Mitigating Hallucinations in Healthcare LLMs with Granular Fact-Checking and Domain-Specific Adaptation

In healthcare, it is essential for any LLM-generated output to be reliable and accurate, particularly in cases involving decision-making and patient safety. However, the outputs are often unreliable in such critical areas due to the risk of hallucinated outputs from the LLMs. To address this issue, we propose a fact-checking module that operates independently of any LLM, along with a domain-specific summarization model designed to minimize hallucination rates. Our model is fine-tuned using Low-Rank Adaptation (LoRa) on the MIMIC III dataset and is paired with the fact-checking module, which uses numerical tests for correctness and logical checks at a granular level through discrete logic in natural language processing (NLP) to validate facts against electronic health records (EHRs). We trained the LLM model on the full MIMIC-III dataset. For evaluation of the fact-checking module, we sampled 104 summaries, extracted them into 3,786 propositions, and used these as facts. The fact-checking module achieves a precision of 0.8904, a recall of 0.8234, and an F1-score of 0.8556. Additionally, the LLM summary model achieves a ROUGE-1 score of 0.5797 and a BERTScore of 0.9120 for summary quality.

Hallucination to Truth: A Review of Fact-Checking and Factuality Evaluation in Large Language Models

Large Language Models (LLMs) are trained on vast and diverse internet corpora that often include inaccurate or misleading content. Consequently, LLMs can generate misinformation, making robust fact-checking essential. This review systematically analyzes how LLM-generated content is evaluated for factual accuracy by exploring key challenges such as hallucinations, dataset limitations, and the reliability of evaluation metrics. The review emphasizes the need for strong fact-checking frameworks that integrate advanced prompting strategies, domain-specific fine-tuning, and retrieval-augmented generation (RAG) methods. It proposes five research questions that guide the analysis of the recent literature from 2020 to 2025, focusing on evaluation methods and mitigation techniques. The review also discusses the role of instruction tuning, multi-agent reasoning, and external knowledge access via RAG frameworks. Key findings highlight the limitations of current metrics, the value of grounding outputs with validated external evidence, and the importance of domain-specific customization to improve factual consistency. Overall, the review underlines the importance of building LLMs that are not only accurate and explainable but also tailored for domain-specific fact-checking. These insights contribute to the advancement of research toward more trustworthy and context-aware language models.