When Retrieval Helps and Distracts: Evaluating Evidence-Generating LLMs for Biomedical Claim Verification

Biomedical retrieval-augmented large language models (LLMs) often face evidence that is incomplete, misleading, or internally contradictory, yet evaluation usually emphasizes answer accuracy under helpful context rather than reliability under conflict. Using HealthContradict, we evaluate six open-weight LLMs under five controlled evidence conditions: no retrieved context, correct-only context, incorrect-only context, and two mixed conditions containing both correct and contradictory documents in opposite orders. In this conflicting-evidence order contrast, where the same two documents are both present and only their order is reversed, accuracy drops for every model and 11.4%--25.2% of predictions flip. To support abstention in these difficult cases, we also evaluate a conflict-aware abstention score that combines model confidence with a detector of evidence conflict. In the two hardest conditions, this score improves selective accuracy over confidence-only, with mean gains of 7.2--33.4 points in incorrect-only (IC') and 3.6--14.4 points in incorrect-first conflicting (ICC') conditions across 75%, 50%, and 25% coverage. These results show that conflicting biomedical evidence is both an uncertainty and robustness problem and motivate evaluation and abstention methods that explicitly account for evidence disagreement.

Large language models (LLMs) excel in generating fluent utterances but can lack reliable grounding in verified information. At the same time, knowledge-graph-based fact-checkers deliver precise and interpretable evidence, yet suffer from limited coverage or latency. By integrating LLMs with knowledge graphs and real-time search agents, we introduce a hybrid fact-checking approach that leverages the individual strengths of each component. Our system comprises three autonomous steps: 1) a Knowledge Graph (KG) Retrieval for rapid one-hop lookups in DBpedia, 2) an LM-based classification guided by a task-specific labeling prompt, producing outputs with internal rule-based logic, and 3) a Web Search Agent invoked only when KG coverage is insufficient. Our pipeline achieves an F1 score of 0.93 on the FEVER benchmark on the Supported/Refuted split without task-specific fine-tuning. To address Not enough information cases, we conduct a targeted reannotation study showing that our approach frequently uncovers valid evidence for claims originally labeled as Not Enough Information (NEI), as confirmed by both expert annotators and LLM reviewers. With this paper, we present a modular, opensource fact-checking pipeline with fallback strategies and generalization across datasets.

Medical knowledge evolves continuously, whereas the parametric knowledge encoded in large language models (LLMs) is fixed at training time. External retrieval, including retrieval-augmented generation (RAG), can provide access to newly available evidence, but retrieved information may be irrelevant, incomplete, or conflicting. As a result, external retrieval can in turn degrade the factual accuracy and evidence grounding of LLM outputs. To address this challenge, we propose \textbf{CLEAR}, an agentic framework for cross-source evidence adjudication in LLMs in medicine. CLEAR independently generates candidate answers from three complementary pathways---parametric knowledge, locally curated corpora, and dynamically retrieved evidence---reflecting three common sources of information available to LLMs. An aggregation verifier jointly evaluates the candidates, supporting evidence, provenance, and source-quality information to identify agreement and conflict across sources. An adjudication module then determines whether the current conclusion should be preserved or revised through complementary override-guard and challenge-audit mechanisms, while unresolved conflicts trigger targeted follow-up search and re-adjudication.