{"id":"https://openalex.org/W7154688201","doi":"https://doi.org/10.3390/a19040315","title":"Agentic Hallucination Risk Scoring for Medical LLMs via Uncertainty Quantification and Clinical Knowledge Injection","display_name":"Agentic Hallucination Risk Scoring for Medical LLMs via Uncertainty Quantification and Clinical Knowledge Injection","publication_year":2026,"publication_date":"2026-04-17","ids":{"openalex":"https://openalex.org/W7154688201","doi":"https://doi.org/10.3390/a19040315"},"language":"en","primary_location":{"id":"doi:10.3390/a19040315","is_oa":true,"landing_page_url":"https://doi.org/10.3390/a19040315","pdf_url":"https://www.mdpi.com/1999-4893/19/4/315/pdf?version=1776418937","source":{"id":"https://openalex.org/S190629608","display_name":"Algorithms","issn_l":"1999-4893","issn":["1999-4893"],"is_oa":true,"is_in_doaj":true,"is_core":true,"host_organization":"https://openalex.org/P4310310987","host_organization_name":"Multidisciplinary Digital Publishing Institute","host_organization_lineage":["https://openalex.org/P4310310987"],"host_organization_lineage_names":["Multidisciplinary Digital Publishing Institute"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Algorithms","raw_type":"journal-article"},"type":"article","indexed_in":["crossref","doaj"],"open_access":{"is_oa":true,"oa_status":"gold","oa_url":"https://www.mdpi.com/1999-4893/19/4/315/pdf?version=1776418937","any_repository_has_fulltext":true},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5114200295","display_name":"Mayank Kapadia","orcid":"https://orcid.org/0009-0009-6777-9227"},"institutions":[{"id":"https://openalex.org/I51504820","display_name":"San Jose State University","ror":"https://ror.org/04qyvz380","country_code":"US","type":"education","lineage":["https://openalex.org/I51504820"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Mayank Kapadia","raw_affiliation_strings":["Department of Applied Data Science, San Jos\u00e9 State University, San Jos\u00e9, CA 95192, USA"],"raw_orcid":"https://orcid.org/0009-0009-6777-9227","affiliations":[{"raw_affiliation_string":"Department of Applied Data Science, San Jos\u00e9 State University, San Jos\u00e9, CA 95192, USA","institution_ids":["https://openalex.org/I51504820"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5083502477","display_name":"Mohammad Masum","orcid":"https://orcid.org/0000-0001-9974-6950"},"institutions":[{"id":"https://openalex.org/I51504820","display_name":"San Jose State University","ror":"https://ror.org/04qyvz380","country_code":"US","type":"education","lineage":["https://openalex.org/I51504820"]}],"countries":["US"],"is_corresponding":true,"raw_author_name":"Mohammad Masum","raw_affiliation_strings":["Department of Applied Data Science, San Jos\u00e9 State University, San Jos\u00e9, CA 95192, USA"],"raw_orcid":"https://orcid.org/0000-0001-9974-6950","affiliations":[{"raw_affiliation_string":"Department of Applied Data Science, San Jos\u00e9 State University, San Jos\u00e9, CA 95192, USA","institution_ids":["https://openalex.org/I51504820"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":1,"corresponding_author_ids":["https://openalex.org/A5083502477"],"corresponding_institution_ids":["https://openalex.org/I51504820"],"apc_list":{"value":1600,"currency":"CHF","value_usd":1782},"apc_paid":{"value":1600,"currency":"CHF","value_usd":1782},"fwci":0.0,"has_fulltext":true,"cited_by_count":0,"citation_normalized_percentile":{"value":0.36614129,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":null,"biblio":{"volume":"19","issue":"4","first_page":"315","last_page":"315"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T11636","display_name":"Artificial Intelligence in Healthcare and Education","score":0.4074000120162964,"subfield":{"id":"https://openalex.org/subfields/2718","display_name":"Health Informatics"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T11636","display_name":"Artificial Intelligence in Healthcare and Education","score":0.4074000120162964,"subfield":{"id":"https://openalex.org/subfields/2718","display_name":"Health Informatics"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T13702","display_name":"Machine Learning in Healthcare","score":0.18930000066757202,"subfield":{"id":"https://openalex.org/subfields/1702","display_name":"Artificial Intelligence"},"field":{"id":"https://openalex.org/fields/17","display_name":"Computer Science"},"domain":{"id":"https://openalex.org/domains/3","display_name":"Physical Sciences"}},{"id":"https://openalex.org/T11689","display_name":"Adversarial Robustness in Machine Learning","score":0.0949999988079071,"subfield":{"id":"https://openalex.org/subfields/1702","display_name":"Artificial Intelligence"},"field":{"id":"https://openalex.org/fields/17","display_name":"Computer Science"},"domain":{"id":"https://openalex.org/domains/3","display_name":"Physical Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/hallucinating","display_name":"Hallucinating","score":0.6974999904632568},{"id":"https://openalex.org/keywords/baseline","display_name":"Baseline (sea)","score":0.48420000076293945},{"id":"https://openalex.org/keywords/task","display_name":"Task (project management)","score":0.4496000111103058},{"id":"https://openalex.org/keywords/uncertainty-quantification","display_name":"Uncertainty quantification","score":0.4480000138282776},{"id":"https://openalex.org/keywords/risk-assessment","display_name":"Risk assessment","score":0.43389999866485596},{"id":"https://openalex.org/keywords/post-hoc","display_name":"Post hoc","score":0.3564999997615814},{"id":"https://openalex.org/keywords/entropy","display_name":"Entropy (arrow of time)","score":0.33820000290870667},{"id":"https://openalex.org/keywords/software-deployment","display_name":"Software deployment","score":0.336899995803833}],"concepts":[{"id":"https://openalex.org/C2911011789","wikidata":"https://www.wikidata.org/wiki/Q130741","display_name":"Hallucinating","level":2,"score":0.6974999904632568},{"id":"https://openalex.org/C41008148","wikidata":"https://www.wikidata.org/wiki/Q21198","display_name":"Computer science","level":0,"score":0.508400022983551},{"id":"https://openalex.org/C12725497","wikidata":"https://www.wikidata.org/wiki/Q810247","display_name":"Baseline (sea)","level":2,"score":0.48420000076293945},{"id":"https://openalex.org/C2780451532","wikidata":"https://www.wikidata.org/wiki/Q759676","display_name":"Task (project management)","level":2,"score":0.4496000111103058},{"id":"https://openalex.org/C32230216","wikidata":"https://www.wikidata.org/wiki/Q7882499","display_name":"Uncertainty quantification","level":2,"score":0.4480000138282776},{"id":"https://openalex.org/C12174686","wikidata":"https://www.wikidata.org/wiki/Q1058438","display_name":"Risk assessment","level":2,"score":0.43389999866485596},{"id":"https://openalex.org/C154945302","wikidata":"https://www.wikidata.org/wiki/Q11660","display_name":"Artificial intelligence","level":1,"score":0.4124000072479248},{"id":"https://openalex.org/C119857082","wikidata":"https://www.wikidata.org/wiki/Q2539","display_name":"Machine learning","level":1,"score":0.36160001158714294},{"id":"https://openalex.org/C2992886853","wikidata":"https://www.wikidata.org/wiki/Q18381816","display_name":"Post hoc","level":2,"score":0.3564999997615814},{"id":"https://openalex.org/C15744967","wikidata":"https://www.wikidata.org/wiki/Q9418","display_name":"Psychology","level":0,"score":0.3434000015258789},{"id":"https://openalex.org/C106301342","wikidata":"https://www.wikidata.org/wiki/Q4117933","display_name":"Entropy (arrow of time)","level":2,"score":0.33820000290870667},{"id":"https://openalex.org/C105339364","wikidata":"https://www.wikidata.org/wiki/Q2297740","display_name":"Software deployment","level":2,"score":0.336899995803833},{"id":"https://openalex.org/C180747234","wikidata":"https://www.wikidata.org/wiki/Q23373","display_name":"Cognitive psychology","level":1,"score":0.3310999870300293},{"id":"https://openalex.org/C62230096","wikidata":"https://www.wikidata.org/wiki/Q275969","display_name":"Crowdsourcing","level":2,"score":0.3019999861717224},{"id":"https://openalex.org/C83849319","wikidata":"https://www.wikidata.org/wiki/Q7295720","display_name":"Rating scale","level":2,"score":0.29420000314712524},{"id":"https://openalex.org/C108650721","wikidata":"https://www.wikidata.org/wiki/Q1783253","display_name":"Counterfactual thinking","level":2,"score":0.2930999994277954},{"id":"https://openalex.org/C9679016","wikidata":"https://www.wikidata.org/wiki/Q1417473","display_name":"Principle of maximum entropy","level":2,"score":0.2858999967575073},{"id":"https://openalex.org/C112930515","wikidata":"https://www.wikidata.org/wiki/Q4389547","display_name":"Risk analysis (engineering)","level":1,"score":0.2840999960899353},{"id":"https://openalex.org/C3017634809","wikidata":"https://www.wikidata.org/wiki/Q84862664","display_name":"Risk communication","level":2,"score":0.27570000290870667},{"id":"https://openalex.org/C192209626","wikidata":"https://www.wikidata.org/wiki/Q190909","display_name":"Focus (optics)","level":2,"score":0.2718000113964081},{"id":"https://openalex.org/C3019960513","wikidata":"https://www.wikidata.org/wiki/Q7431607","display_name":"Schizophrenia research","level":3,"score":0.2689000070095062},{"id":"https://openalex.org/C2778755073","wikidata":"https://www.wikidata.org/wiki/Q10858537","display_name":"Scale (ratio)","level":2,"score":0.2644999921321869},{"id":"https://openalex.org/C188353592","wikidata":"https://www.wikidata.org/wiki/Q450586","display_name":"Expectancy theory","level":2,"score":0.26030001044273376},{"id":"https://openalex.org/C165838908","wikidata":"https://www.wikidata.org/wiki/Q736777","display_name":"Calibration","level":2,"score":0.2515000104904175},{"id":"https://openalex.org/C134537474","wikidata":"https://www.wikidata.org/wiki/Q17144832","display_name":"Naturalness","level":2,"score":0.2508000135421753}],"mesh":[],"locations_count":3,"locations":[{"id":"doi:10.3390/a19040315","is_oa":true,"landing_page_url":"https://doi.org/10.3390/a19040315","pdf_url":"https://www.mdpi.com/1999-4893/19/4/315/pdf?version=1776418937","source":{"id":"https://openalex.org/S190629608","display_name":"Algorithms","issn_l":"1999-4893","issn":["1999-4893"],"is_oa":true,"is_in_doaj":true,"is_core":true,"host_organization":"https://openalex.org/P4310310987","host_organization_name":"Multidisciplinary Digital Publishing Institute","host_organization_lineage":["https://openalex.org/P4310310987"],"host_organization_lineage_names":["Multidisciplinary Digital Publishing Institute"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Algorithms","raw_type":"journal-article"},{"id":"pmh:oai:doaj.org/article:719c0268ee784dcfba0135f655b935f9","is_oa":true,"landing_page_url":"https://doaj.org/article/719c0268ee784dcfba0135f655b935f9","pdf_url":null,"source":{"id":"https://openalex.org/S4306401280","display_name":"DOAJ (DOAJ: Directory of Open Access Journals)","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"host_organization":null,"host_organization_name":null,"host_organization_lineage":[],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by-sa","license_id":"https://openalex.org/licenses/cc-by-sa","version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":"Algorithms, Vol 19, Iss 4, p 315 (2026)","raw_type":"article"},{"id":"pmh:oai:scholarworks.sjsu.edu:faculty_rsca-7872","is_oa":true,"landing_page_url":"https://scholarworks.sjsu.edu/faculty_rsca/6872","pdf_url":null,"source":{"id":"https://openalex.org/S4377196389","display_name":"San Jos\u00e9 State University ScholarWorks (San Jose State University)","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"host_organization":"https://openalex.org/I51504820","host_organization_name":"San Jose State University","host_organization_lineage":["https://openalex.org/I51504820"],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":"Faculty Research, Scholarly, and Creative Activity","raw_type":"text"}],"best_oa_location":{"id":"doi:10.3390/a19040315","is_oa":true,"landing_page_url":"https://doi.org/10.3390/a19040315","pdf_url":"https://www.mdpi.com/1999-4893/19/4/315/pdf?version=1776418937","source":{"id":"https://openalex.org/S190629608","display_name":"Algorithms","issn_l":"1999-4893","issn":["1999-4893"],"is_oa":true,"is_in_doaj":true,"is_core":true,"host_organization":"https://openalex.org/P4310310987","host_organization_name":"Multidisciplinary Digital Publishing Institute","host_organization_lineage":["https://openalex.org/P4310310987"],"host_organization_lineage_names":["Multidisciplinary Digital Publishing Institute"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Algorithms","raw_type":"journal-article"},"sustainable_development_goals":[{"id":"https://metadata.un.org/sdg/16","display_name":"Peace, Justice and strong institutions","score":0.4666138291358948}],"awards":[],"funders":[{"id":"https://openalex.org/F4320316409","display_name":"San Jos\u00e9 State University","ror":"https://ror.org/04qyvz380"}],"has_content":{"grobid_xml":true,"pdf":true},"content_urls":{"pdf":"https://content.openalex.org/works/W7154688201.pdf","grobid_xml":"https://content.openalex.org/works/W7154688201.grobid-xml"},"referenced_works_count":24,"referenced_works":["https://openalex.org/W579397108","https://openalex.org/W2026498605","https://openalex.org/W2033178790","https://openalex.org/W2056716515","https://openalex.org/W2169927893","https://openalex.org/W2292289085","https://openalex.org/W2504526017","https://openalex.org/W2806532810","https://openalex.org/W2970482702","https://openalex.org/W4361001766","https://openalex.org/W4389519219","https://openalex.org/W4391136507","https://openalex.org/W4401043199","https://openalex.org/W4404837143","https://openalex.org/W4405765960","https://openalex.org/W4407243808","https://openalex.org/W4408108874","https://openalex.org/W4411120299","https://openalex.org/W4412875472","https://openalex.org/W4412888674","https://openalex.org/W7118304105","https://openalex.org/W7124262264","https://openalex.org/W7125984739","https://openalex.org/W7135219636"],"related_works":[],"abstract_inverted_index":{"Large":[0],"Language":[1],"Models":[2],"(LLMs)":[3],"have":[4],"witnessed":[5],"significant":[6],"adoption":[7],"across":[8,151,202],"numerous":[9],"domains":[10],"since":[11],"2020,":[12],"but":[13],"their":[14],"proclivity":[15],"to":[16,139,175],"hallucinate":[17],"creates":[18],"unacceptable":[19],"dangers":[20],"in":[21],"high-risk":[22],"environments":[23],"like":[24],"healthcare,":[25],"where":[26],"wrong":[27],"outputs":[28,49,65],"can":[29],"directly":[30],"jeopardize":[31],"human":[32],"safety.":[33],"While":[34],"present":[35],"systems":[36],"focus":[37],"on":[38,180],"pre-generation":[39],"mitigation":[40],"strategies,":[41],"they":[42,67],"cannot":[43],"ensure":[44],"the":[45,144,157,193],"safety":[46,141,215],"of":[47,125],"individual":[48],"during":[50],"inference.":[51],"We":[52],"provide":[53,207],"a":[54,75,78,98,105,114,184,208],"post":[55,213],"hoc":[56,214],"Hallucination":[57],"Risk":[58],"Scoring":[59],"(HRS)":[60],"methodology":[61],"that":[62,101,108,165],"intercepts":[63],"questionable":[64],"before":[66],"reach":[68],"patients":[69],"via":[70],"an":[71,82,137],"agentic":[72],"pipeline.":[73],"Given":[74],"medical":[76,219],"question,":[77],"domain-specific":[79],"LLM":[80],"generates":[81],"initial":[83],"response":[84],"from":[85,199],"which":[86,93],"five":[87],"complimentary":[88],"uncertainty":[89,195],"signals":[90],"are":[91,94],"computed,":[92],"then":[95],"separated":[96],"into":[97],"decision":[99],"layer":[100,107],"governs":[102],"escalation":[103,163],"and":[104,130,161,211],"guidance":[106],"directs":[109],"clinical":[110],"knowledge":[111],"injection":[112],"by":[113,156],"GPT.":[115],"The":[116,134],"framework":[117],"is":[118],"tested":[119],"using":[120],"three":[121],"biological":[122],"question-answering":[123],"datasets":[124],"various":[126],"complexity:":[127],"PubMedQA-Labeled,":[128],"PubMedQA-Artificial,":[129],"BioASQ":[131],"Task":[132],"B.":[133],"results":[135],"show":[136],"up":[138],"38%":[140],"increase":[142],"at":[143],"most":[145],"sensitive":[146],"threshold":[147],"configuration,":[148],"zero":[149],"deterioration":[150],"all":[152,203],"experimental":[153],"configurations":[154],"enforced":[155],"Revert":[158],"Baseline":[159],"method,":[160],"complexity-aware":[162],"rates":[164],"scale":[166],"organically":[167],"with":[168],"dataset":[169],"difficulty.":[170],"Tunable":[171],"thresholds":[172],"allow":[173],"physicians":[174],"calibrate":[176],"system":[177],"behavior":[178],"based":[179],"deployment":[181],"requirements,":[182],"providing":[183],"practical":[185],"safety\u2013accuracy":[186],"trade-off.":[187],"Statistical":[188],"research":[189],"finds":[190],"entropy":[191],"as":[192],"primary":[194],"signal":[196],"separating":[197],"escalated":[198],"non-escalated":[200],"situations":[201],"datasets.":[204],"These":[205],"findings":[206],"deployable,":[209],"interpretable,":[210],"configurable":[212],"paradigm":[216],"for":[217],"reliable":[218],"AI":[220],"implementation.":[221]},"counts_by_year":[],"updated_date":"2026-07-23T08:03:31.855105","created_date":"2026-04-18T00:00:00"}
