Effects of Transcript Compression on LLM-based Medical Misinformation Detection in Japanese YouTube Videos

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, real-world biomedical evidence attribution. Med-V1 is available at https://github.com/NLM-DIR/Med-V1.

As large language models (LLMs) become default tools for online information verification, an implicit assumption follows them: that scale and general capability are sufficient for nuanced classification of misinformation discourse. We test this assumption directly on 900 Reddit comments spanning three PolitiFact-verified misinformation claims (environment, health, immigration), labelled as belief (propagates the claim), fact-check (corrects it), or other. We compare nine models across three paradigms -- BART-MNLI, three Llama variants, three commercial frontier LLMs (Claude Haiku 4.5, Gemini Flash Lite 2.5, Claude Sonnet 4.6), and fine-tuned DistilBERT and RoBERTa -- under universal and topic-specific label schemas. The assumption does not hold. Fine-tuned RoBERTa reaches 0.62 macro-$F_1$ against a best zero-shot result of 0.50 (Claude Haiku 4.5), at a fraction of the per-query cost; the supervised advantage is concentrated on the belief class, the implicit, affective category every zero-shot model under-detects. Scaling does not help: Llama-3-8B matches Llama-3-70B, and Claude Sonnet 4.6 underperforms the smaller Haiku under generic labels, collapsing belief detection to 0.17 and refusing outright on a subset of comments flagged as sensitive. This is a safety-alignment artefact, not a capacity limit. Label schema and topic jointly shape zero-shot performance, with the same model varying by more than 0.13 macro-$F_1$ across topics under matched labels. In a verification context, where missing belief is the costlier error, task-specific fine-tuning remains the more reliable choice despite the proliferation of large generative models.

Large language models (LLMs) are increasingly used for medical summarization, but their outputs can omit medically important information and introduce unsupported claims. Existing error-detection methods produce heuristic or uncalibrated scores, providing no formal control over missed errors and no principled way to trade off safety against clinician review burden. We introduce Conformal Assessment for Risk Evaluation (CARE), a post-hoc, model-agnostic safety layer that uses conformal risk control to overlay calibrated omission and hallucination flags onto summaries from any LLM without retraining. CARE provides finite-sample, distribution-free guarantees through two controllers: a hallucination controller that bounds the probability of a document containing any unflagged hallucinated sentence, and an omission controller that bounds the expected fraction of important omissions not surfaced for review. Unlike hallucination detection, omissions depend jointly on whether a source sentence is important and whether it is covered by the summary. We show that calibrating only one dimension can violate the target risk bound, while marginal decompositions remain valid but overly conservative. By jointly calibrating over the full $(τ,γ)$ threshold space, CARE preserves formal guarantees while surfacing up to 5$\times$ fewer sentences than alternative calibrated baselines. Across five medical summarization tasks, CARE satisfies the target risk bound at $α= 0.15$ with 95% confidence across 100 calibration/test resplits, using only ~100 labeled documents per domain. In a preliminary clinician study (75 document reviews), calibrated flags improved omission detection by 28.6 percentage points on average. These results show that sentence-level safety guarantees are feasible for LLM-assisted medical summarization and offer a tunable mechanism for balancing residual risk and review effort.