Daily Papers

Recent advancements in surgical computer vision have been driven by vision-only models, which lack language semantics, relying on manually annotated videos to predict fixed object categories. This limits their generalizability to unseen surgical procedures and tasks. We propose leveraging surgical video lectures from e-learning platforms to provide effective vision and language supervisory signals for multi-modal representation learning, bypassing manual annotations. We address surgery-specific linguistic challenges using multiple automatic speech recognition systems for text transcriptions. We introduce SurgVLP - Surgical Vision Language Pre-training - a novel method for multi-modal representation learning. SurgVLP employs a new contrastive learning objective, aligning video clip embeddings with corresponding multiple text embeddings in a joint latent space. We demonstrate the representational capability of this space through several vision-and-language surgical tasks and vision-only tasks specific to surgery. Unlike current fully supervised approaches, SurgVLP adapts to different surgical procedures and tasks without specific fine-tuning, achieving zero-shot adaptation to tasks such as surgical tool, phase, and triplet recognition without manual annotation. These results highlight the transferability and versatility of the learned multi-modal representations in surgical video analysis. The code is available at https://github.com/CAMMA-public/SurgVLP

Surgical video-language pretraining (VLP) faces unique challenges due to the knowledge domain gap and the scarcity of multi-modal data. This study aims to bridge the gap by addressing issues regarding textual information loss in surgical lecture videos and the spatial-temporal challenges of surgical VLP. We propose a hierarchical knowledge augmentation approach and a novel Procedure-Encoded Surgical Knowledge-Augmented Video-Language Pretraining (PeskaVLP) framework to tackle these issues. The knowledge augmentation uses large language models (LLM) for refining and enriching surgical concepts, thus providing comprehensive language supervision and reducing the risk of overfitting. PeskaVLP combines language supervision with visual self-supervision, constructing hard negative samples and employing a Dynamic Time Warping (DTW) based loss function to effectively comprehend the cross-modal procedural alignment. Extensive experiments on multiple public surgical scene understanding and cross-modal retrieval datasets show that our proposed method significantly improves zero-shot transferring performance and offers a generalist visual representation for further advancements in surgical scene understanding.The code is available at https://github.com/CAMMA-public/SurgVLP

Medical Vision-Language Pretraining (MedVLP) shows promise in learning generalizable and transferable visual representations from paired and unpaired medical images and reports. MedVLP can provide useful features to downstream tasks and facilitate adapting task-specific models to new setups using fewer examples. However, existing MedVLP methods often differ in terms of datasets, preprocessing, and finetuning implementations. This pose great challenges in evaluating how well a MedVLP method generalizes to various clinically-relevant tasks due to the lack of unified, standardized, and comprehensive benchmark. To fill this gap, we propose BenchX, a unified benchmark framework that enables head-to-head comparison and systematical analysis between MedVLP methods using public chest X-ray datasets. Specifically, BenchX is composed of three components: 1) Comprehensive datasets covering nine datasets and four medical tasks; 2) Benchmark suites to standardize data preprocessing, train-test splits, and parameter selection; 3) Unified finetuning protocols that accommodate heterogeneous MedVLP methods for consistent task adaptation in classification, segmentation, and report generation, respectively. Utilizing BenchX, we establish baselines for nine state-of-the-art MedVLP methods and found that the performance of some early MedVLP methods can be enhanced to surpass more recent ones, prompting a revisiting of the developments and conclusions from prior works in MedVLP. Our code are available at https://github.com/yangzhou12/BenchX.

Surgical practice involves complex visual interpretation, procedural skills, and advanced medical knowledge, making surgical vision-language pretraining (VLP) particularly challenging due to this complexity and the limited availability of annotated data. To address the gap, we propose OphCLIP, a hierarchical retrieval-augmented vision-language pretraining framework specifically designed for ophthalmic surgical workflow understanding. OphCLIP leverages the OphVL dataset we constructed, a large-scale and comprehensive collection of over 375K hierarchically structured video-text pairs with tens of thousands of different combinations of attributes (surgeries, phases/operations/actions, instruments, medications, as well as more advanced aspects like the causes of eye diseases, surgical objectives, and postoperative recovery recommendations, etc). These hierarchical video-text correspondences enable OphCLIP to learn both fine-grained and long-term visual representations by aligning short video clips with detailed narrative descriptions and full videos with structured titles, capturing intricate surgical details and high-level procedural insights, respectively. Our OphCLIP also designs a retrieval-augmented pretraining framework to leverage the underexplored large-scale silent surgical procedure videos, automatically retrieving semantically relevant content to enhance the representation learning of narrative videos. Evaluation across 11 datasets for phase recognition and multi-instrument identification shows OphCLIP's robust generalization and superior performance.

Medical vision-and-language pre-training (Med-VLP) has received considerable attention owing to its applicability to extracting generic vision-and-language representations from medical images and texts. Most existing methods mainly contain three elements: uni-modal encoders (i.e., a vision encoder and a language encoder), a multi-modal fusion module, and pretext tasks, with few studies considering the importance of medical domain expert knowledge and explicitly exploiting such knowledge to facilitate Med-VLP. Although there exist knowledge-enhanced vision-and-language pre-training (VLP) methods in the general domain, most require off-the-shelf toolkits (e.g., object detectors and scene graph parsers), which are unavailable in the medical domain. In this paper, we propose a systematic and effective approach to enhance Med-VLP by structured medical knowledge from three perspectives. First, considering knowledge can be regarded as the intermediate medium between vision and language, we align the representations of the vision encoder and the language encoder through knowledge. Second, we inject knowledge into the multi-modal fusion model to enable the model to perform reasoning using knowledge as the supplementation of the input image and text. Third, we guide the model to put emphasis on the most critical information in images and texts by designing knowledge-induced pretext tasks. To perform a comprehensive evaluation and facilitate further research, we construct a medical vision-and-language benchmark including three tasks. Experimental results illustrate the effectiveness of our approach, where state-of-the-art performance is achieved on all downstream tasks. Further analyses explore the effects of different components of our approach and various settings of pre-training.

Generalist vision language models (VLMs) have made significant strides in computer vision, but they fall short in specialized fields like healthcare, where expert knowledge is essential. In traditional computer vision tasks, creative or approximate answers may be acceptable, but in healthcare, precision is paramount.Current large multimodal models like Gemini and GPT-4o are insufficient for medical tasks due to their reliance on memorized internet knowledge rather than the nuanced expertise required in healthcare. VLMs are usually trained in three stages: vision pre-training, vision-language pre-training, and instruction fine-tuning (IFT). IFT has been typically applied using a mixture of generic and healthcare data. In contrast, we propose that for medical VLMs, a fourth stage of specialized IFT is necessary, which focuses on medical data and includes information from domain expert models. Domain expert models developed for medical use are crucial because they are specifically trained for certain clinical tasks, e.g. to detect tumors and classify abnormalities through segmentation and classification, which learn fine-grained features of medical data-features that are often too intricate for a VLM to capture effectively especially in radiology. This paper introduces a new framework, VILA-M3, for medical VLMs that utilizes domain knowledge via expert models. Through our experiments, we show an improved state-of-the-art (SOTA) performance with an average improvement of ~9% over the prior SOTA model Med-Gemini and ~6% over models trained on the specific tasks. Our approach emphasizes the importance of domain expertise in creating precise, reliable VLMs for medical applications.

Natural language could play an important role in developing generalist surgical models by providing a broad source of supervision from raw texts. This flexible form of supervision can enable the model's transferability across datasets and tasks as natural language can be used to reference learned visual concepts or describe new ones. In this work, we present HecVL, a novel hierarchical video-language pretraining approach for building a generalist surgical model. Specifically, we construct a hierarchical video-text paired dataset by pairing the surgical lecture video with three hierarchical levels of texts: at clip-level, atomic actions using transcribed audio texts; at phase-level, conceptual text summaries; and at video-level, overall abstract text of the surgical procedure. Then, we propose a novel fine-to-coarse contrastive learning framework that learns separate embedding spaces for the three video-text hierarchies using a single model. By disentangling embedding spaces of different hierarchical levels, the learned multi-modal representations encode short-term and long-term surgical concepts in the same model. Thanks to the injected textual semantics, we demonstrate that the HecVL approach can enable zero-shot surgical phase recognition without any human annotation. Furthermore, we show that the same HecVL model for surgical phase recognition can be transferred across different surgical procedures and medical centers. The code is available at https://github.com/CAMMA-public/SurgVLP

Medical visual question answering (VQA) is a challenging multimodal task, where Vision-Language Pre-training (VLP) models can effectively improve the generalization performance. However, most methods in the medical field treat VQA as an answer classification task which is difficult to transfer to practical application scenarios. Additionally, due to the privacy of medical images and the expensive annotation process, large-scale medical image-text pairs datasets for pretraining are severely lacking. In this paper, we propose a large-scale MultI-task Self-Supervised learning based framework (MISS) for medical VQA tasks. Unlike existing methods, we treat medical VQA as a generative task. We unify the text encoder and multimodal encoder and align image-text features through multi-task learning. Furthermore, we propose a Transfer-and-Caption method that extends the feature space of single-modal image datasets using large language models (LLMs), enabling those traditional medical vision field task data to be applied to VLP. Experiments show that our method achieves excellent results with fewer multimodal datasets and demonstrates the advantages of generative VQA models. The code and model weights will be released upon the paper's acceptance.

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.

Vision-language pre-training (VLP) models have shown significant advancements in the medical domain. Yet, most VLP models align raw reports to images at a very coarse level, without modeling fine-grained relationships between anatomical and pathological concepts outlined in reports and the corresponding semantic counterparts in images. To address this problem, we propose a Medical Dual-Stream Language-Image Pre-training (MeDSLIP) framework. Specifically, MeDSLIP establishes vision-language fine-grained alignments via disentangling visual and textual representations into anatomy-relevant and pathology-relevant streams. Moreover, a novel vision-language Prototypical Contr-astive Learning (ProtoCL) method is adopted in MeDSLIP to enhance the alignment within the anatomical and pathological streams. MeDSLIP further employs cross-stream Intra-image Contrastive Learning (ICL) to ensure the consistent coexistence of paired anatomical and pathological concepts within the same image. Such a cross-stream regularization encourages the model to exploit the synchrony between two streams for a more comprehensive representation learning. MeDSLIP is evaluated under zero-shot and supervised fine-tuning settings on three public datasets: NIH CXR14, RSNA Pneumonia, and SIIM-ACR Pneumothorax. Under these settings, MeDSLIP outperforms six leading CNN-based models on classification, grounding, and segmentation tasks.

3D Vision-Language Pre-training (3D-VLP) aims to provide a pre-train model which can bridge 3D scenes with natural language, which is an important technique for embodied intelligence. However, current 3D-VLP datasets are hindered by limited scene-level diversity and insufficient fine-grained annotations (only 1.2K scenes and 280K textual annotations in ScanScribe), primarily due to the labor-intensive of collecting and annotating 3D scenes. To overcome these obstacles, we construct SynVL3D, a comprehensive synthetic scene-text corpus with 10K indoor scenes and 1M descriptions at object, view, and room levels, which has the advantages of diverse scene data, rich textual descriptions, multi-grained 3D-text associations, and low collection cost. Utilizing the rich annotations in SynVL3D, we pre-train a simple and unified Transformer for aligning 3D and language with multi-grained pretraining tasks. Moreover, we propose a synthetic-to-real domain adaptation in downstream task fine-tuning process to address the domain shift. Through extensive experiments, we verify the effectiveness of our model design by achieving state-of-the-art performance on downstream tasks including visual grounding, dense captioning, and question answering.

With recent progress in joint modeling of visual and textual representations, Vision-Language Pretraining (VLP) has achieved impressive performance on many multimodal downstream tasks. However, the requirement for expensive annotations including clean image captions and regional labels limits the scalability of existing approaches, and complicates the pretraining procedure with the introduction of multiple dataset-specific objectives. In this work, we relax these constraints and present a minimalist pretraining framework, named Simple Visual Language Model (SimVLM). Unlike prior work, SimVLM reduces the training complexity by exploiting large-scale weak supervision, and is trained end-to-end with a single prefix language modeling objective. Without utilizing extra data or task-specific customization, the resulting model significantly outperforms previous pretraining methods and achieves new state-of-the-art results on a wide range of discriminative and generative vision-language benchmarks, including VQA (+3.74% vqa-score), NLVR2 (+1.17% accuracy), SNLI-VE (+1.37% accuracy) and image captioning tasks (+10.1% average CIDEr score). Furthermore, we demonstrate that SimVLM acquires strong generalization and transfer ability, enabling zero-shot behavior including open-ended visual question answering and cross-modality transfer.

Vision-and-Language Pre-training (VLP) has improved performance on various joint vision-and-language downstream tasks. Current approaches to VLP heavily rely on image feature extraction processes, most of which involve region supervision (e.g., object detection) and the convolutional architecture (e.g., ResNet). Although disregarded in the literature, we find it problematic in terms of both (1) efficiency/speed, that simply extracting input features requires much more computation than the multimodal interaction steps; and (2) expressive power, as it is upper bounded to the expressive power of the visual embedder and its predefined visual vocabulary. In this paper, we present a minimal VLP model, Vision-and-Language Transformer (ViLT), monolithic in the sense that the processing of visual inputs is drastically simplified to just the same convolution-free manner that we process textual inputs. We show that ViLT is up to tens of times faster than previous VLP models, yet with competitive or better downstream task performance. Our code and pre-trained weights are available at https://github.com/dandelin/vilt.

Modern operating room is becoming increasingly complex, requiring innovative intra-operative support systems. While the focus of surgical data science has largely been on video analysis, integrating surgical computer vision with language capabilities is emerging as a necessity. Our work aims to advance Visual Question Answering (VQA) in the surgical context with scene graph knowledge, addressing two main challenges in the current surgical VQA systems: removing question-condition bias in the surgical VQA dataset and incorporating scene-aware reasoning in the surgical VQA model design. First, we propose a Surgical Scene Graph-based dataset, SSG-QA, generated by employing segmentation and detection models on publicly available datasets. We build surgical scene graphs using spatial and action information of instruments and anatomies. These graphs are fed into a question engine, generating diverse QA pairs. Our SSG-QA dataset provides a more complex, diverse, geometrically grounded, unbiased, and surgical action-oriented dataset compared to existing surgical VQA datasets. We then propose SSG-QA-Net, a novel surgical VQA model incorporating a lightweight Scene-embedded Interaction Module (SIM), which integrates geometric scene knowledge in the VQA model design by employing cross-attention between the textual and the scene features. Our comprehensive analysis of the SSG-QA dataset shows that SSG-QA-Net outperforms existing methods across different question types and complexities. We highlight that the primary limitation in the current surgical VQA systems is the lack of scene knowledge to answer complex queries. We present a novel surgical VQA dataset and model and show that results can be significantly improved by incorporating geometric scene features in the VQA model design. The source code and the dataset will be made publicly available at: https://github.com/CAMMA-public/SSG-QA

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.

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.

In this paper, we propose ``SimVLG'', a streamlined framework for the pre-training of computationally intensive vision-language generative models, leveraging frozen pre-trained large language models (LLMs). The prevailing paradigm in vision-language pre-training (VLP) typically involves a two-stage optimization process: an initial resource-intensive phase dedicated to general-purpose vision-language representation learning, aimed at extracting and consolidating pertinent visual features, followed by a subsequent phase focusing on end-to-end alignment between visual and linguistic modalities. Our one-stage, single-loss framework circumvents the aforementioned computationally demanding first stage of training by gradually merging similar visual tokens during training. This gradual merging process effectively compacts the visual information while preserving the richness of semantic content, leading to fast convergence without sacrificing performance. Our experiments show that our approach can speed up the training of vision-language models by a factor times 5 without noticeable impact on the overall performance. Additionally, we show that our models can achieve comparable performance to current vision-language models with only 1/10 of the data. Finally, we demonstrate how our image-text models can be easily adapted to video-language generative tasks through a novel soft attentive temporal token merging modules.

In this paper, we consider enhancing medical visual-language pre-training (VLP) with domain-specific knowledge, by exploiting the paired image-text reports from the radiological daily practice. In particular, we make the following contributions: First, unlike existing works that directly process the raw reports, we adopt a novel triplet extraction module to extract the medical-related information, avoiding unnecessary complexity from language grammar and enhancing the supervision signals; Second, we propose a novel triplet encoding module with entity translation by querying a knowledge base, to exploit the rich domain knowledge in medical field, and implicitly build relationships between medical entities in the language embedding space; Third, we propose to use a Transformer-based fusion model for spatially aligning the entity description with visual signals at the image patch level, enabling the ability for medical diagnosis; Fourth, we conduct thorough experiments to validate the effectiveness of our architecture, and benchmark on numerous public benchmarks, e.g., ChestX-ray14, RSNA Pneumonia, SIIM-ACR Pneumothorax, COVIDx CXR-2, COVID Rural, and EdemaSeverity. In both zero-shot and fine-tuning settings, our model has demonstrated strong performance compared with the former methods on disease classification and grounding.

Vision-Language Pre-training (VLP) has advanced the performance for many vision-language tasks. However, most existing pre-trained models only excel in either understanding-based tasks or generation-based tasks. Furthermore, performance improvement has been largely achieved by scaling up the dataset with noisy image-text pairs collected from the web, which is a suboptimal source of supervision. In this paper, we propose BLIP, a new VLP framework which transfers flexibly to both vision-language understanding and generation tasks. BLIP effectively utilizes the noisy web data by bootstrapping the captions, where a captioner generates synthetic captions and a filter removes the noisy ones. We achieve state-of-the-art results on a wide range of vision-language tasks, such as image-text retrieval (+2.7% in average recall@1), image captioning (+2.8% in CIDEr), and VQA (+1.6% in VQA score). BLIP also demonstrates strong generalization ability when directly transferred to video-language tasks in a zero-shot manner. Code, models, and datasets are released at https://github.com/salesforce/BLIP.

Despite significant advancements in general artificial intelligence, such as GPT-4, their effectiveness in the medical domain (general medical AI, GMAI) remains constrained due to the absence of specialized medical knowledge. To address this challenge, we present GMAI-VL-5.5M, a comprehensive multimodal medical dataset created by converting hundreds of specialized medical datasets into meticulously constructed image-text pairs. This dataset features comprehensive task coverage, diverse modalities, and high-quality image-text data. Building upon this multimodal dataset, we propose GMAI-VL, a general medical vision-language model with a progressively three-stage training strategy. This approach significantly enhances the model's ability by integrating visual and textual information, thereby improving its ability to process multimodal data and support accurate diagnosis and clinical decision-making. Experimental evaluations demonstrate that GMAI-VL achieves state-of-the-art results across a wide range of multimodal medical tasks, such as visual question answering and medical image diagnosis. Our contributions include the development of the GMAI-VL-5.5M dataset, the introduction of the GMAI-VL model, and the establishment of new benchmarks in multiple medical domains. Code and dataset will be released at https://github.com/uni-medical/GMAI-VL.

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.

Vision-Language Pretraining (VLP) models have recently successfully facilitated many cross-modal downstream tasks. Most existing works evaluated their systems by comparing the fine-tuned downstream task performance. However, only average downstream task accuracy provides little information about the pros and cons of each VLP method, let alone provides insights on how the community can improve the systems in the future. Inspired by the CheckList for testing natural language processing, we exploit VL-CheckList, a novel framework to understand the capabilities of VLP models. The proposed method divides the image-texting ability of a VLP model into three categories: objects, attributes, and relations, and uses a novel taxonomy to further break down these three aspects. We conduct comprehensive studies to analyze seven recently popular VLP models via the proposed framework. Results confirm the effectiveness of the proposed method by revealing fine-grained differences among the compared models that were not visible from downstream task-only evaluation. Further results show promising research direction in building better VLP models. Our data and code are available at: https://github.com/om-ai-lab/VL-CheckList.

This paper presents a unified Vision-Language Pre-training (VLP) model. The model is unified in that (1) it can be fine-tuned for either vision-language generation (e.g., image captioning) or understanding (e.g., visual question answering) tasks, and (2) it uses a shared multi-layer transformer network for both encoding and decoding, which differs from many existing methods where the encoder and decoder are implemented using separate models. The unified VLP model is pre-trained on a large amount of image-text pairs using the unsupervised learning objectives of two tasks: bidirectional and sequence-to-sequence (seq2seq) masked vision-language prediction. The two tasks differ solely in what context the prediction conditions on. This is controlled by utilizing specific self-attention masks for the shared transformer network. To the best of our knowledge, VLP is the first reported model that achieves state-of-the-art results on both vision-language generation and understanding tasks, as disparate as image captioning and visual question answering, across three challenging benchmark datasets: COCO Captions, Flickr30k Captions, and VQA 2.0. The code and the pre-trained models are available at https://github.com/LuoweiZhou/VLP.

Medical vision-and-language pre-training provides a feasible solution to extract effective vision-and-language representations from medical images and texts. However, few studies have been dedicated to this field to facilitate medical vision-and-language understanding. In this paper, we propose a self-supervised learning paradigm with multi-modal masked autoencoders (M^3AE), which learn cross-modal domain knowledge by reconstructing missing pixels and tokens from randomly masked images and texts. There are three key designs to make this simple approach work. First, considering the different information densities of vision and language, we adopt different masking ratios for the input image and text, where a considerably larger masking ratio is used for images. Second, we use visual and textual features from different layers to perform the reconstruction to deal with different levels of abstraction in visual and language. Third, we develop different designs for vision and language decoders (i.e., a Transformer for vision and a multi-layer perceptron for language). To perform a comprehensive evaluation and facilitate further research, we construct a medical vision-and-language benchmark including three tasks. Experimental results demonstrate the effectiveness of our approach, where state-of-the-art results are achieved on all downstream tasks. Besides, we conduct further analysis to better verify the effectiveness of different components of our approach and various settings of pre-training. The source code is available at~https://github.com/zhjohnchan/M3AE.

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.

Large Language Models (LLMs) have introduced a new era of proficiency in comprehending complex healthcare and biomedical topics. However, there is a noticeable lack of models in languages other than English and models that can interpret multi-modal input, which is crucial for global healthcare accessibility. In response, this study introduces Qilin-Med-VL, the first Chinese large vision-language model designed to integrate the analysis of textual and visual data. Qilin-Med-VL combines a pre-trained Vision Transformer (ViT) with a foundational LLM. It undergoes a thorough two-stage curriculum training process that includes feature alignment and instruction tuning. This method enhances the model's ability to generate medical captions and answer complex medical queries. We also release ChiMed-VL, a dataset consisting of more than 1M image-text pairs. This dataset has been carefully curated to enable detailed and comprehensive interpretation of medical data using various types of images.

Pre-trained LLMs that are further trained with image data perform well on vision-language tasks. While adding images during a second training phase effectively unlocks this capability, it is unclear how much of a gain or loss this two-step pipeline gives over VLMs which integrate images earlier into the training process. To investigate this, we train models spanning various datasets, scales, image-text ratios, and amount of pre-training done before introducing vision tokens. We then fine-tune these models and evaluate their downstream performance on a suite of vision-language and text-only tasks. We find that pre-training with a mixture of image and text data allows models to perform better on vision-language tasks while maintaining strong performance on text-only evaluations. On an average of 6 diverse tasks, we find that for a 1B model, introducing visual tokens 80% of the way through pre-training results in a 2% average improvement over introducing visual tokens to a fully pre-trained model.

Conversation agents powered by large language models are revolutionizing the way we interact with visual data. Recently, large vision-language models (LVLMs) have been extensively studied for both images and videos. However, these studies typically focus on common scenarios. In this work, we introduce an LVLM specifically designed for surgical scenarios. We integrate visual representations of surgical images and videos into the language feature space. Consequently, we establish a LVLM model, Surgical-LLaVA, fine-tuned on instruction following data of surgical scenarios. Our experiments demonstrate that Surgical-LLaVA exhibits impressive multi-modal chat abilities in surgical contexts, occasionally displaying multi-modal behaviors on unseen instructions. We conduct a quantitative evaluation of visual question-answering datasets for surgical scenarios. The results show superior performance compared to previous works, indicating the potential of our model to tackle more complex surgery scenarios.

Multimodal/vision language models (VLMs) are increasingly being deployed in healthcare settings worldwide, necessitating robust benchmarks to ensure their safety, efficacy, and fairness. Multiple-choice question and answer (QA) datasets derived from national medical examinations have long served as valuable evaluation tools, but existing datasets are largely text-only and available in a limited subset of languages and countries. To address these challenges, we present WorldMedQA-V, an updated multilingual, multimodal benchmarking dataset designed to evaluate VLMs in healthcare. WorldMedQA-V includes 568 labeled multiple-choice QAs paired with 568 medical images from four countries (Brazil, Israel, Japan, and Spain), covering original languages and validated English translations by native clinicians, respectively. Baseline performance for common open- and closed-source models are provided in the local language and English translations, and with and without images provided to the model. The WorldMedQA-V benchmark aims to better match AI systems to the diverse healthcare environments in which they are deployed, fostering more equitable, effective, and representative applications.

Large Vision-Language Models (LVLMs) are capable of handling diverse data types such as imaging, text, and physiological signals, and can be applied in various fields. In the medical field, LVLMs have a high potential to offer substantial assistance for diagnosis and treatment. Before that, it is crucial to develop benchmarks to evaluate LVLMs' effectiveness in various medical applications. Current benchmarks are often built upon specific academic literature, mainly focusing on a single domain, and lacking varying perceptual granularities. Thus, they face specific challenges, including limited clinical relevance, incomplete evaluations, and insufficient guidance for interactive LVLMs. To address these limitations, we developed the GMAI-MMBench, the most comprehensive general medical AI benchmark with well-categorized data structure and multi-perceptual granularity to date. It is constructed from 285 datasets across 39 medical image modalities, 18 clinical-related tasks, 18 departments, and 4 perceptual granularities in a Visual Question Answering (VQA) format. Additionally, we implemented a lexical tree structure that allows users to customize evaluation tasks, accommodating various assessment needs and substantially supporting medical AI research and applications. We evaluated 50 LVLMs, and the results show that even the advanced GPT-4o only achieves an accuracy of 52%, indicating significant room for improvement. Moreover, we identified five key insufficiencies in current cutting-edge LVLMs that need to be addressed to advance the development of better medical applications. We believe that GMAI-MMBench will stimulate the community to build the next generation of LVLMs toward GMAI. Project Page: https://uni-medical.github.io/GMAI-MMBench.github.io/

Every day, countless surgeries are performed worldwide, each within the distinct settings of operating rooms (ORs) that vary not only in their setups but also in the personnel, tools, and equipment used. This inherent diversity poses a substantial challenge for achieving a holistic understanding of the OR, as it requires models to generalize beyond their initial training datasets. To reduce this gap, we introduce ORacle, an advanced vision-language model designed for holistic OR domain modeling, which incorporates multi-view and temporal capabilities and can leverage external knowledge during inference, enabling it to adapt to previously unseen surgical scenarios. This capability is further enhanced by our novel data augmentation framework, which significantly diversifies the training dataset, ensuring ORacle's proficiency in applying the provided knowledge effectively. In rigorous testing, in scene graph generation, and downstream tasks on the 4D-OR dataset, ORacle not only demonstrates state-of-the-art performance but does so requiring less data than existing models. Furthermore, its adaptability is displayed through its ability to interpret unseen views, actions, and appearances of tools and equipment. This demonstrates ORacle's potential to significantly enhance the scalability and affordability of OR domain modeling and opens a pathway for future advancements in surgical data science. We will release our code and data upon acceptance.

Is vision good enough for language? Recent advancements in multimodal models primarily stem from the powerful reasoning abilities of large language models (LLMs). However, the visual component typically depends only on the instance-level contrastive language-image pre-training (CLIP). Our research reveals that the visual capabilities in recent multimodal LLMs (MLLMs) still exhibit systematic shortcomings. To understand the roots of these errors, we explore the gap between the visual embedding space of CLIP and vision-only self-supervised learning. We identify ''CLIP-blind pairs'' - images that CLIP perceives as similar despite their clear visual differences. With these pairs, we construct the Multimodal Visual Patterns (MMVP) benchmark. MMVP exposes areas where state-of-the-art systems, including GPT-4V, struggle with straightforward questions across nine basic visual patterns, often providing incorrect answers and hallucinated explanations. We further evaluate various CLIP-based vision-and-language models and found a notable correlation between visual patterns that challenge CLIP models and those problematic for multimodal LLMs. As an initial effort to address these issues, we propose a Mixture of Features (MoF) approach, demonstrating that integrating vision self-supervised learning features with MLLMs can significantly enhance their visual grounding capabilities. Together, our research suggests visual representation learning remains an open challenge, and accurate visual grounding is crucial for future successful multimodal systems.

Vision-Language Models (VLMs) trained via contrastive learning have achieved notable success in natural image tasks. However, their application in the medical domain remains limited due to the scarcity of openly accessible, large-scale medical image-text datasets. Existing medical VLMs either train on closed-source proprietary or relatively small open-source datasets that do not generalize well. Similarly, most models remain specific to a single or limited number of medical imaging domains, again restricting their applicability to other modalities. To address this gap, we introduce UniMed, a large-scale, open-source multi-modal medical dataset comprising over 5.3 million image-text pairs across six diverse imaging modalities: X-ray, CT, MRI, Ultrasound, Pathology, and Fundus. UniMed is developed using a data-collection framework that leverages Large Language Models (LLMs) to transform modality-specific classification datasets into image-text formats while incorporating existing image-text data from the medical domain, facilitating scalable VLM pretraining. Using UniMed, we trained UniMed-CLIP, a unified VLM for six modalities that significantly outperforms existing generalist VLMs and matches modality-specific medical VLMs, achieving notable gains in zero-shot evaluations. For instance, UniMed-CLIP improves over BiomedCLIP (trained on proprietary data) by an absolute gain of +12.61, averaged over 21 datasets, while using 3x less training data. To facilitate future research, we release UniMed dataset, training codes, and models at https://github.com/mbzuai-oryx/UniMed-CLIP.

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.

While Large Language Models (LLMs) excel in world knowledge understanding, adapting them to specific subfields requires precise adjustments. Due to the model's vast scale, traditional global fine-tuning methods for large models can be computationally expensive and impact generalization. To address this challenge, a range of innovative Parameters-Efficient Fine-Tuning (PEFT) methods have emerged and achieved remarkable success in both LLMs and Large Vision-Language Models (LVLMs). In the medical domain, fine-tuning a medical Vision-Language Pretrained (VLP) model is essential for adapting it to specific tasks. Can the fine-tuning methods for large models be transferred to the medical field to enhance transfer learning efficiency? In this paper, we delve into the fine-tuning methods of LLMs and conduct extensive experiments to investigate the impact of fine-tuning methods for large models on the existing multimodal model in the medical domain from the training data level and the model structure level. We show the different impacts of fine-tuning methods for large models on medical VLMs and develop the most efficient ways to fine-tune medical VLP models. We hope this research can guide medical domain researchers in optimizing VLMs' training costs, fostering the broader application of VLMs in healthcare fields. The code and dataset have been released at https://github.com/TIMMY-CHAN/MILE.

Vision-Language Pretraining (VLP) has shown impressive results on diverse downstream tasks by offline training on large-scale datasets. Regarding the growing nature of real-world data, such an offline training paradigm on ever-expanding data is unsustainable, because models lack the continual learning ability to accumulate knowledge constantly. However, most continual learning studies are limited to uni-modal classification and existing multi-modal datasets cannot simulate continual non-stationary data stream scenarios. To support the study of Vision-Language Continual Pretraining (VLCP), we first contribute a comprehensive and unified benchmark dataset P9D which contains over one million product image-text pairs from 9 industries. The data from each industry as an independent task supports continual learning and conforms to the real-world long-tail nature to simulate pretraining on web data. We comprehensively study the characteristics and challenges of VLCP, and propose a new algorithm: Compatible momentum contrast with Topology Preservation, dubbed CTP. The compatible momentum model absorbs the knowledge of the current and previous-task models to flexibly update the modal feature. Moreover, Topology Preservation transfers the knowledge of embedding across tasks while preserving the flexibility of feature adjustment. The experimental results demonstrate our method not only achieves superior performance compared with other baselines but also does not bring an expensive training burden. Dataset and codes are available at https://github.com/KevinLight831/CTP.

Large Vision-Language Models (LVLMs) have demonstrated remarkable capabilities in various multimodal tasks. However, their potential in the medical domain remains largely unexplored. A significant challenge arises from the scarcity of diverse medical images spanning various modalities and anatomical regions, which is essential in real-world medical applications. To solve this problem, in this paper, we introduce OmniMedVQA, a novel comprehensive medical Visual Question Answering (VQA) benchmark. This benchmark is collected from 75 different medical datasets, including 12 different modalities and covering more than 20 distinct anatomical regions. Importantly, all images in this benchmark are sourced from authentic medical scenarios, ensuring alignment with the requirements of the medical field and suitability for evaluating LVLMs. Through our extensive experiments, we have found that existing LVLMs struggle to address these medical VQA problems effectively. Moreover, what surprises us is that medical-specialized LVLMs even exhibit inferior performance to those general-domain models, calling for a more versatile and robust LVLM in the biomedical field. The evaluation results not only reveal the current limitations of LVLM in understanding real medical images but also highlight our dataset's significance. Our dataset will be made publicly available.

Vision-language pre-training (VLP) methods are blossoming recently, and its crucial goal is to jointly learn visual and textual features via a transformer-based architecture, demonstrating promising improvements on a variety of vision-language tasks. Prior arts usually focus on how to align visual and textual features, but strategies for improving the robustness of model and speeding up model convergence are left insufficiently explored. In this paper, we propose a novel method ViLTA, comprising of two components to further facilitate the model to learn fine-grained representations among image-text pairs. For Masked Language Modeling (MLM), we propose a cross-distillation method to generate soft labels to enhance the robustness of model, which alleviates the problem of treating synonyms of masked words as negative samples in one-hot labels. For Image-Text Matching (ITM), we leverage the current language encoder to synthesize hard negatives based on the context of language input, encouraging the model to learn high-quality representations by increasing the difficulty of the ITM task. By leveraging the above techniques, our ViLTA can achieve better performance on various vision-language tasks. Extensive experiments on benchmark datasets demonstrate that the effectiveness of ViLTA and its promising potential for vision-language pre-training.

Vision-Language Pre-Training (VLP) has shown promising capabilities to align image and text pairs, facilitating a broad variety of cross-modal learning tasks. However, we observe that VLP models often lack the visual grounding/localization capability which is critical for many downstream tasks such as visual reasoning. In this work, we propose a novel Position-guided Text Prompt (PTP) paradigm to enhance the visual grounding ability of cross-modal models trained with VLP. Specifically, in the VLP phase, PTP divides the image into Ntimes N blocks, and identifies the objects in each block through the widely used object detector in VLP. It then reformulates the visual grounding task into a fill-in-the-blank problem given a PTP by encouraging the model to predict the objects in the given blocks or regress the blocks of a given object, e.g. filling `P" or ``O" in aPTP ``The block P has a O". This mechanism improves the visual grounding capability of VLP models and thus helps them better handle various downstream tasks. By introducing PTP into several state-of-the-art VLP frameworks, we observe consistently significant improvements across representative cross-modal learning model architectures and several benchmarks, e.g. zero-shot Flickr30K Retrieval (+4.8 in average recall@1) for ViLT vilt baseline, and COCO Captioning (+5.3 in CIDEr) for SOTA BLIP blip baseline. Moreover, PTP achieves comparable results with object-detector based methods, and much faster inference speed since PTP discards its object detector for inference while the later cannot. Our code and pre-trained weight will be released at https://github.com/sail-sg/ptp.

Understanding the workflow of surgical procedures in complex operating rooms requires a deep understanding of the interactions between clinicians and their environment. Surgical activity recognition (SAR) is a key computer vision task that detects activities or phases from multi-view camera recordings. Existing SAR models often fail to account for fine-grained clinician movements and multi-view knowledge, or they require calibrated multi-view camera setups and advanced point-cloud processing to obtain better results. In this work, we propose a novel calibration-free multi-view multi-modal pretraining framework called Multiview Pretraining for Video-Pose Surgical Activity Recognition PreViPS, which aligns 2D pose and vision embeddings across camera views. Our model follows CLIP-style dual-encoder architecture: one encoder processes visual features, while the other encodes human pose embeddings. To handle the continuous 2D human pose coordinates, we introduce a tokenized discrete representation to convert the continuous 2D pose coordinates into discrete pose embeddings, thereby enabling efficient integration within the dual-encoder framework. To bridge the gap between these two modalities, we propose several pretraining objectives using cross- and in-modality geometric constraints within the embedding space and incorporating masked pose token prediction strategy to enhance representation learning. Extensive experiments and ablation studies demonstrate improvements over the strong baselines, while data-efficiency experiments on two distinct operating room datasets further highlight the effectiveness of our approach. We highlight the benefits of our approach for surgical activity recognition in both multi-view and single-view settings, showcasing its practical applicability in complex surgical environments. Code will be made available at: https://github.com/CAMMA-public/PreViPS.

In this work, we introduce Vision-Language Generative Pre-trained Transformer (VL-GPT), a transformer model proficient at concurrently perceiving and generating visual and linguistic data. VL-GPT achieves a unified pre-training approach for both image and text modalities by employing a straightforward auto-regressive objective, thereby enabling the model to process image and text as seamlessly as a language model processes text. To accomplish this, we initially propose a novel image tokenizer-detokenizer framework for visual data, specifically designed to transform raw images into a sequence of continuous embeddings and reconstruct them accordingly. In combination with the existing text tokenizer and detokenizer, this framework allows for the encoding of interleaved image-text data into a multimodal sequence, which can subsequently be fed into the transformer model. Consequently, VL-GPT can perform large-scale pre-training on multimodal corpora utilizing a unified auto-regressive objective (i.e., next-token prediction). Upon completion of pre-training, VL-GPT exhibits remarkable zero-shot and few-shot performance across a diverse range of vision and language understanding and generation tasks, including image captioning, visual question answering, text-to-image generation, and more. Additionally, the pre-trained model retrains in-context learning capabilities when provided with multimodal prompts. We further conduct instruction tuning on our VL-GPT, highlighting its exceptional potential for multimodal assistance. The source code and model weights shall be released.

Multimodal Large Language Models (MLLMs) have shown significant potential in medical image analysis. However, their capabilities in interpreting fundus images, a critical skill for ophthalmology, remain under-evaluated. Existing benchmarks lack fine-grained task divisions and fail to provide modular analysis of its two key modules, i.e., large language model (LLM) and vision encoder (VE). This paper introduces FunBench, a novel visual question answering (VQA) benchmark designed to comprehensively evaluate MLLMs' fundus reading skills. FunBench features a hierarchical task organization across four levels (modality perception, anatomy perception, lesion analysis, and disease diagnosis). It also offers three targeted evaluation modes: linear-probe based VE evaluation, knowledge-prompted LLM evaluation, and holistic evaluation. Experiments on nine open-source MLLMs plus GPT-4o reveal significant deficiencies in fundus reading skills, particularly in basic tasks such as laterality recognition. The results highlight the limitations of current MLLMs and emphasize the need for domain-specific training and improved LLMs and VEs.

Recent advancements in artificial intelligence (AI) have precipitated significant breakthroughs in healthcare, particularly in refining diagnostic procedures. However, previous studies have often been constrained to limited functionalities. This study introduces MiniGPT-Med, a vision-language model derived from large-scale language models and tailored for medical applications. MiniGPT-Med demonstrates remarkable versatility across various imaging modalities, including X-rays, CT scans, and MRIs, enhancing its utility. The model is capable of performing tasks such as medical report generation, visual question answering (VQA), and disease identification within medical imagery. Its integrated processing of both image and textual clinical data markedly improves diagnostic accuracy. Our empirical assessments confirm MiniGPT-Med's superior performance in disease grounding, medical report generation, and VQA benchmarks, representing a significant step towards reducing the gap in assisting radiology practice. Furthermore, it achieves state-of-the-art performance on medical report generation, higher than the previous best model by 19\% accuracy. MiniGPT-Med promises to become a general interface for radiology diagnoses, enhancing diagnostic efficiency across a wide range of medical imaging applications.

Over the past decade, computer vision applications in minimally invasive surgery have rapidly increased. Despite this growth, the impact of surgical computer vision remains limited compared to other medical fields like pathology and radiology, primarily due to the scarcity of representative annotated data. Whereas transfer learning from large annotated datasets such as ImageNet has been conventionally the norm to achieve high-performing models, recent advancements in self-supervised learning (SSL) have demonstrated superior performance. In medical image analysis, in-domain SSL pretraining has already been shown to outperform ImageNet-based initialization. Although unlabeled data in the field of surgical computer vision is abundant, the diversity within this data is limited. This study investigates the role of dataset diversity in SSL for surgical computer vision, comparing procedure-specific datasets against a more heterogeneous general surgical dataset across three different downstream surgical applications. The obtained results show that using solely procedure-specific data can lead to substantial improvements of 13.8%, 9.5%, and 36.8% compared to ImageNet pretraining. However, extending this data with more heterogeneous surgical data further increases performance by an additional 5.0%, 5.2%, and 2.5%, suggesting that increasing diversity within SSL data is beneficial for model performance. The code and pretrained model weights are made publicly available at https://github.com/TimJaspers0801/SurgeNet.

Contrastive pretraining on parallel image-text data has attained great success in vision-language processing (VLP), as exemplified by CLIP and related methods. However, prior explorations tend to focus on general domains in the web. Biomedical images and text are rather different, but publicly available datasets are small and skew toward chest X-ray, thus severely limiting progress. In this paper, we conducted by far the largest study on biomedical VLP, using 15 million figure-caption pairs extracted from biomedical research articles in PubMed Central. Our dataset (PMC-15M) is two orders of magnitude larger than existing biomedical image-text datasets such as MIMIC-CXR, and spans a diverse range of biomedical images. The standard CLIP method is suboptimal for the biomedical domain. We propose BiomedCLIP with domain-specific adaptations tailored to biomedical VLP. We conducted extensive experiments and ablation studies on standard biomedical imaging tasks from retrieval to classification to visual question-answering (VQA). BiomedCLIP established new state of the art in a wide range of standard datasets, substantially outperformed prior VLP approaches. Surprisingly, BiomedCLIP even outperformed radiology-specific state-of-the-art models such as BioViL on radiology-specific tasks such as RSNA pneumonia detection, thus highlighting the utility in large-scale pretraining across all biomedical image types. We will release our models at https://aka.ms/biomedclip to facilitate future research in biomedical VLP.

The previous advancements in pathology image understanding primarily involved developing models tailored to specific tasks. Recent studies has demonstrated that the large vision-language model can enhance the performance of various downstream tasks in medical image understanding. In this study, we developed a domain-specific large language-vision assistant (PA-LLaVA) for pathology image understanding. Specifically, (1) we first construct a human pathology image-text dataset by cleaning the public medical image-text data for domain-specific alignment; (2) Using the proposed image-text data, we first train a pathology language-image pretraining (PLIP) model as the specialized visual encoder for pathology image, and then we developed scale-invariant connector to avoid the information loss caused by image scaling; (3) We adopt two-stage learning to train PA-LLaVA, first stage for domain alignment, and second stage for end to end visual question \& answering (VQA) task. In experiments, we evaluate our PA-LLaVA on both supervised and zero-shot VQA datasets, our model achieved the best overall performance among multimodal models of similar scale. The ablation experiments also confirmed the effectiveness of our design. We posit that our PA-LLaVA model and the datasets presented in this work can promote research in field of computational pathology. All codes are available at: https://github.com/ddw2AIGROUP2CQUPT/PA-LLaVA}{https://github.com/ddw2AIGROUP2CQUPT/PA-LLaVA

Purpose: Surgical workflow analysis is crucial for improving surgical efficiency and safety. However, previous studies rely heavily on large-scale annotated datasets, posing challenges in cost, scalability, and reliance on expert annotations. To address this, we propose Surg-FTDA (Few-shot Text-driven Adaptation), designed to handle various surgical workflow analysis tasks with minimal paired image-label data. Methods: Our approach has two key components. First, Few-shot selection-based modality alignment selects a small subset of images and aligns their embeddings with text embeddings from the downstream task, bridging the modality gap. Second, Text-driven adaptation leverages only text data to train a decoder, eliminating the need for paired image-text data. This decoder is then applied to aligned image embeddings, enabling image-related tasks without explicit image-text pairs. Results: We evaluate our approach to generative tasks (image captioning) and discriminative tasks (triplet recognition and phase recognition). Results show that Surg-FTDA outperforms baselines and generalizes well across downstream tasks. Conclusion: We propose a text-driven adaptation approach that mitigates the modality gap and handles multiple downstream tasks in surgical workflow analysis, with minimal reliance on large annotated datasets. The code and dataset will be released in https://github.com/CAMMA-public/Surg-FTDA

Vision-Language Pre-training (VLP) models like CLIP have achieved remarkable success in computer vision and particularly demonstrated superior robustness to distribution shifts of 2D images. However, their robustness under 3D viewpoint variations is still limited, which can hinder the development for real-world applications. This paper successfully addresses this concern while keeping VLPs' original performance by breaking through two primary obstacles: 1) the scarcity of training data and 2) the suboptimal fine-tuning paradigms. To combat data scarcity, we build the Multi-View Caption (MVCap) dataset -- a comprehensive collection of over four million multi-view image-text pairs across more than 100K objects, providing more potential for VLP models to develop generalizable viewpoint-invariant representations. To address the limitations of existing paradigms in performance trade-offs and training efficiency, we design a novel fine-tuning framework named Omniview-Tuning (OVT). Specifically, OVT introduces a Cross-Viewpoint Alignment objective through a minimax-like optimization strategy, which effectively aligns representations of identical objects from diverse viewpoints without causing overfitting. Additionally, OVT fine-tunes VLP models in a parameter-efficient manner, leading to minimal computational cost. Extensive experiments on various VLP models with different architectures validate that OVT significantly improves the models' resilience to viewpoint shifts and keeps the original performance, establishing a pioneering standard for boosting the viewpoint invariance of VLP models.

Quantification of real-time informal feedback delivered by an experienced surgeon to a trainee during surgery is important for skill improvements in surgical training. Such feedback in the live operating room is inherently multimodal, consisting of verbal conversations (e.g., questions and answers) as well as non-verbal elements (e.g., through visual cues like pointing to anatomic elements). In this work, we leverage a clinically-validated five-category classification of surgical feedback: "Anatomic", "Technical", "Procedural", "Praise" and "Visual Aid". We then develop a multi-label machine learning model to classify these five categories of surgical feedback from inputs of text, audio, and video modalities. The ultimate goal of our work is to help automate the annotation of real-time contextual surgical feedback at scale. Our automated classification of surgical feedback achieves AUCs ranging from 71.5 to 77.6 with the fusion improving performance by 3.1%. We also show that high-quality manual transcriptions of feedback audio from experts improve AUCs to between 76.5 and 96.2, which demonstrates a clear path toward future improvements. Empirically, we find that the Staged training strategy, with first pre-training each modality separately and then training them jointly, is more effective than training different modalities altogether. We also present intuitive findings on the importance of modalities for different feedback categories. This work offers an important first look at the feasibility of automated classification of real-world live surgical feedback based on text, audio, and video modalities.

Visual Question Answering (VQA) is a challenging task of natural language processing (NLP) and computer vision (CV), attracting significant attention from researchers. English is a resource-rich language that has witnessed various developments in datasets and models for visual question answering. Visual question answering in other languages also would be developed for resources and models. In addition, there is no multilingual dataset targeting the visual content of a particular country with its own objects and cultural characteristics. To address the weakness, we provide the research community with a benchmark dataset named EVJVQA, including 33,000+ pairs of question-answer over three languages: Vietnamese, English, and Japanese, on approximately 5,000 images taken from Vietnam for evaluating multilingual VQA systems or models. EVJVQA is used as a benchmark dataset for the challenge of multilingual visual question answering at the 9th Workshop on Vietnamese Language and Speech Processing (VLSP 2022). This task attracted 62 participant teams from various universities and organizations. In this article, we present details of the organization of the challenge, an overview of the methods employed by shared-task participants, and the results. The highest performances are 0.4392 in F1-score and 0.4009 in BLUE on the private test set. The multilingual QA systems proposed by the top 2 teams use ViT for the pre-trained vision model and mT5 for the pre-trained language model, a powerful pre-trained language model based on the transformer architecture. EVJVQA is a challenging dataset that motivates NLP and CV researchers to further explore the multilingual models or systems for visual question answering systems. We released the challenge on the Codalab evaluation system for further research.

Background: General-purpose large language models that utilize both text and images have not been evaluated on a diverse array of challenging medical cases. Methods: Using 934 cases from the NEJM Image Challenge published between 2005 and 2023, we evaluated the accuracy of the recently released Generative Pre-trained Transformer 4 with Vision model (GPT-4V) compared to human respondents overall and stratified by question difficulty, image type, and skin tone. We further conducted a physician evaluation of GPT-4V on 69 NEJM clinicopathological conferences (CPCs). Analyses were conducted for models utilizing text alone, images alone, and both text and images. Results: GPT-4V achieved an overall accuracy of 61% (95% CI, 58 to 64%) compared to 49% (95% CI, 49 to 50%) for humans. GPT-4V outperformed humans at all levels of difficulty and disagreement, skin tones, and image types; the exception was radiographic images, where performance was equivalent between GPT-4V and human respondents. Longer, more informative captions were associated with improved performance for GPT-4V but similar performance for human respondents. GPT-4V included the correct diagnosis in its differential for 80% (95% CI, 68 to 88%) of CPCs when using text alone, compared to 58% (95% CI, 45 to 70%) of CPCs when using both images and text. Conclusions: GPT-4V outperformed human respondents on challenging medical cases and was able to synthesize information from both images and text, but performance deteriorated when images were added to highly informative text. Overall, our results suggest that multimodal AI models may be useful in medical diagnostic reasoning but that their accuracy may depend heavily on context.

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.

Video-language pre-training (VLP) has become increasingly important due to its ability to generalize to various vision and language tasks. However, existing egocentric VLP frameworks utilize separate video and language encoders and learn task-specific cross-modal information only during fine-tuning, limiting the development of a unified system. In this work, we introduce the second generation of egocentric video-language pre-training (EgoVLPv2), a significant improvement from the previous generation, by incorporating cross-modal fusion directly into the video and language backbones. EgoVLPv2 learns strong video-text representation during pre-training and reuses the cross-modal attention modules to support different downstream tasks in a flexible and efficient manner, reducing fine-tuning costs. Moreover, our proposed fusion in the backbone strategy is more lightweight and compute-efficient than stacking additional fusion-specific layers. Extensive experiments on a wide range of VL tasks demonstrate the effectiveness of EgoVLPv2 by achieving consistent state-of-the-art performance over strong baselines across all downstream. Our project page can be found at https://shramanpramanick.github.io/EgoVLPv2/.

We introduce CogVLM, a powerful open-source visual language foundation model. Different from the popular shallow alignment method which maps image features into the input space of language model, CogVLM bridges the gap between the frozen pretrained language model and image encoder by a trainable visual expert module in the attention and FFN layers. As a result, CogVLM enables deep fusion of vision language features without sacrificing any performance on NLP tasks. CogVLM-17B achieves state-of-the-art performance on 10 classic cross-modal benchmarks, including NoCaps, Flicker30k captioning, RefCOCO, RefCOCO+, RefCOCOg, Visual7W, GQA, ScienceQA, VizWiz VQA and TDIUC, and ranks the 2nd on VQAv2, OKVQA, TextVQA, COCO captioning, etc., surpassing or matching PaLI-X 55B. Codes and checkpoints are available at https://github.com/THUDM/CogVLM.

Vision-Language Models (VLMs), such as GPT-4V and Llama 3.2 vision, have garnered significant research attention for their ability to leverage Large Language Models (LLMs) in multimodal tasks. However, their potential is constrained by inherent challenges, including proprietary restrictions, substantial computational demands, and limited accessibility. Smaller models, such as GIT and BLIP, exhibit marked limitations, often failing to generate coherent and consistent text beyond a few tokens, even with extensive training. This underscores a pivotal inquiry: how small can a VLM be and still produce fluent and consistent text? Drawing inspiration from the exceptional learning process of 3-4 year old children, who rely heavily on visual cues for understanding and communication, we introduce two novel datasets: ShortDesc (featuring concise image descriptions) and LongDesc (containing more detailed image descriptions). These datasets consist of image-text pairs where the text is restricted to the simple vocabulary and syntax typically used by young children, generated with a scaled- down model, GPT-4o. Using these datasets, we demonstrate that it is possible to train VLMs that are significantly smaller, up to 10 times smaller than state of the art(SOTA) small VLMs while maintaining architectural simplicity. To evaluate the outputs, we leverage GPT-4o to grade the text, as if stories written by students, on creativity, meaningfulness, and consistency, assigning scores out of 10. This method addresses limitations of standard benchmarks by accommodating unstructured outputs and providing a multidimensional evaluation of the model capabilities. Our findings contribute to the development of lightweight, accessible multimodal models for resource constrained environments.

Vision-language (VL) pre-training has recently received considerable attention. However, most existing end-to-end pre-training approaches either only aim to tackle VL tasks such as image-text retrieval, visual question answering (VQA) and image captioning that test high-level understanding of images, or only target region-level understanding for tasks such as phrase grounding and object detection. We present FIBER (Fusion-In-the-Backbone-based transformER), a new VL model architecture that can seamlessly handle both these types of tasks. Instead of having dedicated transformer layers for fusion after the uni-modal backbones, FIBER pushes multimodal fusion deep into the model by inserting cross-attention into the image and text backbones, bringing gains in terms of memory and performance. In addition, unlike previous work that is either only pre-trained on image-text data or on fine-grained data with box-level annotations, we present a two-stage pre-training strategy that uses both these kinds of data efficiently: (i) coarse-grained pre-training based on image-text data; followed by (ii) fine-grained pre-training based on image-text-box data. We conduct comprehensive experiments on a wide range of VL tasks, ranging from VQA, image captioning, and retrieval, to phrase grounding, referring expression comprehension, and object detection. Using deep multimodal fusion coupled with the two-stage pre-training, FIBER provides consistent performance improvements over strong baselines across all tasks, often outperforming methods using magnitudes more data. Code is available at https://github.com/microsoft/FIBER.

In recent years, large language models (LLMs) have made significant progress in natural language processing (NLP), with models like ChatGPT and GPT-4 achieving impressive capabilities in various linguistic tasks. However, training models on such a large scale is challenging, and finding datasets that match the model's scale is often difficult. Fine-tuning and training models with fewer parameters using novel methods have emerged as promising approaches to overcome these challenges. One such model is MiniGPT-4, which achieves comparable vision-language understanding to GPT-4 by leveraging novel pre-training models and innovative training strategies. However, the model still faces some challenges in image understanding, particularly in artistic pictures. A novel multimodal model called ArtGPT-4 has been proposed to address these limitations. ArtGPT-4 was trained on image-text pairs using a Tesla A100 device in just 2 hours, using only about 200 GB of data. The model can depict images with an artistic flair and generate visual code, including aesthetically pleasing HTML/CSS web pages. Furthermore, the article proposes novel benchmarks for evaluating the performance of vision-language models. In the subsequent evaluation methods, ArtGPT-4 scored more than 1 point higher than the current state-of-the-art model and was only 0.25 points lower than artists on a 6-point scale. Our code and pre-trained model are available at https://huggingface.co/Tyrannosaurus/ArtGPT-4.

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.

Large language models (LLMs) have notably accelerated progress towards artificial general intelligence (AGI), with their impressive zero-shot capacity for user-tailored tasks, endowing them with immense potential across a range of applications. However, in the field of computer vision, despite the availability of numerous powerful vision foundation models (VFMs), they are still restricted to tasks in a pre-defined form, struggling to match the open-ended task capabilities of LLMs. In this work, we present an LLM-based framework for vision-centric tasks, termed VisionLLM. This framework provides a unified perspective for vision and language tasks by treating images as a foreign language and aligning vision-centric tasks with language tasks that can be flexibly defined and managed using language instructions. An LLM-based decoder can then make appropriate predictions based on these instructions for open-ended tasks. Extensive experiments show that the proposed VisionLLM can achieve different levels of task customization through language instructions, from fine-grained object-level to coarse-grained task-level customization, all with good results. It's noteworthy that, with a generalist LLM-based framework, our model can achieve over 60\% mAP on COCO, on par with detection-specific models. We hope this model can set a new baseline for generalist vision and language models. The demo shall be released based on https://github.com/OpenGVLab/InternGPT. The code shall be released at https://github.com/OpenGVLab/VisionLLM.

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.

Medical vision-language models enable co-learning and integrating features from medical imaging and clinical text. However, these models are not easy to train and the latent representation space can be complex. Here we propose a novel way for pre-training and regularising medical vision-language models. The proposed method, named Medical vision-language pre-training with Frozen language models and Latent spAce Geometry optimization (M-FLAG), leverages a frozen language model for training stability and efficiency and introduces a novel orthogonality loss to harmonize the latent space geometry. We demonstrate the potential of the pre-trained model on three downstream tasks: medical image classification, segmentation, and object detection. Extensive experiments across five public datasets demonstrate that M-FLAG significantly outperforms existing medical vision-language pre-training approaches and reduces the number of parameters by 78\%. Notably, M-FLAG achieves outstanding performance on the segmentation task while using only 1\% of the RSNA dataset, even outperforming ImageNet pre-trained models that have been fine-tuned using 100\% of the data.

Visual-language pre-training (VLP) has achieved remarkable success in multi-modal tasks, largely attributed to the availability of large-scale image-text datasets. In this work, we demonstrate that multi-modal large language models (MLLMs) can enhance visual-language representation learning by improving data quality. Our approach is simple, utilizing MLLMs to extend multiple captions for each image. To prevent the bias introduced by MLLMs' hallucinations and intrinsic caption styles, we propose "text shearing" to maintain the same length for extended captions as that of the original captions. In image-text retrieval, our method consistently obtains 5.6 ~ 35.0% and 16.8 ~ 46.1% improvement on R@1 under the fine-tuning and zero-shot settings, respectively. Notably, we obtain zero-shot results that are comparable to fine-tuning on target datasets, which encourages more exploration of the versatile use of MLLMs.

This paper presents a comprehensive evaluation of GPT-4V's capabilities across diverse medical imaging tasks, including Radiology Report Generation, Medical Visual Question Answering (VQA), and Visual Grounding. While prior efforts have explored GPT-4V's performance in medical image analysis, to the best of our knowledge, our study represents the first quantitative evaluation on publicly available benchmarks. Our findings highlight GPT-4V's potential in generating descriptive reports for chest X-ray images, particularly when guided by well-structured prompts. Meanwhile, its performance on the MIMIC-CXR dataset benchmark reveals areas for improvement in certain evaluation metrics, such as CIDEr. In the domain of Medical VQA, GPT-4V demonstrates proficiency in distinguishing between question types but falls short of the VQA-RAD benchmark in terms of accuracy. Furthermore, our analysis finds the limitations of conventional evaluation metrics like the BLEU scores, advocating for the development of more semantically robust assessment methods. In the field of Visual Grounding, GPT-4V exhibits preliminary promise in recognizing bounding boxes, but its precision is lacking, especially in identifying specific medical organs and signs. Our evaluation underscores the significant potential of GPT-4V in the medical imaging domain, while also emphasizing the need for targeted refinements to fully unlock its capabilities.

Following the impressive development of LLMs, vision-language alignment in LLMs is actively being researched to enable multimodal reasoning and visual IO. This direction of research is particularly relevant to medical imaging because medical image analysis and generation consist of reasoning based on a combination of visual features and prior knowledge. Many recent works have focused on training adapter networks that serve as an information bridge between image processing networks and LLMs; but presumably, in order to achieve maximum reasoning potential of LLMs on visual information as well, visual and language features should be allowed to interact more freely. This is especially important in the medical domain because understanding and generating medical images such as chest X-rays (CXR) require not only accurate visual and language-based reasoning but also a more intimate mapping between the two modalities. Thus, taking inspiration from previous work on the transformer and VQ-GAN combination for bidirectional image and text generation, we build upon this approach and develop a method for instruction-tuning an LLM pre-trained only on text to gain vision-language capabilities for medical images. Specifically, we leverage a pretrained LLM's existing question-answering and instruction-following abilities to teach it to understand visual inputs by instructing it to answer questions about image inputs and, symmetrically, output both text and image responses appropriate to a given query by tuning the LLM with diverse tasks that encompass image-based text-generation and text-based image-generation. We show that our model, LLM-CXR, trained in this approach shows better image-text alignment in both CXR understanding and generation tasks while being smaller in size compared to previously developed models that perform a narrower range of tasks. The code is at https://github.com/hyn2028/llm-cxr.

Contrastive Language--Image Pre-training (CLIP) has shown remarkable success in learning with cross-modal supervision from extensive amounts of image--text pairs collected online. Thus far, the effectiveness of CLIP has been investigated primarily in general-domain multimodal problems. This work evaluates the effectiveness of CLIP for the task of Medical Visual Question Answering (MedVQA). To this end, we present PubMedCLIP, a fine-tuned version of CLIP for the medical domain based on PubMed articles. Our experiments are conducted on two MedVQA benchmark datasets and investigate two MedVQA methods, MEVF (Mixture of Enhanced Visual Features) and QCR (Question answering via Conditional Reasoning). For each of these, we assess the merits of visual representation learning using PubMedCLIP, the original CLIP, and state-of-the-art MAML (Model-Agnostic Meta-Learning) networks pre-trained only on visual data. We open source the code for our MedVQA pipeline and pre-training PubMedCLIP. CLIP and PubMedCLIP achieve improvements in comparison to MAML's visual encoder. PubMedCLIP achieves the best results with gains in the overall accuracy of up to 3%. Individual examples illustrate the strengths of PubMedCLIP in comparison to the previously widely used MAML networks. Visual representation learning with language supervision in PubMedCLIP leads to noticeable improvements for MedVQA. Our experiments reveal distributional differences in the two MedVQA benchmark datasets that have not been imparted in previous work and cause different back-end visual encoders in PubMedCLIP to exhibit different behavior on these datasets. Moreover, we witness fundamental performance differences of VQA in general versus medical domains.

Visual Question-Answering (VQA) has become a key use-case in several applications to aid user experience, particularly after Vision-Language Models (VLMs) achieving good results in zero-shot inference. But evaluating different VLMs for an application requirement using a standardized framework in practical settings is still challenging. This paper introduces a comprehensive framework for evaluating VLMs tailored to VQA tasks in practical settings. We present a novel dataset derived from established VQA benchmarks, annotated with task types, application domains, and knowledge types, three key practical aspects on which tasks can vary. We also introduce GoEval, a multimodal evaluation metric developed using GPT-4o, achieving a correlation factor of 56.71% with human judgments. Our experiments with ten state-of-the-art VLMs reveals that no single model excelling universally, making appropriate selection a key design decision. Proprietary models such as Gemini-1.5-Pro and GPT-4o-mini generally outperform others, though open-source models like InternVL-2-8B and CogVLM-2-Llama-3-19B demonstrate competitive strengths in specific contexts, while providing additional advantages. This study guides the selection of VLMs based on specific task requirements and resource constraints, and can also be extended to other vision-language tasks.

In this paper, we introduce an open-source Korean-English vision-language model (VLM), VARCO-VISION. We incorporate a step-by-step training strategy that allows a model learn both linguistic and visual information while preserving the backbone model's knowledge. Our model demonstrates outstanding performance in diverse settings requiring bilingual image-text understanding and generation abilities compared to models of similar size. VARCO-VISION is also capable of grounding, referring, and OCR, expanding its usage and potential applications for real-world scenarios. In addition to the model, we release five Korean evaluation datasets, including four closed-set and one openset benchmarks. We anticipate that our milestone will broaden the opportunities for AI researchers aiming to train VLMs. VARCO-VISION is available at https://huggingface.co/NCSOFT/VARCO-VISION-14B.

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.

Vision-language pre-training has significantly elevated performance across a wide range of image-language applications. Yet, the pre-training process for video-related tasks demands exceptionally large computational and data resources, which hinders the progress of video-language models. This paper investigates a straightforward, highly efficient, and resource-light approach to adapting an existing image-language pre-trained model for dense video understanding. Our preliminary experiments reveal that directly fine-tuning pre-trained image-language models with multiple frames as inputs on video datasets leads to performance saturation or even a drop. Our further investigation reveals that it is largely attributed to the bias of learned high-norm visual features. Motivated by this finding, we propose a simple but effective pooling strategy to smooth the feature distribution along the temporal dimension and thus reduce the dominant impacts from the extreme features. The new model is termed Pooling LLaVA, or in short. achieves new state-of-the-art performance on modern benchmark datasets for both video question-answer and captioning tasks. Notably, on the recent popular Video ChatGPT benchmark, PLLaVA achieves a score of 3.48 out of 5 on average of five evaluated dimensions, exceeding the previous SOTA results from GPT4V (IG-VLM) by 9\%. On the latest multi-choice benchmark MVBench, PLLaVA achieves 58.1\% accuracy on average across 20 sub-tasks, 14.5\% higher than GPT4V (IG-VLM). Code is available at https://github.com/magic-research/PLLaVA.

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.

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.

3D vision-language (VL) reasoning has gained significant attention due to its potential to bridge the 3D physical world with natural language descriptions. Existing approaches typically follow task-specific, highly specialized paradigms. Therefore, these methods focus on a limited range of reasoning sub-tasks and rely heavily on the hand-crafted modules and auxiliary losses. This highlights the need for a simpler, unified and general-purpose model. In this paper, we leverage the inherent connection between 3D scene graphs and natural language, proposing a 3D scene graph-guided vision-language pre-training (VLP) framework. Our approach utilizes modality encoders, graph convolutional layers and cross-attention layers to learn universal representations that adapt to a variety of 3D VL reasoning tasks, thereby eliminating the need for task-specific designs. The pre-training objectives include: 1) Scene graph-guided contrastive learning, which leverages the strong correlation between 3D scene graphs and natural language to align 3D objects with textual features at various fine-grained levels; and 2) Masked modality learning, which uses cross-modality information to reconstruct masked words and 3D objects. Instead of directly reconstructing the 3D point clouds of masked objects, we use position clues to predict their semantic categories. Extensive experiments demonstrate that our pre-training model, when fine-tuned on several downstream tasks, achieves performance comparable to or better than existing methods in tasks such as 3D visual grounding, 3D dense captioning, and 3D question answering.

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.

The field of surgical computer vision has undergone considerable breakthroughs in recent years with the rising popularity of deep neural network-based methods. However, standard fully-supervised approaches for training such models require vast amounts of annotated data, imposing a prohibitively high cost; especially in the clinical domain. Self-Supervised Learning (SSL) methods, which have begun to gain traction in the general computer vision community, represent a potential solution to these annotation costs, allowing to learn useful representations from only unlabeled data. Still, the effectiveness of SSL methods in more complex and impactful domains, such as medicine and surgery, remains limited and unexplored. In this work, we address this critical need by investigating four state-of-the-art SSL methods (MoCo v2, SimCLR, DINO, SwAV) in the context of surgical computer vision. We present an extensive analysis of the performance of these methods on the Cholec80 dataset for two fundamental and popular tasks in surgical context understanding, phase recognition and tool presence detection. We examine their parameterization, then their behavior with respect to training data quantities in semi-supervised settings. Correct transfer of these methods to surgery, as described and conducted in this work, leads to substantial performance gains over generic uses of SSL - up to 7.4% on phase recognition and 20% on tool presence detection - as well as state-of-the-art semi-supervised phase recognition approaches by up to 14%. Further results obtained on a highly diverse selection of surgical datasets exhibit strong generalization properties. The code is available at https://github.com/CAMMA-public/SelfSupSurg.

Generating Natural Language Explanations (NLEs) for model predictions on medical images, particularly those depicting thoracic pathologies, remains a critical and challenging task. Existing methodologies often struggle due to general models' insufficient domain-specific medical knowledge and privacy concerns associated with retrieval-based augmentation techniques. To address these issues, we propose a novel Vision-Language framework augmented with a Knowledge Graph (KG)-based datastore, which enhances the model's understanding by incorporating additional domain-specific medical knowledge essential for generating accurate and informative NLEs. Our framework employs a KG-based retrieval mechanism that not only improves the precision of the generated explanations but also preserves data privacy by avoiding direct data retrieval. The KG datastore is designed as a plug-and-play module, allowing for seamless integration with various model architectures. We introduce and evaluate three distinct frameworks within this paradigm: KG-LLaVA, which integrates the pre-trained LLaVA model with KG-RAG; Med-XPT, a custom framework combining MedCLIP, a transformer-based projector, and GPT-2; and Bio-LLaVA, which adapts LLaVA by incorporating the Bio-ViT-L vision model. These frameworks are validated on the MIMIC-NLE dataset, where they achieve state-of-the-art results, underscoring the effectiveness of KG augmentation in generating high-quality NLEs for thoracic pathologies.

Medical Visual Question Answering (MedVQA), which offers language responses to image-based medical inquiries, represents a challenging task and significant advancement in healthcare. It assists medical experts to swiftly interpret medical images, thereby enabling faster and more accurate diagnoses. However, the model interpretability and transparency of existing MedVQA solutions are often limited, posing challenges in understanding their decision-making processes. To address this issue, we devise a semi-automated annotation process to streamline data preparation and build new benchmark MedVQA datasets R-RAD, R-SLAKE and R-Path. These datasets provide intermediate medical decision-making rationales generated by multimodal large language models and human annotations for question-answering pairs in existing MedVQA datasets, i.e., VQA-RAD, SLAKE and PathVQA. Moreover, we design a novel framework, MedThink, which finetunes lightweight pretrained generative models by incorporating medical decision-making rationales. MedThink includes three distinct strategies to generate decision outcomes and corresponding rationales, thereby clearly showcasing the medical decision-making process during reasoning. Our comprehensive experiments show that our method achieves an accuracy of 83.5% on R-RAD, 86.3% on R-SLAKE and 87.2% on R-Path. These results significantly exceed those of existing state-of-the-art models with comparable parameters. Datasets and code will be released.

Recently, several multi-modal models have been developed for joint image and language understanding, which have demonstrated impressive chat abilities by utilizing advanced large language models (LLMs). The process of developing such models is straightforward yet effective. It involves pre-training an adaptation module to align the semantics of the vision encoder and language model, followed by fine-tuning on the instruction-following data. However, despite the success of this pipeline in image and language understanding, its effectiveness in joint video and language understanding has not been widely explored. In this paper, we aim to develop a novel multi-modal foundation model capable of perceiving video, image, and language within a general framework. To achieve this goal, we introduce Valley: Video Assistant with Large Language model Enhanced ability. Specifically, our proposed Valley model is designed with a simple projection module that bridges video, image, and language modalities, and is further unified with a multi-lingual LLM. We also collect multi-source vision-text pairs and adopt a spatio-temporal pooling strategy to obtain a unified vision encoding of video and image input for pre-training. Furthermore, we generate multi-task instruction-following video data, including multi-shot captions, long video descriptions, action recognition, causal relationship inference, etc. To obtain the instruction-following data, we design diverse rounds of task-oriented conversations between humans and videos, facilitated by ChatGPT. Qualitative examples demonstrate that our proposed model has the potential to function as a highly effective multilingual video assistant that can make complex video understanding scenarios easy. Code, data, and models will be available at https://github.com/RupertLuo/Valley.

The field of computer vision applied to videos of minimally invasive surgery is ever-growing. Workflow recognition pertains to the automated recognition of various aspects of a surgery: including which surgical steps are performed; and which surgical instruments are used. This information can later be used to assist clinicians when learning the surgery; during live surgery; and when writing operation notes. The Pituitary Vision (PitVis) 2023 Challenge tasks the community to step and instrument recognition in videos of endoscopic pituitary surgery. This is a unique task when compared to other minimally invasive surgeries due to the smaller working space, which limits and distorts vision; and higher frequency of instrument and step switching, which requires more precise model predictions. Participants were provided with 25-videos, with results presented at the MICCAI-2023 conference as part of the Endoscopic Vision 2023 Challenge in Vancouver, Canada, on 08-Oct-2023. There were 18-submissions from 9-teams across 6-countries, using a variety of deep learning models. A commonality between the top performing models was incorporating spatio-temporal and multi-task methods, with greater than 50% and 10% macro-F1-score improvement over purely spacial single-task models in step and instrument recognition respectively. The PitVis-2023 Challenge therefore demonstrates state-of-the-art computer vision models in minimally invasive surgery are transferable to a new dataset, with surgery specific techniques used to enhance performance, progressing the field further. Benchmark results are provided in the paper, and the dataset is publicly available at: https://doi.org/10.5522/04/26531686.

Conversational generative AI has demonstrated remarkable promise for empowering biomedical practitioners, but current investigations focus on unimodal text. Multimodal conversational AI has seen rapid progress by leveraging billions of image-text pairs from the public web, but such general-domain vision-language models still lack sophistication in understanding and conversing about biomedical images. In this paper, we propose a cost-efficient approach for training a vision-language conversational assistant that can answer open-ended research questions of biomedical images. The key idea is to leverage a large-scale, broad-coverage biomedical figure-caption dataset extracted from PubMed Central, use GPT-4 to self-instruct open-ended instruction-following data from the captions, and then fine-tune a large general-domain vision-language model using a novel curriculum learning method. Specifically, the model first learns to align biomedical vocabulary using the figure-caption pairs as is, then learns to master open-ended conversational semantics using GPT-4 generated instruction-following data, broadly mimicking how a layperson gradually acquires biomedical knowledge. This enables us to train a Large Language and Vision Assistant for BioMedicine (LLaVA-Med) in less than 15 hours (with eight A100s). LLaVA-Med exhibits excellent multimodal conversational capability and can follow open-ended instruction to assist with inquiries about a biomedical image. On three standard biomedical visual question answering datasets, LLaVA-Med outperforms previous supervised state-of-the-art on certain metrics. To facilitate biomedical multimodal research, we will release our instruction-following data and the LLaVA-Med model.

Purpose: General consensus amongst researchers and industry points to a lack of large, representative annotated datasets as the biggest obstacle to progress in the field of surgical data science. Self-supervised learning represents a solution to part of this problem, removing the reliance on annotations. However, the robustness of current self-supervised learning methods to domain shifts remains unclear, limiting our understanding of its utility for leveraging diverse sources of surgical data. Methods: In this work, we employ self-supervised learning to flexibly leverage diverse surgical datasets, thereby learning taskagnostic representations that can be used for various surgical downstream tasks. Based on this approach, to elucidate the impact of pre-training on downstream task performance, we explore 22 different pre-training dataset combinations by modulating three variables: source hospital, type of surgical procedure, and pre-training scale (number of videos). We then finetune the resulting model initializations on three diverse downstream tasks: namely, phase recognition and critical view of safety in laparoscopic cholecystectomy and phase recognition in laparoscopic hysterectomy. Results: Controlled experimentation highlights sizable boosts in performance across various tasks, datasets, and labeling budgets. However, this performance is intricately linked to the composition of the pre-training dataset, robustly proven through several study stages. Conclusion: The composition of pre-training datasets can severely affect the effectiveness of SSL methods for various downstream tasks and should critically inform future data collection efforts to scale the application of SSL methodologies. Keywords: Self-Supervised Learning, Transfer Learning, Surgical Computer Vision, Endoscopic Videos, Critical View of Safety, Phase Recognition

Trustworthiness is essential for the precise and interpretable application of artificial intelligence (AI) in medical imaging. Traditionally, precision and interpretability have been addressed as separate tasks, namely medical image analysis and explainable AI, each developing its own models independently. In this study, for the first time, we investigate the development of a unified medical vision-language pre-training model that can achieve both accurate analysis and interpretable understanding of medical images across various modalities. To build the model, we construct MedConcept-23M, a large-scale dataset comprising 23 million medical image-text pairs extracted from 6.2 million scientific articles, enriched with concepts from the Unified Medical Language System (UMLS). Based on MedConcept-23M, we introduce ConceptCLIP, a medical AI model utilizing concept-enhanced contrastive language-image pre-training. The pre-training of ConceptCLIP involves two primary components: image-text alignment learning (IT-Align) and patch-concept alignment learning (PC-Align). This dual alignment strategy enhances the model's capability to associate specific image regions with relevant concepts, thereby improving both the precision of analysis and the interpretability of the AI system. We conducted extensive experiments on 5 diverse types of medical image analysis tasks, spanning 51 subtasks across 10 image modalities, with the broadest range of downstream tasks. The results demonstrate the effectiveness of the proposed vision-language pre-training model. Further explainability analysis across 6 modalities reveals that ConceptCLIP achieves superior performance, underscoring its robust ability to advance explainable AI in medical imaging. These findings highlight ConceptCLIP's capability in promoting trustworthy AI in the field of medicine.

We introduce a radiology-focused visual language model designed to generate radiology reports from chest X-rays. Building on previous findings that large language models (LLMs) can acquire multimodal capabilities when aligned with pretrained vision encoders, we demonstrate similar potential with chest X-ray images. This integration enhances the ability of model to understand and describe chest X-ray images. Our model combines an image encoder with a fine-tuned LLM based on the Vicuna-7B architecture, enabling it to generate different sections of a radiology report with notable accuracy. The training process involves a two-stage approach: (i) initial alignment of chest X-ray features with the LLM (ii) followed by fine-tuning for radiology report generation.

We present VARGPT, a novel multimodal large language model (MLLM) that unifies visual understanding and generation within a single autoregressive framework. VARGPT employs a next-token prediction paradigm for visual understanding and a next-scale prediction paradigm for visual autoregressive generation. VARGPT innovatively extends the LLaVA architecture, achieving efficient scale-wise autoregressive visual generation within MLLMs while seamlessly accommodating mixed-modal input and output within a single model framework. Our VARGPT undergoes a three-stage unified training process on specially curated datasets, comprising a pre-training phase and two mixed visual instruction-tuning phases. The unified training strategy are designed to achieve alignment between visual and textual features, enhance instruction following for both understanding and generation, and improve visual generation quality, respectively. Despite its LLAVA-based architecture for multimodel understanding, VARGPT significantly outperforms LLaVA-1.5 across various vision-centric benchmarks, such as visual question-answering and reasoning tasks. Notably, VARGPT naturally supports capabilities in autoregressive visual generation and instruction-to-image synthesis, showcasing its versatility in both visual understanding and generation tasks. Project page is at: https://vargpt-1.github.io/

Vision Language Models (VLMs) like CLIP have attracted substantial attention in pathology, serving as backbones for applications such as zero-shot image classification and Whole Slide Image (WSI) analysis. Additionally, they can function as vision encoders when combined with large language models (LLMs) to support broader capabilities. Current efforts to train pathology VLMs rely on pathology image-text pairs from platforms like PubMed, YouTube, and Twitter, which provide limited, unscalable data with generally suboptimal image quality. In this work, we leverage large-scale WSI datasets like TCGA to extract numerous high-quality image patches. We then train a large multimodal model to generate captions for these images, creating PathGen-1.6M, a dataset containing 1.6 million high-quality image-caption pairs. Our approach involves multiple agent models collaborating to extract representative WSI patches, generating and refining captions to obtain high-quality image-text pairs. Extensive experiments show that integrating these generated pairs with existing datasets to train a pathology-specific CLIP model, PathGen-CLIP, significantly enhances its ability to analyze pathological images, with substantial improvements across nine pathology-related zero-shot image classification tasks and three whole-slide image tasks. Furthermore, we construct 200K instruction-tuning data based on PathGen-1.6M and integrate PathGen-CLIP with the Vicuna LLM to create more powerful multimodal models through instruction tuning. Overall, we provide a scalable pathway for high-quality data generation in pathology, paving the way for next-generation general pathology models.

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.

The field of vision-and-language (VL) understanding has made unprecedented progress with end-to-end large pre-trained VL models (VLMs). However, they still fall short in zero-shot reasoning tasks that require multi-step inferencing. To achieve this goal, previous works resort to a divide-and-conquer pipeline. In this paper, we argue that previous efforts have several inherent shortcomings: 1) They rely on domain-specific sub-question decomposing models. 2) They force models to predict the final answer even if the sub-questions or sub-answers provide insufficient information. We address these limitations via IdealGPT, a framework that iteratively decomposes VL reasoning using large language models (LLMs). Specifically, IdealGPT utilizes an LLM to generate sub-questions, a VLM to provide corresponding sub-answers, and another LLM to reason to achieve the final answer. These three modules perform the divide-and-conquer procedure iteratively until the model is confident about the final answer to the main question. We evaluate IdealGPT on multiple challenging VL reasoning tasks under a zero-shot setting. In particular, our IdealGPT outperforms the best existing GPT-4-like models by an absolute 10% on VCR and 15% on SNLI-VE. Code is available at https://github.com/Hxyou/IdealGPT

Beginning with VisualGLM and CogVLM, we are continuously exploring VLMs in pursuit of enhanced vision-language fusion, efficient higher-resolution architecture, and broader modalities and applications. Here we propose the CogVLM2 family, a new generation of visual language models for image and video understanding including CogVLM2, CogVLM2-Video and GLM-4V. As an image understanding model, CogVLM2 inherits the visual expert architecture with improved training recipes in both pre-training and post-training stages, supporting input resolution up to 1344 times 1344 pixels. As a video understanding model, CogVLM2-Video integrates multi-frame input with timestamps and proposes automated temporal grounding data construction. Notably, CogVLM2 family has achieved state-of-the-art results on benchmarks like MMBench, MM-Vet, TextVQA, MVBench and VCGBench. All models are open-sourced in https://github.com/THUDM/CogVLM2 and https://github.com/THUDM/GLM-4, contributing to the advancement of the field.

Vision-Language Pre-training (VLP) shows remarkable progress with the assistance of extremely heavy parameters, which challenges deployment in real applications. Knowledge distillation is well recognized as the essential procedure in model compression. However, existing knowledge distillation techniques lack an in-depth investigation and analysis of VLP, and practical guidelines for VLP-oriented distillation are still not yet explored. In this paper, we present DLIP, a simple yet efficient Distilling Language-Image Pre-training framework, through which we investigate how to distill a light VLP model. Specifically, we dissect the model distillation from multiple dimensions, such as the architecture characteristics of different modules and the information transfer of different modalities. We conduct comprehensive experiments and provide insights on distilling a light but performant VLP model. Experimental results reveal that DLIP can achieve a state-of-the-art accuracy/efficiency trade-off across diverse cross-modal tasks, e.g., image-text retrieval, image captioning and visual question answering. For example, DLIP compresses BLIP by 1.9x, from 213M to 108M parameters, while achieving comparable or better performance. Furthermore, DLIP succeeds in retaining more than 95% of the performance with 22.4% parameters and 24.8% FLOPs compared to the teacher model and accelerates inference speed by 2.7x.

Vision-language pre-training for chest X-rays has made significant strides, primarily by utilizing paired radiographs and radiology reports. However, existing approaches often face challenges in encoding medical knowledge effectively. While radiology reports provide insights into the current disease manifestation, medical definitions (as used by contemporary methods) tend to be overly abstract, creating a gap in knowledge. To address this, we propose DeViDe, a novel transformer-based method that leverages radiographic descriptions from the open web. These descriptions outline general visual characteristics of diseases in radiographs, and when combined with abstract definitions and radiology reports, provide a holistic snapshot of knowledge. DeViDe incorporates three key features for knowledge-augmented vision language alignment: First, a large-language model-based augmentation is employed to homogenise medical knowledge from diverse sources. Second, this knowledge is aligned with image information at various levels of granularity. Third, a novel projection layer is proposed to handle the complexity of aligning each image with multiple descriptions arising in a multi-label setting. In zero-shot settings, DeViDe performs comparably to fully supervised models on external datasets and achieves state-of-the-art results on three large-scale datasets. Additionally, fine-tuning DeViDe on four downstream tasks and six segmentation tasks showcases its superior performance across data from diverse distributions.

A key goal for the advancement of AI is to develop technologies that serve the needs not just of one group but of all communities regardless of their geographical region. In fact, a significant proportion of knowledge is locally shared by people from certain regions but may not apply equally in other regions because of cultural differences. If a model is unaware of regional characteristics, it may lead to performance disparity across regions and result in bias against underrepresented groups. We propose GIVL, a Geographically Inclusive Vision-and-Language Pre-trained model. There are two attributes of geo-diverse visual concepts which can help to learn geo-diverse knowledge: 1) concepts under similar categories have unique knowledge and visual characteristics, 2) concepts with similar visual features may fall in completely different categories. Motivated by the attributes, we design new pre-training objectives Image Knowledge Matching (IKM) and Image Edit Checking (IEC) to pre-train GIVL. Compared with similar-size models pre-trained with similar scale of data, GIVL achieves state-of-the-art (SOTA) and more balanced performance on geo-diverse V&L tasks.

Vision-Language (VL) models have gained significant research focus, enabling remarkable advances in multimodal reasoning. These architectures typically comprise a vision encoder, a Large Language Model (LLM), and a projection module that aligns visual features with the LLM's representation space. Despite their success, a critical limitation persists: the vision encoding process remains decoupled from user queries, often in the form of image-related questions. Consequently, the resulting visual features may not be optimally attuned to the query-specific elements of the image. To address this, we introduce QA-ViT, a Question Aware Vision Transformer approach for multimodal reasoning, which embeds question awareness directly within the vision encoder. This integration results in dynamic visual features focusing on relevant image aspects to the posed question. QA-ViT is model-agnostic and can be incorporated efficiently into any VL architecture. Extensive experiments demonstrate the effectiveness of applying our method to various multimodal architectures, leading to consistent improvement across diverse tasks and showcasing its potential for enhancing visual and scene-text understanding.

Vision-Language adaptation (VL adaptation) transforms Large Language Models (LLMs) into Large Vision-Language Models (LVLMs) for multimodal tasks, but this process often compromises the inherent safety capabilities embedded in the original LLMs. Despite potential harmfulness due to weakened safety measures, in-depth analysis on the effects of VL adaptation on safety remains under-explored. This study examines how VL adaptation influences safety and evaluates the impact of safety fine-tuning methods. Our analysis reveals that safety degradation occurs during VL adaptation, even when the training data is safe. While safety tuning techniques like supervised fine-tuning with safety datasets or reinforcement learning from human feedback mitigate some risks, they still lead to safety degradation and a reduction in helpfulness due to over-rejection issues. Further analysis of internal model weights suggests that VL adaptation may impact certain safety-related layers, potentially lowering overall safety levels. Additionally, our findings demonstrate that the objectives of VL adaptation and safety tuning are divergent, which often results in their simultaneous application being suboptimal. To address this, we suggest the weight merging approach as an optimal solution effectively reducing safety degradation while maintaining helpfulness. These insights help guide the development of more reliable and secure LVLMs for real-world applications.

The rapid development of multimodal large language models (MLLMs), such as GPT-4V, has led to significant advancements. However, these models still face challenges in medical multimodal capabilities due to limitations in the quantity and quality of medical vision-text data, stemming from data privacy concerns and high annotation costs. While pioneering approaches utilize PubMed's large-scale, de-identified medical image-text pairs to address these limitations, they still fall short due to inherent data noise. To tackle this, we refined medical image-text pairs from PubMed and employed MLLMs (GPT-4V) in an 'unblinded' capacity to denoise and reformat the data, resulting in the creation of the PubMedVision dataset with 1.3 million medical VQA samples. Our validation demonstrates that: (1) PubMedVision can significantly enhance the medical multimodal capabilities of current MLLMs, showing significant improvement in benchmarks including the MMMU Health & Medicine track; (2) manual checks by medical experts and empirical results validate the superior data quality of our dataset compared to other data construction methods. Using PubMedVision, we train a 34B medical MLLM HuatuoGPT-Vision, which shows superior performance in medical multimodal scenarios among open-source MLLMs.

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.

Several recent works seek to develop foundation models specifically for medical applications, adapting general-purpose large language models (LLMs) and vision-language models (VLMs) via continued pretraining on publicly available biomedical corpora. These works typically claim that such domain-adaptive pretraining (DAPT) improves performance on downstream medical tasks, such as answering medical licensing exam questions. In this paper, we compare seven public "medical" LLMs and two VLMs against their corresponding base models, arriving at a different conclusion: all medical VLMs and nearly all medical LLMs fail to consistently improve over their base models in the zero-/few-shot prompting regime for medical question-answering (QA) tasks. For instance, across the tasks and model pairs we consider in the 3-shot setting, medical LLMs only outperform their base models in 12.1% of cases, reach a (statistical) tie in 49.8% of cases, and are significantly worse than their base models in the remaining 38.2% of cases. Our conclusions are based on (i) comparing each medical model head-to-head, directly against the corresponding base model; (ii) optimizing the prompts for each model separately; and (iii) accounting for statistical uncertainty in comparisons. While these basic practices are not consistently adopted in the literature, our ablations show that they substantially impact conclusions. Our findings suggest that state-of-the-art general-domain models may already exhibit strong medical knowledge and reasoning capabilities, and offer recommendations to strengthen the conclusions of future studies.

Due to their multimodal capabilities, Vision-Language Models (VLMs) have found numerous impactful applications in real-world scenarios. However, recent studies have revealed that VLMs are vulnerable to image-based adversarial attacks, particularly targeted adversarial images that manipulate the model to generate harmful content specified by the adversary. Current attack methods rely on predefined target labels to create targeted adversarial attacks, which limits their scalability and applicability for large-scale robustness evaluations. In this paper, we propose AnyAttack, a self-supervised framework that generates targeted adversarial images for VLMs without label supervision, allowing any image to serve as a target for the attack. Our framework employs the pre-training and fine-tuning paradigm, with the adversarial noise generator pre-trained on the large-scale LAION-400M dataset. This large-scale pre-training endows our method with powerful transferability across a wide range of VLMs. Extensive experiments on five mainstream open-source VLMs (CLIP, BLIP, BLIP2, InstructBLIP, and MiniGPT-4) across three multimodal tasks (image-text retrieval, multimodal classification, and image captioning) demonstrate the effectiveness of our attack. Additionally, we successfully transfer AnyAttack to multiple commercial VLMs, including Google Gemini, Claude Sonnet, Microsoft Copilot and OpenAI GPT. These results reveal an unprecedented risk to VLMs, highlighting the need for effective countermeasures.

State-of-the-art vision and vision-and-language models rely on large-scale visio-linguistic pretraining for obtaining good performance on a variety of downstream tasks. Generally, such models are often either cross-modal (contrastive) or multi-modal (with earlier fusion) but not both; and they often only target specific modalities or tasks. A promising direction would be to use a single holistic universal model, as a "foundation", that targets all modalities at once -- a true vision and language foundation model should be good at vision tasks, language tasks, and cross- and multi-modal vision and language tasks. We introduce FLAVA as such a model and demonstrate impressive performance on a wide range of 35 tasks spanning these target modalities.

Foundation models have revolutionized computer vision by achieving vastly superior performance across diverse tasks through large-scale pretraining on extensive datasets. However, their application in surgical computer vision has been limited. This study addresses this gap by introducing SurgeNetXL, a novel surgical foundation model that sets a new benchmark in surgical computer vision. Trained on the largest reported surgical dataset to date, comprising over 4.7 million video frames, SurgeNetXL achieves consistent top-tier performance across six datasets spanning four surgical procedures and three tasks, including semantic segmentation, phase recognition, and critical view of safety (CVS) classification. Compared with the best-performing surgical foundation models, SurgeNetXL shows mean improvements of 2.4, 9.0, and 12.6 percent for semantic segmentation, phase recognition, and CVS classification, respectively. Additionally, SurgeNetXL outperforms the best-performing ImageNet-based variants by 14.4, 4.0, and 1.6 percent in the respective tasks. In addition to advancing model performance, this study provides key insights into scaling pretraining datasets, extending training durations, and optimizing model architectures specifically for surgical computer vision. These findings pave the way for improved generalizability and robustness in data-scarce scenarios, offering a comprehensive framework for future research in this domain. All models and a subset of the SurgeNetXL dataset, including over 2 million video frames, are publicly available at: https://github.com/TimJaspers0801/SurgeNet.

With the recent success of the pre-training technique for NLP and image-linguistic tasks, some video-linguistic pre-training works are gradually developed to improve video-text related downstream tasks. However, most of the existing multimodal models are pre-trained for understanding tasks, leading to a pretrain-finetune discrepancy for generation tasks. This paper proposes UniVL: a Unified Video and Language pre-training model for both multimodal understanding and generation. It comprises four components, including two single-modal encoders, a cross encoder, and a decoder with the Transformer backbone. Five objectives, including video-text joint, conditioned masked language model (CMLM), conditioned masked frame model (CMFM), video-text alignment, and language reconstruction, are designed to train each of the components. We further develop two pre-training strategies, stage by stage pre-training (StagedP) and enhanced video representation (EnhancedV), to make the training process of the UniVL more effective. The pre-train is carried out on a sizeable instructional video dataset HowTo100M. Experimental results demonstrate that the UniVL can learn strong video-text representation and achieves state-of-the-art results on five downstream tasks.

We introduce EXAMS-V, a new challenging multi-discipline multimodal multilingual exam benchmark for evaluating vision language models. It consists of 20,932 multiple-choice questions across 20 school disciplines covering natural science, social science, and other miscellaneous studies, e.g., religion, fine arts, business, etc. EXAMS-V includes a variety of multimodal features such as text, images, tables, figures, diagrams, maps, scientific symbols, and equations. The questions come in 11 languages from 7 language families. Unlike existing benchmarks, EXAMS-V is uniquely curated by gathering school exam questions from various countries, with a variety of education systems. This distinctive approach calls for intricate reasoning across diverse languages and relies on region-specific knowledge. Solving the problems in the dataset requires advanced perception and joint reasoning over the text and the visual content of the image. Our evaluation results demonstrate that this is a challenging dataset, which is difficult even for advanced vision-text models such as GPT-4V and Gemini; this underscores the inherent complexity of the dataset and its significance as a future benchmark.

3D vision-language grounding (3D-VL) is an emerging field that aims to connect the 3D physical world with natural language, which is crucial for achieving embodied intelligence. Current 3D-VL models rely heavily on sophisticated modules, auxiliary losses, and optimization tricks, which calls for a simple and unified model. In this paper, we propose 3D-VisTA, a pre-trained Transformer for 3D Vision and Text Alignment that can be easily adapted to various downstream tasks. 3D-VisTA simply utilizes self-attention layers for both single-modal modeling and multi-modal fusion without any sophisticated task-specific design. To further enhance its performance on 3D-VL tasks, we construct ScanScribe, the first large-scale 3D scene-text pairs dataset for 3D-VL pre-training. ScanScribe contains 2,995 RGB-D scans for 1,185 unique indoor scenes originating from ScanNet and 3R-Scan datasets, along with paired 278K scene descriptions generated from existing 3D-VL tasks, templates, and GPT-3. 3D-VisTA is pre-trained on ScanScribe via masked language/object modeling and scene-text matching. It achieves state-of-the-art results on various 3D-VL tasks, ranging from visual grounding and dense captioning to question answering and situated reasoning. Moreover, 3D-VisTA demonstrates superior data efficiency, obtaining strong performance even with limited annotations during downstream task fine-tuning.

Vision-language pre-training (VLP) models have shown vulnerability to adversarial examples in multimodal tasks. Furthermore, malicious adversaries can be deliberately transferred to attack other black-box models. However, existing work has mainly focused on investigating white-box attacks. In this paper, we present the first study to investigate the adversarial transferability of recent VLP models. We observe that existing methods exhibit much lower transferability, compared to the strong attack performance in white-box settings. The transferability degradation is partly caused by the under-utilization of cross-modal interactions. Particularly, unlike unimodal learning, VLP models rely heavily on cross-modal interactions and the multimodal alignments are many-to-many, e.g., an image can be described in various natural languages. To this end, we propose a highly transferable Set-level Guidance Attack (SGA) that thoroughly leverages modality interactions and incorporates alignment-preserving augmentation with cross-modal guidance. Experimental results demonstrate that SGA could generate adversarial examples that can strongly transfer across different VLP models on multiple downstream vision-language tasks. On image-text retrieval, SGA significantly enhances the attack success rate for transfer attacks from ALBEF to TCL by a large margin (at least 9.78% and up to 30.21%), compared to the state-of-the-art.

MM-Vet, with open-ended vision-language questions targeting at evaluating integrated capabilities, has become one of the most popular benchmarks for large multimodal model evaluation. MM-Vet assesses six core vision-language (VL) capabilities: recognition, knowledge, spatial awareness, language generation, OCR, and math. However, its question format is restricted to single image-text pairs, lacking the interleaved image and text sequences prevalent in real-world scenarios. To address this limitation, we introduce MM-Vet v2, which includes a new VL capability called "image-text sequence understanding", evaluating models' ability to process VL sequences. Furthermore, we maintain the high quality of evaluation samples while further expanding the evaluation set size. Using MM-Vet v2 to benchmark large multimodal models, we found that Claude 3.5 Sonnet is the best model with a score of 71.8, slightly outperforming GPT-4o which scored 71.0. Among open-weight models, InternVL2-Llama3-76B leads with a score of 68.4.

This paper examines the problems of severe image-text misalignment and high redundancy in the widely-used large-scale Vision-Language Pre-Training (VLP) datasets. To address these issues, we propose an efficient and straightforward Vision-Language learning algorithm called TL;DR, which aims to compress the existing large VLP data into a small, high-quality set. Our approach consists of two major steps. First, a codebook-based encoder-decoder captioner is developed to select representative samples. Second, a new caption is generated to complement the original captions for selected samples, mitigating the text-image misalignment problem while maintaining uniqueness. As the result, TL;DR enables us to reduce the large dataset into a small set of high-quality data, which can serve as an alternative pre-training dataset. This algorithm significantly speeds up the time-consuming pretraining process. Specifically, TL;DR can compress the mainstream VLP datasets at a high ratio, e.g., reduce well-cleaned CC3M dataset from 2.82M to 0.67M (sim24\%) and noisy YFCC15M from 15M to 2.5M (sim16.7\%). Extensive experiments with three popular VLP models over seven downstream tasks show that VLP model trained on the compressed dataset provided by TL;DR can perform similar or even better results compared with training on the full-scale dataset. The code will be made available at https://github.com/showlab/datacentric.vlp.

The recent upsurge in pre-trained large models (e.g. GPT-4) has swept across the entire deep learning community. Such powerful large language models (LLMs) demonstrate advanced generative ability and multimodal understanding capability, which quickly achieve new state-of-the-art performances on a variety of benchmarks. The pre-trained LLM usually plays the role as a universal AI model that can conduct various tasks, including context reasoning, article analysis and image content comprehension. However, considering the prohibitively high memory and computational cost for implementing such a large model, the conventional models (such as CNN and ViT), are still essential for many visual perception tasks. In this paper, we propose to enhance the representation ability of ordinary vision models for perception tasks (e.g. image classification) by taking advantage of large pre-trained models. We present a new learning paradigm in which the knowledge extracted from large pre-trained models are utilized to help models like CNN and ViT learn enhanced representations and achieve better performance. Firstly, we curate a high quality description set by prompting a multimodal LLM to generate descriptive text for all training images. Furthermore, we feed these detailed descriptions into a pre-trained encoder to extract text embeddings with rich semantic information that encodes the content of images. During training, text embeddings will serve as extra supervising signals and be aligned with image representations learned by vision models. The alignment process helps vision models learn better and achieve higher accuracy with the assistance of pre-trained LLMs. We conduct extensive experiments to verify that the proposed algorithm consistently improves the performance for various vision models with heterogeneous architectures.

Reasoning is a critical frontier for advancing medical image analysis, where transparency and trustworthiness play a central role in both clinician trust and regulatory approval. Although Medical Visual Language Models (VLMs) show promise for radiological tasks, most existing VLMs merely produce final answers without revealing the underlying reasoning. To address this gap, we introduce MedVLM-R1, a medical VLM that explicitly generates natural language reasoning to enhance transparency and trustworthiness. Instead of relying on supervised fine-tuning (SFT), which often suffers from overfitting to training distributions and fails to foster genuine reasoning, MedVLM-R1 employs a reinforcement learning framework that incentivizes the model to discover human-interpretable reasoning paths without using any reasoning references. Despite limited training data (600 visual question answering samples) and model parameters (2B), MedVLM-R1 boosts accuracy from 55.11% to 78.22% across MRI, CT, and X-ray benchmarks, outperforming larger models trained on over a million samples. It also demonstrates robust domain generalization under out-of-distribution tasks. By unifying medical image analysis with explicit reasoning, MedVLM-R1 marks a pivotal step toward trustworthy and interpretable AI in clinical practice.

Large language models have the potential to be valuable in the healthcare industry, but it's crucial to verify their safety and effectiveness through rigorous evaluation. For this purpose, we comprehensively evaluated both open-source LLMs and Google's new multimodal LLM called Gemini across Medical reasoning, hallucination detection, and Medical Visual Question Answering tasks. While Gemini showed competence, it lagged behind state-of-the-art models like MedPaLM 2 and GPT-4 in diagnostic accuracy. Additionally, Gemini achieved an accuracy of 61.45\% on the medical VQA dataset, significantly lower than GPT-4V's score of 88\%. Our analysis revealed that Gemini is highly susceptible to hallucinations, overconfidence, and knowledge gaps, which indicate risks if deployed uncritically. We also performed a detailed analysis by medical subject and test type, providing actionable feedback for developers and clinicians. To mitigate risks, we applied prompting strategies that improved performance. Additionally, we facilitated future research and development by releasing a Python module for medical LLM evaluation and establishing a dedicated leaderboard on Hugging Face for medical domain LLMs. Python module can be found at https://github.com/promptslab/RosettaEval

Deep learning has enabled the development of highly robust foundation models for various pathological tasks across diverse diseases and patient cohorts. Among these models, vision-language pre-training, which leverages large-scale paired data to align pathology image and text embedding spaces, and provides a novel zero-shot paradigm for downstream tasks. However, existing models have been primarily data-driven and lack the incorporation of domain-specific knowledge, which limits their performance in cancer diagnosis, especially for rare tumor subtypes. To address this limitation, we establish a Knowledge-enhanced Pathology (KEEP) foundation model that harnesses disease knowledge to facilitate vision-language pre-training. Specifically, we first construct a disease knowledge graph (KG) that covers 11,454 human diseases with 139,143 disease attributes, including synonyms, definitions, and hypernym relations. We then systematically reorganize the millions of publicly available noisy pathology image-text pairs, into 143K well-structured semantic groups linked through the hierarchical relations of the disease KG. To derive more nuanced image and text representations, we propose a novel knowledge-enhanced vision-language pre-training approach that integrates disease knowledge into the alignment within hierarchical semantic groups instead of unstructured image-text pairs. Validated on 18 diverse benchmarks with more than 14,000 whole slide images (WSIs), KEEP achieves state-of-the-art performance in zero-shot cancer diagnostic tasks. Notably, for cancer detection, KEEP demonstrates an average sensitivity of 89.8% at a specificity of 95.0% across 7 cancer types. For cancer subtyping, KEEP achieves a median balanced accuracy of 0.456 in subtyping 30 rare brain cancers, indicating strong generalizability for diagnosing rare tumors.

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.

Vision-language models (VLMs) are achieving increasingly strong performance on multimodal tasks. However, reasoning capabilities remain limited particularly for smaller VLMs, while those of large-language models (LLMs) have seen numerous improvements. We propose a technique to transfer capabilities from LLMs to VLMs. On the recently introduced ChartQA, our method obtains state-of-the-art performance when applied on the PaLI3-5B VLM by chen2023pali3, while also enabling much better performance on PlotQA and FigureQA. We first improve the chart representation by continuing the pre-training stage using an improved version of the chart-to-table translation task by liu2023deplot. We then propose constructing a 20x larger dataset than the original training set. To improve general reasoning capabilities and improve numerical operations, we synthesize reasoning traces using the table representation of charts. Lastly, our model is fine-tuned using the multitask loss introduced by hsieh2023distilling. Our variant ChartPaLI-5B outperforms even 10x larger models such as PaLIX-55B without using an upstream OCR system, while keeping inference time constant compared to the PaLI3-5B baseline. When rationales are further refined with a simple program-of-thought prompt chen2023program, our model outperforms the recently introduced Gemini Ultra and GPT-4V.

Large language models have exhibited exceptional performance on various Natural Language Processing (NLP) tasks, leveraging techniques such as the pre-training, and instruction fine-tuning. Despite these advances, their effectiveness in medical applications is limited, due to challenges such as factual inaccuracies, reasoning abilities, and lack grounding in real-world experience. In this study, we present ClinicalGPT, a language model explicitly designed and optimized for clinical scenarios. By incorporating extensive and diverse real-world data, such as medical records, domain-specific knowledge, and multi-round dialogue consultations in the training process, ClinicalGPT is better prepared to handle multiple clinical task. Furthermore, we introduce a comprehensive evaluation framework that includes medical knowledge question-answering, medical exams, patient consultations, and diagnostic analysis of medical records. Our results demonstrate that ClinicalGPT significantly outperforms other models in these tasks, highlighting the effectiveness of our approach in adapting large language models to the critical domain of healthcare.

Pre-trained vision-language (V-L) models such as CLIP have shown excellent generalization ability to downstream tasks. However, they are sensitive to the choice of input text prompts and require careful selection of prompt templates to perform well. Inspired by the Natural Language Processing (NLP) literature, recent CLIP adaptation approaches learn prompts as the textual inputs to fine-tune CLIP for downstream tasks. We note that using prompting to adapt representations in a single branch of CLIP (language or vision) is sub-optimal since it does not allow the flexibility to dynamically adjust both representation spaces on a downstream task. In this work, we propose Multi-modal Prompt Learning (MaPLe) for both vision and language branches to improve alignment between the vision and language representations. Our design promotes strong coupling between the vision-language prompts to ensure mutual synergy and discourages learning independent uni-modal solutions. Further, we learn separate prompts across different early stages to progressively model the stage-wise feature relationships to allow rich context learning. We evaluate the effectiveness of our approach on three representative tasks of generalization to novel classes, new target datasets and unseen domain shifts. Compared with the state-of-the-art method Co-CoOp, MaPLe exhibits favorable performance and achieves an absolute gain of 3.45% on novel classes and 2.72% on overall harmonic-mean, averaged over 11 diverse image recognition datasets. Our code and pre-trained models are available at https://github.com/muzairkhattak/multimodal-prompt-learning.

Radiologists play a crucial role by translating medical images into medical reports. However, the field faces staffing shortages and increasing workloads. While automated approaches using vision-language models (VLMs) show promise as assistants, they require exceptionally high accuracy. Most current VLMs in radiology rely solely on supervised fine-tuning (SFT). Meanwhile, in the general domain, additional preference fine-tuning has become standard practice. The challenge in radiology lies in the prohibitive cost of obtaining radiologist feedback. We propose a scalable automated preference alignment technique for VLMs in radiology, focusing on chest X-ray (CXR) report generation. Our method leverages publicly available datasets with an LLM-as-a-Judge mechanism, eliminating the need for additional expert radiologist feedback. We evaluate and benchmark five direct alignment algorithms (DAAs). Our results show up to a 57.4% improvement in average GREEN scores, a LLM-based metric for evaluating CXR reports, and a 9.2% increase in an average across six metrics (domain specific and general), compared to the SFT baseline. We study reward overoptimization via length exploitation, with reports lengthening by up to 3.2x. To assess a potential alignment tax, we benchmark on six additional diverse tasks, finding no significant degradations. A reader study involving four board-certified radiologists indicates win rates of up to 0.62 over the SFT baseline, while significantly penalizing verbosity. Our analysis provides actionable insights for the development of VLMs in high-stakes fields like radiology.

Surgical video segmentation is a critical task in computer-assisted surgery and is vital for enhancing surgical quality and patient outcomes. Recently, the Segment Anything Model 2 (SAM2) framework has shown superior advancements in image and video segmentation. However, SAM2 struggles with efficiency due to the high computational demands of processing high-resolution images and complex and long-range temporal dynamics in surgical videos. To address these challenges, we introduce Surgical SAM 2 (SurgSAM-2), an advanced model to utilize SAM2 with an Efficient Frame Pruning (EFP) mechanism, to facilitate real-time surgical video segmentation. The EFP mechanism dynamically manages the memory bank by selectively retaining only the most informative frames, reducing memory usage and computational cost while maintaining high segmentation accuracy. Our extensive experiments demonstrate that SurgSAM-2 significantly improves both efficiency and segmentation accuracy compared to the vanilla SAM2. Remarkably, SurgSAM-2 achieves a 3times FPS compared with SAM2, while also delivering state-of-the-art performance after fine-tuning with lower-resolution data. These advancements establish SurgSAM-2 as a leading model for surgical video analysis, making real-time surgical video segmentation in resource-constrained environments a feasible reality.

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.

This work introduces the first framework for reconstructing surgical dialogue from unstructured real-world recordings, which is crucial for characterizing teaching tasks. In surgical training, the formative verbal feedback that trainers provide to trainees during live surgeries is crucial for ensuring safety, correcting behavior immediately, and facilitating long-term skill acquisition. However, analyzing and quantifying this feedback is challenging due to its unstructured and specialized nature. Automated systems are essential to manage these complexities at scale, allowing for the creation of structured datasets that enhance feedback analysis and improve surgical education. Our framework integrates voice activity detection, speaker diarization, and automated speech recaognition, with a novel enhancement that 1) removes hallucinations (non-existent utterances generated during speech recognition fueled by noise in the operating room) and 2) separates speech from trainers and trainees using few-shot voice samples. These aspects are vital for reconstructing accurate surgical dialogues and understanding the roles of operating room participants. Using data from 33 real-world surgeries, we demonstrated the system's capability to reconstruct surgical teaching dialogues and detect feedback instances effectively (F1 score of 0.79+/-0.07). Moreover, our hallucination removal step improves feedback detection performance by ~14%. Evaluation on downstream clinically relevant tasks of predicting Behavioral Adjustment of trainees and classifying Technical feedback, showed performances comparable to manual annotations with F1 scores of 0.82+/0.03 and 0.81+/0.03 respectively. These results highlight the effectiveness of our framework in supporting clinically relevant tasks and improving over manual methods.

Obtaining large pre-trained models that can be fine-tuned to new tasks with limited annotated samples has remained an open challenge for medical imaging data. While pre-trained deep networks on ImageNet and vision-language foundation models trained on web-scale data are prevailing approaches, their effectiveness on medical tasks is limited due to the significant domain shift between natural and medical images. To bridge this gap, we introduce LVM-Med, the first family of deep networks trained on large-scale medical datasets. We have collected approximately 1.3 million medical images from 55 publicly available datasets, covering a large number of organs and modalities such as CT, MRI, X-ray, and Ultrasound. We benchmark several state-of-the-art self-supervised algorithms on this dataset and propose a novel self-supervised contrastive learning algorithm using a graph-matching formulation. The proposed approach makes three contributions: (i) it integrates prior pair-wise image similarity metrics based on local and global information; (ii) it captures the structural constraints of feature embeddings through a loss function constructed via a combinatorial graph-matching objective; and (iii) it can be trained efficiently end-to-end using modern gradient-estimation techniques for black-box solvers. We thoroughly evaluate the proposed LVM-Med on 15 downstream medical tasks ranging from segmentation and classification to object detection, and both for the in and out-of-distribution settings. LVM-Med empirically outperforms a number of state-of-the-art supervised, self-supervised, and foundation models. For challenging tasks such as Brain Tumor Classification or Diabetic Retinopathy Grading, LVM-Med improves previous vision-language models trained on 1 billion masks by 6-7% while using only a ResNet-50.

Self-supervised learning in vision-language processing exploits semantic alignment between imaging and text modalities. Prior work in biomedical VLP has mostly relied on the alignment of single image and report pairs even though clinical notes commonly refer to prior images. This does not only introduce poor alignment between the modalities but also a missed opportunity to exploit rich self-supervision through existing temporal content in the data. In this work, we explicitly account for prior images and reports when available during both training and fine-tuning. Our approach, named BioViL-T, uses a CNN-Transformer hybrid multi-image encoder trained jointly with a text model. It is designed to be versatile to arising challenges such as pose variations and missing input images across time. The resulting model excels on downstream tasks both in single- and multi-image setups, achieving state-of-the-art performance on (I) progression classification, (II) phrase grounding, and (III) report generation, whilst offering consistent improvements on disease classification and sentence-similarity tasks. We release a novel multi-modal temporal benchmark dataset, MS-CXR-T, to quantify the quality of vision-language representations in terms of temporal semantics. Our experimental results show the advantages of incorporating prior images and reports to make most use of the data.

Artificial Intelligence (AI) has demonstrated significant potential in healthcare, particularly in disease diagnosis and treatment planning. Recent progress in Medical Large Vision-Language Models (Med-LVLMs) has opened up new possibilities for interactive diagnostic tools. However, these models often suffer from factual hallucination, which can lead to incorrect diagnoses. Fine-tuning and retrieval-augmented generation (RAG) have emerged as methods to address these issues. However, the amount of high-quality data and distribution shifts between training data and deployment data limit the application of fine-tuning methods. Although RAG is lightweight and effective, existing RAG-based approaches are not sufficiently general to different medical domains and can potentially cause misalignment issues, both between modalities and between the model and the ground truth. In this paper, we propose a versatile multimodal RAG system, MMed-RAG, designed to enhance the factuality of Med-LVLMs. Our approach introduces a domain-aware retrieval mechanism, an adaptive retrieved contexts selection method, and a provable RAG-based preference fine-tuning strategy. These innovations make the RAG process sufficiently general and reliable, significantly improving alignment when introducing retrieved contexts. Experimental results across five medical datasets (involving radiology, ophthalmology, pathology) on medical VQA and report generation demonstrate that MMed-RAG can achieve an average improvement of 43.8% in the factual accuracy of Med-LVLMs. Our data and code are available in https://github.com/richard-peng-xia/MMed-RAG.

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.

In this paper, we propose a Vision-Audio-Language Omni-peRception pretraining model (VALOR) for multi-modal understanding and generation. Different from widely-studied vision-language pretraining models, VALOR jointly models relationships of vision, audio and language in an end-to-end manner. It contains three separate encoders for single modality representations, and a decoder for multimodal conditional text generation. We design two pretext tasks to pretrain VALOR model, including Multimodal Grouping Alignment (MGA) and Multimodal Grouping Captioning (MGC). MGA projects vision, language and audio to the same common space, building vision-language, audio-language and audiovisual-language alignment simultaneously. MGC learns how to generate text tokens in conditions of vision, audio or their both. To promote vision-audio-language pretraining research, we construct a large-scale high-quality tri-modality dataset named VALOR-1M, which contains 1M audiable videos with human annotated audiovisual captions. Extensive experiments show that VALOR can learn strong multimodal correlations and be generalized to various downstream tasks (e.g., retrieval, captioning and question answering), with different input modalities (e.g., vision-language, audio-language and audiovisual-language). VALOR achieves new state-of-the-art performances on series of public cross-modality benchmarks. Code and data are available at project page https://casia-iva-group.github.io/projects/VALOR.

The exponential growth of large language models (LLMs) has opened up numerous possibilities for multi-modal AGI systems. However, the progress in vision and vision-language foundation models, which are also critical elements of multi-modal AGI, has not kept pace with LLMs. In this work, we design a large-scale vision-language foundation model (InternVL), which scales up the vision foundation model to 6 billion parameters and progressively aligns it with the large language model, using web-scale image-text data from various sources. This model can be broadly applied to and achieve state-of-the-art performance on visual perception tasks such as image-level or pixel-level recognition, vision-language tasks such as zero-shot image/video classification, zero-shot image/video-text retrieval, and link with LLMs to create multi-modal dialogue systems. We hope that our research could contribute to the development of multi-modal large models. Code and models are available at https://github.com/OpenGVLab/InternVL.

A Vision Transformer (ViT) is a simple neural architecture amenable to serve several computer vision tasks. It has limited built-in architectural priors, in contrast to more recent architectures that incorporate priors either about the input data or of specific tasks. Recent works show that ViTs benefit from self-supervised pre-training, in particular BerT-like pre-training like BeiT. In this paper, we revisit the supervised training of ViTs. Our procedure builds upon and simplifies a recipe introduced for training ResNet-50. It includes a new simple data-augmentation procedure with only 3 augmentations, closer to the practice in self-supervised learning. Our evaluations on Image classification (ImageNet-1k with and without pre-training on ImageNet-21k), transfer learning and semantic segmentation show that our procedure outperforms by a large margin previous fully supervised training recipes for ViT. It also reveals that the performance of our ViT trained with supervision is comparable to that of more recent architectures. Our results could serve as better baselines for recent self-supervised approaches demonstrated on ViT.

Large Vision-Language Models (LVLMs) have demonstrated outstanding performance in various general multimodal applications such as image recognition and visual reasoning, and have also shown promising potential in specialized domains. However, the application potential of LVLMs in the insurance domain-characterized by rich application scenarios and abundant multimodal data-has not been effectively explored. There is no systematic review of multimodal tasks in the insurance domain, nor a benchmark specifically designed to evaluate the capabilities of LVLMs in insurance. This gap hinders the development of LVLMs within the insurance domain. In this paper, we systematically review and distill multimodal tasks for four representative types of insurance: auto insurance, property insurance, health insurance, and agricultural insurance. We propose INS-MMBench, the first comprehensive LVLMs benchmark tailored for the insurance domain. INS-MMBench comprises a total of 2.2K thoroughly designed multiple-choice questions, covering 12 meta-tasks and 22 fundamental tasks. Furthermore, we evaluate multiple representative LVLMs, including closed-source models such as GPT-4o and open-source models like BLIP-2. This evaluation not only validates the effectiveness of our benchmark but also provides an in-depth performance analysis of current LVLMs on various multimodal tasks in the insurance domain. We hope that INS-MMBench will facilitate the further application of LVLMs in the insurance domain and inspire interdisciplinary development. Our dataset and evaluation code are available at https://github.com/FDU-INS/INS-MMBench.

In this paper, the LCVO modular method is proposed for the Visual Question Answering (VQA) Grounding task in the vision-language multimodal domain. This approach relies on a frozen large language model (LLM) as intermediate mediator between the off-the-shelf VQA model and the off-the-shelf Open-Vocabulary Object Detection (OVD) model, where the LLM transforms and conveys textual information between the two modules based on a designed prompt. LCVO establish an integrated plug-and-play framework without the need for any pre-training process. This framework can be deployed for VQA Grounding tasks under low computational resources. The modularized model within the framework allows application with various state-of-the-art pre-trained models, exhibiting significant potential to be advance with the times. Experimental implementations were conducted under constrained computational and memory resources, evaluating the proposed method's performance on benchmark datasets including GQA, CLEVR, and VizWiz-VQA-Grounding. Comparative analyses with baseline methods demonstrate the robust competitiveness of LCVO.

3D Visual Grounding (3DVG) aims at localizing 3D object based on textual descriptions. Conventional supervised methods for 3DVG often necessitate extensive annotations and a predefined vocabulary, which can be restrictive. To address this issue, we propose a novel visual programming approach for zero-shot open-vocabulary 3DVG, leveraging the capabilities of large language models (LLMs). Our approach begins with a unique dialog-based method, engaging with LLMs to establish a foundational understanding of zero-shot 3DVG. Building on this, we design a visual program that consists of three types of modules, i.e., view-independent, view-dependent, and functional modules. These modules, specifically tailored for 3D scenarios, work collaboratively to perform complex reasoning and inference. Furthermore, we develop an innovative language-object correlation module to extend the scope of existing 3D object detectors into open-vocabulary scenarios. Extensive experiments demonstrate that our zero-shot approach can outperform some supervised baselines, marking a significant stride towards effective 3DVG.

Large language models (LLMs) have demonstrated remarkable capabilities in natural language understanding and generation across various domains, including medicine. We present a comprehensive evaluation of GPT-4, a state-of-the-art LLM, on medical competency examinations and benchmark datasets. GPT-4 is a general-purpose model that is not specialized for medical problems through training or engineered to solve clinical tasks. Our analysis covers two sets of official practice materials for the USMLE, a three-step examination program used to assess clinical competency and grant licensure in the United States. We also evaluate performance on the MultiMedQA suite of benchmark datasets. Beyond measuring model performance, experiments were conducted to investigate the influence of test questions containing both text and images on model performance, probe for memorization of content during training, and study probability calibration, which is of critical importance in high-stakes applications like medicine. Our results show that GPT-4, without any specialized prompt crafting, exceeds the passing score on USMLE by over 20 points and outperforms earlier general-purpose models (GPT-3.5) as well as models specifically fine-tuned on medical knowledge (Med-PaLM, a prompt-tuned version of Flan-PaLM 540B). In addition, GPT-4 is significantly better calibrated than GPT-3.5, demonstrating a much-improved ability to predict the likelihood that its answers are correct. We also explore the behavior of the model qualitatively through a case study that shows the ability of GPT-4 to explain medical reasoning, personalize explanations to students, and interactively craft new counterfactual scenarios around a medical case. Implications of the findings are discussed for potential uses of GPT-4 in medical education, assessment, and clinical practice, with appropriate attention to challenges of accuracy and safety.

This paper introduces MedTrinity-25M, a comprehensive, large-scale multimodal dataset for medicine, covering over 25 million images across 10 modalities, with multigranular annotations for more than 65 diseases. These enriched annotations encompass both global textual information, such as disease/lesion type, modality, region-specific descriptions, and inter-regional relationships, as well as detailed local annotations for regions of interest (ROIs), including bounding boxes, segmentation masks. Unlike existing approach which is limited by the availability of image-text pairs, we have developed the first automated pipeline that scales up multimodal data by generating multigranular visual and texual annotations (in the form of image-ROI-description triplets) without the need for any paired text descriptions. Specifically, data from over 90 different sources have been collected, preprocessed, and grounded using domain-specific expert models to identify ROIs related to abnormal regions. We then build a comprehensive knowledge base and prompt multimodal large language models to perform retrieval-augmented generation with the identified ROIs as guidance, resulting in multigranular texual descriptions. Compared to existing datasets, MedTrinity-25M provides the most enriched annotations, supporting a comprehensive range of multimodal tasks such as captioning and report generation, as well as vision-centric tasks like classification and segmentation. Pretraining on MedTrinity-25M, our model achieves state-of-the-art performance on VQA-RAD and PathVQA, surpassing both multimodal large language models and other representative SoTA approaches. This dataset can also be utilized to support large-scale pre-training of multimodal medical AI models, contributing to the development of future foundation models in the medical domain.

Recently, vision model pre-training has evolved from relying on manually annotated datasets to leveraging large-scale, web-crawled image-text data. Despite these advances, there is no pre-training method that effectively exploits the interleaved image-text data, which is very prevalent on the Internet. Inspired by the recent success of compression learning in natural language processing, we propose a novel vision model pre-training method called Latent Compression Learning (LCL) for interleaved image-text data. This method performs latent compression learning by maximizing the mutual information between the inputs and outputs of a causal attention model. The training objective can be decomposed into two basic tasks: 1) contrastive learning between visual representation and preceding context, and 2) generating subsequent text based on visual representation. Our experiments demonstrate that our method not only matches the performance of CLIP on paired pre-training datasets (e.g., LAION), but can also leverage interleaved pre-training data (e.g., MMC4) to learn robust visual representation from scratch, showcasing the potential of vision model pre-training with interleaved image-text data. Code is released at https://github.com/OpenGVLab/LCL.

Over 85 million computed tomography (CT) scans are performed annually in the US, of which approximately one quarter focus on the abdomen. Given the current radiologist shortage, there is a large impetus to use artificial intelligence to alleviate the burden of interpreting these complex imaging studies. Prior state-of-the-art approaches for automated medical image interpretation leverage vision language models (VLMs). However, current medical VLMs are generally limited to 2D images and short reports, and do not leverage electronic health record (EHR) data for supervision. We introduce Merlin - a 3D VLM that we train using paired CT scans (6+ million images from 15,331 CTs), EHR diagnosis codes (1.8+ million codes), and radiology reports (6+ million tokens). We evaluate Merlin on 6 task types and 752 individual tasks. The non-adapted (off-the-shelf) tasks include zero-shot findings classification (31 findings), phenotype classification (692 phenotypes), and zero-shot cross-modal retrieval (image to findings and image to impressions), while model adapted tasks include 5-year disease prediction (6 diseases), radiology report generation, and 3D semantic segmentation (20 organs). We perform internal validation on a test set of 5,137 CTs, and external validation on 7,000 clinical CTs and on two public CT datasets (VerSe, TotalSegmentator). Beyond these clinically-relevant evaluations, we assess the efficacy of various network architectures and training strategies to depict that Merlin has favorable performance to existing task-specific baselines. We derive data scaling laws to empirically assess training data needs for requisite downstream task performance. Furthermore, unlike conventional VLMs that require hundreds of GPUs for training, we perform all training on a single GPU.

We present DeepSeek-VL, an open-source Vision-Language (VL) Model designed for real-world vision and language understanding applications. Our approach is structured around three key dimensions: We strive to ensure our data is diverse, scalable, and extensively covers real-world scenarios including web screenshots, PDFs, OCR, charts, and knowledge-based content, aiming for a comprehensive representation of practical contexts. Further, we create a use case taxonomy from real user scenarios and construct an instruction tuning dataset accordingly. The fine-tuning with this dataset substantially improves the model's user experience in practical applications. Considering efficiency and the demands of most real-world scenarios, DeepSeek-VL incorporates a hybrid vision encoder that efficiently processes high-resolution images (1024 x 1024), while maintaining a relatively low computational overhead. This design choice ensures the model's ability to capture critical semantic and detailed information across various visual tasks. We posit that a proficient Vision-Language Model should, foremost, possess strong language abilities. To ensure the preservation of LLM capabilities during pretraining, we investigate an effective VL pretraining strategy by integrating LLM training from the beginning and carefully managing the competitive dynamics observed between vision and language modalities. The DeepSeek-VL family (both 1.3B and 7B models) showcases superior user experiences as a vision-language chatbot in real-world applications, achieving state-of-the-art or competitive performance across a wide range of visual-language benchmarks at the same model size while maintaining robust performance on language-centric benchmarks. We have made both 1.3B and 7B models publicly accessible to foster innovations based on this foundation model.

During surgical training, real-time feedback from trainers to trainees is important for preventing errors and enhancing long-term skill acquisition. Accurately predicting the effectiveness of this feedback, specifically whether it leads to a change in trainee behavior, is crucial for developing methods for improving surgical training and education. However, relying on human annotations to assess feedback effectiveness is laborious and prone to biases, underscoring the need for an automated, scalable, and objective method. Creating such an automated system poses challenges, as it requires an understanding of both the verbal feedback delivered by the trainer and the visual context of the real-time surgical scene. To address this, we propose a method that integrates information from transcribed verbal feedback and corresponding surgical video to predict feedback effectiveness. Our findings show that both transcribed feedback and surgical video are individually predictive of trainee behavior changes, and their combination achieves an AUROC of 0.70+/-0.02, improving prediction accuracy by up to 6.6%. Additionally, we introduce self-supervised fine-tuning as a strategy for enhancing surgical video representation learning, which is scalable and further enhances prediction performance. Our results demonstrate the potential of multi-modal learning to advance the automated assessment of surgical feedback.

This work focuses on the potential of Vision LLMs (VLLMs) in visual reasoning. Different from prior studies, we shift our focus from evaluating standard performance to introducing a comprehensive safety evaluation suite, covering both out-of-distribution (OOD) generalization and adversarial robustness. For the OOD evaluation, we present two novel VQA datasets, each with one variant, designed to test model performance under challenging conditions. In exploring adversarial robustness, we propose a straightforward attack strategy for misleading VLLMs to produce visual-unrelated responses. Moreover, we assess the efficacy of two jailbreaking strategies, targeting either the vision or language component of VLLMs. Our evaluation of 21 diverse models, ranging from open-source VLLMs to GPT-4V, yields interesting observations: 1) Current VLLMs struggle with OOD texts but not images, unless the visual information is limited; and 2) These VLLMs can be easily misled by deceiving vision encoders only, and their vision-language training often compromise safety protocols. We release this safety evaluation suite at https://github.com/UCSC-VLAA/vllm-safety-benchmark.

Vision language models (VLMs) have experienced rapid advancements through the integration of large language models (LLMs) with image-text pairs, yet they struggle with detailed regional visual understanding due to limited spatial awareness of the vision encoder, and the use of coarse-grained training data that lacks detailed, region-specific captions. To address this, we introduce RegionGPT (short as RGPT), a novel framework designed for complex region-level captioning and understanding. RGPT enhances the spatial awareness of regional representation with simple yet effective modifications to existing visual encoders in VLMs. We further improve performance on tasks requiring a specific output scope by integrating task-guided instruction prompts during both training and inference phases, while maintaining the model's versatility for general-purpose tasks. Additionally, we develop an automated region caption data generation pipeline, enriching the training set with detailed region-level captions. We demonstrate that a universal RGPT model can be effectively applied and significantly enhancing performance across a range of region-level tasks, including but not limited to complex region descriptions, reasoning, object classification, and referring expressions comprehension.

Several recent works seek to develop foundation models specifically for medical applications, adapting general-purpose large language models (LLMs) and vision-language models (VLMs) via continued pretraining on publicly available biomedical corpora. These works typically claim that such domain-adaptive pretraining (DAPT) improves performance on downstream medical tasks, such as answering medical licensing exam questions. In this paper, we compare ten public "medical" LLMs and two VLMs against their corresponding base models, arriving at a different conclusion: all medical VLMs and nearly all medical LLMs fail to consistently improve over their base models in the zero-/few-shot prompting and supervised fine-tuning regimes for medical question-answering (QA). For instance, across all tasks and model pairs we consider in the 3-shot setting, medical LLMs only outperform their base models in 22.7% of cases, reach a (statistical) tie in 36.8% of cases, and are significantly worse than their base models in the remaining 40.5% of cases. Our conclusions are based on (i) comparing each medical model head-to-head, directly against the corresponding base model; (ii) optimizing the prompts for each model separately in zero-/few-shot prompting; and (iii) accounting for statistical uncertainty in comparisons. While these basic practices are not consistently adopted in the literature, our ablations show that they substantially impact conclusions. Meanwhile, we find that after fine-tuning on specific QA tasks, medical LLMs can show performance improvements, but the benefits do not carry over to tasks based on clinical notes. Our findings suggest that state-of-the-art general-domain models may already exhibit strong medical knowledge and reasoning capabilities, and offer recommendations to strengthen the conclusions of future studies.

Vision-Language Models (VLMs) such as GPT-4V have recently demonstrated incredible strides on diverse vision language tasks. We dig into vision-based deductive reasoning, a more sophisticated but less explored realm, and find previously unexposed blindspots in the current SOTA VLMs. Specifically, we leverage Raven's Progressive Matrices (RPMs), to assess VLMs' abilities to perform multi-hop relational and deductive reasoning relying solely on visual clues. We perform comprehensive evaluations of several popular VLMs employing standard strategies such as in-context learning, self-consistency, and Chain-of-thoughts (CoT) on three diverse datasets, including the Mensa IQ test, IntelligenceTest, and RAVEN. The results reveal that despite the impressive capabilities of LLMs in text-based reasoning, we are still far from achieving comparable proficiency in visual deductive reasoning. We found that certain standard strategies that are effective when applied to LLMs do not seamlessly translate to the challenges presented by visual reasoning tasks. Moreover, a detailed analysis reveals that VLMs struggle to solve these tasks mainly because they are unable to perceive and comprehend multiple, confounding abstract patterns in RPM examples.

There is enormous enthusiasm and concerns in using large language models (LLMs) in healthcare, yet current assumptions are all based on general-purpose LLMs such as ChatGPT. This study develops a clinical generative LLM, GatorTronGPT, using 277 billion words of mixed clinical and English text with a GPT-3 architecture of 20 billion parameters. GatorTronGPT improves biomedical natural language processing for medical research. Synthetic NLP models trained using GatorTronGPT generated text outperform NLP models trained using real-world clinical text. Physicians Turing test using 1 (worst) to 9 (best) scale shows that there is no significant difference in linguistic readability (p = 0.22; 6.57 of GatorTronGPT compared with 6.93 of human) and clinical relevance (p = 0.91; 7.0 of GatorTronGPT compared with 6.97 of human) and that physicians cannot differentiate them (p < 0.001). This study provides insights on the opportunities and challenges of LLMs for medical research and healthcare.

This technical report delves into the application of GPT-4 Vision (GPT-4V) in the nuanced realm of COVID-19 image classification, leveraging the transformative potential of in-context learning to enhance diagnostic processes.

Scene Graph Generation (SGG) converts visual scenes into structured graph representations, providing deeper scene understanding for complex vision tasks. However, existing SGG models often overlook essential spatial relationships and struggle with generalization in open-vocabulary contexts. To address these limitations, we propose LLaVA-SpaceSGG, a multimodal large language model (MLLM) designed for open-vocabulary SGG with enhanced spatial relation modeling. To train it, we collect the SGG instruction-tuning dataset, named SpaceSGG. This dataset is constructed by combining publicly available datasets and synthesizing data using open-source models within our data construction pipeline. It combines object locations, object relations, and depth information, resulting in three data formats: spatial SGG description, question-answering, and conversation. To enhance the transfer of MLLMs' inherent capabilities to the SGG task, we introduce a two-stage training paradigm. Experiments show that LLaVA-SpaceSGG outperforms other open-vocabulary SGG methods, boosting recall by 8.6% and mean recall by 28.4% compared to the baseline. Our codebase, dataset, and trained models are publicly accessible on GitHub at the following URL: https://github.com/Endlinc/LLaVA-SpaceSGG.

Prompt learning is a new paradigm in the Natural Language Processing (NLP) field which has shown impressive performance on a number of natural language tasks with common benchmarking text datasets in full, few-shot, and zero-shot train-evaluation setups. Recently, it has even been observed that large but frozen pre-trained language models (PLMs) with prompt learning outperform smaller but fine-tuned models. However, as with many recent NLP trends, the performance of even the largest PLMs such as GPT-3 do not perform well on specialized domains (e.g. medical text), and the common practice to achieve State of the Art (SoTA) results still consists of pre-training and fine-tuning the PLMs on downstream tasks. The reliance on fine-tuning large PLMs is problematic in clinical settings where data is often held in non-GPU environments, and more resource efficient methods of training specialized domain models is crucial. We investigated the viability of prompt learning on clinically meaningful decision tasks and directly compared with more traditional fine-tuning methods. Results are partially in line with the prompt learning literature, with prompt learning able to match or improve on traditional fine-tuning with substantially fewer trainable parameters and requiring less training data. We argue that prompt learning therefore provides lower computational resource costs applicable to clinical settings, that can serve as an alternative to fine-tuning ever increasing in size PLMs. Complementary code to reproduce experiments presented in this work can be found at: https://github.com/NtaylorOX/Public_Clinical_Prompt.

Medical image classification in radiology faces significant challenges, particularly in generalizing to unseen pathologies. In contrast, CLIP offers a promising solution by leveraging multimodal learning to improve zero-shot classification performance. However, in the medical domain, lesions can be small and might not be well represented in the embedding space. Therefore, in this paper, we explore the potential of visual prompt engineering to enhance the capabilities of Vision Language Models (VLMs) in radiology. Leveraging BiomedCLIP, trained on extensive biomedical image-text pairs, we investigate the impact of embedding visual markers directly within radiological images to guide the model's attention to critical regions. Our evaluation on the JSRT dataset, focusing on lung nodule malignancy classification, demonstrates that incorporating visual prompts x2013 such as arrows, circles, and contours x2013 significantly improves classification metrics including AUROC, AUPRC, F1 score, and accuracy. Moreover, the study provides attention maps, showcasing enhanced model interpretability and focus on clinically relevant areas. These findings underscore the efficacy of visual prompt engineering as a straightforward yet powerful approach to advance VLM performance in medical image analysis.

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.

Vision Transformer (ViT) based Vision-Language Pre-training (VLP) models have demonstrated impressive performance in various tasks. However, the lengthy visual token sequences fed into ViT can lead to training inefficiency and ineffectiveness. Existing efforts address the challenge by either bottom-level patch extraction in the ViT backbone or top-level patch abstraction outside, not balancing training efficiency and effectiveness well. Inspired by text summarization in natural language processing, we propose a Bottom-Up Patch Summarization approach named BUS, coordinating bottom-level extraction and top-level abstraction to learn a concise summary of lengthy visual token sequences efficiently. Specifically, We incorporate a Text-Semantics-Aware Patch Selector (TSPS) into the ViT backbone to perform a coarse-grained visual token extraction and then attach a flexible Transformer-based Patch Abstraction Decoder (PAD) upon the backbone for top-level visual abstraction. This bottom-up collaboration enables our BUS to yield high training efficiency while maintaining or even improving effectiveness. We evaluate our approach on various visual-language understanding and generation tasks and show competitive downstream task performance while boosting the training efficiency by 50\%. Additionally, our model achieves state-of-the-art performance on many downstream tasks by increasing input image resolution without increasing computational costs over baselines.

Large-scale pre-training has shown promising results on the vision-and-language navigation (VLN) task. However, most existing pre-training methods employ discrete panoramas to learn visual-textual associations. This requires the model to implicitly correlate incomplete, duplicate observations within the panoramas, which may impair an agent's spatial understanding. Thus, we propose a new map-based pre-training paradigm that is spatial-aware for use in VLN. Concretely, we build a local metric map to explicitly aggregate incomplete observations and remove duplicates, while modeling navigation dependency in a global topological map. This hybrid design can balance the demand of VLN for both short-term reasoning and long-term planning. Then, based on the hybrid map, we devise a pre-training framework to learn a multimodal map representation, which enhances spatial-aware cross-modal reasoning thereby facilitating the language-guided navigation goal. Extensive experiments demonstrate the effectiveness of the map-based pre-training route for VLN, and the proposed method achieves state-of-the-art on four VLN benchmarks.

Pre-trained vision-language models~(VLMs) are the de-facto foundation models for various downstream tasks. However, scene text recognition methods still prefer backbones pre-trained on a single modality, namely, the visual modality, despite the potential of VLMs to serve as powerful scene text readers. For example, CLIP can robustly identify regular (horizontal) and irregular (rotated, curved, blurred, or occluded) text in images. With such merits, we transform CLIP into a scene text reader and introduce CLIP4STR, a simple yet effective STR method built upon image and text encoders of CLIP. It has two encoder-decoder branches: a visual branch and a cross-modal branch. The visual branch provides an initial prediction based on the visual feature, and the cross-modal branch refines this prediction by addressing the discrepancy between the visual feature and text semantics. To fully leverage the capabilities of both branches, we design a dual predict-and-refine decoding scheme for inference. We scale CLIP4STR in terms of the model size, pre-training data, and training data, achieving state-of-the-art performance on 11 STR benchmarks. Additionally, a comprehensive empirical study is provided to enhance the understanding of the adaptation of CLIP to STR. We believe our method establishes a simple yet strong baseline for future STR research with VLMs.

Despite recent advances in Vision-Language Models (VLMs), many still over-rely on visual language priors present in their training data rather than true visual reasoning. To examine the situation, we introduce ViLP, a visual question answering (VQA) benchmark that pairs each question with three potential answers and three corresponding images: one image whose answer can be inferred from text alone, and two images that demand visual reasoning. By leveraging image generative models, we ensure significant variation in texture, shape, conceptual combinations, hallucinated elements, and proverb-based contexts, making our benchmark images distinctly out-of-distribution. While humans achieve near-perfect accuracy, modern VLMs falter; for instance, GPT-4 achieves only 66.17% on ViLP. To alleviate this, we propose a self-improving framework in which models generate new VQA pairs and images, then apply pixel-level and semantic corruptions to form "good-bad" image pairs for self-training. Our training objectives compel VLMs to focus more on actual visual inputs and have demonstrated their effectiveness in enhancing the performance of open-source VLMs, including LLaVA-v1.5 and Cambrian.

Pre-trained Vision Language Models (VLMs) have demonstrated notable progress in various zero-shot tasks, such as classification and retrieval. Despite their performance, because improving performance on new tasks requires task-specific knowledge, their adaptation is essential. While labels are needed for the adaptation, acquiring them is typically expensive. To overcome this challenge, active learning, a method of achieving a high performance by obtaining labels for a small number of samples from experts, has been studied. Active learning primarily focuses on selecting unlabeled samples for labeling and leveraging them to train models. In this study, we pose the question, "how can the pre-trained VLMs be adapted under the active learning framework?" In response to this inquiry, we observe that (1) simply applying a conventional active learning framework to pre-trained VLMs even may degrade performance compared to random selection because of the class imbalance in labeling candidates, and (2) the knowledge of VLMs can provide hints for achieving the balance before labeling. Based on these observations, we devise a novel active learning framework for VLMs, denoted as PCB. To assess the effectiveness of our approach, we conduct experiments on seven different real-world datasets, and the results demonstrate that PCB surpasses conventional active learning and random sampling methods. Code will be available in https://github.com/kaist-dmlab/pcb .

Pre-trained multi-modal vision-language models (VLMs) are becoming increasingly popular due to their exceptional performance on downstream vision applications, particularly in the few- and zero-shot settings. However, selecting the best-performing VLM for some downstream applications is non-trivial, as it is dataset and task-dependent. Meanwhile, the exhaustive evaluation of all available VLMs on a novel application is not only time and computationally demanding but also necessitates the collection of a labeled dataset for evaluation. As the number of open-source VLM variants increases, there is a need for an efficient model selection strategy that does not require access to a curated evaluation dataset. This paper proposes a novel task and benchmark for efficiently evaluating VLMs' zero-shot performance on downstream applications without access to the downstream task dataset. Specifically, we introduce a new task LOVM: Language-Only Vision Model Selection, where methods are expected to perform both model selection and performance prediction based solely on a text description of the desired downstream application. We then introduced an extensive LOVM benchmark consisting of ground-truth evaluations of 35 pre-trained VLMs and 23 datasets, where methods are expected to rank the pre-trained VLMs and predict their zero-shot performance.

Human-scene vision-language tasks are increasingly prevalent in diverse social applications, yet recent advancements predominantly rely on models specifically tailored to individual tasks. Emerging research indicates that large vision-language models (VLMs) can enhance performance across various downstream vision-language understanding tasks. However, general-domain models often underperform in specialized fields. This study introduces a domain-specific Large Vision-Language Model, Human-Scene Vision-Language Model (HumanVLM), designed to provide a foundation for human-scene Vision-Language tasks. Specifically, (1) we create a large-scale human-scene multimodal image-text dataset (HumanCaption-10M) sourced from the Internet to facilitate domain-specific alignment; (2) develop a captioning approach for human-centered images, capturing human faces, bodies, and backgrounds, and construct a high-quality Human-Scene image-text dataset (HumanCaptionHQ, about 311k pairs) that contain as much detailed information as possible about human; (3) Using HumanCaption-10M and HumanCaptionHQ, we train a HumanVLM. In the experiments, we then evaluate our HumanVLM across varous downstream tasks, where it demonstrates superior overall performance among multimodal models of comparable scale, particularly excelling in human-related tasks and significantly outperforming similar models, including Qwen2VL and ChatGPT-4o. HumanVLM, alongside the data introduced, will stimulate the research in human-around fields.

Vision-Language Models (VLMs) have transformed tasks requiring visual and reasoning abilities, such as image retrieval and Visual Question Answering (VQA). Despite their success, VLMs face significant challenges with tasks involving geometric reasoning, algebraic problem-solving, and counting. These limitations stem from difficulties effectively integrating multiple modalities and accurately interpreting geometry-related tasks. Various works claim that introducing a captioning pipeline before VQA tasks enhances performance. We incorporated this pipeline for tasks involving geometry, algebra, and counting. We found that captioning results are not generalizable, specifically with larger VLMs primarily trained on downstream QnA tasks showing random performance on math-related challenges. However, we present a promising alternative: task-based prompting, enriching the prompt with task-specific guidance. This approach shows promise and proves more effective than direct captioning methods for math-heavy problems.

Large language models have demonstrated robust performance on various language tasks using zero-shot or few-shot learning paradigms. While being actively researched, multimodal models that can additionally handle images as input have yet to catch up in size and generality with language-only models. In this work, we ask whether language-only models can be utilised for tasks that require visual input -- but also, as we argue, often require a strong reasoning component. Similar to some recent related work, we make visual information accessible to the language model using separate verbalisation models. Specifically, we investigate the performance of open-source, open-access language models against GPT-3 on five vision-language tasks when given textually-encoded visual information. Our results suggest that language models are effective for solving vision-language tasks even with limited samples. This approach also enhances the interpretability of a model's output by providing a means of tracing the output back through the verbalised image content.

Vision Language Models (VLMs) demonstrate remarkable proficiency in addressing a wide array of visual questions, which requires strong perception and reasoning faculties. Assessing these two competencies independently is crucial for model refinement, despite the inherent difficulty due to the intertwined nature of seeing and reasoning in existing VLMs. To tackle this issue, we present Prism, an innovative framework designed to disentangle the perception and reasoning processes involved in visual question solving. Prism comprises two distinct stages: a perception stage that utilizes a VLM to extract and articulate visual information in textual form, and a reasoning stage that formulates responses based on the extracted visual information using a Large Language Model (LLM). This modular design enables the systematic comparison and assessment of both proprietary and open-source VLM for their perception and reasoning strengths. Our analytical framework provides several valuable insights, underscoring Prism's potential as a cost-effective solution for vision-language tasks. By combining a streamlined VLM focused on perception with a powerful LLM tailored for reasoning, Prism achieves superior results in general vision-language tasks while substantially cutting down on training and operational expenses. Quantitative evaluations show that Prism, when configured with a vanilla 2B LLaVA and freely accessible GPT-3.5, delivers performance on par with VLMs 10 times larger on the rigorous multimodal benchmark MMStar. The project is released at: https://github.com/SparksJoe/Prism.

Performing robotic grasping from a cluttered bin based on human instructions is a challenging task, as it requires understanding both the nuances of free-form language and the spatial relationships between objects. Vision-Language Models (VLMs) trained on web-scale data, such as GPT-4o, have demonstrated remarkable reasoning capabilities across both text and images. But can they truly be used for this task in a zero-shot setting? And what are their limitations? In this paper, we explore these research questions via the free-form language-based robotic grasping task, and propose a novel method, FreeGrasp, leveraging the pre-trained VLMs' world knowledge to reason about human instructions and object spatial arrangements. Our method detects all objects as keypoints and uses these keypoints to annotate marks on images, aiming to facilitate GPT-4o's zero-shot spatial reasoning. This allows our method to determine whether a requested object is directly graspable or if other objects must be grasped and removed first. Since no existing dataset is specifically designed for this task, we introduce a synthetic dataset FreeGraspData by extending the MetaGraspNetV2 dataset with human-annotated instructions and ground-truth grasping sequences. We conduct extensive analyses with both FreeGraspData and real-world validation with a gripper-equipped robotic arm, demonstrating state-of-the-art performance in grasp reasoning and execution. Project website: https://tev-fbk.github.io/FreeGrasp/.

Surgical scene perception via videos are critical for advancing robotic surgery, telesurgery, and AI-assisted surgery, particularly in ophthalmology. However, the scarcity of diverse and richly annotated video datasets has hindered the development of intelligent systems for surgical workflow analysis. Existing datasets for surgical workflow analysis, which typically face challenges such as small scale, a lack of diversity in surgery and phase categories, and the absence of time-localized annotations, limit the requirements for action understanding and model generalization validation in complex and diverse real-world surgical scenarios. To address this gap, we introduce OphNet, a large-scale, expert-annotated video benchmark for ophthalmic surgical workflow understanding. OphNet features: 1) A diverse collection of 2,278 surgical videos spanning 66 types of cataract, glaucoma, and corneal surgeries, with detailed annotations for 102 unique surgical phases and 150 granular operations; 2) It offers sequential and hierarchical annotations for each surgery, phase, and operation, enabling comprehensive understanding and improved interpretability; 3) Moreover, OphNet provides time-localized annotations, facilitating temporal localization and prediction tasks within surgical workflows. With approximately 205 hours of surgical videos, OphNet is about 20 times larger than the largest existing surgical workflow analysis benchmark. Our dataset and code have been made available at: https://github.com/minghu0830/OphNet-benchmark.

Vision Language Models (VLMs) extend remarkable capabilities of text-only large language models and vision-only models, and are able to learn from and process multi-modal vision-text input. While modern VLMs perform well on a number of standard image classification and image-text matching tasks, they still struggle with a number of crucial vision-language (VL) reasoning abilities such as counting and spatial reasoning. Moreover, while they might be very brittle to small variations in instructions and/or evaluation protocols, existing benchmarks fail to evaluate their robustness (or rather the lack of it). In order to couple challenging VL scenarios with comprehensive robustness evaluation, we introduce DARE, Diverse Visual Question Answering with Robustness Evaluation, a carefully created and curated multiple-choice VQA benchmark. DARE evaluates VLM performance on five diverse categories and includes four robustness-oriented evaluations based on the variations of: prompts, the subsets of answer options, the output format and the number of correct answers. Among a spectrum of other findings, we report that state-of-the-art VLMs still struggle with questions in most categories and are unable to consistently deliver their peak performance across the tested robustness evaluations. The worst case performance across the subsets of options is up to 34% below the performance in the standard case. The robustness of the open-source VLMs such as LLaVA 1.6 and Idefics2 cannot match the closed-source models such as GPT-4 and Gemini, but even the latter remain very brittle to different variations.

VLMs (Vision-Language Models) extend the capabilities of LLMs (Large Language Models) to accept multimodal inputs. Since it has been verified that LLMs can be induced to generate harmful or inaccurate content through specific test cases (termed as Red Teaming), how VLMs perform in similar scenarios, especially with their combination of textual and visual inputs, remains a question. To explore this problem, we present a novel red teaming dataset RTVLM, which encompasses 10 subtasks (e.g., image misleading, multi-modal jail-breaking, face fairness, etc) under 4 primary aspects (faithfulness, privacy, safety, fairness). Our RTVLM is the first red-teaming dataset to benchmark current VLMs in terms of these 4 different aspects. Detailed analysis shows that 10 prominent open-sourced VLMs struggle with the red teaming in different degrees and have up to 31% performance gap with GPT-4V. Additionally, we simply apply red teaming alignment to LLaVA-v1.5 with Supervised Fine-tuning (SFT) using RTVLM, and this bolsters the models' performance with 10% in RTVLM test set, 13% in MM-Hal, and without noticeable decline in MM-Bench, overpassing other LLaVA-based models with regular alignment data. This reveals that current open-sourced VLMs still lack red teaming alignment. Our code and datasets will be open-source.

Recent advancements in vision-language models (VLMs), such as CLIP, have demonstrated substantial success in self-supervised representation learning for vision tasks. However, effectively adapting VLMs to downstream applications remains challenging, as their accuracy often depends on time-intensive and expertise-demanding prompt engineering, while full model fine-tuning is costly. This is particularly true for biomedical images, which, unlike natural images, typically suffer from limited annotated datasets, unintuitive image contrasts, and nuanced visual features. Recent prompt learning techniques, such as Context Optimization (CoOp) intend to tackle these issues, but still fall short in generalizability. Meanwhile, explorations in prompt learning for biomedical image analysis are still highly limited. In this work, we propose BiomedCoOp, a novel prompt learning framework that enables efficient adaptation of BiomedCLIP for accurate and highly generalizable few-shot biomedical image classification. Our approach achieves effective prompt context learning by leveraging semantic consistency with average prompt ensembles from Large Language Models (LLMs) and knowledge distillation with a statistics-based prompt selection strategy. We conducted comprehensive validation of our proposed framework on 11 medical datasets across 9 modalities and 10 organs against existing state-of-the-art methods, demonstrating significant improvements in both accuracy and generalizability. The code is publicly available at https://github.com/HealthX-Lab/BiomedCoOp.

Multi-modality promises to unlock further uses for large language models. Recently, the state-of-the-art language model GPT-4 was enhanced with vision capabilities. We carry out a prompting evaluation of GPT-4V and five other baselines on structured reasoning tasks, such as mathematical reasoning, visual data analysis, and code generation. We show that visual Chain-of-Thought, an extension of Chain-of-Thought to multi-modal LLMs, yields significant improvements over the vanilla model. We also present a categorized analysis of scenarios where these models perform well and where they struggle, highlighting challenges associated with coherent multimodal reasoning.

While Vision Language Models (VLMs) are impressive in tasks such as visual question answering (VQA) and image captioning, their ability to apply multi-step reasoning to images has lagged, giving rise to perceptions of modality imbalance or brittleness. Towards systematic study of such issues, we introduce a synthetic framework for assessing the ability of VLMs to perform algorithmic visual reasoning (AVR), comprising three tasks: Table Readout, Grid Navigation, and Visual Analogy. Each has two levels of difficulty, SIMPLE and HARD, and even the SIMPLE versions are difficult for frontier VLMs. We seek strategies for training on the SIMPLE version of the tasks that improve performance on the corresponding HARD task, i.e., S2H generalization. This synthetic framework, where each task also has a text-only version, allows a quantification of the modality imbalance, and how it is impacted by training strategy. Ablations highlight the importance of explicit image-to-text conversion in promoting S2H generalization when using auto-regressive training. We also report results of mechanistic study of this phenomenon, including a measure of gradient alignment that seems to identify training strategies that promote better S2H generalization.

Glaucoma is the number one cause of irreversible blindness globally. A major challenge for accurate glaucoma detection and progression forecasting is the bottleneck of limited labeled patients with the state-of-the-art (SOTA) 3D retinal imaging data of optical coherence tomography (OCT). To address the data scarcity issue, this paper proposes two solutions. First, we develop a novel generalization-reinforced semi-supervised learning (SSL) model called pseudo supervisor to optimally utilize unlabeled data. Compared with SOTA models, the proposed pseudo supervisor optimizes the policy of predicting pseudo labels with unlabeled samples to improve empirical generalization. Our pseudo supervisor model is evaluated with two clinical tasks consisting of glaucoma detection and progression forecasting. The progression forecasting task is evaluated both unimodally and multimodally. Our pseudo supervisor model demonstrates superior performance than SOTA SSL comparison models. Moreover, our model also achieves the best results on the publicly available LAG fundus dataset. Second, we introduce the Harvard Glaucoma Detection and Progression (Harvard-GDP) Dataset, a multimodal multitask dataset that includes data from 1,000 patients with OCT imaging data, as well as labels for glaucoma detection and progression. This is the largest glaucoma detection dataset with 3D OCT imaging data and the first glaucoma progression forecasting dataset that is publicly available. Detailed sex and racial analysis are provided, which can be used by interested researchers for fairness learning studies. Our released dataset is benchmarked with several SOTA supervised CNN and transformer deep learning models. The dataset and code are made publicly available via https://ophai.hms.harvard.edu/datasets/harvard-gdp1000.

Large vision language models (LVLMs) integrate large language models (LLMs) with pre-trained vision encoders, thereby activating the perception capability of the model to understand image inputs for different queries and conduct subsequent reasoning. Improving this capability requires high-quality vision-language data, which is costly and labor-intensive to acquire. Self-training approaches have been effective in single-modal settings to alleviate the need for labeled data by leveraging model's own generation. However, effective self-training remains a challenge regarding the unique visual perception and reasoning capability of LVLMs. To address this, we introduce Self-Training on Image Comprehension (STIC), which emphasizes a self-training approach specifically for image comprehension. First, the model self-constructs a preference dataset for image descriptions using unlabeled images. Preferred responses are generated through a step-by-step prompt, while dis-preferred responses are generated from either corrupted images or misleading prompts. To further self-improve reasoning on the extracted visual information, we let the model reuse a small portion of existing instruction-tuning data and append its self-generated image descriptions to the prompts. We validate the effectiveness of STIC across seven different benchmarks, demonstrating substantial performance gains of 4.0% on average while using 70% less supervised fine-tuning data than the current method. Further studies investigate various components of STIC and highlight its potential to leverage vast quantities of unlabeled images for self-training. Code and data are made publicly available.

Continual pre-training has increasingly become the predominant approach for adapting Large Language Models (LLMs) to new domains. This process involves updating the pre-trained LLM with a corpus from a new domain, resulting in a shift in the training distribution. To study the behavior of LLMs during this shift, we measured the model's performance throughout the continual pre-training process. we observed a temporary performance drop at the beginning, followed by a recovery phase, a phenomenon known as the "stability gap," previously noted in vision models classifying new classes. To address this issue and enhance LLM performance within a fixed compute budget, we propose three effective strategies: (1) Continually pre-training the LLM on a subset with a proper size for multiple epochs, resulting in faster performance recovery than pre-training the LLM on a large corpus in a single epoch; (2) Pre-training the LLM only on high-quality sub-corpus, which rapidly boosts domain performance; and (3) Using a data mixture similar to the pre-training data to reduce distribution gap. We conduct various experiments on Llama-family models to validate the effectiveness of our strategies in both medical continual pre-training and instruction tuning. For example, our strategies improve the average medical task performance of the OpenLlama-3B model from 36.2% to 40.7% with only 40% of the original training budget and enhance the average general task performance without causing forgetting. Furthermore, we apply our strategies to the Llama-3-8B model. The resulting model, Llama-3-Physician, achieves the best medical performance among current open-source models, and performs comparably to or even better than GPT-4 on several medical benchmarks. We release our models at https://huggingface.co/YiDuo1999/Llama-3-Physician-8B-Instruct.

Large language models (LLMs), after being aligned with vision models and integrated into vision-language models (VLMs), can bring impressive improvement in image reasoning tasks. This was shown by the recently released GPT-4V(ison), LLaVA-1.5, etc. However, the strong language prior in these SOTA LVLMs can be a double-edged sword: they may ignore the image context and solely rely on the (even contradictory) language prior for reasoning. In contrast, the vision modules in VLMs are weaker than LLMs and may result in misleading visual representations, which are then translated to confident mistakes by LLMs. To study these two types of VLM mistakes, i.e., language hallucination and visual illusion, we curated HallusionBench, an image-context reasoning benchmark that is still challenging to even GPT-4V and LLaVA-1.5. We provide a detailed analysis of examples in HallusionBench, which sheds novel insights on the illusion or hallucination of VLMs and how to improve them in the future. The benchmark and codebase will be released at https://github.com/tianyi-lab/HallusionBench.

In today's interconnected globe, moving abroad is more and more prevalent, whether it's for employment, refugee resettlement, or other causes. Language difficulties between natives and immigrants present a common issue on a daily basis, especially in medical domain. This can make it difficult for patients and doctors to communicate during anamnesis or in the emergency room, which compromises patient care. The goal of the HYKIST Project is to develop a speech translation system to support patient-doctor communication with ASR and MT. ASR systems have recently displayed astounding performance on particular tasks for which enough quantities of training data are available, such as LibriSpeech. Building a good model is still difficult due to a variety of speaking styles, acoustic and recording settings, and a lack of in-domain training data. In this thesis, we describe our efforts to construct ASR systems for a conversational telephone speech recognition task in the medical domain for Vietnamese language to assist emergency room contact between doctors and patients across linguistic barriers. In order to enhance the system's performance, we investigate various training schedules and data combining strategies. We also examine how best to make use of the little data that is available. The use of publicly accessible models like XLSR-53 is compared to the use of customized pre-trained models, and both supervised and unsupervised approaches are utilized using wav2vec 2.0 as architecture.

Vision-Language Models (VLMs) such as CLIP are trained on large amounts of image-text pairs, resulting in remarkable generalization across several data distributions. The prohibitively expensive training and data collection/curation costs of these models make them valuable Intellectual Property (IP) for organizations. This motivates a vendor-client paradigm, where a vendor trains a large-scale VLM and grants only input-output access to clients on a pay-per-query basis in a black-box setting. The client aims to minimize inference cost by distilling the VLM to a student model using the limited available task-specific data, and further deploying this student model in the downstream application. While naive distillation largely improves the In-Domain (ID) accuracy of the student, it fails to transfer the superior out-of-distribution (OOD) generalization of the VLM teacher using the limited available labeled images. To mitigate this, we propose Vision-Language to Vision-Align, Distill, Predict (VL2V-ADiP), which first aligns the vision and language modalities of the teacher model with the vision modality of a pre-trained student model, and further distills the aligned VLM embeddings to the student. This maximally retains the pre-trained features of the student, while also incorporating the rich representations of the VLM image encoder and the superior generalization of the text embeddings. The proposed approach achieves state-of-the-art results on the standard Domain Generalization benchmarks in a black-box teacher setting, and also when weights of the VLM are accessible.

Medical visual question answering (VQA) aims to answer clinically relevant questions regarding input medical images. This technique has the potential to improve the efficiency of medical professionals while relieving the burden on the public health system, particularly in resource-poor countries. Existing medical VQA methods tend to encode medical images and learn the correspondence between visual features and questions without exploiting the spatial, semantic, or medical knowledge behind them. This is partially because of the small size of the current medical VQA dataset, which often includes simple questions. Therefore, we first collected a comprehensive and large-scale medical VQA dataset, focusing on chest X-ray images. The questions involved detailed relationships, such as disease names, locations, levels, and types in our dataset. Based on this dataset, we also propose a novel baseline method by constructing three different relationship graphs: spatial relationship, semantic relationship, and implicit relationship graphs on the image regions, questions, and semantic labels. The answer and graph reasoning paths are learned for different questions.

Large vision-language models (LVLMs) are ignorant of the up-to-date knowledge, such as LLaVA series, because they cannot be updated frequently due to the large amount of resources required, and therefore fail in many cases. For example, if a LVLM was released on January 2024, and it wouldn't know the detailed plot of the new movie Dune 2, which wasn't released until February 2024. To solve the problem, a promising solution is to provide LVLMs with up-to-date knowledge via internet search during inference, i.e., internet-augmented generation (IAG), which is already integrated in some closed-source commercial LVLMs such as GPT-4V. However, the specific mechanics underpinning them remain a mystery. In this paper, we propose a plug-and-play framework, for augmenting existing LVLMs in handling visual question answering (VQA) about up-to-date knowledge, dubbed UDKAG. A hierarchical filtering model is trained to effectively and efficiently find the most helpful content from the websites returned by a search engine to prompt LVLMs with up-to-date knowledge. To train the model and evaluate our framework's performance, we propose a pipeline to automatically generate news-related VQA samples to construct a dataset, dubbed UDK-VQA. A multi-model voting mechanism is introduced to label the usefulness of website/content for VQA samples to construct the training set. Experimental results demonstrate the effectiveness of our framework, outperforming GPT-4V by about 25% in accuracy.

Large language models (LLMs) have demonstrated a powerful ability to answer various queries as a general-purpose assistant. The continuous multi-modal large language models (MLLM) empower LLMs with the ability to perceive visual signals. The launch of GPT-4 (Generative Pre-trained Transformers) has generated significant interest in the research communities. GPT-4V(ison) has demonstrated significant power in both academia and industry fields, as a focal point in a new artificial intelligence generation. Though significant success was achieved by GPT-4V, exploring MLLMs in domain-specific analysis (e.g., marine analysis) that required domain-specific knowledge and expertise has gained less attention. In this study, we carry out the preliminary and comprehensive case study of utilizing GPT-4V for marine analysis. This report conducts a systematic evaluation of existing GPT-4V, assessing the performance of GPT-4V on marine research and also setting a new standard for future developments in MLLMs. The experimental results of GPT-4V show that the responses generated by GPT-4V are still far away from satisfying the domain-specific requirements of the marine professions. All images and prompts used in this study will be available at https://github.com/hkust-vgd/Marine_GPT-4V_Eval

To effectively exploit the potential of large-scale models, various pre-training strategies supported by massive data from different sources are proposed, including supervised pre-training, weakly-supervised pre-training, and self-supervised pre-training. It has been proved that combining multiple pre-training strategies and data from various modalities/sources can greatly boost the training of large-scale models. However, current works adopt a multi-stage pre-training system, where the complex pipeline may increase the uncertainty and instability of the pre-training. It is thus desirable that these strategies can be integrated in a single-stage manner. In this paper, we first propose a general multi-modal mutual information formula as a unified optimization target and demonstrate that all existing approaches are special cases of our framework. Under this unified perspective, we propose an all-in-one single-stage pre-training approach, named Maximizing Multi-modal Mutual Information Pre-training (M3I Pre-training). Our approach achieves better performance than previous pre-training methods on various vision benchmarks, including ImageNet classification, COCO object detection, LVIS long-tailed object detection, and ADE20k semantic segmentation. Notably, we successfully pre-train a billion-level parameter image backbone and achieve state-of-the-art performance on various benchmarks. Code shall be released at https://github.com/OpenGVLab/M3I-Pretraining.

Large vision-language models (LVLMs) have demonstrated remarkable achievements, yet the generation of non-factual responses remains prevalent in fact-seeking question answering (QA). Current multimodal fact-seeking benchmarks primarily focus on comparing model outputs to ground truth answers, providing limited insights into the performance of modality-specific modules. To bridge this gap, we introduce VisualSimpleQA, a multimodal fact-seeking benchmark with two key features. First, it enables streamlined and decoupled evaluation of LVLMs in visual and linguistic modalities. Second, it incorporates well-defined difficulty criteria to guide human annotation and facilitates the extraction of a challenging subset, VisualSimpleQA-hard. Experiments on 15 LVLMs show that even state-of-the-art models such as GPT-4o achieve merely 60%+ correctness in multimodal fact-seeking QA on VisualSimpleQA and 30%+ on VisualSimpleQA-hard. Furthermore, the decoupled evaluation across these models highlights substantial opportunities for improvement in both visual and linguistic modules. The dataset is available at https://huggingface.co/datasets/WYLing/VisualSimpleQA.