# Detecting and Evaluating Medical Hallucinations in Large Vision Language Models

arXiv: https://arxiv.org/abs/2406.10185 · HTML: https://mlsanity.com/paper/2406.10185/

## Key facts

- Cited by 57 papers in the map (data through 14 Oct 2026).
- Placed in Hallucination mitigation in LVLMs, one of 16 directions in Multimodal LLMs / vision-language models.
- Builds on 20 of its 29 references that are in the map.
- First posted on arXiv 14 Jun 2024.

## Placed in

- Multimodal LLMs / vision-language models / [Hallucination mitigation in LVLMs](https://mlsanity.com/mllm/hallucination-mitigation-in-lvlms/)

## Builds on (most cited first, 20 of 20)

- [Visual Instruction Tuning](https://mlsanity.com/paper/2304.08485/) (2023)
- [BLIP-2: Bootstrapping Language-Image Pre-training with Frozen Image Encoders and Large Language Models](https://mlsanity.com/paper/2301.12597/) (2023)
- [InstructBLIP: Towards General-purpose Vision-Language Models with Instruction Tuning](https://mlsanity.com/paper/2305.06500/) (2023)
- [Survey of Hallucination in Natural Language Generation](https://mlsanity.com/paper/2202.03629/) (2022)
- [Evaluating Object Hallucination in Large Vision-Language Models](https://mlsanity.com/paper/2305.10355/) (2023)
- [LLaVA-Med: Training a Large Language-and-Vision Assistant for Biomedicine in One Day](https://mlsanity.com/paper/2306.00890/) (2023)
- [ChestX-ray8: Hospital-scale Chest X-ray Database and Benchmarks on Weakly-Supervised Classification and Localization of Common Thorax Diseases](https://mlsanity.com/paper/1705.02315/) (2017)
- [Object Hallucination in Image Captioning](https://mlsanity.com/paper/1809.02156/) (2018)
- [mPLUG-Owl2: Revolutionizing Multi-modal Large Language Model with Modality Collaboration](https://mlsanity.com/paper/2311.04257/) (2023)
- [SLAKE: A Semantically-Labeled Knowledge-Enhanced Dataset for Medical Visual Question Answering](https://mlsanity.com/paper/2102.09542/) (2021)
- [Mitigating Hallucination in Large Multi-Modal Models via Robust Instruction Tuning](https://mlsanity.com/paper/2306.14565/) (2023)
- [Hallucination of Multimodal Large Language Models: A Survey](https://mlsanity.com/paper/2404.18930/) (2024)
- [Analyzing and Mitigating Object Hallucination in Large Vision-Language Models](https://mlsanity.com/paper/2310.00754/) (2023)
- [Detecting and Preventing Hallucinations in Large Vision Language Models](https://mlsanity.com/paper/2308.06394/) (2023)
- [Beyond Hallucinations: Enhancing LVLMs through Hallucination-Aware Direct Preference Optimization](https://mlsanity.com/paper/2311.16839/) (2023)
- [Mitigating Hallucinations in Large Vision-Language Models with Instruction Contrastive Decoding](https://mlsanity.com/paper/2403.18715/) (2024)
- [Evaluation and Analysis of Hallucination in Large Vision-Language Models](https://mlsanity.com/paper/2308.15126/) (2023)
- [Detecting and Mitigating Hallucination in Large Vision Language Models via Fine-Grained AI Feedback](https://mlsanity.com/paper/2404.14233/) (2024)
- [Unified Hallucination Detection for Multimodal Large Language Models](https://mlsanity.com/paper/2402.03190/) (2024)
- [MISS: A Generative Pretraining and Finetuning Approach for Med-VQA](https://mlsanity.com/paper/2401.05163/) (2024)

## Built on by (most cited first, 30 of 57)

- [MMed-RAG: Versatile Multimodal RAG System for Medical Vision Language Models](https://mlsanity.com/paper/2410.13085/) (2024)
- [VILA-M3: Enhancing Vision-Language Models with Medical Expert Knowledge](https://mlsanity.com/paper/2411.12915/) (2024)
- [Self-Correcting Decoding with Generative Feedback for Mitigating Hallucinations in Large Vision-Language Models](https://mlsanity.com/paper/2502.06130/) (2025)
- [GEMeX: A Large-Scale, Groundable, and Explainable Medical VQA Benchmark for Chest X-ray Diagnosis](https://mlsanity.com/paper/2411.16778/) (2024)
- [A Survey of Multimodal Hallucination Evaluation and Detection](https://mlsanity.com/paper/2507.19024/) (2025)
- [From Perception to Cognition: A Survey of Vision-Language Interactive Reasoning in Multimodal Large Language Models](https://mlsanity.com/paper/2509.25373/) (2025)
- [CoMT: Chain-of-Medical-Thought Reduces Hallucination in Medical Report Generation](https://mlsanity.com/paper/2406.11451/) (2024)
- [MedHalu: Hallucinations in Responses to Healthcare Queries by Large Language Models](https://mlsanity.com/paper/2409.19492/) (2024)
- [MMedPO: Aligning Medical Vision-Language Models with Clinical-Aware Multimodal Preference Optimization](https://mlsanity.com/paper/2412.06141/) (2024)
- [Has Multimodal Learning Delivered Universal Intelligence in Healthcare? A Comprehensive Survey](https://mlsanity.com/paper/2408.12880/) (2024)
- [A Survey on Trustworthiness in Foundation Models for Medical Image Analysis](https://mlsanity.com/paper/2407.15851/) (2024)
- [ONLY: One-Layer Intervention Sufficiently Mitigates Hallucinations in Large Vision-Language Models](https://mlsanity.com/paper/2507.00898/) (2025)
- [MedSynapse-V: Bridging Visual Perception and Clinical Intuition via Latent Memory Evolution](https://mlsanity.com/paper/2604.26283/) (2026)
- [Towards Context-Aware Emotion Recognition Debiasing from a Causal Demystification Perspective via De-confounded Training](https://mlsanity.com/paper/2407.04963/) (2024)
- [Asynchronous Multimodal Video Sequence Fusion via Learning Modality-Exclusive and -Agnostic Representations](https://mlsanity.com/paper/2407.04955/) (2024)
- [Hallucination-Aware Multimodal Benchmark for Gastrointestinal Image Analysis with Large Vision-Language Models](https://mlsanity.com/paper/2505.07001/) (2025)
- [Mitigating Image Captioning Hallucinations in Vision-Language Models](https://mlsanity.com/paper/2505.03420/) (2025)
- [MedHallTune: An Instruction-Tuning Benchmark for Mitigating Medical Hallucination in Vision-Language Models](https://mlsanity.com/paper/2502.20780/) (2025)
- [TECP: Token-Entropy Conformal Prediction for LLMs](https://mlsanity.com/paper/2509.00461/) (2025)
- [Med-VCD: Mitigating Hallucination for Medical Large Vision Language Models through Visual Contrastive Decoding](https://mlsanity.com/paper/2512.01922/) (2025)
- [MindWatcher: Toward Smarter Multimodal Tool-Integrated Reasoning](https://mlsanity.com/paper/2512.23412/) (2025)
- [UniVRSE: Unified Vision-conditioned Response Semantic Entropy for Hallucination Detection in Medical Vision-Language Models](https://mlsanity.com/paper/2503.20504/) (2025)
- [From Gaze to Insight: Bridging Human Visual Attention and Vision Language Model Explanation for Weakly-Supervised Medical Image Segmentation](https://mlsanity.com/paper/2504.11368/) (2025)
- [Visual Alignment of Medical Vision-Language Models for Grounded Radiology Report Generation](https://mlsanity.com/paper/2512.16201/) (2025)
- [Scorecards for Synthetic Medical Data Evaluation and Reporting](https://mlsanity.com/paper/2406.11143/) (2024)
- [CCD: Mitigating Hallucinations in Radiology MLLMs via Clinical Contrastive Decoding](https://mlsanity.com/paper/2509.23379/) (2025)
- [OPGAgent: An Agent for Auditable Dental Panoramic X-ray Interpretation](https://mlsanity.com/paper/2603.00462/) (2026)
- [Fair Foundation Models for Medical Image Analysis: Challenges and Perspectives](https://mlsanity.com/paper/2502.16841/) (2025)
- [HERO: Hierarchical Evidential Reasoning Optimization for Radiology Report Generation via Reason-then-Summarize](https://mlsanity.com/paper/2601.03321/) (2026)
- [A Scoping Review of Natural Language Processing in Addressing Medically Inaccurate Information: Errors, Misinformation, and Hallucination](https://mlsanity.com/paper/2505.00008/) (2025)

## Abstract (arXiv)

Large Vision Language Models (LVLMs) are increasingly integral to healthcare applications, including medical visual question answering and imaging report generation. While these models inherit the robust capabilities of foundational Large Language Models (LLMs), they also inherit susceptibility to hallucinations-a significant concern in high-stakes medical contexts where the margin for error is minimal. However, currently, there are no dedicated methods or benchmarks for hallucination detection and evaluation in the medical field. To bridge this gap, we introduce Med-HallMark, the first benchmark specifically designed for hallucination detection and evaluation within the medical multimodal domain. This benchmark provides multi-tasking hallucination support, multifaceted hallucination data, and hierarchical hallucination categorization. Furthermore, we propose the MediHall Score, a new medical evaluative metric designed to assess LVLMs' hallucinations through a hierarchical scoring system that considers the severity and type of hallucination, thereby enabling a granular assessment of potential clinical impacts. We also present MediHallDetector, a novel Medical LVLM engineered for precise hallucination detection, which employs multitask training for hallucination detection. Through extensive experimental evaluations, we establish baselines for popular LVLMs using our benchmark. The findings indicate that MediHall Score provides a more nuanced understanding of hallucination impacts compared to traditional metrics and demonstrate the enhanced performance of MediHallDetector. We hope this work can significantly improve the reliability of LVLMs in medical applications. All resources of this work have been released at https://github.com/ydk122024/Med-HallMark.