arXiv:2608.23666cs.AIcs.CL2026-08

通过动态门控机制,让医疗问答模型更抗误导、减少胡说八道。

Gated Activation Steering for Reducing Sycophancy & Hallucination in Medical Question Answering

  • 用对比临床数据学习对抗幻觉和讨好行为的独立引导方向
  • 在40亿参数模型上,92%的压力测试中保持答案稳定
  • 仅在必要时干预,适合追求高可靠性的医疗AI应用

大语言模型在临床问答中易出现幻觉和讨好行为,导致回答脱离上下文或因用户压力改变正确答案。现有方法常孤立处理或全局干预,影响原本正确的响应。本文提出一种基于推理时干预(ITI)的统一框架:从对比临床对中学习幻觉与讨好行为的独立引导方向,并作用于因果验证过的注意力头。运行时,行为专用门控决定是否干预——幻觉组件抑制无依据陈述,讨好组件防止因用户压力而改变答案。在真实电子病历数据上评估,共执行15,900次响应测试。针对40亿参数模型的600条压力轨迹,未引导模型在570次中妥协;使用门控引导后,在551次中坚持了原答案。其抗压能力接近超过1000亿参数模型水平,证明精准的推理时引导可显著提升鲁棒性,且无需每轮干预。

原文摘要 · Abstract (English)

Sycophancy and hallucination are persistent failure modes of Large Language Models (LLMs) across domains. However, it becomes particularly consequential in clinical question answering, where responses must remain grounded in the provided context and robust to user pressure. Hallucination can introduce information that is unsupported by the context, while sycophancy can cause a model to abandon a previously correct answer when challenged by the user. Existing approaches, such as prompt-based safeguards and always-on activation steering, often address these behaviors separately or apply interventions broadly across turns, which can unnecessarily deteriorate responses that were already correct. To address these limitations within a single framework, we employ Inference Time Intervention (ITI) to jointly control both behaviors by learning separate steering directions for hallucination and sycophancy from contrastive clinical pairs and applying them to causally verified attention heads. During runtime, behavior-specific gates then determine when intervention is needed: the hallucination component mitigates unsupported claims, while the sycophancy component mitigates answer shifts caused by user pressure. We evaluate this framework on clinical questions grounded in EHR data while keeping the model weights frozen. Across all evaluation settings, we conducted 15,900 model-response runs. Across 600 pressure trajectories for the 4-billion-parameter model, the unsteered model caved in 570 cases. At the same time, gated steering helped it last longer in 551 of them. It held its ground under pressure at levels comparable to those of models with more than 100 billion parameters, showing that targeted inference-time steering can improve robustness without intervening at every turn.

医疗问答幻觉抑制推理时干预

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