Modern large language models (LLMs) often exhibit overconfident errors, assigning high confidence to incorrect predictions and thereby undermining reliability in real-world use. Existing calibration methods typically rely on post-hoc adjustment or retraining, operating at the output level without addressing the underlying causes of miscalibration. We propose CoCHI, (Class-oriented Causal Head Intervention), a framework that improves calibration by identifying and intervening on internal components responsible for distinct confidence behaviours. By analysing predictions through correctness-confidence patterns, CoCHI enables targeted intervention on model internals, reducing overconfident errors while preserving correct predictions. Our approach provides a mechanistic perspective on calibration, linking reliability to identifiable structures within the model rather than treating it as an output-level issue. Experiments across multiple LLMs show consistent improvements in calibration metrics, including Expected Calibration Error, Negative Log-Likelihood, and Brier Score, while maintaining accuracy on five multiple-choice question answering benchmarks. These results suggest that effective calibration requires not only adjusting outputs, but also addressing the underlying causal mechanisms within the model.
Sizhe Wang Washington University in St. Louis, Ziqi Xu, Claire Najjuuko Washington University, Saint Louis, Charles Alba, Chenyang Lu Washington University, Saint Louis
Clinical language models (LMs) are increasingly applied to support clinical risk prediction from free-text notes, yet their uncertainty estimates often remain poorly calibrated and clinically unreliable. In this work, we propose Clinical Uncertainty Risk Alignment (CURA), a framework that aligns clinical LM-based risk estimates and uncertainty with both individual error likelihoods and cohort-level ambiguities. CURA first fine-tunes domain-specific clinical LMs to obtain task-adapted patient embeddings, and then performs uncertainty fine-tuning of a multi-head classifier using a bi-level uncertainty objective. Specifically, an individual-level calibration term aligns predictive uncertainty with each patient’s likelihood of error, while a cohort-aware regularizer pulls risk estimates toward event rates in their local neighborhoods in the embedding space and places extra weight on ambiguous cohorts near the decision boundary. We further show that this cohort-aware term can be interpreted as a cross-entropy loss with neighborhood-informed soft labels, providing a label-smoothing view of our method. Extensive experiments on MIMIC-IV clinical risk prediction tasks across various clinical LMs show that CURA consistently improves calibration metrics without substantially compromising discrimination. Further analysis illustrates that CURA reduces overconfident false reassurance and yields more trustworthy uncertainty estimates for downstream clinical decision support.
尚无 AI 解读，展示原文摘要
cs.CL
Proceedings of the 64th Annual Meeting of the Association for Computational Linguistics (Volume 1: Long Papers) · 2026 · 正式发表