Large Language Models exhibit strong reasoning and semantic understanding capabilities but often hallucinate in domains that require expert knowledge, among which fabrications, the generation of factually incorrect yet fluent statements, pose the greatest risk in medical contexts. Existing medical hallucination datasets inadequately capture fabrication phenomena due to limited fabrication coverage, stylistic disparities between human and LLM-authored texts, and distributional drift during hallucinated sample synthesis. To address this, we propose a data-centric pipeline to generate realistic and word-level fabrications that preserve syntactic and stylistic fidelity while introducing subtle factual deviations, resulting in MedFabric. Building upon this dataset, we introduce ETHER, a modular word-level fabrication detector integrating Text2Table Decomposition, Word Masking and Filling and Hybrid Sentence Pair Evaluation to enhance factual alignment. Empirical results demonstrate that MedFabric outperforms state-of-the-art detectors by over 15% on word-level fabrication benchmarks while maintaining consistent performance across structural similarities, offering a comprehensive framework for reliable and domain-specific factuality detection.
Large language models (LLMs) can generate factually inconsistent claims, motivating accurate and scalable hallucination detectors. Prior work largely enlarges training sets via synthesis or new annotations, introducing increasing cost and potential bias while underusing the consistency implied by semantically equivalent paraphrases. We propose Consistency-Constrained Hallucination Detector (CCHD), which formulates training as a constrained optimization problem. The standard cross-entropy on original document-claim pairs is complemented by (i) paraphrase-consistency constraints bounding divergence across paraphrased views, and (ii) label-preservation constraints tying paraphrases to ground truth. We solve the problem by gradient descent-ascent over model parameters and per-view Lagrange multipliers, adding only a few scalar dual variables and no inference-time overhead. With DeBERTa and Flan-T5 backbones, CCHD consistently outperforms strong baselines (FactCG, MiniCheck, and AlignScore) on standard factuality benchmarks, demonstrating its superiority on hallucination detection.
Large language models (LLMs) hallucinate with confidence: their outputs can be fluent, authoritative, and simply wrong. In medical, legal, and scientific applications this failure causes direct harm, and detecting it from internal model states offers a path to safer deployment. A growing body of work reports that this problem is increasingly tractable, with recent methods achieving high detection performance on widely used benchmarks. We show, however, that much of this apparent progress does not survive scrutiny. Four of the six corpora embed the ground-truth answer directly in the input prompt. A naïve text-similarity baseline we call \textsc{TxTemb} exploits this to achieve near-perfect detection scores without any access to model internals. To measure what genuine detection capability remains once these artifacts are controlled, we conduct a large-scale evaluation spanning twenty-two detection methods, twelve open-source models spanning six architectural families, and six corpora. We further introduce \textbf{DRIFT}, a supervised probe over inter-layer hidden-state transitions, as a point of comparison for live-generation detection. Our findings suggest that the field's reported progress on hallucination detection is substantially explained by benchmark construction artifacts in widely used corpora, and that the majority of established baselines perform near chance under controlled conditions; the consistent exceptions are SAPLMA and DRIFT, both supervised probes on upper-layer hidden states.
Hallucinations in medical large language models (LLMs) pose serious risks for clinical decision support, particularly when models must reason over complex electronic health records (EHRs). However, existing benchmarks often lack a realistic clinical context and provide limited insight into how hallucinations can be mitigated in practice. We introduce Med-HEAL, a framework for systematically identifying, analyzing, and mitigating hallucinations in medical LLMs using clinically grounded data. Building on the EHRNoteQA benchmark derived from MIMIC-IV discharge summaries, we construct a hallucination dataset by evaluating BioMistral-7B on open-ended clinical question answering tasks. Model outputs are labeled through a dual evaluation pipeline that combines LLM-as-a-Judge assessment (GPT-4o) with human auditing by medical student reviewers, producing correctness judgments and annotations of reasoning errors via a custom web-based evaluation system. We then leverage this dataset to investigate mitigation strategies: a self-critique pipeline, in which the test model reviews its own answers to detect potential errors and regenerates responses for flagged cases, and retrieval-augmented in-context learning (RA-ICL), which exposes the model to hallucinated and corrected examples. Experiments across five open-source LLMs-BioMistral, Llama-3.1, DeepSeek, Qwen2.5, and Qwen3, show that the self-critique strategy improves accuracy for three of five models (p < 0.05) without requiring parameter updates. Med-HEAL provides both a reusable hallucination dataset and a practical framework for studying and mitigating hallucinations in medical LLMs, supporting safer deployment of AI systems in clinical environments. Our code and data are publicly available at https://github.com/yimingliao-blad/med-heal.git.
Yiming Liao, Zeno Franco, Jose Eduardo Lizarraga Mazaba +1