Trust but Verify: Mitigating Medical Hallucinations via Post-Hoc Adversarial Auditing and Multi-Agent Feedback Loops
On the map: LLM agents and tool use → Medical and scientific domain agents
Abstract (arXiv)
Large Language Models (LLMs) are increasingly deployed in healthcare settings, yet their tendency to hallucinate poses risks when clinical decisions are involved. This study examine whether LLMs recommend recently banned or withdrawn pharmaceuticals when answering clinical questions and tests an agent-based method for reducing such errors. We developed a five-agent "Trust but Verify" system using a single LLM backbone. To measure regulatory knowledge obsolescence, we created an adversarial dataset of 103 clinical MCQs where historically correct answers now refer to banned substances. This scale ensures statistical significance across various therapeutic classes. We evaluated three open-access model families (GPT-OSS, Llama-3, Falcon-3) under vanilla and agentic conditions. Performance was measured via pointwise score, label accuracy, Hallucination Error Rate (HER), and Component Fidelity (CF) score. We also observed clinical safety regression in proprietary models. In default configurations, all models showed high hallucination rates, consistently selecting banned drugs that matched training data patterns. Our proposed agentic architecture reduced HER by approximately 53% across models. Pointwise scores shifted from -0.25 (unsafe recommendation) toward 0.0 (appropriate refusal). The safety audit intercepted dangerous outputs even when models' parametric knowledge favored the banned substance. The proposed multi-agent framework offers a model-agnostic method for enforcing regulatory compliance that prioritizes patient safety over fluent text generation. Our work demonstrates a practical approach for deploying autonomous AI systems in safety-critical healthcare settings. It shows how real-time regulatory data can be integrated into LLM pipelines to support clinical decision-making.
Key facts. Cited by 1 paper in the map (data through 14 Oct 2026). Placed in Medical and scientific domain agents, one of 16 directions in LLM agents and tool use. Builds on 10 of its 33 references that are in the map. First posted on arXiv 12 Jun 2026.
Builds on
10 of 33 references.
Closest ancestors · 1
Same direction, newest first
Other references · 9
- 2020Retrieval-Augmented Generation for Knowledge-Intensive NLP Taskscited by 9,297
- 2023A Survey on Hallucination in Large Language Models: Principles, Taxonomy, Challenges, and Open Questionscited by 1,601
- 2023Med-HALT: Medical Domain Hallucination Test for Large Language Modelscited by 157
- 2023Almanac: Retrieval-Augmented Language Models for Clinical Medicinecited by 123
- 2024CRUD-RAG: A Comprehensive Chinese Benchmark for Retrieval-Augmented Generation of Large Language Modelscited by 50
- 2024Fast-DDPM: Fast Denoising Diffusion Probabilistic Models for Medical Image-to-Image Generationcited by 33
- 2024The Need for Guardrails with Large Language Models in Medical Safety-Critical Settings: An Artificial Intelligence Application in the Pharmacovigilance Ecosystemcited by 11
- 2024Enhancing Guardrails for Safe and Secure Healthcare AIcited by 7
- 2024HALO: Hallucination Analysis and Learning Optimization to Empower LLMs with Retrieval-Augmented Context for Guided Clinical Decision Makingcited by 3
Built on by
Citing papers per year: 2026: 1.
1 paper.
Similar, not cited
Close in wording, no citation either way
- 2026Med-HEAL: Analyzing and Mitigating Hallucinations in Medical LLMs with Hallucination-Aware In-Context Learning
- 2025Trustworthy Agents for Electronic Health Records through Confidence Estimation
- 2025Diagnosing Hallucination Risk in AI Surgical Decision-Support: A Sequential Framework for Sequential Validation
- 2024MedHallBench: A New Benchmark for Assessing Hallucination in Medical Large Language Models
- 2025Demo: Statistically Significant Results On Biases and Errors of LLMs Do Not Guarantee Generalizable Results
- 2025Medical Hallucinations in Foundation Models and Their Impact on Healthcare
- 2025Addressing Benchmarking Gaps in Large Language Models for Health and Medicine with Dynamic Red-Teaming
- 2024MedHalu: Hallucinations in Responses to Healthcare Queries by Large Language Models