Hallucinations and opaque reasoning remain unacceptable failure modes for clinical LLMs. We present a production-grade GraphRAG stack that constrains answers to verifiable graph chain-of-thought paths in a heterogeneous, ~700K-node medical knowledge graph powering a fertility assistant. The core idea is targeted navigation: a directed Pruned Landmark Labeling (PLL) oracle provides exact distances for sub-millisecond feasibility checks and simple-path enumeration, while a lightweight AStarNet heuristic operates strictly within the PLL corridor to prioritize clinically plausible expansions. We score and pack a small, diverse set of paths (CUI/semantic-type overlap, length prior, provenance priors) to condition generation, yielding compact prompts and improved Time to First Token (TTFT). On fertility-focused queries, the hybrid (PLL+AStarNet) establishes a better latency/recall Pareto frontier than text-only RAG and single-component baselines, lowers TTFT, and reduces clinician-audited hallucinations while preserving explanation clarity. The result is a practical recipe for explainable, low-hallucination multi-hop medical reasoning ready for real-world deployment.
Large language models (LLMs) have fundamentally transformed the landscape of Natural Language Processing. Despite these advances, LLMs and LLM-based systems remain prone to a variety of failure modes. Retrieval-augmented generation (RAG) systems have emerged as a common deployment scenario seeking to both avoid the well known risk of the LLM "hallucinating" information, and to enable reasoning and question answering over proprietary information that the LLM did not have access to during training without resorting to expensive model fine-tuning. In this work, we explore the idea of using a lightweight graph structure with a relatively simple graph schema, to support the RAG subsystem via a dedicated toolset. We design an agentic system with a variety of vector search and graph query tools operating over a structured dataset based on a curated subset of English Wikipedia articles, and evaluate its performance on questions from MoNaCo, a challenging Wikipedia QA benchmark of complex query answering tasks. Our results show that the introduction of graph-based tools can significantly increase the precision and recall of factual correctness, can halve the number of hallucinated answers, and achieves the highest fine-grained truthfulness score among the three evaluated scenarios. All this with a modest increase in token usage.
Christopher J. Wedge, Joshua Stutter, Danny Dixon +1
When medical AI systems hallucinate clinical reasoning, the consequences extend beyond incorrect answers: fabricated justifications that superficially reference retrieved evidence can mislead clinicians into unsafe treatment decisions. Medical reasoning agents must therefore produce not only correct answers but also faithful justifications that clinicians can verify against cited evidence. We identify a systematic failure mode in RL-trained retrieval agents: outcome-only rewards improve accuracy while degrading faithfulness, a phenomenon we term confident hallucination. The agent learns to answer from parametric memory and backfill plausible but unsupported justifications; citation fabrication rates rise from 16.5% to 31.8% even as accuracy improves by 5 points over the supervised baseline. We address this with a faithfulness-gated reward design: accuracy credit is conditioned on evidence grounding via a hard gate, complemented by retrieval validity and conciseness signals that close exploitation paths unique to agentic retrieval. The resulting system, MedAgent-R1, reduces citation fabrication from 31.8% to 4.7% and raises evidence completeness from 58.7 to 82.6 while maintaining 75.1% accuracy, with 13.2-point gains on HealthBench Safety. Under the same agentic retrieval setup, MedAgent-R1 outscores GPT-4o on faithfulness-specific dimensions (Factual Support 4.55 vs. 4.25; Overclaiming 4.40 vs. 4.15) while remaining below GPT-4o in overall accuracy, suggesting that explicit faithfulness training yields evidence-grounding gains not achieved by scaling alone.
Retrieval-Augmented Generation (RAG) has become a core paradigm for enhancing factual grounding and multi-hop reasoning in Large Language Models (LLMs). Traditional text-based RAG often retrieves logically irrelevant pseudo-evidence, while graph-based RAG is frequently hindered by search-time pruning, which may discard potentially valid reasoning paths. Existing hybrid approaches primarily adopt simple evidence concatenation or unidirectional enhancement, which fails to address the fundamental "Information Island" problem caused by asymmetric reasoning flows between unstructured text and structured graphs. We propose \textbf{TGS-RAG}, a unified framework for \textbf{T}ext-\textbf{G}raph \textbf{S}ynergistic enhancement. TGS-RAG introduces a bidirectional mechanism: (i) a \textbf{Graph-to-Text} channel that employs a Global Voting strategy from visited graph nodes to re-rank and refine textual evidence, filtering out semantic noise; and (ii) a \textbf{Text-to-Graph} channel that utilizes the \textbf{Memory-based Orphan Entity Bridging} algorithm. This algorithm utilizes textual cues to proactively resurrect valid but previously pruned reasoning paths from the search history without additional database overhead. Experimental results on multiple multi-hop reasoning benchmarks demonstrate that TGS-RAG significantly outperforms state-of-the-art baselines, achieving a superior balance between retrieval precision and computational efficiency.