# Towards Transparent Reasoning: What Drives Faithfulness in Large Language Models?

arXiv: https://arxiv.org/abs/2510.24236 · HTML: https://mlsanity.com/paper/2510.24236/

## Key facts

- Cited by 5 papers in the map (data through 14 Oct 2026).
- Placed in Clinical and biomedical applications, one of 17 directions in LLM reasoning.
- Builds on 15 of its 20 references that are in the map.
- First posted on arXiv 28 Oct 2025.

## Placed in

- LLM reasoning / [Clinical and biomedical applications](https://mlsanity.com/lr/clinical-and-biomedical-applications/)

## Builds on (most cited first, 15 of 15)

- [Training language models to follow instructions with human feedback](https://mlsanity.com/paper/2203.02155/) (2022)
- [Survey of Hallucination in Natural Language Generation](https://mlsanity.com/paper/2202.03629/) (2022)
- [Large Language Models Encode Clinical Knowledge](https://mlsanity.com/paper/2212.13138/) (2022)
- [What Disease does this Patient Have? A Large-scale Open Domain Question Answering Dataset from Medical Exams](https://mlsanity.com/paper/2009.13081/) (2020)
- [Language Models Don't Always Say What They Think: Unfaithful Explanations in Chain-of-Thought Prompting](https://mlsanity.com/paper/2305.04388/) (2023)
- [Measuring Faithfulness in Chain-of-Thought Reasoning](https://mlsanity.com/paper/2307.13702/) (2023)
- [BBQ: A Hand-Built Bias Benchmark for Question Answering](https://mlsanity.com/paper/2110.08193/) (2021)
- [ERASER: A Benchmark to Evaluate Rationalized NLP Models](https://mlsanity.com/paper/1911.03429/) (2019)
- [Faithful Chain-of-Thought Reasoning](https://mlsanity.com/paper/2301.13379/) (2023)
- [Faithful Reasoning Using Large Language Models](https://mlsanity.com/paper/2208.14271/) (2022)
- [Question Decomposition Improves the Faithfulness of Model-Generated Reasoning](https://mlsanity.com/paper/2307.11768/) (2023)
- [Faithfulness Tests for Natural Language Explanations](https://mlsanity.com/paper/2305.18029/) (2023)
- [Are self-explanations from Large Language Models faithful?](https://mlsanity.com/paper/2401.07927/) (2024)
- [Walk the Talk? Measuring the Faithfulness of Large Language Model Explanations](https://mlsanity.com/paper/2504.14150/) (2025)
- [The Probabilities Also Matter: A More Faithful Metric for Faithfulness of Free-Text Explanations in Large Language Models](https://mlsanity.com/paper/2404.03189/) (2024)

## Built on by (most cited first, 5 of 5)

- [Counterfactual Simulation Training for Chain-of-Thought Faithfulness](https://mlsanity.com/paper/2602.20710/) (2026)
- [HalluHard: A Hard Multi-Turn Hallucination Benchmark](https://mlsanity.com/paper/2602.01031/) (2026)
- [Outcome Rewards Do Not Guarantee Verifiable or Causally Important Reasoning](https://mlsanity.com/paper/2604.22074/) (2026)
- [Balancing Faithfulness and Performance in Reasoning via Multi-Listener Soft Execution](https://mlsanity.com/paper/2602.16154/) (2026)
- [Training Large Language Models for Self-Explanation Faithfulness](https://mlsanity.com/paper/2607.21090/) (2026)

## Abstract (arXiv)

Large Language Models (LLMs) often produce explanations that do not faithfully reflect the factors driving their predictions. In healthcare settings, such unfaithfulness is especially problematic: explanations that omit salient clinical cues or mask spurious shortcuts can undermine clinician trust and lead to unsafe decision support. We study how inference and training-time choices shape explanation faithfulness, focusing on factors practitioners can control at deployment. We evaluate three LLMs (GPT-4.1-mini, LLaMA 70B, LLaMA 8B) on two datasets-BBQ (social bias) and MedQA (medical licensing questions), and manipulate the number and type of few-shot examples, prompting strategies, and training procedure. Our results show: (i) both the quantity and quality of few-shot examples significantly impact model faithfulness; (ii) faithfulness is sensitive to prompting design; (iii) the instruction-tuning phase improves measured faithfulness on MedQA. These findings offer insights into strategies for enhancing the interpretability and trustworthiness of LLMs in sensitive domains.