HalluPrism: When Multimodal Uncertainty Should Diagnose, Not Decide

Although Multimodal Large Language Models have achieved strong performance across a wide range of vision-language tasks, they still suffer from hallucinations, where model outputs become inconsistent with the visual content, textual context, or commonsense knowledge. Existing studies primarily address this problem through coarse-grained detection. However, these approaches often provide insufficient diagnostic information for understanding hallucination types and supporting downstream hallucination mitigation. To bridge this gap, we propose fine-grained hallucination diagnosis for MLLMs, a new unified task that jointly performs hallucination detection, classification, and interpretable explanation generation. We develop an automated data generation pipeline and construct HalluScope-30K, a large-scale diagnostic dataset covering eight sources and five task categories. Based on this dataset, we design a multi-granular joint reward function and train two diagnosis models, HalluScope-4B and HalluScope-8B, which achieve state-of-the-art performance on both the MHALO benchmark and our fine-grained hallucination classification benchmark. Notably, detection and classification are mutually beneficial under joint optimization. Furthermore, diagnosis-driven feedback experiments show that the fine-grained diagnostic explanations produced by our model effectively guide target models to correct their hallucinations, with full diagnosis substantially outperforming all baselines on both Qwen3-VL-8B-Instruct and LLaVA-1.5-7B. Our code, data, and models are available at https://github.com/wkinglin/HalluScope.

Multimodal large language models (MLLMs) increasingly answer questions whose correctness depends on visual, textual, temporal, acoustic, document, chart, or embodied evidence. Their failures are therefore not only linguistic. A fluent answer may conceal poor input quality, a perceptual error, weak grounding, conflict between modalities, unstable reasoning, distribution shift, or a question that is not answerable from the supplied evidence. This survey organizes the literature on uncertainty-aware MLLMs around a decision-centered framework: uncertainty sources give rise to observable signals, signals must be calibrated or controlled for risk, and calibrated uncertainty should determine the system action. We review work on token and logit uncertainty, semantic disagreement, perturbation instability, grounding and attribution scores, verbalized confidence, verifier and judge scores, conformal prediction, selective answering, abstention, clarification, retrieval, self-checking, and escalation. The central argument is that uncertainty should not be evaluated only as a confidence number; it should be evaluated by whether it improves behavior under insufficient, conflicting, shifted, or high-risk multimodal evidence. We position this survey against text-only uncertainty and abstention surveys, broad MLLM surveys, MLLM hallucination surveys, and safety-oriented reviews. We conclude with open problems in source-aware decomposition, action-aware benchmarks, calibration under shift, black-box uncertainty estimation, broader modality coverage, reproducible reporting, and human-centered uncertainty communication.

Multimodal large language models (MLLMs) have demonstrated strong capabilities in vision-language understanding and natural-language response generation. However, these systems can still produce overconfident predictions and hallucination-like outputs, particularly when the visual evidence is weak, ambiguous, or semantically inconsistent. Most existing approaches focus on improving multimodal representation alignment or retrieval-augmented generation, while providing limited mechanisms to quantify instance-level prediction reliability or identify incorrect visual outputs. This work proposes a retrieval-augmented reliability-aware inference framework for trustworthy multimodal visual understanding. The proposed framework constructs an external visual evidence database using pretrained visual embeddings and nearest-neighbor retrieval over normalized feature representations. Retrieved evidence is used to estimate prediction trustworthiness through multiple reliability indicators, including similarity strength, class-support agreement, evidence margin, entropy-based uncertainty, and an aggregate reliability score. Based on these signals, a decision gate determines whether the system should accept the prediction, answer with caution, or abstain/fallback when evidence is insufficient. A multimodal response-generation layer then produces a final user-facing response conditioned on the reliability decision. Experiments on ImageNet-100 demonstrate that the proposed reliability-aware framework improves accepted prediction accuracy from 85.84% to 88.88% at 89.04% coverage. The hallucination-like accepted wrong-answer rate is reduced from 14.16% to 11.12%. These results show that integrating retrieval evidence, reliability estimation, and selective decision gating can improve calibration and reduce overconfident visual errors without retraining large multimodal models.