Daily Papers

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.

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.

Foundation models, often pre-trained with large-scale data, have achieved paramount success in jump-starting various vision and language applications. Recent advances further enable adapting foundation models in downstream tasks efficiently using only a few training samples, e.g., in-context learning. Yet, the application of such learning paradigms in medical image analysis remains scarce due to the shortage of publicly accessible data and benchmarks. In this paper, we aim at approaches adapting the foundation models for medical image classification and present a novel dataset and benchmark for the evaluation, i.e., examining the overall performance of accommodating the large-scale foundation models downstream on a set of diverse real-world clinical tasks. We collect five sets of medical imaging data from multiple institutes targeting a variety of real-world clinical tasks (22,349 images in total), i.e., thoracic diseases screening in X-rays, pathological lesion tissue screening, lesion detection in endoscopy images, neonatal jaundice evaluation, and diabetic retinopathy grading. Results of multiple baseline methods are demonstrated using the proposed dataset from both accuracy and cost-effective perspectives.

Chest X-rays (CXRs) are the most frequently performed imaging test in clinical practice. Recent advances in the development of vision-language foundation models (FMs) give rise to the possibility of performing automated CXR interpretation, which can assist physicians with clinical decision-making and improve patient outcomes. However, developing FMs that can accurately interpret CXRs is challenging due to the (1) limited availability of large-scale vision-language datasets in the medical image domain, (2) lack of vision and language encoders that can capture the complexities of medical data, and (3) absence of evaluation frameworks for benchmarking the abilities of FMs on CXR interpretation. In this work, we address these challenges by first introducing CheXinstruct - a large-scale instruction-tuning dataset curated from 28 publicly-available datasets. We then present CheXagent - an instruction-tuned FM capable of analyzing and summarizing CXRs. To build CheXagent, we design a clinical large language model (LLM) for parsing radiology reports, a vision encoder for representing CXR images, and a network to bridge the vision and language modalities. Finally, we introduce CheXbench - a novel benchmark designed to systematically evaluate FMs across 8 clinically-relevant CXR interpretation tasks. Extensive quantitative evaluations and qualitative reviews with five expert radiologists demonstrate that CheXagent outperforms previously-developed general- and medical-domain FMs on CheXbench tasks. Furthermore, in an effort to improve model transparency, we perform a fairness evaluation across factors of sex, race and age to highlight potential performance disparities. Our project is at https://stanford-aimi.github.io/chexagent.html.

Medical Visual Question Answering (Med-VQA) combines computer vision and natural language processing to automatically answer clinical inquiries about medical images. However, current Med-VQA datasets exhibit two significant limitations: (1) they often lack visual and textual explanations for answers, hindering comprehension for patients and junior doctors; (2) they typically offer a narrow range of question formats, inadequately reflecting the diverse requirements in practical scenarios. These limitations pose significant challenges to the development of a reliable and user-friendly Med-VQA system. To address these challenges, we introduce a large-scale, Groundable, and Explainable Medical VQA benchmark for chest X-ray diagnosis (GEMeX), featuring several innovative components: (1) a multi-modal explainability mechanism that offers detailed visual and textual explanations for each question-answer pair, thereby enhancing answer comprehensibility; (2) four question types, open-ended, closed-ended, single-choice, and multiple-choice, to better reflect practical needs. With 151,025 images and 1,605,575 questions, GEMeX is the currently largest chest X-ray VQA dataset. Evaluation of 12 representative large vision language models (LVLMs) on GEMeX reveals suboptimal performance, underscoring the dataset's complexity. Meanwhile, we propose a strong model by fine-tuning an existing LVLM on the GEMeX training set. The substantial performance improvement showcases the dataset's effectiveness. The benchmark is available at https://www.med-vqa.com/GEMeX.

In many real-world applications, deployed models encounter inputs that differ from the data seen during training. Out-of-distribution detection identifies whether an input stems from an unseen distribution, while open-world recognition flags such inputs to ensure the system remains robust as ever-emerging, previously unknown categories appear and must be addressed without retraining. Foundation and vision-language models are pre-trained on large and diverse datasets with the expectation of broad generalization across domains, including medical imaging. However, benchmarking these models on test sets with only a few common outlier types silently collapses the evaluation back to a closed-set problem, masking failures on rare or truly novel conditions encountered in clinical use. We therefore present NOVA, a challenging, real-life evaluation-only benchmark of sim900 brain MRI scans that span 281 rare pathologies and heterogeneous acquisition protocols. Each case includes rich clinical narratives and double-blinded expert bounding-box annotations. Together, these enable joint assessment of anomaly localisation, visual captioning, and diagnostic reasoning. Because NOVA is never used for training, it serves as an extreme stress-test of out-of-distribution generalisation: models must bridge a distribution gap both in sample appearance and in semantic space. Baseline results with leading vision-language models (GPT-4o, Gemini 2.0 Flash, and Qwen2.5-VL-72B) reveal substantial performance drops across all tasks, establishing NOVA as a rigorous testbed for advancing models that can detect, localize, and reason about truly unknown anomalies.

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.

Artificial intelligence has significantly impacted medical applications, particularly with the advent of Medical Large Vision Language Models (Med-LVLMs), sparking optimism for the future of automated and personalized healthcare. However, the trustworthiness of Med-LVLMs remains unverified, posing significant risks for future model deployment. In this paper, we introduce CARES and aim to comprehensively evaluate the Trustworthiness of Med-LVLMs across the medical domain. We assess the trustworthiness of Med-LVLMs across five dimensions, including trustfulness, fairness, safety, privacy, and robustness. CARES comprises about 41K question-answer pairs in both closed and open-ended formats, covering 16 medical image modalities and 27 anatomical regions. Our analysis reveals that the models consistently exhibit concerns regarding trustworthiness, often displaying factual inaccuracies and failing to maintain fairness across different demographic groups. Furthermore, they are vulnerable to attacks and demonstrate a lack of privacy awareness. We publicly release our benchmark and code in https://github.com/richard-peng-xia/CARES.

The recent emergence of Medical Large Vision Language Models (Med-LVLMs) has enhanced medical diagnosis. However, current Med-LVLMs frequently encounter factual issues, often generating responses that do not align with established medical facts. Retrieval-Augmented Generation (RAG), which utilizes external knowledge, can improve the factual accuracy of these models but introduces two major challenges. First, limited retrieved contexts might not cover all necessary information, while excessive retrieval can introduce irrelevant and inaccurate references, interfering with the model's generation. Second, in cases where the model originally responds correctly, applying RAG can lead to an over-reliance on retrieved contexts, resulting in incorrect answers. To address these issues, we propose RULE, which consists of two components. First, we introduce a provably effective strategy for controlling factuality risk through the calibrated selection of the number of retrieved contexts. Second, based on samples where over-reliance on retrieved contexts led to errors, we curate a preference dataset to fine-tune the model, balancing its dependence on inherent knowledge and retrieved contexts for generation. We demonstrate the effectiveness of RULE on three medical VQA datasets, achieving an average improvement of 20.8% in factual accuracy. We publicly release our benchmark and code in https://github.com/richard-peng-xia/RULE.

Medical Vision-Language Models (MVLMs) have achieved par excellence generalization in medical image analysis, yet their performance under noisy, corrupted conditions remains largely untested. Clinical imaging is inherently susceptible to acquisition artifacts and noise; however, existing evaluations predominantly assess generally clean datasets, overlooking robustness -- i.e., the model's ability to perform under real-world distortions. To address this gap, we first introduce MediMeta-C, a corruption benchmark that systematically applies several perturbations across multiple medical imaging datasets. Combined with MedMNIST-C, this establishes a comprehensive robustness evaluation framework for MVLMs. We further propose RobustMedCLIP, a visual encoder adaptation of a pretrained MVLM that incorporates few-shot tuning to enhance resilience against corruptions. Through extensive experiments, we benchmark 5 major MVLMs across 5 medical imaging modalities, revealing that existing models exhibit severe degradation under corruption and struggle with domain-modality tradeoffs. Our findings highlight the necessity of diverse training and robust adaptation strategies, demonstrating that efficient low-rank adaptation when paired with few-shot tuning, improves robustness while preserving generalization across modalities.

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.

Compound figures, which are multi-panel composites containing diverse subfigures, are ubiquitous in biomedical literature, yet large-scale subfigure extraction remains largely unaddressed. Prior work on subfigure extraction has been limited in both dataset size and generalizability, leaving a critical open question: How does high-fidelity image-text alignment via large-scale subfigure extraction impact representation learning in vision-language models? We address this gap by introducing a scalable subfigure extraction pipeline based on transformer-based object detection, trained on a synthetic corpus of 500,000 compound figures, and achieving state-of-the-art performance on both ImageCLEF 2016 and synthetic benchmarks. Using this pipeline, we release OPEN-PMC-18M, a large-scale high quality biomedical vision-language dataset comprising 18 million clinically relevant subfigure-caption pairs spanning radiology, microscopy, and visible light photography. We train and evaluate vision-language models on our curated datasets and show improved performance across retrieval, zero-shot classification, and robustness benchmarks, outperforming existing baselines. We release our dataset, models, and code to support reproducible benchmarks and further study into biomedical vision-language modeling and representation learning.

We perform a comprehensive benchmarking of contrastive frameworks for learning multimodal representations in the medical domain. Through this study, we aim to answer the following research questions: (i) How transferable are general-domain representations to the medical domain? (ii) Is multimodal contrastive training sufficient, or does it benefit from unimodal training as well? (iii) What is the impact of feature granularity on the effectiveness of multimodal medical representation learning? To answer these questions, we investigate eight contrastive learning approaches under identical training setups, and train them on 2.8 million image-text pairs from four datasets, and evaluate them on 25 downstream tasks, including classification (zero-shot and linear probing), image-to-text and text-to-image retrieval, and visual question-answering. Our findings suggest a positive answer to the first question, a negative answer to the second question, and the benefit of learning fine-grained features. Finally, we make our code publicly available.

Large-scale Vision-Language Models (LVLMs) have significantly advanced with text-aligned vision inputs. They have made remarkable progress in computer vision tasks by aligning text modality with vision inputs. There are also endeavors to incorporate multi-vision sensors beyond RGB, including thermal, depth, and medical X-ray images. However, we observe that current LVLMs view images taken from multi-vision sensors as if they were in the same RGB domain without considering the physical characteristics of multi-vision sensors. They fail to convey the fundamental multi-vision sensor information from the dataset and the corresponding contextual knowledge properly. Consequently, alignment between the information from the actual physical environment and the text is not achieved correctly, making it difficult to answer complex sensor-related questions that consider the physical environment. In this paper, we aim to establish a multi-vision Sensor Perception And Reasoning benchmarK called SPARK that can reduce the fundamental multi-vision sensor information gap between images and multi-vision sensors. We generated 6,248 vision-language test samples automatically to investigate multi-vision sensory perception and multi-vision sensory reasoning on physical sensor knowledge proficiency across different formats, covering different types of sensor-related questions. We utilized these samples to assess ten leading LVLMs. The results showed that most models displayed deficiencies in multi-vision sensory reasoning to varying extents. Codes and data are available at https://github.com/top-yun/SPARK

Vision-Language Models (VLMs) have shown promise in various 2D visual tasks, yet their readiness for 3D clinical diagnosis remains unclear due to stringent demands for recognition precision, reasoning ability, and domain knowledge. To systematically evaluate these dimensions, we present DeepTumorVQA, a diagnostic visual question answering (VQA) benchmark targeting abdominal tumors in CT scans. It comprises 9,262 CT volumes (3.7M slices) from 17 public datasets, with 395K expert-level questions spanning four categories: Recognition, Measurement, Visual Reasoning, and Medical Reasoning. DeepTumorVQA introduces unique challenges, including small tumor detection and clinical reasoning across 3D anatomy. Benchmarking four advanced VLMs (RadFM, M3D, Merlin, CT-CHAT), we find current models perform adequately on measurement tasks but struggle with lesion recognition and reasoning, and are still not meeting clinical needs. Two key insights emerge: (1) large-scale multimodal pretraining plays a crucial role in DeepTumorVQA testing performance, making RadFM stand out among all VLMs. (2) Our dataset exposes critical differences in VLM components, where proper image preprocessing and design of vision modules significantly affect 3D perception. To facilitate medical multimodal research, we have released DeepTumorVQA as a rigorous benchmark: https://github.com/Schuture/DeepTumorVQA.

Vision-Language Models (VLMs) have shown impressive performance in vision tasks, but adapting them to new domains often requires expensive fine-tuning. Prompt tuning techniques, including textual, visual, and multimodal prompting, offer efficient alternatives by leveraging learnable prompts. However, their application to Vision-Language Segmentation Models (VLSMs) and evaluation under significant domain shifts remain unexplored. This work presents an open-source benchmarking framework, TuneVLSeg, to integrate various unimodal and multimodal prompt tuning techniques into VLSMs, making prompt tuning usable for downstream segmentation datasets with any number of classes. TuneVLSeg includes 6 prompt tuning strategies on various prompt depths used in 2 VLSMs totaling of 8 different combinations. We test various prompt tuning on 8 diverse medical datasets, including 3 radiology datasets (breast tumor, echocardiograph, chest X-ray pathologies) and 5 non-radiology datasets (polyp, ulcer, skin cancer), and two natural domain segmentation datasets. Our study found that textual prompt tuning struggles under significant domain shifts, from natural-domain images to medical data. Furthermore, visual prompt tuning, with fewer hyperparameters than multimodal prompt tuning, often achieves performance competitive to multimodal approaches, making it a valuable first attempt. Our work advances the understanding and applicability of different prompt-tuning techniques for robust domain-specific segmentation. The source code is available at https://github.com/naamiinepal/tunevlseg.

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.

Zero-shot medical detection can further improve detection performance without relying on annotated medical images even upon the fine-tuned model, showing great clinical value. Recent studies leverage grounded vision-language models (GLIP) to achieve this by using detailed disease descriptions as prompts for the target disease name during the inference phase. However, these methods typically treat prompts as equivalent context to the target name, making it difficult to assign specific disease knowledge based on visual information, leading to a coarse alignment between images and target descriptions. In this paper, we propose StructuralGLIP, which introduces an auxiliary branch to encode prompts into a latent knowledge bank layer-by-layer, enabling more context-aware and fine-grained alignment. Specifically, in each layer, we select highly similar features from both the image representation and the knowledge bank, forming structural representations that capture nuanced relationships between image patches and target descriptions. These features are then fused across modalities to further enhance detection performance. Extensive experiments demonstrate that StructuralGLIP achieves a +4.1\% AP improvement over prior state-of-the-art methods across seven zero-shot medical detection benchmarks, and consistently improves fine-tuned models by +3.2\% AP on endoscopy image datasets.

Large Vision-Language Models (LVLMs) are increasingly being explored for applications in telemedicine, yet their ability to engage with diverse patient behaviors remains underexplored. We introduce 3MDBench (Medical Multimodal Multi-agent Dialogue Benchmark), an open-source evaluation framework designed to assess LLM-driven medical consultations. Unlike existing benchmarks, 3MDBench simulates real-world patient variability by incorporating four temperament-driven Patient Agents and an Assessor Agent that evaluates diagnostic accuracy and dialogue quality. The benchmark integrates textual and image-based patient data across 34 common diagnoses, mirroring real-world telemedicine interactions. Under different diagnostic strategies, we evaluate state-of-the-art LVLMs. Our findings demonstrate that incorporating dialogue improves the F1 score from 50.4 to 54.2 compared to non-dialogue settings, underscoring the value of context-driven, information-seeking questioning. Additionally, we demonstrate that multimodal inputs enhance diagnostic efficiency. Image-supported models outperform text-only counterparts by raising the diagnostic F1 score from 52.8 to 54.2 in a similar dialogue setting. Finally, we suggest an approach that improves the diagnostic F1-score to 70.3 by training the CNN model on the diagnosis prediction task and incorporating its top-3 predictions into the LVLM context. 3MDBench provides a reproducible and extendable evaluation framework for AI-driven medical assistants. It offers insights into how patient temperament, dialogue strategies, and multimodal reasoning influence diagnosis quality. By addressing real-world complexities in telemedicine, our benchmark paves the way for more empathetic, reliable, and context-aware AI-driven healthcare solutions. The source code of our benchmark is publicly available: https://github.com/univanxx/3mdbench

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/

Medical vision-language models (VLMs) have shown promise as clinical assistants across various medical fields. However, specialized dermatology VLM capable of delivering professional and detailed diagnostic analysis remains underdeveloped, primarily due to less specialized text descriptions in current dermatology multimodal datasets. To address this issue, we propose MM-Skin, the first large-scale multimodal dermatology dataset that encompasses 3 imaging modalities, including clinical, dermoscopic, and pathological and nearly 10k high-quality image-text pairs collected from professional textbooks. In addition, we generate over 27k diverse, instruction-following vision question answering (VQA) samples (9 times the size of current largest dermatology VQA dataset). Leveraging public datasets and MM-Skin, we developed SkinVL, a dermatology-specific VLM designed for precise and nuanced skin disease interpretation. Comprehensive benchmark evaluations of SkinVL on VQA, supervised fine-tuning (SFT) and zero-shot classification tasks across 8 datasets, reveal its exceptional performance for skin diseases in comparison to both general and medical VLM models. The introduction of MM-Skin and SkinVL offers a meaningful contribution to advancing the development of clinical dermatology VLM assistants. MM-Skin is available at https://github.com/ZwQ803/MM-Skin

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.

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.

Many practical vision-language applications require models that understand negation, e.g., when using natural language to retrieve images which contain certain objects but not others. Despite advancements in vision-language models (VLMs) through large-scale training, their ability to comprehend negation remains underexplored. This study addresses the question: how well do current VLMs understand negation? We introduce NegBench, a new benchmark designed to evaluate negation understanding across 18 task variations and 79k examples spanning image, video, and medical datasets. The benchmark consists of two core tasks designed to evaluate negation understanding in diverse multimodal settings: Retrieval with Negation and Multiple Choice Questions with Negated Captions. Our evaluation reveals that modern VLMs struggle significantly with negation, often performing at chance level. To address these shortcomings, we explore a data-centric approach wherein we finetune CLIP models on large-scale synthetic datasets containing millions of negated captions. We show that this approach can result in a 10% increase in recall on negated queries and a 40% boost in accuracy on multiple-choice questions with negated captions.

Recent progress in Large Vision-Language Models (LVLMs) has enabled promising applications in medical tasks, such as report generation and visual question answering. However, existing benchmarks focus mainly on the final diagnostic answer, offering limited insight into whether models engage in clinically meaningful reasoning. To address this, we present CheXStruct and CXReasonBench, a structured pipeline and benchmark built on the publicly available MIMIC-CXR-JPG dataset. CheXStruct automatically derives a sequence of intermediate reasoning steps directly from chest X-rays, such as segmenting anatomical regions, deriving anatomical landmarks and diagnostic measurements, computing diagnostic indices, and applying clinical thresholds. CXReasonBench leverages this pipeline to evaluate whether models can perform clinically valid reasoning steps and to what extent they can learn from structured guidance, enabling fine-grained and transparent assessment of diagnostic reasoning. The benchmark comprises 18,988 QA pairs across 12 diagnostic tasks and 1,200 cases, each paired with up to 4 visual inputs, and supports multi-path, multi-stage evaluation including visual grounding via anatomical region selection and diagnostic measurements. Even the strongest of 10 evaluated LVLMs struggle with structured reasoning and generalization, often failing to link abstract knowledge with anatomically grounded visual interpretation. The code is available at https://github.com/ttumyche/CXReasonBench

Recent proprietary models (e.g., o3) have begun to demonstrate strong multimodal reasoning capabilities. Yet, most existing open-source research concentrates on training text-only reasoning models, with evaluations limited to mainly mathematical and general-domain tasks. Therefore, it remains unclear how to effectively extend reasoning capabilities beyond text input and general domains. This paper explores a fundamental research question: Is reasoning generalizable across modalities and domains? Our findings support an affirmative answer: General-domain text-based post-training can enable such strong generalizable reasoning. Leveraging this finding, we introduce X-Reasoner, a vision-language model post-trained solely on general-domain text for generalizable reasoning, using a two-stage approach: an initial supervised fine-tuning phase with distilled long chain-of-thoughts, followed by reinforcement learning with verifiable rewards. Experiments show that X-Reasoner successfully transfers reasoning capabilities to both multimodal and out-of-domain settings, outperforming existing state-of-the-art models trained with in-domain and multimodal data across various general and medical benchmarks (Figure 1). Additionally, we find that X-Reasoner's performance in specialized domains can be further enhanced through continued training on domain-specific text-only data. Building upon this, we introduce X-Reasoner-Med, a medical-specialized variant that achieves new state of the art on numerous text-only and multimodal medical benchmarks.

Despite the impressive performance of deep networks in vision, language, and healthcare, unpredictable behaviors on samples from the distribution different than the training distribution cause severe problems in deployment. For better reliability of neural-network-based classifiers, we define a new task, natural attribute-based shift (NAS) detection, to detect the samples shifted from the training distribution by some natural attribute such as age of subjects or brightness of images. Using the natural attributes present in existing datasets, we introduce benchmark datasets in vision, language, and medical for NAS detection. Further, we conduct an extensive evaluation of prior representative out-of-distribution (OOD) detection methods on NAS datasets and observe an inconsistency in their performance. To understand this, we provide an analysis on the relationship between the location of NAS samples in the feature space and the performance of distance- and confidence-based OOD detection methods. Based on the analysis, we split NAS samples into three categories and further suggest a simple modification to the training objective to obtain an improved OOD detection method that is capable of detecting samples from all NAS categories.

Multimodal language models (MLMs) show promise for clinical decision support and diagnostic reasoning, raising the prospect of end-to-end automated medical image interpretation. However, clinicians are highly selective in adopting AI tools; a model that makes errors on seemingly simple perception tasks such as determining image orientation or identifying whether a CT scan is contrast-enhance are unlikely to be adopted for clinical tasks. We introduce Medblink, a benchmark designed to probe these models for such perceptual abilities. Medblink spans eight clinically meaningful tasks across multiple imaging modalities and anatomical regions, totaling 1,429 multiple-choice questions over 1,605 images. We evaluate 19 state-of-the-art MLMs, including general purpose (GPT4o, Claude 3.5 Sonnet) and domain specific (Med Flamingo, LLaVA Med, RadFM) models. While human annotators achieve 96.4% accuracy, the best-performing model reaches only 65%. These results show that current MLMs frequently fail at routine perceptual checks, suggesting the need to strengthen their visual grounding to support clinical adoption. Data is available on our project page.

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.

Multimodal large language models (MLLMs) have made significant strides, yet they face challenges in the medical domain due to limited specialized knowledge. While recent medical MLLMs demonstrate strong performance in lab settings, they often struggle in real-world applications, highlighting a substantial gap between research and practice. In this paper, we seek to address this gap at various stages of the end-to-end learning pipeline, including data collection, model fine-tuning, and evaluation. At the data collection stage, we introduce SemiHVision, a dataset that combines human annotations with automated augmentation techniques to improve both medical knowledge representation and diagnostic reasoning. For model fine-tuning, we trained PMC-Cambrian-8B-AN over 2400 H100 GPU hours, resulting in performance that surpasses public medical models like HuatuoGPT-Vision-34B (79.0% vs. 66.7%) and private general models like Claude3-Opus (55.7%) on traditional benchmarks such as SLAKE and VQA-RAD. In the evaluation phase, we observed that traditional benchmarks cannot accurately reflect realistic clinical task capabilities. To overcome this limitation and provide more targeted guidance for model evaluation, we introduce the JAMA Clinical Challenge, a novel benchmark specifically designed to evaluate diagnostic reasoning. On this benchmark, PMC-Cambrian-AN achieves state-of-the-art performance with a GPT-4 score of 1.29, significantly outperforming HuatuoGPT-Vision-34B (1.13) and Claude3-Opus (1.17), demonstrating its superior diagnostic reasoning abilities.

The accelerating development of general medical artificial intelligence (GMAI), powered by multimodal large language models (MLLMs), offers transformative potential for addressing persistent healthcare challenges, including workforce deficits and escalating costs. The parallel development of systematic evaluation benchmarks emerges as a critical imperative to enable performance assessment and provide technological guidance. Meanwhile, as an invaluable knowledge source, the potential of medical textbooks for benchmark development remains underexploited. Here, we present MedBookVQA, a systematic and comprehensive multimodal benchmark derived from open-access medical textbooks. To curate this benchmark, we propose a standardized pipeline for automated extraction of medical figures while contextually aligning them with corresponding medical narratives. Based on this curated data, we generate 5,000 clinically relevant questions spanning modality recognition, disease classification, anatomical identification, symptom diagnosis, and surgical procedures. A multi-tier annotation system categorizes queries through hierarchical taxonomies encompassing medical imaging modalities (42 categories), body anatomies (125 structures), and clinical specialties (31 departments), enabling nuanced analysis across medical subdomains. We evaluate a wide array of MLLMs, including proprietary, open-sourced, medical, and reasoning models, revealing significant performance disparities across task types and model categories. Our findings highlight critical capability gaps in current GMAI systems while establishing textbook-derived multimodal benchmarks as essential evaluation tools. MedBookVQA establishes textbook-derived benchmarking as a critical paradigm for advancing clinical AI, exposing limitations in GMAI systems while providing anatomically structured performance metrics across specialties.

Current benchmarks for assessing vision-language models (VLMs) often focus on their perception or problem-solving capabilities and neglect other critical aspects such as fairness, multilinguality, or toxicity. Furthermore, they differ in their evaluation procedures and the scope of the evaluation, making it difficult to compare models. To address these issues, we extend the HELM framework to VLMs to present the Holistic Evaluation of Vision Language Models (VHELM). VHELM aggregates various datasets to cover one or more of the 9 aspects: visual perception, knowledge, reasoning, bias, fairness, multilinguality, robustness, toxicity, and safety. In doing so, we produce a comprehensive, multi-dimensional view of the capabilities of the VLMs across these important factors. In addition, we standardize the standard inference parameters, methods of prompting, and evaluation metrics to enable fair comparisons across models. Our framework is designed to be lightweight and automatic so that evaluation runs are cheap and fast. Our initial run evaluates 22 VLMs on 21 existing datasets to provide a holistic snapshot of the models. We uncover new key findings, such as the fact that efficiency-focused models (e.g., Claude 3 Haiku or Gemini 1.5 Flash) perform significantly worse than their full models (e.g., Claude 3 Opus or Gemini 1.5 Pro) on the bias benchmark but not when evaluated on the other aspects. For transparency, we release the raw model generations and complete results on our website (https://crfm.stanford.edu/helm/vhelm/v2.0.1). VHELM is intended to be a living benchmark, and we hope to continue adding new datasets and models over time.

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.

Large vision-language models have recently achieved remarkable progress, exhibiting great perception and reasoning abilities concerning visual information. However, how to effectively evaluate these large vision-language models remains a major obstacle, hindering future model development. Traditional benchmarks like VQAv2 or COCO Caption provide quantitative performance measurements but suffer from a lack of fine-grained ability assessment and non-robust evaluation metrics. Recent subjective benchmarks, such as OwlEval, offer comprehensive evaluations of a model's abilities by incorporating human labor, but they are not scalable and display significant bias. In response to these challenges, we propose MMBench, a novel multi-modality benchmark. MMBench methodically develops a comprehensive evaluation pipeline, primarily comprised of two elements. The first element is a meticulously curated dataset that surpasses existing similar benchmarks in terms of the number and variety of evaluation questions and abilities. The second element introduces a novel CircularEval strategy and incorporates the use of ChatGPT. This implementation is designed to convert free-form predictions into pre-defined choices, thereby facilitating a more robust evaluation of the model's predictions. MMBench is a systematically-designed objective benchmark for robustly evaluating the various abilities of vision-language models. We hope MMBench will assist the research community in better evaluating their models and encourage future advancements in this domain. Project page: https://opencompass.org.cn/mmbench.

The recent emergence of Large Vision-Language Models(VLMs) has resulted in a variety of different benchmarks for evaluating such models. Despite this, we observe that most existing evaluation methods suffer from the fact that they either require the model to choose from pre-determined responses, sacrificing open-endedness, or evaluate responses using a judge model, resulting in subjective and unreliable evaluation. In addition, we observe a lack of benchmarks for VLMs in the Korean language, which are necessary as a separate metric from more common English language benchmarks, as the performance of generative language models can differ significantly based on the language being used. Therefore, we present KOFFVQA, a general-purpose free-form visual question answering benchmark in the Korean language for the evaluation of VLMs. Our benchmark consists of 275 carefully crafted questions each paired with an image and grading criteria covering 10 different aspects of VLM performance. The grading criteria eliminate the problem of unreliability by allowing the judge model to grade each response based on a pre-determined set of rules. By defining the evaluation criteria in an objective manner, even a small open-source model can be used to evaluate models on our benchmark reliably. In addition to evaluating a large number of existing VLMs on our benchmark, we also experimentally verify that our method of using pre-existing grading criteria for evaluation is much more reliable than existing methods. Our evaluation code is available at https://github.com/maum-ai/KOFFVQA

Large Vision-Language Models (LVLMs) have demonstrated outstanding performance across various multimodal tasks. However, they suffer from a problem known as language prior, where responses are generated based solely on textual patterns while disregarding image information. Addressing the issue of language prior is crucial, as it can lead to undesirable biases or hallucinations when dealing with images that are out of training distribution. Despite its importance, current methods for accurately measuring language priors in LVLMs are poorly studied. Although existing benchmarks based on counterfactual or out-of-distribution images can partially be used to measure language priors, they fail to disentangle language priors from other confounding factors. To this end, we propose a new benchmark called VLind-Bench, which is the first benchmark specifically designed to measure the language priors, or blindness, of LVLMs. It not only includes tests on counterfactual images to assess language priors but also involves a series of tests to evaluate more basic capabilities such as commonsense knowledge, visual perception, and commonsense biases. For each instance in our benchmark, we ensure that all these basic tests are passed before evaluating the language priors, thereby minimizing the influence of other factors on the assessment. The evaluation and analysis of recent LVLMs in our benchmark reveal that almost all models exhibit a significant reliance on language priors, presenting a strong challenge in the field.

Current benchmarks for evaluating Vision Language Models (VLMs) often fall short in thoroughly assessing model abilities to understand and process complex visual and textual content. They typically focus on simple tasks that do not require deep reasoning or the integration of multiple data modalities to solve an original problem. To address this gap, we introduce the PARROT-360V Benchmark, a novel and comprehensive benchmark featuring 2487 challenging visual puzzles designed to test VLMs on complex visual reasoning tasks. We evaluated leading models: GPT-4o, Claude-3.5-Sonnet, and Gemini-1.5-Pro, using PARROT-360V to assess their capabilities in combining visual clues with language skills to solve tasks in a manner akin to human problem-solving. Our findings reveal a notable performance gap: state-of-the-art models scored between 28 to 56 percentage on our benchmark, significantly lower than their performance on popular benchmarks. This underscores the limitations of current VLMs in handling complex, multi-step reasoning tasks and highlights the need for more robust evaluation frameworks to advance the field.

Joint vision-language models have shown great performance over a diverse set of tasks. However, little is known about their limitations, as the high dimensional space learned by these models makes it difficult to identify semantic errors. Recent work has addressed this problem by designing highly controlled probing task benchmarks. Our paper introduces a more scalable solution that relies on already annotated benchmarks. Our method consists of extracting a large set of diverse features from a vision-language benchmark and measuring their correlation with the output of the target model. We confirm previous findings that CLIP behaves like a bag of words model and performs better with nouns and verbs; we also uncover novel insights such as CLIP getting confused by concrete words. Our framework is available at https://github.com/MichiganNLP/Scalable-VLM-Probing and can be used with other multimodal models and benchmarks.

Recent advances in large language models (LLMs) have demonstrated notable performance in medical licensing exams. However, comprehensive evaluation of LLMs across various healthcare roles, particularly in high-stakes clinical scenarios, remains a challenge. Existing benchmarks are typically text-based, English-centric, and focus primarily on medicines, which limits their ability to assess broader healthcare knowledge and multimodal reasoning. To address these gaps, we introduce KokushiMD-10, the first multimodal benchmark constructed from ten Japanese national healthcare licensing exams. This benchmark spans multiple fields, including Medicine, Dentistry, Nursing, Pharmacy, and allied health professions. It contains over 11588 real exam questions, incorporating clinical images and expert-annotated rationales to evaluate both textual and visual reasoning. We benchmark over 30 state-of-the-art LLMs, including GPT-4o, Claude 3.5, and Gemini, across both text and image-based settings. Despite promising results, no model consistently meets passing thresholds across domains, highlighting the ongoing challenges in medical AI. KokushiMD-10 provides a comprehensive and linguistically grounded resource for evaluating and advancing reasoning-centric medical AI across multilingual and multimodal clinical tasks.

Medical benchmark datasets significantly contribute to developing Large Language Models (LLMs) for medical knowledge extraction, diagnosis, summarization, and other uses. Yet, current benchmarks are mainly derived from exam questions given to medical students or cases described in the medical literature, lacking the complexity of real-world patient cases that deviate from classic textbook abstractions. These include rare diseases, uncommon presentations of common diseases, and unexpected treatment responses. Here, we construct Clinically Uncommon Patient Cases and Diagnosis Dataset (CUPCase) based on 3,562 real-world case reports from BMC, including diagnoses in open-ended textual format and as multiple-choice options with distractors. Using this dataset, we evaluate the ability of state-of-the-art LLMs, including both general-purpose and Clinical LLMs, to identify and correctly diagnose a patient case, and test models' performance when only partial information about cases is available. Our findings show that general-purpose GPT-4o attains the best performance in both the multiple-choice task (average accuracy of 87.9%) and the open-ended task (BERTScore F1 of 0.764), outperforming several LLMs with a focus on the medical domain such as Meditron-70B and MedLM-Large. Moreover, GPT-4o was able to maintain 87% and 88% of its performance with only the first 20% of tokens of the case presentation in multiple-choice and free text, respectively, highlighting the potential of LLMs to aid in early diagnosis in real-world cases. CUPCase expands our ability to evaluate LLMs for clinical decision support in an open and reproducible manner.

Inspired by the success of the General Language Understanding Evaluation benchmark, we introduce the Biomedical Language Understanding Evaluation (BLUE) benchmark to facilitate research in the development of pre-training language representations in the biomedicine domain. The benchmark consists of five tasks with ten datasets that cover both biomedical and clinical texts with different dataset sizes and difficulties. We also evaluate several baselines based on BERT and ELMo and find that the BERT model pre-trained on PubMed abstracts and MIMIC-III clinical notes achieves the best results. We make the datasets, pre-trained models, and codes publicly available at https://github.com/ncbi-nlp/BLUE_Benchmark.

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.

Since the release of ChatGPT, the field of Natural Language Processing has experienced rapid advancements, particularly in Large Language Models (LLMs) and their multimodal counterparts, Large Multimodal Models (LMMs). Despite their impressive capabilities, LLMs often exhibit significant performance disparities across different languages and cultural contexts, as demonstrated by various text-only benchmarks. However, current research lacks such benchmarks for multimodal visio-linguistic settings. This work fills this gap by introducing M5, the first comprehensive benchmark designed to evaluate LMMs on diverse vision-language tasks within a multilingual and multicultural context. M5 includes eight datasets covering five tasks and 41 languages, with a focus on underrepresented languages and culturally diverse images. Furthermore, we introduce two novel datasets, M5-VGR and M5-VLOD, including a new Visio-Linguistic Outlier Detection task, in which all evaluated open-source models fail to significantly surpass the random baseline. Through extensive evaluation and analyses, we highlight substantial task-agnostic performance disparities between high- and low-resource languages. Moreover, we show that larger models do not necessarily outperform smaller ones in a multilingual setting.

We present MedConceptsQA, a dedicated open source benchmark for medical concepts question answering. The benchmark comprises of questions of various medical concepts across different vocabularies: diagnoses, procedures, and drugs. The questions are categorized into three levels of difficulty: easy, medium, and hard. We conducted evaluations of the benchmark using various Large Language Models. Our findings show that pre-trained clinical Large Language Models achieved accuracy levels close to random guessing on this benchmark, despite being pre-trained on medical data. However, GPT-4 achieves an absolute average improvement of nearly 27%-37% (27% for zero-shot learning and 37% for few-shot learning) when compared to clinical Large Language Models. Our benchmark serves as a valuable resource for evaluating the understanding and reasoning of medical concepts by Large Language Models. Our benchmark is available at https://huggingface.co/datasets/ofir408/MedConceptsQA

Multimodal Large Language Models (MLLMs) have tremendous potential to improve the accuracy, availability, and cost-effectiveness of healthcare by providing automated solutions or serving as aids to medical professionals. Despite promising first steps in developing medical MLLMs in the past few years, their capabilities and limitations are not well-understood. Recently, many benchmark datasets have been proposed that test the general medical knowledge of such models across a variety of medical areas. However, the systematic failure modes and vulnerabilities of such models are severely underexplored with most medical benchmarks failing to expose the shortcomings of existing models in this safety-critical domain. In this paper, we introduce MediConfusion, a challenging medical Visual Question Answering (VQA) benchmark dataset, that probes the failure modes of medical MLLMs from a vision perspective. We reveal that state-of-the-art models are easily confused by image pairs that are otherwise visually dissimilar and clearly distinct for medical experts. Strikingly, all available models (open-source or proprietary) achieve performance below random guessing on MediConfusion, raising serious concerns about the reliability of existing medical MLLMs for healthcare deployment. We also extract common patterns of model failure that may help the design of a new generation of more trustworthy and reliable MLLMs in healthcare.

Large Language Models (LLMs) have the potential of facilitating the development of Artificial Intelligence technology to assist medical experts for interactive decision support, which has been demonstrated by their competitive performances in Medical QA. However, while impressive, the required quality bar for medical applications remains far from being achieved. Currently, LLMs remain challenged by outdated knowledge and by their tendency to generate hallucinated content. Furthermore, most benchmarks to assess medical knowledge lack reference gold explanations which means that it is not possible to evaluate the reasoning of LLMs predictions. Finally, the situation is particularly grim if we consider benchmarking LLMs for languages other than English which remains, as far as we know, a totally neglected topic. In order to address these shortcomings, in this paper we present MedExpQA, the first multilingual benchmark based on medical exams to evaluate LLMs in Medical Question Answering. To the best of our knowledge, MedExpQA includes for the first time reference gold explanations written by medical doctors which can be leveraged to establish various gold-based upper-bounds for comparison with LLMs performance. Comprehensive multilingual experimentation using both the gold reference explanations and Retrieval Augmented Generation (RAG) approaches show that performance of LLMs still has large room for improvement, especially for languages other than English. Furthermore, and despite using state-of-the-art RAG methods, our results also demonstrate the difficulty of obtaining and integrating readily available medical knowledge that may positively impact results on downstream evaluations for Medical Question Answering. So far the benchmark is available in four languages, but we hope that this work may encourage further development to other languages.

In this study, we present MedS-Bench, a comprehensive benchmark designed to evaluate the performance of large language models (LLMs) in clinical contexts. Unlike existing benchmarks that focus on multiple-choice question answering, MedS-Bench spans 11 high-level clinical tasks, including clinical report summarization, treatment recommendations, diagnosis, named entity recognition, and medical concept explanation, among others. We evaluated six leading LLMs, e.g., MEDITRON, Mistral, InternLM 2, Llama 3, GPT-4, and Claude-3.5 using few-shot prompting, and found that even the most sophisticated models struggle with these complex tasks. To address these limitations, we developed MedS-Ins, a large-scale instruction tuning dataset for medicine. MedS-Ins comprises 58 medically oriented language corpora, totaling 13.5 million samples across 122 tasks. To demonstrate the dataset's utility, we conducted a proof-of-concept experiment by performing instruction tuning on a lightweight, open-source medical language model. The resulting model, MMedIns-Llama 3, significantly outperformed existing models across nearly all clinical tasks. To promote further advancements in the application of LLMs to clinical challenges, we have made the MedS-Ins dataset fully accessible and invite the research community to contribute to its expansion.Additionally, we have launched a dynamic leaderboard for MedS-Bench, which we plan to regularly update the test set to track progress and enhance the adaptation of general LLMs to the medical domain. Leaderboard: https://henrychur.github.io/MedS-Bench/. Github: https://github.com/MAGIC-AI4Med/MedS-Ins.

The advancement of large language models (LLMs) has significantly broadened the scope of applications in natural language processing, with multi-modal LLMs extending these capabilities to integrate and interpret visual data. However, existing benchmarks for visual language models (VLMs) predominantly focus on single-image inputs, neglecting the crucial aspect of multi-image understanding. In this paper, we introduce a Multi-Image Relational Benchmark MIRB, designed to evaluate VLMs' ability to compare, analyze, and reason across multiple images. Our benchmark encompasses four categories: perception, visual world knowledge, reasoning, and multi-hop reasoning. Through a comprehensive evaluation of a wide range of open-source and closed-source models, we demonstrate that while open-source VLMs were shown to approach the performance of GPT-4V in single-image tasks, a significant performance gap remains in multi-image reasoning tasks. Our findings also reveal that even the state-of-the-art GPT-4V model struggles with our benchmark, underscoring the need for further research and development in this area. We believe our contribution of MIRB could serve as a testbed for developing the next-generation multi-modal models.

Medical image analysis is essential to clinical diagnosis and treatment, which is increasingly supported by multi-modal large language models (MLLMs). However, previous research has primarily focused on 2D medical images, leaving 3D images under-explored, despite their richer spatial information. This paper aims to advance 3D medical image analysis with MLLMs. To this end, we present a large-scale 3D multi-modal medical dataset, M3D-Data, comprising 120K image-text pairs and 662K instruction-response pairs specifically tailored for various 3D medical tasks, such as image-text retrieval, report generation, visual question answering, positioning, and segmentation. Additionally, we propose M3D-LaMed, a versatile multi-modal large language model for 3D medical image analysis. Furthermore, we introduce a new 3D multi-modal medical benchmark, M3D-Bench, which facilitates automatic evaluation across eight tasks. Through comprehensive evaluation, our method proves to be a robust model for 3D medical image analysis, outperforming existing solutions. All code, data, and models are publicly available at: https://github.com/BAAI-DCAI/M3D.

Recent advances in microscopy have enabled the rapid generation of terabytes of image data in cell biology and biomedical research. Vision-language models (VLMs) offer a promising solution for large-scale biological image analysis, enhancing researchers' efficiency, identifying new image biomarkers, and accelerating hypothesis generation and scientific discovery. However, there is a lack of standardized, diverse, and large-scale vision-language benchmarks to evaluate VLMs' perception and cognition capabilities in biological image understanding. To address this gap, we introduce {\mu}-Bench, an expert-curated benchmark encompassing 22 biomedical tasks across various scientific disciplines (biology, pathology), microscopy modalities (electron, fluorescence, light), scales (subcellular, cellular, tissue), and organisms in both normal and abnormal states. We evaluate state-of-the-art biomedical, pathology, and general VLMs on {\mu}-Bench and find that: i) current models struggle on all categories, even for basic tasks such as distinguishing microscopy modalities; ii) current specialist models fine-tuned on biomedical data often perform worse than generalist models; iii) fine-tuning in specific microscopy domains can cause catastrophic forgetting, eroding prior biomedical knowledge encoded in their base model. iv) weight interpolation between fine-tuned and pre-trained models offers one solution to forgetting and improves general performance across biomedical tasks. We release {\mu}-Bench under a permissive license to accelerate the research and development of microscopy foundation models.

The evaluation of vision-language models (VLMs) has mainly relied on English-language benchmarks, leaving significant gaps in both multilingual and multicultural coverage. While multilingual benchmarks have expanded, both in size and languages, many rely on translations of English datasets, failing to capture cultural nuances. In this work, we propose Kaleidoscope, as the most comprehensive exam benchmark to date for the multilingual evaluation of vision-language models. Kaleidoscope is a large-scale, in-language multimodal benchmark designed to evaluate VLMs across diverse languages and visual inputs. Kaleidoscope covers 18 languages and 14 different subjects, amounting to a total of 20,911 multiple-choice questions. Built through an open science collaboration with a diverse group of researchers worldwide, Kaleidoscope ensures linguistic and cultural authenticity. We evaluate top-performing multilingual vision-language models and find that they perform poorly on low-resource languages and in complex multimodal scenarios. Our results highlight the need for progress on culturally inclusive multimodal evaluation frameworks.

This paper introduces BiMediX2, a bilingual (Arabic-English) Bio-Medical EXpert Large Multimodal Model (LMM) with a unified architecture that integrates text and visual modalities, enabling advanced image understanding and medical applications. BiMediX2 leverages the Llama3.1 architecture and integrates text and visual capabilities to facilitate seamless interactions in both English and Arabic, supporting text-based inputs and multi-turn conversations involving medical images. The model is trained on an extensive bilingual healthcare dataset consisting of 1.6M samples of diverse medical interactions for both text and image modalities, mixed in Arabic and English. We also propose the first bilingual GPT-4o based medical LMM benchmark named BiMed-MBench. BiMediX2 is benchmarked on both text-based and image-based tasks, achieving state-of-the-art performance across several medical benchmarks. It outperforms recent state-of-the-art models in medical LLM evaluation benchmarks. Our model also sets a new benchmark in multimodal medical evaluations with over 9% improvement in English and over 20% in Arabic evaluations. Additionally, it surpasses GPT-4 by around 9% in UPHILL factual accuracy evaluations and excels in various medical Visual Question Answering, Report Generation, and Report Summarization tasks. The project page including source code and the trained model, is available at https://github.com/mbzuai-oryx/BiMediX2.

Large Vision-Language Models (LVLMs) have achieved remarkable performance in many vision-language tasks, yet their capabilities in fine-grained visual understanding remain insufficiently evaluated. Existing benchmarks either contain limited fine-grained evaluation samples that are mixed with other data, or are confined to object-level assessments in natural images. To holistically assess LVLMs' fine-grained visual understanding capabilities, we propose using document images with multi-granularity and multi-modal information to supplement natural images. In this light, we construct MMDocBench, a benchmark with various OCR-free document understanding tasks for the evaluation of fine-grained visual perception and reasoning abilities. MMDocBench defines 15 main tasks with 4,338 QA pairs and 11,353 supporting regions, covering various document images such as research papers, receipts, financial reports, Wikipedia tables, charts, and infographics. Based on MMDocBench, we conduct extensive experiments using 13 open-source and 3 proprietary advanced LVLMs, assessing their strengths and weaknesses across different tasks and document image types. The benchmark, task instructions, and evaluation code will be made publicly available.

Current Vision Language Models (VLMs) remain vulnerable to malicious prompts that induce harmful outputs. Existing safety benchmarks for VLMs primarily rely on automated evaluation methods, but these methods struggle to detect implicit harmful content or produce inaccurate evaluations. Therefore, we found that existing benchmarks have low levels of harmfulness, ambiguous data, and limited diversity in image-text pair combinations. To address these issues, we propose the ELITE benchmark, a high-quality safety evaluation benchmark for VLMs, underpinned by our enhanced evaluation method, the ELITE evaluator. The ELITE evaluator explicitly incorporates a toxicity score to accurately assess harmfulness in multimodal contexts, where VLMs often provide specific, convincing, but unharmful descriptions of images. We filter out ambiguous and low-quality image-text pairs from existing benchmarks using the ELITE evaluator and generate diverse combinations of safe and unsafe image-text pairs. Our experiments demonstrate that the ELITE evaluator achieves superior alignment with human evaluations compared to prior automated methods, and the ELITE benchmark offers enhanced benchmark quality and diversity. By introducing ELITE, we pave the way for safer, more robust VLMs, contributing essential tools for evaluating and mitigating safety risks in real-world applications.

Existing multimodal retrieval benchmarks primarily focus on evaluating whether models can retrieve and utilize external textual knowledge for question answering. However, there are scenarios where retrieving visual information is either more beneficial or easier to access than textual data. In this paper, we introduce a multimodal retrieval-augmented generation benchmark, MRAG-Bench, in which we systematically identify and categorize scenarios where visually augmented knowledge is better than textual knowledge, for instance, more images from varying viewpoints. MRAG-Bench consists of 16,130 images and 1,353 human-annotated multiple-choice questions across 9 distinct scenarios. With MRAG-Bench, we conduct an evaluation of 10 open-source and 4 proprietary large vision-language models (LVLMs). Our results show that all LVLMs exhibit greater improvements when augmented with images compared to textual knowledge, confirming that MRAG-Bench is vision-centric. Additionally, we conduct extensive analysis with MRAG-Bench, which offers valuable insights into retrieval-augmented LVLMs. Notably, the top-performing model, GPT-4o, faces challenges in effectively leveraging retrieved knowledge, achieving only a 5.82% improvement with ground-truth information, in contrast to a 33.16% improvement observed in human participants. These findings highlight the importance of MRAG-Bench in encouraging the community to enhance LVLMs' ability to utilize retrieved visual knowledge more effectively.

Despite the growing scale of medical Vision-Language datasets, the impact of dataset quality on model performance remains under-explored. We introduce Open-PMC, a high-quality medical dataset from PubMed Central, containing 2.2 million image-text pairs, enriched with image modality annotations, subfigures, and summarized in-text references. Notably, the in-text references provide richer medical context, extending beyond the abstract information typically found in captions. Through extensive experiments, we benchmark Open-PMC against larger datasets across retrieval and zero-shot classification tasks. Our results show that dataset quality-not just size-drives significant performance gains. We complement our benchmark with an in-depth analysis of feature representation. Our findings highlight the crucial role of data curation quality in advancing multimodal medical AI. We release Open-PMC, along with the trained models and our codebase.

Recent breakthroughs in vision-language models (VLMs) start a new page in the vision community. The VLMs provide stronger and more generalizable feature embeddings compared to those from ImageNet-pretrained models, thanks to the training on the large-scale Internet image-text pairs. However, despite the amazing achievement from the VLMs, vanilla Vision Transformers (ViTs) remain the default choice for the image encoder. Although pure transformer proves its effectiveness in the text encoding area, it remains questionable whether it is also the case for image encoding, especially considering that various types of networks are proposed on the ImageNet benchmark, which, unfortunately, are rarely studied in VLMs. Due to small data/model scale, the original conclusions of model design on ImageNet can be limited and biased. In this paper, we aim at building an evaluation protocol of vision models in the vision-language era under the contrastive language-image pretraining (CLIP) framework. We provide a comprehensive way to benchmark different vision models, covering their zero-shot performance and scalability in both model and training data sizes. To this end, we introduce ViTamin, a new vision models tailored for VLMs. ViTamin-L significantly outperforms ViT-L by 2.0% ImageNet zero-shot accuracy, when using the same publicly available DataComp-1B dataset and the same OpenCLIP training scheme. ViTamin-L presents promising results on 60 diverse benchmarks, including classification, retrieval, open-vocabulary detection and segmentation, and large multi-modal models. When further scaling up the model size, our ViTamin-XL with only 436M parameters attains 82.9% ImageNet zero-shot accuracy, surpassing 82.0% achieved by EVA-E that has ten times more parameters (4.4B).

Large Language Models (LLMs) have shown impressive performance on existing medical question-answering benchmarks. This high performance makes it increasingly difficult to meaningfully evaluate and differentiate advanced methods. We present MedAgentsBench, a benchmark that focuses on challenging medical questions requiring multi-step clinical reasoning, diagnosis formulation, and treatment planning-scenarios where current models still struggle despite their strong performance on standard tests. Drawing from seven established medical datasets, our benchmark addresses three key limitations in existing evaluations: (1) the prevalence of straightforward questions where even base models achieve high performance, (2) inconsistent sampling and evaluation protocols across studies, and (3) lack of systematic analysis of the interplay between performance, cost, and inference time. Through experiments with various base models and reasoning methods, we demonstrate that the latest thinking models, DeepSeek R1 and OpenAI o3, exhibit exceptional performance in complex medical reasoning tasks. Additionally, advanced search-based agent methods offer promising performance-to-cost ratios compared to traditional approaches. Our analysis reveals substantial performance gaps between model families on complex questions and identifies optimal model selections for different computational constraints. Our benchmark and evaluation framework are publicly available at https://github.com/gersteinlab/medagents-benchmark.

The paper describes the open Russian medical language understanding benchmark covering several task types (classification, question answering, natural language inference, named entity recognition) on a number of novel text sets. Given the sensitive nature of the data in healthcare, such a benchmark partially closes the problem of Russian medical dataset absence. We prepare the unified format labeling, data split, and evaluation metrics for new tasks. The remaining tasks are from existing datasets with a few modifications. A single-number metric expresses a model's ability to cope with the benchmark. Moreover, we implement several baseline models, from simple ones to neural networks with transformer architecture, and release the code. Expectedly, the more advanced models yield better performance, but even a simple model is enough for a decent result in some tasks. Furthermore, for all tasks, we provide a human evaluation. Interestingly the models outperform humans in the large-scale classification tasks. However, the advantage of natural intelligence remains in the tasks requiring more knowledge and reasoning.

Large multimodal models (LMMs) have demonstrated impressive capabilities in understanding various types of image, including text-rich images. Most existing text-rich image benchmarks are simple extraction-based question answering, and many LMMs now easily achieve high scores. This means that current benchmarks fail to accurately reflect performance of different models, and a natural idea is to build a new benchmark to evaluate their complex reasoning and spatial understanding abilities. In this work, we propose the Multi-Modal Reading (MMR) benchmark in 11 diverse tasks to evaluate LMMs for text-rich image understanding. MMR is the first text-rich image benchmark built on human annotations with the help of language models. By evaluating several state-of-the-art LMMs, including GPT-4o, it reveals the limited capabilities of existing LMMs underscoring the value of our benchmark.

Existing multilingual benchmarks for Large Vision Language Models (LVLMs) suffer from limitations including language-specific content biases, disjointed multimodal input formats, and a lack of safety evaluation. To address these gaps, we propose PM4Bench, the first Parallel Multilingual Multi-Modal Multi-task Benchmark for LVLMs. PM4Bench features a parallel corpus design across 10 languages, enabling fair and accurate cross-lingual comparisons. It includes the vision setting where text and queries are embedded in images, requiring LVLMs to simultaneously "see", "read", and "think", aligning with real-world applications. Additionally, PM4Bench incorporates safety evaluations, addressing critical oversight in existing multilingual benchmarks. Using PM4Bench, we evaluate 11 mainstream LVLMs, revealing significant cross-linguistic performance disparities, particularly in vision settings, and identifying OCR capability as a key determinant of these imbalances. We will release PM4Bench at https://github.com/opendatalab/PM4Bench .

Following the success of Large Language Models (LLMs), expanding their boundaries to new modalities represents a significant paradigm shift in multimodal understanding. Human perception is inherently multimodal, relying not only on text but also on auditory and visual cues for a complete understanding of the world. In recognition of this fact, audio-visual LLMs have recently emerged. Despite promising developments, the lack of dedicated benchmarks poses challenges for understanding and evaluating models. In this work, we show that audio-visual LLMs struggle to discern subtle relationships between audio and visual signals, leading to hallucinations, underscoring the need for reliable benchmarks. To address this, we introduce AVHBench, the first comprehensive benchmark specifically designed to evaluate the perception and comprehension capabilities of audio-visual LLMs. Our benchmark includes tests for assessing hallucinations, as well as the cross-modal matching and reasoning abilities of these models. Our results reveal that most existing audio-visual LLMs struggle with hallucinations caused by cross-interactions between modalities, due to their limited capacity to perceive complex multimodal signals and their relationships. Additionally, we demonstrate that simple training with our AVHBench improves robustness of audio-visual LLMs against hallucinations.

Existing multilingual vision-language (VL) benchmarks often only cover a handful of languages. Consequently, evaluations of large vision-language models (LVLMs) predominantly target high-resource languages, underscoring the need for evaluation data for low-resource languages. To address this limitation, we introduce MVL-SIB, a massively multilingual vision-language benchmark that evaluates both cross-modal and text-only topical matching across 205 languages -- over 100 more than the most multilingual existing VL benchmarks encompass. We then benchmark a range of of open-weight LVLMs together with GPT-4o(-mini) on MVL-SIB. Our results reveal that LVLMs struggle in cross-modal topic matching in lower-resource languages, performing no better than chance on languages like N'Koo. Our analysis further reveals that VL support in LVLMs declines disproportionately relative to textual support for lower-resource languages, as evidenced by comparison of cross-modal and text-only topical matching performance. We further observe that open-weight LVLMs do not benefit from representing a topic with more than one image, suggesting that these models are not yet fully effective at handling multi-image tasks. By correlating performance on MVL-SIB with other multilingual VL benchmarks, we highlight that MVL-SIB serves as a comprehensive probe of multilingual VL understanding in LVLMs.

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.

We introduce Blink, a new benchmark for multimodal language models (LLMs) that focuses on core visual perception abilities not found in other evaluations. Most of the Blink tasks can be solved by humans "within a blink" (e.g., relative depth estimation, visual correspondence, forensics detection, and multi-view reasoning). However, we find these perception-demanding tasks cast significant challenges for current multimodal LLMs because they resist mediation through natural language. Blink reformats 14 classic computer vision tasks into 3,807 multiple-choice questions, paired with single or multiple images and visual prompting. While humans get 95.70% accuracy on average, Blink is surprisingly challenging for existing multimodal LLMs: even the best-performing GPT-4V and Gemini achieve accuracies of 51.26% and 45.72%, only 13.17% and 7.63% higher than random guessing, indicating that such perception abilities have not "emerged" yet in recent multimodal LLMs. Our analysis also highlights that specialist CV models could solve these problems much better, suggesting potential pathways for future improvements. We believe Blink will stimulate the community to help multimodal LLMs catch up with human-level visual perception.

The evaluation of text-generative vision-language models is a challenging yet crucial endeavor. By addressing the limitations of existing Visual Question Answering (VQA) benchmarks and proposing innovative evaluation methodologies, our research seeks to advance our understanding of these models' capabilities. We propose a novel VQA benchmark based on well-known visual classification datasets which allows a granular evaluation of text-generative vision-language models and their comparison with discriminative vision-language models. To improve the assessment of coarse answers on fine-grained classification tasks, we suggest using the semantic hierarchy of the label space to ask automatically generated follow-up questions about the ground-truth category. Finally, we compare traditional NLP and LLM-based metrics for the problem of evaluating model predictions given ground-truth answers. We perform a human evaluation study upon which we base our decision on the final metric. We apply our benchmark to a suite of vision-language models and show a detailed comparison of their abilities on object, action, and attribute classification. Our contributions aim to lay the foundation for more precise and meaningful assessments, facilitating targeted progress in the exciting field of vision-language modeling.

Currently many benchmarks have been proposed to evaluate the perception ability of the Large Vision-Language Models (LVLMs). However, most benchmarks conduct questions by selecting images from existing datasets, resulting in the potential data leakage. Besides, these benchmarks merely focus on evaluating LVLMs on the realistic style images and clean scenarios, leaving the multi-stylized images and noisy scenarios unexplored. In response to these challenges, we propose a dynamic and scalable benchmark named Dysca for evaluating LVLMs by leveraging synthesis images. Specifically, we leverage Stable Diffusion and design a rule-based method to dynamically generate novel images, questions and the corresponding answers. We consider 51 kinds of image styles and evaluate the perception capability in 20 subtasks. Moreover, we conduct evaluations under 4 scenarios (i.e., Clean, Corruption, Print Attacking and Adversarial Attacking) and 3 question types (i.e., Multi-choices, True-or-false and Free-form). Thanks to the generative paradigm, Dysca serves as a scalable benchmark for easily adding new subtasks and scenarios. A total of 8 advanced open-source LVLMs with 10 checkpoints are evaluated on Dysca, revealing the drawbacks of current LVLMs. The benchmark is released in https://github.com/Benchmark-Dysca/Dysca.

Large vision-language models (LVLMs) have recently achieved rapid progress, sparking numerous studies to evaluate their multi-modal capabilities. However, we dig into current evaluation works and identify two primary issues: 1) Visual content is unnecessary for many samples. The answers can be directly inferred from the questions and options, or the world knowledge embedded in LLMs. This phenomenon is prevalent across current benchmarks. For instance, GeminiPro achieves 42.9% on the MMMU benchmark without any visual input, and outperforms the random choice baseline across six benchmarks over 20% on average. 2) Unintentional data leakage exists in LLM and LVLM training. LLM and LVLM could still answer some visual-necessary questions without visual content, indicating the memorizing of these samples within large-scale training data. For example, Sphinx-X-MoE gets 43.6% on MMMU without accessing images, surpassing its LLM backbone with 17.9%. Both problems lead to misjudgments of actual multi-modal gains and potentially misguide the study of LVLM. To this end, we present MMStar, an elite vision-indispensable multi-modal benchmark comprising 1,500 samples meticulously selected by humans. MMStar benchmarks 6 core capabilities and 18 detailed axes, aiming to evaluate LVLMs' multi-modal capacities with carefully balanced and purified samples. These samples are first roughly selected from current benchmarks with an automated pipeline, human review is then involved to ensure each curated sample exhibits visual dependency, minimal data leakage, and requires advanced multi-modal capabilities. Moreover, two metrics are developed to measure data leakage and actual performance gain in multi-modal training. We evaluate 16 leading LVLMs on MMStar to assess their multi-modal capabilities, and on 7 benchmarks with the proposed metrics to investigate their data leakage and actual multi-modal gain.

Vision-language models (VLMs) have made significant progress in recent visual-question-answering (VQA) benchmarks that evaluate complex visio-linguistic reasoning. However, are these models truly effective? In this work, we show that VLMs still struggle with natural images and questions that humans can easily answer, which we term natural adversarial samples. We also find it surprisingly easy to generate these VQA samples from natural image-text corpora using off-the-shelf models like CLIP and ChatGPT. We propose a semi-automated approach to collect a new benchmark, NaturalBench, for reliably evaluating VLMs with 10,000 human-verified VQA samples. Crucially, we adopt a vision-centric design by pairing each question with two images that yield different answers, preventing blind solutions from answering without using the images. This makes NaturalBench more challenging than previous benchmarks that can be solved with commonsense priors. We evaluate 53 state-of-the-art VLMs on NaturalBench, showing that models like LLaVA-OneVision, Cambrian-1, Llama3.2-Vision, Molmo, Qwen2-VL, and even GPT-4o lag 50%-70% behind human performance (over 90%). We analyze why NaturalBench is hard from two angles: (1) Compositionality: Solving NaturalBench requires diverse visio-linguistic skills, including understanding attribute bindings, object relationships, and advanced reasoning like logic and counting. To this end, unlike prior work that uses a single tag per sample, we tag each NaturalBench sample with 1 to 8 skill tags for fine-grained evaluation. (2) Biases: NaturalBench exposes severe biases in VLMs, as models often choose the same answer regardless of the image. Lastly, we apply our benchmark curation method to diverse data sources, including long captions (over 100 words) and non-English languages like Chinese and Hindi, highlighting its potential for dynamic evaluations of VLMs.

Multimodal Large Language Models (MLLMs) show reasoning promise, yet their visual perception is a critical bottleneck. Strikingly, MLLMs can produce correct answers even while misinterpreting crucial visual elements, masking these underlying failures. Our preliminary study on a joint perception-reasoning dataset revealed that for one leading MLLM, 29% of its correct answers to reasoning questions still exhibited visual perception errors. To systematically address this, we introduce "Do You See Me", a scalable benchmark with 1,758 images and 2,612 questions. It spans seven human-psychology inspired subtasks in 2D and 3D, featuring controllable complexity to rigorously evaluate MLLM visual skills. Our findings on 3 leading closed-source and 5 major open-source models reveal a stark deficit: humans achieve 96.49% accuracy, while top MLLMs average below 50%. This performance gap widens rapidly with increased task complexity (e.g., from 12% to 45% in the visual form constancy subtask). Further analysis into the root causes suggests that failures stem from challenges like misallocated visual attention and the instability of internal representations for fine-grained details, especially at or below encoder patch resolution. This underscores an urgent need for MLLMs with truly robust visual perception. The benchmark dataset, source code and evaluation scripts are available at https://github.com/microsoft/Do-You-See-Me.

Vision language models (VLM) have demonstrated remarkable performance across various downstream tasks. However, understanding fine-grained visual-linguistic concepts, such as attributes and inter-object relationships, remains a significant challenge. While several benchmarks aim to evaluate VLMs in finer granularity, their primary focus remains on the linguistic aspect, neglecting the visual dimension. Here, we highlight the importance of evaluating VLMs from both a textual and visual perspective. We introduce a progressive pipeline to synthesize images that vary in a specific attribute while ensuring consistency in all other aspects. Utilizing this data engine, we carefully design a benchmark, SPEC, to diagnose the comprehension of object size, position, existence, and count. Subsequently, we conduct a thorough evaluation of four leading VLMs on SPEC. Surprisingly, their performance is close to random guess, revealing significant limitations. With this in mind, we propose a simple yet effective approach to optimize VLMs in fine-grained understanding, achieving significant improvements on SPEC without compromising the zero-shot performance. Results on two additional fine-grained benchmarks also show consistent improvements, further validating the transferability of our approach. Code and data are available at https://github.com/wjpoom/SPEC.

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.

Interleaved multimodal comprehension and generation, enabling models to produce and interpret both images and text in arbitrary sequences, have become a pivotal area in multimodal learning. Despite significant advancements, the evaluation of this capability remains insufficient. Existing benchmarks suffer from limitations in data scale, scope, and evaluation depth, while current evaluation metrics are often costly or biased, lacking in reliability for practical applications. To address these challenges, we introduce MMIE, a large-scale knowledge-intensive benchmark for evaluating interleaved multimodal comprehension and generation in Large Vision-Language Models (LVLMs). MMIE comprises 20K meticulously curated multimodal queries, spanning 3 categories, 12 fields, and 102 subfields, including mathematics, coding, physics, literature, health, and arts. It supports both interleaved inputs and outputs, offering a mix of multiple-choice and open-ended question formats to evaluate diverse competencies. Moreover, we propose a reliable automated evaluation metric, leveraging a scoring model fine-tuned with human-annotated data and systematic evaluation criteria, aimed at reducing bias and improving evaluation accuracy. Extensive experiments demonstrate the effectiveness of our benchmark and metrics in providing a comprehensive evaluation of interleaved LVLMs. Specifically, we evaluate eight LVLMs, revealing that even the best models show significant room for improvement, with most achieving only moderate results. We believe MMIE will drive further advancements in the development of interleaved LVLMs. We publicly release our benchmark and code in https://mmie-bench.github.io/.

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.

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

Large language models (LLMs) can potentially democratize access to medical knowledge. While many efforts have been made to harness and improve LLMs' medical knowledge and reasoning capacities, the resulting models are either closed-source (e.g., PaLM, GPT-4) or limited in scale (<= 13B parameters), which restricts their abilities. In this work, we improve access to large-scale medical LLMs by releasing MEDITRON: a suite of open-source LLMs with 7B and 70B parameters adapted to the medical domain. MEDITRON builds on Llama-2 (through our adaptation of Nvidia's Megatron-LM distributed trainer), and extends pretraining on a comprehensively curated medical corpus, including selected PubMed articles, abstracts, and internationally-recognized medical guidelines. Evaluations using four major medical benchmarks show significant performance gains over several state-of-the-art baselines before and after task-specific finetuning. Overall, MEDITRON achieves a 6% absolute performance gain over the best public baseline in its parameter class and 3% over the strongest baseline we finetuned from Llama-2. Compared to closed-source LLMs, MEDITRON-70B outperforms GPT-3.5 and Med-PaLM and is within 5% of GPT-4 and 10% of Med-PaLM-2. We release our code for curating the medical pretraining corpus and the MEDITRON model weights to drive open-source development of more capable medical LLMs.

As language models improve and become capable of performing more complex tasks across modalities, evaluating them automatically becomes increasingly challenging. Developing strong and robust task-specific automatic metrics gets harder, and human-annotated test sets -- which are expensive to create -- saturate more quickly. A compelling alternative is to design reliable strategies to automate the creation of test data and evaluation, but previous attempts either rely on pre-existing data, or focus solely on individual tasks. We present Zero-shot Benchmarking (ZSB), a framework for creating high-quality benchmarks for any task by leveraging language models for both synthetic test data creation and evaluation. ZSB is simple and flexible: it requires only the creation of a prompt for data generation and one for evaluation; it is scalable to tasks and languages where collecting real-world data is costly or impractical; it is model-agnostic, allowing the creation of increasingly challenging benchmarks as models improve. To assess the effectiveness of our framework, we create benchmarks for five text-only tasks and a multi-modal one: general capabilities in four languages (English, Chinese, French, and Korean), translation, and general vision-language capabilities in English. We then rank a broad range of open and closed systems on our benchmarks. ZSB rankings consistently correlate strongly with human rankings, outperforming widely-adopted standard benchmarks. Through ablations, we find that strong benchmarks can be created with open models, and that judge model size and dataset variety are crucial drivers of performance. We release all our benchmarks, and code to reproduce our experiments and to produce new benchmarks.

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.

The rapid development of Large Language Models (LLMs) for healthcare applications has spurred calls for holistic evaluation beyond frequently-cited benchmarks like USMLE, to better reflect real-world performance. While real-world assessments are valuable indicators of utility, they often lag behind the pace of LLM evolution, likely rendering findings obsolete upon deployment. This temporal disconnect necessitates a comprehensive upfront evaluation that can guide model selection for specific clinical applications. We introduce MEDIC, a framework assessing LLMs across five critical dimensions of clinical competence: medical reasoning, ethics and bias, data and language understanding, in-context learning, and clinical safety. MEDIC features a novel cross-examination framework quantifying LLM performance across areas like coverage and hallucination detection, without requiring reference outputs. We apply MEDIC to evaluate LLMs on medical question-answering, safety, summarization, note generation, and other tasks. Our results show performance disparities across model sizes, baseline vs medically finetuned models, and have implications on model selection for applications requiring specific model strengths, such as low hallucination or lower cost of inference. MEDIC's multifaceted evaluation reveals these performance trade-offs, bridging the gap between theoretical capabilities and practical implementation in healthcare settings, ensuring that the most promising models are identified and adapted for diverse healthcare applications.

Significant research efforts have been made to scale and improve vision-language model (VLM) training approaches. Yet, with an ever-growing number of benchmarks, researchers are tasked with the heavy burden of implementing each protocol, bearing a non-trivial computational cost, and making sense of how all these benchmarks translate into meaningful axes of progress. To facilitate a systematic evaluation of VLM progress, we introduce UniBench: a unified implementation of 50+ VLM benchmarks spanning a comprehensive range of carefully categorized capabilities from object recognition to spatial awareness, counting, and much more. We showcase the utility of UniBench for measuring progress by evaluating nearly 60 publicly available vision-language models, trained on scales of up to 12.8B samples. We find that while scaling training data or model size can boost many vision-language model capabilities, scaling offers little benefit for reasoning or relations. Surprisingly, we also discover today's best VLMs struggle on simple digit recognition and counting tasks, e.g. MNIST, which much simpler networks can solve. Where scale falls short, we find that more precise interventions, such as data quality or tailored-learning objectives offer more promise. For practitioners, we also offer guidance on selecting a suitable VLM for a given application. Finally, we release an easy-to-run UniBench code-base with the full set of 50+ benchmarks and comparisons across 59 models as well as a distilled, representative set of benchmarks that runs in 5 minutes on a single GPU.

There is a lack of benchmarks for evaluating large language models (LLMs) in long-form medical question answering (QA). Most existing medical QA evaluation benchmarks focus on automatic metrics and multiple-choice questions. While valuable, these benchmarks fail to fully capture or assess the complexities of real-world clinical applications where LLMs are being deployed. Furthermore, existing studies on evaluating long-form answer generation in medical QA are primarily closed-source, lacking access to human medical expert annotations, which makes it difficult to reproduce results and enhance existing baselines. In this work, we introduce a new publicly available benchmark featuring real-world consumer medical questions with long-form answer evaluations annotated by medical doctors. We performed pairwise comparisons of responses from various open and closed-source medical and general-purpose LLMs based on criteria such as correctness, helpfulness, harmfulness, and bias. Additionally, we performed a comprehensive LLM-as-a-judge analysis to study the alignment between human judgments and LLMs. Our preliminary results highlight the strong potential of open LLMs in medical QA compared to leading closed models. Code & Data: https://github.com/lavita-ai/medical-eval-sphere

The proliferation of multimodal Large Language Models has significantly advanced the ability to analyze and understand complex data inputs from different modalities. However, the processing of long documents remains under-explored, largely due to a lack of suitable benchmarks. To address this, we introduce Document Haystack, a comprehensive benchmark designed to evaluate the performance of Vision Language Models (VLMs) on long, visually complex documents. Document Haystack features documents ranging from 5 to 200 pages and strategically inserts pure text or multimodal text+image "needles" at various depths within the documents to challenge VLMs' retrieval capabilities. Comprising 400 document variants and a total of 8,250 questions, it is supported by an objective, automated evaluation framework. We detail the construction and characteristics of the Document Haystack dataset, present results from prominent VLMs and discuss potential research avenues in this area.

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

Medical image segmentation allows quantifying target structure size and shape, aiding in disease diagnosis, prognosis, surgery planning, and comprehension.Building upon recent advancements in foundation Vision-Language Models (VLMs) from natural image-text pairs, several studies have proposed adapting them to Vision-Language Segmentation Models (VLSMs) that allow using language text as an additional input to segmentation models. Introducing auxiliary information via text with human-in-the-loop prompting during inference opens up unique opportunities, such as open vocabulary segmentation and potentially more robust segmentation models against out-of-distribution data. Although transfer learning from natural to medical images has been explored for image-only segmentation models, the joint representation of vision-language in segmentation problems remains underexplored. This study introduces the first systematic study on transferring VLSMs to 2D medical images, using carefully curated 11 datasets encompassing diverse modalities and insightful language prompts and experiments. Our findings demonstrate that although VLSMs show competitive performance compared to image-only models for segmentation after finetuning in limited medical image datasets, not all VLSMs utilize the additional information from language prompts, with image features playing a dominant role. While VLSMs exhibit enhanced performance in handling pooled datasets with diverse modalities and show potential robustness to domain shifts compared to conventional segmentation models, our results suggest that novel approaches are required to enable VLSMs to leverage the various auxiliary information available through language prompts. The code and datasets are available at https://github.com/naamiinepal/medvlsm.

This technical report introduces a Named Clinical Entity Recognition Benchmark for evaluating language models in healthcare, addressing the crucial natural language processing (NLP) task of extracting structured information from clinical narratives to support applications like automated coding, clinical trial cohort identification, and clinical decision support. The leaderboard provides a standardized platform for assessing diverse language models, including encoder and decoder architectures, on their ability to identify and classify clinical entities across multiple medical domains. A curated collection of openly available clinical datasets is utilized, encompassing entities such as diseases, symptoms, medications, procedures, and laboratory measurements. Importantly, these entities are standardized according to the Observational Medical Outcomes Partnership (OMOP) Common Data Model, ensuring consistency and interoperability across different healthcare systems and datasets, and a comprehensive evaluation of model performance. Performance of models is primarily assessed using the F1-score, and it is complemented by various assessment modes to provide comprehensive insights into model performance. The report also includes a brief analysis of models evaluated to date, highlighting observed trends and limitations. By establishing this benchmarking framework, the leaderboard aims to promote transparency, facilitate comparative analyses, and drive innovation in clinical entity recognition tasks, addressing the need for robust evaluation methods in healthcare NLP.

Large Vision-Language Models (LVLMs) have become essential for advancing the integration of visual and linguistic information. However, the evaluation of LVLMs presents significant challenges as the evaluation benchmark always demands lots of human cost for its construction, and remains static, lacking flexibility once constructed. Even though automatic evaluation has been explored in textual modality, the visual modality remains under-explored. As a result, in this work, we address a question: "Can LVLMs themselves be used to benchmark each other in the visual automatically domain?". We introduce AutoBench-V, an automated framework for serving evaluation on demand, i.e., benchmarking LVLMs based on specific aspects of model capability. AutoBench-V leverages text-to-image models to generate relevant image samples and then utilizes LVLMs to orchestrate visual question-answering (VQA) tasks, completing the evaluation process efficiently and flexibly. Through an extensive evaluation of nine popular LVLMs across five demanded user inputs (i.e., evaluation capabilities), the framework shows effectiveness and reliability.

Current ophthalmology clinical workflows are plagued by over-referrals, long waits, and complex and heterogeneous medical records. Large language models (LLMs) present a promising solution to automate various procedures such as triaging, preliminary tests like visual acuity assessment, and report summaries. However, LLMs have demonstrated significantly varied performance across different languages in natural language question-answering tasks, potentially exacerbating healthcare disparities in Low and Middle-Income Countries (LMICs). This study introduces the first multilingual ophthalmological question-answering benchmark with manually curated questions parallel across languages, allowing for direct cross-lingual comparisons. Our evaluation of 6 popular LLMs across 7 different languages reveals substantial bias across different languages, highlighting risks for clinical deployment of LLMs in LMICs. Existing debiasing methods such as Translation Chain-of-Thought or Retrieval-augmented generation (RAG) by themselves fall short of closing this performance gap, often failing to improve performance across all languages and lacking specificity for the medical domain. To address this issue, We propose CLARA (Cross-Lingual Reflective Agentic system), a novel inference time de-biasing method leveraging retrieval augmented generation and self-verification. Our approach not only improves performance across all languages but also significantly reduces the multilingual bias gap, facilitating equitable LLM application across the globe.

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

As multimodal large language models (MLLMs) advance rapidly, rigorous evaluation has become essential, providing further guidance for their development. In this work, we focus on a unified and robust evaluation of vision perception abilities, the foundational skill of MLLMs. We find that existing perception benchmarks, each focusing on different question types, domains, and evaluation metrics, introduce significant evaluation variance, complicating comprehensive assessments of perception abilities when relying on any single benchmark. To address this, we introduce AbilityLens, a unified benchmark designed to evaluate MLLMs across six key perception abilities, focusing on both accuracy and stability, with each ability encompassing diverse question types, domains, and metrics. With the assistance of AbilityLens, we: (1) identify the strengths and weaknesses of current models, highlighting stability patterns and revealing a notable performance gap between open-source and closed-source models; (2) introduce an online evaluation mode, which uncovers interesting ability conflict and early convergence phenomena during MLLM training; and (3) design a simple ability-specific model merging method that combines the best ability checkpoint from early training stages, effectively mitigating performance decline due to ability conflict. The benchmark and online leaderboard will be released soon.

Vision-Language Models (VLMs) have demonstrated remarkable progress in multimodal understanding, yet their capabilities for scientific reasoning remains inadequately assessed. Current multimodal benchmarks predominantly evaluate generic image comprehension or text-driven reasoning, lacking authentic scientific contexts that require domain-specific knowledge integration with visual evidence analysis. To fill this gap, we present CSVQA, a diagnostic multimodal benchmark specifically designed for evaluating scientific reasoning through domain-grounded visual question answering.Our benchmark features 1,378 carefully constructed question-answer pairs spanning diverse STEM disciplines, each demanding domain knowledge, integration of visual evidence, and higher-order reasoning. Compared to prior multimodal benchmarks, CSVQA places greater emphasis on real-world scientific content and complex reasoning.We additionally propose a rigorous evaluation protocol to systematically assess whether model predictions are substantiated by valid intermediate reasoning steps based on curated explanations. Our comprehensive evaluation of 15 VLMs on this benchmark reveals notable performance disparities, as even the top-ranked proprietary model attains only 49.6\% accuracy.This empirical evidence underscores the pressing need for advancing scientific reasoning capabilities in VLMs. Our CSVQA is released at https://huggingface.co/datasets/Skywork/CSVQA.

Curated datasets for healthcare are often limited due to the need of human annotations from experts. In this paper, we present MedEval, a multi-level, multi-task, and multi-domain medical benchmark to facilitate the development of language models for healthcare. MedEval is comprehensive and consists of data from several healthcare systems and spans 35 human body regions from 8 examination modalities. With 22,779 collected sentences and 21,228 reports, we provide expert annotations at multiple levels, offering a granular potential usage of the data and supporting a wide range of tasks. Moreover, we systematically evaluated 10 generic and domain-specific language models under zero-shot and finetuning settings, from domain-adapted baselines in healthcare to general-purposed state-of-the-art large language models (e.g., ChatGPT). Our evaluations reveal varying effectiveness of the two categories of language models across different tasks, from which we notice the importance of instruction tuning for few-shot usage of large language models. Our investigation paves the way toward benchmarking language models for healthcare and provides valuable insights into the strengths and limitations of adopting large language models in medical domains, informing their practical applications and future advancements.

Large Multimodal Models (LMMs) demonstrate impressive capabilities. However, current benchmarks predominantly focus on image comprehension in specific domains, and these benchmarks are labor-intensive to construct. Moreover, their answers tend to be brief, making it difficult to assess the ability of LMMs to generate detailed descriptions of images. To address these limitations, we propose the MMGenBench-Pipeline, a straightforward and fully automated evaluation pipeline. This involves generating textual descriptions from input images, using these descriptions to create auxiliary images via text-to-image generative models, and then comparing the original and generated images. Furthermore, to ensure the effectiveness of MMGenBench-Pipeline, we design MMGenBench-Test, evaluating LMMs across 13 distinct image patterns, and MMGenBench-Domain, focusing on generative image performance. A thorough evaluation involving over 50 popular LMMs demonstrates the effectiveness and reliability of both the pipeline and benchmark. Our observations indicate that numerous LMMs excelling in existing benchmarks fail to adequately complete the basic tasks related to image understanding and description. This finding highlights the substantial potential for performance improvement in current LMMs and suggests avenues for future model optimization. Concurrently, MMGenBench-Pipeline can efficiently assess the performance of LMMs across diverse domains using only image inputs.

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

Large Vision-Language Models (LVLMs) have made significant progress in the field of video understanding recently. However, current benchmarks uniformly lean on text prompts for evaluation, which often necessitate complex referential language and fail to provide precise spatial and temporal references. This limitation diminishes the experience and efficiency of human-model interaction. To address this limitation, we propose the Video Visual Prompt Benchmark(V2P-Bench), a comprehensive benchmark specifically designed to evaluate LVLMs' video understanding capabilities in multimodal human-model interaction scenarios. V2P-Bench includes 980 unique videos and 1,172 QA pairs, covering 5 main tasks and 12 dimensions, facilitating instance-level fine-grained understanding aligned with human cognition. Benchmarking results reveal that even the most powerful models perform poorly on V2P-Bench (65.4% for GPT-4o and 67.9% for Gemini-1.5-Pro), significantly lower than the human experts' 88.3%, highlighting the current shortcomings of LVLMs in understanding video visual prompts. We hope V2P-Bench will serve as a foundation for advancing multimodal human-model interaction and video understanding evaluation. Project page: https://github.com/gaotiexinqu/V2P-Bench.

Multimodal large language models (MLLMs) have experienced significant advancements recently, but still struggle to recognize and interpret intricate details in high-resolution (HR) images effectively. While state-of-the-art (SOTA) MLLMs claim to process images at 4K resolution, existing MLLM benchmarks only support up to 2K, leaving the capabilities of SOTA models on true HR images largely untested. Furthermore, existing methods for enhancing HR image perception in MLLMs rely on computationally expensive visual instruction tuning. To address these limitations, we introduce HR-Bench, the first deliberately designed benchmark to rigorously evaluate MLLM performance on 4K&8K images. Through extensive experiments, we demonstrate that while downsampling HR images leads to vision information loss, leveraging complementary modalities, e.g., text, can effectively compensate for this loss. Building upon this insight, we propose Divide, Conquer and Combine (DC^2), a novel training-free framework for enhancing MLLM perception of HR images. DC^2 follows a three-staged approach: 1) Divide: recursively partitioning the HR image into patches and merging similar patches to minimize computational overhead, 2) Conquer: leveraging the MLLM to generate accurate textual descriptions for each image patch, and 3) Combine: utilizing the generated text descriptions to enhance the MLLM's understanding of the overall HR image. Extensive experiments show that: 1) the SOTA MLLM achieves 63% accuracy, which is markedly lower than the 87% accuracy achieved by humans on HR-Bench; 2) our DC^2 brings consistent and significant improvements (a relative increase of +6% on HR-Bench and +8% on general multimodal benchmarks). The benchmark and code will be released to facilitate the multimodal R&D community.

The rapid development of Multi-modality Large Language Models (MLLMs) has navigated a paradigm shift in computer vision, moving towards versatile foundational models. However, evaluating MLLMs in low-level visual perception and understanding remains a yet-to-explore domain. To this end, we design benchmark settings to emulate human language responses related to low-level vision: the low-level visual perception (A1) via visual question answering related to low-level attributes (e.g. clarity, lighting); and the low-level visual description (A2), on evaluating MLLMs for low-level text descriptions. Furthermore, given that pairwise comparison can better avoid ambiguity of responses and has been adopted by many human experiments, we further extend the low-level perception-related question-answering and description evaluations of MLLMs from single images to image pairs. Specifically, for perception (A1), we carry out the LLVisionQA+ dataset, comprising 2,990 single images and 1,999 image pairs each accompanied by an open-ended question about its low-level features; for description (A2), we propose the LLDescribe+ dataset, evaluating MLLMs for low-level descriptions on 499 single images and 450 pairs. Additionally, we evaluate MLLMs on assessment (A3) ability, i.e. predicting score, by employing a softmax-based approach to enable all MLLMs to generate quantifiable quality ratings, tested against human opinions in 7 image quality assessment (IQA) datasets. With 24 MLLMs under evaluation, we demonstrate that several MLLMs have decent low-level visual competencies on single images, but only GPT-4V exhibits higher accuracy on pairwise comparisons than single image evaluations (like humans). We hope that our benchmark will motivate further research into uncovering and enhancing these nascent capabilities of MLLMs. Datasets will be available at https://github.com/Q-Future/Q-Bench.

Vision Language Models (VLMs) have undergone a rapid evolution, giving rise to significant advancements in the realm of multimodal understanding tasks. However, the majority of these models are trained and evaluated on English-centric datasets, leaving a gap in the development and evaluation of VLMs for other languages, such as Japanese. This gap can be attributed to the lack of methodologies for constructing VLMs and the absence of benchmarks to accurately measure their performance. To address this issue, we introduce a novel benchmark, Japanese Heron-Bench, for evaluating Japanese capabilities of VLMs. The Japanese Heron-Bench consists of a variety of imagequestion answer pairs tailored to the Japanese context. Additionally, we present a baseline Japanese VLM that has been trained with Japanese visual instruction tuning datasets. Our Heron-Bench reveals the strengths and limitations of the proposed VLM across various ability dimensions. Furthermore, we clarify the capability gap between strong closed models like GPT-4V and the baseline model, providing valuable insights for future research in this domain. We release the benchmark dataset and training code to facilitate further developments in Japanese VLM research.

Evaluating the alignment capabilities of large Vision-Language Models (VLMs) is essential for determining their effectiveness as helpful assistants. However, existing benchmarks primarily focus on basic abilities using nonverbal methods, such as yes-no and multiple-choice questions. In this paper, we address this gap by introducing AlignMMBench, a comprehensive alignment benchmark specifically designed for emerging Chinese VLMs. This benchmark is meticulously curated from real-world scenarios and Chinese Internet sources, encompassing thirteen specific tasks across three categories, and includes both single-turn and multi-turn dialogue scenarios. Incorporating a prompt rewrite strategy, AlignMMBench encompasses 1,054 images and 4,978 question-answer pairs. To facilitate the evaluation pipeline, we propose CritiqueVLM, a rule-calibrated evaluator that exceeds GPT-4's evaluation ability. Finally, we report the performance of representative VLMs on AlignMMBench, offering insights into the capabilities and limitations of different VLM architectures. All evaluation codes and data are available on https://alignmmbench.github.io.

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.

Image representations are often evaluated through disjointed, task-specific protocols, leading to a fragmented understanding of model capabilities. For instance, it is unclear whether an image embedding model adept at clustering images is equally good at retrieving relevant images given a piece of text. We introduce the Massive Image Embedding Benchmark (MIEB) to evaluate the performance of image and image-text embedding models across the broadest spectrum to date. MIEB spans 38 languages across 130 individual tasks, which we group into 8 high-level categories. We benchmark 50 models across our benchmark, finding that no single method dominates across all task categories. We reveal hidden capabilities in advanced vision models such as their accurate visual representation of texts, and their yet limited capabilities in interleaved encodings and matching images and texts in the presence of confounders. We also show that the performance of vision encoders on MIEB correlates highly with their performance when used in multimodal large language models. Our code, dataset, and leaderboard are publicly available at https://github.com/embeddings-benchmark/mteb.

Large-scale multi-modal deep learning models have revolutionized domains such as healthcare, highlighting the importance of computational power. However, in resource-constrained regions like Low and Middle-Income Countries (LMICs), limited access to GPUs and data poses significant challenges, often leaving CPUs as the sole resource. To address this, we advocate for leveraging vector embeddings to enable flexible and efficient computational methodologies, democratizing multimodal deep learning across diverse contexts. Our paper investigates the efficiency and effectiveness of using vector embeddings from single-modal foundation models and multi-modal Vision-Language Models (VLMs) for multimodal deep learning in low-resource environments, particularly in healthcare. Additionally, we propose a simple yet effective inference-time method to enhance performance by aligning image-text embeddings. Comparing these approaches with traditional methods, we assess their impact on computational efficiency and model performance using metrics like accuracy, F1-score, inference time, training time, and memory usage across three medical modalities: BRSET (ophthalmology), HAM10000 (dermatology), and SatelliteBench (public health). Our findings show that embeddings reduce computational demands without compromising model performance. Furthermore, our alignment method improves performance in medical tasks. This research promotes sustainable AI practices by optimizing resources in constrained environments, highlighting the potential of embedding-based approaches for efficient multimodal learning. Vector embeddings democratize multimodal deep learning in LMICs, particularly in healthcare, enhancing AI adaptability in varied use cases.

This research paper focuses on the challenges posed by hallucinations in large language models (LLMs), particularly in the context of the medical domain. Hallucination, wherein these models generate plausible yet unverified or incorrect information, can have serious consequences in healthcare applications. We propose a new benchmark and dataset, Med-HALT (Medical Domain Hallucination Test), designed specifically to evaluate and reduce hallucinations. Med-HALT provides a diverse multinational dataset derived from medical examinations across various countries and includes multiple innovative testing modalities. Med-HALT includes two categories of tests reasoning and memory-based hallucination tests, designed to assess LLMs's problem-solving and information retrieval abilities. Our study evaluated leading LLMs, including Text Davinci, GPT-3.5, LlaMa-2, MPT, and Falcon, revealing significant differences in their performance. The paper provides detailed insights into the dataset, promoting transparency and reproducibility. Through this work, we aim to contribute to the development of safer and more reliable language models in healthcare. Our benchmark can be found at medhalt.github.io

Large Vision-Language Models (LVLMs) have demonstrated remarkable capabilities across multimodal tasks such as visual perception and reasoning, leading to good performance on various multimodal evaluation benchmarks. However, these benchmarks keep a static nature and overlap with the pre-training data, resulting in fixed complexity constraints and data contamination issues. This raises the concern regarding the validity of the evaluation. To address these two challenges, we introduce a dynamic multimodal evaluation protocol called Vision-Language Bootstrapping (VLB). VLB provides a robust and comprehensive assessment for LVLMs with reduced data contamination and flexible complexity. To this end, VLB dynamically generates new visual question-answering samples through a multimodal bootstrapping module that modifies both images and language, while ensuring that newly generated samples remain consistent with the original ones by a judge module. By composing various bootstrapping strategies, VLB offers dynamic variants of existing benchmarks with diverse complexities, enabling the evaluation to co-evolve with the ever-evolving capabilities of LVLMs. Extensive experimental results across multiple benchmarks, including SEEDBench, MMBench, and MME, show that VLB significantly reduces data contamination and exposes performance limitations of LVLMs.

We introduce LingoQA, a novel dataset and benchmark for visual question answering in autonomous driving. The dataset contains 28K unique short video scenarios, and 419K annotations. Evaluating state-of-the-art vision-language models on our benchmark shows that their performance is below human capabilities, with GPT-4V responding truthfully to 59.6% of the questions compared to 96.6% for humans. For evaluation, we propose a truthfulness classifier, called Lingo-Judge, that achieves a 0.95 Spearman correlation coefficient to human evaluations, surpassing existing techniques like METEOR, BLEU, CIDEr, and GPT-4. We establish a baseline vision-language model and run extensive ablation studies to understand its performance. We release our dataset and benchmark https://github.com/wayveai/LingoQA as an evaluation platform for vision-language models in autonomous driving.

Despite the advancements and impressive performance of Multimodal Large Language Models (MLLMs) on benchmarks, their effectiveness in real-world, long-context, and multi-image tasks is unclear due to the benchmarks' limited scope. Existing benchmarks often focus on single-image and short-text samples, and when assessing multi-image tasks, they either limit the image count or focus on specific task (e.g time-series captioning), potentially obscuring the performance challenges of MLLMs. To address these limitations, we introduce MileBench, a pioneering benchmark designed to test the MultImodal Long-contExt capabilities of MLLMs. This benchmark comprises not only multimodal long contexts, but also multiple tasks requiring both comprehension and generation. We establish two distinct evaluation sets, diagnostic and realistic, to systematically assess MLLMs' long-context adaptation capacity and their ability to complete tasks in long-context scenarios. Our experimental results, obtained from testing 20 models, revealed that while the closed-source GPT-4(Vision) and Gemini 1.5 outperform others, most open-source MLLMs struggle in long-context situations. Interestingly, the performance gap tends to widen with an increase in the number of images. We strongly encourage an intensification of research efforts towards enhancing MLLMs' long-context capabilities, especially in scenarios involving multiple images.

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.

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.

In the current literature, most embedding models are based on the encoder-only transformer architecture to extract a dense and meaningful representation of the given input, which can be a text, an image, and more. With the recent advances in language modeling thanks to the introduction of Large Language Models, the possibility of extracting embeddings from these large and extensively trained models has been explored. However, current studies focus on textual embeddings in English, which is also the main language on which these models have been trained. Furthermore, there are very few models that consider multimodal and multilingual input. In light of this, we propose an adaptation methodology for Large Vision-Language Models trained on English language data to improve their performance in extracting multilingual and multimodal embeddings. Finally, we design and introduce a benchmark to evaluate the effectiveness of multilingual and multimodal embedding models.

Several studies showed that Large Language Models (LLMs) can answer medical questions correctly, even outperforming the average human score in some medical exams. However, to our knowledge, no study has been conducted to assess the ability of language models to validate existing or generated medical text for correctness and consistency. In this paper, we introduce MEDEC (https://github.com/abachaa/MEDEC), the first publicly available benchmark for medical error detection and correction in clinical notes, covering five types of errors (Diagnosis, Management, Treatment, Pharmacotherapy, and Causal Organism). MEDEC consists of 3,848 clinical texts, including 488 clinical notes from three US hospital systems that were not previously seen by any LLM. The dataset has been used for the MEDIQA-CORR shared task to evaluate seventeen participating systems [Ben Abacha et al., 2024]. In this paper, we describe the data creation methods and we evaluate recent LLMs (e.g., o1-preview, GPT-4, Claude 3.5 Sonnet, and Gemini 2.0 Flash) for the tasks of detecting and correcting medical errors requiring both medical knowledge and reasoning capabilities. We also conducted a comparative study where two medical doctors performed the same task on the MEDEC test set. The results showed that MEDEC is a sufficiently challenging benchmark to assess the ability of models to validate existing or generated notes and to correct medical errors. We also found that although recent LLMs have a good performance in error detection and correction, they are still outperformed by medical doctors in these tasks. We discuss the potential factors behind this gap, the insights from our experiments, the limitations of current evaluation metrics, and share potential pointers for future research.

We introduce Falcon2-11B, a foundation model trained on over five trillion tokens, and its multimodal counterpart, Falcon2-11B-vlm, which is a vision-to-text model. We report our findings during the training of the Falcon2-11B which follows a multi-stage approach where the early stages are distinguished by their context length and a final stage where we use a curated, high-quality dataset. Additionally, we report the effect of doubling the batch size mid-training and how training loss spikes are affected by the learning rate. The downstream performance of the foundation model is evaluated on established benchmarks, including multilingual and code datasets. The foundation model shows strong generalization across all the tasks which makes it suitable for downstream finetuning use cases. For the vision language model, we report the performance on several benchmarks and show that our model achieves a higher average score compared to open-source models of similar size. The model weights and code of both Falcon2-11B and Falcon2-11B-vlm are made available under a permissive license.

With the advancements in Large Language Models (LLMs), Vision-Language Models (VLMs) have reached a new level of sophistication, showing notable competence in executing intricate cognition and reasoning tasks. However, existing evaluation benchmarks, primarily relying on rigid, hand-crafted datasets to measure task-specific performance, face significant limitations in assessing the alignment of these increasingly anthropomorphic models with human intelligence. In this work, we address the limitations via Auto-Bench, which delves into exploring LLMs as proficient aligners, measuring the alignment between VLMs and human intelligence and value through automatic data curation and assessment. Specifically, for data curation, Auto-Bench utilizes LLMs (e.g., GPT-4) to automatically generate a vast set of question-answer-reasoning triplets via prompting on visual symbolic representations (e.g., captions, object locations, instance relationships, and etc.). The curated data closely matches human intent, owing to the extensive world knowledge embedded in LLMs. Through this pipeline, a total of 28.5K human-verified and 3,504K unfiltered question-answer-reasoning triplets have been curated, covering 4 primary abilities and 16 sub-abilities. We subsequently engage LLMs like GPT-3.5 to serve as judges, implementing the quantitative and qualitative automated assessments to facilitate a comprehensive evaluation of VLMs. Our validation results reveal that LLMs are proficient in both evaluation data curation and model assessment, achieving an average agreement rate of 85%. We envision Auto-Bench as a flexible, scalable, and comprehensive benchmark for evaluating the evolving sophisticated VLMs.

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.

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.

Given the remarkable success that large visual language models (LVLMs) have achieved in image perception tasks, the endeavor to make LVMLs perceive the world like humans is drawing increasing attention. Current multi-modal benchmarks mainly focus on the objective fact or certain topic related potential knowledge within a image, but overlook the associative relations between multiple images. Therefore, we define a multi-image relation association task, and meticulously curate MMRA benchmark, a Multi-granularity Multi-image Relational Association benchmark, consisted of 1026 samples. In order to systematically and comprehensively evaluate mainstream LVLMs, we establish an associational relation system among images that contain 11 subtasks (e.g, UsageSimilarity, SubEvent, etc.) at two granularity levels (i.e., "image" and "entity") according to the relations in ConceptNet. Our experiments demonstrate that, on our MMRA benchmark, current mainstream LVLMs all have their own advantages and disadvantages across different subtasks. It is worth noting that, at the entity level, the performance of all models is worse than that of them at the image level, indicating that the fine-grained multi-image perception task is still challenging for LVLMs. The tasks related to spatial perception are relatively difficult for LVLMs to handle. Furthermore, we find that LVMLs exhibit a good ability to perceive image details, and the key to enhancing their multi-image association capability is to strengthen the reasoning ability of their language model component. All our codes and data are released at htthttps://github.com/Wusiwei0410/MMRA.

Vision language models (VLMs) perceive the world through a combination of a visual encoder and a large language model (LLM). The visual encoder, pre-trained on large-scale vision-text datasets, provides zero-shot generalization to visual data, and the LLM endows its high reasoning ability to VLMs. It leads VLMs to achieve high performance on wide benchmarks without fine-tuning, exhibiting zero or few-shot capability. However, recent studies show that VLMs are vulnerable to hallucination. This undesirable behavior degrades reliability and credibility, thereby making users unable to fully trust the output from VLMs. To enhance trustworthiness and better tackle the hallucination of VLMs, we curate a new evaluation dataset, called the BEfore-AFter hallucination dataset (BEAF), and introduce new metrics: True Understanding (TU), IGnorance (IG), StuBbornness (SB), and InDecision (ID). Unlike prior works that focus only on constructing questions and answers, the key idea of our benchmark is to manipulate visual scene information by image editing models and to design the metrics based on scene changes. This allows us to clearly assess whether VLMs correctly understand a given scene by observing the ability to perceive changes. We also visualize image-wise object relationship by virtue of our two-axis view: vision and text. Upon evaluating VLMs with our dataset, we observed that our metrics reveal different aspects of VLM hallucination that have not been reported before. Project page: https://beafbench.github.io/

Recent advancements in Large Language Models (LLMs) have demonstrated their potential in delivering accurate answers to questions about world knowledge. Despite this, existing benchmarks for evaluating LLMs in healthcare predominantly focus on medical doctors, leaving other critical healthcare professions underrepresented. To fill this research gap, we introduce the Examinations for Medical Personnel in Chinese (EMPEC), a pioneering large-scale healthcare knowledge benchmark in traditional Chinese. EMPEC consists of 157,803 exam questions across 124 subjects and 20 healthcare professions, including underrepresented occupations like Optometrists and Audiologists. Each question is tagged with its release time and source, ensuring relevance and authenticity. We conducted extensive experiments on 17 LLMs, including proprietary, open-source models, general domain models and medical specific models, evaluating their performance under various settings. Our findings reveal that while leading models like GPT-4 achieve over 75\% accuracy, they still struggle with specialized fields and alternative medicine. Surprisingly, general-purpose LLMs outperformed medical-specific models, and incorporating EMPEC's training data significantly enhanced performance. Additionally, the results on questions released after the models' training cutoff date were consistent with overall performance trends, suggesting that the models' performance on the test set can predict their effectiveness in addressing unseen healthcare-related queries. The transition from traditional to simplified Chinese characters had a negligible impact on model performance, indicating robust linguistic versatility. Our study underscores the importance of expanding benchmarks to cover a broader range of healthcare professions to better assess the applicability of LLMs in real-world healthcare scenarios.

Multimodal Large Language Models (MLLMs) have demonstrated impressive capabilities in understanding common visual elements, largely due to their large-scale datasets and advanced training strategies. However, their effectiveness in medical applications remains limited due to the inherent discrepancies between data and tasks in medical scenarios and those in the general domain. Concretely, existing medical MLLMs face the following critical limitations: (1) limited coverage of medical knowledge beyond imaging, (2) heightened susceptibility to hallucinations due to suboptimal data curation processes, (3) lack of reasoning capabilities tailored for complex medical scenarios. To address these challenges, we first propose a comprehensive data curation procedure that (1) efficiently acquires rich medical knowledge data not only from medical imaging but also from extensive medical texts and general-domain data; and (2) synthesizes accurate medical captions, visual question answering (VQA), and reasoning samples. As a result, we build a multimodal dataset enriched with extensive medical knowledge. Building on the curated data, we introduce our medical-specialized MLLM: Lingshu. Lingshu undergoes multi-stage training to embed medical expertise and enhance its task-solving capabilities progressively. Besides, we preliminarily explore the potential of applying reinforcement learning with verifiable rewards paradigm to enhance Lingshu's medical reasoning ability. Additionally, we develop MedEvalKit, a unified evaluation framework that consolidates leading multimodal and textual medical benchmarks for standardized, fair, and efficient model assessment. We evaluate the performance of Lingshu on three fundamental medical tasks, multimodal QA, text-based QA, and medical report generation. The results show that Lingshu consistently outperforms the existing open-source multimodal models on most tasks ...

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.

Recently, large language and vision models (LLVMs) have received significant attention and development efforts due to their remarkable generalization performance across a wide range of tasks requiring perception and cognitive abilities. A key factor behind their success is their simple architecture, which consists of a vision encoder, a projector, and a large language model (LLM). Despite their achievements in advanced reasoning tasks, their performance on fundamental perception-related tasks (e.g., MMVP) remains surprisingly low. This discrepancy raises the question of how LLVMs truly perceive images and exploit the advantages of the vision encoder. To address this, we systematically investigate this question regarding several aspects: permutation invariance, robustness, math reasoning, alignment preserving and importance, by evaluating the most common LLVM's families (i.e., LLaVA) across 10 evaluation benchmarks. Our extensive experiments reveal several intriguing properties of current LLVMs: (1) they internally process the image in a global manner, even when the order of visual patch sequences is randomly permuted; (2) they are sometimes able to solve math problems without fully perceiving detailed numerical information; (3) the cross-modal alignment is overfitted to complex reasoning tasks, thereby, causing them to lose some of the original perceptual capabilities of their vision encoder; (4) the representation space in the lower layers (<25%) plays a crucial role in determining performance and enhancing visual understanding. Lastly, based on the above observations, we suggest potential future directions for building better LLVMs and constructing more challenging evaluation benchmarks.

With the ever-increasing popularity of pretrained Video-Language Models (VidLMs), there is a pressing need to develop robust evaluation methodologies that delve deeper into their visio-linguistic capabilities. To address this challenge, we present ViLMA (Video Language Model Assessment), a task-agnostic benchmark that places the assessment of fine-grained capabilities of these models on a firm footing. Task-based evaluations, while valuable, fail to capture the complexities and specific temporal aspects of moving images that VidLMs need to process. Through carefully curated counterfactuals, ViLMA offers a controlled evaluation suite that sheds light on the true potential of these models, as well as their performance gaps compared to human-level understanding. ViLMA also includes proficiency tests, which assess basic capabilities deemed essential to solving the main counterfactual tests. We show that current VidLMs' grounding abilities are no better than those of vision-language models which use static images. This is especially striking once the performance on proficiency tests is factored in. Our benchmark serves as a catalyst for future research on VidLMs, helping to highlight areas that still need to be explored.

We introduce VisIT-Bench (Visual InsTruction Benchmark), a benchmark for evaluation of instruction-following vision-language models for real-world use. Our starting point is curating 70 'instruction families' that we envision instruction tuned vision-language models should be able to address. Extending beyond evaluations like VQAv2 and COCO, tasks range from basic recognition to game playing and creative generation. Following curation, our dataset comprises 592 test queries, each with a human-authored instruction-conditioned caption. These descriptions surface instruction-specific factors, e.g., for an instruction asking about the accessibility of a storefront for wheelchair users, the instruction-conditioned caption describes ramps/potential obstacles. These descriptions enable 1) collecting human-verified reference outputs for each instance; and 2) automatic evaluation of candidate multimodal generations using a text-only LLM, aligning with human judgment. We quantify quality gaps between models and references using both human and automatic evaluations; e.g., the top-performing instruction-following model wins against the GPT-4 reference in just 27% of the comparison. VisIT-Bench is dynamic to participate, practitioners simply submit their model's response on the project website; Data, code and leaderboard is available at visit-bench.github.io.

With the rapid advancement of multimodal large language models (MLLMs), their evaluation has become increasingly comprehensive. However, understanding long multimodal content, as a foundational ability for real-world applications, remains underexplored. In this work, we present Needle In A Multimodal Haystack (MM-NIAH), the first benchmark specifically designed to systematically evaluate the capability of existing MLLMs to comprehend long multimodal documents. Our benchmark includes three types of evaluation tasks: multimodal retrieval, counting, and reasoning. In each task, the model is required to answer the questions according to different key information scattered throughout the given multimodal document. Evaluating the leading MLLMs on MM-NIAH, we observe that existing models still have significant room for improvement on these tasks, especially on vision-centric evaluation. We hope this work can provide a platform for further research on long multimodal document comprehension and contribute to the advancement of MLLMs. Code and benchmark are released at https://github.com/OpenGVLab/MM-NIAH.

As large language models (LLMs) continue to advance in linguistic capabilities, robust multilingual evaluation has become essential for promoting equitable technological progress. This position paper examines over 2,000 multilingual (non-English) benchmarks from 148 countries, published between 2021 and 2024, to evaluate past, present, and future practices in multilingual benchmarking. Our findings reveal that, despite significant investments amounting to tens of millions of dollars, English remains significantly overrepresented in these benchmarks. Additionally, most benchmarks rely on original language content rather than translations, with the majority sourced from high-resource countries such as China, India, Germany, the UK, and the USA. Furthermore, a comparison of benchmark performance with human judgments highlights notable disparities. STEM-related tasks exhibit strong correlations with human evaluations (0.70 to 0.85), while traditional NLP tasks like question answering (e.g., XQuAD) show much weaker correlations (0.11 to 0.30). Moreover, translating English benchmarks into other languages proves insufficient, as localized benchmarks demonstrate significantly higher alignment with local human judgments (0.68) than their translated counterparts (0.47). This underscores the importance of creating culturally and linguistically tailored benchmarks rather than relying solely on translations. Through this comprehensive analysis, we highlight six key limitations in current multilingual evaluation practices, propose the guiding principles accordingly for effective multilingual benchmarking, and outline five critical research directions to drive progress in the field. Finally, we call for a global collaborative effort to develop human-aligned benchmarks that prioritize real-world applications.

Multimodal in-context learning (ICL) remains underexplored despite significant potential for domains such as medicine. Clinicians routinely encounter diverse, specialized tasks requiring adaptation from limited examples, such as drawing insights from a few relevant prior cases or considering a constrained set of differential diagnoses. While multimodal large language models (MLLMs) have shown advances in medical visual question answering (VQA), their ability to learn multimodal tasks from context is largely unknown. We introduce SMMILE, the first expert-driven multimodal ICL benchmark for medical tasks. Eleven medical experts curated problems, each including a multimodal query and multimodal in-context examples as task demonstrations. SMMILE encompasses 111 problems (517 question-image-answer triplets) covering 6 medical specialties and 13 imaging modalities. We further introduce SMMILE++, an augmented variant with 1038 permuted problems. A comprehensive evaluation of 15 MLLMs demonstrates that most models exhibit moderate to poor multimodal ICL ability in medical tasks. In open-ended evaluations, ICL contributes only 8% average improvement over zero-shot on SMMILE and 9.4% on SMMILE++. We observe a susceptibility for irrelevant in-context examples: even a single noisy or irrelevant example can degrade performance by up to 9.5%. Moreover, example ordering exhibits a recency bias, i.e., placing the most relevant example last can lead to substantial performance improvements by up to 71%. Our findings highlight critical limitations and biases in current MLLMs when learning multimodal medical tasks from context.

Although large Vision-Language Models (VLMs) have demonstrated remarkable performance in a wide range of multimodal tasks, their true reasoning capabilities on human IQ tests remain underexplored. To advance research on the fluid intelligence of VLMs, we introduce **IQBench**, a new benchmark designed to evaluate VLMs on standardized visual IQ tests. We focus on evaluating the reasoning capabilities of VLMs, which we argue are more important than the accuracy of the final prediction. **Our benchmark is visually centric, minimizing the dependence on unnecessary textual content**, thus encouraging models to derive answers primarily from image-based information rather than learned textual knowledge. To this end, we manually collected and annotated 500 visual IQ questions to **prevent unintentional data leakage during training**. Unlike prior work that focuses primarily on the accuracy of the final answer, we evaluate the reasoning ability of the models by assessing their explanations and the patterns used to solve each problem, along with the accuracy of the final prediction and human evaluation. Our experiments show that there are substantial performance disparities between tasks, with models such as `o4-mini`, `gemini-2.5-flash`, and `claude-3.7-sonnet` achieving the highest average accuracies of 0.615, 0.578, and 0.548, respectively. However, all models struggle with 3D spatial and anagram reasoning tasks, highlighting significant limitations in current VLMs' general reasoning abilities. In terms of reasoning scores, `o4-mini`, `gemini-2.5-flash`, and `claude-3.7-sonnet` achieved top averages of 0.696, 0.586, and 0.516, respectively. These results highlight inconsistencies between the reasoning processes of the models and their final answers, emphasizing the importance of evaluating the accuracy of the reasoning in addition to the final predictions.

Comprehending text-rich visual content is paramount for the practical application of Multimodal Large Language Models (MLLMs), since text-rich scenarios are ubiquitous in the real world, which are characterized by the presence of extensive texts embedded within images. Recently, the advent of MLLMs with impressive versatility has raised the bar for what we can expect from MLLMs. However, their proficiency in text-rich scenarios has yet to be comprehensively and objectively assessed, since current MLLM benchmarks primarily focus on evaluating general visual comprehension. In this work, we introduce SEED-Bench-2-Plus, a benchmark specifically designed for evaluating text-rich visual comprehension of MLLMs. Our benchmark comprises 2.3K multiple-choice questions with precise human annotations, spanning three broad categories: Charts, Maps, and Webs, each of which covers a wide spectrum of text-rich scenarios in the real world. These categories, due to their inherent complexity and diversity, effectively simulate real-world text-rich environments. We further conduct a thorough evaluation involving 34 prominent MLLMs (including GPT-4V, Gemini-Pro-Vision and Claude-3-Opus) and emphasize the current limitations of MLLMs in text-rich visual comprehension. We hope that our work can serve as a valuable addition to existing MLLM benchmarks, providing insightful observations and inspiring further research in the area of text-rich visual comprehension with MLLMs. The dataset and evaluation code can be accessed at https://github.com/AILab-CVC/SEED-Bench.

Large Vision-Language Models (LVLMs) have demonstrated remarkable performance in performing complex multimodal tasks. However, they are still plagued by object hallucination: the misidentification or misclassification of objects present in images. To this end, we propose HALLUCINOGEN, a novel visual question answering (VQA) object hallucination attack benchmark that utilizes diverse contextual reasoning prompts to evaluate object hallucination in state-of-the-art LVLMs. We design a series of contextual reasoning hallucination prompts to evaluate LVLMs' ability to accurately identify objects in a target image while asking them to perform diverse visual-language tasks such as identifying, locating or performing visual reasoning around specific objects. Further, we extend our benchmark to high-stakes medical applications and introduce MED-HALLUCINOGEN, hallucination attacks tailored to the biomedical domain, and evaluate the hallucination performance of LVLMs on medical images, a critical area where precision is crucial. Finally, we conduct extensive evaluations of eight LVLMs and two hallucination mitigation strategies across multiple datasets to show that current generic and medical LVLMs remain susceptible to hallucination attacks.

Developing the required technology to assist medical experts in their everyday activities is currently a hot topic in the Artificial Intelligence research field. Thus, a number of large language models (LLMs) and automated benchmarks have recently been proposed with the aim of facilitating information extraction in Evidence-Based Medicine (EBM) using natural language as a tool for mediating in human-AI interaction. The most representative benchmarks are limited to either multiple-choice or long-form answers and are available only in English. In order to address these shortcomings, in this paper we present a new dataset which, unlike previous work: (i) includes not only explanatory arguments for the correct answer, but also arguments to reason why the incorrect answers are not correct; (ii) the explanations are written originally by medical doctors to answer questions from the Spanish Residency Medical Exams. Furthermore, this new benchmark allows us to setup a novel extractive task which consists of identifying the explanation of the correct answer written by medical doctors. An additional benefit of our setting is that we can leverage the extractive QA paradigm to automatically evaluate performance of LLMs without resorting to costly manual evaluation by medical experts. Comprehensive experimentation with language models for Spanish shows that sometimes multilingual models fare better than monolingual ones, even outperforming models which have been adapted to the medical domain. Furthermore, results across the monolingual models are mixed, with supposedly smaller and inferior models performing competitively. In any case, the obtained results show that our novel dataset and approach can be an effective technique to help medical practitioners in identifying relevant evidence-based explanations for medical questions.

We introduce Pixtral-12B, a 12--billion-parameter multimodal language model. Pixtral-12B is trained to understand both natural images and documents, achieving leading performance on various multimodal benchmarks, surpassing a number of larger models. Unlike many open-source models, Pixtral is also a cutting-edge text model for its size, and does not compromise on natural language performance to excel in multimodal tasks. Pixtral uses a new vision encoder trained from scratch, which allows it to ingest images at their natural resolution and aspect ratio. This gives users flexibility on the number of tokens used to process an image. Pixtral is also able to process any number of images in its long context window of 128K tokens. Pixtral 12B substanially outperforms other open models of similar sizes (Llama-3.2 11B \& Qwen-2-VL 7B). It also outperforms much larger open models like Llama-3.2 90B while being 7x smaller. We further contribute an open-source benchmark, MM-MT-Bench, for evaluating vision-language models in practical scenarios, and provide detailed analysis and code for standardized evaluation protocols for multimodal LLMs. Pixtral-12B is released under Apache 2.0 license.

To create culturally inclusive vision-language models (VLMs), the foremost requirement is developing a test benchmark that can diagnose the models' ability to respond to questions reflecting cultural elements. This paper addresses the necessity for such benchmarks, noting that existing research has relied on human annotators' manual efforts, which impedes diversity and efficiency. We propose a semi-automated pipeline for constructing cultural VLM benchmarks to enhance diversity and efficiency. This pipeline leverages human-VLM collaboration, where VLMs generate questions based on guidelines, human-annotated examples, and image-wise relevant knowledge, which are then reviewed by native speakers for quality and cultural relevance. The effectiveness of our adaptable pipeline is demonstrated through a specific application: creating a dataset tailored to Korean culture, dubbed K-Viscuit. The resulting benchmark features two types of questions: Type 1 questions measure visual recognition abilities, while Type 2 assess fine-grained visual reasoning skills. This ensures a thorough diagnosis of VLM models across various aspects. Our evaluation using K-Viscuit revealed that open-source models notably lag behind proprietary models in understanding Korean culture, highlighting areas for improvement. We provided diverse analyses of VLM performance across different cultural aspects. Besides, we explored the potential of incorporating external knowledge retrieval to enhance the generation process, suggesting future directions for improving cultural interpretation ability of VLMs. Our dataset and code will be made publicly available.

The advancement of Large Vision-Language Models (LVLMs) has propelled their application in the medical field. However, Medical LVLMs (Med-LVLMs) encounter factuality challenges due to modality misalignment, where the models prioritize textual knowledge over visual input, leading to hallucinations that contradict information in medical images. Previous attempts to enhance modality alignment in Med-LVLMs through preference optimization have inadequately mitigated clinical relevance in preference data, making these samples easily distinguishable and reducing alignment effectiveness. To address this challenge, we propose MMedPO, a novel multimodal medical preference optimization approach that considers the clinical relevance of preference samples to enhance Med-LVLM alignment. MMedPO curates multimodal preference data by introducing two types of dispreference: (1) plausible hallucinations injected through target Med-LVLMs or GPT-4o to produce medically inaccurate responses, and (2) lesion region neglect achieved through local lesion-noising, disrupting visual understanding of critical areas. We then calculate clinical relevance for each sample based on scores from multiple Med-LLMs and visual tools, and integrate these scores into the preference optimization process as weights, enabling effective alignment. Our experiments demonstrate that MMedPO significantly enhances factual accuracy in Med-LVLMs, achieving substantial improvements over existing preference optimization methods by averaging 14.2% and 51.7% across the Med-VQA and report generation tasks. Our code are available in https://github.com/aiming-lab/MMedPO.

Recent advancements in Large Vision-Language Models (LVLMs) have significantly enhanced their ability to integrate visual and linguistic information, achieving near-human proficiency in tasks like object recognition, captioning, and visual question answering. However, current benchmarks typically focus on knowledge-centric evaluations that assess domain-specific expertise, often neglecting the core ability to reason about fundamental mathematical elements and visual concepts. We identify a gap in evaluating elementary-level math problems, which rely on explicit visual dependencies-requiring models to discern, integrate, and reason across multiple images while incorporating commonsense knowledge, all of which are crucial for advancing toward broader AGI capabilities. To address this gap, we introduce VCBENCH, a comprehensive benchmark for multimodal mathematical reasoning with explicit visual dependencies. VCBENCH includes 1,720 problems across six cognitive domains, featuring 6,697 images (averaging 3.9 per question) to ensure multi-image reasoning. We evaluate 26 state-of-the-art LVLMs on VCBENCH, revealing substantial performance disparities, with even the top models unable to exceed 50% accuracy. Our findings highlight the ongoing challenges in visual-mathematical integration and suggest avenues for future LVLM advancements.

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.

The rapid extension of context windows in large vision-language models has given rise to long-context vision-language models (LCVLMs), which are capable of handling hundreds of images with interleaved text tokens in a single forward pass. In this work, we introduce MMLongBench, the first benchmark covering a diverse set of long-context vision-language tasks, to evaluate LCVLMs effectively and thoroughly. MMLongBench is composed of 13,331 examples spanning five different categories of downstream tasks, such as Visual RAG and Many-Shot ICL. It also provides broad coverage of image types, including various natural and synthetic images. To assess the robustness of the models to different input lengths, all examples are delivered at five standardized input lengths (8K-128K tokens) via a cross-modal tokenization scheme that combines vision patches and text tokens. Through a thorough benchmarking of 46 closed-source and open-source LCVLMs, we provide a comprehensive analysis of the current models' vision-language long-context ability. Our results show that: i) performance on a single task is a weak proxy for overall long-context capability; ii) both closed-source and open-source models face challenges in long-context vision-language tasks, indicating substantial room for future improvement; iii) models with stronger reasoning ability tend to exhibit better long-context performance. By offering wide task coverage, various image types, and rigorous length control, MMLongBench provides the missing foundation for diagnosing and advancing the next generation of LCVLMs.

We introduce MIA-Bench, a new benchmark designed to evaluate multimodal large language models (MLLMs) on their ability to strictly adhere to complex instructions. Our benchmark comprises a diverse set of 400 image-prompt pairs, each crafted to challenge the models' compliance with layered instructions in generating accurate responses that satisfy specific requested patterns. Evaluation results from a wide array of state-of-the-art MLLMs reveal significant variations in performance, highlighting areas for improvement in instruction fidelity. Additionally, we create extra training data and explore supervised fine-tuning to enhance the models' ability to strictly follow instructions without compromising performance on other tasks. We hope this benchmark not only serves as a tool for measuring MLLM adherence to instructions, but also guides future developments in MLLM training methods.

The rapid progress in Large Language Models (LLMs) has prompted the creation of numerous benchmarks to evaluate their capabilities.This study focuses on the Comprehensive Medical Benchmark in Chinese (CMB), showcasing how dataset diversity and distribution in supervised fine-tuning (SFT) may enhance LLM performance.Remarkably, We successfully trained a smaller base model to achieve scores comparable to larger models, indicating that a diverse and well-distributed dataset can optimize performance regardless of model size.This study suggests that even smaller models may reach high performance levels with carefully curated and varied datasets.By integrating a wide range of instructional content, our approach addresses potential issues such as data quality inconsistencies. Our results imply that a broader spectrum of training data may enhance a model's ability to generalize and perform effectively across different medical scenarios, highlighting the importance of dataset quality and diversity in fine-tuning processes.

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.

Large Multimodal Models (LMMs) exhibit major shortfalls when interpreting images and, by some measures, have poorer spatial cognition than small children or animals. Despite this, they attain high scores on many popular visual benchmarks, with headroom rapidly eroded by an ongoing surge of model progress. To address this, there is a pressing need for difficult benchmarks that remain relevant for longer. We take this idea to its limit by introducing ZeroBench-a lightweight visual reasoning benchmark that is entirely impossible for contemporary frontier LMMs. Our benchmark consists of 100 manually curated questions and 334 less difficult subquestions. We evaluate 20 LMMs on ZeroBench, all of which score 0.0%, and rigorously analyse the errors. To encourage progress in visual understanding, we publicly release ZeroBench.

Multimodal large language models (MLLMs), building upon the foundation of powerful large language models (LLMs), have recently demonstrated exceptional capabilities in generating not only texts but also images given interleaved multimodal inputs (acting like a combination of GPT-4V and DALL-E 3). However, existing MLLM benchmarks remain limited to assessing only models' comprehension ability of single image-text inputs, failing to keep up with the strides made in MLLMs. A comprehensive benchmark is imperative for investigating the progress and uncovering the limitations of current MLLMs. In this work, we categorize the capabilities of MLLMs into hierarchical levels from L_0 to L_4 based on the modalities they can accept and generate, and propose SEED-Bench-2, a comprehensive benchmark that evaluates the hierarchical capabilities of MLLMs. Specifically, SEED-Bench-2 comprises 24K multiple-choice questions with accurate human annotations, which spans 27 dimensions, including the evaluation of both text and image generation. Multiple-choice questions with groundtruth options derived from human annotation enables an objective and efficient assessment of model performance, eliminating the need for human or GPT intervention during evaluation. We further evaluate the performance of 23 prominent open-source MLLMs and summarize valuable observations. By revealing the limitations of existing MLLMs through extensive evaluations, we aim for SEED-Bench-2 to provide insights that will motivate future research towards the goal of General Artificial Intelligence. Dataset and evaluation code are available at https://github.com/AILab-CVC/SEED-Bench

The rapid evolution of Multi-modality Large Language Models (MLLMs) has catalyzed a shift in computer vision from specialized models to general-purpose foundation models. Nevertheless, there is still an inadequacy in assessing the abilities of MLLMs on low-level visual perception and understanding. To address this gap, we present Q-Bench, a holistic benchmark crafted to systematically evaluate potential abilities of MLLMs on three realms: low-level visual perception, low-level visual description, and overall visual quality assessment. a) To evaluate the low-level perception ability, we construct the LLVisionQA dataset, consisting of 2,990 diverse-sourced images, each equipped with a human-asked question focusing on its low-level attributes. We then measure the correctness of MLLMs on answering these questions. b) To examine the description ability of MLLMs on low-level information, we propose the LLDescribe dataset consisting of long expert-labelled golden low-level text descriptions on 499 images, and a GPT-involved comparison pipeline between outputs of MLLMs and the golden descriptions. c) Besides these two tasks, we further measure their visual quality assessment ability to align with human opinion scores. Specifically, we design a softmax-based strategy that enables MLLMs to predict quantifiable quality scores, and evaluate them on various existing image quality assessment (IQA) datasets. Our evaluation across the three abilities confirms that MLLMs possess preliminary low-level visual skills. However, these skills are still unstable and relatively imprecise, indicating the need for specific enhancements on MLLMs towards these abilities. We hope that our benchmark can encourage the research community to delve deeper to discover and enhance these untapped potentials of MLLMs. Project Page: https://vqassessment.github.io/Q-Bench.

Large Vision-Language Models (LVLMs) show significant strides in general-purpose multimodal applications such as visual dialogue and embodied navigation. However, existing multimodal evaluation benchmarks cover a limited number of multimodal tasks testing rudimentary capabilities, falling short in tracking LVLM development. In this study, we present MMT-Bench, a comprehensive benchmark designed to assess LVLMs across massive multimodal tasks requiring expert knowledge and deliberate visual recognition, localization, reasoning, and planning. MMT-Bench comprises 31,325 meticulously curated multi-choice visual questions from various multimodal scenarios such as vehicle driving and embodied navigation, covering 32 core meta-tasks and 162 subtasks in multimodal understanding. Due to its extensive task coverage, MMT-Bench enables the evaluation of LVLMs using a task map, facilitating the discovery of in- and out-of-domain tasks. Evaluation results involving 30 LVLMs such as the proprietary GPT-4V, GeminiProVision, and open-sourced InternVL-Chat, underscore the significant challenges posed by MMT-Bench. We anticipate that MMT-Bench will inspire the community to develop next-generation multimodal foundation models aimed at achieving general-purpose multimodal intelligence.

While deep networks have achieved broad success in analyzing natural images, when applied to medical scans, they often fail in unexcepted situations. We investigate this challenge and focus on model sensitivity to domain shifts, such as data sampled from different hospitals or data confounded by demographic variables such as sex, race, etc, in the context of chest X-rays and skin lesion images. A key finding we show empirically is that existing visual backbones lack an appropriate prior from the architecture for reliable generalization in these settings. Taking inspiration from medical training, we propose giving deep networks a prior grounded in explicit medical knowledge communicated in natural language. To this end, we introduce Knowledge-enhanced Bottlenecks (KnoBo), a class of concept bottleneck models that incorporates knowledge priors that constrain it to reason with clinically relevant factors found in medical textbooks or PubMed. KnoBo uses retrieval-augmented language models to design an appropriate concept space paired with an automatic training procedure for recognizing the concept. We evaluate different resources of knowledge and recognition architectures on a broad range of domain shifts across 20 datasets. In our comprehensive evaluation with two imaging modalities, KnoBo outperforms fine-tuned models on confounded datasets by 32.4% on average. Finally, evaluations reveal that PubMed is a promising resource for making medical models less sensitive to domain shift, outperforming other resources on both diversity of information and final prediction performance.

Vision-language models (VLMs) are typically composed of a vision encoder, e.g. CLIP, and a language model (LM) that interprets the encoded features to solve downstream tasks. Despite remarkable progress, VLMs are subject to several shortcomings due to the limited capabilities of vision encoders, e.g. "blindness" to certain image features, visual hallucination, etc. To address these issues, we study broadening the visual encoding capabilities of VLMs. We first comprehensively benchmark several vision encoders with different inductive biases for solving VLM tasks. We observe that there is no single encoding configuration that consistently achieves top performance across different tasks, and encoders with different biases can perform surprisingly similarly. Motivated by this, we introduce a method, named BRAVE, that consolidates features from multiple frozen encoders into a more versatile representation that can be directly fed as the input to a frozen LM. BRAVE achieves state-of-the-art performance on a broad range of captioning and VQA benchmarks and significantly reduces the aforementioned issues of VLMs, while requiring a smaller number of trainable parameters than existing methods and having a more compressed representation. Our results highlight the potential of incorporating different visual biases for a more broad and contextualized visual understanding of VLMs.

High computation costs and latency of large language models such as GPT-4 have limited their deployment in clinical settings. Small language models (SLMs) offer a cost-effective alternative, but their limited capacity requires biomedical domain adaptation, which remains challenging. An additional bottleneck is the unavailability and high sensitivity of clinical data. To address these challenges, we propose a novel framework for adapting SLMs into high-performing clinical models. We introduce the MediPhi collection of 3.8B-parameter SLMs developed with our novel framework: pre-instruction tuning of experts on relevant medical and clinical corpora (PMC, Medical Guideline, MedWiki, etc.), model merging, and clinical-tasks alignment. To cover most clinical tasks, we extended the CLUE benchmark to CLUE+, doubling its size. Our expert models deliver relative improvements on this benchmark over the base model without any task-specific fine-tuning: 64.3% on medical entities, 49.5% on radiology reports, and 44% on ICD-10 coding (outperforming GPT-4-0125 by 14%). We unify the expert models into MediPhi via model merging, preserving gains across benchmarks. Furthermore, we built the MediFlow collection, a synthetic dataset of 2.5 million high-quality instructions on 14 medical NLP tasks, 98 fine-grained document types, and JSON format support. Alignment of MediPhi using supervised fine-tuning and direct preference optimization achieves further gains of 18.9% on average.

We introduce MedXpertQA, a highly challenging and comprehensive benchmark to evaluate expert-level medical knowledge and advanced reasoning. MedXpertQA includes 4,460 questions spanning 17 specialties and 11 body systems. It includes two subsets, Text for text evaluation and MM for multimodal evaluation. Notably, MM introduces expert-level exam questions with diverse images and rich clinical information, including patient records and examination results, setting it apart from traditional medical multimodal benchmarks with simple QA pairs generated from image captions. MedXpertQA applies rigorous filtering and augmentation to address the insufficient difficulty of existing benchmarks like MedQA, and incorporates specialty board questions to improve clinical relevance and comprehensiveness. We perform data synthesis to mitigate data leakage risk and conduct multiple rounds of expert reviews to ensure accuracy and reliability. We evaluate 16 leading models on MedXpertQA. Moreover, medicine is deeply connected to real-world decision-making, providing a rich and representative setting for assessing reasoning abilities beyond mathematics and code. To this end, we develop a reasoning-oriented subset to facilitate the assessment of o1-like models.

Large Multimodal Models (LMMs) exhibit impressive cross-modal understanding and reasoning abilities, often assessed through multiple-choice questions (MCQs) that include an image, a question, and several options. However, many benchmarks used for such evaluations suffer from systematic biases. Remarkably, Large Language Models (LLMs) without any visual perception capabilities achieve non-trivial performance, undermining the credibility of these evaluations. To address this issue while maintaining the efficiency of MCQ evaluations, we propose MMEvalPro, a benchmark designed to avoid Type-I errors through a trilogy evaluation pipeline and more rigorous metrics. For each original question from existing benchmarks, human annotators augment it by creating one perception question and one knowledge anchor question through a meticulous annotation process. MMEvalPro comprises 2,138 question triplets, totaling 6,414 distinct questions. Two-thirds of these questions are manually labeled by human experts, while the rest are sourced from existing benchmarks (MMMU, ScienceQA, and MathVista). Compared with the existing benchmarks, our experiments with the latest LLMs and LMMs demonstrate that MMEvalPro is more challenging (the best LMM lags behind human performance by 31.73%, compared to an average gap of 8.03% in previous benchmarks) and more trustworthy (the best LLM trails the best LMM by 23.09%, whereas the gap for previous benchmarks is just 14.64%). Our in-depth analysis explains the reason for the large performance gap and justifies the trustworthiness of evaluation, underscoring its significant potential for advancing future research.

We introduce Image2Struct, a benchmark to evaluate vision-language models (VLMs) on extracting structure from images. Our benchmark 1) captures real-world use cases, 2) is fully automatic and does not require human judgment, and 3) is based on a renewable stream of fresh data. In Image2Struct, VLMs are prompted to generate the underlying structure (e.g., LaTeX code or HTML) from an input image (e.g., webpage screenshot). The structure is then rendered to produce an output image (e.g., rendered webpage), which is compared against the input image to produce a similarity score. This round-trip evaluation allows us to quantitatively evaluate VLMs on tasks with multiple valid structures. We create a pipeline that downloads fresh data from active online communities upon execution and evaluates the VLMs without human intervention. We introduce three domains (Webpages, LaTeX, and Musical Scores) and use five image metrics (pixel similarity, cosine similarity between the Inception vectors, learned perceptual image patch similarity, structural similarity index measure, and earth mover similarity) that allow efficient and automatic comparison between pairs of images. We evaluate Image2Struct on 14 prominent VLMs and find that scores vary widely, indicating that Image2Struct can differentiate between the performances of different VLMs. Additionally, the best score varies considerably across domains (e.g., 0.402 on sheet music vs. 0.830 on LaTeX equations), indicating that Image2Struct contains tasks of varying difficulty. For transparency, we release the full results at https://crfm.stanford.edu/helm/image2struct/v1.0.1/.

Multimodal Large Language models (MLLMs) have shown promise in web-related tasks, but evaluating their performance in the web domain remains a challenge due to the lack of comprehensive benchmarks. Existing benchmarks are either designed for general multimodal tasks, failing to capture the unique characteristics of web pages, or focus on end-to-end web agent tasks, unable to measure fine-grained abilities such as OCR, understanding, and grounding. In this paper, we introduce , a multimodal benchmark designed to assess the capabilities of MLLMs across a variety of web tasks. consists of seven tasks, and comprises 1.5K human-curated instances from 139 real websites, covering 87 sub-domains. We evaluate 14 open-source MLLMs, Gemini Pro, Claude-3 series, and GPT-4V(ision) on , revealing significant challenges and performance gaps. Further analysis highlights the limitations of current MLLMs, including inadequate grounding in text-rich environments and subpar performance with low-resolution image inputs. We believe will serve as a valuable resource for the research community and contribute to the creation of more powerful and versatile MLLMs for web-related applications.

We propose a novel multimodal video benchmark - the Perception Test - to evaluate the perception and reasoning skills of pre-trained multimodal models (e.g. Flamingo, BEiT-3, or GPT-4). Compared to existing benchmarks that focus on computational tasks (e.g. classification, detection or tracking), the Perception Test focuses on skills (Memory, Abstraction, Physics, Semantics) and types of reasoning (descriptive, explanatory, predictive, counterfactual) across video, audio, and text modalities, to provide a comprehensive and efficient evaluation tool. The benchmark probes pre-trained models for their transfer capabilities, in a zero-shot / few-shot or limited finetuning regime. For these purposes, the Perception Test introduces 11.6k real-world videos, 23s average length, designed to show perceptually interesting situations, filmed by around 100 participants worldwide. The videos are densely annotated with six types of labels (multiple-choice and grounded video question-answers, object and point tracks, temporal action and sound segments), enabling both language and non-language evaluations. The fine-tuning and validation splits of the benchmark are publicly available (CC-BY license), in addition to a challenge server with a held-out test split. Human baseline results compared to state-of-the-art video QA models show a significant gap in performance (91.4% vs 43.6%), suggesting that there is significant room for improvement in multimodal video understanding. Dataset, baselines code, and challenge server are available at https://github.com/deepmind/perception_test

Most Large Vision-Language Models (LVLMs) to date are trained predominantly on English data, which makes them struggle to understand non-English input and fail to generate output in the desired target language. Existing efforts mitigate these issues by adding multilingual training data, but do so in a largely ad-hoc manner, lacking insight into how different training mixes tip the scale for different groups of languages. In this work, we present a comprehensive investigation into the training strategies for massively multilingual LVLMs. First, we conduct a series of multi-stage experiments spanning 13 downstream vision-language tasks and 43 languages, systematically examining: (1) the number of training languages that can be included without degrading English performance and (2) optimal language distributions of pre-training as well as (3) instruction-tuning data. Further, we (4) investigate how to improve multilingual text-in-image understanding, and introduce a new benchmark for the task. Surprisingly, our analysis reveals that one can (i) include as many as 100 training languages simultaneously (ii) with as little as 25-50\% of non-English data, to greatly improve multilingual performance while retaining strong English performance. We further find that (iii) including non-English OCR data in pre-training and instruction-tuning is paramount for improving multilingual text-in-image understanding. Finally, we put all our findings together and train Centurio, a 100-language LVLM, offering state-of-the-art performance in an evaluation covering 14 tasks and 56 languages.

How can we test AI performance? This question seems trivial, but it isn't. Standard benchmarks often have problems such as in-distribution and small-size test sets, oversimplified metrics, unfair comparisons, and short-term outcome pressure. As a consequence, good performance on standard benchmarks does not guarantee success in real-world scenarios. To address these problems, we present Touchstone, a large-scale collaborative segmentation benchmark of 9 types of abdominal organs. This benchmark is based on 5,195 training CT scans from 76 hospitals around the world and 5,903 testing CT scans from 11 additional hospitals. This diverse test set enhances the statistical significance of benchmark results and rigorously evaluates AI algorithms across various out-of-distribution scenarios. We invited 14 inventors of 19 AI algorithms to train their algorithms, while our team, as a third party, independently evaluated these algorithms on three test sets. In addition, we also evaluated pre-existing AI frameworks--which, differing from algorithms, are more flexible and can support different algorithms--including MONAI from NVIDIA, nnU-Net from DKFZ, and numerous other open-source frameworks. We are committed to expanding this benchmark to encourage more innovation of AI algorithms for the medical domain.

The rapidly developing field of large multimodal models (LMMs) has led to the emergence of diverse models with remarkable capabilities. However, existing benchmarks fail to comprehensively, objectively and accurately evaluate whether LMMs align with the diverse needs of humans in real-world scenarios. To bridge this gap, we propose the Multi-Dimensional Insights (MDI) benchmark, which includes over 500 images covering six common scenarios of human life. Notably, the MDI-Benchmark offers two significant advantages over existing evaluations: (1) Each image is accompanied by two types of questions: simple questions to assess the model's understanding of the image, and complex questions to evaluate the model's ability to analyze and reason beyond basic content. (2) Recognizing that people of different age groups have varying needs and perspectives when faced with the same scenario, our benchmark stratifies questions into three age categories: young people, middle-aged people, and older people. This design allows for a detailed assessment of LMMs' capabilities in meeting the preferences and needs of different age groups. With MDI-Benchmark, the strong model like GPT-4o achieve 79% accuracy on age-related tasks, indicating that existing LMMs still have considerable room for improvement in addressing real-world applications. Looking ahead, we anticipate that the MDI-Benchmark will open new pathways for aligning real-world personalization in LMMs. The MDI-Benchmark data and evaluation code are available at https://mdi-benchmark.github.io/

In standard large vision-language models (LVLMs) pre-training, the model typically maximizes the joint probability of the caption conditioned on the image via next-token prediction (NTP); however, since only a small subset of caption tokens directly relates to the visual content, this naive NTP unintentionally fits the model to noise and increases the risk of hallucination. We present PRIOR, a simple vision-language pre-training approach that addresses this issue by prioritizing image-related tokens through differential weighting in the NTP loss, drawing from the importance sampling framework. PRIOR introduces a reference model-a text-only large language model (LLM) trained on the captions without image inputs, to weight each token based on its probability for LVLMs training. Intuitively, tokens that are directly related to the visual inputs are harder to predict without the image and thus receive lower probabilities from the text-only reference LLM. During training, we implement a token-specific re-weighting term based on the importance scores to adjust each token's loss. We implement PRIOR in two distinct settings: LVLMs with visual encoders and LVLMs without visual encoders. We observe 19% and 8% average relative improvement, respectively, on several vision-language benchmarks compared to NTP. In addition, PRIOR exhibits superior scaling properties, as demonstrated by significantly higher scaling coefficients, indicating greater potential for performance gains compared to NTP given increasing compute and data.

Large Language Models (LLMs) have demonstrated significant potential in handling specialized tasks, including medical problem-solving. However, most studies predominantly focus on English-language contexts. This study introduces a novel benchmark dataset based on Polish medical licensing and specialization exams (LEK, LDEK, PES) taken by medical doctor candidates and practicing doctors pursuing specialization. The dataset was web-scraped from publicly available resources provided by the Medical Examination Center and the Chief Medical Chamber. It comprises over 24,000 exam questions, including a subset of parallel Polish-English corpora, where the English portion was professionally translated by the examination center for foreign candidates. By creating a structured benchmark from these existing exam questions, we systematically evaluate state-of-the-art LLMs, including general-purpose, domain-specific, and Polish-specific models, and compare their performance against human medical students. Our analysis reveals that while models like GPT-4o achieve near-human performance, significant challenges persist in cross-lingual translation and domain-specific understanding. These findings underscore disparities in model performance across languages and medical specialties, highlighting the limitations and ethical considerations of deploying LLMs in clinical practice.

The lack of standardized evaluation benchmarks in the medical domain for text inputs can be a barrier to widely adopting and leveraging the potential of natural language models for health-related downstream tasks. This paper revisited an openly available MIMIC-IV benchmark for electronic health records (EHRs) to address this issue. First, we integrate the MIMIC-IV data within the Hugging Face datasets library to allow an easy share and use of this collection. Second, we investigate the application of templates to convert EHR tabular data to text. Experiments using fine-tuned and zero-shot LLMs on the mortality of patients task show that fine-tuned text-based models are competitive against robust tabular classifiers. In contrast, zero-shot LLMs struggle to leverage EHR representations. This study underlines the potential of text-based approaches in the medical field and highlights areas for further improvement.

The integration of neural-network-based systems into clinical practice is limited by challenges related to domain generalization and robustness. The computer vision community established benchmarks such as ImageNet-C as a fundamental prerequisite to measure progress towards those challenges. Similar datasets are largely absent in the medical imaging community which lacks a comprehensive benchmark that spans across imaging modalities and applications. To address this gap, we create and open-source MedMNIST-C, a benchmark dataset based on the MedMNIST+ collection covering 12 datasets and 9 imaging modalities. We simulate task and modality-specific image corruptions of varying severity to comprehensively evaluate the robustness of established algorithms against real-world artifacts and distribution shifts. We further provide quantitative evidence that our simple-to-use artificial corruptions allow for highly performant, lightweight data augmentation to enhance model robustness. Unlike traditional, generic augmentation strategies, our approach leverages domain knowledge, exhibiting significantly higher robustness when compared to widely adopted methods. By introducing MedMNIST-C and open-sourcing the corresponding library allowing for targeted data augmentations, we contribute to the development of increasingly robust methods tailored to the challenges of medical imaging. The code is available at https://github.com/francescodisalvo05/medmnistc-api .

Text-guided image editing has seen rapid progress in natural image domains, but its adaptation to medical imaging remains limited and lacks standardized evaluation. Clinically, such editing holds promise for simulating surgical outcomes, creating personalized teaching materials, and enhancing patient communication. To bridge this gap, we introduce MedEBench, a comprehensive benchmark for evaluating text-guided medical image editing. It consists of 1,182 clinically sourced image-prompt triplets spanning 70 tasks across 13 anatomical regions. MedEBench offers three key contributions: (1) a clinically relevant evaluation framework covering Editing Accuracy, Contextual Preservation, and Visual Quality, supported by detailed descriptions of expected change and ROI (Region of Interest) masks; (2) a systematic comparison of seven state-of-the-art models, revealing common failure patterns; and (3) a failure analysis protocol based on attention grounding, using IoU between attention maps and ROIs to identify mislocalization. MedEBench provides a solid foundation for developing and evaluating reliable, clinically meaningful medical image editing systems.

We investigate fine-tuning Vision-Language Models (VLMs) for multi-task medical image understanding, focusing on detection, localization, and counting of findings in medical images. Our objective is to evaluate whether instruction-tuned VLMs can simultaneously improve these tasks, with the goal of enhancing diagnostic accuracy and efficiency. Using MedMultiPoints, a multimodal dataset with annotations from endoscopy (polyps and instruments) and microscopy (sperm cells), we reformulate each task into instruction-based prompts suitable for vision-language reasoning. We fine-tune Qwen2.5-VL-7B-Instruct using Low-Rank Adaptation (LoRA) across multiple task combinations. Results show that multi-task training improves robustness and accuracy. For example, it reduces the Count Mean Absolute Error (MAE) and increases Matching Accuracy in the Counting + Pointing task. However, trade-offs emerge, such as more zero-case point predictions, indicating reduced reliability in edge cases despite overall performance gains. Our study highlights the potential of adapting general-purpose VLMs to specialized medical tasks via prompt-driven fine-tuning. This approach mirrors clinical workflows, where radiologists simultaneously localize, count, and describe findings - demonstrating how VLMs can learn composite diagnostic reasoning patterns. The model produces interpretable, structured outputs, offering a promising step toward explainable and versatile medical AI. Code, model weights, and scripts will be released for reproducibility at https://github.com/simula/PointDetectCount.

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.

We propose a new benchmark evaluating the performance of multimodal large language models on rebus puzzles. The dataset covers 333 original examples of image-based wordplay, cluing 13 categories such as movies, composers, major cities, and food. To achieve good performance on the benchmark of identifying the clued word or phrase, models must combine image recognition and string manipulation with hypothesis testing, multi-step reasoning, and an understanding of human cognition, making for a complex, multimodal evaluation of capabilities. We find that proprietary models such as GPT-4V and Gemini Pro significantly outperform all other tested models. However, even the best model has a final accuracy of just 24%, highlighting the need for substantial improvements in reasoning. Further, models rarely understand all parts of a puzzle, and are almost always incapable of retroactively explaining the correct answer. Our benchmark can therefore be used to identify major shortcomings in the knowledge and reasoning of multimodal large language models.

Medical image analysis is a fundamental component. As deep learning progresses, the focus has shifted from single-task applications, such as classification and segmentation, to more complex multimodal tasks, including medical visual question answering and report generation. Traditional shallow and task-specific models are increasingly limited in addressing the complexity and scalability required in clinical practice. The emergence of large language models (LLMs) has driven the development of medical Large Vision-Language Models (LVLMs), offering a unified solution for diverse vision-language tasks. In this study, we investigate various architectural designs for medical LVLMs based on the widely adopted LLaVA framework, which follows an encoder-connector-LLM paradigm. We construct two distinct models targeting 2D and 3D modalities, respectively. These models are designed to support both general-purpose medical tasks and domain-specific fine-tuning, thereby serving as effective foundation models. To facilitate reproducibility and further research, we develop a modular and extensible codebase, MedM-VL, and release two LVLM variants: MedM-VL-2D for 2D medical image analysis and MedM-VL-CT-Chest for 3D CT-based applications. The code and models are available at: https://github.com/MSIIP/MedM-VL

Recent years have witnessed a significant interest in developing large multimodal models (LMMs) capable of performing various visual reasoning and understanding tasks. This has led to the introduction of multiple LMM benchmarks to evaluate LMMs on different tasks. However, most existing LMM evaluation benchmarks are predominantly English-centric. In this work, we develop a comprehensive LMM evaluation benchmark for the Arabic language to represent a large population of over 400 million speakers. The proposed benchmark, named CAMEL-Bench, comprises eight diverse domains and 38 sub-domains including, multi-image understanding, complex visual perception, handwritten document understanding, video understanding, medical imaging, plant diseases, and remote sensing-based land use understanding to evaluate broad scenario generalizability. Our CAMEL-Bench comprises around 29,036 questions that are filtered from a larger pool of samples, where the quality is manually verified by native speakers to ensure reliable model assessment. We conduct evaluations of both closed-source, including GPT-4 series, and open-source LMMs. Our analysis reveals the need for substantial improvement, especially among the best open-source models, with even the closed-source GPT-4o achieving an overall score of 62%. Our benchmark and evaluation scripts are open-sourced.

Large Language Models (LLMs) have achieved remarkable performance on a wide range of NLP benchmarks, often surpassing human-level accuracy. However, their reliability in high-stakes domains such as medicine, particularly in low-resource languages, remains underexplored. In this work, we introduce PersianMedQA, a large-scale, expert-validated dataset of multiple-choice Persian medical questions, designed to evaluate LLMs across both Persian and English. We benchmark over 40 state-of-the-art models, including general-purpose, Persian fine-tuned, and medical LLMs, in zero-shot and chain-of-thought (CoT) settings. Our results show that closed-source general models (e.g., GPT-4.1) consistently outperform all other categories, achieving 83.3% accuracy in Persian and 80.7% in English, while Persian fine-tuned models such as Dorna underperform significantly (e.g., 35.9% in Persian), often struggling with both instruction-following and domain reasoning. We also analyze the impact of translation, showing that while English performance is generally higher, Persian responses are sometimes more accurate due to cultural and clinical contextual cues. Finally, we demonstrate that model size alone is insufficient for robust performance without strong domain or language adaptation. PersianMedQA provides a foundation for evaluating multilingual and culturally grounded medical reasoning in LLMs. The PersianMedQA dataset can be accessed at: https://huggingface.co/datasets/MohammadJRanjbar/PersianMedQA](https://huggingface.co/datasets/MohammadJRanjbar/PersianMedQA

Visual captioning benchmarks have become outdated with the emergence of modern multimodal large language models (MLLMs), as the brief ground-truth sentences and traditional metrics fail to assess detailed captions effectively. While recent benchmarks attempt to address this by focusing on keyword extraction or object-centric evaluation, they remain limited to vague-view or object-view analyses and incomplete visual element coverage. In this paper, we introduce CAPability, a comprehensive multi-view benchmark for evaluating visual captioning across 12 dimensions spanning six critical views. We curate nearly 11K human-annotated images and videos with visual element annotations to evaluate the generated captions. CAPability stably assesses both the correctness and thoroughness of captions using F1-score. By converting annotations to QA pairs, we further introduce a heuristic metric, know but cannot tell (KT), indicating a significant performance gap between QA and caption capabilities. Our work provides the first holistic analysis of MLLMs' captioning abilities, as we identify their strengths and weaknesses across various dimensions, guiding future research to enhance specific aspects of capabilities.

Large language models (LLMs) have shown potential in biomedical applications, leading to efforts to fine-tune them on domain-specific data. However, the effectiveness of this approach remains unclear. This study evaluates the performance of biomedically fine-tuned LLMs against their general-purpose counterparts on a variety of clinical tasks. We evaluated their performance on clinical case challenges from the New England Journal of Medicine (NEJM) and the Journal of the American Medical Association (JAMA) and on several clinical tasks (e.g., information extraction, document summarization, and clinical coding). Using benchmarks specifically chosen to be likely outside the fine-tuning datasets of biomedical models, we found that biomedical LLMs mostly perform inferior to their general-purpose counterparts, especially on tasks not focused on medical knowledge. While larger models showed similar performance on case tasks (e.g., OpenBioLLM-70B: 66.4% vs. Llama-3-70B-Instruct: 65% on JAMA cases), smaller biomedical models showed more pronounced underperformance (e.g., OpenBioLLM-8B: 30% vs. Llama-3-8B-Instruct: 64.3% on NEJM cases). Similar trends were observed across the CLUE (Clinical Language Understanding Evaluation) benchmark tasks, with general-purpose models often performing better on text generation, question answering, and coding tasks. Our results suggest that fine-tuning LLMs to biomedical data may not provide the expected benefits and may potentially lead to reduced performance, challenging prevailing assumptions about domain-specific adaptation of LLMs and highlighting the need for more rigorous evaluation frameworks in healthcare AI. Alternative approaches, such as retrieval-augmented generation, may be more effective in enhancing the biomedical capabilities of LLMs without compromising their general knowledge.

Scientific research demands sophisticated reasoning over multimodal data, a challenge especially prevalent in biology. Despite recent advances in multimodal large language models (MLLMs) for AI-assisted research, existing multimodal reasoning benchmarks only target up to college-level difficulty, while research-level benchmarks emphasize lower-level perception, falling short of the complex multimodal reasoning needed for scientific discovery. To bridge this gap, we introduce MicroVQA, a visual-question answering (VQA) benchmark designed to assess three reasoning capabilities vital in research workflows: expert image understanding, hypothesis generation, and experiment proposal. MicroVQA consists of 1,042 multiple-choice questions (MCQs) curated by biology experts across diverse microscopy modalities, ensuring VQA samples represent real scientific practice. In constructing the benchmark, we find that standard MCQ generation methods induce language shortcuts, motivating a new two-stage pipeline: an optimized LLM prompt structures question-answer pairs into MCQs; then, an agent-based `RefineBot' updates them to remove shortcuts. Benchmarking on state-of-the-art MLLMs reveal a peak performance of 53\%; models with smaller LLMs only slightly underperform top models, suggesting that language-based reasoning is less challenging than multimodal reasoning; and tuning with scientific articles enhances performance. Expert analysis of chain-of-thought responses shows that perception errors are the most frequent, followed by knowledge errors and then overgeneralization errors. These insights highlight the challenges in multimodal scientific reasoning, showing MicroVQA is a valuable resource advancing AI-driven biomedical research. MicroVQA is available at https://huggingface.co/datasets/jmhb/microvqa, and project page at https://jmhb0.github.io/microvqa.

This study presents a comprehensive analysis and comparison of two predominant fine-tuning methodologies - full-parameter fine-tuning and parameter-efficient tuning - within the context of medical Large Language Models (LLMs). We developed and refined a series of LLMs, based on the Llama-2 architecture, specifically designed to enhance medical knowledge retrieval, reasoning, and question-answering capabilities. Our experiments systematically evaluate the effectiveness of these tuning strategies across various well-known medical benchmarks. Notably, our medical LLM Med42 showed an accuracy level of 72% on the US Medical Licensing Examination (USMLE) datasets, setting a new standard in performance for openly available medical LLMs. Through this comparative analysis, we aim to identify the most effective and efficient method for fine-tuning LLMs in the medical domain, thereby contributing significantly to the advancement of AI-driven healthcare applications.

In multimodal large language models (MLLMs), vision transformers (ViTs) are widely employed for visual encoding. However, their performance in solving universal MLLM tasks is not satisfactory. We attribute it to a lack of information from diverse visual levels, impeding alignment with the various semantic granularity required for language generation. To address this issue, we present LLaVA-UHD v2, an advanced MLLM centered around a Hierarchical window transformer that enables capturing diverse visual granularity by constructing and integrating a high-resolution feature pyramid. As a vision-language projector, Hiwin transformer comprises two primary modules: (i) an inverse feature pyramid, constructed by a ViT-derived feature up-sampling process utilizing high-frequency details from an image pyramid, and (ii) hierarchical window attention, focusing on a set of key sampling features within cross-scale windows to condense multi-level feature maps. Extensive experiments demonstrate that LLaVA-UHD v2 achieves superior performance over existing MLLMs on popular benchmarks. Notably, our design brings an average boost of 3.7% across 14 benchmarks compared with the baseline method, 9.3% on DocVQA for instance. We make all the data, model checkpoint, and code publicly available to facilitate future research.

Multilingual multimodal reasoning is a core component in achieving human-level intelligence. However, most existing benchmarks for multilingual multimodal reasoning struggle to differentiate between models of varying performance; even language models without visual capabilities can easily achieve high scores. This leaves a comprehensive evaluation of leading multilingual multimodal models largely unexplored. In this work, we introduce M4U, a novel and challenging benchmark for assessing the capability of multi-discipline multilingual multimodal understanding and reasoning. M4U contains 8,931 samples covering 64 disciplines across 16 subfields in Science, Engineering, and Healthcare in Chinese, English, and German. Using M4U, we conduct extensive evaluations of 21 leading Large Multimodal Models (LMMs) and Large Language Models (LLMs) with external tools. The evaluation results show that the state-of-the-art model, GPT-4o, achieves only 47.6% average accuracy on M4U. Additionally, we observe that the leading LMMs exhibit significant language preferences. Our in-depth analysis indicates that leading LMMs, including GPT-4o, suffer performance degradation when prompted with cross-lingual multimodal questions, such as images with key textual information in Chinese while the question is in German. We believe that M4U can serve as a crucial tool for systematically evaluating LMMs based on their multilingual multimodal reasoning capabilities and monitoring their development. The homepage, codes and data are public available.

Scoring the Optical Character Recognition (OCR) capabilities of Large Multimodal Models (LMMs) has witnessed growing interest recently. Existing benchmarks have highlighted the impressive performance of LMMs in text recognition; however, their abilities on certain challenging tasks, such as text localization, handwritten content extraction, and logical reasoning, remain underexplored. To bridge this gap, we introduce OCRBench v2, a large-scale bilingual text-centric benchmark with currently the most comprehensive set of tasks (4x more tasks than the previous multi-scene benchmark OCRBench), the widest coverage of scenarios (31 diverse scenarios including street scene, receipt, formula, diagram, and so on), and thorough evaluation metrics, with a total of 10,000 human-verified question-answering pairs and a high proportion of difficult samples. After carefully benchmarking state-of-the-art LMMs on OCRBench v2, we find that 20 out of 22 LMMs score below 50 (100 in total) and suffer from five-type limitations, including less frequently encountered text recognition, fine-grained perception, layout perception, complex element parsing, and logical reasoning. The benchmark and evaluation scripts are available at https://github.com/Yuliang-liu/MultimodalOCR.

How well do text-only Large Language Models (LLMs) grasp the visual world? As LLMs are increasingly used in computer vision, addressing this question becomes both fundamental and pertinent. However, existing studies have primarily focused on limited scenarios, such as their ability to generate visual content or cluster multimodal data. To this end, we propose the Visual Text Representation Benchmark (ViTeRB) to isolate key properties that make language models well-aligned with the visual world. With this, we identify large-scale decoder-based LLMs as ideal candidates for representing text in vision-centric contexts, counter to the current practice of utilizing text encoders. Building on these findings, we propose ShareLock, an ultra-lightweight CLIP-like model. By leveraging precomputable frozen features from strong vision and language models, ShareLock achieves an impressive 51% accuracy on ImageNet despite utilizing just 563k image-caption pairs. Moreover, training requires only 1 GPU hour (or 10 hours including the precomputation of features) - orders of magnitude less than prior methods. Code will be released.

High-resolution image (HRI) understanding aims to process images with a large number of pixels, such as pathological images and agricultural aerial images, both of which can exceed 1 million pixels. Vision Large Language Models (VLMs) can allegedly handle HRIs, however, there is a lack of a comprehensive benchmark for VLMs to evaluate HRI understanding. To address this gap, we introduce HRScene, a novel unified benchmark for HRI understanding with rich scenes. HRScene incorporates 25 real-world datasets and 2 synthetic diagnostic datasets with resolutions ranging from 1,024 times 1,024 to 35,503 times 26,627. HRScene is collected and re-annotated by 10 graduate-level annotators, covering 25 scenarios, ranging from microscopic to radiology images, street views, long-range pictures, and telescope images. It includes HRIs of real-world objects, scanned documents, and composite multi-image. The two diagnostic evaluation datasets are synthesized by combining the target image with the gold answer and distracting images in different orders, assessing how well models utilize regions in HRI. We conduct extensive experiments involving 28 VLMs, including Gemini 2.0 Flash and GPT-4o. Experiments on HRScene show that current VLMs achieve an average accuracy of around 50% on real-world tasks, revealing significant gaps in HRI understanding. Results on synthetic datasets reveal that VLMs struggle to effectively utilize HRI regions, showing significant Regional Divergence and lost-in-middle, shedding light on future research.

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

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.

Curation methods for massive vision-language datasets trade off between dataset size and quality. However, even the highest quality of available curated captions are far too short to capture the rich visual detail in an image. To show the value of dense and highly-aligned image-text pairs, we collect the Densely Captioned Images (DCI) dataset, containing 8012 natural images human-annotated with mask-aligned descriptions averaging above 1000 words each. With precise and reliable captions associated with specific parts of an image, we can evaluate vision-language models' (VLMs) understanding of image content with a novel task that matches each caption with its corresponding subcrop. As current models are often limited to 77 text tokens, we also introduce a summarized version (sDCI) in which each caption length is limited. We show that modern techniques that make progress on standard benchmarks do not correspond with significant improvement on our sDCI based benchmark. Lastly, we finetune CLIP using sDCI and show significant improvements over the baseline despite a small training set. By releasing the first human annotated dense image captioning dataset, we hope to enable the development of new benchmarks or fine-tuning recipes for the next generation of VLMs to come.

Recently, multimodal large language models (MLLMs), such as GPT-4o, Gemini 1.5 Pro, and Reka Core, have expanded their capabilities to include vision and audio modalities. While these models demonstrate impressive performance across a wide range of audio-visual applications, our proposed DeafTest reveals that MLLMs often struggle with simple tasks humans find trivial: 1) determining which of two sounds is louder, and 2) determining which of two sounds has a higher pitch. Motivated by these observations, we introduce AV-Odyssey Bench, a comprehensive audio-visual benchmark designed to assess whether those MLLMs can truly understand the audio-visual information. This benchmark encompasses 4,555 carefully crafted problems, each incorporating text, visual, and audio components. To successfully infer answers, models must effectively leverage clues from both visual and audio inputs. To ensure precise and objective evaluation of MLLM responses, we have structured the questions as multiple-choice, eliminating the need for human evaluation or LLM-assisted assessment. We benchmark a series of closed-source and open-source models and summarize the observations. By revealing the limitations of current models, we aim to provide useful insight for future dataset collection and model development.

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.

Doctors and patients alike increasingly use Large Language Models (LLMs) to diagnose clinical cases. However, unlike domains such as math or coding, where correctness can be objectively defined by the final answer, medical diagnosis requires both the outcome and the reasoning process to be accurate. Currently, widely used medical benchmarks like MedQA and MMLU assess only accuracy in the final answer, overlooking the quality and faithfulness of the clinical reasoning process. To address this limitation, we introduce MedCaseReasoning, the first open-access dataset for evaluating LLMs on their ability to align with clinician-authored diagnostic reasoning. The dataset includes 14,489 diagnostic question-and-answer cases, each paired with detailed reasoning statements derived from open-access medical case reports. We evaluate state-of-the-art reasoning LLMs on MedCaseReasoning and find significant shortcomings in their diagnoses and reasoning: for instance, the top-performing open-source model, DeepSeek-R1, achieves only 48% 10-shot diagnostic accuracy and mentions only 64% of the clinician reasoning statements (recall). However, we demonstrate that fine-tuning LLMs on the reasoning traces derived from MedCaseReasoning significantly improves diagnostic accuracy and clinical reasoning recall by an average relative gain of 29% and 41%, respectively. The open-source dataset, code, and models are available at https://github.com/kevinwu23/Stanford-MedCaseReasoning.

Comparative settings (e.g. pairwise choice, listwise ranking) have been adopted by a wide range of subjective studies for image quality assessment (IQA), as it inherently standardizes the evaluation criteria across different observers and offer more clear-cut responses. In this work, we extend the edge of emerging large multi-modality models (LMMs) to further advance visual quality comparison into open-ended settings, that 1) can respond to open-range questions on quality comparison; 2) can provide detailed reasonings beyond direct answers. To this end, we propose the Co-Instruct. To train this first-of-its-kind open-source open-ended visual quality comparer, we collect the Co-Instruct-562K dataset, from two sources: (a) LMM-merged single image quality description, (b) GPT-4V "teacher" responses on unlabeled data. Furthermore, to better evaluate this setting, we propose the MICBench, the first benchmark on multi-image comparison for LMMs. We demonstrate that Co-Instruct not only achieves 30% higher superior accuracy than state-of-the-art open-source LMMs, but also outperforms GPT-4V (its teacher), on both existing related benchmarks and the proposed MICBench. Our model is published at https://huggingface.co/q-future/co-instruct.

Multimodal large language models (MLLMs) have demonstrated promising results in a variety of tasks that combine vision and language. As these models become more integral to research and applications, conducting comprehensive evaluations of their capabilities has grown increasingly important. However, most existing benchmarks fail to consider that, in certain situations, images need to be interpreted within a broader context. In this work, we introduce a new benchmark, named as CODIS, designed to assess the ability of models to use context provided in free-form text to enhance visual comprehension. Our findings indicate that MLLMs consistently fall short of human performance on this benchmark. Further analysis confirms that these models struggle to effectively extract and utilize contextual information to improve their understanding of images. This underscores the pressing need to enhance the ability of MLLMs to comprehend visuals in a context-dependent manner. View our project website at https://thunlp-mt.github.io/CODIS.

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.

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.

We present MEGA-Bench, an evaluation suite that scales multimodal evaluation to over 500 real-world tasks, to address the highly heterogeneous daily use cases of end users. Our objective is to optimize for a set of high-quality data samples that cover a highly diverse and rich set of multimodal tasks, while enabling cost-effective and accurate model evaluation. In particular, we collected 505 realistic tasks encompassing over 8,000 samples from 16 expert annotators to extensively cover the multimodal task space. Instead of unifying these problems into standard multi-choice questions (like MMMU, MMBench, and MMT-Bench), we embrace a wide range of output formats like numbers, phrases, code, \LaTeX, coordinates, JSON, free-form, etc. To accommodate these formats, we developed over 40 metrics to evaluate these tasks. Unlike existing benchmarks, MEGA-Bench offers a fine-grained capability report across multiple dimensions (e.g., application, input type, output format, skill), allowing users to interact with and visualize model capabilities in depth. We evaluate a wide variety of frontier vision-language models on MEGA-Bench to understand their capabilities across these dimensions.

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.

Large vision-language models (VLMs) are widely getting adopted in industry and academia. In this work we build a unified framework to systematically evaluate gender-profession bias in VLMs. Our evaluation encompasses all supported inference modes of the recent VLMs, including image-to-text, text-to-text, text-to-image, and image-to-image. We construct a synthetic, high-quality dataset of text and images that blurs gender distinctions across professional actions to benchmark gender bias. In our benchmarking of recent vision-language models (VLMs), we observe that different input-output modalities result in distinct bias magnitudes and directions. We hope our work will help guide future progress in improving VLMs to learn socially unbiased representations. We will release our data and code.

Recently a number of studies demonstrated impressive performance on diverse vision-language multi-modal tasks such as image captioning and visual question answering by extending the BERT architecture with multi-modal pre-training objectives. In this work we explore a broad set of multi-modal representation learning tasks in the medical domain, specifically using radiology images and the unstructured report. We propose Medical Vision Language Learner (MedViLL), which adopts a BERT-based architecture combined with a novel multi-modal attention masking scheme to maximize generalization performance for both vision-language understanding tasks (diagnosis classification, medical image-report retrieval, medical visual question answering) and vision-language generation task (radiology report generation). By statistically and rigorously evaluating the proposed model on four downstream tasks with three radiographic image-report datasets (MIMIC-CXR, Open-I, and VQA-RAD), we empirically demonstrate the superior downstream task performance of MedViLL against various baselines, including task-specific architectures. The source code is publicly available at: https://github.com/SuperSupermoon/MedViLL

Foundation vision-language models are currently transforming computer vision, and are on the rise in medical imaging fueled by their very promising generalization capabilities. However, the initial attempts to transfer this new paradigm to medical imaging have shown less impressive performances than those observed in other domains, due to the significant domain shift and the complex, expert domain knowledge inherent to medical-imaging tasks. Motivated by the need for domain-expert foundation models, we present FLAIR, a pre-trained vision-language model for universal retinal fundus image understanding. To this end, we compiled 37 open-access, mostly categorical fundus imaging datasets from various sources, with up to 97 different target conditions and 284,660 images. We integrate the expert's domain knowledge in the form of descriptive textual prompts, during both pre-training and zero-shot inference, enhancing the less-informative categorical supervision of the data. Such a textual expert's knowledge, which we compiled from the relevant clinical literature and community standards, describes the fine-grained features of the pathologies as well as the hierarchies and dependencies between them. We report comprehensive evaluations, which illustrate the benefit of integrating expert knowledge and the strong generalization capabilities of FLAIR under difficult scenarios with domain shifts or unseen categories. When adapted with a lightweight linear probe, FLAIR outperforms fully-trained, dataset-focused models, more so in the few-shot regimes. Interestingly, FLAIR outperforms by a large margin more generalist, larger-scale image-language models, which emphasizes the potential of embedding experts' domain knowledge and the limitations of generalist models in medical imaging.

Research on language technology for the development of medical applications is currently a hot topic in Natural Language Understanding and Generation. Thus, a number of large language models (LLMs) have recently been adapted to the medical domain, so that they can be used as a tool for mediating in human-AI interaction. While these LLMs display competitive performance on automated medical texts benchmarks, they have been pre-trained and evaluated with a focus on a single language (English mostly). This is particularly true of text-to-text models, which typically require large amounts of domain-specific pre-training data, often not easily accessible for many languages. In this paper, we address these shortcomings by compiling, to the best of our knowledge, the largest multilingual corpus for the medical domain in four languages, namely English, French, Italian and Spanish. This new corpus has been used to train Medical mT5, the first open-source text-to-text multilingual model for the medical domain. Additionally, we present two new evaluation benchmarks for all four languages with the aim of facilitating multilingual research in this domain. A comprehensive evaluation shows that Medical mT5 outperforms both encoders and similarly sized text-to-text models for the Spanish, French, and Italian benchmarks, while being competitive with current state-of-the-art LLMs in English.

Large Vision-Language Models (VLMs) have demonstrated impressive performance on complex tasks involving visual input with natural language instructions. However, it remains unclear to what extent capabilities on natural images transfer to Earth observation (EO) data, which are predominantly satellite and aerial images less common in VLM training data. In this work, we propose a comprehensive benchmark to gauge the progress of VLMs toward being useful tools for EO data by assessing their abilities on scene understanding, localization and counting, and change detection tasks. Motivated by real-world applications, our benchmark includes scenarios like urban monitoring, disaster relief, land use, and conservation. We discover that, although state-of-the-art VLMs like GPT-4V possess extensive world knowledge that leads to strong performance on open-ended tasks like location understanding and image captioning, their poor spatial reasoning limits usefulness on object localization and counting tasks. Our benchmark will be made publicly available at https://vleo.danielz.ch/ and on Hugging Face at https://huggingface.co/collections/mit-ei/vleo-benchmark-datasets-65b789b0466555489cce0d70 for easy model evaluation.

Recent Multimodal Large Language Models (MLLMs) excel on benchmark vision-language tasks, yet little is known about how input visual quality shapes their responses. Does higher perceptual quality of images already translate to better MLLM understanding? We conduct the first systematic study spanning leading MLLMs and a suite of vision-language benchmarks, applying controlled degradations and stylistic shifts to each image. Surprisingly, we uncover a visual-quality paradox: model, task, and even individual-instance performance can improve when images deviate from human-perceived fidelity. Off-the-shelf restoration pipelines fail to reconcile these idiosyncratic preferences. To close the gap, we introduce Visual-Quality Test-Time Tuning (VQ-TTT)-a lightweight adaptation module that: (1) inserts a learnable, low-rank kernel before the frozen vision encoder to modulate frequency content; and (2) fine-tunes only shallow vision-encoder layers via LoRA. VQ-TTT dynamically adjusts each input image in a single forward pass, aligning it with task-specific model preferences. Across the evaluated MLLMs and all datasets, VQ-TTT lifts significant average accuracy, with no external models, cached features, or extra training data. These findings redefine ``better'' visual inputs for MLLMs and highlight the need for adaptive, rather than universally ``clean'', imagery, in the new era of AI being the main data customer.

We present the training recipe and results of scaling up PaLI-X, a multilingual vision and language model, both in terms of size of the components and the breadth of its training task mixture. Our model achieves new levels of performance on a wide-range of varied and complex tasks, including multiple image-based captioning and question-answering tasks, image-based document understanding and few-shot (in-context) learning, as well as object detection, video question answering, and video captioning. PaLI-X advances the state-of-the-art on most vision-and-language benchmarks considered (25+ of them). Finally, we observe emerging capabilities, such as complex counting and multilingual object detection, tasks that are not explicitly in the training mix.