about
Deceptive Grounding: Entity Attribution Failure in Clinical RAG (arxiv.org)
2 points by sbulaev 82 days ago | hide | past | pdf | discuss on HN

In plain words: Checks confirm claims come from real documents, but never ask whether the evidence is about the right drug, so drug Y's studies can pass as proof about drug X. A new check that the evidence fits the queried drug caught 98.7% of these mix-ups.

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

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.

Cedric Caruzzo, Donggeun Yoo, Tae Soo Kim
arXiv:2607.09349 · cs.CL, cs.AI, cs.LG · submitted Jul 10, 2026
abstract · pdf · html · 24 pages, 7 figures, 12 tables

add comment on HN