Chain-of-thought (CoT) may often look plausible, yet it may not faithfully reflect the model’s decision-making process. While methods for measuring the faithfulness of CoTs for textual inputs have been increasingly introduced, using these methods for visual inputs is not straightforward. In this work, we adapt the family of counterfactual methods for measuring CoT faithfulness, namely the Counterfactual Test (CT) and Correlational Counterfactual Test (CCT), to visual inputs, and call them vCT and vCCT, respectively. Using vCT and vCCT, we benchmark eight recent open-source Vision Language Models (VLMs) on two datasets. Our analysis shows that CoTs do not reliably track visual evidence that influences model predictions: they may omit the removed object even when its removal causes a large prediction shift, yet mention it when the shift is small. We further find that Predict-then-Explain explanations align more strongly with perturbation-induced probability shifts than pre-answer CoTs, while binary vCT scores are often nearly saturated. We also include a reconstruction control, in which images pass through the same editing pipeline without object removal, and find that the main object-removal intervention induces larger shifts than reconstruction alone. We construct and release Counter-SNLI-VE and Counter-A-OKVQA, two datasets of image pairs that differ by a single object.

The growing capabilities of AI models are leading to their wider use, including in safety-critical domains. Explainable AI (XAI) aims to make these models safer to use by making their inference process more transparent. However, current explainability methods are seldom evaluated in the way they are intended to be used: by real-world end users. To address this, we conducted a large-scale user study with 85 healthcare practitioners in the context of human-AI collaborative chest X-ray analysis. We evaluated three types of explanations: visual explanations (saliency maps), natural language explanations, and a combination of both modalities. We specifically examined how different explanation types influence users depending on whether the AI advice and explanations are factually correct. We find that text-based explanations lead to significant over-reliance, which is alleviated by combining them with saliency maps. We also observe that the quality of explanations, that is, how much factually correct information they entail, and how much this aligns with AI correctness, significantly impacts the usefulness of the different explanation types.