Logit-Level Uncertainty Quantification in Vision-Language Models for Histopathology Image Analysis

Vision-Language Models (VLMs) with their multimodal capabilities have demonstrated remarkable success in almost all domains, including education, transportation, healthcare, energy, finance, law, and retail. Nevertheless, the utilization of VLMs in healthcare applications raises crucial concerns due to the sensitivity of large-scale medical data and the trustworthiness of these models (reliability, transparency, and security). This study proposes a logit-level uncertainty quantification (UQ) framework for histopathology image analysis using VLMs to deal with these concerns. UQ is evaluated for three VLMs using metrics derived from temperature-controlled output logits. The proposed framework demonstrates a critical separation in uncertainty behavior. While VLMs show high stochastic sensitivity (cosine similarity (CS) $<0.71$ and $<0.84$, Jensen-Shannon divergence (JS) $<0.57$ and $<0.38$, and Kullback-Leibler divergence (KL) $<0.55$ and $<0.35$, respectively for mean values of VILA-M3-8B and LLaVA-Med v1.5), near-maximal temperature impacts ($Δ_T \approx 1.00$), and displaying abrupt uncertainty transitions, particularly for complex diagnostic prompts. In contrast, the pathology-specific PRISM model maintains near-deterministic behavior (mean CS $>0.90$, JS $<0.10$, KL $<0.09$) and significantly minimal temperature effects across all prompt complexities. These findings emphasize the importance of logit-level uncertainty quantification to evaluate trustworthiness in histopathology applications utilizing VLMs.

EvalQReason: A Framework for Step-Level Reasoning Evaluation in Large Language Models

Large Language Models (LLMs) are increasingly deployed in critical applications requiring reliable reasoning, yet their internal reasoning processes remain difficult to evaluate systematically. Existing methods focus on final-answer correctness, providing limited insight into how reasoning unfolds across intermediate steps. We present EvalQReason, a framework that quantifies LLM reasoning quality through step-level probability distribution analysis without requiring human annotation. The framework introduces two complementary algorithms: Consecutive Step Divergence (CSD), which measures local coherence between adjacent reasoning steps, and Step-to-Final Convergence (SFC), which assesses global alignment with final answers. Each algorithm employs five statistical metrics to capture reasoning dynamics. Experiments across mathematical and medical datasets with open-source 7B-parameter models demonstrate that CSD-based features achieve strong predictive performance for correctness classification, with classical machine learning models reaching F1=0.78 and ROC-AUC=0.82, and sequential neural models substantially improving performance (F1=0.88, ROC-AUC=0.97). CSD consistently outperforms SFC, and sequential architectures outperform classical machine learning approaches. Critically, reasoning dynamics prove domain-specific: mathematical reasoning exhibits clear divergence-based discrimination patterns between correct and incorrect solutions, while medical reasoning shows minimal discriminative signals, revealing fundamental differences in how LLMs process different reasoning types. EvalQReason enables scalable, process-aware evaluation of reasoning reliability, establishing probability-based divergence analysis as a principled approach for trustworthy AI deployment.