Daily Papers

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.

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.

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

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

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

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

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.

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.

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

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

Fine-tuned vision-language models (VLMs) often capture spurious correlations between image features and textual attributes, resulting in degraded zero-shot performance at test time. Existing approaches for addressing spurious correlations (i) primarily operate at the global image-level rather than intervening directly on fine-grained image features and (ii) are predominantly designed for unimodal settings. In this work, we present RaVL, which takes a fine-grained perspective on VLM robustness by discovering and mitigating spurious correlations using local image features rather than operating at the global image level. Given a fine-tuned VLM, RaVL first discovers spurious correlations by leveraging a region-level clustering approach to identify precise image features contributing to zero-shot classification errors. Then, RaVL mitigates the identified spurious correlation with a novel region-aware loss function that enables the VLM to focus on relevant regions and ignore spurious relationships during fine-tuning. We evaluate RaVL on 654 VLMs with various model architectures, data domains, and learned spurious correlations. Our results show that RaVL accurately discovers (191% improvement over the closest baseline) and mitigates (8.2% improvement on worst-group image classification accuracy) spurious correlations. Qualitative evaluations on general-domain and medical-domain VLMs confirm our findings.

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.

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

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.

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

Large vision language models (VLMs) combine large language models with vision encoders, demonstrating promise across various tasks. However, they often underperform in task-specific applications due to domain gaps between pre-training and fine-tuning. We introduce VITask, a novel framework that enhances task-specific adaptability of VLMs by integrating task-specific models (TSMs). VITask employs three key strategies: exemplar prompting (EP), response distribution alignment (RDA), and contrastive response tuning (CRT) to improve the task-specific performance of VLMs by adjusting their response distributions. EP allows TSM features to guide VLMs, while RDA enables VLMs to adapt without TSMs during inference by learning from exemplar-prompted models. CRT further optimizes the ranking of correct image-response pairs, thereby reducing the risk of generating undesired responses. Experiments on 12 medical diagnosis datasets across 9 imaging modalities show that VITask outperforms both vanilla instruction-tuned VLMs and TSMs, showcasing its ability to integrate complementary features from both models effectively. Additionally, VITask offers practical advantages such as flexible TSM integration and robustness to incomplete instructions, making it a versatile and efficient solution for task-specific VLM tuning. Our code are available at https://github.com/baiyang4/VITask.

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.

The mining of adverse drug events (ADEs) is pivotal in pharmacovigilance, enhancing patient safety by identifying potential risks associated with medications, facilitating early detection of adverse events, and guiding regulatory decision-making. Traditional ADE detection methods are reliable but slow, not easily adaptable to large-scale operations, and offer limited information. With the exponential increase in data sources like social media content, biomedical literature, and Electronic Medical Records (EMR), extracting relevant ADE-related information from these unstructured texts is imperative. Previous ADE mining studies have focused on text-based methodologies, overlooking visual cues, limiting contextual comprehension, and hindering accurate interpretation. To address this gap, we present a MultiModal Adverse Drug Event (MMADE) detection dataset, merging ADE-related textual information with visual aids. Additionally, we introduce a framework that leverages the capabilities of LLMs and VLMs for ADE detection by generating detailed descriptions of medical images depicting ADEs, aiding healthcare professionals in visually identifying adverse events. Using our MMADE dataset, we showcase the significance of integrating visual cues from images to enhance overall performance. This approach holds promise for patient safety, ADE awareness, and healthcare accessibility, paving the way for further exploration in personalized healthcare.

Vision-language models (VLMs), such as CLIP and ALIGN, are generally trained on datasets consisting of image-caption pairs obtained from the web. However, real-world multimodal datasets, such as healthcare data, are significantly more complex: each image (e.g. X-ray) is often paired with text (e.g. physician report) that describes many distinct attributes occurring in fine-grained regions of the image. We refer to these samples as exhibiting high pairwise complexity, since each image-text pair can be decomposed into a large number of region-attribute pairings. The extent to which VLMs can capture fine-grained relationships between image regions and textual attributes when trained on such data has not been previously evaluated. The first key contribution of this work is to demonstrate through systematic evaluations that as the pairwise complexity of the training dataset increases, standard VLMs struggle to learn region-attribute relationships, exhibiting performance degradations of up to 37% on retrieval tasks. In order to address this issue, we introduce ViLLA as our second key contribution. ViLLA, which is trained to capture fine-grained region-attribute relationships from complex datasets, involves two components: (a) a lightweight, self-supervised mapping model to decompose image-text samples into region-attribute pairs, and (b) a contrastive VLM to learn representations from generated region-attribute pairs. We demonstrate with experiments across four domains (synthetic, product, medical, and natural images) that ViLLA outperforms comparable VLMs on fine-grained reasoning tasks, such as zero-shot object detection (up to 3.6 AP50 points on COCO and 0.6 mAP points on LVIS) and retrieval (up to 14.2 R-Precision points).

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.

Mixture of Expert Tuning (MoE-Tuning) has effectively enhanced the performance of general MLLMs with fewer parameters, yet its application in resource-limited medical settings has not been fully explored. To address this gap, we developed MoE-TinyMed, a model tailored for medical applications that significantly lowers parameter demands. In evaluations on the VQA-RAD, SLAKE, and Path-VQA datasets, MoE-TinyMed outperformed LLaVA-Med in all Med-VQA closed settings with just 3.6B parameters. Additionally, a streamlined version with 2B parameters surpassed LLaVA-Med's performance in PathVQA, showcasing its effectiveness in resource-limited healthcare settings.

Several medical Multimodal Large Languange Models (MLLMs) have been developed to address tasks involving visual images with textual instructions across various medical modalities, achieving impressive results. Most current medical generalist models are region-agnostic, treating the entire image as a holistic representation. However, they struggle to identify which specific regions they are focusing on when generating a sentence. To mimic the behavior of doctors, who typically begin by reviewing the entire image before concentrating on specific regions for a thorough evaluation, we aim to enhance the capability of medical MLLMs in understanding anatomical regions within entire medical scans. To achieve it, we first formulate Region-Centric tasks and construct a large-scale dataset, MedRegInstruct, to incorporate regional information into training. Combining our collected dataset with other medical multimodal corpora for training, we propose a Region-Aware medical MLLM, MedRegA, which is the first bilingual generalist medical AI system to simultaneously handle image-level and region-level medical vision-language tasks across a broad range of modalities. Our MedRegA not only enables three region-centric tasks, but also achieves the best performance for visual question answering, report generation and medical image classification over 8 modalities, showcasing significant versatility. Experiments demonstrate that our model can not only accomplish powerful performance across various medical vision-language tasks in bilingual settings, but also recognize and detect structures in multimodal medical scans, boosting the interpretability and user interactivity of medical MLLMs. Our project page is https://medrega.github.io.

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.

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.

We introduce Xmodel-VLM, a cutting-edge multimodal vision language model. It is designed for efficient deployment on consumer GPU servers. Our work directly confronts a pivotal industry issue by grappling with the prohibitive service costs that hinder the broad adoption of large-scale multimodal systems. Through rigorous training, we have developed a 1B-scale language model from the ground up, employing the LLaVA paradigm for modal alignment. The result, which we call Xmodel-VLM, is a lightweight yet powerful multimodal vision language model. Extensive testing across numerous classic multimodal benchmarks has revealed that despite its smaller size and faster execution, Xmodel-VLM delivers performance comparable to that of larger models. Our model checkpoints and code are publicly available on GitHub at https://github.com/XiaoduoAILab/XmodelVLM.

Multimodal large language models (MLLMs) represent an evolutionary expansion in the capabilities of traditional large language models, enabling them to tackle challenges that surpass the scope of purely text-based applications. It leverages the knowledge previously encoded within these language models, thereby enhancing their applicability and functionality in the reign of multimodal contexts. Recent works investigate the adaptation of MLLMs to predict free-form answers as a generative task to solve medical visual question answering (Med-VQA) tasks. In this paper, we propose a parameter efficient framework for fine-tuning MLLM specifically tailored to Med-VQA applications, and empirically validate it on a public benchmark dataset. To accurately measure the performance, we employ human evaluation and the results reveal that our model achieves an overall accuracy of 81.9%, and outperforms the GPT-4v model by a significant margin of 26% absolute accuracy on closed-ended questions. The code will be available here: https://github.com/jinlHe/PeFoMed.

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.

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/

In recent years, Multimodal Large Language Models (MLLM) have achieved notable advancements, demonstrating the feasibility of developing an intelligent biomedical assistant. However, current biomedical MLLMs predominantly focus on image-level understanding and restrict interactions to textual commands, thus limiting their capability boundaries and the flexibility of usage. In this paper, we introduce a novel end-to-end multimodal large language model for the biomedical domain, named MedPLIB, which possesses pixel-level understanding. Excitingly, it supports visual question answering (VQA), arbitrary pixel-level prompts (points, bounding boxes, and free-form shapes), and pixel-level grounding. We propose a novel Mixture-of-Experts (MoE) multi-stage training strategy, which divides MoE into separate training phases for a visual-language expert model and a pixel-grounding expert model, followed by fine-tuning using MoE. This strategy effectively coordinates multitask learning while maintaining the computational cost at inference equivalent to that of a single expert model. To advance the research of biomedical MLLMs, we introduce the Medical Complex Vision Question Answering Dataset (MeCoVQA), which comprises an array of 8 modalities for complex medical imaging question answering and image region understanding. Experimental results indicate that MedPLIB has achieved state-of-the-art outcomes across multiple medical visual language tasks. More importantly, in zero-shot evaluations for the pixel grounding task, MedPLIB leads the best small and large models by margins of 19.7 and 15.6 respectively on the mDice metric. The codes, data, and model checkpoints will be made publicly available at https://github.com/ShawnHuang497/MedPLIB.

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.

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

Vision Large Language Models (VLMs) combine visual understanding with natural language processing, enabling tasks like image captioning, visual question answering, and video analysis. While VLMs show impressive capabilities across domains such as autonomous vehicles, smart surveillance, and healthcare, their deployment on resource-constrained edge devices remains challenging due to processing power, memory, and energy limitations. This survey explores recent advancements in optimizing VLMs for edge environments, focusing on model compression techniques, including pruning, quantization, knowledge distillation, and specialized hardware solutions that enhance efficiency. We provide a detailed discussion of efficient training and fine-tuning methods, edge deployment challenges, and privacy considerations. Additionally, we discuss the diverse applications of lightweight VLMs across healthcare, environmental monitoring, and autonomous systems, illustrating their growing impact. By highlighting key design strategies, current challenges, and offering recommendations for future directions, this survey aims to inspire further research into the practical deployment of VLMs, ultimately making advanced AI accessible in resource-limited settings.

When we look around and perform complex tasks, how we see and selectively process what we see is crucial. However, the lack of this visual search mechanism in current multimodal LLMs (MLLMs) hinders their ability to focus on important visual details, especially when handling high-resolution and visually crowded images. To address this, we introduce V*, an LLM-guided visual search mechanism that employs the world knowledge in LLMs for efficient visual querying. When combined with an MLLM, this mechanism enhances collaborative reasoning, contextual understanding, and precise targeting of specific visual elements. This integration results in a new MLLM meta-architecture, named Show, sEArch, and TelL (SEAL). We further create V*Bench, a benchmark specifically designed to evaluate MLLMs in their ability to process high-resolution images and focus on visual details. Our study highlights the necessity of incorporating visual search capabilities into multimodal systems. The code is available https://github.com/penghao-wu/vstar.

In recent advancements, multimodal large language models (MLLMs) have been fine-tuned on specific medical image datasets to address medical visual question answering (Med-VQA) tasks. However, this common approach of task-specific fine-tuning is costly and necessitates separate models for each downstream task, limiting the exploration of zero-shot capabilities. In this paper, we introduce MC-CoT, a modular cross-modal collaboration Chain-of-Thought (CoT) framework designed to enhance the zero-shot performance of MLLMs in Med-VQA by leveraging large language models (LLMs). MC-CoT improves reasoning and information extraction by integrating medical knowledge and task-specific guidance, where LLM provides various complex medical reasoning chains and MLLM provides various observations of medical images based on instructions of the LLM. Our experiments on datasets such as SLAKE, VQA-RAD, and PATH-VQA show that MC-CoT surpasses standalone MLLMs and various multimodality CoT frameworks in recall rate and accuracy. These findings highlight the importance of incorporating background information and detailed guidance in addressing complex zero-shot Med-VQA tasks.

We present MobileVLM, a competent multimodal vision language model (MMVLM) targeted to run on mobile devices. It is an amalgamation of a myriad of architectural designs and techniques that are mobile-oriented, which comprises a set of language models at the scale of 1.4B and 2.7B parameters, trained from scratch, a multimodal vision model that is pre-trained in the CLIP fashion, cross-modality interaction via an efficient projector. We evaluate MobileVLM on several typical VLM benchmarks. Our models demonstrate on par performance compared with a few much larger models. More importantly, we measure the inference speed on both a Qualcomm Snapdragon 888 CPU and an NVIDIA Jeston Orin GPU, and we obtain state-of-the-art performance of 21.5 tokens and 65.3 tokens per second, respectively. Our code will be made available at: https://github.com/Meituan-AutoML/MobileVLM.

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

Recent advancements in large language models (LLMs) have shown promise in medical applications such as disease diagnosis and treatment planning. However, most existing medical LLMs struggle with the advanced reasoning required for complex clinical scenarios, such as differential diagnosis or personalized treatment suggestions. We proposed FineMedLM-o1, which leverages high-quality synthetic medical data and long-form reasoning data for Supervised Fine-Tuning (SFT) and Direct Preference Optimization (DPO), enabling advanced dialogue and deep reasoning capabilities. Additionally, we introduced Test-Time Training (TTT) in the medical domain for the first time, facilitating domain adaptation and ensuring reliable, accurate reasoning. Experimental results demonstrate that FineMedLM-o1 achieves a 23% average performance improvement over prior models on key medical benchmarks. Furthermore, the introduction of TTT provides an additional 14% performance boost, highlighting its effectiveness in enhancing medical reasoning capabilities. To support this process, we also proposed a novel method for synthesizing medical dialogue. Compared to other open-source datasets, our dataset stands out as superior in both quality and complexity. The project and data will be released on GitHub.

LLMs have become increasingly capable at accomplishing a range of specialized-tasks and can be utilized to expand equitable access to medical knowledge. Most medical LLMs have involved extensive fine-tuning, leveraging specialized medical data and significant, thus costly, amounts of computational power. Many of the top performing LLMs are proprietary and their access is limited to very few research groups. However, open-source (OS) models represent a key area of growth for medical LLMs due to significant improvements in performance and an inherent ability to provide the transparency and compliance required in healthcare. We present OpenMedLM, a prompting platform which delivers state-of-the-art (SOTA) performance for OS LLMs on medical benchmarks. We evaluated a range of OS foundation LLMs (7B-70B) on four medical benchmarks (MedQA, MedMCQA, PubMedQA, MMLU medical-subset). We employed a series of prompting strategies, including zero-shot, few-shot, chain-of-thought (random selection and kNN selection), and ensemble/self-consistency voting. We found that OpenMedLM delivers OS SOTA results on three common medical LLM benchmarks, surpassing the previous best performing OS models that leveraged computationally costly extensive fine-tuning. The model delivers a 72.6% accuracy on the MedQA benchmark, outperforming the previous SOTA by 2.4%, and achieves 81.7% accuracy on the MMLU medical-subset, establishing itself as the first OS LLM to surpass 80% accuracy on this benchmark. Our results highlight medical-specific emergent properties in OS LLMs which have not yet been documented to date elsewhere, and showcase the benefits of further leveraging prompt engineering to improve the performance of accessible LLMs for medical applications.

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

Vision-Language Models (VLMs) are trained on vast amounts of data captured by humans emulating our understanding of the world. However, known as visual illusions, human's perception of reality isn't always faithful to the physical world. This raises a key question: do VLMs have the similar kind of illusions as humans do, or do they faithfully learn to represent reality? To investigate this question, we build a dataset containing five types of visual illusions and formulate four tasks to examine visual illusions in state-of-the-art VLMs. Our findings have shown that although the overall alignment is low, larger models are closer to human perception and more susceptible to visual illusions. Our dataset and initial findings will promote a better understanding of visual illusions in humans and machines and provide a stepping stone for future computational models that can better align humans and machines in perceiving and communicating about the shared visual world. The code and data are available at https://github.com/vl-illusion/dataset.

Models such as GPT-4 and Med-PaLM 2 have demonstrated impressive performance on a wide variety of biomedical NLP tasks. However, these models have hundreds of billions of parameters, are computationally expensive to run, require users to send their input data over the internet, and are trained on unknown data sources. Can smaller, more targeted models compete? To address this question, we build and release BioMedLM, a 2.7 billion parameter GPT-style autoregressive model trained exclusively on PubMed abstracts and full articles. When fine-tuned, BioMedLM can produce strong multiple-choice biomedical question-answering results competitive with much larger models, such as achieving a score of 57.3% on MedMCQA (dev) and 69.0% on the MMLU Medical Genetics exam. BioMedLM can also be fine-tuned to produce useful answers to patient questions on medical topics. This demonstrates that smaller models can potentially serve as transparent, privacy-preserving, economical and environmentally friendly foundations for particular NLP applications, such as in biomedicine. The model is available on the Hugging Face Hub: https://huggingface.co/stanford-crfm/BioMedLM.

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.

We introduce MobileVLM V2, a family of significantly improved vision language models upon MobileVLM, which proves that a delicate orchestration of novel architectural design, an improved training scheme tailored for mobile VLMs, and rich high-quality dataset curation can substantially benefit VLMs' performance. Specifically, MobileVLM V2 1.7B achieves better or on-par performance on standard VLM benchmarks compared with much larger VLMs at the 3B scale. Notably, our 3B model outperforms a large variety of VLMs at the 7B+ scale. Our models will be released at https://github.com/Meituan-AutoML/MobileVLM .

The Large Vision-Language Model (LVLM) field has seen significant advancements, yet its progression has been hindered by challenges in comprehending fine-grained visual content due to limited resolution. Recent efforts have aimed to enhance the high-resolution understanding capabilities of LVLMs, yet they remain capped at approximately 1500 x 1500 pixels and constrained to a relatively narrow resolution range. This paper represents InternLM-XComposer2-4KHD, a groundbreaking exploration into elevating LVLM resolution capabilities up to 4K HD (3840 x 1600) and beyond. Concurrently, considering the ultra-high resolution may not be necessary in all scenarios, it supports a wide range of diverse resolutions from 336 pixels to 4K standard, significantly broadening its scope of applicability. Specifically, this research advances the patch division paradigm by introducing a novel extension: dynamic resolution with automatic patch configuration. It maintains the training image aspect ratios while automatically varying patch counts and configuring layouts based on a pre-trained Vision Transformer (ViT) (336 x 336), leading to dynamic training resolution from 336 pixels to 4K standard. Our research demonstrates that scaling training resolution up to 4K HD leads to consistent performance enhancements without hitting the ceiling of potential improvements. InternLM-XComposer2-4KHD shows superb capability that matches or even surpasses GPT-4V and Gemini Pro in 10 of the 16 benchmarks. The InternLM-XComposer2-4KHD model series with 7B parameters are publicly available at https://github.com/InternLM/InternLM-XComposer.

The adoption of tablets with touchscreens and styluses is increasing, and a key feature is converting handwriting to text, enabling search, indexing, and AI assistance. Meanwhile, vision-language models (VLMs) are now the go-to solution for image understanding, thanks to both their state-of-the-art performance across a variety of tasks and the simplicity of a unified approach to training, fine-tuning, and inference. While VLMs obtain high performance on image-based tasks, they perform poorly on handwriting recognition when applied naively, i.e., by rendering handwriting as an image and performing optical character recognition (OCR). In this paper, we study online handwriting recognition with VLMs, going beyond naive OCR. We propose a novel tokenized representation of digital ink (online handwriting) that includes both a time-ordered sequence of strokes as text, and as image. We show that this representation yields results comparable to or better than state-of-the-art online handwriting recognizers. Wide applicability is shown through results with two different VLM families, on multiple public datasets. Our approach can be applied to off-the-shelf VLMs, does not require any changes in their architecture, and can be used in both fine-tuning and parameter-efficient tuning. We perform a detailed ablation study to identify the key elements of the proposed representation.

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.

Vision-language models (VLMs), which process image and text inputs, are increasingly integrated into chat assistants and other consumer AI applications. Without proper safeguards, however, VLMs may give harmful advice (e.g. how to self-harm) or encourage unsafe behaviours (e.g. to consume drugs). Despite these clear hazards, little work so far has evaluated VLM safety and the novel risks created by multimodal inputs. To address this gap, we introduce MSTS, a Multimodal Safety Test Suite for VLMs. MSTS comprises 400 test prompts across 40 fine-grained hazard categories. Each test prompt consists of a text and an image that only in combination reveal their full unsafe meaning. With MSTS, we find clear safety issues in several open VLMs. We also find some VLMs to be safe by accident, meaning that they are safe because they fail to understand even simple test prompts. We translate MSTS into ten languages, showing non-English prompts to increase the rate of unsafe model responses. We also show models to be safer when tested with text only rather than multimodal prompts. Finally, we explore the automation of VLM safety assessments, finding even the best safety classifiers to be lacking.

In the healthcare domain, summarizing medical questions posed by patients is critical for improving doctor-patient interactions and medical decision-making. Although medical data has grown in complexity and quantity, the current body of research in this domain has primarily concentrated on text-based methods, overlooking the integration of visual cues. Also prior works in the area of medical question summarisation have been limited to the English language. This work introduces the task of multimodal medical question summarization for codemixed input in a low-resource setting. To address this gap, we introduce the Multimodal Medical Codemixed Question Summarization MMCQS dataset, which combines Hindi-English codemixed medical queries with visual aids. This integration enriches the representation of a patient's medical condition, providing a more comprehensive perspective. We also propose a framework named MedSumm that leverages the power of LLMs and VLMs for this task. By utilizing our MMCQS dataset, we demonstrate the value of integrating visual information from images to improve the creation of medically detailed summaries. This multimodal strategy not only improves healthcare decision-making but also promotes a deeper comprehension of patient queries, paving the way for future exploration in personalized and responsive medical care. Our dataset, code, and pre-trained models will be made publicly available.

Multimodal large language models (MLLMs) have demonstrated impressive performance in vision-language tasks across a broad spectrum of domains. However, the large model scale and associated high computational costs pose significant challenges for training and deploying MLLMs on consumer-grade GPUs or edge devices, thereby hindering their widespread application. In this work, we introduce Mini-InternVL, a series of MLLMs with parameters ranging from 1B to 4B, which achieves 90% of the performance with only 5% of the parameters. This significant improvement in efficiency and effectiveness makes our models more accessible and applicable in various real-world scenarios. To further promote the adoption of our models, we develop a unified adaptation framework for Mini-InternVL, which enables our models to transfer and outperform specialized models in downstream tasks, including autonomous driving, medical images, and remote sensing. We believe that our study can provide valuable insights and resources to advance the development of efficient and effective MLLMs. Code is available at https://github.com/OpenGVLab/InternVL.

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

The emergence of Vision Language Models (VLMs) is a significant advancement in integrating computer vision with Large Language Models (LLMs) to produce detailed text descriptions based on visual inputs, yet it introduces new security vulnerabilities. Unlike prior work that centered on single modalities or classification tasks, this study introduces TrojVLM, the first exploration of backdoor attacks aimed at VLMs engaged in complex image-to-text generation. Specifically, TrojVLM inserts predetermined target text into output text when encountering poisoned images. Moreover, a novel semantic preserving loss is proposed to ensure the semantic integrity of the original image content. Our evaluation on image captioning and visual question answering (VQA) tasks confirms the effectiveness of TrojVLM in maintaining original semantic content while triggering specific target text outputs. This study not only uncovers a critical security risk in VLMs and image-to-text generation but also sets a foundation for future research on securing multimodal models against such sophisticated threats.

In this technical report, we propose ChemVLM, the first open-source multimodal large language model dedicated to the fields of chemistry, designed to address the incompatibility between chemical image understanding and text analysis. Built upon the VIT-MLP-LLM architecture, we leverage ChemLLM-20B as the foundational large model, endowing our model with robust capabilities in understanding and utilizing chemical text knowledge. Additionally, we employ InternVIT-6B as a powerful image encoder. We have curated high-quality data from the chemical domain, including molecules, reaction formulas, and chemistry examination data, and compiled these into a bilingual multimodal question-answering dataset. We test the performance of our model on multiple open-source benchmarks and three custom evaluation sets. Experimental results demonstrate that our model achieves excellent performance, securing state-of-the-art results in five out of six involved tasks. Our model can be found at https://huggingface.co/AI4Chem/ChemVLM-26B.

Scaling the input image resolution is essential for enhancing the performance of Vision Language Models (VLMs), particularly in text-rich image understanding tasks. However, popular visual encoders such as ViTs become inefficient at high resolutions due to the large number of tokens and high encoding latency caused by stacked self-attention layers. At different operational resolutions, the vision encoder of a VLM can be optimized along two axes: reducing encoding latency and minimizing the number of visual tokens passed to the LLM, thereby lowering overall latency. Based on a comprehensive efficiency analysis of the interplay between image resolution, vision latency, token count, and LLM size, we introduce FastVLM, a model that achieves an optimized trade-off between latency, model size and accuracy. FastVLM incorporates FastViTHD, a novel hybrid vision encoder designed to output fewer tokens and significantly reduce encoding time for high-resolution images. Unlike previous methods, FastVLM achieves the optimal balance between visual token count and image resolution solely by scaling the input image, eliminating the need for additional token pruning and simplifying the model design. In the LLaVA-1.5 setup, FastVLM achieves 3.2times improvement in time-to-first-token (TTFT) while maintaining similar performance on VLM benchmarks compared to prior works. Compared to LLaVa-OneVision at the highest resolution (1152times1152), FastVLM achieves comparable performance on key benchmarks like SeedBench and MMMU, using the same 0.5B LLM, but with 85times faster TTFT and a vision encoder that is 3.4times smaller.

Starting from the resurgence of deep learning, vision-language models (VLMs) benefiting from large language models (LLMs) have never been so popular. However, while LLMs can utilize extensive background knowledge and task information with in-context learning, most VLMs still struggle with understanding complex multi-modal prompts with multiple images. The issue can traced back to the architectural design of VLMs or pre-training data. Specifically, the current VLMs primarily emphasize utilizing multi-modal data with a single image some, rather than multi-modal prompts with interleaved multiple images and text. Even though some newly proposed VLMs could handle user prompts with multiple images, pre-training data does not provide more sophisticated multi-modal prompts than interleaved image and text crawled from the web. We propose MMICL to address the issue by considering both the model and data perspectives. We introduce a well-designed architecture capable of seamlessly integrating visual and textual context in an interleaved manner and MIC dataset to reduce the gap between the training data and the complex user prompts in real-world applications, including: 1) multi-modal context with interleaved images and text, 2) textual references for each image, and 3) multi-image data with spatial, logical, or temporal relationships. Our experiments confirm that MMICL achieves new stat-of-the-art zero-shot and few-shot performance on a wide range of general vision-language tasks, especially for complex reasoning benchmarks including MME and MMBench. Our analysis demonstrates that MMICL effectively deals with the challenge of complex multi-modal prompt understanding. The experiments on ScienceQA-IMG also show that MMICL successfully alleviates the issue of language bias in VLMs, which we believe is the reason behind the advanced performance of MMICL.

The emergence and growing popularity of multimodal large language models (MLLMs) have significant potential to enhance various aspects of daily life, from improving communication to facilitating learning and problem-solving. Mobile phones, as essential daily companions, represent the most effective and accessible deployment platform for MLLMs, enabling seamless integration into everyday tasks. However, deploying MLLMs on mobile phones presents challenges due to limitations in memory size and computational capability, making it difficult to achieve smooth and real-time processing without extensive optimization. In this paper, we present BlueLM-V-3B, an algorithm and system co-design approach specifically tailored for the efficient deployment of MLLMs on mobile platforms. To be specific, we redesign the dynamic resolution scheme adopted by mainstream MLLMs and implement system optimization for hardware-aware deployment to optimize model inference on mobile phones. BlueLM-V-3B boasts the following key highlights: (1) Small Size: BlueLM-V-3B features a language model with 2.7B parameters and a vision encoder with 400M parameters. (2) Fast Speed: BlueLM-V-3B achieves a generation speed of 24.4 token/s on the MediaTek Dimensity 9300 processor with 4-bit LLM weight quantization. (3) Strong Performance: BlueLM-V-3B has attained the highest average score of 66.1 on the OpenCompass benchmark among models with leq 4B parameters and surpassed a series of models with much larger parameter sizes (e.g., MiniCPM-V-2.6, InternVL2-8B).

The field of vision-language models (VLMs), which take images and texts as inputs and output texts, is rapidly evolving and has yet to reach consensus on several key aspects of the development pipeline, including data, architecture, and training methods. This paper can be seen as a tutorial for building a VLM. We begin by providing a comprehensive overview of the current state-of-the-art approaches, highlighting the strengths and weaknesses of each, addressing the major challenges in the field, and suggesting promising research directions for underexplored areas. We then walk through the practical steps to build Idefics3-8B, a powerful VLM that significantly outperforms its predecessor Idefics2-8B, while being trained efficiently, exclusively on open datasets, and using a straightforward pipeline. These steps include the creation of Docmatix, a dataset for improving document understanding capabilities, which is 240 times larger than previously available datasets. We release the model along with the datasets created for its training.

Using vision-language models (VLMs) in web development presents a promising strategy to increase efficiency and unblock no-code solutions: by providing a screenshot or a sketch of a UI, a VLM could generate the code to reproduce it, for instance in a language like HTML. Despite the advancements in VLMs for various tasks, the specific challenge of converting a screenshot into a corresponding HTML has been minimally explored. We posit that this is mainly due to the absence of a suitable, high-quality dataset. This work introduces WebSight, a synthetic dataset consisting of 2 million pairs of HTML codes and their corresponding screenshots. We fine-tune a foundational VLM on our dataset and show proficiency in converting webpage screenshots to functional HTML code. To accelerate the research in this area, we open-source WebSight.

Multimodal large language models (MLLMs) hold significant potential in the medical field, but their capabilities are often limited by insufficient data in certain medical domains, highlighting the need for understanding what kinds of images can be used by MLLMs for generalization. Current research suggests that multi-task training outperforms single-task as different tasks can benefit each other, but they often overlook the internal relationships within these tasks, providing limited guidance on selecting datasets to enhance specific tasks. To analyze this phenomenon, we attempted to employ compositional generalization (CG)-the ability of models to understand novel combinations by recombining learned elements-as a guiding framework. Since medical images can be precisely defined by Modality, Anatomical area, and Task, naturally providing an environment for exploring CG. Therefore, we assembled 106 medical datasets to create Med-MAT for comprehensive experiments. The experiments confirmed that MLLMs can use CG to understand unseen medical images and identified CG as one of the main drivers of the generalization observed in multi-task training. Additionally, further studies demonstrated that CG effectively supports datasets with limited data and delivers consistent performance across different backbones, highlighting its versatility and broad applicability. Med-MAT is publicly available at https://github.com/FreedomIntelligence/Med-MAT.

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.

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.

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.

Image classification is one of the most fundamental capabilities of machine vision intelligence. In this work, we revisit the image classification task using visually-grounded language models (VLMs) such as GPT-4V and LLaVA. We find that existing proprietary and public VLMs, despite often using CLIP as a vision encoder and having many more parameters, significantly underperform CLIP on standard image classification benchmarks like ImageNet. To understand the reason, we explore several hypotheses concerning the inference algorithms, training objectives, and data processing in VLMs. Our analysis reveals that the primary cause is data-related: critical information for image classification is encoded in the VLM's latent space but can only be effectively decoded with enough training data. Specifically, there is a strong correlation between the frequency of class exposure during VLM training and instruction-tuning and the VLM's performance in those classes; when trained with sufficient data, VLMs can match the accuracy of state-of-the-art classification models. Based on these findings, we enhance a VLM by integrating classification-focused datasets into its training, and demonstrate that the enhanced classification performance of the VLM transfers to its general capabilities, resulting in an improvement of 11.8% on the newly collected ImageWikiQA dataset.

The increasing interest in developing Artificial Intelligence applications in the medical domain, suffers from the lack of high-quality dataset, mainly due to privacy-related issues. Moreover, the recent rising of Multimodal Large Language Models (MLLM) leads to a need for multimodal medical datasets, where clinical reports and findings are attached to the corresponding CT or MR scans. This paper illustrates the entire workflow for building the data set MedPix 2.0. Starting from the well-known multimodal dataset MedPix\textregistered, mainly used by physicians, nurses and healthcare students for Continuing Medical Education purposes, a semi-automatic pipeline was developed to extract visual and textual data followed by a manual curing procedure where noisy samples were removed, thus creating a MongoDB database. Along with the dataset, we developed a GUI aimed at navigating efficiently the MongoDB instance, and obtaining the raw data that can be easily used for training and/or fine-tuning MLLMs. To enforce this point, we also propose a CLIP-based model trained on MedPix 2.0 for scan classification tasks.

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

The standard practice for developing contemporary MLLMs is to feed features from vision encoder(s) into the LLM and train with natural language supervision. In this work, we posit an overlooked opportunity to optimize the intermediate LLM representations through a vision perspective (objective), i.e., solely natural language supervision is sub-optimal for the MLLM's visual understanding ability. To that end, we propose OLA-VLM, the first approach distilling knowledge into the LLM's hidden representations from a set of target visual representations. Firstly, we formulate the objective during the pretraining stage in MLLMs as a coupled optimization of predictive visual embedding and next text-token prediction. Secondly, we investigate MLLMs trained solely with natural language supervision and identify a positive correlation between the quality of visual representations within these models and their downstream performance. Moreover, upon probing our OLA-VLM, we observe improved representation quality owing to the embedding optimization. Thirdly, we demonstrate that our OLA-VLM outperforms the single and multi-encoder baselines, proving our approach's superiority over explicitly feeding the corresponding features to the LLM. Particularly, OLA-VLM boosts performance by an average margin of up to 2.5% on various benchmarks, with a notable improvement of 8.7% on the Depth task in CV-Bench. Our code is open-sourced at https://github.com/SHI-Labs/OLA-VLM .

To build scalable models for challenging real-world tasks, it is important to learn from diverse, multi-modal data in various forms (e.g., videos, text, and images). Among the existing works, a plethora of them have focused on leveraging large but cumbersome cross-modal architectures. Regardless of their effectiveness, larger architectures unavoidably prevent the models from being extended to real-world applications, so building a lightweight VL architecture and an efficient learning schema is of great practical value. In this paper, we propose an Efficient Video-Language Model (dubbed as E-ViLM) and a masked video modeling (MVM) schema, assisted with a semantic vector-quantized tokenizer. In particular, our E-ViLM learns to reconstruct the semantic labels of masked video regions, produced by the pre-trained vector-quantized tokenizer, which discretizes the continuous visual signals into labels. We show that with our simple MVM task and regular VL pre-training modelings, our E-ViLM, despite its compactness, is able to learn expressive representations from Video-Language corpus and generalize well to extensive Video-Language tasks including video question answering, text-to-video retrieval, etc. In particular, our E-ViLM obtains obvious efficiency improvements by reaching competing performances with faster inference speed, i.e., our model reaches 39.3% Top-1 accuracy on the MSRVTT benchmark, retaining 91.4% of the accuracy of state-of-the-art larger VL architecture with only 15% parameters and 94.8% fewer GFLOPs. We also provide extensive ablative studies that validate the effectiveness of our proposed learning schema for E-ViLM.

This study evaluates the performance of large language models (LLMs) as medical agents in Portuguese, aiming to develop a reliable and relevant virtual assistant for healthcare professionals. The HealthCareMagic-100k-en and MedQuAD datasets, translated from English using GPT-3.5, were used to fine-tune the ChatBode-7B model using the PEFT-QLoRA method. The InternLM2 model, with initial training on medical data, presented the best overall performance, with high precision and adequacy in metrics such as accuracy, completeness and safety. However, DrBode models, derived from ChatBode, exhibited a phenomenon of catastrophic forgetting of acquired medical knowledge. Despite this, these models performed frequently or even better in aspects such as grammaticality and coherence. A significant challenge was low inter-rater agreement, highlighting the need for more robust assessment protocols. This work paves the way for future research, such as evaluating multilingual models specific to the medical field, improving the quality of training data, and developing more consistent evaluation methodologies for the medical field.

Multimodal large language models (MLLMs) have achieved significant success in the general field of image processing. Their emerging task generalization and freeform conversational capabilities can greatly facilitate medical diagnostic assistance, helping patients better understand their conditions and enhancing doctor-patient trust. Computed Tomography (CT) is a non-invasive imaging technique used to capture the internal mechanisms of a patient's condition and is widely utilized. However, in past research, the complex textural features of this imaging data have made accurate interpretation by algorithms challenging, impeding the performance of general LLMs in diagnostic assistance. To address this, we developed OrthoDoc, a MLLM designed for CT diagnostics. OrthoDoc is trained on 120,000 CT images and diagnostic reports and includes a Retrieval-Augmented Generation (RAG) module capable of effectively mitigating model hallucinations. This module is informed by extensive medical literature, textbooks, and explanatory data. Thus, OrthoDoc not only processes complex CT images but also stores, understands, and reasons over medical knowledge and language. In extensive experiments, OrthoDoc outperforms commercial models led by GPT-4, demonstrating superior diagnostic capabilities and accuracy. Specifically, OrthoDoc significantly surpasses existing models in the diagnosis of common orthopedic conditions such as fractures, arthritis, and tumors. Additionally, OrthoDoc exhibits robust generalization and stability when handling rare and complex cases.

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

Following the recent popularity of Large Language Models (LLMs), several attempts have been made to extend them to the visual domain. From having a visual assistant that could guide us through unfamiliar environments to generative models that produce images using only a high-level text description, the vision-language model (VLM) applications will significantly impact our relationship with technology. However, there are many challenges that need to be addressed to improve the reliability of those models. While language is discrete, vision evolves in a much higher dimensional space in which concepts cannot always be easily discretized. To better understand the mechanics behind mapping vision to language, we present this introduction to VLMs which we hope will help anyone who would like to enter the field. First, we introduce what VLMs are, how they work, and how to train them. Then, we present and discuss approaches to evaluate VLMs. Although this work primarily focuses on mapping images to language, we also discuss extending VLMs to videos.

The widespread use of chest X-rays (CXRs), coupled with a shortage of radiologists, has driven growing interest in automated CXR analysis and AI-assisted reporting. While existing vision-language models (VLMs) show promise in specific tasks such as report generation or abnormality detection, they often lack support for interactive diagnostic capabilities. In this work we present RadVLM, a compact, multitask conversational foundation model designed for CXR interpretation. To this end, we curate a large-scale instruction dataset comprising over 1 million image-instruction pairs containing both single-turn tasks -- such as report generation, abnormality classification, and visual grounding -- and multi-turn, multi-task conversational interactions. After fine-tuning RadVLM on this instruction dataset, we evaluate it across different tasks along with re-implemented baseline VLMs. Our results show that RadVLM achieves state-of-the-art performance in conversational capabilities and visual grounding while remaining competitive in other radiology tasks. Ablation studies further highlight the benefit of joint training across multiple tasks, particularly for scenarios with limited annotated data. Together, these findings highlight the potential of RadVLM as a clinically relevant AI assistant, providing structured CXR interpretation and conversational capabilities to support more effective and accessible diagnostic workflows.

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.

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.

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.

Security concerns related to Large Language Models (LLMs) have been extensively explored, yet the safety implications for Multimodal Large Language Models (MLLMs), particularly in medical contexts (MedMLLMs), remain insufficiently studied. This paper delves into the underexplored security vulnerabilities of MedMLLMs, especially when deployed in clinical environments where the accuracy and relevance of question-and-answer interactions are critically tested against complex medical challenges. By combining existing clinical medical data with atypical natural phenomena, we redefine two types of attacks: mismatched malicious attack (2M-attack) and optimized mismatched malicious attack (O2M-attack). Using our own constructed voluminous 3MAD dataset, which covers a wide range of medical image modalities and harmful medical scenarios, we conduct a comprehensive analysis and propose the MCM optimization method, which significantly enhances the attack success rate on MedMLLMs. Evaluations with this dataset and novel attack methods, including white-box attacks on LLaVA-Med and transfer attacks on four other state-of-the-art models, indicate that even MedMLLMs designed with enhanced security features are vulnerable to security breaches. Our work underscores the urgent need for a concerted effort to implement robust security measures and enhance the safety and efficacy of open-source MedMLLMs, particularly given the potential severity of jailbreak attacks and other malicious or clinically significant exploits in medical settings. For further research and replication, anonymous access to our code is available at https://github.com/dirtycomputer/O2M_attack. Warning: Medical large model jailbreaking may generate content that includes unverified diagnoses and treatment recommendations. Always consult professional medical advice.

This report introduces an enhanced method for the Foundational Few-Shot Object Detection (FSOD) task, leveraging the vision-language model (VLM) for object detection. However, on specific datasets, VLM may encounter the problem where the detected targets are misaligned with the target concepts of interest. This misalignment hinders the zero-shot performance of VLM and the application of fine-tuning methods based on pseudo-labels. To address this issue, we propose the VLM+ framework, which integrates the multimodal large language model (MM-LLM). Specifically, we use MM-LLM to generate a series of referential expressions for each category. Based on the VLM predictions and the given annotations, we select the best referential expression for each category by matching the maximum IoU. Subsequently, we use these referential expressions to generate pseudo-labels for all images in the training set and then combine them with the original labeled data to fine-tune the VLM. Additionally, we employ iterative pseudo-label generation and optimization to further enhance the performance of the VLM. Our approach achieve 32.56 mAP in the final test.

Smaller vision-language models (VLMs) are becoming increasingly important for privacy-focused, on-device applications due to their ability to run efficiently on consumer hardware for processing enterprise commercial documents and images. These models require strong language understanding and visual capabilities to enhance human-machine interaction. To address this need, we present H2OVL-Mississippi, a pair of small VLMs trained on 37 million image-text pairs using 240 hours of compute on 8 x H100 GPUs. H2OVL-Mississippi-0.8B is a tiny model with 0.8 billion parameters that specializes in text recognition, achieving state of the art performance on the Text Recognition portion of OCRBench and surpassing much larger models in this area. Additionally, we are releasing H2OVL-Mississippi-2B, a 2 billion parameter model for general use cases, exhibiting highly competitive metrics across various academic benchmarks. Both models build upon our prior work with H2O-Danube language models, extending their capabilities into the visual domain. We release them under the Apache 2.0 license, making VLMs accessible to everyone, democratizing document AI and visual LLMs.

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).

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

In recent years, multimodal large language models (MLLMs) have shown strong potential in real-world applications. They are developing rapidly due to their remarkable ability to comprehend multimodal information and their inherent powerful cognitive and reasoning capabilities. Among MLLMs, vision language models (VLM) stand out for their ability to understand vision information. However, the scaling trend of VLMs under the current mainstream paradigm has not been extensively studied. Whether we can achieve better performance by training even larger models is still unclear. To address this issue, we conducted experiments on the pretraining stage of MLLMs. We conduct our experiment using different encoder sizes and large language model (LLM) sizes. Our findings indicate that merely increasing the size of encoders does not necessarily enhance the performance of VLMs. Moreover, we analyzed the effects of LLM backbone parameter size and data quality on the pretraining outcomes. Additionally, we explored the differences in scaling laws between LLMs and VLMs.

Multimodal vision language models (VLMs) have made significant progress with the support of continuously increasing model sizes and data volumes. Running VLMs on edge devices has become a challenge for their widespread application. There are several efficient VLM efforts, but they often sacrifice linguistic capabilities to enhance multimodal abilities, or require extensive training. To address this quandary,we introduce the innovative framework of Efficient Vision Language Models with Elastic Visual Experts (Eve). By strategically incorporating adaptable visual expertise at multiple stages of training, Eve strikes a balance between preserving linguistic abilities and augmenting multimodal capabilities. This balanced approach results in a versatile model with only 1.8B parameters that delivers significant improvements in both multimodal and linguistic tasks. Notably, in configurations below 3B parameters, Eve distinctly outperforms in language benchmarks and achieves state-of-the-art results 68.87% in VLM Benchmarks. Additionally, its multimodal accuracy outstrips that of the larger 7B LLaVA-1.5 model. Our code is available at https://github.com/rangmiao/Eve.

PaliGemma is an open Vision-Language Model (VLM) that is based on the SigLIP-So400m vision encoder and the Gemma-2B language model. It is trained to be a versatile and broadly knowledgeable base model that is effective to transfer. It achieves strong performance on a wide variety of open-world tasks. We evaluate PaliGemma on almost 40 diverse tasks including standard VLM benchmarks, but also more specialized tasks such as remote-sensing and segmentation.

We present VLMEvalKit: an open-source toolkit for evaluating large multi-modality models based on PyTorch. The toolkit aims to provide a user-friendly and comprehensive framework for researchers and developers to evaluate existing multi-modality models and publish reproducible evaluation results. In VLMEvalKit, we implement over 70 different large multi-modality models, including both proprietary APIs and open-source models, as well as more than 20 different multi-modal benchmarks. By implementing a single interface, new models can be easily added to the toolkit, while the toolkit automatically handles the remaining workloads, including data preparation, distributed inference, prediction post-processing, and metric calculation. Although the toolkit is currently mainly used for evaluating large vision-language models, its design is compatible with future updates that incorporate additional modalities, such as audio and video. Based on the evaluation results obtained with the toolkit, we host OpenVLM Leaderboard, a comprehensive leaderboard to track the progress of multi-modality learning research. The toolkit is released at https://github.com/open-compass/VLMEvalKit and is actively maintained.

Large-scale Vision-Language Models (VLMs) have advanced by aligning vision inputs with text, significantly improving performance in computer vision tasks. Moreover, for VLMs to be effectively utilized in real-world applications, an understanding of diverse multi-vision sensor data, such as thermal, depth, and X-ray information, is essential. However, we find that current VLMs process multi-vision sensor images without deep understanding of sensor information, disregarding each sensor's unique physical properties. This limitation restricts their capacity to interpret and respond to complex questions requiring multi-vision sensor reasoning. To address this, we propose a novel Multi-vision Sensor Perception and Reasoning (MS-PR) benchmark, assessing VLMs on their capacity for sensor-specific reasoning. Moreover, we introduce Diverse Negative Attributes (DNA) optimization to enable VLMs to perform deep reasoning on multi-vision sensor tasks, helping to bridge the core information gap between images and sensor data. Extensive experimental results validate that the proposed DNA method can significantly improve the multi-vision sensor reasoning for VLMs.

With the rapid development of artificial intelligence, large language models (LLMs) have shown promising capabilities in mimicking human-level language comprehension and reasoning. This has sparked significant interest in applying LLMs to enhance various aspects of healthcare, ranging from medical education to clinical decision support. However, medicine involves multifaceted data modalities and nuanced reasoning skills, presenting challenges for integrating LLMs. This paper provides a comprehensive review on the applications and implications of LLMs in medicine. It begins by examining the fundamental applications of general-purpose and specialized LLMs, demonstrating their utilities in knowledge retrieval, research support, clinical workflow automation, and diagnostic assistance. Recognizing the inherent multimodality of medicine, the review then focuses on multimodal LLMs, investigating their ability to process diverse data types like medical imaging and EHRs to augment diagnostic accuracy. To address LLMs' limitations regarding personalization and complex clinical reasoning, the paper explores the emerging development of LLM-powered autonomous agents for healthcare. Furthermore, it summarizes the evaluation methodologies for assessing LLMs' reliability and safety in medical contexts. Overall, this review offers an extensive analysis on the transformative potential of LLMs in modern medicine. It also highlights the pivotal need for continuous optimizations and ethical oversight before these models can be effectively integrated into clinical practice. Visit https://github.com/mingze-yuan/Awesome-LLM-Healthcare for an accompanying GitHub repository containing latest papers.

Purpose: In radiology, large language models (LLMs), including ChatGPT, have recently gained attention, and their utility is being rapidly evaluated. However, concerns have emerged regarding their reliability in clinical applications due to limitations such as hallucinations and insufficient referencing. To address these issues, we focus on the latest technology, retrieval-augmented generation (RAG), which enables LLMs to reference reliable external knowledge (REK). Specifically, this study examines the utility and reliability of a recently released RAG-equipped LLM (RAG-LLM), NotebookLM, for staging lung cancer. Materials and methods: We summarized the current lung cancer staging guideline in Japan and provided this as REK to NotebookLM. We then tasked NotebookLM with staging 100 fictional lung cancer cases based on CT findings and evaluated its accuracy. For comparison, we performed the same task using a gold-standard LLM, GPT-4 Omni (GPT-4o), both with and without the REK. Results: NotebookLM achieved 86% diagnostic accuracy in the lung cancer staging experiment, outperforming GPT-4o, which recorded 39% accuracy with the REK and 25% without it. Moreover, NotebookLM demonstrated 95% accuracy in searching reference locations within the REK. Conclusion: NotebookLM successfully performed lung cancer staging by utilizing the REK, demonstrating superior performance compared to GPT-4o. Additionally, it provided highly accurate reference locations within the REK, allowing radiologists to efficiently evaluate the reliability of NotebookLM's responses and detect possible hallucinations. Overall, this study highlights the potential of NotebookLM, a RAG-LLM, in image diagnosis.

Most visual recognition studies rely heavily on crowd-labelled data in deep neural networks (DNNs) training, and they usually train a DNN for each single visual recognition task, leading to a laborious and time-consuming visual recognition paradigm. To address the two challenges, Vision-Language Models (VLMs) have been intensively investigated recently, which learns rich vision-language correlation from web-scale image-text pairs that are almost infinitely available on the Internet and enables zero-shot predictions on various visual recognition tasks with a single VLM. This paper provides a systematic review of visual language models for various visual recognition tasks, including: (1) the background that introduces the development of visual recognition paradigms; (2) the foundations of VLM that summarize the widely-adopted network architectures, pre-training objectives, and downstream tasks; (3) the widely-adopted datasets in VLM pre-training and evaluations; (4) the review and categorization of existing VLM pre-training methods, VLM transfer learning methods, and VLM knowledge distillation methods; (5) the benchmarking, analysis and discussion of the reviewed methods; (6) several research challenges and potential research directions that could be pursued in the future VLM studies for visual recognition. A project associated with this survey has been created at https://github.com/jingyi0000/VLM_survey.

Embedding models have been crucial in enabling various downstream tasks such as semantic similarity, information retrieval, and clustering. Recently, there has been a surge of interest in developing universal text embedding models that can generalize across tasks (e.g., MTEB). However, progress in learning universal multimodal embedding models has been relatively slow despite their importance. In this work, we aim to explore the potential for building universal embeddings capable of handling a wide range of downstream tasks. Our contributions are twofold: (1) MMEB (Massive Multimodal Embedding Benchmark), which covers 4 meta-tasks (i.e. classification, visual question answering, multimodal retrieval, and visual grounding) and 36 datasets, including 20 training and 16 evaluation datasets, and (2) VLM2Vec (Vision-Language Model -> Vector), a contrastive training framework that converts any state-of-the-art vision-language model into an embedding model via training on MMEB. Unlike previous models such as CLIP and BLIP, VLM2Vec can process any combination of images and text to generate a fixed-dimensional vector based on task instructions. We build a series of VLM2Vec models on Phi-3.5-V and evaluate them on MMEB's evaluation split. Our results show that \model achieves an absolute average improvement of 10% to 20% over existing multimodal embedding models on both in-distribution and out-of-distribution datasets in MMEB.

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/

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

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

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.

Multimodal Vision-Language Models (VLMs) enable powerful applications from their fused understanding of images and language, but many perform poorly on UI tasks due to the lack of UI training data. In this paper, we adapt a recipe for generating paired text-image training data for VLMs to the UI domain by combining existing pixel-based methods with a Large Language Model (LLM). Unlike prior art, our method requires no human-provided annotations, and it can be applied to any dataset of UI screenshots. We generate a dataset of 335K conversational examples paired with UIs that cover Q&A, UI descriptions, and planning, and use it to fine-tune a conversational VLM for UI tasks. To assess the performance of our model, we benchmark it on UI element detection tasks, evaluate response quality, and showcase its applicability to multi-step UI navigation and planning.

Large Vision-Language Models (LVLMs) are an extension of Large Language Models (LLMs) that facilitate processing both image and text inputs, expanding AI capabilities. However, LVLMs struggle with object hallucinations due to their reliance on text cues and learned object co-occurrence biases. While most research quantifies these hallucinations, mitigation strategies are still lacking. Our study introduces a Language Contrastive Decoding (LCD) algorithm that adjusts LVLM outputs based on LLM distribution confidence levels, effectively reducing object hallucinations. We demonstrate the advantages of LCD in leading LVLMs, showing up to %4 improvement in POPE F1 scores and up to %36 reduction in CHAIR scores on the COCO validation set, while also improving captioning quality scores. Our method effectively improves LVLMs without needing complex post-processing or retraining, and is easily applicable to different models. Our findings highlight the potential of further exploration of LVLM-specific decoding algorithms.

We introduce Lavender, a simple supervised fine-tuning (SFT) method that boosts the performance of advanced vision-language models (VLMs) by leveraging state-of-the-art image generation models such as Stable Diffusion. Specifically, Lavender aligns the text-vision attention in the VLM transformer with the equivalent used by Stable Diffusion during SFT, instead of adapting separate encoders. This alignment enriches the model's visual understanding and significantly boosts performance across in- and out-of-distribution tasks. Lavender requires just 0.13 million training examples, 2.5% of typical large-scale SFT datasets, and fine-tunes on standard hardware (8 GPUs) in a single day. It consistently improves state-of-the-art open-source multimodal LLMs (e.g., Llama-3.2-11B, MiniCPM-Llama3-v2.5), achieving up to 30% gains and a 68% boost on challenging out-of-distribution medical QA tasks. By efficiently transferring the visual expertise of image generators with minimal supervision, Lavender offers a scalable solution for more accurate vision-language systems. All code, training data, and models will be shared at https://astrazeneca.github.io/vlm/.

The pursuit of autonomous driving technology hinges on the sophisticated integration of perception, decision-making, and control systems. Traditional approaches, both data-driven and rule-based, have been hindered by their inability to grasp the nuance of complex driving environments and the intentions of other road users. This has been a significant bottleneck, particularly in the development of common sense reasoning and nuanced scene understanding necessary for safe and reliable autonomous driving. The advent of Visual Language Models (VLM) represents a novel frontier in realizing fully autonomous vehicle driving. This report provides an exhaustive evaluation of the latest state-of-the-art VLM, \modelnamefull, and its application in autonomous driving scenarios. We explore the model's abilities to understand and reason about driving scenes, make decisions, and ultimately act in the capacity of a driver. Our comprehensive tests span from basic scene recognition to complex causal reasoning and real-time decision-making under varying conditions. Our findings reveal that \modelname demonstrates superior performance in scene understanding and causal reasoning compared to existing autonomous systems. It showcases the potential to handle out-of-distribution scenarios, recognize intentions, and make informed decisions in real driving contexts. However, challenges remain, particularly in direction discernment, traffic light recognition, vision grounding, and spatial reasoning tasks. These limitations underscore the need for further research and development. Project is now available on GitHub for interested parties to access and utilize: https://github.com/PJLab-ADG/GPT4V-AD-Exploration

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.

Multi-modal foundation models like OpenFlamingo, LLaVA, and GPT-4 are increasingly used for various real-world tasks. Prior work has shown that these models are highly vulnerable to adversarial attacks on the vision modality. These attacks can be leveraged to spread fake information or defraud users, and thus pose a significant risk, which makes the robustness of large multi-modal foundation models a pressing problem. The CLIP model, or one of its variants, is used as a frozen vision encoder in many vision-language models (VLMs), e.g. LLaVA and OpenFlamingo. We propose an unsupervised adversarial fine-tuning scheme to obtain a robust CLIP vision encoder, which yields robustness on all vision down-stream tasks (VLMs, zero-shot classification) that rely on CLIP. In particular, we show that stealth-attacks on users of VLMs by a malicious third party providing manipulated images are no longer possible once one replaces the original CLIP model with our robust one. No retraining or fine-tuning of the VLM is required. The code and robust models are available at https://github.com/chs20/RobustVLM

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

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.

Large language models with vision capabilities (VLMs), e.g., GPT-4o and Gemini 1.5 Pro are powering countless image-text applications and scoring high on many vision-understanding benchmarks. Yet, we find that VLMs fail on 7 visual tasks absurdly easy to humans such as identifying (a) whether two circles overlap; (b) whether two lines intersect; (c) which letter is being circled in a word; and (d) counting the number of circles in a Olympic-like logo. The shockingly poor performance of four state-of-the-art VLMs suggests their vision is, at best, like of a person with myopia seeing fine details as blurry, and at worst, like an intelligent person that is blind making educated guesses. Code is available at: https://vlmsareblind.github.io/

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

The advent of Vision Language Models (VLM) has allowed researchers to investigate the visual understanding of a neural network using natural language. Beyond object classification and detection, VLMs are capable of visual comprehension and common-sense reasoning. This naturally led to the question: How do VLMs respond when the image itself is inherently unreasonable? To this end, we present IllusionVQA: a diverse dataset of challenging optical illusions and hard-to-interpret scenes to test the capability of VLMs in two distinct multiple-choice VQA tasks - comprehension and soft localization. GPT4V, the best-performing VLM, achieves 62.99% accuracy (4-shot) on the comprehension task and 49.7% on the localization task (4-shot and Chain-of-Thought). Human evaluation reveals that humans achieve 91.03% and 100% accuracy in comprehension and localization. We discover that In-Context Learning (ICL) and Chain-of-Thought reasoning substantially degrade the performance of GeminiPro on the localization task. Tangentially, we discover a potential weakness in the ICL capabilities of VLMs: they fail to locate optical illusions even when the correct answer is in the context window as a few-shot example.

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.

Safety concerns of Multimodal large language models (MLLMs) have gradually become an important problem in various applications. Surprisingly, previous works indicate a counter-intuitive phenomenon that using textual unlearning to align MLLMs achieves comparable safety performances with MLLMs trained with image-text pairs. To explain such a counter-intuitive phenomenon, we discover a visual safety information leakage (VSIL) problem in existing multimodal safety benchmarks, i.e., the potentially risky and sensitive content in the image has been revealed in the textual query. In this way, MLLMs can easily refuse these sensitive text-image queries according to textual queries. However, image-text pairs without VSIL are common in real-world scenarios and are overlooked by existing multimodal safety benchmarks. To this end, we construct multimodal visual leakless safety benchmark (VLSBench) preventing visual safety leakage from image to textual query with 2.4k image-text pairs. Experimental results indicate that VLSBench poses a significant challenge to both open-source and close-source MLLMs, including LLaVA, Qwen2-VL, Llama3.2-Vision, and GPT-4o. This study demonstrates that textual alignment is enough for multimodal safety scenarios with VSIL, while multimodal alignment is a more promising solution for multimodal safety scenarios without VSIL. Please see our code and data at: http://hxhcreate.github.io/VLSBench

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

Open-source, multilingual medical large language models (LLMs) have the potential to serve linguistically diverse populations across different regions. Adapting generic LLMs for healthcare often requires continual pretraining, but this approach is computationally expensive and sometimes impractical. Instruction fine-tuning on a specific task may not always guarantee optimal performance due to the lack of broader domain knowledge that the model needs to understand and reason effectively in diverse scenarios. To address these challenges, we introduce two multilingual instruction fine-tuning datasets, MMed-IFT and MMed-IFT-MC, containing over 200k high-quality medical samples in six languages. We propose a two-stage training paradigm: the first stage injects general medical knowledge using MMed-IFT, while the second stage fine-tunes task-specific multiple-choice questions with MMed-IFT-MC. Our method achieves competitive results on both English and multilingual benchmarks, striking a balance between computational efficiency and performance. We plan to make our dataset and model weights public at https://github.com/SpassMed/Med-Llama3 in the future.

Large Language Models (LLMs) have gained significant attention in the medical domain for their human-level capabilities, leading to increased efforts to explore their potential in various healthcare applications. However, despite such a promising future, there are multiple challenges and obstacles that remain for their real-world uses in practical settings. This work discusses key challenges for LLMs in medical applications from four unique aspects: operational vulnerabilities, ethical and social considerations, performance and assessment difficulties, and legal and regulatory compliance. Addressing these challenges is crucial for leveraging LLMs to their full potential and ensuring their responsible integration into healthcare.