decision-making and open-ended generation is hindered by a notable rate of hallucinations, where generated text inaccurately represents the visual contents. To address this issue, this paper introduces the Instruction Contrastive Decoding (ICD) method, a novel approach designed to reduce hallucinations during LVLM inference. Our method is inspired by our observation that what we call disturbance instructions significantly exacerbate hallucinations in multimodal fusion modules. ICD contrasts distributions from standard and instruction disturbance, thereby increasing alignment uncertainty and effectively subtracting hallucinated concepts from the original distribution. Through comprehensive experiments on discriminative benchmarks (POPE and MME) and a generative benchmark (LLaVa-Bench), we demonstrate that ICD significantly mitigates both object-level and attribute-level hallucinations. Moreover, our method not only addresses hallucinations but also significantly enhances the general perception and recognition capabilities of LVLMs.

Instruction-following Vision Large Language Models (VLLMs) have achieved significant progress recently on a variety of tasks. These approaches merge strong pre-trained vision models and large language models (LLMs). Since these components are trained separately, the learned representations need to be aligned with joint training on additional image-language pairs. This procedure is not perfect and can cause the model to hallucinate - provide answers that do not accurately reflect the image, even when the core LLM is highly factual and the vision backbone has sufficiently complete representations. In this work, we frame the hallucination problem as an alignment issue, tackle it with preference tuning. Specifically, we propose POVID to generate feedback data with AI models. We use ground-truth instructions as the preferred response and a two-stage approach to generate dispreferred data. First, we prompt GPT-4V to inject plausible hallucinations into the correct answer. Second, we distort the image to trigger the inherent hallucination behavior of the VLLM. This is an automated approach, which does not rely on human data generation or require a perfect expert, which makes it easily scalable. Finally, both of these generation strategies are integrated into an RLHF pipeline via Direct Preference Optimization. In experiments across broad benchmarks, we show that we can not only reduce hallucinations, but improve model performance across standard benchmarks, outperforming prior approaches. Our data and code are available at https://github.com/YiyangZhou/POVID.

Despite their impressive capabilities, large language models (LLMs) have been observed to generate responses that include inaccurate or fabricated information, a phenomenon commonly known as ``hallucination''. In this work, we propose a simple Induce-then-Contrast Decoding (ICD) strategy to alleviate hallucinations. We first construct a factually weak LLM by inducing hallucinations from the original LLMs. Then, we penalize these induced hallucinations during decoding to enhance the factuality of the generated content. Concretely, we determine the final next-token predictions by amplifying the predictions from the original model and downplaying the induced untruthful predictions via contrastive decoding. Experimental results on both discrimination-based and generation-based hallucination evaluation benchmarks, such as TruthfulQA and FActScore, demonstrate that our proposed ICD methods can effectively enhance the factuality of LLMs across various model sizes and families. For example, when equipped with ICD, Llama2-7B-Chat and Mistral-7B-Instruct achieve performance comparable to ChatGPT and GPT4 on TruthfulQA, respectively.

Recent advancements in Multimodal Large Language Models (MLLMs) have extended their capabilities to video understanding. Yet, these models are often plagued by "hallucinations", where irrelevant or nonsensical content is generated, deviating from the actual video context. This work introduces VideoHallucer, the first comprehensive benchmark for hallucination detection in large video-language models (LVLMs). VideoHallucer categorizes hallucinations into two main types: intrinsic and extrinsic, offering further subcategories for detailed analysis, including object-relation, temporal, semantic detail, extrinsic factual, and extrinsic non-factual hallucinations. We adopt an adversarial binary VideoQA method for comprehensive evaluation, where pairs of basic and hallucinated questions are crafted strategically. By evaluating eleven LVLMs on VideoHallucer, we reveal that i) the majority of current models exhibit significant issues with hallucinations; ii) while scaling datasets and parameters improves models' ability to detect basic visual cues and counterfactuals, it provides limited benefit for detecting extrinsic factual hallucinations; iii) existing models are more adept at detecting facts than identifying hallucinations. As a byproduct, these analyses further instruct the development of our self-PEP framework, achieving an average of 5.38% improvement in hallucination resistance across all model architectures.

Object hallucination is a critical issue in Large Vision-Language Models (LVLMs), where outputs include objects that do not appear in the input image. A natural question arises from this phenomenon: Which component of the LVLM pipeline primarily contributes to object hallucinations? The vision encoder to perceive visual information, or the language decoder to generate text responses? In this work, we strive to answer this question through designing a systematic experiment to analyze the roles of the vision encoder and the language decoder in hallucination generation. Our observations reveal that object hallucinations are predominantly associated with the strong priors from the language decoder. Based on this finding, we propose a simple and training-free framework, No-Language-Hallucination Decoding, NoLan, which refines the output distribution by dynamically suppressing language priors, modulated based on the output distribution difference between multimodal and text-only inputs. Experimental results demonstrate that NoLan effectively reduces object hallucinations across various LVLMs on different tasks. For instance, NoLan achieves substantial improvements on POPE, enhancing the accuracy of LLaVA-1.5 7B and Qwen-VL 7B by up to 6.45 and 7.21, respectively. The code is publicly available at: https://github.com/lingfengren/NoLan.

Reinforcement learning (RL) is increasingly used to post-train medical Vision-Language Models (VLMs), yet it remains unclear whether RL improves medical visual reasoning or mainly sharpens behaviors already induced by supervised fine-tuning (SFT). We present a controlled study that disentangles these effects along three axes: vision, SFT, and RL. Using MedMNIST as a multi-modality testbed, we probe visual perception by benchmarking VLM vision towers against vision-only baselines, quantify reasoning support and sampling efficiency via Accuracy@1 versus Pass@K, and evaluate when RL closes the support gap and how gains transfer across modalities. We find that RL is most effective when the model already has non-trivial support (high Pass@K): it primarily sharpens the output distribution, improving Acc@1 and sampling efficiency, while SFT expands support and makes RL effective. Based on these findings, we propose a boundary-aware recipe and instantiate it by RL post-training an OctoMed-initialized model on a small, balanced subset of PMC multiple-choice VQA, achieving strong average performance across six medical VQA benchmarks.

Complex visual reasoning remains a key challenge today. Typically, the challenge is tackled using methodologies such as Chain of Thought (COT) and visual instruction tuning. However, how to organically combine these two methodologies for greater success remains unexplored. Also, issues like hallucinations and high training cost still need to be addressed. In this work, we devise an innovative multi-round training and reasoning framework suitable for lightweight Multimodal Large Language Models (MLLMs). Our self-questioning approach heuristically guides MLLMs to focus on visual clues relevant to the target problem, reducing hallucinations and enhancing the model's ability to describe fine-grained image details. This ultimately enables the model to perform well in complex visual reasoning and question-answering tasks. We have named this framework Socratic Questioning(SQ). To facilitate future research, we create a multimodal mini-dataset named CapQA, which includes 1k images of fine-grained activities, for visual instruction tuning and evaluation, our proposed SQ method leads to a 31.2% improvement in the hallucination score. Our extensive experiments on various benchmarks demonstrate SQ's remarkable capabilities in heuristic self-questioning, zero-shot visual reasoning and hallucination mitigation. Our model and code will be publicly available.

Recent advancements in Large Vision Language Models (LVLMs) have revolutionized how machines understand and generate textual responses based on visual inputs. Despite their impressive capabilities, they often produce "hallucinatory" outputs that do not accurately reflect the visual information, posing challenges in reliability and trustworthiness. Current methods such as contrastive decoding have made strides in addressing these issues by contrasting the original probability distribution of generated tokens with distorted counterparts; yet, generating visually-faithful outputs remains a challenge. In this work, we shift our focus to the opposite: What could serve as a complementary enhancement to the original probability distribution? We propose a simple, training-free method termed RITUAL to enhance robustness against hallucinations in LVLMs. Our approach employs random image transformations as complements to the original probability distribution, aiming to mitigate the likelihood of hallucinatory visual explanations by enriching the model's exposure to varied visual scenarios. Our empirical results show that while the isolated use of transformed images initially degrades performance, strategic implementation of these transformations can indeed serve as effective complements. Notably, our method is compatible with current contrastive decoding methods and does not require external models or costly self-feedback mechanisms, making it a practical addition. In experiments, RITUAL significantly outperforms existing contrastive decoding methods across several object hallucination benchmarks, including POPE, CHAIR, and MME.

Object hallucination in Large Vision-Language Models (LVLMs) significantly impedes their real-world applicability. As the primary component for accurately interpreting visual information, the choice of visual encoder is pivotal. We hypothesize that the diverse training paradigms employed by different visual encoders instill them with distinct inductive biases, which leads to their diverse hallucination performances. Existing benchmarks typically focus on coarse-grained hallucination detection and fail to capture the diverse hallucinations elaborated in our hypothesis. To systematically analyze these effects, we introduce VHBench-10, a comprehensive benchmark with approximately 10,000 samples for evaluating LVLMs across ten fine-grained hallucination categories. Our evaluations confirm encoders exhibit unique hallucination characteristics. Building on these insights and the suboptimality of simple feature fusion, we propose VisionWeaver, a novel Context-Aware Routing Network. It employs global visual features to generate routing signals, dynamically aggregating visual features from multiple specialized experts. Comprehensive experiments confirm the effectiveness of VisionWeaver in significantly reducing hallucinations and improving overall model performance.

Multi-Agent System (MAS) powered by Visual Language Models (VLMs) enables challenging tasks but suffers from a novel failure term, multi-agent visual hallucination snowballing, where hallucinations are seeded in a single agent and amplified by following ones due to the over-reliance on textual flow to relay visual information. Through turn-, layer-, and token-wise attention analyses, we provide detailed insights into the essence of hallucination snowballing regarding the reduction of visual attention allocation. It leads us to identify a subset of vision tokens with a unimodal attention peak in middle layers that best preserve visual evidence but gradually diminish in deeper agent turns, resulting in the visual hallucination snowballing in MAS. Thus, we propose ViF, a lightweight, plug-and-play mitigation paradigm that relays inter-agent messages with Visual Flow powered by the selected visual relay tokens and applies attention reallocation to amplify this pattern. The experiment results demonstrate that our method markedly reduces hallucination snowballing, consistently improving the performance across eight benchmarks based on four common MAS structures and ten base models. The source code will be available at: https://github.com/YU-deep/ViF.git.

Reinforcement learning (RL) has shown great effectiveness for fine-tuning large language models (LLMs) using tasks that are challenging yet easily verifiable, such as math reasoning or code generation. However, extending this success to visual perception in vision-language models (VLMs) has been impeded by the scarcity of vision-centric tasks that are simultaneously challenging and unambiguously verifiable. To this end, we introduce ViCrit (Visual Caption Hallucination Critic), an RL proxy task that trains VLMs to localize a subtle, synthetic visual hallucination injected into paragraphs of human-written image captions. Starting from a 200-word captions, we inject a single, subtle visual description error-altering a few words on objects, attributes, counts, or spatial relations-and task the model to pinpoint the corrupted span given the image and the modified caption. This formulation preserves the full perceptual difficulty while providing a binary, exact-match reward that is easy to compute and unambiguous. Models trained with the ViCrit Task exhibit substantial gains across a variety of VL benchmarks. Crucially, the improvements transfer beyond natural-image training data to abstract image reasoning and visual math, showing promises of learning to perceive rather than barely memorizing seen objects. To facilitate evaluation, we further introduce ViCrit-Bench, a category-balanced diagnostic benchmark that systematically probes perception errors across diverse image domains and error types. Together, our results demonstrate that fine-grained hallucination criticism is an effective and generalizable objective for enhancing visual perception in VLMs.

Recent progress in vision-language segmentation has significantly advanced grounded visual understanding. However, these models often exhibit hallucinations by producing segmentation masks for objects not grounded in the image content or by incorrectly labeling irrelevant regions. Existing evaluation protocols for segmentation hallucination primarily focus on label or textual hallucinations without manipulating the visual context, limiting their capacity to diagnose critical failures. In response, we introduce HalluSegBench, the first benchmark specifically designed to evaluate hallucinations in visual grounding through the lens of counterfactual visual reasoning. Our benchmark consists of a novel dataset of 1340 counterfactual instance pairs spanning 281 unique object classes, and a set of newly introduced metrics that quantify hallucination sensitivity under visually coherent scene edits. Experiments on HalluSegBench with state-of-the-art vision-language segmentation models reveal that vision-driven hallucinations are significantly more prevalent than label-driven ones, with models often persisting in false segmentation, highlighting the need for counterfactual reasoning to diagnose grounding fidelity.

Large vision language models have demonstrated remarkable efficacy in addressing challenges related to both textual and visual content. Nevertheless, these models are susceptible to various hallucinations. In this paper, we focus on a new form of hallucination, specifically termed as number hallucination, which denotes instances where models fail to accurately identify the quantity of objects in an image. We establish a dataset and employ evaluation metrics to assess number hallucination, revealing a pronounced prevalence of this issue across mainstream large vision language models (LVLMs). Additionally, we delve into a thorough analysis of number hallucination, examining inner and outer inconsistency problem from two related perspectives. We assert that this inconsistency is one cause of number hallucination and propose a consistency training method as a means to alleviate such hallucination, which achieves an average improvement of 8\% compared with direct finetuning method.

In this paper, we focus on the problem of Medical Visual Question Answering (MedVQA), which is crucial in efficiently interpreting medical images with vital clinic-relevant information. Firstly, we reframe the problem of MedVQA as a generation task that naturally follows the human-machine interaction, we propose a generative-based model for medical visual understanding by aligning visual information from a pre-trained vision encoder with a large language model. Secondly, we establish a scalable pipeline to construct a large-scale medical visual question-answering dataset, named PMC-VQA, which contains 227k VQA pairs of 149k images that cover various modalities or diseases. Thirdly, we pre-train our proposed model on PMC-VQA and then fine-tune it on multiple public benchmarks, e.g., VQA-RAD and SLAKE, outperforming existing work by a large margin. Additionally, we propose a test set that has undergone manual verification, which is significantly more challenging, even the best models struggle to solve.

Hallucinations in large vision-language models (LVLMs) are a significant challenge, i.e., generating objects that are not presented in the visual input, which impairs their reliability. Recent studies often attribute hallucinations to a lack of understanding of visual input, yet ignore a more fundamental issue: the model's inability to effectively extract or decouple visual features. In this paper, we revisit the hallucinations in LVLMs from an architectural perspective, investigating whether the primary cause lies in the visual encoder (feature extraction) or the modal alignment module (feature decoupling). Motivated by our findings on the preliminary investigation, we propose a novel tuning strategy, PATCH, to mitigate hallucinations in LVLMs. This plug-and-play method can be integrated into various LVLMs, utilizing adaptive virtual tokens to extract object features from bounding boxes, thereby addressing hallucinations caused by insufficient decoupling of visual features. PATCH achieves state-of-the-art performance on multiple multi-modal hallucination datasets. We hope this approach provides researchers with deeper insights into the underlying causes of hallucinations in LVLMs, fostering further advancements and innovation in this field.

Despite the outstanding performance in vision-language reasoning, Large Vision-Language Models (LVLMs) might generate hallucinated contents that do not exist in the given image. Most existing LVLM hallucination benchmarks are constrained to evaluate the object-related hallucinations. However, the potential hallucination on the relations between two objects, i.e., relation hallucination, still lacks investigation. To remedy that, in this paper we design a unified framework to measure object and relation hallucination in LVLMs simultaneously. The core idea of our framework is to conduct hallucination evaluation on (object, relation, object) triplets extracted from LVLMs' responses, and thus, could be easily generalized to different vision-language tasks. Based on our framework, we further introduce Tri-HE, a novel Triplet-level Hallucination Evaluation benchmark which can be used to study both object and relation hallucination at the same time. We conduct comprehensive evaluations on Tri-HE and observe that the relation hallucination issue is even more serious than object hallucination among existing LVLMs, highlighting a previously neglected problem towards reliable LVLMs. Moreover, based on our findings, we design a simple yet effective training-free approach to mitigate hallucinations for LVLMs, with which, we exceed all open-sourced counterparts on Tri-HE, achieving comparable performance with the powerful GPT-4V. Our dataset and code for the reproduction of our experiments are available publicly at https://github.com/wujunjie1998/Tri-HE.

Large vision language models (LVLMs) often suffer from object hallucination, producing objects not present in the given images. While current benchmarks for object hallucination primarily concentrate on the presence of a single object class rather than individual entities, this work systematically investigates multi-object hallucination, examining how models misperceive (e.g., invent nonexistent objects or become distracted) when tasked with focusing on multiple objects simultaneously. We introduce Recognition-based Object Probing Evaluation (ROPE), an automated evaluation protocol that considers the distribution of object classes within a single image during testing and uses visual referring prompts to eliminate ambiguity. With comprehensive empirical studies and analysis of potential factors leading to multi-object hallucination, we found that (1) LVLMs suffer more hallucinations when focusing on multiple objects compared to a single object. (2) The tested object class distribution affects hallucination behaviors, indicating that LVLMs may follow shortcuts and spurious correlations.(3) Hallucinatory behaviors are influenced by data-specific factors, salience and frequency, and model intrinsic behaviors. We hope to enable LVLMs to recognize and reason about multiple objects that often occur in realistic visual scenes, provide insights, and quantify our progress towards mitigating the issues.

Large vision-language models (LVLMs) suffer from hallucination, resulting in misalignment between the output textual response and the input visual content. Recent research indicates that the over-reliance on the Large Language Model (LLM) backbone, as one cause of the LVLM hallucination, inherently introduces bias from language priors, leading to insufficient context attention to the visual inputs. We tackle this issue of hallucination by mitigating such over-reliance through preference learning. We propose Vision-guided Direct Preference Optimization (V-DPO) to enhance visual context learning at training time. To interpret the effectiveness and generalizability of V-DPO on different types of training data, we construct a synthetic dataset containing both response- and image-contrast preference pairs, compared against existing human-annotated hallucination samples. Our approach achieves significant improvements compared with baseline methods across various hallucination benchmarks. Our analysis indicates that V-DPO excels in learning from image-contrast preference data, demonstrating its superior ability to elicit and understand nuances of visual context. Our code is publicly available at https://github.com/YuxiXie/V-DPO.

Multimodal large language models (MLLMs) have advanced the integration of visual and linguistic modalities, establishing themselves as the dominant paradigm for visual-language tasks. Current approaches like chain of thought (CoT) reasoning have augmented the cognitive capabilities of large language models (LLMs), yet their adaptation to MLLMs is hindered by heightened risks of hallucination in cross-modality comprehension. In this paper, we find that the thinking while looking paradigm in current multimodal CoT approaches--where reasoning chains are generated alongside visual input--fails to mitigate hallucinations caused by misleading images. To address these limitations, we propose the Visual Inference Chain (VIC) framework, a novel approach that constructs reasoning chains using textual context alone before introducing visual input, effectively reducing cross-modal biases and enhancing multimodal reasoning accuracy. Comprehensive evaluations demonstrate that VIC significantly improves zero-shot performance across various vision-related tasks, mitigating hallucinations while refining the reasoning capabilities of MLLMs. Our code repository can be found at https://github.com/Terry-Xu-666/visual_inference_chain.

Hallucination is a well-known phenomenon in text generated by large language models (LLMs). The existence of hallucinatory responses is found in almost all application scenarios e.g., summarization, question-answering (QA) etc. For applications requiring high reliability (e.g., customer-facing assistants), the potential existence of hallucination in LLM-generated text is a critical problem. The amount of hallucination can be reduced by leveraging information retrieval to provide relevant background information to the LLM. However, LLMs can still generate hallucinatory content for various reasons (e.g., prioritizing its parametric knowledge over the context, failure to capture the relevant information from the context, etc.). Detecting hallucinations through automated methods is thus paramount. To facilitate research in this direction, we introduce a sophisticated dataset, DelucionQA, that captures hallucinations made by retrieval-augmented LLMs for a domain-specific QA task. Furthermore, we propose a set of hallucination detection methods to serve as baselines for future works from the research community. Analysis and case study are also provided to share valuable insights on hallucination phenomena in the target scenario.

As large language models (LLMs) become increasingly deployed across various industries, concerns regarding their reliability, particularly due to hallucinations-outputs that are factually inaccurate or irrelevant to user input-have grown. Our research investigates the relationship between the training process and the emergence of hallucinations to address a key gap in existing research that focuses primarily on post hoc detection and mitigation strategies. Using models from the Pythia suite (70M-12B parameters) and several hallucination detection metrics, we analyze hallucination trends throughout training and explore LLM internal dynamics. We introduce SEnsitive Neuron Dropout (SeND), a novel training protocol designed to mitigate hallucinations by reducing variance during training. SeND achieves this by deterministically dropping neurons with significant variability on a dataset, referred to as Sensitive Neurons. In addition, we develop an unsupervised hallucination detection metric, Efficient EigenScore (EES), which approximates the traditional EigenScore in 2x speed. This efficient metric is integrated into our protocol, allowing SeND to be both computationally scalable and effective at reducing hallucinations. Our empirical evaluation demonstrates that our approach improves LLM reliability at test time by up to 40% compared to normal training while also providing an efficient method to improve factual accuracy when adapting LLMs to domains such as Wikipedia and Medical datasets.

Hallucinations in Large Language Model (LLM) outputs for Question Answering (QA) tasks can critically undermine their real-world reliability. This paper introduces a methodology for robust, one-shot hallucination detection, specifically designed for scenarios with limited data access, such as interacting with black-box LLM APIs that typically expose only a few top candidate log-probabilities per token. Our approach derives uncertainty indicators directly from these readily available log-probabilities generated during non-greedy decoding. We first derive an Entropy Production Rate (EPR) that offers baseline performance, later augmented with supervised learning. Our learned model leverages the entropic contributions of the accessible top-ranked tokens within a single generated sequence, without multiple re-runs per query. Evaluated across diverse QA datasets and multiple LLMs, this estimator significantly improves token-level hallucination detection over state-of-the-art methods. Crucially, high performance is demonstrated using only the typically small set of available log-probabilities (e.g., top-10 per token), confirming its practical efficiency and suitability for API-constrained deployments. This work provides a lightweight technique to enhance the trustworthiness of LLM responses, at the token level, after a single generation pass, for QA and Retrieval-Augmented Generation (RAG) systems. Our experiments confirmed the performance of our method against existing approaches on public dataset as well as for a financial framework analyzing annual company reports.

Current vision-language models (VLMs) in medicine are primarily designed for categorical question answering (e.g., "Is this normal or abnormal?") or qualitative descriptive tasks. However, clinical decision-making often relies on quantitative assessments, such as measuring the size of a tumor or the angle of a joint, from which physicians draw their own diagnostic conclusions. This quantitative reasoning capability remains underexplored and poorly supported in existing VLMs. In this work, we introduce MedVision, a large-scale dataset and benchmark specifically designed to evaluate and improve VLMs on quantitative medical image analysis. MedVision spans 22 public datasets covering diverse anatomies and modalities, with 30.8 million image-annotation pairs. We focus on three representative quantitative tasks: (1) detection of anatomical structures and abnormalities, (2) tumor/lesion (T/L) size estimation, and (3) angle/distance (A/D) measurement. Our benchmarks show that current off-the-shelf VLMs perform poorly on these tasks. However, with supervised fine-tuning on MedVision, we significantly enhance their performance across detection, T/L estimation, and A/D measurement, demonstrating reduced error rates and improved precision. This work provides a foundation for developing VLMs with robust quantitative reasoning capabilities in medical imaging. Code and data are available at https://medvision-vlm.github.io.

Artificial Intelligence (AI) has demonstrated significant potential in healthcare, particularly in disease diagnosis and treatment planning. Recent progress in Medical Large Vision-Language Models (Med-LVLMs) has opened up new possibilities for interactive diagnostic tools. However, these models often suffer from factual hallucination, which can lead to incorrect diagnoses. Fine-tuning and retrieval-augmented generation (RAG) have emerged as methods to address these issues. However, the amount of high-quality data and distribution shifts between training data and deployment data limit the application of fine-tuning methods. Although RAG is lightweight and effective, existing RAG-based approaches are not sufficiently general to different medical domains and can potentially cause misalignment issues, both between modalities and between the model and the ground truth. In this paper, we propose a versatile multimodal RAG system, MMed-RAG, designed to enhance the factuality of Med-LVLMs. Our approach introduces a domain-aware retrieval mechanism, an adaptive retrieved contexts selection method, and a provable RAG-based preference fine-tuning strategy. These innovations make the RAG process sufficiently general and reliable, significantly improving alignment when introducing retrieved contexts. Experimental results across five medical datasets (involving radiology, ophthalmology, pathology) on medical VQA and report generation demonstrate that MMed-RAG can achieve an average improvement of 43.8% in the factual accuracy of Med-LVLMs. Our data and code are available in https://github.com/richard-peng-xia/MMed-RAG.

Aligning large language models (LLMs) to accurately detect hallucinations remains a significant challenge due to the sophisticated nature of hallucinated text. Recognizing that hallucinated samples typically exhibit higher deceptive quality than traditional negative samples, we use these carefully engineered hallucinations as negative examples in the DPO alignment procedure. Our method incorporates a curriculum learning strategy, gradually transitioning the training from easier samples, identified based on the greatest reduction in probability scores from independent fact checking models, to progressively harder ones. This structured difficulty scaling ensures stable and incremental learning. Experimental evaluation demonstrates that our HaluCheck models, trained with curriculum DPO approach and high quality negative samples, significantly improves model performance across various metrics, achieving improvements of upto 24% on difficult benchmarks like MedHallu and HaluEval. Additionally, HaluCheck models demonstrate robustness in zero-shot settings, significantly outperforming larger state-of-the-art models across various benchmarks.

Multimodal Large Language Models (MLLMs) have achieved impressive advances, yet object hallucination remains a persistent challenge. Existing methods, based on the flawed assumption that omission and fabrication hallucinations share a common cause, often reduce omissions only to trigger more fabrications. In this work, we overturn this view by demonstrating that omission hallucinations arise from insufficient confidence when mapping perceived visual features to linguistic expressions, whereas fabrication hallucinations result from spurious associations within the cross-modal representation space due to statistical biases in the training corpus. Building on findings from visual attention intervention experiments, we propose the Visual-Semantic Attention Potential Field, a conceptual framework that reveals how the model constructs visual evidence to infer the presence or absence of objects. Leveraging this insight, we introduce Visual Potential Field Calibration (VPFC), a plug-and-play hallucination mitigation method that effectively reduces omission hallucinations without introducing additional fabrication hallucinations. Our findings reveal a critical oversight in current object hallucination research and chart new directions for developing more robust and balanced hallucination mitigation strategies.

Large Vision-Language Models (LVLMs) may produce outputs that are unfaithful to reality, also known as visual hallucinations (VH), which significantly impedes their real-world usage. To alleviate VH, various decoding strategies have been proposed to enhance visual information. However, many of these methods may require secondary decoding and rollback, which significantly reduces inference speed. In this work, we propose an efficient plug-and-play decoding algorithm via Visual-Aware Sparsification (VASparse) from the perspective of token sparsity for mitigating VH. VASparse is inspired by empirical observations: (1) the sparse activation of attention in LVLMs, and (2) visual-agnostic tokens sparsification exacerbates VH. Based on these insights, we propose a novel token sparsification strategy that balances efficiency and trustworthiness. Specifically, VASparse implements a visual-aware token selection strategy during decoding to reduce redundant tokens while preserving visual context effectively. Additionally, we innovatively introduce a sparse-based visual contrastive decoding method to recalibrate the distribution of hallucinated outputs without the time overhead associated with secondary decoding. Subsequently, VASparse recalibrates attention scores to penalize attention sinking of LVLMs towards text tokens. Extensive experiments across four popular benchmarks confirm the effectiveness of VASparse in mitigating VH across different LVLM families without requiring additional training or post-processing. Impressively, VASparse achieves state-of-the-art performance for mitigating VH while maintaining competitive decoding speed. Code is available at https://github.com/mengchuang123/VASparse-github.

Response consistency-based, reference-free hallucination detection (RFHD) methods do not depend on internal model states, such as generation probabilities or gradients, which Grey-box models typically rely on but are inaccessible in closed-source LLMs. However, their inability to capture query-response alignment patterns often results in lower detection accuracy. Additionally, the lack of large-scale benchmark datasets spanning diverse domains remains a challenge, as most existing datasets are limited in size and scope. To this end, we propose HalluCounter, a novel reference-free hallucination detection method that utilizes both response-response and query-response consistency and alignment patterns. This enables the training of a classifier that detects hallucinations and provides a confidence score and an optimal response for user queries. Furthermore, we introduce HalluCounterEval, a benchmark dataset comprising both synthetically generated and human-curated samples across multiple domains. Our method outperforms state-of-the-art approaches by a significant margin, achieving over 90\% average confidence in hallucination detection across datasets.

In this work, we identify an inherent bias in prevailing LVLM architectures toward the language modality, largely resulting from the common practice of simply appending visual embeddings to the input text sequence. To address this, we propose a simple yet effective method that refines textual embeddings by integrating average-pooled visual features. Our approach demonstrably improves visual grounding and significantly reduces hallucinations on established benchmarks. While average pooling offers a straightforward, robust, and efficient means of incorporating visual information, we believe that more sophisticated fusion methods could further enhance visual grounding and cross-modal alignment. Given that the primary focus of this work is to highlight the modality imbalance and its impact on hallucinations -- and to show that refining textual embeddings with visual information mitigates this issue -- we leave exploration of advanced fusion strategies for future work.

The surge in applications of large language models (LLMs) has prompted concerns about the generation of misleading or fabricated information, known as hallucinations. Therefore, detecting hallucinations has become critical to maintaining trust in LLM-generated content. A primary challenge in learning a truthfulness classifier is the lack of a large amount of labeled truthful and hallucinated data. To address the challenge, we introduce HaloScope, a novel learning framework that leverages the unlabeled LLM generations in the wild for hallucination detection. Such unlabeled data arises freely upon deploying LLMs in the open world, and consists of both truthful and hallucinated information. To harness the unlabeled data, we present an automated membership estimation score for distinguishing between truthful and untruthful generations within unlabeled mixture data, thereby enabling the training of a binary truthfulness classifier on top. Importantly, our framework does not require extra data collection and human annotations, offering strong flexibility and practicality for real-world applications. Extensive experiments show that HaloScope can achieve superior hallucination detection performance, outperforming the competitive rivals by a significant margin. Code is available at https://github.com/deeplearningwisc/haloscope.

Multi-modal Large Language Models (MLLMs) tuned on machine-generated instruction-following data have demonstrated remarkable performance in various multi-modal understanding and generation tasks. However, the hallucinations inherent in machine-generated data, which could lead to hallucinatory outputs in MLLMs, remain under-explored. This work aims to investigate various hallucinations (i.e., object, relation, attribute hallucinations) and mitigate those hallucinatory toxicities in large-scale machine-generated visual instruction datasets. Drawing on the human ability to identify factual errors, we present a novel hallucination detection and elimination framework, HalluciDoctor, based on the cross-checking paradigm. We use our framework to identify and eliminate hallucinations in the training data automatically. Interestingly, HalluciDoctor also indicates that spurious correlations arising from long-tail object co-occurrences contribute to hallucinations. Based on that, we execute counterfactual visual instruction expansion to balance data distribution, thereby enhancing MLLMs' resistance to hallucinations. Comprehensive experiments on hallucination evaluation benchmarks show that our method successfully mitigates 44.6% hallucinations relatively and maintains competitive performance compared to LLaVA.The source code will be released at https://github.com/Yuqifan1117/HalluciDoctor.

Large vision-language models (LVLMs) remain vulnerable to hallucination, often generating content misaligned with visual inputs. While recent approaches advance multi-modal Direct Preference Optimization (DPO) to mitigate hallucination, they typically rely on predefined or randomly edited negative samples that fail to reflect actual model errors, limiting training efficacy. In this work, we propose an Online Vision-language Preference Learning (OViP) framework that dynamically constructs contrastive training data based on the model's own hallucinated outputs. By identifying semantic differences between sampled response pairs and synthesizing negative images using a diffusion model, OViP generates more relevant supervision signals in real time. This failure-driven training enables adaptive alignment of both textual and visual preferences. Moreover, we refine existing evaluation protocols to better capture the trade-off between hallucination suppression and expressiveness. Experiments on hallucination and general benchmarks demonstrate that OViP effectively reduces hallucinations while preserving core multi-modal capabilities.

Vision-language models (VLMs) have demonstrated remarkable potential in integrating visual and linguistic information, but their performance is often constrained by the need for extensive, high-quality image-text training data. Curation of these image-text pairs is both time-consuming and computationally expensive. To address this challenge, we introduce SVP (Sampling-based Visual Projection), a novel framework that enhances vision-language alignment without relying on manually curated text-image pairs or preference annotation. SVP leverages a small set of manually selected images, self-captioning and a pre-trained grounding model as a feedback mechanism to elicit latent information in VLMs. We evaluate our approach across six key areas: captioning, referring, visual question answering, multitasking, hallucination control, and object recall. Results demonstrate significant improvements, including a 14 % average improvement in captioning tasks, up to 12 % increase in object recall, and significantly reduced hallucinations, while maintaining question-answering capabilities. Using SVP, a small VLM achieves hallucination reductions similar to a model five times larger, while a VLM with initially poor referring capabilities more than doubles its performance, approaching parity with a model twice its size.

While large vision-language models (LVLMs) have demonstrated impressive capabilities in interpreting multi-modal contexts, they invariably suffer from object hallucinations (OH). We introduce HALC, a novel decoding algorithm designed to mitigate OH in LVLMs. HALC leverages distinct fine-grained optimal visual information in vision-language tasks and operates on both local and global contexts simultaneously. Specifically, HALC integrates a robust auto-focal grounding mechanism (locally) to correct hallucinated tokens on the fly, and a specialized beam search algorithm (globally) to significantly reduce OH while preserving text generation quality. Additionally, HALC can be integrated into any LVLMs as a plug-and-play module without extra training. Extensive experimental studies demonstrate the effectiveness of HALC in reducing OH, outperforming state-of-the-arts across four benchmarks.

Hallucinations in large language model (LLM) outputs severely limit their reliability in knowledge-intensive tasks such as question answering. To address this challenge, we introduce REFIND (Retrieval-augmented Factuality hallucINation Detection), a novel framework that detects hallucinated spans within LLM outputs by directly leveraging retrieved documents. As part of the REFIND, we propose the Context Sensitivity Ratio (CSR), a novel metric that quantifies the sensitivity of LLM outputs to retrieved evidence. This innovative approach enables REFIND to efficiently and accurately detect hallucinations, setting it apart from existing methods. In the evaluation, REFIND demonstrated robustness across nine languages, including low-resource settings, and significantly outperformed baseline models, achieving superior IoU scores in identifying hallucinated spans. This work highlights the effectiveness of quantifying context sensitivity for hallucination detection, thereby paving the way for more reliable and trustworthy LLM applications across diverse languages.

The ability to accurately interpret complex visual information is a crucial topic of multimodal large language models (MLLMs). Recent work indicates that enhanced visual perception significantly reduces hallucinations and improves performance on resolution-sensitive tasks, such as optical character recognition and document analysis. A number of recent MLLMs achieve this goal using a mixture of vision encoders. Despite their success, there is a lack of systematic comparisons and detailed ablation studies addressing critical aspects, such as expert selection and the integration of multiple vision experts. This study provides an extensive exploration of the design space for MLLMs using a mixture of vision encoders and resolutions. Our findings reveal several underlying principles common to various existing strategies, leading to a streamlined yet effective design approach. We discover that simply concatenating visual tokens from a set of complementary vision encoders is as effective as more complex mixing architectures or strategies. We additionally introduce Pre-Alignment to bridge the gap between vision-focused encoders and language tokens, enhancing model coherence. The resulting family of MLLMs, Eagle, surpasses other leading open-source models on major MLLM benchmarks. Models and code: https://github.com/NVlabs/Eagle

Vision-Language Models (VLMs) often generate plausible but incorrect responses to visual queries. However, reliably quantifying the effect of such hallucinations in free-form responses to open-ended queries is challenging as it requires visually verifying each claim within the response. We propose Programmatic VLM Evaluation (PROVE), a new benchmarking paradigm for evaluating VLM responses to open-ended queries. To construct PROVE, we provide a large language model (LLM) with a high-fidelity scene-graph representation constructed from a hyper-detailed image caption, and prompt it to generate diverse question-answer (QA) pairs, as well as programs that can be executed over the scene graph object to verify each QA pair. We thus construct a benchmark of 10.5k challenging but visually grounded QA pairs. Next, to evaluate free-form model responses to queries in PROVE, we propose a programmatic evaluation strategy that measures both the helpfulness and truthfulness of a response within a unified scene graph-based framework. We benchmark the helpfulness-truthfulness trade-offs of a range of VLMs on PROVE, finding that very few are in-fact able to achieve a good balance between the two. Project page: https://prove-explorer.netlify.app/.

Hallucinations in large vision-language models (LVLMs) pose significant challenges for real-world applications, as LVLMs may generate responses that appear plausible yet remain inconsistent with the associated visual content. This issue rarely occurs in human cognition. We argue that this discrepancy arises from humans' ability to effectively leverage multimodal interaction information in data samples. Specifically, humans typically first gather multimodal information, analyze the interactions across modalities for understanding, and then express their understanding through language. Motivated by this observation, we conduct extensive experiments on popular LVLMs and obtained insights that surprisingly reveal human-like, though less pronounced, cognitive behavior of LVLMs on multimodal samples. Building on these findings, we further propose INTER: Interaction Guidance Sampling, a novel training-free algorithm that mitigate hallucinations without requiring additional data. Specifically, INTER explicitly guides LVLMs to effectively reapply their understanding of multimodal interaction information when generating responses, thereby reducing potential hallucinations. On six benchmarks including VQA and image captioning tasks, INTER achieves an average improvement of up to 3.4\% on five LVLMs compared to the state-of-the-art decoding strategy. The code will be released when the paper is accepted.