Caifeng Shan

Xiao Song, Haonan Qin, Zhaoxu Zhang et al.

Large vision-language models (LVLMs) are increasingly used for clinical image understanding, yet they remain vulnerable to \emph{hallucinations}--producing textual findings or attributes not supported by the image. We present a vision-traceable hallucination detection framework that audits arbitrary LVLM responses via visual evidence grounding, requiring neither modification nor internal access to the hidden states of LVLMs. Given an LVLM response, we extract visually verifiable entities and use a medical-domain-adapted Qwen-VL grounding verifier to localize each entity on the input image. To enhance the robustness of our detection method, we introduce a counterfactual entity perturbation method and estimate visual evidence uncertainty by contrasting factual and counterfactual grounding results. Specifically, we compute an entity-level uncertainty score from the positive confidence, counterfactual confidence, and their grounding overlap for binary hallucination decision-making. Experiments on multiple medical imaging modalities and LVLM backbones demonstrate that our method consistently improves hallucination detection performance over recent baselines, while providing interpretable localization evidence and strong cross-model transferability. Code and dataset are available at https://github.com/Agentic-CliniAI/CounterVHD.

Yinan Zhou, Haokun Lin, Yichen Wu et al.

Large multimodal models have achieved strong reasoning on complex visual tasks, but their inference efficiency is often restricted by long chains of thought. A promising solution is to pair a small draft model with a large target model, enabling cooperative inference employing a routing signal that adaptively routes queries to either the draft or target model based on their difficulties for optimal efficiency and accuracy. Yet, the remaining bottleneck is to establish a reliable query difficulty signal under multimodal settings. Existing approaches designed for language models either rely on post-hoc token probabilities, which fall short in multimodal scenarios, or depend on supervised fine-tuning, which is a data-sensitive strategy. Both paradigms perform routing only after a complete output, and ignore whether the target model can actually solve the routed instances. To address this, we propose PRP, a Proactive Routing Paradigm that enables early decision-making by jointly evaluating the competence of both the draft and target models. Our Draft Rating Learning (DRL) equips the draft model with an internal confidence estimator, while Joint Rating Learning (JRL) predicts how well the target model can handle a given query, thereby prioritizing the allocation of samples it excels at rather than the hardest ones. These ratings enable fine-grained, instance-level \textbf{Proactive Routing} and substantially accelerate inference without compromising overall performance. Extensive experiments across multiple multimodal reasoning benchmarks validate our effectiveness and efficiency.