arXiv:2607.09349cs.CLcs.AI2026-07

临床RAG模型可能把药物的证据错归给另一药物,导致误导性结果。

Deceptive Grounding: Entity Attribution Failure in Clinical Retrieval-Augmented Generation

论文配图:Deceptive Grounding: Entity Attribution Failure in Clinical Retrieval-Augmented Generation
图 1 · 摘自论文原文
  • 通过控制实验发现,8%-87%的生成结果存在实体归属错误。
  • 真实文档引用但错误关联实体,传统检测方法无法发现此问题。
  • 新增实体归属验证可精准识别97%以上的此类错误,适合医疗AI部署场景。

检索增强生成(RAG)评估通常检查模型声明是否在检索文档中得到事实支持,却未验证证据是否正确归属于查询实体。临床RAG响应可能通过所有自动化检测(零幻觉、高忠实度、真实引用),却将药物Y的临床证据错误地作为药物X的证据呈现。我们称此为欺骗性接地(Deceptive Grounding, DG):一种对忠实度、幻觉和引用检查均不可见的失败,因每条主张均源自真实文档,但对象错误。我们在13个模型上使用受控因子基准测试发现,在对抗性最强条件下DG率介于8%至87%之间;医学与生物医学微调模型最高达86.7%;领域专业化反而加剧了该问题。受控消融分析表明,移除检索文档中的实体特异性临床证据可彻底消除归属失败,所有失败转为编造。两种失败模式由同一触发因素引发,但路径不同。在740个药物-疾病组合的生产环境测量中,部署系统整体DG率为7.8%,新获批药物高达13.6%。实体归属验证(检查引用证据是否适用于查询实体)在经IPW校正的人工黄金标准下,实现97.0%精度和98.7%的DG召回率;现有框架均未实现此功能。

原文摘要 · Abstract (English)

Retrieval-augmented generation evaluation checks whether model claims are factually grounded in retrieved documents. It does not check whether retrieved evidence is attributed to the correct entity. A clinical RAG response can pass every automated check (zero hallucinations, near-perfect faithfulness, real citations) while presenting drug Y's clinical evidence as evidence about queried drug X. We term this deceptive grounding (DG): a failure invisible to faithfulness, hallucination, and citation checks because every claim is sourced from a real document, about the wrong entity. Using a controlled factorial benchmark across 13 models, we find DG rates spanning 8-87% at peak adversarial conditions. Medical and biomedical fine-tuned models reach up to 86.7%; domain specialization amplifies the failure rather than mitigating it. A controlled ablation identifies the mechanism: removing entity-specific clinical evidence from retrieved documents eliminates entity-attribution failure entirely, shifting all failures to confabulation. The two failure modes respond to the same trigger, taking different paths. Production measurement across 740 drug-disease pairs finds 7.8% overall DG in a deployed RAG system, rising to 13.6% for recently approved drugs. Entity-attribution verification (checking that cited evidence applies to the queried entity) detects DG at 97.0% precision and 98.7% DG recall (IPW-adjusted human gold standard); no existing framework implements it.

临床AIRAG实体归属医疗大模型

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