Existing metrics often lack the granularity and interpretability to capture nuanced clinical differences between candidate and ground-truth radiology reports, resulting in suboptimal evaluation. We introduce a Clinically grounded tabular framework with Expert-curated labels and Attribute-level comparison for Radiology report evaluation (CLEAR). CLEAR not only examines whether a report can accurately identify the presence or absence of medical conditions, but it also assesses whether the report can precisely describe each positively identified condition across five key attributes: first occurrence, change, severity, descriptive location, and recommendation. Compared with prior works, CLEAR’s multi-dimensional, attribute-level outputs enable a more comprehensive and clinically interpretable evaluation of report quality. Additionally, to measure the clinical alignment of CLEAR, we collaborated with five board-certified radiologists to develop CLEAR-Bench, a dataset of 100 chest radiograph reports from MIMIC-CXR, annotated across 6 curated attributes and 13 CheXpert conditions. Our experiments demonstrated that CLEAR achieves high accuracy in extracting clinical attributes and provides automated metrics that are strongly aligned with clinical judgment.

Large language models (LLMs) possess extensive world knowledge, including geospatial knowledge, which has been successfully applied to various geospatial tasks such as mobility prediction and social indicator prediction. However, LLMs often generate inaccurate geospatial knowledge, leading to geospatial hallucinations—incorrect or inconsistent representations of geospatial information—that compromise their reliability. While the phenomenon of general knowledge hallucination in LLMs has been widely studied, the systematic evaluation and mitigation of geospatial hallucinations remain largely unexplored. To address this gap, we propose a comprehensive evaluation framework for geospatial hallucinations, leveraging structured geospatial knowledge graphs for controlled assessment. Through extensive evaluation across 20 advanced LLMs, we uncover the hallucinations in their geospatial knowledge. Building on these insights, we introduce a dynamic factuality aligning method based on Kahneman-Tversky Optimization (KTO) to mitigate geospatial hallucinations in LLMs, leading to a performance improvement of over 29.6% on the proposed benchmark. Extensive experimental results demonstrate the effectiveness of our benchmark and learning algorithm in enhancing the trustworthiness of LLMs in geospatial knowledge and reasoning tasks.