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byAK and the research community

Mar 14

Preference Fine-Tuning for Factuality in Chest X-Ray Interpretation Models Without Human Feedback

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.

Visual Program Distillation: Distilling Tools and Programmatic Reasoning into Vision-Language Models

Solving complex visual tasks such as "Who invented the musical instrument on the right?" involves a composition of skills: understanding space, recognizing instruments, and also retrieving prior knowledge. Recent work shows promise by decomposing such tasks using a large language model (LLM) into an executable program that invokes specialized vision models. However, generated programs are error-prone: they omit necessary steps, include spurious ones, and are unable to recover when the specialized models give incorrect outputs. Moreover, they require loading multiple models, incurring high latency and computation costs. We propose Visual Program Distillation (VPD), an instruction tuning framework that produces a vision-language model (VLM) capable of solving complex visual tasks with a single forward pass. VPD distills the reasoning ability of LLMs by using them to sample multiple candidate programs, which are then executed and verified to identify a correct one. It translates each correct program into a language description of the reasoning steps, which are then distilled into a VLM. Extensive experiments show that VPD improves the VLM's ability to count, understand spatial relations, and reason compositionally. Our VPD-trained PaLI-X outperforms all prior VLMs, achieving state-of-the-art performance across complex vision tasks, including MMBench, OK-VQA, A-OKVQA, TallyQA, POPE, and Hateful Memes. An evaluation with human annotators also confirms that VPD improves model response factuality and consistency. Finally, experiments on content moderation demonstrate that VPD is also helpful for adaptation to real-world applications with limited data.