Toward Guarantees for Clinical Reasoning in Vision Language Models via Formal Verification

The paper introduces a neurosymbolic verification framework that audits the internal consistency of vision-language models (VLMs) when generating radiology reports. By autoformalizing free‑text findings into structured propositional evidence and using an SMT solver (Z3) alongside a clinical knowledge base, the system determines whether each diagnostic claim is entailed, hallucinated, or omitted. Evaluation on seven VLMs across five chest X‑ray benchmarks reveals distinct reasoning failure modes—such as conservative observation and stochastic hallucination—that traditional metrics miss, and shows that enforcing solver‑backed entailment can eliminate unsupported hallucinations and improve diagnostic soundness and precision.

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• llms
• rag
• multimodal
• benchmarks
• safety