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Mar 13

Specialist vision-language models for clinical ophthalmology

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.

Are VLMs Ready for Autonomous Driving? An Empirical Study from the Reliability, Data, and Metric Perspectives

Recent advancements in Vision-Language Models (VLMs) have sparked interest in their use for autonomous driving, particularly in generating interpretable driving decisions through natural language. However, the assumption that VLMs inherently provide visually grounded, reliable, and interpretable explanations for driving remains largely unexamined. To address this gap, we introduce DriveBench, a benchmark dataset designed to evaluate VLM reliability across 17 settings (clean, corrupted, and text-only inputs), encompassing 19,200 frames, 20,498 question-answer pairs, three question types, four mainstream driving tasks, and a total of 12 popular VLMs. Our findings reveal that VLMs often generate plausible responses derived from general knowledge or textual cues rather than true visual grounding, especially under degraded or missing visual inputs. This behavior, concealed by dataset imbalances and insufficient evaluation metrics, poses significant risks in safety-critical scenarios like autonomous driving. We further observe that VLMs struggle with multi-modal reasoning and display heightened sensitivity to input corruptions, leading to inconsistencies in performance. To address these challenges, we propose refined evaluation metrics that prioritize robust visual grounding and multi-modal understanding. Additionally, we highlight the potential of leveraging VLMs' awareness of corruptions to enhance their reliability, offering a roadmap for developing more trustworthy and interpretable decision-making systems in real-world autonomous driving contexts. The benchmark toolkit is publicly accessible.

T2Vs Meet VLMs: A Scalable Multimodal Dataset for Visual Harmfulness Recognition

To address the risks of encountering inappropriate or harmful content, researchers managed to incorporate several harmful contents datasets with machine learning methods to detect harmful concepts. However, existing harmful datasets are curated by the presence of a narrow range of harmful objects, and only cover real harmful content sources. This hinders the generalizability of methods based on such datasets, potentially leading to misjudgments. Therefore, we propose a comprehensive harmful dataset, Visual Harmful Dataset 11K (VHD11K), consisting of 10,000 images and 1,000 videos, crawled from the Internet and generated by 4 generative models, across a total of 10 harmful categories covering a full spectrum of harmful concepts with nontrivial definition. We also propose a novel annotation framework by formulating the annotation process as a multi-agent Visual Question Answering (VQA) task, having 3 different VLMs "debate" about whether the given image/video is harmful, and incorporating the in-context learning strategy in the debating process. Therefore, we can ensure that the VLMs consider the context of the given image/video and both sides of the arguments thoroughly before making decisions, further reducing the likelihood of misjudgments in edge cases. Evaluation and experimental results demonstrate that (1) the great alignment between the annotation from our novel annotation framework and those from human, ensuring the reliability of VHD11K; (2) our full-spectrum harmful dataset successfully identifies the inability of existing harmful content detection methods to detect extensive harmful contents and improves the performance of existing harmfulness recognition methods; (3) VHD11K outperforms the baseline dataset, SMID, as evidenced by the superior improvement in harmfulness recognition methods. The complete dataset and code can be found at https://github.com/nctu-eva-lab/VHD11K.

VLMGuard: Defending VLMs against Malicious Prompts via Unlabeled Data

Vision-language models (VLMs) are essential for contextual understanding of both visual and textual information. However, their vulnerability to adversarially manipulated inputs presents significant risks, leading to compromised outputs and raising concerns about the reliability in VLM-integrated applications. Detecting these malicious prompts is thus crucial for maintaining trust in VLM generations. A major challenge in developing a safeguarding prompt classifier is the lack of a large amount of labeled benign and malicious data. To address the issue, we introduce VLMGuard, a novel learning framework that leverages the unlabeled user prompts in the wild for malicious prompt detection. These unlabeled prompts, which naturally arise when VLMs are deployed in the open world, consist of both benign and malicious information. To harness the unlabeled data, we present an automated maliciousness estimation score for distinguishing between benign and malicious samples within this unlabeled mixture, thereby enabling the training of a binary prompt classifier on top. Notably, our framework does not require extra human annotations, offering strong flexibility and practicality for real-world applications. Extensive experiment shows VLMGuard achieves superior detection results, significantly outperforming state-of-the-art methods. Disclaimer: This paper may contain offensive examples; reader discretion is advised.

GeoChat: Grounded Large Vision-Language Model for Remote Sensing

Recent advancements in Large Vision-Language Models (VLMs) have shown great promise in natural image domains, allowing users to hold a dialogue about given visual content. However, such general-domain VLMs perform poorly for Remote Sensing (RS) scenarios, leading to inaccurate or fabricated information when presented with RS domain-specific queries. Such a behavior emerges due to the unique challenges introduced by RS imagery. For example, to handle high-resolution RS imagery with diverse scale changes across categories and many small objects, region-level reasoning is necessary alongside holistic scene interpretation. Furthermore, the lack of domain-specific multimodal instruction following data as well as strong backbone models for RS make it hard for the models to align their behavior with user queries. To address these limitations, we propose GeoChat - the first versatile remote sensing VLM that offers multitask conversational capabilities with high-resolution RS images. Specifically, GeoChat can not only answer image-level queries but also accepts region inputs to hold region-specific dialogue. Furthermore, it can visually ground objects in its responses by referring to their spatial coordinates. To address the lack of domain-specific datasets, we generate a novel RS multimodal instruction-following dataset by extending image-text pairs from existing diverse RS datasets. We establish a comprehensive benchmark for RS multitask conversations and compare with a number of baseline methods. GeoChat demonstrates robust zero-shot performance on various RS tasks, e.g., image and region captioning, visual question answering, scene classification, visually grounded conversations and referring detection. Our code is available at https://github.com/mbzuai-oryx/geochat.

Words or Vision: Do Vision-Language Models Have Blind Faith in Text?

Vision-Language Models (VLMs) excel in integrating visual and textual information for vision-centric tasks, but their handling of inconsistencies between modalities is underexplored. We investigate VLMs' modality preferences when faced with visual data and varied textual inputs in vision-centered settings. By introducing textual variations to four vision-centric tasks and evaluating ten Vision-Language Models (VLMs), we discover a ``blind faith in text'' phenomenon: VLMs disproportionately trust textual data over visual data when inconsistencies arise, leading to significant performance drops under corrupted text and raising safety concerns. We analyze factors influencing this text bias, including instruction prompts, language model size, text relevance, token order, and the interplay between visual and textual certainty. While certain factors, such as scaling up the language model size, slightly mitigate text bias, others like token order can exacerbate it due to positional biases inherited from language models. To address this issue, we explore supervised fine-tuning with text augmentation and demonstrate its effectiveness in reducing text bias. Additionally, we provide a theoretical analysis suggesting that the blind faith in text phenomenon may stem from an imbalance of pure text and multi-modal data during training. Our findings highlight the need for balanced training and careful consideration of modality interactions in VLMs to enhance their robustness and reliability in handling multi-modal data inconsistencies.

ViCor: Bridging Visual Understanding and Commonsense Reasoning with Large Language Models

In our work, we explore the synergistic capabilities of pre-trained vision-and-language models (VLMs) and large language models (LLMs) for visual commonsense reasoning (VCR). We categorize the problem of VCR into visual commonsense understanding (VCU) and visual commonsense inference (VCI). For VCU, which involves perceiving the literal visual content, pre-trained VLMs exhibit strong cross-dataset generalization. On the other hand, in VCI, where the goal is to infer conclusions beyond image content, VLMs face difficulties. We find that a baseline where VLMs provide perception results (image captions) to LLMs leads to improved performance on VCI. However, we identify a challenge with VLMs' passive perception, which often misses crucial context information, leading to incorrect or uncertain reasoning by LLMs. To mitigate this issue, we suggest a collaborative approach where LLMs, when uncertain about their reasoning, actively direct VLMs to concentrate on and gather relevant visual elements to support potential commonsense inferences. In our method, named ViCor, pre-trained LLMs serve as problem classifiers to analyze the problem category, VLM commanders to leverage VLMs differently based on the problem classification, and visual commonsense reasoners to answer the question. VLMs will perform visual recognition and understanding. We evaluate our framework on two VCR benchmark datasets and outperform all other methods that do not require in-domain supervised fine-tuning.

PIVOT: Iterative Visual Prompting Elicits Actionable Knowledge for VLMs

Vision language models (VLMs) have shown impressive capabilities across a variety of tasks, from logical reasoning to visual understanding. This opens the door to richer interaction with the world, for example robotic control. However, VLMs produce only textual outputs, while robotic control and other spatial tasks require outputting continuous coordinates, actions, or trajectories. How can we enable VLMs to handle such settings without fine-tuning on task-specific data? In this paper, we propose a novel visual prompting approach for VLMs that we call Prompting with Iterative Visual Optimization (PIVOT), which casts tasks as iterative visual question answering. In each iteration, the image is annotated with a visual representation of proposals that the VLM can refer to (e.g., candidate robot actions, localizations, or trajectories). The VLM then selects the best ones for the task. These proposals are iteratively refined, allowing the VLM to eventually zero in on the best available answer. We investigate PIVOT on real-world robotic navigation, real-world manipulation from images, instruction following in simulation, and additional spatial inference tasks such as localization. We find, perhaps surprisingly, that our approach enables zero-shot control of robotic systems without any robot training data, navigation in a variety of environments, and other capabilities. Although current performance is far from perfect, our work highlights potentials and limitations of this new regime and shows a promising approach for Internet-Scale VLMs in robotic and spatial reasoning domains. Website: pivot-prompt.github.io and HuggingFace: https://huggingface.co/spaces/pivot-prompt/pivot-prompt-demo.

BEAF: Observing BEfore-AFter Changes to Evaluate Hallucination in Vision-language Models

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/

HiRED: Attention-Guided Token Dropping for Efficient Inference of High-Resolution Vision-Language Models in Resource-Constrained Environments

High-resolution Vision-Language Models (VLMs) have been widely used in multimodal tasks to enhance accuracy by preserving detailed image information. However, these models often generate excessive visual tokens due to encoding multiple partitions of the input image. Processing these excessive visual tokens is computationally challenging, especially in resource-constrained environments with commodity GPUs. To support high-resolution images while meeting resource constraints, we propose High-Resolution Early Dropping (HiRED), a token-dropping scheme that operates within a fixed token budget before the Large Language Model (LLM) stage. HiRED can be integrated with existing high-resolution VLMs in a plug-and-play manner, as it requires no additional training while still maintaining superior accuracy. We strategically use the vision encoder's attention in the initial layers to assess the visual content of each image partition and allocate the token budget accordingly. Then, using the attention in the final layer, we select the most important visual tokens from each partition within the allocated budget, dropping the rest. Empirically, when applied to LLaVA-Next-7B on NVIDIA TESLA P40 GPU, HiRED with a 20% token budget increases token generation throughput by 4.7, reduces first-token generation latency by 15 seconds, and saves 2.3 GB of GPU memory for a single inference.