MC-CXR: A Multi-Context Chest X-ray Benchmark for Context-Induced Disruption in Vision-Language Models

Junhyeok Lee; Songsoo Kim; Kyu Sung Choi

Home/Archive/arXiv

arXiv · 2608.24118

MC-CXR: A Multi-Context Chest X-ray Benchmark for Context-Induced Disruption in Vision-Language Models

Junhyeok Lee·Songsoo Kim·Kyu Sung Choi

View original source ↗Read source document ↗Export metadata ↓

Abstract

Vision-language models (VLMs) are increasingly used in clinical pipelines where a chest X-ray is interpreted alongside retrieved reports, preliminary notes, or prior imaging. Existing benchmarks measure whether models answer correctly in isolation, but not whether they preserve a correct image-only decision when plausible context conflicts with the image. We introduce Multi-Context Chest X-ray (MC-CXR), a benchmark of 240 cases expanded into 2,522 instances that isolates context-induced disruption through paired perturbation. Each case fixes the current image and target finding while presenting matched reliable and misleading context across text and prior CXR, with visual overlays where available. MC-CXR defines three task families and two paired metrics, the switch-to-wrong rate and the context-aligned error rate. We evaluate ten VLMs spanning open-source general, medical-domain, and closed-source systems. Image-only accuracy is necessary but insufficient. Mean switch rates range from 45.6-78.1% across misleading textual sources and 35.7-61.7% across misleading visual sources. Among switched predictions, 74.6% align with the misleading label for text versus 17.6% for visual context, a 57.0-point gap (95% CI 50.9-62.8). This text-visual asymmetry is observed under the standardized direct-answer protocol. The dataset is available on PhysioNet.

Explore related subjects

cs.CL

Keep this discovery

Explore connections, maps & timelines

BibTeX RIS

Junhyeok Lee, Songsoo Kim, Kyu Sung Choi. 2026-08-25. MC-CXR: A Multi-Context Chest X-ray Benchmark for Context-Induced Disruption in Vision-Language Models. https://arxiv.org/abs/2608.24118

Cite the original work for its findings. Save a collection to share your selection of sources.

KEEP EXPLORING

Related papers

arXiv2026

SafetyFlow: An Agent-Flow System for Automated LLM Safety Benchmarking

The rapid proliferation of large language models (LLMs) has intensified the requirement for reliable safety evaluation to uncover model vulnerabilities. To this end, numerous LLM safety evaluation benchmarks are proposed. However, existing benchmarks generally rely on labor-intensive manual curation, which causes excessive time and resource consumption. They also exhibit significant redundancy and limited difficulty. To alleviate these problems, we introduce SafetyFlow, the first agent-flow system designed to automate the construction of LLM safety benchmarks. SafetyFlow can automatically build a comprehensive safety benchmark in only four days without any human intervention by orchestrating seven specialized agents, significantly reducing time and resource cost. Equipped with versatile tools, the agents of SafetyFlow ensure process and cost controllability while integrating human expertise into the automatic pipeline. The final constructed dataset, SafetyFlowBench, contains 23,446 queries with low redundancy and strong discriminative power. Our contribution includes the first fully automated benchmarking pipeline and a comprehensive safety benchmark. We evaluate the safety of 49 advanced LLMs on our dataset and conduct extensive experiments to validate our efficacy and efficiency.

cs.CL↗

arXiv2026

Geometric Uncertainty for Detecting and Correcting Hallucinations in LLMs

Large language models are known to hallucinate, generating linguistically plausible but incorrect answers to questions. Uncertainty quantification has been proposed as a strategy to detect such behaviour, but existing methods lack a unified framework to assess reliability at both the prompt and answer level. We introduce a geometric framework which quantifies language model uncertainty at both levels by explicitly modelling a prompt-conditioned semantic distribution in answer embedding space. Our approach is black-box and sampling-based; we generate multiple answers per prompt, and use archetypal analysis to estimate a geometric support for the answer distribution. At the prompt level, we approximate the distribution entropy to quantify uncertainty; for each individual answer, we then use notions of atypicality to assess its reliability relative to the batch. We employ our framework to not only detect hallucinations but correct them, by selecting the batch example deemed most reliable. Experiments show that our framework performs comparably to or better than prior methods on short form question-answering datasets, and achieves superior results on medical datasets where hallucinations carry particularly critical risks. Beyond pure performance, we suggest the theoretical grounding of our work provides support for semantic distributions as useful objects of study for language model uncertainty.

cs.CL↗

arXiv2026

Calibrated Confidence Expression for Radiology Report Generation

Safe deployment of Large Vision-Language Models (LVLMs) in radiology report generation requires not only accurate predictions but also clinically interpretable indicators of when outputs should be thoroughly reviewed, enabling selective radiologist verification and reducing the risk of hallucinated findings influencing clinical decisions. One intuitive approach to this is verbalized confidence, where the model explicitly states its certainty. However, current state-of-the-art language models are often overconfident, and research on calibration in multimodal settings such as radiology report generation is limited. To address this gap, we introduce ConRad (Confidence Calibration for Radiology Reports), a reinforcement learning framework for fine-tuning medical LVLMs to produce calibrated verbalized confidence estimates alongside radiology reports. We study two settings: a single report-level confidence score and a sentence-level variant assigning a confidence to each claim. Both are trained using the GRPO algorithm with reward functions based on the logarithmic scoring rule, which incentivizes truthful self-assessment by penalizing miscalibration and guarantees optimal calibration under reward maximization. Experimentally, ConRad substantially improves calibration and outperforms competing methods. In a clinical evaluation we show that ConRad's report level scores are well aligned with clinicians' judgment. By highlighting full reports or low-confidence statements for targeted review, ConRad can support safer clinical integration of AI-assistance for report generation.

cs.CL↗