# CoMT: Chain-of-Medical-Thought Reduces Hallucination in Medical Report Generation

arXiv: https://arxiv.org/abs/2406.11451 · HTML: https://mlsanity.com/paper/2406.11451/

## Key facts

- Cited by 25 papers in the map (data through 14 Oct 2026).
- Placed in Hallucination detection and mitigation, one of 17 directions in LLM reasoning.
- Builds on 21 of its 32 references that are in the map.
- First posted on arXiv 17 Jun 2024.

## Placed in

- LLM reasoning / [Hallucination detection and mitigation](https://mlsanity.com/lr/hallucination-detection-and-mitigation/)

## Builds on (most cited first, 21 of 21)

- [Learning Transferable Visual Models From Natural Language Supervision](https://mlsanity.com/paper/2103.00020/) (2021)
- [Chain-of-Thought Prompting Elicits Reasoning in Large Language Models](https://mlsanity.com/paper/2201.11903/) (2022)
- [BERTScore: Evaluating Text Generation with BERT](https://mlsanity.com/paper/1904.09675/) (2019)
- [MiniGPT-4: Enhancing Vision-Language Understanding with Advanced Large Language Models](https://mlsanity.com/paper/2304.10592/) (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)
- [MIMIC-CXR-JPG, a large publicly available database of labeled chest radiographs](https://mlsanity.com/paper/1901.07042/) (2019)
- [mPLUG-Owl2: Revolutionizing Multi-modal Large Language Model with Modality Collaboration](https://mlsanity.com/paper/2311.04257/) (2023)
- [Generating Radiology Reports via Memory-driven Transformer](https://mlsanity.com/paper/2010.16056/) (2020)
- [Improving CLIP Training with Language Rewrites](https://mlsanity.com/paper/2305.20088/) (2023)
- [On the Automatic Generation of Medical Imaging Reports](https://mlsanity.com/paper/1711.08195/) (2017)
- [Exploring and Distilling Posterior and Prior Knowledge for Radiology Report Generation](https://mlsanity.com/paper/2106.06963/) (2021)
- [When Radiology Report Generation Meets Knowledge Graph](https://mlsanity.com/paper/2002.08277/) (2020)
- [PromptMRG: Diagnosis-Driven Prompts for Medical Report Generation](https://mlsanity.com/paper/2308.12604/) (2023)
- [Contrastive Attention for Automatic Chest X-ray Report Generation](https://mlsanity.com/paper/2106.06965/) (2021)
- [Mitigating Fine-Grained Hallucination by Fine-Tuning Large Vision-Language Models with Caption Rewrites](https://mlsanity.com/paper/2312.01701/) (2023)
- [Detecting and Evaluating Medical Hallucinations in Large Vision Language Models](https://mlsanity.com/paper/2406.10185/) (2024)
- [Mitigating Hallucination in Visual Language Models with Visual Supervision](https://mlsanity.com/paper/2311.16479/) (2023)
- [Contextual Feature Extraction Hierarchies Converge in Large Language Models and the Brain](https://mlsanity.com/paper/2401.17671/) (2024)
- [Recurrent Topic-Transition GAN for Visual Paragraph Generation](https://mlsanity.com/paper/1703.07022/) (2017)
- [MISS: A Generative Pretraining and Finetuning Approach for Med-VQA](https://mlsanity.com/paper/2401.05163/) (2024)

## Built on by (most cited first, 25 of 25)

- [Can Pruning Improve Reasoning? Revisiting Long-CoT Compression with Capability in Mind for Better Reasoning](https://mlsanity.com/paper/2505.14582/) (2025)
- [Towards Faithful Reasoning in Remote Sensing: A Perceptually-Grounded GeoSpatial Chain-of-Thought for Vision-Language Models](https://mlsanity.com/paper/2509.22221/) (2025)
- [The Rise of Small Language Models in Healthcare: A Comprehensive Survey](https://mlsanity.com/paper/2504.17119/) (2025)
- [Vision Language Models in Medicine](https://mlsanity.com/paper/2503.01863/) (2025)
- [MedSynapse-V: Bridging Visual Perception and Clinical Intuition via Latent Memory Evolution](https://mlsanity.com/paper/2604.26283/) (2026)
- [MedHEval: Benchmarking Hallucinations and Mitigation Strategies in Medical Large Vision-Language Models](https://mlsanity.com/paper/2503.02157/) (2025)
- [Hallucination-Aware Multimodal Benchmark for Gastrointestinal Image Analysis with Large Vision-Language Models](https://mlsanity.com/paper/2505.07001/) (2025)
- [DanmakuTPPBench: A Multi-modal Benchmark for Temporal Point Process Modeling and Understanding](https://mlsanity.com/paper/2505.18411/) (2025)
- [TECP: Token-Entropy Conformal Prediction for LLMs](https://mlsanity.com/paper/2509.00461/) (2025)
- [MindWatcher: Toward Smarter Multimodal Tool-Integrated Reasoning](https://mlsanity.com/paper/2512.23412/) (2025)
- [Hallucinations and Key Information Extraction in Medical Texts: A Comprehensive Assessment of Open-Source Large Language Models](https://mlsanity.com/paper/2504.19061/) (2025)
- [Reason Like a Radiologist: Chain-of-Thought and Reinforcement Learning for Verifiable Report Generation](https://mlsanity.com/paper/2504.18453/) (2025)
- [Focus on What Matters: Enhancing Medical Vision-Language Models with Automatic Attention Alignment Tuning](https://mlsanity.com/paper/2505.18503/) (2025)
- [SatireDecoder: Visual Cascaded Decoupling for Enhancing Satirical Image Comprehension](https://mlsanity.com/paper/2512.00582/) (2025)
- [Evaluating the Search Agent in a Parallel World](https://mlsanity.com/paper/2603.04751/) (2026)
- [MM-Snowball: Evaluating and Mitigating Hallucination Snowballing in Multimodal Multi-Turn Dialogue](https://mlsanity.com/paper/2606.00622/) (2026)
- [Scalable Medication Extraction and Discontinuation Identification from Electronic Health Records Using Large Language Models](https://mlsanity.com/paper/2506.11137/) (2025)
- [COPO: Consistency-Aware Policy Optimization](https://mlsanity.com/paper/2508.04138/) (2025)
- [Enhancing Medical Large Vision-Language Models via Alignment Distillation](https://mlsanity.com/paper/2512.18554/) (2025)
- [ClinCoT: Clinical-Aware Visual Chain-of-Thought for Medical Vision Language Models](https://mlsanity.com/paper/2603.01124/) (2026)
- [Multi-Modal Multi-Agent Reinforcement Learning for Radiology Report Generation](https://mlsanity.com/paper/2603.16876/) (2026)
- [MI-CXR: A Benchmark for Longitudinal Reasoning over Multi-Interval Chest X-rays](https://mlsanity.com/paper/2605.15574/) (2026)
- [SPADE: A Large Language Model Framework for Soil Moisture Pattern Recognition and Anomaly Detection in Precision Agriculture](https://mlsanity.com/paper/2509.18123/) (2025)
- [LiteMedCoT-VL: Parameter-Efficient Adaptation for Medical Visual Question Answering](https://mlsanity.com/paper/2605.09384/) (2026)
- [DECIS: Dual-Evidence Corrective Verification for Interpretable Strabismus Diagnostic Decision-Making](https://mlsanity.com/paper/2606.09249/) (2026)

## Abstract (arXiv)

Automatic medical report generation (MRG), which possesses significant research value as it can aid radiologists in clinical diagnosis and report composition, has garnered increasing attention. Despite recent progress, generating accurate reports remains arduous due to the requirement for precise clinical comprehension and disease diagnosis inference. Furthermore, owing to the limited accessibility of medical data and the imbalanced distribution of diseases, the underrepresentation of rare diseases in training data makes large-scale medical visual language models (LVLMs) prone to hallucinations, such as omissions or fabrications, severely undermining diagnostic performance and further intensifying the challenges for MRG in practice. In this study, to effectively mitigate hallucinations in medical report generation, we propose a chain-of-medical-thought approach (CoMT), which intends to imitate the cognitive process of human doctors by decomposing diagnostic procedures. The radiological features with different importance are structured into fine-grained medical thought chains to enhance the inferential ability during diagnosis, thereby alleviating hallucination problems and enhancing the diagnostic accuracy of MRG. The code and dataset have been released at https://github.com/FRENKIE-CHIANG/CoMT.