Daily Papers

Pre-trained large vision-language models (VLMs) like CLIP have revolutionized visual representation learning using natural language as supervisions, and demonstrated promising generalization ability. In this work, we propose ViP, a novel visual symptom-guided prompt learning framework for medical image analysis, which facilitates general knowledge transfer from CLIP. ViP consists of two key components: a visual symptom generator (VSG) and a dual-prompt network. Specifically, VSG aims to extract explicable visual symptoms from pre-trained large language models, while the dual-prompt network utilizes these visual symptoms to guide the training on two learnable prompt modules, i.e., context prompt and merge prompt, which effectively adapts our framework to medical image analysis via large VLMs. Extensive experimental results demonstrate that ViP can outperform state-of-the-art methods on two challenging datasets.

The need for improved diagnostic methods in ophthalmology is acute, especially in the underdeveloped regions with limited access to specialists and advanced equipment. Therefore, we introduce VisionUnite, a novel vision-language foundation model for ophthalmology enhanced with clinical knowledge. VisionUnite has been pretrained on an extensive dataset comprising 1.24 million image-text pairs, and further refined using our proposed MMFundus dataset, which includes 296,379 high-quality fundus image-text pairs and 889,137 simulated doctor-patient dialogue instances. Our experiments indicate that VisionUnite outperforms existing generative foundation models such as GPT-4V and Gemini Pro. It also demonstrates diagnostic capabilities comparable to junior ophthalmologists. VisionUnite performs well in various clinical scenarios including open-ended multi-disease diagnosis, clinical explanation, and patient interaction, making it a highly versatile tool for initial ophthalmic disease screening. VisionUnite can also serve as an educational aid for junior ophthalmologists, accelerating their acquisition of knowledge regarding both common and underrepresented ophthalmic conditions. VisionUnite represents a significant advancement in ophthalmology, with broad implications for diagnostics, medical education, and understanding of disease mechanisms. The source code is at https://github.com/HUANGLIZI/VisionUnite.

Traditionally, AI research in medical diagnosis has largely centered on image analysis. While this has led to notable advancements, the absence of patient-reported symptoms continues to hinder diagnostic accuracy. To address this, we propose a Pre-Consultation Dialogue Framework (PCDF) that mimics real-world diagnostic procedures, where doctors iteratively query patients before reaching a conclusion. Specifically, we simulate diagnostic dialogues between two vision-language models (VLMs): a DocVLM, which generates follow-up questions based on the image and dialogue history, and a PatientVLM, which responds using a symptom profile derived from the ground-truth diagnosis. We additionally conducted a small-scale clinical validation of the synthetic symptoms generated by our framework, with licensed clinicians confirming their clinical relevance, symptom coverage, and overall realism. These findings indicate that the resulting DocVLM-PatientVLM interactions form coherent, multi-turn consultations paired with images and diagnoses, which we then use to fine-tune the DocVLM. This dialogue-based supervision leads to substantial gains over image-only training, highlighting the value of realistic symptom elicitation for diagnosis.

Automatic medical report generation (MRG), which possesses significant research value as it can aid radiologists in clinical diagnosis and report composition, has garnered increasing attention. Despite recent progress, generating accurate reports remains arduous due to the requirement for precise clinical comprehension and disease diagnosis inference. Furthermore, owing to the limited accessibility of medical data and the imbalanced distribution of diseases, the underrepresentation of rare diseases in training data makes large-scale medical visual language models (LVLMs) prone to hallucinations, such as omissions or fabrications, severely undermining diagnostic performance and further intensifying the challenges for MRG in practice. In this study, to effectively mitigate hallucinations in medical report generation, we propose a chain-of-medical-thought approach (CoMT), which intends to imitate the cognitive process of human doctors by decomposing diagnostic procedures. The radiological features with different importance are structured into fine-grained medical thought chains to enhance the inferential ability during diagnosis, thereby alleviating hallucination problems and enhancing the diagnostic accuracy of MRG. The code and dataset have been released at https://github.com/FRENKIE-CHIANG/CoMT.

Medical report generation has achieved remarkable advancements yet has still been faced with several challenges. First, the inherent imbalance in the distribution of normal and abnormal cases may lead models to exhibit a biased focus on normal samples, resulting in unreliable diagnoses. Second, the frequent occurrence of common template sentences in the reports may overwhelm the critical abnormal information. Moreover, existing works focus on 2D chest X-rays, leaving CT report generation underexplored due to the high-dimensional nature of CT images and the limited availability of CT-report pairs. Recently, LLM has shown a great ability to generate reliable answers with appropriate prompts, which shed light on addressing the aforementioned challenges. In this paper, we propose Dia-LLaMA, a framework to adapt the LLaMA2-7B for CT report generation by incorporating diagnostic information as guidance prompts. Considering the high dimension of CT, we leverage a pre-trained ViT3D with perceiver to extract the visual information. To tailor the LLM for report generation and emphasize abnormality, we extract additional diagnostic information by referring to a disease prototype memory bank, which is updated during training to capture common disease representations. Furthermore, we introduce disease-aware attention to enable the model to adjust attention for different diseases. Experiments on the chest CT dataset demonstrated that our proposed method outperformed previous methods and achieved state-of-the-art on both clinical efficacy performance and natural language generation metrics. The code will be made publically available.

Often, the needs and visual abilities differ between the annotator group and the end user group. Generating detailed diagram descriptions for blind and low-vision (BLV) users is one such challenging domain. Sighted annotators could describe visuals with ease, but existing studies have shown that direct generations by them are costly, bias-prone, and somewhat lacking by BLV standards. In this study, we ask sighted individuals to assess -- rather than produce -- diagram descriptions generated by vision-language models (VLM) that have been guided with latent supervision via a multi-pass inference. The sighted assessments prove effective and useful to professional educators who are themselves BLV and teach visually impaired learners. We release Sightation, a collection of diagram description datasets spanning 5k diagrams and 137k samples for completion, preference, retrieval, question answering, and reasoning training purposes and demonstrate their fine-tuning potential in various downstream tasks.

Blind and low vision (BLV) creators use images to communicate with sighted audiences. However, creating or retrieving images is challenging for BLV creators as it is difficult to use authoring tools or assess image search results. Thus, creators limit the types of images they create or recruit sighted collaborators. While text-to-image generation models let creators generate high-fidelity images based on a text description (i.e. prompt), it is difficult to assess the content and quality of generated images. We present GenAssist, a system to make text-to-image generation accessible. Using our interface, creators can verify whether generated image candidates followed the prompt, access additional details in the image not specified in the prompt, and skim a summary of similarities and differences between image candidates. To power the interface, GenAssist uses a large language model to generate visual questions, vision-language models to extract answers, and a large language model to summarize the results. Our study with 12 BLV creators demonstrated that GenAssist enables and simplifies the process of image selection and generation, making visual authoring more accessible to all.

Vision-language models in pathology enable multimodal case retrieval and automated report generation. Many of the models developed so far, however, have been trained on pathology reports that include information which cannot be inferred from paired whole slide images (e.g., patient history), potentially leading to hallucinated sentences in generated reports. To this end, we investigate how the selection of information from pathology reports for vision-language modeling affects the quality of the multimodal representations and generated reports. More concretely, we compare a model trained on full reports against a model trained on preprocessed reports that only include sentences describing the cell and tissue appearances based on the H&E-stained slides. For the experiments, we built upon the BLIP-2 framework and used a cutaneous melanocytic lesion dataset of 42,433 H&E-stained whole slide images and 19,636 corresponding pathology reports. Model performance was assessed using image-to-text and text-to-image retrieval, as well as qualitative evaluation of the generated reports by an expert pathologist. Our results demonstrate that text preprocessing prevents hallucination in report generation. Despite the improvement in the quality of the generated reports, training the vision-language model on full reports showed better cross-modal retrieval performance.

Medicine, by its nature, is a multifaceted domain that requires the synthesis of information across various modalities. Medical generative vision-language models (VLMs) make a first step in this direction and promise many exciting clinical applications. However, existing models typically have to be fine-tuned on sizeable down-stream datasets, which poses a significant limitation as in many medical applications data is scarce, necessitating models that are capable of learning from few examples in real-time. Here we propose Med-Flamingo, a multimodal few-shot learner adapted to the medical domain. Based on OpenFlamingo-9B, we continue pre-training on paired and interleaved medical image-text data from publications and textbooks. Med-Flamingo unlocks few-shot generative medical visual question answering (VQA) abilities, which we evaluate on several datasets including a novel challenging open-ended VQA dataset of visual USMLE-style problems. Furthermore, we conduct the first human evaluation for generative medical VQA where physicians review the problems and blinded generations in an interactive app. Med-Flamingo improves performance in generative medical VQA by up to 20\% in clinician's rating and firstly enables multimodal medical few-shot adaptations, such as rationale generation. We release our model, code, and evaluation app under https://github.com/snap-stanford/med-flamingo.

Vision Language Models (VLMs) are increasingly used for tasks like medical report generation and visual question answering. However, fluent diagnostic text does not guarantee safe visual understanding. In clinical practice, interpretation begins with pre-diagnostic sanity checks: verifying that the input is valid to read (correct modality and anatomy, plausible viewpoint and orientation, and no obvious integrity violations). Existing benchmarks largely assume this step is solved, and therefore miss a critical failure mode: a model can produce plausible narratives even when the input is inconsistent or invalid. We introduce MedObvious, a 1,880-task benchmark that isolates input validation as a set-level consistency capability over small multi-panel image sets: the model must identify whether any panel violates expected coherence. MedObvious spans five progressive tiers, from basic orientation/modality mismatches to clinically motivated anatomy/viewpoint verification and triage-style cues, and includes five evaluation formats to test robustness across interfaces. Evaluating 17 different VLMs, we find that sanity checking remains unreliable: several models hallucinate anomalies on normal (negative-control) inputs, performance degrades when scaling to larger image sets, and measured accuracy varies substantially between multiple-choice and open-ended settings. These results show that pre-diagnostic verification remains unsolved for medical VLMs and should be treated as a distinct, safety-critical capability before deployment.

The prevalence of vision-threatening eye diseases is a significant global burden, with many cases remaining undiagnosed or diagnosed too late for effective treatment. Large vision-language models (LVLMs) have the potential to assist in understanding anatomical information, diagnosing eye diseases, and drafting interpretations and follow-up plans, thereby reducing the burden on clinicians and improving access to eye care. However, limited benchmarks are available to assess LVLMs' performance in ophthalmology-specific applications. In this study, we introduce LMOD, a large-scale multimodal ophthalmology benchmark consisting of 21,993 instances across (1) five ophthalmic imaging modalities: optical coherence tomography, color fundus photographs, scanning laser ophthalmoscopy, lens photographs, and surgical scenes; (2) free-text, demographic, and disease biomarker information; and (3) primary ophthalmology-specific applications such as anatomical information understanding, disease diagnosis, and subgroup analysis. In addition, we benchmarked 13 state-of-the-art LVLM representatives from closed-source, open-source, and medical domains. The results demonstrate a significant performance drop for LVLMs in ophthalmology compared to other domains. Systematic error analysis further identified six major failure modes: misclassification, failure to abstain, inconsistent reasoning, hallucination, assertions without justification, and lack of domain-specific knowledge. In contrast, supervised neural networks specifically trained on these tasks as baselines demonstrated high accuracy. These findings underscore the pressing need for benchmarks in the development and validation of ophthalmology-specific LVLMs.

Automatic radiology report generation is booming due to its huge application potential for the healthcare industry. However, existing computer vision and natural language processing approaches to tackle this problem are limited in two aspects. First, when extracting image features, most of them neglect multi-view reasoning in vision and model single-view structure of medical images, such as space-view or channel-view. However, clinicians rely on multi-view imaging information for comprehensive judgment in daily clinical diagnosis. Second, when generating reports, they overlook context reasoning with multi-modal information and focus on pure textual optimization utilizing retrieval-based methods. We aim to address these two issues by proposing a model that better simulates clinicians' perspectives and generates more accurate reports. Given the above limitation in feature extraction, we propose a Globally-intensive Attention (GIA) module in the medical image encoder to simulate and integrate multi-view vision perception. GIA aims to learn three types of vision perception: depth view, space view, and pixel view. On the other hand, to address the above problem in report generation, we explore how to involve multi-modal signals to generate precisely matched reports, i.e., how to integrate previously predicted words with region-aware visual content in next word prediction. Specifically, we design a Visual Knowledge-guided Decoder (VKGD), which can adaptively consider how much the model needs to rely on visual information and previously predicted text to assist next word prediction. Hence, our final Intensive Vision-guided Network (IVGN) framework includes a GIA-guided Visual Encoder and the VKGD. Experiments on two commonly-used datasets IU X-Ray and MIMIC-CXR demonstrate the superior ability of our method compared with other state-of-the-art approaches.

Recent advances in generative vision-language models (VLMs) have exciting potential implications for AI in radiology, yet VLMs are also known to produce hallucinations, nonsensical text, and other unwanted behaviors that can waste clinicians' time and cause patient harm. Drawing on recent work on direct preference optimization (DPO), we propose a simple method for modifying the behavior of pretrained VLMs performing radiology report generation by suppressing unwanted types of generations. We apply our method to the prevention of hallucinations of prior exams, addressing a long-established problem behavior in models performing chest X-ray report generation. Across our experiments, we find that DPO fine-tuning achieves a 3.2-4.8x reduction in lines hallucinating prior exams while maintaining model performance on clinical accuracy metrics. Our work is, to the best of our knowledge, the first work to apply DPO to medical VLMs, providing a data- and compute- efficient way to suppress problem behaviors while maintaining overall clinical accuracy.

Recent development of Large Vision-Language Models (LVLMs) has attracted growing attention within the AI landscape for its practical implementation potential. However, ``hallucination'', or more specifically, the misalignment between factual visual content and corresponding textual generation, poses a significant challenge of utilizing LVLMs. In this comprehensive survey, we dissect LVLM-related hallucinations in an attempt to establish an overview and facilitate future mitigation. Our scrutiny starts with a clarification of the concept of hallucinations in LVLMs, presenting a variety of hallucination symptoms and highlighting the unique challenges inherent in LVLM hallucinations. Subsequently, we outline the benchmarks and methodologies tailored specifically for evaluating hallucinations unique to LVLMs. Additionally, we delve into an investigation of the root causes of these hallucinations, encompassing insights from the training data and model components. We also critically review existing methods for mitigating hallucinations. The open questions and future directions pertaining to hallucinations within LVLMs are discussed to conclude this survey.

Recent advances in Large Vision-Language Models (LVLMs) have significantly improve performance in image comprehension tasks, such as formatted charts and rich-content images. Yet, Graphical User Interface (GUI) pose a greater challenge due to their structured format and detailed textual information. Existing LVLMs often overly depend on internal knowledge and neglect image content, resulting in hallucinations and incorrect responses in GUI comprehension. To address these issues, we introduce VGA, a fine-tuned model designed for comprehensive GUI understanding. Our model aims to enhance the interpretation of visual data of GUI and reduce hallucinations. We first construct a Vision Question Answering (VQA) dataset of 63.8k high-quality examples with our propose Referent Method, which ensures the model's responses are highly depend on visual content within the image. We then design a two-stage fine-tuning method called Foundation and Advanced Comprehension (FAC) to enhance both the model's ability to extract information from image content and alignment with human intent. Experiments show that our approach enhances the model's ability to extract information from images and achieves state-of-the-art results in GUI understanding tasks. Our dataset and fine-tuning script will be released soon.

Clinicians spend a significant amount of time reviewing medical images and transcribing their findings regarding patient diagnosis, referral and treatment in text form. Vision-language models (VLMs), which automatically interpret images and summarize their findings as text, have enormous potential to alleviate clinical workloads and increase patient access to high-quality medical care. While foundational models have stirred considerable interest in the medical community, it is unclear whether their general capabilities translate to real-world clinical utility. In this work, we show that foundation VLMs markedly underperform compared to practicing ophthalmologists on specialist tasks crucial to the care of patients with age-related macular degeneration (AMD). To address this, we initially identified the essential capabilities required for image-based clinical decision-making, and then developed a curriculum to selectively train VLMs in these skills. The resulting model, RetinaVLM, can be instructed to write reports that significantly outperform those written by leading foundation medical VLMs in disease staging (F1 score of 0.63 vs. 0.11) and patient referral (0.67 vs. 0.39), and approaches the diagnostic performance of junior ophthalmologists (who achieve 0.77 and 0.78 on the respective tasks). Furthermore, in a reader study involving two senior ophthalmologists with up to 32 years of experience, RetinaVLM's reports were found to be similarly correct (78.6% vs. 82.1%) and complete (both 78.6%) as reports written by junior ophthalmologists with up to 10 years of experience. These results demonstrate that our curriculum-based approach provides a blueprint for specializing generalist foundation medical VLMs to handle real-world clinical tasks.

Recent interest in Large Vision-Language Models (LVLMs) for practical applications is moderated by the significant challenge of hallucination or the inconsistency between the factual information and the generated text. In this paper, we first perform an in-depth analysis of hallucinations and discover several novel insights about how and when LVLMs hallucinate. From our analysis, we show that: (1) The community's efforts have been primarily targeted towards reducing hallucinations related to visual recognition (VR) prompts (e.g., prompts that only require describing the image), thereby ignoring hallucinations for cognitive prompts (e.g., prompts that require additional skills like reasoning on contents of the image). (2) LVLMs lack visual perception, i.e., they can see but not necessarily understand or perceive the input image. We analyze responses to cognitive prompts and show that LVLMs hallucinate due to a perception gap: although LVLMs accurately recognize visual elements in the input image and possess sufficient cognitive skills, they struggle to respond accurately and hallucinate. To overcome this shortcoming, we propose Visual Description Grounded Decoding (VDGD), a simple, robust, and training-free method for alleviating hallucinations. Specifically, we first describe the image and add it as a prefix to the instruction. Next, during auto-regressive decoding, we sample from the plausible candidates according to their KL-Divergence (KLD) to the description, where lower KLD is given higher preference. Experimental results on several benchmarks and LVLMs show that VDGD improves significantly over other baselines in reducing hallucinations. We also propose VaLLu, a benchmark for the comprehensive evaluation of the cognitive capabilities of LVLMs.

In the era of modern healthcare, swiftly generating medical question summaries is crucial for informed and timely patient care. Despite the increasing complexity and volume of medical data, existing studies have focused solely on text-based summarization, neglecting the integration of visual information. Recognizing the untapped potential of combining textual queries with visual representations of medical conditions, we introduce the Multimodal Medical Question Summarization (MMQS) Dataset. This dataset, a major contribution to our work, pairs medical queries with visual aids, facilitating a richer and more nuanced understanding of patient needs. We also propose a framework, utilizing the power of Contrastive Language Image Pretraining(CLIP) and Large Language Models(LLMs), consisting of four modules that identify medical disorders, generate relevant context, filter medical concepts, and craft visually aware summaries. Our comprehensive framework harnesses the power of CLIP, a multimodal foundation model, and various general-purpose LLMs, comprising four main modules: the medical disorder identification module, the relevant context generation module, the context filtration module for distilling relevant medical concepts and knowledge, and finally, a general-purpose LLM to generate visually aware medical question summaries. Leveraging our MMQS dataset, we showcase how visual cues from images enhance the generation of medically nuanced summaries. This multimodal approach not only enhances the decision-making process in healthcare but also fosters a more nuanced understanding of patient queries, laying the groundwork for future research in personalized and responsive medical care

Vision-language models (VLMs) still struggle with visual perception tasks such as spatial understanding and viewpoint recognition. One plausible contributing factor is that natural image datasets provide limited supervision for low-level visual skills. This motivates a practical question: can targeted synthetic supervision, generated from only a task keyword such as Depth Order, address these weaknesses? To investigate this question, we introduce VisionFoundry, a task-aware synthetic data generation pipeline that takes only the task name as input and uses large language models (LLMs) to generate questions, answers, and text-to-image (T2I) prompts, then synthesizes images with T2I models and verifies consistency with a proprietary VLM, requiring no reference images or human annotation. Using VisionFoundry, we construct VisionFoundry-10K, a synthetic visual question answering (VQA) dataset containing 10k image-question-answer triples spanning 10 tasks. Models trained on VisionFoundry-10K achieve substantial improvements on visual perception benchmarks: +7% on MMVP and +10% on CV-Bench-3D, while preserving broader capabilities and showing favorable scaling behavior as data size increases. Our results suggest that limited task-targeted supervision is an important contributor to this bottleneck and that synthetic supervision is a promising path toward more systematic training for VLMs.

Mental health disorders are one of the most serious diseases in the world. Most people with such a disease lack access to adequate care, which highlights the importance of training models for the diagnosis and treatment of mental health disorders. However, in the mental health domain, privacy concerns limit the accessibility of personalized treatment data, making it challenging to build powerful models. In this paper, we introduce MentalArena, a self-play framework to train language models by generating domain-specific personalized data, where we obtain a better model capable of making a personalized diagnosis and treatment (as a therapist) and providing information (as a patient). To accurately model human-like mental health patients, we devise Symptom Encoder, which simulates a real patient from both cognition and behavior perspectives. To address intent bias during patient-therapist interactions, we propose Symptom Decoder to compare diagnosed symptoms with encoded symptoms, and dynamically manage the dialogue between patient and therapist according to the identified deviations. We evaluated MentalArena against 6 benchmarks, including biomedicalQA and mental health tasks, compared to 6 advanced models. Our models, fine-tuned on both GPT-3.5 and Llama-3-8b, significantly outperform their counterparts, including GPT-4o. We hope that our work can inspire future research on personalized care. Code is available in https://github.com/Scarelette/MentalArena/tree/main

Automatic medical report generation (MRG) is of great research value as it has the potential to relieve radiologists from the heavy burden of report writing. Despite recent advancements, accurate MRG remains challenging due to the need for precise clinical understanding and the identification of clinical findings. Moreover, the imbalanced distribution of diseases makes the challenge even more pronounced, as rare diseases are underrepresented in training data, making their diagnostic performance unreliable. To address these challenges, we propose diagnosis-driven prompts for medical report generation (PromptMRG), a novel framework that aims to improve the diagnostic accuracy of MRG with the guidance of diagnosis-aware prompts. Specifically, PromptMRG is based on encoder-decoder architecture with an extra disease classification branch. When generating reports, the diagnostic results from the classification branch are converted into token prompts to explicitly guide the generation process. To further improve the diagnostic accuracy, we design cross-modal feature enhancement, which retrieves similar reports from the database to assist the diagnosis of a query image by leveraging the knowledge from a pre-trained CLIP. Moreover, the disease imbalanced issue is addressed by applying an adaptive logit-adjusted loss to the classification branch based on the individual learning status of each disease, which overcomes the barrier of text decoder's inability to manipulate disease distributions. Experiments on two MRG benchmarks show the effectiveness of the proposed method, where it obtains state-of-the-art clinical efficacy performance on both datasets.

Enabling machines to understand structured visuals like slides and user interfaces is essential for making them accessible to people with disabilities. However, achieving such understanding computationally has required manual data collection and annotation, which is time-consuming and labor-intensive. To overcome this challenge, we present a method to generate synthetic, structured visuals with target labels using code generation. Our method allows people to create datasets with built-in labels and train models with a small number of human-annotated examples. We demonstrate performance improvements in three tasks for understanding slides and UIs: recognizing visual elements, describing visual content, and classifying visual content types.

The rapid advancement of large-scale vision-language models has showcased remarkable capabilities across various tasks. However, the lack of extensive and high-quality image-text data in medicine has greatly hindered the development of large-scale medical vision-language models. In this work, we present a diagnosis-guided bootstrapping strategy that exploits both image and label information to construct vision-language datasets. Based on the constructed dataset, we developed MedDr, a generalist foundation model for healthcare capable of handling diverse medical data modalities, including radiology, pathology, dermatology, retinography, and endoscopy. Moreover, during inference, we propose a simple but effective retrieval-augmented medical diagnosis strategy, which enhances the model's generalization ability. Extensive experiments on visual question answering, medical report generation, and medical image diagnosis demonstrate the superiority of our method.

Language models excel at diagnostic assessments on currated medical case-studies and vignettes, performing on par with, or better than, clinical professionals. However, existing studies focus on complex scenarios with rich context making it difficult to draw conclusions about how these systems perform for patients reporting symptoms in everyday life. We deployed SymptomAI, a set of conversational AI agents for end-to-end patient interviewing and differential diagnosis (DDx), via the Fitbit app in a study that randomized participants (N=13,917) to interact with five AI agents. This corpus captures diverse communication and a realistic distribution of illnesses from a real world population. A subset of 1,228 participants reported a clinician-provided diagnosis, and 517 of these were further evaluated by a panel of clinicians during over 250 hours of annotation. SymptomAI DDx were significantly more accurate (OR = 2.47, p < 0.001) than those from independent clinicians given the same dialogue in a blinded randomized comparison. Moreover, agentic strategies which conduct a dedicated symptom interview that elicit additional symptom information before providing a diagnosis, perform substantially better than baseline, user-guided conversations (p < 0.001). An auxiliary analysis on 1,509 conversations from a general US population panel validated that these results generalize beyond wearable device users. We used SymptomAI diagnoses as labels for all 13,917 participants to analyze over 500,000 days of wearable metrics across nearly 400 unique conditions. We identified strong associations between acute infections and physiological shifts (e.g., OR > 7 for influenza). While limited by self-reported ground truth, these results demonstrate the benefits of a dedicated and complete symptom interview compared to a user-guided symptom discussion, which is the default of most consumer LLMs.

Captions that describe or explain charts help improve recall and comprehension of the depicted data and provide a more accessible medium for people with visual disabilities. However, current approaches for automatically generating such captions struggle to articulate the perceptual or cognitive features that are the hallmark of charts (e.g., complex trends and patterns). In response, we introduce VisText: a dataset of 12,441 pairs of charts and captions that describe the charts' construction, report key statistics, and identify perceptual and cognitive phenomena. In VisText, a chart is available as three representations: a rasterized image, a backing data table, and a scene graph -- a hierarchical representation of a chart's visual elements akin to a web page's Document Object Model (DOM). To evaluate the impact of VisText, we fine-tune state-of-the-art language models on our chart captioning task and apply prefix-tuning to produce captions that vary the semantic content they convey. Our models generate coherent, semantically rich captions and perform on par with state-of-the-art chart captioning models across machine translation and text generation metrics. Through qualitative analysis, we identify six broad categories of errors that our models make that can inform future work.

Artificial intelligence (AI) is vital in ophthalmology, tackling tasks like diagnosis, classification, and visual question answering (VQA). However, existing AI models in this domain often require extensive annotation and are task-specific, limiting their clinical utility. While recent developments have brought about foundation models for ophthalmology, they are limited by the need to train separate weights for each imaging modality, preventing a comprehensive representation of multi-modal features. This highlights the need for versatile foundation models capable of handling various tasks and modalities in ophthalmology. To address this gap, we present EyeFound, a multimodal foundation model for ophthalmic images. Unlike existing models, EyeFound learns generalizable representations from unlabeled multimodal retinal images, enabling efficient model adaptation across multiple applications. Trained on 2.78 million images from 227 hospitals across 11 ophthalmic modalities, EyeFound facilitates generalist representations and diverse multimodal downstream tasks, even for detecting challenging rare diseases. It outperforms previous work RETFound in diagnosing eye diseases, predicting systemic disease incidents, and zero-shot multimodal VQA. EyeFound provides a generalizable solution to improve model performance and lessen the annotation burden on experts, facilitating widespread clinical AI applications for retinal imaging.

Counterfactual medical image generation enables clinicians to explore clinical hypotheses, such as predicting disease progression, facilitating their decision-making. While existing methods can generate visually plausible images from disease progression prompts, they produce silent predictions that lack interpretation to verify how the generation reflects the hypothesized progression -- a critical gap for medical applications that require traceable reasoning. In this paper, we propose Interpretable Counterfactual Generation (ICG), a novel task requiring the joint generation of counterfactual images that reflect the clinical hypothesis and interpretation texts that outline the visual changes induced by the hypothesis. To enable ICG, we present ICG-CXR, the first dataset pairing longitudinal medical images with hypothetical progression prompts and textual interpretations. We further introduce ProgEmu, an autoregressive model that unifies the generation of counterfactual images and textual interpretations. We demonstrate the superiority of ProgEmu in generating progression-aligned counterfactuals and interpretations, showing significant potential in enhancing clinical decision support and medical education. Project page: https://progemu.github.io.

Vietnamese medical research has become an increasingly vital domain, particularly with the rise of intelligent technologies aimed at reducing time and resource burdens in clinical diagnosis. Recent advances in vision-language models (VLMs), such as Gemini and GPT-4V, have sparked a growing interest in applying AI to healthcare. However, most existing VLMs lack exposure to Vietnamese medical data, limiting their ability to generate accurate and contextually appropriate diagnostic outputs for Vietnamese patients. To address this challenge, we introduce ViX-Ray, a novel dataset comprising 5,400 Vietnamese chest X-ray images annotated with expert-written findings and impressions from physicians at a major Vietnamese hospital. We analyze linguistic patterns within the dataset, including the frequency of mentioned body parts and diagnoses, to identify domain-specific linguistic characteristics of Vietnamese radiology reports. Furthermore, we fine-tune five state-of-the-art open-source VLMs on ViX-Ray and compare their performance to leading proprietary models, GPT-4V and Gemini. Our results show that while several models generate outputs partially aligned with clinical ground truths, they often suffer from low precision and excessive hallucination, especially in impression generation. These findings not only demonstrate the complexity and challenge of our dataset but also establish ViX-Ray as a valuable benchmark for evaluating and advancing vision-language models in the Vietnamese clinical domain.

Generating clinical reports from raw recordings such as X-rays and electroencephalogram (EEG) is an essential and routine task for doctors. However, it is often time-consuming to write accurate and detailed reports. Most existing methods try to generate the whole reports from the raw input with limited success because 1) generated reports often contain errors that need manual review and correction, 2) it does not save time when doctors want to write additional information into the report, and 3) the generated reports are not customized based on individual doctors' preference. We propose {\it CL}inic{\it A}l {\it R}eport {\it A}uto-completion (CLARA), an interactive method that generates reports in a sentence by sentence fashion based on doctors' anchor words and partially completed sentences. CLARA searches for most relevant sentences from existing reports as the template for the current report. The retrieved sentences are sequentially modified by combining with the input feature representations to create the final report. In our experimental evaluation, CLARA achieved 0.393 CIDEr and 0.248 BLEU-4 on X-ray reports and 0.482 CIDEr and 0.491 BLEU-4 for EEG reports for sentence-level generation, which is up to 35% improvement over the best baseline. Also via our qualitative evaluation, CLARA is shown to produce reports which have a significantly higher level of approval by doctors in a user study (3.74 out of 5 for CLARA vs 2.52 out of 5 for the baseline).

Generative Vision-Language Models (VLMs) are prone to generate plausible-sounding textual answers that, however, are not always grounded in the input image. We investigate this phenomenon, usually referred to as "hallucination" and show that it stems from an excessive reliance on the language prior. In particular, we show that as more tokens are generated, the reliance on the visual prompt decreases, and this behavior strongly correlates with the emergence of hallucinations. To reduce hallucinations, we introduce Multi-Modal Mutual-Information Decoding (M3ID), a new sampling method for prompt amplification. M3ID amplifies the influence of the reference image over the language prior, hence favoring the generation of tokens with higher mutual information with the visual prompt. M3ID can be applied to any pre-trained autoregressive VLM at inference time without necessitating further training and with minimal computational overhead. If training is an option, we show that M3ID can be paired with Direct Preference Optimization (DPO) to improve the model's reliance on the prompt image without requiring any labels. Our empirical findings show that our algorithms maintain the fluency and linguistic capabilities of pre-trained VLMs while reducing hallucinations by mitigating visually ungrounded answers. Specifically, for the LLaVA 13B model, M3ID and M3ID+DPO reduce the percentage of hallucinated objects in captioning tasks by 25% and 28%, respectively, and improve the accuracy on VQA benchmarks such as POPE by 21% and 24%.

Large vision-language models (LVLMs) have made substantial progress in integrating large language models (LLMs) with visual inputs, enabling advanced multimodal reasoning. Despite their success, a persistent challenge is hallucination-where generated text fails to accurately reflect visual content-undermining both accuracy and reliability. Existing methods focus on alignment training or decoding refinements but primarily address symptoms at the generation stage without probing the underlying causes. In this work, we investigate the internal mechanisms driving hallucination in LVLMs, with an emphasis on the multi-head attention module. Specifically, we introduce Vision-aware Head Divergence (VHD), a metric that quantifies the sensitivity of attention head outputs to visual context. Based on this, our findings reveal the presence of vision-aware attention heads that are more attuned to visual information; however, the model's overreliance on its prior language patterns is closely related to hallucinations. Building on these insights, we propose Vision-aware Head Reinforcement (VHR), a training-free approach to mitigate hallucination by enhancing the role of vision-aware attention heads. Extensive experiments demonstrate that our method achieves superior performance compared to state-of-the-art approaches in mitigating hallucinations, while maintaining high efficiency with negligible additional time overhead.

Medical vision-and-language models (MVLMs) have attracted substantial interest due to their capability to offer a natural language interface for interpreting complex medical data. Their applications are versatile and have the potential to improve diagnostic accuracy and decision-making for individual patients while also contributing to enhanced public health monitoring, disease surveillance, and policy-making through more efficient analysis of large data sets. MVLMS integrate natural language processing with medical images to enable a more comprehensive and contextual understanding of medical images alongside their corresponding textual information. Unlike general vision-and-language models trained on diverse, non-specialized datasets, MVLMs are purpose-built for the medical domain, automatically extracting and interpreting critical information from medical images and textual reports to support clinical decision-making. Popular clinical applications of MVLMs include automated medical report generation, medical visual question answering, medical multimodal segmentation, diagnosis and prognosis and medical image-text retrieval. Here, we provide a comprehensive overview of MVLMs and the various medical tasks to which they have been applied. We conduct a detailed analysis of various vision-and-language model architectures, focusing on their distinct strategies for cross-modal integration/exploitation of medical visual and textual features. We also examine the datasets used for these tasks and compare the performance of different models based on standardized evaluation metrics. Furthermore, we highlight potential challenges and summarize future research trends and directions. The full collection of papers and codes is available at: https://github.com/YtongXie/Medical-Vision-and-Language-Tasks-and-Methodologies-A-Survey.

Vision disorders significantly impact millions of lives, altering how visual information is processed and perceived. In this work, a computational framework was developed using the BrokenEyes system to simulate five common eye disorders: Age-related macular degeneration, cataract, glaucoma, refractive errors, and diabetic retinopathy and analyze their effects on neural-like feature representations in deep learning models. Leveraging a combination of human and non-human datasets, models trained under normal and disorder-specific conditions revealed critical disruptions in feature maps, particularly for cataract and glaucoma, which align with known neural processing challenges in these conditions. Evaluation metrics such as activation energy and cosine similarity quantified the severity of these distortions, providing insights into the interplay between degraded visual inputs and learned representations.

We present HealthGPT, a powerful Medical Large Vision-Language Model (Med-LVLM) that integrates medical visual comprehension and generation capabilities within a unified autoregressive paradigm. Our bootstrapping philosophy is to progressively adapt heterogeneous comprehension and generation knowledge to pre-trained large language models (LLMs). This is achieved through a novel heterogeneous low-rank adaptation (H-LoRA) technique, which is complemented by a tailored hierarchical visual perception approach and a three-stage learning strategy. To effectively learn the HealthGPT, we devise a comprehensive medical domain-specific comprehension and generation dataset called VL-Health. Experimental results demonstrate exceptional performance and scalability of HealthGPT in medical visual unified tasks. Our project can be accessed at https://github.com/DCDmllm/HealthGPT.

Fundus imaging such as CFP, OCT and UWF is crucial for the early detection of retinal anomalies and diseases. Fundus image understanding, due to its knowledge-intensive nature, poses a challenging vision-language task. An emerging approach to addressing the task is to post-train a generic multimodal large language model (MLLM), either by supervised finetuning (SFT) or by reinforcement learning with verifiable rewards (RLVR), on a considerable amount of in-house samples paired with high-quality clinical reports. However, these valuable samples are not publicly accessible, which not only hinders reproducibility but also practically limits research to few players. To overcome the barrier, we make a novel attempt to train a reasoning-enhanced fundus-reading MLLM, which we term Fundus-R1, using exclusively public datasets, wherein over 94\% of the data are annotated with only image-level labels. Our technical contributions are two-fold. First, we propose a RAG-based method for composing image-specific, knowledge-aware reasoning traces. Such auto-generated traces link visual findings identified by a generic MLLM to the image labels in terms of ophthalmic knowledge. Second, we enhance RLVR with a process reward that encourages self-consistency of the generated reasoning trace in each rollout. Extensive experiments on three fundus-reading benchmarks, i.e., FunBench, Omni-Fundus and GMAI-Fundus, show that Fundus-R1 clearly outperforms multiple baselines, including its generic counterpart (Qwen2.5-VL) and a stronger edition post-trained without using the generated traces. This work paves the way for training powerful fundus-reading MLLMs with publicly available data.

Knowledge Graph (KG) plays a crucial role in Medical Report Generation (MRG) because it reveals the relations among diseases and thus can be utilized to guide the generation process. However, constructing a comprehensive KG is labor-intensive and its applications on the MRG process are under-explored. In this study, we establish a complete KG on chest X-ray imaging that includes 137 types of diseases and abnormalities. Based on this KG, we find that the current MRG data sets exhibit a long-tailed problem in disease distribution. To mitigate this problem, we introduce a novel augmentation strategy that enhances the representation of disease types in the tail-end of the distribution. We further design a two-stage MRG approach, where a classifier is first trained to detect whether the input images exhibit any abnormalities. The classified images are then independently fed into two transformer-based generators, namely, ``disease-specific generator" and ``disease-free generator" to generate the corresponding reports. To enhance the clinical evaluation of whether the generated reports correctly describe the diseases appearing in the input image, we propose diverse sensitivity (DS), a new metric that checks whether generated diseases match ground truth and measures the diversity of all generated diseases. Results show that the proposed two-stage generation framework and augmentation strategies improve DS by a considerable margin, indicating a notable reduction in the long-tailed problem associated with under-represented diseases.

Radiology reports are crucial for planning treatment strategies and enhancing doctor-patient communication, yet manually writing these reports is burdensome for radiologists. While automatic report generation offers a solution, existing methods often rely on single-view radiographs, limiting diagnostic accuracy. To address this problem, we propose MCL, a Multi-view enhanced Contrastive Learning method for chest X-ray report generation. Specifically, we first introduce multi-view enhanced contrastive learning for visual representation by maximizing agreements between multi-view radiographs and their corresponding report. Subsequently, to fully exploit patient-specific indications (e.g., patient's symptoms) for report generation, we add a transitional ``bridge" for missing indications to reduce embedding space discrepancies caused by their presence or absence. Additionally, we construct Multi-view CXR and Two-view CXR datasets from public sources to support research on multi-view report generation. Our proposed MCL surpasses recent state-of-the-art methods across multiple datasets, achieving a 5.0% F1 RadGraph improvement on MIMIC-CXR, a 7.3% BLEU-1 improvement on MIMIC-ABN, a 3.1% BLEU-4 improvement on Multi-view CXR, and an 8.2% F1 CheXbert improvement on Two-view CXR.

Traditional computer vision generally solves each single task independently by a dedicated model with the task instruction implicitly designed in the model architecture, arising two limitations: (1) it leads to task-specific models, which require multiple models for different tasks and restrict the potential synergies from diverse tasks; (2) it leads to a pre-defined and fixed model interface that has limited interactivity and adaptability in following user' task instructions. To address them, Visual Instruction Tuning (VIT) has been intensively studied recently, which finetunes a large vision model with language as task instructions, aiming to learn from a wide range of vision tasks described by language instructions a general-purpose multimodal model that can follow arbitrary instructions and thus solve arbitrary tasks specified by the user. This work aims to provide a systematic review of visual instruction tuning, covering (1) the background that presents computer vision task paradigms and the development of VIT; (2) the foundations of VIT that introduce commonly used network architectures, visual instruction tuning frameworks and objectives, and evaluation setups and tasks; (3) the commonly used datasets in visual instruction tuning and evaluation; (4) the review of existing VIT methods that categorizes them with a taxonomy according to both the studied vision task and the method design and highlights the major contributions, strengths, and shortcomings of them; (5) the comparison and discussion of VIT methods over various instruction-following benchmarks; (6) several challenges, open directions and possible future works in visual instruction tuning research.

Vision-Language Models (VLM) can support clinicians by analyzing medical images and engaging in natural language interactions to assist in diagnostic and treatment tasks. However, VLMs often exhibit "hallucinogenic" behavior, generating textual outputs not grounded in contextual multimodal information. This challenge is particularly pronounced in the medical domain, where we do not only require VLM outputs to be accurate in single interactions but also to be consistent with clinical reasoning and diagnostic pathways throughout multi-turn conversations. For this purpose, we propose a new alignment algorithm that uses symbolic representations of clinical reasoning to ground VLMs in medical knowledge. These representations are utilized to (i) generate GPT-4-guided visual instruction tuning data at scale, simulating clinician-VLM conversations with demonstrations of clinical reasoning, and (ii) create an automatic reward function that evaluates the clinical validity of VLM generations throughout clinician-VLM interactions. Our algorithm eliminates the need for human involvement in training data generation or reward model construction, reducing costs compared to standard reinforcement learning with human feedback (RLHF). We apply our alignment algorithm to develop Dr-LLaVA, a conversational VLM finetuned for analyzing bone marrow pathology slides, demonstrating strong performance in multi-turn medical conversations.

Visual Language Models (VLMs) have demonstrated impressive capabilities in visual grounding tasks. However, their effectiveness in the medical domain, particularly for abnormality detection and localization within medical images, remains underexplored. A major challenge is the complex and abstract nature of medical terminology, which makes it difficult to directly associate pathological anomaly terms with their corresponding visual features. In this work, we introduce a novel approach to enhance VLM performance in medical abnormality detection and localization by leveraging decomposed medical knowledge. Instead of directly prompting models to recognize specific abnormalities, we focus on breaking down medical concepts into fundamental attributes and common visual patterns. This strategy promotes a stronger alignment between textual descriptions and visual features, improving both the recognition and localization of abnormalities in medical images.We evaluate our method on the 0.23B Florence-2 base model and demonstrate that it achieves comparable performance in abnormality grounding to significantly larger 7B LLaVA-based medical VLMs, despite being trained on only 1.5% of the data used for such models. Experimental results also demonstrate the effectiveness of our approach in both known and previously unseen abnormalities, suggesting its strong generalization capabilities.

Large Vision Language Models (VLMs) effectively bridge the modality gap through extensive pretraining, acquiring sophisticated visual representations aligned with language. However, it remains underexplored whether these representations, optimized for multimodal understanding tasks, harbor an inherent potential for visual generation. In this paper, we propose VGT, Visual Generation Tuning, a novel paradigm designed to stimulate the underlying capabilities of visual generation within any vision language models. By performing efficient visual generation tuning on well-pretrained VLMs, we significantly mitigate the alignment costs and accelerate the convergence of autoregressive modeling in the continuous space (20x speedup). Specifically, we dismiss the entangled pixel-level VAEs designed for diffusion transformers and formulate VGT-AE through aligning the semantic encoders from pretrained VLMs with the latent representations of pixel decoders. In image reconstruction tasks, we achieve 26.67 PSNR and 0.50 rFID at a 28x compression ratio, outperforming specialized VAEs; in visual generation tasks, we achieve state-of-the-art outcomes among autoregressive models, 0.77 on GenEval and 78.73 on DPG-Bench. Furthermore, our proposed VGT showcases significant scaling promise and is versatile for endowing any VLMs trained for multimodal understanding with the capabilities of visual generation, which paves the new avenue to explore next-generation unified multimodal foundation models. Models and codes are available at https://github.com/hustvl/VGT.

Recent works show that image and video generators exhibit zero-shot visual understanding behaviors, in a way reminiscent of how LLMs develop emergent capabilities of language understanding and reasoning from generative pretraining. While it has long been conjectured that the ability to create visual content implies an ability to understand it, there has been limited evidence that generative vision models have developed strong understanding capabilities. In this work, we demonstrate that image generation training serves a role similar to LLM pretraining, and lets models learn powerful and general visual representations that enable SOTA performance on various vision tasks. We introduce Vision Banana, a generalist model built by instruction-tuning Nano Banana Pro (NBP) on a mixture of its original training data alongside a small amount of vision task data. By parameterizing the output space of vision tasks as RGB images, we seamlessly reframe perception as image generation. Our generalist model, Vision Banana, achieves SOTA results on a variety of vision tasks involving both 2D and 3D understanding, beating or rivaling zero-shot domain-specialists, including Segment Anything Model 3 on segmentation tasks, and the Depth Anything series on metric depth estimation. We show that these results can be achieved with lightweight instruction-tuning without sacrificing the base model's image generation capabilities. The superior results suggest that image generation pretraining is a generalist vision learner. It also shows that image generation serves as a unified and universal interface for vision tasks, similar to text generation's role in language understanding and reasoning. We could be witnessing a major paradigm shift for computer vision, where generative vision pretraining takes a central role in building Foundational Vision Models for both generation and understanding.

Despite significant advancements in vision-language models (VLMs), there lacks effective approaches to enhance response quality by scaling inference-time computation. This capability is known to be a core step towards the self-improving models in recent large language model studies. In this paper, we present Vision Value Model (VisVM) that can guide VLM inference-time search to generate responses with better visual comprehension. Specifically, VisVM not only evaluates the generated sentence quality in the current search step, but also anticipates the quality of subsequent sentences that may result from the current step, thus providing a long-term value. In this way, VisVM steers VLMs away from generating sentences prone to hallucinations or insufficient detail, thereby producing higher quality responses. Experimental results demonstrate that VisVM-guided search significantly enhances VLMs' ability to generate descriptive captions with richer visual details and fewer hallucinations, compared with greedy decoding and search methods with other visual reward signals. Furthermore, we find that self-training the model with the VisVM-guided captions improve VLM's performance across a wide range of multimodal benchmarks, indicating the potential for developing self-improving VLMs. Our value model and code are available at https://github.com/si0wang/VisVM.

While recent Large Vision-Language Models (LVLMs) have shown remarkable performance in multi-modal tasks, they are prone to generating hallucinatory text responses that do not align with the given visual input, which restricts their practical applicability in real-world scenarios. In this work, inspired by the observation that the text-to-image generation process is the inverse of image-conditioned response generation in LVLMs, we explore the potential of leveraging text-to-image generative models to assist in mitigating hallucinations in LVLMs. We discover that generative models can offer valuable self-feedback for mitigating hallucinations at both the response and token levels. Building on this insight, we introduce self-correcting Decoding with Generative Feedback (DeGF), a novel training-free algorithm that incorporates feedback from text-to-image generative models into the decoding process to effectively mitigate hallucinations in LVLMs. Specifically, DeGF generates an image from the initial response produced by LVLMs, which acts as an auxiliary visual reference and provides self-feedback to verify and correct the initial response through complementary or contrastive decoding. Extensive experimental results validate the effectiveness of our approach in mitigating diverse types of hallucinations, consistently surpassing state-of-the-art methods across six benchmarks. Code is available at https://github.com/zhangce01/DeGF.

Vision language models (VLMs) often generate hallucination, i.e., content that cannot be substantiated by either textual or visual inputs. Prior work primarily attributes this to over-reliance on linguistic prior knowledge rather than visual inputs. Some methods attempt to mitigate hallucination by amplifying visual token attention proportionally to their attention scores. However, these methods overlook the visual attention sink problem, where attention is frequently misallocated to task-irrelevant visual regions, and neglect cross-modal fusion balance by enhancing only visual attention without adjusting attention to the user query. This can result in amplifying incorrect areas while failing to properly interpret the user query. To address these challenges, we propose a simple yet effective method called Gaze Shift-Guided Cross-modal Fusion Enhancement (GIFT). GIFT pre-computes a holistic visual saliency map by tracking positive changes in visual attention, or "gaze shifts", during user query comprehension, and leverages this map to amplify attention to both salient visual information and the user query at each decoding step. This reduces the impact of visual attention sink, as irrelevant tokens exhibit minimal shifts, while ensuring balanced cross-modal fusion for well-integrated representation. Extensive experiments show that GIFT effectively mitigates hallucination in VLMs across both generative and classification tasks, achieving up to 20.7% improvement over greedy decoding, while maintaining general vision-language performance with low computational overhead.

Recently, the visual generation ability by GPT-4o(mni) has been unlocked by OpenAI. It demonstrates a very remarkable generation capability with excellent multimodal condition understanding and varied task instructions. In this paper, we aim to explore the capabilities of GPT-4o across various tasks. Inspired by previous study, we constructed a task taxonomy along with a carefully curated set of test samples to conduct a comprehensive qualitative test. Benefiting from GPT-4o's powerful multimodal comprehension, its image-generation process demonstrates abilities surpassing those of traditional image-generation tasks. Thus, regarding the dimensions of model capabilities, we evaluate its performance across six task categories: traditional image generation tasks, discriminative tasks, knowledge-based generation, commonsense-based generation, spatially-aware image generation, and temporally-aware image generation. These tasks not only assess the quality and conditional alignment of the model's outputs but also probe deeper into GPT-4o's understanding of real-world concepts. Our results reveal that GPT-4o performs impressively well in general-purpose synthesis tasks, showing strong capabilities in text-to-image generation, visual stylization, and low-level image processing. However, significant limitations remain in its ability to perform precise spatial reasoning, instruction-grounded generation, and consistent temporal prediction. Furthermore, when faced with knowledge-intensive or domain-specific scenarios, such as scientific illustrations or mathematical plots, the model often exhibits hallucinations, factual errors, or structural inconsistencies. These findings suggest that while GPT-4o marks a substantial advancement in unified multimodal generation, there is still a long way to go before it can be reliably applied to professional or safety-critical domains.

With the advancement of telemedicine, both researchers and medical practitioners are working hand-in-hand to develop various techniques to automate various medical operations, such as diagnosis report generation. In this paper, we first present a multi-modal clinical conversation summary generation task that takes a clinician-patient interaction (both textual and visual information) and generates a succinct synopsis of the conversation. We propose a knowledge-infused, multi-modal, multi-tasking medical domain identification and clinical conversation summary generation (MM-CliConSummation) framework. It leverages an adapter to infuse knowledge and visual features and unify the fused feature vector using a gated mechanism. Furthermore, we developed a multi-modal, multi-intent clinical conversation summarization corpus annotated with intent, symptom, and summary. The extensive set of experiments, both quantitatively and qualitatively, led to the following findings: (a) critical significance of visuals, (b) more precise and medical entity preserving summary with additional knowledge infusion, and (c) a correlation between medical department identification and clinical synopsis generation. Furthermore, the dataset and source code are available at https://github.com/NLP-RL/MM-CliConSummation.

Visual Prompt Tuning (VPT) is an effective tuning method for adapting pretrained Vision Transformers (ViTs) to downstream tasks. It leverages extra learnable tokens, known as prompts, which steer the frozen pretrained ViTs. Although VPT has demonstrated its applicability with supervised vision transformers, it often underperforms with self-supervised ones. Through empirical observations, we deduce that the effectiveness of VPT hinges largely on the ViT blocks with which the prompt tokens interact. Specifically, VPT shows improved performance on image classification tasks for MAE and MoCo v3 when the prompt tokens are inserted into later blocks rather than the first block. These observations suggest that there exists an optimal location of blocks for the insertion of prompt tokens. Unfortunately, identifying the optimal blocks for prompts within each self-supervised ViT for diverse future scenarios is a costly process. To mitigate this problem, we propose a simple yet effective method that learns a gate for each ViT block to adjust its intervention into the prompt tokens. With our method, prompt tokens are selectively influenced by blocks that require steering for task adaptation. Our method outperforms VPT variants in FGVC and VTAB image classification and ADE20K semantic segmentation. The code is available at https://github.com/ryongithub/GatedPromptTuning.

Developing an interpretable system for generating reports in chest X-ray (CXR) analysis is becoming increasingly crucial in Computer-aided Diagnosis (CAD) systems, enabling radiologists to comprehend the decisions made by these systems. Despite the growth of diverse datasets and methods focusing on report generation, there remains a notable gap in how closely these models' generated reports align with the interpretations of real radiologists. In this study, we tackle this challenge by initially introducing Fine-Grained CXR (FG-CXR) dataset, which provides fine-grained paired information between the captions generated by radiologists and the corresponding gaze attention heatmaps for each anatomy. Unlike existing datasets that include a raw sequence of gaze alongside a report, with significant misalignment between gaze location and report content, our FG-CXR dataset offers a more grained alignment between gaze attention and diagnosis transcript. Furthermore, our analysis reveals that simply applying black-box image captioning methods to generate reports cannot adequately explain which information in CXR is utilized and how long needs to attend to accurately generate reports. Consequently, we propose a novel explainable radiologist's attention generator network (Gen-XAI) that mimics the diagnosis process of radiologists, explicitly constraining its output to closely align with both radiologist's gaze attention and transcript. Finally, we perform extensive experiments to illustrate the effectiveness of our method. Our datasets and checkpoint is available at https://github.com/UARK-AICV/FG-CXR.

The integration of visual encoders and large language models (LLMs) has driven recent progress in multimodal large language models (MLLMs). However, the scarcity of high-quality instruction-tuning data for vision-language tasks remains a challenge. The current leading paradigm, such as LLaVA, relies on language-only GPT-4 to generate data, which requires pre-annotated image captions and detection bounding boxes, suffering from understanding image details. A practical solution to this problem would be to utilize the available multimodal large language models (MLLMs) to generate instruction data for vision-language tasks. However, it's worth noting that the currently accessible MLLMs are not as powerful as their LLM counterparts, as they tend to produce inadequate responses and generate false information. As a solution for addressing the current issue, this paper proposes the Visual Instruction Generation and Correction (VIGC) framework that enables multimodal large language models to generate instruction-tuning data and progressively enhance its quality on-the-fly. Specifically, Visual Instruction Generation (VIG) guides the vision-language model to generate diverse instruction-tuning data. To ensure generation quality, Visual Instruction Correction (VIC) adopts an iterative update mechanism to correct any inaccuracies in data produced by VIG, effectively reducing the risk of hallucination. Leveraging the diverse, high-quality data generated by VIGC, we finetune mainstream models and validate data quality based on various evaluations. Experimental results demonstrate that VIGC not only compensates for the shortcomings of language-only data generation methods, but also effectively enhances the benchmark performance. The models, datasets, and code are available at https://opendatalab.github.io/VIGC.

Stroboscopic light stimulation (SLS) on closed eyes typically induces simple visual hallucinations (VHs), characterised by vivid, geometric and colourful patterns. A dataset of 862 sentences, extracted from 422 open subjective reports, was recently compiled as part of the Dreamachine programme (Collective Act, 2022), an immersive multisensory experience that combines SLS and spatial sound in a collective setting. Although open reports extend the range of reportable phenomenology, their analysis presents significant challenges, particularly in systematically identifying patterns. To address this challenge, we implemented a data-driven approach leveraging Large Language Models and Topic Modelling to uncover and interpret latent experiential topics directly from the Dreamachine's text-based reports. Our analysis confirmed the presence of simple VHs typically documented in scientific studies of SLS, while also revealing experiences of altered states of consciousness and complex hallucinations. Building on these findings, our computational approach expands the systematic study of subjective experience by enabling data-driven analyses of open-ended phenomenological reports, capturing experiences not readily identified through standard questionnaires. By revealing rich and multifaceted aspects of experiences, our study broadens our understanding of stroboscopically-induced phenomena while highlighting the potential of Natural Language Processing and Large Language Models in the emerging field of computational (neuro)phenomenology. More generally, this approach provides a practically applicable methodology for uncovering subtle hidden patterns of subjective experience across diverse research domains.

Multimodal large language models (MLLMs) have recently achieved remarkable progress in radiology by integrating visual perception with natural language understanding. However, they often generate clinically unsupported descriptions, known as medical hallucinations, which pose serious risks in medical applications that demand accuracy and image-grounded outputs. Through empirical analysis, we find that prompt-induced hallucinations remain prevalent in radiology MLLMs, largely due to over-sensitivity to clinical sections. To address this, we introduce Clinical Contrastive Cecoding (CCD), a training-free and retrieval-free inference framework that integrates structured clinical signals from task-specific radiology expert models. CCD introduces a dual-stage contrastive mechanism to refine token-level logits during generation, thereby enhancing clinical fidelity without modifying the base MLLM. Experiments on three datasets and multiple models demonstrate that CCD consistently improves overall performance on radiology report generation (RRG). On the MIMIC-CXR dataset, it yields up to a 17% improvement in RadGraph-F1 when applied to state-of-the-art RRG models. Our approach provides a lightweight and generalisable solution for mitigating medical hallucinations, effectively bridging expert models and MLLMs in radiology.

The scarcity of high-quality, labelled retinal imaging data, which presents a significant challenge in the development of machine learning models for ophthalmology, hinders progress in the field. Existing methods for synthesising Colour Fundus Photographs (CFPs) largely rely on predefined disease labels, which restricts their ability to generate images that reflect fine-grained anatomical variations, subtle disease stages, and diverse pathological features beyond coarse class categories. To overcome these challenges, we first introduce an innovative pipeline that creates a large-scale, captioned retinal dataset comprising 1.4 million entries, called RetinaLogos-1400k. Specifically, RetinaLogos-1400k uses the visual language model(VLM) to describe retinal conditions and key structures, such as optic disc configuration, vascular distribution, nerve fibre layers, and pathological features. Building on this dataset, we employ a novel three-step training framework, RetinaLogos, which enables fine-grained semantic control over retinal images and accurately captures different stages of disease progression, subtle anatomical variations, and specific lesion types. Through extensive experiments, our method demonstrates superior performance across multiple datasets, with 62.07% of text-driven synthetic CFPs indistinguishable from real ones by ophthalmologists. Moreover, the synthetic data improves accuracy by 5%-10% in diabetic retinopathy grading and glaucoma detection. Codes are available at https://github.com/uni-medical/retina-text2cfp.

Most medical multimodal benchmarks focus on static tasks such as image question answering, report generation, and plain-language rewriting. Patient education is more demanding: systems must identify relevant evidence across images, show patients where to look, explain findings in accessible language, and handle confusion or distress. Yet most patient education work remains text-only, even though combined image-and-text explanations may better support understanding. We introduce MedImageEdu, a benchmark for multi-turn, evidence-grounded radiology patient education. Each case provides a radiology report with report text and case images. A DoctorAgent interacts with a PatientAgent, conditioned on a hidden profile that captures factors such as education level, health literacy, and personality. When a patient question would benefit from visual support, the DoctorAgent can issue drawing instructions grounded in the report, case images, and the current question to a benchmark-provided drawing tool. The tool returns image(s), after which the DoctorAgent produces a final multimodal response consisting of the image(s) and a grounded plain-language explanation. MedImageEdu contains 150 cases from three sources and evaluates both the consultation process and the final multimodal response along five dimensions: Consultation, Safety and Scope, Language Quality, Drawing Quality, and Image-Text Response Quality. Across representative open- and closed-source vision-language model agents, we find three consistent gaps: fluent language often outpaces faithful visual grounding, safety is the weakest dimension across disease categories, and emotionally tense interactions are harder than low education or low health literacy. MedImageEdu provides a controlled testbed for assessing whether multimodal agents can teach from evidence rather than merely answer from text.

Positron emission tomography (PET) is a cornerstone of modern oncologic and neurologic imaging, distinguished by its unique ability to illuminate dynamic metabolic processes that transcend the anatomical focus of traditional imaging technologies. Radiology reports are essential for clinical decision making, yet their manual creation is labor-intensive and time-consuming. Recent advancements of vision-language models (VLMs) have shown strong potential in medical applications, presenting a promising avenue for automating report generation. However, existing applications of VLMs in the medical domain have predominantly focused on structural imaging modalities, while the unique characteristics of molecular PET imaging have largely been overlooked. To bridge the gap, we introduce PET2Rep, a large-scale comprehensive benchmark for evaluation of general and medical VLMs for radiology report generation for PET images. PET2Rep stands out as the first dedicated dataset for PET report generation with metabolic information, uniquely capturing whole-body image-report pairs that cover dozens of organs to fill the critical gap in existing benchmarks and mirror real-world clinical comprehensiveness. In addition to widely recognized natural language generation metrics, we introduce a series of clinical efficiency metrics to evaluate the quality of radiotracer uptake pattern description in key organs in generated reports. We conduct a head-to-head comparison of 30 cutting-edge general-purpose and medical-specialized VLMs. The results show that the current state-of-the-art VLMs perform poorly on PET report generation task, falling considerably short of fulfilling practical needs. Moreover, we identify several key insufficiency that need to be addressed to advance the development in medical applications.

Brain tumor diagnosis is largely dependent on Magnetic Resonance Imaging (MRI) evaluation, which requires radiologists to synthesize thousands of images across multiple 3D sequences and longitudinal studies. This process requires advanced neuro-radiology training, poses substantial cognitive load, and is highly time-consuming. Despite increasing demands in radiology, this expertise is difficult to scale, straining the current health systems. Vision-Language Models (VLMs) provide an opportunity to reduce this burden through a semi-automated, interactive interpretation of complex brain MRIs. However, they are currently underutilized in neuro-oncology due to a lack of specialized benchmarks for evaluating them. We introduce a clinically relevant visual question answering (VQA) benchmark -- the UCSF-PDGM-VQA dataset -- consisting of 2,387 QA pairs from 473 glioma-related MRI studies in the public UCSF-PDGM dataset. We further establish a performance baseline for six state-of-the-art vision-language models (VLMs) and one large language model on this dataset. We find that current models are incapable of effectively processing multi-sequence, 3-dimensional MRI scans, thus resulting in a suppression of visual features and over-reliance on language priors, causing modality collapse. These findings underscore a critical deficiency in current model reliability and safety within clinical settings, necessitating the development of robust, domain-specific VLMs.

Current vision-language models (VLMs) in medicine are primarily designed for categorical question answering (e.g., "Is this normal or abnormal?") or qualitative descriptive tasks. However, clinical decision-making often relies on quantitative assessments, such as measuring the size of a tumor or the angle of a joint, from which physicians draw their own diagnostic conclusions. This quantitative reasoning capability remains underexplored and poorly supported in existing VLMs. In this work, we introduce MedVision, a large-scale dataset and benchmark specifically designed to evaluate and improve VLMs on quantitative medical image analysis. MedVision spans 22 public datasets covering diverse anatomies and modalities, with 30.8 million image-annotation pairs. We focus on three representative quantitative tasks: (1) detection of anatomical structures and abnormalities, (2) tumor/lesion (T/L) size estimation, and (3) angle/distance (A/D) measurement. Our benchmarks show that current off-the-shelf VLMs perform poorly on these tasks. However, with supervised fine-tuning on MedVision, we significantly enhance their performance across detection, T/L estimation, and A/D measurement, demonstrating reduced error rates and improved precision. This work provides a foundation for developing VLMs with robust quantitative reasoning capabilities in medical imaging. Code and data are available at https://medvision-vlm.github.io.

Despite the rapid success of Large Vision-Language Models (LVLMs), a persistent challenge is their tendency to generate hallucinated content, undermining reliability in real-world use. Existing training-free methods address hallucinations but face two limitations: (i) they rely on narrow assumptions about hallucination sources, and (ii) their effectiveness declines toward the end of generation, where hallucinations are most likely to occur. A common strategy is to build hallucinated models by completely or partially removing visual tokens and contrasting them with the original model. Yet, this alone proves insufficient, since visual information still propagates into generated text. Building on this insight, we propose a novel hallucinated model that captures hallucination effects by selectively removing key text tokens. We further introduce Generalized Contrastive Decoding, which integrates multiple hallucinated models to represent diverse hallucination sources. Together, these ideas form CRoPS, a training-free hallucination mitigation framework that improves CHAIR scores by 20% and achieves consistent gains across six benchmarks and three LVLM families, outperforming state-of-the-art training-free methods.

Video descriptions are crucial for blind and low vision (BLV) users to access visual content. However, current artificial intelligence models for generating descriptions often fall short due to limitations in the quality of human annotations within training datasets, resulting in descriptions that do not fully meet BLV users' needs. To address this gap, we introduce VideoA11y, an approach that leverages multimodal large language models (MLLMs) and video accessibility guidelines to generate descriptions tailored for BLV individuals. Using this method, we have curated VideoA11y-40K, the largest and most comprehensive dataset of 40,000 videos described for BLV users. Rigorous experiments across 15 video categories, involving 347 sighted participants, 40 BLV participants, and seven professional describers, showed that VideoA11y descriptions outperform novice human annotations and are comparable to trained human annotations in clarity, accuracy, objectivity, descriptiveness, and user satisfaction. We evaluated models on VideoA11y-40K using both standard and custom metrics, demonstrating that MLLMs fine-tuned on this dataset produce high-quality accessible descriptions. Code and dataset are available at https://people-robots.github.io/VideoA11y.

Current Cross-Modality Generation Models (GMs) demonstrate remarkable capabilities in various generative tasks. Given the ubiquity and information richness of vision modality inputs in real-world scenarios, Cross-vision, encompassing Vision-Language Perception (VLP) and Image-to-Image (I2I), tasks have attracted significant attention. Large Vision Language Models (LVLMs) and I2I GMs are employed to handle VLP and I2I tasks, respectively. Previous research indicates that printing typographic words into input images significantly induces LVLMs and I2I GMs to generate disruptive outputs semantically related to those words. Additionally, visual prompts, as a more sophisticated form of typography, are also revealed to pose security risks to various applications of VLP tasks when injected into images. In this paper, we comprehensively investigate the performance impact induced by Typographic Visual Prompt Injection (TVPI) in various LVLMs and I2I GMs. To better observe performance modifications and characteristics of this threat, we also introduce the TVPI Dataset. Through extensive explorations, we deepen the understanding of the underlying causes of the TVPI threat in various GMs and offer valuable insights into its potential origins.

Vision-language foundation models (VLMs) show promise for diverse imaging tasks but often underperform on medical benchmarks. Prior efforts to improve performance include model finetuning, which requires large domain-specific datasets and significant compute, or manual prompt engineering, which is hard to generalize and often inaccessible to medical institutions seeking to deploy these tools. These challenges motivate interest in approaches that draw on a model's embedded knowledge while abstracting away dependence on human-designed prompts to enable scalable, weight-agnostic performance improvements. To explore this, we adapt the Declarative Self-improving Python (DSPy) framework for structured automated prompt optimization in medical vision-language systems through a comprehensive, formal evaluation. We implement prompting pipelines for five medical imaging tasks across radiology, gastroenterology, and dermatology, evaluating 10 open-source VLMs with four prompt optimization techniques. Optimized pipelines achieved a median relative improvement of 53% over zero-shot prompting baselines, with the largest gains ranging from 300% to 3,400% on tasks where zero-shot performance is low. These results highlight the substantial potential of applying automated prompt optimization to medical AI systems, demonstrating significant gains for vision-based applications requiring accurate clinical image interpretation. By reducing dependence on prompt design to elicit intended outputs, these techniques allow clinicians to focus on patient care and clinical decision-making. Furthermore, our experiments offer scalability and preserve data privacy, demonstrating performance improvement on open-source VLMs. We publicly release our evaluation pipelines to support reproducible research on specialized medical tasks, available at https://github.com/DaneshjouLab/prompt-triage-lab.

Generating clinical reports that summarize abnormal patterns, diagnostic findings, and clinical interpretations from long-term EEG recordings remains labor-intensive. We curate a large-scale clinical EEG dataset with 9{,}922 reports paired with approximately 11{,}000 hours of EEG recordings from 9{,}048 patients. We therefore develop CELM, the first clinical EEG-to-Language foundation model capable of summarizing long-duration, variable-length EEG recordings and performing end-to-end clinical report generation at multiple scales, including recording description, background activity, epileptiform abnormalities, events/seizures, and impressions. Experimental results show that, with patient history supervision, our method achieves 70%-95% average relative improvements in standard generation metrics (e.g., ROUGE-1 and METEOR) from 0.2-0.3 to 0.4-0.6. In the zero-shot setting without patient history, CELM attains generation scores in the range of 0.43-0.52, compared to baselines of 0.17-0.26. CELM integrates pretrained EEG foundation models with language models to enable scalable multimodal learning. We release our model and benchmark construction pipeline at https://github.com/Jathurshan0330/CELM.

Large Vision Language Models (LVLMs) are increasingly integral to healthcare applications, including medical visual question answering and imaging report generation. While these models inherit the robust capabilities of foundational Large Language Models (LLMs), they also inherit susceptibility to hallucinations-a significant concern in high-stakes medical contexts where the margin for error is minimal. However, currently, there are no dedicated methods or benchmarks for hallucination detection and evaluation in the medical field. To bridge this gap, we introduce Med-HallMark, the first benchmark specifically designed for hallucination detection and evaluation within the medical multimodal domain. This benchmark provides multi-tasking hallucination support, multifaceted hallucination data, and hierarchical hallucination categorization. Furthermore, we propose the MediHall Score, a new medical evaluative metric designed to assess LVLMs' hallucinations through a hierarchical scoring system that considers the severity and type of hallucination, thereby enabling a granular assessment of potential clinical impacts. We also present MediHallDetector, a novel Medical LVLM engineered for precise hallucination detection, which employs multitask training for hallucination detection. Through extensive experimental evaluations, we establish baselines for popular LVLMs using our benchmark. The findings indicate that MediHall Score provides a more nuanced understanding of hallucination impacts compared to traditional metrics and demonstrate the enhanced performance of MediHallDetector. We hope this work can significantly improve the reliability of LVLMs in medical applications. All resources of this work will be released soon.

There has been a rapidly growing interest in Automatic Symptom Detection (ASD) and Automatic Diagnosis (AD) systems in the machine learning research literature, aiming to assist doctors in telemedicine services. These systems are designed to interact with patients, collect evidence about their symptoms and relevant antecedents, and possibly make predictions about the underlying diseases. Doctors would review the interactions, including the evidence and the predictions, collect if necessary additional information from patients, before deciding on next steps. Despite recent progress in this area, an important piece of doctors' interactions with patients is missing in the design of these systems, namely the differential diagnosis. Its absence is largely due to the lack of datasets that include such information for models to train on. In this work, we present a large-scale synthetic dataset of roughly 1.3 million patients that includes a differential diagnosis, along with the ground truth pathology, symptoms and antecedents for each patient. Unlike existing datasets which only contain binary symptoms and antecedents, this dataset also contains categorical and multi-choice symptoms and antecedents useful for efficient data collection. Moreover, some symptoms are organized in a hierarchy, making it possible to design systems able to interact with patients in a logical way. As a proof-of-concept, we extend two existing AD and ASD systems to incorporate the differential diagnosis, and provide empirical evidence that using differentials as training signals is essential for the efficiency of such systems or for helping doctors better understand the reasoning of those systems.

Vision-Language Models (VLMs) often generate plausible but incorrect responses to visual queries. However, reliably quantifying the effect of such hallucinations in free-form responses to open-ended queries is challenging as it requires visually verifying each claim within the response. We propose Programmatic VLM Evaluation (PROVE), a new benchmarking paradigm for evaluating VLM responses to open-ended queries. To construct PROVE, we provide a large language model (LLM) with a high-fidelity scene-graph representation constructed from a hyper-detailed image caption, and prompt it to generate diverse question-answer (QA) pairs, as well as programs that can be executed over the scene graph object to verify each QA pair. We thus construct a benchmark of 10.5k challenging but visually grounded QA pairs. Next, to evaluate free-form model responses to queries in PROVE, we propose a programmatic evaluation strategy that measures both the helpfulness and truthfulness of a response within a unified scene graph-based framework. We benchmark the helpfulness-truthfulness trade-offs of a range of VLMs on PROVE, finding that very few are in-fact able to achieve a good balance between the two. Project page: https://prove-explorer.netlify.app/.

The development of vision-language models (VLMs) is driven by large-scale and diverse multimodal datasets. However, progress toward generalist biomedical VLMs is limited by the lack of annotated, publicly accessible datasets across biology and medicine. Existing efforts are restricted to narrow domains, missing the full diversity of biomedical knowledge encoded in scientific literature. To address this gap, we introduce BIOMEDICA, a scalable, open-source framework to extract, annotate, and serialize the entirety of the PubMed Central Open Access subset into an easy-to-use, publicly accessible dataset.Our framework produces a comprehensive archive with over 24 million unique image-text pairs from over 6 million articles. Metadata and expert-guided annotations are also provided. We demonstrate the utility and accessibility of our resource by releasing BMCA-CLIP, a suite of CLIP-style models continuously pre-trained on the BIOMEDICA dataset via streaming, eliminating the need to download 27 TB of data locally.On average, our models achieve state-of-the-art performance across 40 tasks - spanning pathology, radiology, ophthalmology, dermatology, surgery, molecular biology, parasitology, and cell biology - excelling in zero-shot classification with a 6.56% average improvement (as high as 29.8% and 17.5% in dermatology and ophthalmology, respectively), and stronger image-text retrieval, all while using 10x less compute. To foster reproducibility and collaboration, we release our codebase and dataset for the broader research community.

Vision evaluations are typically done through multi-step processes. In most contemporary fields, experts analyze images using structured, evidence-based adaptive questioning. In plant pathology, botanists inspect leaf images, identify visual cues, infer diagnostic intent, and probe further with targeted questions that adapt to species, symptoms, and severity. This structured probing is crucial for accurate disease diagnosis and treatment formulation. Yet current vision-language models are evaluated on single-turn question answering. To address this gap, we introduce PlantInquiryVQA, a benchmark for studying multi-step, intent-driven visual reasoning in botanical diagnosis. We formalize a Chain of Inquiry framework modeling diagnostic trajectories as ordered question-answer sequences conditioned on grounded visual cues and explicit epistemic intent. We release a dataset of 24,950 expert-curated plant images and 138,068 question-answer pairs annotated with visual grounding, severity labels, and domain-specific reasoning templates. Evaluations on top-tier Multimodal Large Language Models reveal that while they describe visual symptoms adequately, they struggle with safe clinical reasoning and accurate diagnosis. Importantly, structured question-guided inquiry significantly improves diagnostic correctness, reduces hallucination, and increases reasoning efficiency. We hope PlantInquiryVQA serves as a foundational benchmark in advancing research to train diagnostic agents to reason like expert botanists rather than static classifiers.

In the realms of computer vision and natural language processing, Large Vision-Language Models (LVLMs) have become indispensable tools, proficient in generating textual descriptions based on visual inputs. Despite their advancements, our investigation reveals a noteworthy bias in the generated content, where the output is primarily influenced by the underlying Large Language Models (LLMs) prior rather than the input image. Our empirical experiments underscore the persistence of this bias, as LVLMs often provide confident answers even in the absence of relevant images or given incongruent visual input. To rectify these biases and redirect the model's focus toward vision information, we introduce two simple, training-free strategies. Firstly, for tasks such as classification or multi-choice question-answering (QA), we propose a ``calibration'' step through affine transformation to adjust the output distribution. This ``Post-Hoc debias'' approach ensures uniform scores for each answer when the image is absent, serving as an effective regularization technique to alleviate the influence of LLM priors. For more intricate open-ended generation tasks, we extend this method to ``Debias sampling'', drawing inspirations from contrastive decoding methods. Furthermore, our investigation sheds light on the instability of LVLMs across various decoding configurations. Through systematic exploration of different settings, we significantly enhance performance, surpassing reported results and raising concerns about the fairness of existing evaluations. Comprehensive experiments substantiate the effectiveness of our proposed strategies in mitigating biases. These strategies not only prove beneficial in minimizing hallucinations but also contribute to the generation of more helpful and precise illustrations.

The emergence of multimodal large models (MLMs) has significantly advanced the field of visual understanding, offering remarkable capabilities in the realm of visual question answering (VQA). Yet, the true challenge lies in the domain of knowledge-intensive VQA tasks, which necessitate not just recognition of visual elements, but also a deep comprehension of the visual information in conjunction with a vast repository of learned knowledge. To uncover such capabilities of MLMs, particularly the newly introduced GPT-4V and Gemini, we provide an in-depth evaluation from three perspectives: 1) Commonsense Knowledge, which assesses how well models can understand visual cues and connect to general knowledge; 2) Fine-grained World Knowledge, which tests the model's skill in reasoning out specific knowledge from images, showcasing their proficiency across various specialized fields; 3) Comprehensive Knowledge with Decision-making Rationales, which examines model's capability to provide logical explanations for its inference, facilitating a deeper analysis from the interpretability perspective. Additionally, we utilize a visual knowledge-enhanced training strategy and multimodal retrieval-augmented generation approach to enhance MLMs, highlighting the future need for advancements in this research direction. Extensive experiments indicate that: a) GPT-4V demonstrates enhanced explanation generation when using composite images as few-shots; b) GPT-4V and other MLMs produce severe hallucinations when dealing with world knowledge; c) Visual knowledge enhanced training and prompting technicals present potential to improve performance. Codes: https://github.com/HITsz-TMG/Cognitive-Visual-Language-Mapper

Millions of melanocytic skin lesions are examined by pathologists each year, the majority of which concern common nevi (i.e., ordinary moles). While most of these lesions can be diagnosed in seconds, writing the corresponding pathology report is much more time-consuming. Automating part of the report writing could, therefore, alleviate the increasing workload of pathologists. In this work, we develop a vision-language model specifically for the pathology domain of cutaneous melanocytic lesions. The model follows the Contrastive Captioner framework and was trained and evaluated using a melanocytic lesion dataset of 42,512 H&E-stained whole slide images and 19,645 corresponding pathology reports. Our results show that the quality scores of model-generated reports were on par with pathologist-written reports for common nevi, assessed by an expert pathologist in a reader study. While report generation revealed to be more difficult for rare melanocytic lesion subtypes, the cross-modal retrieval performance for these cases was considerably better.

Large Vision Language Models (LVLMs) have recently achieved superior performance in various tasks on natural image and text data, which inspires a large amount of studies for LVLMs fine-tuning and training. Despite their advancements, there has been scant research on the robustness of these models against hallucination when fine-tuned on smaller datasets. In this study, we introduce a new benchmark dataset, the Medical Visual Hallucination Test (MedVH), to evaluate the hallucination of domain-specific LVLMs. MedVH comprises five tasks to evaluate hallucinations in LVLMs within the medical context, which includes tasks for comprehensive understanding of textual and visual input, as well as long textual response generation. Our extensive experiments with both general and medical LVLMs reveal that, although medical LVLMs demonstrate promising performance on standard medical tasks, they are particularly susceptible to hallucinations, often more so than the general models, raising significant concerns about the reliability of these domain-specific models. For medical LVLMs to be truly valuable in real-world applications, they must not only accurately integrate medical knowledge but also maintain robust reasoning abilities to prevent hallucination. Our work paves the way for future evaluations of these studies.

While developing a new vision-language LLM (VL-LLM) by pre-training on tremendous image-text pairs from scratch can be exceedingly resource-consuming, connecting an existing LLM with a comparatively lightweight visual prompt generator (VPG) becomes a feasible paradigm. However, further tuning the VPG part of the VL-LLM still suffers from indispensable computational costs, i.e., requiring thousands of GPU hours and millions of training data. One alternative solution is to transfer an existing VPG from any existing VL-LLMs for the target VL-LLM. In this work, we for the first time investigate the VPG transferability across LLMs, and explore a solution to reduce the cost of VPG transfer. We first study the VPG transfer across different LLM sizes (e.g., small-to-large), and across different LLM types, through which we diagnose the key factors to maximize the transfer efficiency. Based on our observation, we design a two-stage transfer framework named VPGTrans, which is simple yet highly effective. Through extensive experiments, we demonstrate that VPGTrans helps significantly speed up the transfer learning process without compromising performance. Remarkably, it helps achieve the VPG transfer from BLIP-2 OPT_2.7B to BLIP-2 OPT_6.7B with over 10 times speed-up and 10.7% training data compared with connecting a VPG to OPT_6.7B from scratch. Further, a series of intriguing findings and potential rationales behind them are provided and discussed. Finally, we showcase the practical value of our VPGTrans approach, by customizing two novel VL-LLMs, including VL-LLaMA and VL-Vicuna, with recently released LLaMA and Vicuna LLMs.

Vision generation remains a challenging frontier in artificial intelligence, requiring seamless integration of visual understanding and generative capabilities. In this paper, we propose a novel framework, Vision-Driven Prompt Optimization (VDPO), that leverages Large Language Models (LLMs) to dynamically generate textual prompts from visual inputs, guiding high-fidelity image synthesis. VDPO combines a visual embedding prompt tuner, a textual instruction generator, and a vision generation module to achieve state-of-the-art performance in diverse vision generation tasks. Extensive experiments on benchmarks such as COCO and Sketchy demonstrate that VDPO consistently outperforms existing methods, achieving significant improvements in FID, LPIPS, and BLEU/CIDEr scores. Additional analyses reveal the scalability, robustness, and generalization capabilities of VDPO, making it a versatile solution for in-domain and out-of-domain tasks. Human evaluations further validate the practical superiority of VDPO in generating visually appealing and semantically coherent outputs.

Vision-Language Models (VLMs) excel at visual understanding but often suffer from visual hallucinations, where they generate descriptions of nonexistent objects, actions, or concepts, posing significant risks in safety-critical applications. Existing hallucination mitigation methods typically follow one of two paradigms: generation adjustment, which modifies decoding behavior to align text with visual inputs, and post-hoc verification, where external models assess and correct outputs. While effective, generation adjustment methods often rely on heuristics and lack correction mechanisms, while post-hoc verification is complicated, typically requiring multiple models and tending to reject outputs rather than refine them. In this work, we introduce REVERSE, a unified framework that integrates hallucination-aware training with on-the-fly self-verification. By leveraging a new hallucination-verification dataset containing over 1.3M semi-synthetic samples, along with a novel inference-time retrospective resampling technique, our approach enables VLMs to both detect hallucinations during generation and dynamically revise those hallucinations. Our evaluations show that REVERSE achieves state-of-the-art hallucination reduction, outperforming the best existing methods by up to 12% on CHAIR-MSCOCO and 28% on HaloQuest. Our dataset, model, and code are available at: https://reverse-vlm.github.io.

Leading vision-language models (VLMs) are trained on general Internet content, overlooking scientific journals' rich, domain-specific knowledge. Training on specialty-specific literature could yield high-performance, task-specific tools, enabling generative AI to match generalist models in specialty publishing, educational, and clinical tasks. We created NeuroPubs, a multimodal dataset of 23,000 Neurosurgery Publications articles (134M words, 78K image-caption pairs). Using NeuroPubs, VLMs generated publication-ready graphical abstracts (70% of 100 abstracts) and board-style questions indistinguishable from human-written ones (54% of 89,587 questions). We used these questions to train CNS-Obsidian, a 34B-parameter VLM. In a blinded, randomized controlled trial, our model demonstrated non-inferiority to then state-of-the-art GPT-4o in neurosurgical differential diagnosis (clinical utility, 40.62% upvotes vs. 57.89%, p=0.1150; accuracy, 59.38% vs. 65.79%, p=0.3797). Our pilot study demonstrates how training generative AI models on specialty-specific journal content - without large-scale internet data - results in high-performance academic and clinical tools, enabling domain-tailored AI across diverse fields.

As large language models continue to develop in the field of AI, text generation systems are susceptible to a worrisome phenomenon known as hallucination. In this study, we summarize recent compelling insights into hallucinations in LLMs. We present a novel taxonomy of hallucinations from various text generation tasks, thus provide theoretical insights, detection methods and improvement approaches. Based on this, future research directions are proposed. Our contribution are threefold: (1) We provide a detailed and complete taxonomy for hallucinations appearing in text generation tasks; (2) We provide theoretical analyses of hallucinations in LLMs and provide existing detection and improvement methods; (3) We propose several research directions that can be developed in the future. As hallucinations garner significant attention from the community, we will maintain updates on relevant research progress.

In this paper, we focus on the problem of Medical Visual Question Answering (MedVQA), which is crucial in efficiently interpreting medical images with vital clinic-relevant information. Firstly, we reframe the problem of MedVQA as a generation task that naturally follows the human-machine interaction, we propose a generative-based model for medical visual understanding by aligning visual information from a pre-trained vision encoder with a large language model. Secondly, we establish a scalable pipeline to construct a large-scale medical visual question-answering dataset, named PMC-VQA, which contains 227k VQA pairs of 149k images that cover various modalities or diseases. Thirdly, we pre-train our proposed model on PMC-VQA and then fine-tune it on multiple public benchmarks, e.g., VQA-RAD and SLAKE, outperforming existing work by a large margin. Additionally, we propose a test set that has undergone manual verification, which is significantly more challenging, even the best models struggle to solve.

Vision-language pre-training, i.e., aligning images with paired text, is a powerful paradigm to create encoders that can be directly used for tasks such as classification and retrieval, and for downstream tasks such as segmentation and report generation. In the 3D medical image domain, these capabilities allow vision-language encoders (VLEs) to support radiologists by retrieving patients with similar abnormalities or predicting likelihoods of abnormality. While the methodology holds promise, data availability limits the capabilities of current 3D VLEs. In this paper, we alleviate the lack of data by injecting additional inductive biases: introducing a report generation objective and pairing vision-language pre-training with vision-only pre-training. This allows us to leverage both image-only and paired image-text 3D datasets, increasing the total amount of data to which our model is exposed. Through these additional inductive biases, paired with best practices of the 3D medical imaging domain, we develop the Comprehensive Language-image Pre-training (COLIPRI) encoder family. Our COLIPRI encoders achieve state-of-the-art performance in report generation, classification probing, and zero-shot classification, and remain competitive for semantic segmentation.

Medical vision-and-language pre-training (Med-VLP) has shown promising improvements on many downstream medical tasks owing to its applicability to extracting generic representations from medical images and texts. Practically, there exist two typical types, i.e., the fusion-encoder type and the dual-encoder type, depending on whether a heavy fusion module is used. The former is superior at multi-modal tasks owing to the sufficient interaction between modalities; the latter is good at uni-modal and cross-modal tasks due to the single-modality encoding ability. To take advantage of these two types, we propose an effective yet straightforward scheme named PTUnifier to unify the two types. We first unify the input format by introducing visual and textual prompts, which serve as a feature bank that stores the most representative images/texts. By doing so, a single model could serve as a foundation model that processes various tasks adopting different input formats (i.e., image-only, text-only, and image-text-pair). Furthermore, we construct a prompt pool (instead of static ones) to improve diversity and scalability. Experimental results show that our approach achieves state-of-the-art results on a broad range of tasks, spanning uni-modal tasks (i.e., image/text classification and text summarization), cross-modal tasks (i.e., image-to-text generation and image-text/text-image retrieval), and multi-modal tasks (i.e., visual question answering), demonstrating the effectiveness of our approach. Note that the adoption of prompts is orthogonal to most existing Med-VLP approaches and could be a beneficial and complementary extension to these approaches.

Although Vision Language Models (VLMs) have shown strong generalization in medical imaging, pathology presents unique challenges due to ultra-high resolution, complex tissue structures, and nuanced clinical semantics. These factors make pathology VLMs prone to hallucinations, i.e., generating outputs inconsistent with visual evidence, which undermines clinical trust. Existing RAG approaches in this domain largely depend on text-based knowledge bases, limiting their ability to leverage diagnostic visual cues. To address this, we propose Patho-AgenticRAG, a multimodal RAG framework with a database built on page-level embeddings from authoritative pathology textbooks. Unlike traditional text-only retrieval systems, it supports joint text-image search, enabling direct retrieval of textbook pages that contain both the queried text and relevant visual cues, thus avoiding the loss of critical image-based information. Patho-AgenticRAG also supports reasoning, task decomposition, and multi-turn search interactions, improving accuracy in complex diagnostic scenarios. Experiments show that Patho-AgenticRAG significantly outperforms existing multimodal models in complex pathology tasks like multiple-choice diagnosis and visual question answering. Our project is available at the Patho-AgenticRAG repository: https://github.com/Wenchuan-Zhang/Patho-AgenticRAG.

Visual prompting techniques are widely used to efficiently fine-tune pretrained Vision Transformers (ViT) by learning a small set of shared prompts for all tokens. However, existing methods overlook the unique roles of different tokens in conveying discriminative information and interact with all tokens using the same prompts, thereby limiting the representational capacity of ViT. This often leads to indistinguishable and biased prompt-extracted features, hindering performance. To address this issue, we propose a plug-and-play Token Coordinated Prompt Attention (TCPA) module, which assigns specific coordinated prompts to different tokens for attention-based interactions. Firstly, recognizing the distinct functions of CLS and image tokens-global information aggregation and local feature extraction, we disentangle the prompts into CLS Prompts and Image Prompts, which interact exclusively with CLS tokens and image tokens through attention mechanisms. This enhances their respective discriminative abilities. Furthermore, as different image tokens correspond to distinct image patches and contain diverse information, we employ a matching function to automatically assign coordinated prompts to individual tokens. This enables more precise attention interactions, improving the diversity and representational capacity of the extracted features. Extensive experiments across various benchmarks demonstrate that TCPA significantly enhances the diversity and discriminative power of the extracted features. The code is available at https://github.com/zhoujiahuan1991/ICML2025-TCPA.

Vision-Language Models (VLMs) are increasingly used in safety-critical applications that require reliable visual grounding. However, these models often hallucinate details that are not present in the image to satisfy user prompts. While recent datasets and benchmarks have been introduced to evaluate systematic hallucinations in VLMs, many hallucination behaviors remain insufficiently characterized. In particular, prior work primarily focuses on object presence or absence, leaving it unclear how prompt phrasing and structural constraints can systematically induce hallucinations. In this paper, we investigate how different forms of prompt pressure influence hallucination behavior. We introduce Ghost-100, a procedurally generated dataset of synthetic scenes in which key visual details are deliberately removed, enabling controlled analysis of absence-based hallucinations. Using a structured 5-Level Prompt Intensity Framework, we vary prompts from neutral queries to toxic demands and rigid formatting constraints. We evaluate three representative open-weight VLMs: MiniCPM-V 2.6-8B, Qwen2-VL-7B, and Qwen3-VL-8B. Across all three models, hallucination rates do not increase monotonically with prompt intensity. All models exhibit reductions at higher intensity levels at different thresholds, though not all show sustained reduction under maximum coercion. These results suggest that current safety alignment is more effective at detecting semantic hostility than structural coercion, revealing model-specific limitations in handling compliance pressure. Our dataset is available at: https://github.com/bli1/tone-matters

Multimodal large language models (MLLMs) demonstrate significant potential in the field of medical diagnosis. However, they face critical challenges in specialized domains such as ophthalmology, particularly the fragmentation of annotation granularity and inconsistencies in clinical reasoning logic, which hinder precise cross-modal understanding. This paper introduces FundusExpert, an ophthalmology-specific MLLM with integrated positioning-diagnosis reasoning capabilities, along with FundusGen, a dataset constructed through the intelligent Fundus-Engine system. Fundus-Engine automates localization and leverages MLLM-based semantic expansion to integrate global disease classification, local object detection, and fine-grained feature analysis within a single fundus image. Additionally, by constructing a clinically aligned cognitive chain, it guides the model to generate interpretable reasoning paths. FundusExpert, fine-tuned with instruction data from FundusGen, achieves the best performance in ophthalmic question-answering tasks, surpassing the average accuracy of the 40B MedRegA by 26.6%. It also excels in zero-shot report generation tasks, achieving a clinical consistency of 77.0%, significantly outperforming GPT-4o's 47.6%. Furthermore, we reveal a scaling law between data quality and model capability (L propto N^{0.068}), demonstrating that the cognitive alignment annotations in FundusGen enhance data utilization efficiency. By integrating region-level localization with diagnostic reasoning chains, our work develops a scalable, clinically-aligned MLLM and explores a pathway toward bridging the visual-language gap in specific MLLMs. Our project can be found at https://github.com/MeteorElf/FundusExpert.

Depression is a pervasive mental health condition that affects hundreds of millions of individuals worldwide, yet many cases remain undiagnosed due to barriers in traditional clinical access and pervasive stigma. Social media platforms, and Reddit in particular, offer rich, user-generated narratives that can reveal early signs of depressive symptomatology. However, existing computational approaches often label entire posts simply as depressed or not depressed, without linking language to specific criteria from the DSM-5, the standard clinical framework for diagnosing depression. This limits both clinical relevance and interpretability. To address this gap, we introduce ReDSM5, a novel Reddit corpus comprising 1484 long-form posts, each exhaustively annotated at the sentence level by a licensed psychologist for the nine DSM-5 depression symptoms. For each label, the annotator also provides a concise clinical rationale grounded in DSM-5 methodology. We conduct an exploratory analysis of the collection, examining lexical, syntactic, and emotional patterns that characterize symptom expression in social media narratives. Compared to prior resources, ReDSM5 uniquely combines symptom-specific supervision with expert explanations, facilitating the development of models that not only detect depression but also generate human-interpretable reasoning. We establish baseline benchmarks for both multi-label symptom classification and explanation generation, providing reference results for future research on detection and interpretability.

Medical diagnostic applications require models that can process multimodal medical inputs (images, patient histories, lab results) and generate diverse outputs including both textual reports and visual content (annotations, segmentation masks, and images). Despite this need, existing medical AI systems disrupt this unified process: medical image understanding models interpret images but cannot generate visual outputs, while medical image generation models synthesize images but cannot provide textual explanations. This leads to gaps in data representation, feature integration, and task-level multimodal capabilities. To this end, we propose a multi-level framework that draws inspiration from diagnostic workflows through the Observation-Knowledge-Analysis (OKA) paradigm. Specifically, at the observation level, we construct UniMed-5M, a dataset comprising over 5.6M samples that reformat diverse unimodal data into multimodal pairs for foundational observation. At the knowledge level, we propose Progressive Curriculum Learning that systematically introduces medical multimodal knowledge. At the analysis level, we introduce UniMedVL, the first medical unified multimodal model for the simultaneous analysis of image understanding and generation tasks within a single architecture. UniMedVL achieves superior performance on five medical image understanding benchmarks, while matching specialized models in generation quality across eight medical imaging modalities. Crucially, our unified architecture enables bidirectional knowledge sharing: generation tasks enhance visual understanding features, demonstrating that integrating traditionally separate capabilities within a single medical framework unlocks improvements across diverse medical vision-language tasks. Code is available at https://github.com/uni-medical/UniMedVL.

This paper examines the performance of Multimodal LLMs (MLLMs) in skilled production work, with a focus on welding. Using a novel data set of real-world and online weld images, annotated by a domain expert, we evaluate the performance of two state-of-the-art MLLMs in assessing weld acceptability across three contexts: RV \& Marine, Aeronautical, and Farming. While both models perform better on online images, likely due to prior exposure or memorization, they also perform relatively well on unseen, real-world weld images. Additionally, we introduce WeldPrompt, a prompting strategy that combines Chain-of-Thought generation with in-context learning to mitigate hallucinations and improve reasoning. WeldPrompt improves model recall in certain contexts but exhibits inconsistent performance across others. These results underscore the limitations and potentials of MLLMs in high-stakes technical domains and highlight the importance of fine-tuning, domain-specific data, and more sophisticated prompting strategies to improve model reliability. The study opens avenues for further research into multimodal learning in industry applications.

Automated clinical diagnosis remains a core challenge in medical AI, which usually requires models to integrate multi-modal data and reason across complex, case-specific contexts. Although recent methods have advanced medical report generation (MRG) and visual question answering (VQA) with medical vision-language models (VLMs), these methods, however, predominantly operate under a sample-isolated inference paradigm, as such processing cases independently without access to longitudinal electronic health records (EHRs) or structurally related patient examples. This paradigm limits reasoning to image-derived information alone, which ignores external complementary medical evidence for potentially more accurate diagnosis. To overcome this limitation, we propose HyperWalker, a Deep Diagnosis framework that reformulates clinical reasoning via dynamic hypergraphs and test-time training. First, we construct a dynamic hypergraph, termed iBrochure, to model the structural heterogeneity of EHR data and implicit high-order associations among multimodal clinical information. Within this hypergraph, a reinforcement learning agent, Walker, navigates to and identifies optimal diagnostic paths. To ensure comprehensive coverage of diverse clinical characteristics in test samples, we incorporate a linger mechanism, a multi-hop orthogonal retrieval strategy that iteratively selects clinically complementary neighborhood cases reflecting distinct clinical attributes. Experiments on MRG with MIMIC and medical VQA on EHRXQA demonstrate that HyperWalker achieves state-of-the-art performance. Code is available at: https://github.com/Bean-Young/HyperWalker

Hallucination is a common problem for Large Vision-Language Models (LVLMs) with long generations which is difficult to eradicate. The generation with hallucinations is partially inconsistent with the image content. To mitigate hallucination, current studies either focus on the process of model inference or the results of model generation, but the solutions they design sometimes do not deal appropriately with various types of queries and the hallucinations of the generations about these queries. To accurately deal with various hallucinations, we present a unified framework, Dentist, for hallucination mitigation. The core step is to first classify the queries, then perform different processes of hallucination mitigation based on the classification result, just like a dentist first observes the teeth and then makes a plan. In a simple deployment, Dentist can classify queries as perception or reasoning and easily mitigate potential hallucinations in answers which has been demonstrated in our experiments. On MMbench, we achieve a 13.44%/10.2%/15.8% improvement in accuracy on Image Quality, a Coarse Perception visual question answering (VQA) task, over the baseline InstructBLIP/LLaVA/VisualGLM.

With the advent of Vision-Language Models (VLMs), medical artificial intelligence (AI) has experienced significant technological progress and paradigm shifts. This survey provides an extensive review of recent advancements in Medical Vision-Language Models (Med-VLMs), which integrate visual and textual data to enhance healthcare outcomes. We discuss the foundational technology behind Med-VLMs, illustrating how general models are adapted for complex medical tasks, and examine their applications in healthcare. The transformative impact of Med-VLMs on clinical practice, education, and patient care is highlighted, alongside challenges such as data scarcity, narrow task generalization, interpretability issues, and ethical concerns like fairness, accountability, and privacy. These limitations are exacerbated by uneven dataset distribution, computational demands, and regulatory hurdles. Rigorous evaluation methods and robust regulatory frameworks are essential for safe integration into healthcare workflows. Future directions include leveraging large-scale, diverse datasets, improving cross-modal generalization, and enhancing interpretability. Innovations like federated learning, lightweight architectures, and Electronic Health Record (EHR) integration are explored as pathways to democratize access and improve clinical relevance. This review aims to provide a comprehensive understanding of Med-VLMs' strengths and limitations, fostering their ethical and balanced adoption in healthcare.

Existing medical reasoning benchmarks for vision-language models primarily focus on analyzing a patient's condition based on an image from a single visit. However, this setting deviates significantly from real-world clinical practice, where doctors typically refer to a patient's historical conditions to provide a comprehensive assessment by tracking their changes over time. In this paper, we introduce TemMed-Bench, the first benchmark designed for analyzing changes in patients' conditions between different clinical visits, which challenges large vision-language models (LVLMs) to reason over temporal medical images. TemMed-Bench consists of a test set comprising three tasks - visual question-answering (VQA), report generation, and image-pair selection - and a supplementary knowledge corpus of over 17,000 instances. With TemMed-Bench, we conduct an evaluation of six proprietary and six open-source LVLMs. Our results show that most LVLMs lack the ability to analyze patients' condition changes over temporal medical images, and a large proportion perform only at a random-guessing level in the closed-book setting. In contrast, GPT o3, o4-mini and Claude 3.5 Sonnet demonstrate comparatively decent performance, though they have yet to reach the desired level. Furthermore, we explore augmenting the input with both retrieved visual and textual modalities in the medical domain. We also show that multi-modal retrieval augmentation yields notably higher performance gains than no retrieval and textual retrieval alone across most models on our benchmark, with the VQA task showing an average improvement of 2.59%. Overall, we compose a benchmark grounded on real-world clinical practice, and it reveals LVLMs' limitations in temporal medical image reasoning, as well as highlighting the use of multi-modal retrieval augmentation as a potentially promising direction worth exploring to address this challenge.

Depression poses significant challenges to patients and healthcare organizations, necessitating efficient assessment methods. Existing paradigms typically focus on a patient-doctor way that overlooks multi-role interactions, such as family involvement in the evaluation and caregiving process. Moreover, current automatic depression detection (ADD) methods usually model depression detection as a classification or regression task, lacking interpretability for the decision-making process. To address these issues, we developed InterMind, a doctor-patient-family interactive depression assessment system empowered by large language models (LLMs). Our system enables patients and families to contribute descriptions, generates assistive diagnostic reports for doctors, and provides actionable insights, improving diagnostic precision and efficiency. To enhance LLMs' performance in psychological counseling and diagnostic interpretability, we integrate retrieval-augmented generation (RAG) and chain-of-thoughts (CoT) techniques for data augmentation, which mitigates the hallucination issue of LLMs in specific scenarios after instruction fine-tuning. Quantitative experiments and professional assessments by clinicians validate the effectiveness of our system.

Rare cancers comprise 20-25% of all malignancies but face major diagnostic challenges due to limited expert availability-especially in pediatric oncology, where they represent over 70% of cases. While pathology vision-language (VL) foundation models show promising zero-shot capabilities for common cancer subtyping, their clinical performance for rare cancers remains limited. Existing multi-instance learning (MIL) methods rely only on visual features, overlooking cross-modal knowledge and compromising interpretability critical for rare cancer diagnosis. To address this limitation, we propose PathPT, a novel framework that fully exploits the potential of vision-language pathology foundation models through spatially-aware visual aggregation and task-specific prompt tuning. Unlike conventional MIL, PathPT converts WSI-level supervision into fine-grained tile-level guidance by leveraging the zero-shot capabilities of VL models, thereby preserving localization on cancerous regions and enabling cross-modal reasoning through prompts aligned with histopathological semantics. We benchmark PathPT on eight rare cancer datasets(four adult and four pediatric) spanning 56 subtypes and 2,910 WSIs, as well as three common cancer datasets, evaluating four state-of-the-art VL models and four MIL frameworks under three few-shot settings. Results show that PathPT consistently delivers superior performance, achieving substantial gains in subtyping accuracy and cancerous region grounding ability. This work advances AI-assisted diagnosis for rare cancers, offering a scalable solution for improving subtyping accuracy in settings with limited access to specialized expertise.

Vision-language models (VLMs) adapted to the medical domain have shown strong performance on visual question answering benchmarks, yet their robustness against two critical failure modes, hallucination and sycophancy, remains poorly understood, particularly in combination. We evaluate six VLMs (three general-purpose, three medical-specialist) on three medical VQA datasets and uncover a grounding-sycophancy tradeoff: models with the lowest hallucination propensity are the most sycophantic, while the most pressure-resistant model hallucinates more than all medical-specialist models. To characterize this tradeoff, we propose three metrics: L-VASE, a logit-space reformulation of VASE that avoids its double-normalization; CCS, a confidence-calibrated sycophancy score that penalizes high-confidence capitulation; and Clinical Safety Index (CSI), a unified safety index that combines grounding, autonomy, and calibration via a geometric mean. Across 1,151 test cases, no model achieves a CSI above 0.35, indicating that none of the evaluated 7-8B parameter VLMs is simultaneously well-grounded and robust to social pressure. Our findings suggest that joint evaluation of both properties is necessary before these models can be considered for clinical use. Code is available at https://github.com/UTSA-VIRLab/AgreeOrRight

Recent studies have shown that Large Vision-Language Models (VLMs) tend to neglect image content and over-rely on language-model priors, resulting in errors in visually grounded tasks and hallucinations. We hypothesize that this issue arises because existing VLMs are not explicitly trained to generate texts that are accurately grounded in fine-grained image details. To enhance visual feedback during VLM training, we propose S-VCO (Symmetrical Visual Contrastive Optimization), a novel finetuning objective that steers the model toward capturing important visual details and aligning them with corresponding text tokens. To further facilitate this detailed alignment, we introduce MVC, a paired image-text dataset built by automatically filtering and augmenting visual counterfactual data to challenge the model with hard contrastive cases involving Minimal Visual Contrasts. Experiments show that our method consistently improves VLM performance across diverse benchmarks covering various abilities and domains, achieving up to a 22% reduction in hallucinations, and significant gains in vision-centric and general tasks. Notably, these improvements become increasingly pronounced in benchmarks with higher visual dependency. In short, S-VCO offers a significant enhancement of VLM's visually-dependent task performance while retaining or even improving the model's general abilities. We opensource our code at https://s-vco.github.io/

We present a simple approach to make pre-trained Vision Transformers (ViTs) interpretable for fine-grained analysis, aiming to identify and localize the traits that distinguish visually similar categories, such as bird species. Pre-trained ViTs, such as DINO, have demonstrated remarkable capabilities in extracting localized, discriminative features. However, saliency maps like Grad-CAM often fail to identify these traits, producing blurred, coarse heatmaps that highlight entire objects instead. We propose a novel approach, Prompt Class Attention Map (Prompt-CAM), to address this limitation. Prompt-CAM learns class-specific prompts for a pre-trained ViT and uses the corresponding outputs for classification. To correctly classify an image, the true-class prompt must attend to unique image patches not present in other classes' images (i.e., traits). As a result, the true class's multi-head attention maps reveal traits and their locations. Implementation-wise, Prompt-CAM is almost a ``free lunch,'' requiring only a modification to the prediction head of Visual Prompt Tuning (VPT). This makes Prompt-CAM easy to train and apply, in stark contrast to other interpretable methods that require designing specific models and training processes. Extensive empirical studies on a dozen datasets from various domains (e.g., birds, fishes, insects, fungi, flowers, food, and cars) validate the superior interpretation capability of Prompt-CAM. The source code and demo are available at https://github.com/Imageomics/Prompt_CAM.

Avoiding synthesizing specific visual concepts is an essential challenge in responsible visual synthesis. However, the visual concept that needs to be avoided for responsible visual synthesis tends to be diverse, depending on the region, context, and usage scenarios. In this work, we formalize a new task, Open-vocabulary Responsible Visual Synthesis (ORES), where the synthesis model is able to avoid forbidden visual concepts while allowing users to input any desired content. To address this problem, we present a Two-stage Intervention (TIN) framework. By introducing 1) rewriting with learnable instruction through a large-scale language model (LLM) and 2) synthesizing with prompt intervention on a diffusion synthesis model, it can effectively synthesize images avoiding any concepts but following the user's query as much as possible. To evaluate on ORES, we provide a publicly available dataset, baseline models, and benchmark. Experimental results demonstrate the effectiveness of our method in reducing risks of image generation. Our work highlights the potential of LLMs in responsible visual synthesis. Our code and dataset is public available.

Recent works have shown that Large Language Models (LLMs) could empower traditional neuro-symbolic models via programming capabilities to translate language into module descriptions, thus achieving strong visual reasoning results while maintaining the model's transparency and efficiency. However, these models usually exhaustively generate the entire code snippet given each new instance of a task, which is extremely ineffective. We propose generative neuro-symbolic visual reasoning by growing and reusing modules. Specifically, our model consists of three unique stages, module initialization, module generation, and module execution. First, given a vision-language task, we adopt LLMs to examine whether we could reuse and grow over established modules to handle this new task. If not, we initialize a new module needed by the task and specify the inputs and outputs of this new module. After that, the new module is created by querying LLMs to generate corresponding code snippets that match the requirements. In order to get a better sense of the new module's ability, we treat few-shot training examples as test cases to see if our new module could pass these cases. If yes, the new module is added to the module library for future reuse. Finally, we evaluate the performance of our model on the testing set by executing the parsed programs with the newly made visual modules to get the results. We find the proposed model possesses several advantages. First, it performs competitively on standard tasks like visual question answering and referring expression comprehension; Second, the modules learned from one task can be seamlessly transferred to new tasks; Last but not least, it is able to adapt to new visual reasoning tasks by observing a few training examples and reusing modules.

Set-of-Mark (SoM) Prompting unleashes the visual grounding capability of GPT-4V, by enabling the model to associate visual objects with tags inserted on the image. These tags, marked with alphanumerics, can be indexed via text tokens for easy reference. Despite the extraordinary performance from GPT-4V, we observe that other Multimodal Large Language Models (MLLMs) struggle to understand these visual tags. To promote the learning of SoM prompting for open-source models, we propose a new learning paradigm: "list items one by one," which asks the model to enumerate and describe all visual tags placed on the image following the alphanumeric orders of tags. By integrating our curated dataset with other visual instruction tuning datasets, we are able to equip existing MLLMs with the SoM prompting ability. Furthermore, we evaluate our finetuned SoM models on five MLLM benchmarks. We find that this new dataset, even in a relatively small size (10k-30k images with tags), significantly enhances visual reasoning capabilities and reduces hallucinations for MLLMs. Perhaps surprisingly, these improvements persist even when the visual tags are omitted from input images during inference. This suggests the potential of "list items one by one" as a new paradigm for training MLLMs, which strengthens the object-text alignment through the use of visual tags in the training stage. Finally, we conduct analyses by probing trained models to understand the working mechanism of SoM. Our code and data are available at https://github.com/zzxslp/SoM-LLaVA.

Vision-language models hold considerable promise for ophthalmology, but their development depends on large-scale, high-quality image-text datasets that remain scarce. We present PubMed-Ophtha, a hierarchical dataset of 102,023 ophthalmological image-caption pairs extracted from 15,842 open-access articles in PubMed Central. Unlike existing datasets, figures are extracted directly from article PDFs at full resolution and decomposed into their constituent panels, panel identifiers, and individual images. Each image is annotated with its imaging modality -- color fundus photography, optical coherence tomography, retinal imaging, or other -- and a mark status indicating the presence of annotation marks such as arrows. Figure captions are split into panel-level subcaptions using a two-step LLM approach, achieving a mean average sentence BLEU score of 0.913 on human-annotated data. Panel and image detection models reach a mAP@0.50 of 0.909 and 0.892, respectively, and figure extraction achieves a median IoU of 0.997. To support reproducibility, we additionally release the human-annotated ground-truth data, all trained models, and the full dataset generation pipeline.

Language provides a natural interface to specify and evaluate performance on visual tasks. To realize this possibility, vision language models (VLMs) must successfully integrate visual and linguistic information. Our work compares VLMs to a direct readout of their visual encoders to understand their ability to integrate across these modalities. Across a series of vision-centric benchmarks (e.g., depth estimation, correspondence), we find that VLMs perform substantially worse than their visual encoders, dropping to near-chance performance. We investigate these results through a series of analyses across the entire VLM: namely 1) the degradation of vision representations, 2) brittleness to task prompt, and 3) the language model's role in solving the task. We find that the bottleneck in performing these vision-centric tasks lies in this third category; VLMs are not effectively using visual information easily accessible throughout the entire model, and they inherit the language priors present in the LLM. Our work helps diagnose the failure modes of open-source VLMs, and presents a series of evaluations useful for future investigations into visual understanding within VLMs.

Automated radiology report generation holds immense potential to alleviate the heavy workload of radiologists. Despite the formidable vision-language capabilities of recent Multimodal Large Language Models (MLLMs), their clinical deployment is severely constrained by inherent limitations: their "black-box" decision-making renders the generated reports untraceable due to the lack of explicit visual evidence to support the diagnosis, and they struggle to access external domain knowledge. To address these challenges, we propose the Evidence-driven Radiology Report Generation Agent (EviAgent). Unlike opaque end-to-end paradigms, EviAgent coordinates a transparent reasoning trajectory by breaking down the complex generation process into granular operational units. We integrate multi-dimensional visual experts and retrieval mechanisms as external support modules, endowing the system with explicit visual evidence and high-quality clinical priors. Extensive experiments on MIMIC-CXR, CheXpert Plus, and IU-Xray datasets demonstrate that EviAgent outperforms both large-scale generalist models and specialized medical models, providing a robust and trustworthy solution for automated radiology report generation.

Large vision-language models (LVLMs) have shown great promise in medical applications, particularly in visual question answering (MedVQA) and diagnosis from medical images. However, existing datasets and models often fail to consider critical aspects of medical diagnostics, such as the integration of historical records and the analysis of disease progression over time. In this paper, we introduce MMXU (Multimodal and MultiX-ray Understanding), a novel dataset for MedVQA that focuses on identifying changes in specific regions between two patient visits. Unlike previous datasets that primarily address single-image questions, MMXU enables multi-image questions, incorporating both current and historical patient data. We demonstrate the limitations of current LVLMs in identifying disease progression on MMXU-test, even those that perform well on traditional benchmarks. To address this, we propose a MedRecord-Augmented Generation (MAG) approach, incorporating both global and regional historical records. Our experiments show that integrating historical records significantly enhances diagnostic accuracy by at least 20\%, bridging the gap between current LVLMs and human expert performance. Additionally, we fine-tune models with MAG on MMXU-dev, which demonstrates notable improvements. We hope this work could illuminate the avenue of advancing the use of LVLMs in medical diagnostics by emphasizing the importance of historical context in interpreting medical images. Our dataset is released at https://github.com/linjiemu/MMXU{https://github.com/linjiemu/MMXU}.

Visual generation grounded in Visual Foundation Model (VFM) representations offers a highly promising unified pathway for integrating visual understanding, perception, and generation. Despite this potential, training large-scale text-to-image diffusion models entirely within the VFM representation space remains largely unexplored. To bridge this gap, we scale the SVG (Self-supervised representations for Visual Generation) framework, proposing SVG-T2I to support high-quality text-to-image synthesis directly in the VFM feature domain. By leveraging a standard text-to-image diffusion pipeline, SVG-T2I achieves competitive performance, reaching 0.75 on GenEval and 85.78 on DPG-Bench. This performance validates the intrinsic representational power of VFMs for generative tasks. We fully open-source the project, including the autoencoder and generation model, together with their training, inference, evaluation pipelines, and pre-trained weights, to facilitate further research in representation-driven visual generation.

Our research is motivated by the urgent global issue of a large population affected by retinal diseases, which are evenly distributed but underserved by specialized medical expertise, particularly in non-urban areas. Our primary objective is to bridge this healthcare gap by developing a comprehensive diagnostic system capable of accurately predicting retinal diseases solely from fundus images. However, we faced significant challenges due to limited, diverse datasets and imbalanced class distributions. To overcome these issues, we have devised innovative strategies. Our research introduces novel approaches, utilizing hybrid models combining deeper Convolutional Neural Networks (CNNs), Transformer encoders, and ensemble architectures sequentially and in parallel to classify retinal fundus images into 20 disease labels. Our overarching goal is to assess these advanced models' potential in practical applications, with a strong focus on enhancing retinal disease diagnosis accuracy across a broader spectrum of conditions. Importantly, our efforts have surpassed baseline model results, with the C-Tran ensemble model emerging as the leader, achieving a remarkable model score of 0.9166, surpassing the baseline score of 0.9. Additionally, experiments with the IEViT model showcased equally promising outcomes with improved computational efficiency. We've also demonstrated the effectiveness of dynamic patch extraction and the integration of domain knowledge in computer vision tasks. In summary, our research strives to contribute significantly to retinal disease diagnosis, addressing the critical need for accessible healthcare solutions in underserved regions while aiming for comprehensive and accurate disease prediction.

The potential of Vision-Language Models (VLMs) often remains underutilized in handling complex text-based problems, particularly when these problems could benefit from visual representation. Resonating with humans' ability to solve complex text-based problems by (1) creating a visual diagram from the problem and (2) deducing what steps they need to take to solve it, we propose Self-Imagine. We leverage a single Vision-Language Model (VLM) to generate a structured representation of the question using HTML, then render the HTML as an image, and finally use the same VLM to answer the question using both the question and the image. Our approach does not require any additional training data or training. We evaluate our approach on three mathematics tasks and nine general-purpose reasoning tasks using state-of-the-art (LLAVA-1.5 and GEMINI PRO) VLMs. Our approach boosts the performance of LLAVA-1.5 and GEMINI PRO on all math tasks (on average GSM8K: +3.1%; ASDIV: +3.2%; SVAMP: +6.9%) and the majority of the general-purpose reasoning tasks by 3.2% to 6.0% on average.

Multimodal Large Language Models (MLLMs) inherit the superior text understanding capabilities of LLMs and extend these capabilities to multimodal scenarios. These models achieve excellent results in the general domain of multimodal tasks. However, in the medical domain, the substantial training costs and the requirement for extensive medical data pose challenges to the development of medical MLLMs. Furthermore, due to the free-text form of answers, tasks such as visual grounding that need to produce output in a prescribed form become difficult for MLLMs. So far, there have been no medical MLLMs works in medical visual grounding area. For the medical vision grounding task, which involves identifying locations in medical images based on short text descriptions, we propose Parameter-efficient Fine-tuning medical multimodal large language models for Medcial Visual Grounding (PFMVG). To validate the performance of the model, we evaluate it on a public benchmark dataset for medical visual grounding, where it achieves competitive results, and significantly outperforming GPT-4v. Our code will be open sourced after peer review.

In this paper, we critically evaluate the capabilities of the state-of-the-art multimodal large language model, i.e., GPT-4 with Vision (GPT-4V), on Visual Question Answering (VQA) task. Our experiments thoroughly assess GPT-4V's proficiency in answering questions paired with images using both pathology and radiology datasets from 11 modalities (e.g. Microscopy, Dermoscopy, X-ray, CT, etc.) and fifteen objects of interests (brain, liver, lung, etc.). Our datasets encompass a comprehensive range of medical inquiries, including sixteen distinct question types. Throughout our evaluations, we devised textual prompts for GPT-4V, directing it to synergize visual and textual information. The experiments with accuracy score conclude that the current version of GPT-4V is not recommended for real-world diagnostics due to its unreliable and suboptimal accuracy in responding to diagnostic medical questions. In addition, we delineate seven unique facets of GPT-4V's behavior in medical VQA, highlighting its constraints within this complex arena. The complete details of our evaluation cases are accessible at https://github.com/ZhilingYan/GPT4V-Medical-Report.

Medical imaging is widely used in clinical practice for diagnosis and treatment. Report-writing can be error-prone for unexperienced physicians, and time- consuming and tedious for experienced physicians. To address these issues, we study the automatic generation of medical imaging reports. This task presents several challenges. First, a complete report contains multiple heterogeneous forms of information, including findings and tags. Second, abnormal regions in medical images are difficult to identify. Third, the re- ports are typically long, containing multiple sentences. To cope with these challenges, we (1) build a multi-task learning framework which jointly performs the pre- diction of tags and the generation of para- graphs, (2) propose a co-attention mechanism to localize regions containing abnormalities and generate narrations for them, (3) develop a hierarchical LSTM model to generate long paragraphs. We demonstrate the effectiveness of the proposed methods on two publicly available datasets.

Recent advances in radiology report generation (RRG) have been driven by large paired image-text datasets; however, progress in neuro-oncology has been limited due to a lack of open paired image-report datasets. Here, we introduce BTReport, an open-source framework for brain tumor RRG that constructs natural language radiology reports using deterministically extracted imaging features. Unlike existing approaches that rely on large general-purpose or fine-tuned vision-language models for both image interpretation and report composition, BTReport performs deterministic feature extraction for image analysis and uses large language models only for syntactic structuring and narrative formatting. By separating RRG into a deterministic feature extraction step and a report generation step, the generated reports are completely interpretable and less prone to hallucinations. We show that the features used for report generation are predictive of key clinical outcomes, including survival and IDH mutation status, and reports generated by BTReport are more closely aligned with reference clinical reports than existing baselines for RRG. Finally, we introduce BTReport-BraTS, a companion dataset that augments BraTS imaging with synthetically generated radiology reports produced with BTReport. Code for this project can be found at https://github.com/KurtLabUW/BTReport.

The ability to accurately interpret complex visual information is a crucial topic of multimodal large language models (MLLMs). Recent work indicates that enhanced visual perception significantly reduces hallucinations and improves performance on resolution-sensitive tasks, such as optical character recognition and document analysis. A number of recent MLLMs achieve this goal using a mixture of vision encoders. Despite their success, there is a lack of systematic comparisons and detailed ablation studies addressing critical aspects, such as expert selection and the integration of multiple vision experts. This study provides an extensive exploration of the design space for MLLMs using a mixture of vision encoders and resolutions. Our findings reveal several underlying principles common to various existing strategies, leading to a streamlined yet effective design approach. We discover that simply concatenating visual tokens from a set of complementary vision encoders is as effective as more complex mixing architectures or strategies. We additionally introduce Pre-Alignment to bridge the gap between vision-focused encoders and language tokens, enhancing model coherence. The resulting family of MLLMs, Eagle, surpasses other leading open-source models on major MLLM benchmarks. Models and code: https://github.com/NVlabs/Eagle

Though advanced in understanding visual information with human languages, Large Vision-Language Models (LVLMs) still suffer from multimodal hallucinations. A natural concern is that during multimodal interaction, the generated hallucinations could influence the LVLMs' subsequent generation. Thus, we raise a question: When presented with a query relevant to the previously generated hallucination, will LVLMs be misled and respond incorrectly, even though the ground visual information exists? To answer this, we propose a framework called MMHalSnowball to evaluate LVLMs' behaviors when encountering generated hallucinations, where LVLMs are required to answer specific visual questions within a curated hallucinatory conversation. Crucially, our experiment shows that the performance of open-source LVLMs drops by at least 31%, indicating that LVLMs are prone to accept the generated hallucinations and make false claims that they would not have supported without distractions. We term this phenomenon Multimodal Hallucination Snowballing. To mitigate this, we further propose a training-free method called Residual Visual Decoding, where we revise the output distribution of LVLMs with the one derived from the residual visual input, providing models with direct access to the visual information. Experiments show that our method can mitigate more than 24% of the snowballed multimodal hallucination while maintaining capabilities.

This paper introduces an innovative approach to Medical Vision-Language Pre-training (Med-VLP) area in the specialized context of radiograph representation learning. While conventional methods frequently merge textual annotations into unified reports, we acknowledge the intrinsic hierarchical relationship between the findings and impression section in radiograph datasets. To establish a targeted correspondence between images and texts, we propose a novel HybridMED framework to align global-level visual representations with impression and token-level visual representations with findings. Moreover, our framework incorporates a generation decoder that employs two proxy tasks, responsible for generating the impression from (1) images, via a captioning branch, and (2) findings, through a summarization branch. Additionally, knowledge distillation is leveraged to facilitate the training process. Experiments on the MIMIC-CXR dataset reveal that our summarization branch effectively distills knowledge to the captioning branch, enhancing model performance without significantly increasing parameter requirements due to the shared self-attention and feed-forward architecture.

In question-answering scenarios, humans can assess whether the available information is sufficient and seek additional information if necessary, rather than providing a forced answer. In contrast, Vision Language Models (VLMs) typically generate direct, one-shot responses without evaluating the sufficiency of the information. To investigate this gap, we identify a critical and challenging task in the Visual Question Answering (VQA) scenario: can VLMs indicate how to adjust an image when the visual information is insufficient to answer a question? This capability is especially valuable for assisting visually impaired individuals who often need guidance to capture images correctly. To evaluate this capability of current VLMs, we introduce a human-labeled dataset as a benchmark for this task. Additionally, we present an automated framework that generates synthetic training data by simulating ``where to know'' scenarios. Our empirical results show significant performance improvements in mainstream VLMs when fine-tuned with this synthetic data. This study demonstrates the potential to narrow the gap between information assessment and acquisition in VLMs, bringing their performance closer to humans.

Vision-Language Models (VLMs) are advancing computational pathology with superior visual understanding capabilities. However, current systems often reduce diagnosis to directly output conclusions without verifiable evidence-linked reasoning, which severely limits clinical trust and hinders expert error rectification. To address these barriers, we construct PathReasoner, the first large-scale dataset of whole-slide image (WSI) reasoning. Unlike previous work reliant on unverified distillation, we develop a rigorous knowledge-guided generation pipeline. By leveraging medical knowledge graphs, we explicitly align structured pathological findings and clinical reasoning with diagnoses, generating over 20K high-quality instructional samples. Based on the database, we propose PathReasoner-R1, which synergizes trajectory-masked supervised fine-tuning with reasoning-oriented reinforcement learning to instill structured chain-of-thought capabilities. To ensure medical rigor, we engineer a knowledge-aware multi-granular reward function incorporating an Entity Reward mechanism strictly aligned with knowledge graphs. This effectively guides the model to optimize for logical consistency rather than mere outcome matching, thereby enhancing robustness. Extensive experiments demonstrate that PathReasoner-R1 achieves state-of-the-art performance on both PathReasoner and public benchmarks across various image scales, equipping pathology models with transparent, clinically grounded reasoning capabilities. Dataset and code are available at https://github.com/cyclexfy/PathReasoner-R1.

Generative AI has made rapid advancements in recent years, achieving unprecedented capabilities in multimodal understanding and code generation. This can enable a new paradigm of front-end development, in which multimodal LLMs might directly convert visual designs into code implementations. In this work, we formalize this as a Design2Code task and conduct comprehensive benchmarking. Specifically, we manually curate a benchmark of 484 diverse real-world webpages as test cases and develop a set of automatic evaluation metrics to assess how well current multimodal LLMs can generate the code implementations that directly render into the given reference webpages, given the screenshots as input. We also complement automatic metrics with comprehensive human evaluations. We develop a suite of multimodal prompting methods and show their effectiveness on GPT-4V and Gemini Pro Vision. We further finetune an open-source Design2Code-18B model that successfully matches the performance of Gemini Pro Vision. Both human evaluation and automatic metrics show that GPT-4V performs the best on this task compared to other models. Moreover, annotators think GPT-4V generated webpages can replace the original reference webpages in 49% of cases in terms of visual appearance and content; and perhaps surprisingly, in 64% of cases GPT-4V generated webpages are considered better than the original reference webpages. Our fine-grained break-down metrics indicate that open-source models mostly lag in recalling visual elements from the input webpages and in generating correct layout designs, while aspects like text content and coloring can be drastically improved with proper finetuning.

The rapid advancement of visual generation models has outpaced traditional evaluation approaches, necessitating the adoption of Vision-Language Models as surrogate judges. In this work, we systematically investigate the reliability of the prevailing absolute pointwise scoring standard, across a wide spectrum of visual generation tasks. Our analysis reveals that this paradigm is limited due to stochastic inconsistency and poor alignment with human perception. To resolve these limitations, we introduce GenArena, a unified evaluation framework that leverages a pairwise comparison paradigm to ensure stable and human-aligned evaluation. Crucially, our experiments uncover a transformative finding that simply adopting this pairwise protocol enables off-the-shelf open-source models to outperform top-tier proprietary models. Notably, our method boosts evaluation accuracy by over 20% and achieves a Spearman correlation of 0.86 with the authoritative LMArena leaderboard, drastically surpassing the 0.36 correlation of pointwise methods. Based on GenArena, we benchmark state-of-the-art visual generation models across diverse tasks, providing the community with a rigorous and automated evaluation standard for visual generation.

Vision Transformers (ViTs) have attracted a lot of popularity in recent years, due to their exceptional capabilities in modeling long-range spatial dependencies and scalability for large scale training. Although the training parallelism of self-attention mechanism plays an important role in retaining great performance, its quadratic complexity baffles the application of ViTs in many scenarios which demand fast inference. This effect is even more pronounced in applications in which autoregressive modeling of input features is required. In Natural Language Processing (NLP), a new stream of efforts have proposed parallelizable models with recurrent formulation that allows for efficient inference in generative applications. Inspired by this trend, we propose a new class of computer vision models, dubbed Vision Retention Networks (ViR), with dual parallel and recurrent formulations, which strike an optimal balance between fast inference and parallel training with competitive performance. In particular, ViR scales favorably for image throughput and memory consumption in tasks that require higher-resolution images due to its flexible formulation in processing large sequence lengths. The ViR is the first attempt to realize dual parallel and recurrent equivalency in a general vision backbone for recognition tasks. We have validated the effectiveness of ViR through extensive experiments with different dataset sizes and various image resolutions and achieved competitive performance. Our code and pretrained models will be made publicly available.

Natural Language Generation (NLG) has improved exponentially in recent years thanks to the development of sequence-to-sequence deep learning technologies such as Transformer-based language models. This advancement has led to more fluent and coherent NLG, leading to improved development in downstream tasks such as abstractive summarization, dialogue generation and data-to-text generation. However, it is also apparent that deep learning based generation is prone to hallucinate unintended text, which degrades the system performance and fails to meet user expectations in many real-world scenarios. To address this issue, many studies have been presented in measuring and mitigating hallucinated texts, but these have never been reviewed in a comprehensive manner before. In this survey, we thus provide a broad overview of the research progress and challenges in the hallucination problem in NLG. The survey is organized into two parts: (1) a general overview of metrics, mitigation methods, and future directions; and (2) an overview of task-specific research progress on hallucinations in the following downstream tasks, namely abstractive summarization, dialogue generation, generative question answering, data-to-text generation, machine translation, and visual-language generation. This survey serves to facilitate collaborative efforts among researchers in tackling the challenge of hallucinated texts in NLG.

Real-world clinical decision-making grapples with integrating information from diverse data modalities, including medical text, 2D/3D images, and video, leading to inefficiencies and potential diagnostic oversights. While generalist vision-language models (VLMs) offer promise, their medical development faces challenges of opaque pipelines, data scarcity, and architectural inflexibility. Here we present Hulu-Med, a transparent medical VLM that unifies understanding across all these modalities. Built upon a unified patch-based vision encoder and an LLM decoder, Hulu-Med was progressively trained on 16.7 million (M) samples to scale from 2D to 3D and video comprehension. The medical-aware token reduction enables efficient training, requiring only 4,000 to 40,000 GPU hours for 7B to 32B parameter variants. Extensive evaluation across 30 benchmarks exhibits state-of-the-art performance, surpassing leading open-source models and competing with proprietary systems in tasks spanning visual question-answering, medical report generation, and complex reasoning in multilingual and rare disease scenarios. By open-sourcing our complete pipeline, we establish that high-performance medical VLM can be achieved transparently, providing a foundational tool for accessible and impactful clinical AI. Code is released on https://github.com/ZJUI-AI4H/Hulu-Med{https://github.com/ZJUI-AI4H/Hulu-Med}.

Most current medical vision language models struggle to jointly generate diagnostic text and pixel-level segmentation masks in response to complex visual questions. This represents a major limitation towards clinical application, as assistive systems that fail to provide both modalities simultaneously offer limited value to medical practitioners. To alleviate this limitation, we first introduce RadDiagSeg-D, a dataset combining abnormality detection, diagnosis, and multi-target segmentation into a unified and hierarchical task. RadDiagSeg-D covers multiple imaging modalities and is precisely designed to support the development of models that produce descriptive text and corresponding segmentation masks in tandem. Subsequently, we leverage the dataset to propose a novel vision-language model, RadDiagSeg-M, capable of joint abnormality detection, diagnosis, and flexible segmentation. RadDiagSeg-M provides highly informative and clinically useful outputs, effectively addressing the need to enrich contextual information for assistive diagnosis. Finally, we benchmark RadDiagSeg-M and showcase its strong performance across all components involved in the task of multi-target text-and-mask generation, establishing a robust and competitive baseline.