# Fact-Controlled Diagnosis of Hallucinations in Medical Text Summarization

arXiv: https://arxiv.org/abs/2506.00448 · HTML: https://mlsanity.com/paper/2506.00448/

## Key facts

- Cited by 2 papers in the map (data through 14 Oct 2026).
- Builds on 14 of its 24 references that are in the map.
- First posted on arXiv 31 May 2025.

## Builds on (most cited first, 14 of 14)

- [The Llama 3 Herd of Models](https://mlsanity.com/paper/2407.21783/) (2024)
- [BERTScore: Evaluating Text Generation with BERT](https://mlsanity.com/paper/1904.09675/) (2019)
- [BioBERT: a pre-trained biomedical language representation model for biomedical text mining](https://mlsanity.com/paper/1901.08746/) (2019)
- [MiniLM: Deep Self-Attention Distillation for Task-Agnostic Compression of Pre-Trained Transformers](https://mlsanity.com/paper/2002.10957/) (2020)
- [On Faithfulness and Factuality in Abstractive Summarization](https://mlsanity.com/paper/2005.00661/) (2020)
- [Evaluating the Factual Consistency of Abstractive Text Summarization](https://mlsanity.com/paper/1910.12840/) (2019)
- [SummaC: Re-Visiting NLI-based Models for Inconsistency Detection in Summarization](https://mlsanity.com/paper/2111.09525/) (2021)
- [FEQA: A Question Answering Evaluation Framework for Faithfulness Assessment in Abstractive Summarization](https://mlsanity.com/paper/2005.03754/) (2020)
- [AlignScore: Evaluating Factual Consistency with a Unified Alignment Function](https://mlsanity.com/paper/2305.16739/) (2023)
- [QuestEval: Summarization Asks for Fact-based Evaluation](https://mlsanity.com/paper/2103.12693/) (2021)
- [Q2: Evaluating Factual Consistency in Knowledge-Grounded Dialogues via Question Generation and Question Answering](https://mlsanity.com/paper/2104.08202/) (2021)
- [ACI-BENCH: a Novel Ambient Clinical Intelligence Dataset for Benchmarking Automatic Visit Note Generation](https://mlsanity.com/paper/2306.02022/) (2023)
- [InfoLM: A New Metric to Evaluate Summarization & Data2Text Generation](https://mlsanity.com/paper/2112.01589/) (2021)
- [FENICE: Factuality Evaluation of summarization based on Natural language Inference and Claim Extraction](https://mlsanity.com/paper/2403.02270/) (2024)

## Built on by (most cited first, 2 of 2)

- [HEDGE: Hallucination Estimation via Dense Geometric Entropy for VQA with Vision-Language Models](https://mlsanity.com/paper/2511.12693/) (2025)
- [AI Safety Training Can be Clinically Harmful](https://mlsanity.com/paper/2604.23445/) (2026)

## Abstract (arXiv)

Hallucinations in large language models (LLMs) during summarization of patient-clinician dialogues pose significant risks to patient care and clinical decision-making. However, the phenomenon remains understudied in the clinical domain, with uncertainty surrounding the applicability of general-domain hallucination detectors. The rarity and randomness of hallucinations further complicate their investigation. In this paper, we conduct an evaluation of hallucination detection methods in the medical domain, and construct two datasets for the purpose: A fact-controlled Leave-N-out dataset -- generated by systematically removing facts from source dialogues to induce hallucinated content in summaries; and a natural hallucination dataset -- arising organically during LLM-based medical summarization. We show that general-domain detectors struggle to detect clinical hallucinations, and that performance on fact-controlled hallucinations does not reliably predict effectiveness on natural hallucinations. We then develop fact-based approaches that count hallucinations, offering explainability not available with existing methods. Notably, our LLM-based detectors, which we developed using fact-controlled hallucinations, generalize well to detecting real-world clinical hallucinations. This research contributes a suite of specialized metrics supported by expert-annotated datasets to advance faithful clinical summarization systems.