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Dec 10

Proactive Reasoning-with-Retrieval Framework for Medical Multimodal Large Language Models

Incentivizing the reasoning ability of Multimodal Large Language Models (MLLMs) is essential for medical applications to transparently analyze medical scans and provide reliable diagnosis. However, existing medical MLLMs rely solely on internal knowledge during reasoning, leading to hallucinated reasoning and factual inaccuracies when encountering cases beyond their training scope. Although recent Agentic Retrieval-Augmented Generation (RAG) methods elicit the medical model's proactive retrieval ability during reasoning, they are confined to unimodal LLMs, neglecting the crucial visual information during reasoning and retrieval. Consequently, we propose the first Multimodal Medical Reasoning-with-Retrieval framework, Med-RwR, which actively retrieves external knowledge by querying observed symptoms or domain-specific medical concepts during reasoning. Specifically, we design a two-stage reinforcement learning strategy with tailored rewards that stimulate the model to leverage both visual diagnostic findings and textual clinical information for effective retrieval. Building on this foundation, we further propose a Confidence-Driven Image Re-retrieval (CDIR) method for test-time scaling when low prediction confidence is detected. Evaluation on various public medical benchmarks demonstrates Med-RwR's significant improvements over baseline models, proving the effectiveness of enhancing reasoning capabilities with external knowledge integration. Furthermore, Med-RwR demonstrates remarkable generalizability to unfamiliar domains, evidenced by 8.8% performance gain on our proposed EchoCardiography Benchmark (ECBench), despite the scarcity of echocardiography data in the training corpus. Our data, model, and codes will be made publicly available at https://github.com/xmed-lab/Med-RwR.

  • 4 authors
·
Oct 21

TemMed-Bench: Evaluating Temporal Medical Image Reasoning in Vision-Language Models

Existing medical reasoning benchmarks for vision-language models primarily focus on analyzing a patient's condition based on an image from a single visit. However, this setting deviates significantly from real-world clinical practice, where doctors typically refer to a patient's historical conditions to provide a comprehensive assessment by tracking their changes over time. In this paper, we introduce TemMed-Bench, the first benchmark designed for analyzing changes in patients' conditions between different clinical visits, which challenges large vision-language models (LVLMs) to reason over temporal medical images. TemMed-Bench consists of a test set comprising three tasks - visual question-answering (VQA), report generation, and image-pair selection - and a supplementary knowledge corpus of over 17,000 instances. With TemMed-Bench, we conduct an evaluation of six proprietary and six open-source LVLMs. Our results show that most LVLMs lack the ability to analyze patients' condition changes over temporal medical images, and a large proportion perform only at a random-guessing level in the closed-book setting. In contrast, GPT o3, o4-mini and Claude 3.5 Sonnet demonstrate comparatively decent performance, though they have yet to reach the desired level. Furthermore, we explore augmenting the input with both retrieved visual and textual modalities in the medical domain. We also show that multi-modal retrieval augmentation yields notably higher performance gains than no retrieval and textual retrieval alone across most models on our benchmark, with the VQA task showing an average improvement of 2.59%. Overall, we compose a benchmark grounded on real-world clinical practice, and it reveals LVLMs' limitations in temporal medical image reasoning, as well as highlighting the use of multi-modal retrieval augmentation as a potentially promising direction worth exploring to address this challenge.

  • 6 authors
·
Sep 29

MRMR: A Realistic and Expert-Level Multidisciplinary Benchmark for Reasoning-Intensive Multimodal Retrieval

We introduce MRMR, the first expert-level multidisciplinary multimodal retrieval benchmark requiring intensive reasoning. MRMR contains 1,502 queries spanning 23 domains, with positive documents carefully verified by human experts. Compared to prior benchmarks, MRMR introduces three key advancements. First, it challenges retrieval systems across diverse areas of expertise, enabling fine-grained model comparison across domains. Second, queries are reasoning-intensive, with images requiring deeper interpretation such as diagnosing microscopic slides. We further introduce Contradiction Retrieval, a novel task requiring models to identify conflicting concepts. Finally, queries and documents are constructed as image-text interleaved sequences. Unlike earlier benchmarks restricted to single images or unimodal documents, MRMR offers a realistic setting with multi-image queries and mixed-modality corpus documents. We conduct an extensive evaluation of 4 categories of multimodal retrieval systems and 14 frontier models on MRMR. The text embedding model Qwen3-Embedding with LLM-generated image captions achieves the highest performance, highlighting substantial room for improving multimodal retrieval models. Although latest multimodal models such as Ops-MM-Embedding perform competitively on expert-domain queries, they fall short on reasoning-intensive tasks. We believe that MRMR paves the way for advancing multimodal retrieval in more realistic and challenging scenarios.

  • 8 authors
·
Oct 10 2

MR^2-Bench: Going Beyond Matching to Reasoning in Multimodal Retrieval

Multimodal retrieval is becoming a crucial component of modern AI applications, yet its evaluation lags behind the demands of more realistic and challenging scenarios. Existing benchmarks primarily probe surface-level semantic correspondence (e.g., object-text matching) while failing to assess the deeper reasoning required to capture complex relationships between visual and textual information. To address this gap, we introduce MR^2-Bench, a reasoning-intensive benchmark for multimodal retrieval. MR^2-Bench presents the following critical values: 1) all tasks are reasoning-driven, going beyond shallow matching to effectively assess models' capacity for logical, spatial, and causal inference; 2) it features diverse multimodal data, such as natural images, diagrams, and visual puzzles, enabling comprehensive evaluation across content types; 3) it supports complex queries and documents containing multiple images and covers diverse retrieval scenarios, more accurately reflecting real-world applications. Our benchmark contains 1,309 curated queries, derived either from manual collection and annotation or from selective consolidation of public datasets. Despite achieving strong results on existing benchmarks, current state-of-the-art models still struggle on MR^2-Bench: for example, the leading Seed1.6-Embedding model attains a Recall@1 of 77.78 on MMEB, but only 9.91 on MR^2-Bench. This substantial performance gap highlights both the increased challenge posed by our benchmark and the pressing need for further advances in reasoning-intensive multimodal retrieval. The dataset and evaluation code will be made publicly available at https://github.com/VectorSpaceLab/MR2-Bench.

  • 13 authors
·
Sep 30

CliniQ: A Multi-faceted Benchmark for Electronic Health Record Retrieval with Semantic Match Assessment

Electronic Health Record (EHR) retrieval plays a pivotal role in various clinical tasks, but its development has been severely impeded by the lack of publicly available benchmarks. In this paper, we introduce a novel public EHR retrieval benchmark, CliniQ, to address this gap. We consider two retrieval settings: Single-Patient Retrieval and Multi-Patient Retrieval, reflecting various real-world scenarios. Single-Patient Retrieval focuses on finding relevant parts within a patient note, while Multi-Patient Retrieval involves retrieving EHRs from multiple patients. We build our benchmark upon 1,000 discharge summary notes along with the ICD codes and prescription labels from MIMIC-III, and collect 1,246 unique queries with 77,206 relevance judgments by further leveraging powerful LLMs as annotators. Additionally, we include a novel assessment of the semantic gap issue in EHR retrieval by categorizing matching types into string match and four types of semantic matches. On our proposed benchmark, we conduct a comprehensive evaluation of various retrieval methods, ranging from conventional exact match to popular dense retrievers. Our experiments find that BM25 sets a strong baseline and performs competitively to the dense retrievers, and general domain dense retrievers surprisingly outperform those designed for the medical domain. In-depth analyses on various matching types reveal the strengths and drawbacks of different methods, enlightening the potential for targeted improvement. We believe that our benchmark will stimulate the research communities to advance EHR retrieval systems.

  • 8 authors
·
Feb 10

R2MED: A Benchmark for Reasoning-Driven Medical Retrieval

Current medical retrieval benchmarks primarily emphasize lexical or shallow semantic similarity, overlooking the reasoning-intensive demands that are central to clinical decision-making. In practice, physicians often retrieve authoritative medical evidence to support diagnostic hypotheses. Such evidence typically aligns with an inferred diagnosis rather than the surface form of a patient's symptoms, leading to low lexical or semantic overlap between queries and relevant documents. To address this gap, we introduce R2MED, the first benchmark explicitly designed for reasoning-driven medical retrieval. It comprises 876 queries spanning three tasks: Q&A reference retrieval, clinical evidence retrieval, and clinical case retrieval. These tasks are drawn from five representative medical scenarios and twelve body systems, capturing the complexity and diversity of real-world medical information needs. We evaluate 15 widely-used retrieval systems on R2MED and find that even the best model achieves only 31.4 nDCG@10, demonstrating the benchmark's difficulty. Classical re-ranking and generation-augmented retrieval methods offer only modest improvements. Although large reasoning models improve performance via intermediate inference generation, the best results still peak at 41.4 nDCG@10. These findings underscore a substantial gap between current retrieval techniques and the reasoning demands of real clinical tasks. We release R2MED as a challenging benchmark to foster the development of next-generation medical retrieval systems with enhanced reasoning capabilities. Data and code are available at https://github.com/R2MED/R2MED

  • 3 authors
·
May 20

MRAG-Bench: Vision-Centric Evaluation for Retrieval-Augmented Multimodal Models

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

  • 7 authors
·
Oct 10, 2024

MMDocIR: Benchmarking Multi-Modal Retrieval for Long Documents

Multi-modal document retrieval is designed to identify and retrieve various forms of multi-modal content, such as figures, tables, charts, and layout information from extensive documents. Despite its significance, there is a notable lack of a robust benchmark to effectively evaluate the performance of systems in multi-modal document retrieval. To address this gap, this work introduces a new benchmark, named as MMDocIR, encompassing two distinct tasks: page-level and layout-level retrieval. The former focuses on localizing the most relevant pages within a long document, while the latter targets the detection of specific layouts, offering a more fine-grained granularity than whole-page analysis. A layout can refer to a variety of elements such as textual paragraphs, equations, figures, tables, or charts. The MMDocIR benchmark comprises a rich dataset featuring expertly annotated labels for 1,685 questions and bootstrapped labels for 173,843 questions, making it a pivotal resource for advancing multi-modal document retrieval for both training and evaluation. Through rigorous experiments, we reveal that (i) visual retrievers significantly outperform their text counterparts, (ii) MMDocIR train set can effectively benefit the training process of multi-modal document retrieval and (iii) text retrievers leveraging on VLM-text perform much better than those using OCR-text. These findings underscores the potential advantages of integrating visual elements for multi-modal document retrieval.

  • 6 authors
·
Jan 15 2

MM-Embed: Universal Multimodal Retrieval with Multimodal LLMs

State-of-the-art retrieval models typically address a straightforward search scenario, where retrieval tasks are fixed (e.g., finding a passage to answer a specific question) and only a single modality is supported for both queries and retrieved results. This paper introduces techniques for advancing information retrieval with multimodal large language models (MLLMs), enabling a broader search scenario, termed universal multimodal retrieval, where multiple modalities and diverse retrieval tasks are accommodated. To this end, we first study fine-tuning an MLLM as a bi-encoder retriever on 10 datasets with 16 retrieval tasks. Our empirical results show that the fine-tuned MLLM retriever is capable of understanding challenging queries, composed of both text and image, but underperforms a smaller CLIP retriever in cross-modal retrieval tasks due to modality bias from MLLMs. To address the issue, we propose modality-aware hard negative mining to mitigate the modality bias exhibited by MLLM retrievers. Second, we propose to continually fine-tune the universal multimodal retriever to enhance its text retrieval capability while maintaining multimodal retrieval capability. As a result, our model, MM-Embed, achieves state-of-the-art performance on the multimodal retrieval benchmark M-BEIR, which spans multiple domains and tasks, while also surpassing the state-of-the-art text retrieval model, NV-Embed-v1, on MTEB retrieval benchmark. Finally, we explore to prompt the off-the-shelf MLLMs as the zero-shot rerankers to refine the ranking of the candidates from the multimodal retriever. We find that through prompt-and-reranking, MLLMs can further improve multimodal retrieval when the user queries (e.g., text-image composed queries) are more complex and challenging to understand. These findings also pave the way to advance universal multimodal retrieval in the future.

  • 6 authors
·
Nov 4, 2024 1

INQUIRE: A Natural World Text-to-Image Retrieval Benchmark

We introduce INQUIRE, a text-to-image retrieval benchmark designed to challenge multimodal vision-language models on expert-level queries. INQUIRE includes iNaturalist 2024 (iNat24), a new dataset of five million natural world images, along with 250 expert-level retrieval queries. These queries are paired with all relevant images comprehensively labeled within iNat24, comprising 33,000 total matches. Queries span categories such as species identification, context, behavior, and appearance, emphasizing tasks that require nuanced image understanding and domain expertise. Our benchmark evaluates two core retrieval tasks: (1) INQUIRE-Fullrank, a full dataset ranking task, and (2) INQUIRE-Rerank, a reranking task for refining top-100 retrievals. Detailed evaluation of a range of recent multimodal models demonstrates that INQUIRE poses a significant challenge, with the best models failing to achieve an mAP@50 above 50%. In addition, we show that reranking with more powerful multimodal models can enhance retrieval performance, yet there remains a significant margin for improvement. By focusing on scientifically-motivated ecological challenges, INQUIRE aims to bridge the gap between AI capabilities and the needs of real-world scientific inquiry, encouraging the development of retrieval systems that can assist with accelerating ecological and biodiversity research. Our dataset and code are available at https://inquire-benchmark.github.io

  • 8 authors
·
Nov 4, 2024

MedBookVQA: A Systematic and Comprehensive Medical Benchmark Derived from Open-Access Book

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

  • 7 authors
·
Jun 1

Guided Query Refinement: Multimodal Hybrid Retrieval with Test-Time Optimization

Multimodal encoders have pushed the boundaries of visual document retrieval, matching textual query tokens directly to image patches and achieving state-of-the-art performance on public benchmarks. Recent models relying on this paradigm have massively scaled the sizes of their query and document representations, presenting obstacles to deployment and scalability in real-world pipelines. Furthermore, purely vision-centric approaches may be constrained by the inherent modality gap still exhibited by modern vision-language models. In this work, we connect these challenges to the paradigm of hybrid retrieval, investigating whether a lightweight dense text retriever can enhance a stronger vision-centric model. Existing hybrid methods, which rely on coarse-grained fusion of ranks or scores, fail to exploit the rich interactions within each model's representation space. To address this, we introduce Guided Query Refinement (GQR), a novel test-time optimization method that refines a primary retriever's query embedding using guidance from a complementary retriever's scores. Through extensive experiments on visual document retrieval benchmarks, we demonstrate that GQR allows vision-centric models to match the performance of models with significantly larger representations, while being up to 14x faster and requiring 54x less memory. Our findings show that GQR effectively pushes the Pareto frontier for performance and efficiency in multimodal retrieval. We release our code at https://github.com/IBM/test-time-hybrid-retrieval

  • 5 authors
·
Oct 6

AutoMIR: Effective Zero-Shot Medical Information Retrieval without Relevance Labels

Medical information retrieval (MIR) is essential for retrieving relevant medical knowledge from diverse sources, including electronic health records, scientific literature, and medical databases. However, achieving effective zero-shot dense retrieval in the medical domain poses substantial challenges due to the lack of relevance-labeled data. In this paper, we introduce a novel approach called Self-Learning Hypothetical Document Embeddings (SL-HyDE) to tackle this issue. SL-HyDE leverages large language models (LLMs) as generators to generate hypothetical documents based on a given query. These generated documents encapsulate key medical context, guiding a dense retriever in identifying the most relevant documents. The self-learning framework progressively refines both pseudo-document generation and retrieval, utilizing unlabeled medical corpora without requiring any relevance-labeled data. Additionally, we present the Chinese Medical Information Retrieval Benchmark (CMIRB), a comprehensive evaluation framework grounded in real-world medical scenarios, encompassing five tasks and ten datasets. By benchmarking ten models on CMIRB, we establish a rigorous standard for evaluating medical information retrieval systems. Experimental results demonstrate that SL-HyDE significantly surpasses existing methods in retrieval accuracy while showcasing strong generalization and scalability across various LLM and retriever configurations. CMIRB data and evaluation code are publicly available at: https://github.com/CMIRB-benchmark/CMIRB.

  • 4 authors
·
Oct 25, 2024 2

IDMR: Towards Instance-Driven Precise Visual Correspondence in Multimodal Retrieval

Multimodal retrieval systems are becoming increasingly vital for cutting-edge AI technologies, such as embodied AI and AI-driven digital content industries. However, current multimodal retrieval tasks lack sufficient complexity and demonstrate limited practical application value. It spires us to design Instance-Driven Multimodal Image Retrieval (IDMR), a novel task that requires models to retrieve images containing the same instance as a query image while matching a text-described scenario. Unlike existing retrieval tasks focused on global image similarity or category-level matching, IDMR demands fine-grained instance-level consistency across diverse contexts. To benchmark this capability, we develop IDMR-bench using real-world object tracking and first-person video data. Addressing the scarcity of training data, we propose a cross-domain synthesis method that creates 557K training samples by cropping objects from standard detection datasets. Our Multimodal Large Language Model (MLLM) based retrieval model, trained on 1.2M samples, outperforms state-of-the-art approaches on both traditional benchmarks and our zero-shot IDMR-bench. Experimental results demonstrate previous models' limitations in instance-aware retrieval and highlight the potential of MLLM for advanced retrieval applications. The whole training dataset, codes and models, with wide ranges of sizes, are available at https://github.com/BwLiu01/IDMR.

  • 8 authors
·
Apr 1

MedTrinity-25M: A Large-scale Multimodal Dataset with Multigranular Annotations for Medicine

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

  • 11 authors
·
Aug 5, 2024 2

Where Does the Performance Improvement Come From? -- A Reproducibility Concern about Image-Text Retrieval

This article aims to provide the information retrieval community with some reflections on recent advances in retrieval learning by analyzing the reproducibility of image-text retrieval models. Due to the increase of multimodal data over the last decade, image-text retrieval has steadily become a major research direction in the field of information retrieval. Numerous researchers train and evaluate image-text retrieval algorithms using benchmark datasets such as MS-COCO and Flickr30k. Research in the past has mostly focused on performance, with multiple state-of-the-art methodologies being suggested in a variety of ways. According to their assertions, these techniques provide improved modality interactions and hence more precise multimodal representations. In contrast to previous works, we focus on the reproducibility of the approaches and the examination of the elements that lead to improved performance by pretrained and nonpretrained models in retrieving images and text. To be more specific, we first examine the related reproducibility concerns and explain why our focus is on image-text retrieval tasks. Second, we systematically summarize the current paradigm of image-text retrieval models and the stated contributions of those approaches. Third, we analyze various aspects of the reproduction of pretrained and nonpretrained retrieval models. To complete this, we conducted ablation experiments and obtained some influencing factors that affect retrieval recall more than the improvement claimed in the original paper. Finally, we present some reflections and challenges that the retrieval community should consider in the future. Our source code is publicly available at https://github.com/WangFei-2019/Image-text-Retrieval.

  • 7 authors
·
Mar 8, 2022

SMMILE: An Expert-Driven Benchmark for Multimodal Medical In-Context Learning

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

  • 12 authors
·
Jun 26 1

M3Ret: Unleashing Zero-shot Multimodal Medical Image Retrieval via Self-Supervision

Medical image retrieval is essential for clinical decision-making and translational research, relying on discriminative visual representations. Yet, current methods remain fragmented, relying on separate architectures and training strategies for 2D, 3D, and video-based medical data. This modality-specific design hampers scalability and inhibits the development of unified representations. To enable unified learning, we curate a large-scale hybrid-modality dataset comprising 867,653 medical imaging samples, including 2D X-rays and ultrasounds, RGB endoscopy videos, and 3D CT scans. Leveraging this dataset, we train M3Ret, a unified visual encoder without any modality-specific customization. It successfully learns transferable representations using both generative (MAE) and contrastive (SimDINO) self-supervised learning (SSL) paradigms. Our approach sets a new state-of-the-art in zero-shot image-to-image retrieval across all individual modalities, surpassing strong baselines such as DINOv3 and the text-supervised BMC-CLIP. More remarkably, strong cross-modal alignment emerges without paired data, and the model generalizes to unseen MRI tasks, despite never observing MRI during pretraining, demonstrating the generalizability of purely visual self-supervision to unseen modalities. Comprehensive analyses further validate the scalability of our framework across model and data sizes. These findings deliver a promising signal to the medical imaging community, positioning M3Ret as a step toward foundation models for visual SSL in multimodal medical image understanding.

MediConfusion: Can you trust your AI radiologist? Probing the reliability of multimodal medical foundation models

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.

  • 4 authors
·
Sep 23, 2024

MedFrameQA: A Multi-Image Medical VQA Benchmark for Clinical Reasoning

Existing medical VQA benchmarks mostly focus on single-image analysis, yet clinicians almost always compare a series of images before reaching a diagnosis. To better approximate this workflow, we introduce MedFrameQA -- the first benchmark that explicitly evaluates multi-image reasoning in medical VQA. To build MedFrameQA both at scale and in high-quality, we develop 1) an automated pipeline that extracts temporally coherent frames from medical videos and constructs VQA items whose content evolves logically across images, and 2) a multiple-stage filtering strategy, including model-based and manual review, to preserve data clarity, difficulty, and medical relevance. The resulting dataset comprises 2,851 VQA pairs (gathered from 9,237 high-quality frames in 3,420 videos), covering nine human body systems and 43 organs; every question is accompanied by two to five images. We comprehensively benchmark ten advanced Multimodal LLMs -- both proprietary and open source, with and without explicit reasoning modules -- on MedFrameQA. The evaluation challengingly reveals that all models perform poorly, with most accuracies below 50%, and accuracy fluctuates as the number of images per question increases. Error analysis further shows that models frequently ignore salient findings, mis-aggregate evidence across images, and propagate early mistakes through their reasoning chains; results also vary substantially across body systems, organs, and modalities. We hope this work can catalyze research on clinically grounded, multi-image reasoning and accelerate progress toward more capable diagnostic AI systems.

  • 5 authors
·
May 22

Large Language Models Encode Clinical Knowledge

Large language models (LLMs) have demonstrated impressive capabilities in natural language understanding and generation, but the quality bar for medical and clinical applications is high. Today, attempts to assess models' clinical knowledge typically rely on automated evaluations on limited benchmarks. There is no standard to evaluate model predictions and reasoning across a breadth of tasks. To address this, we present MultiMedQA, a benchmark combining six existing open question answering datasets spanning professional medical exams, research, and consumer queries; and HealthSearchQA, a new free-response dataset of medical questions searched online. We propose a framework for human evaluation of model answers along multiple axes including factuality, precision, possible harm, and bias. In addition, we evaluate PaLM (a 540-billion parameter LLM) and its instruction-tuned variant, Flan-PaLM, on MultiMedQA. Using a combination of prompting strategies, Flan-PaLM achieves state-of-the-art accuracy on every MultiMedQA multiple-choice dataset (MedQA, MedMCQA, PubMedQA, MMLU clinical topics), including 67.6% accuracy on MedQA (US Medical License Exam questions), surpassing prior state-of-the-art by over 17%. However, human evaluation reveals key gaps in Flan-PaLM responses. To resolve this we introduce instruction prompt tuning, a parameter-efficient approach for aligning LLMs to new domains using a few exemplars. The resulting model, Med-PaLM, performs encouragingly, but remains inferior to clinicians. We show that comprehension, recall of knowledge, and medical reasoning improve with model scale and instruction prompt tuning, suggesting the potential utility of LLMs in medicine. Our human evaluations reveal important limitations of today's models, reinforcing the importance of both evaluation frameworks and method development in creating safe, helpful LLM models for clinical applications.

  • 30 authors
·
Dec 26, 2022

CUPCase: Clinically Uncommon Patient Cases and Diagnoses Dataset

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

  • 4 authors
·
Mar 8

LongHealth: A Question Answering Benchmark with Long Clinical Documents

Background: Recent advancements in large language models (LLMs) offer potential benefits in healthcare, particularly in processing extensive patient records. However, existing benchmarks do not fully assess LLMs' capability in handling real-world, lengthy clinical data. Methods: We present the LongHealth benchmark, comprising 20 detailed fictional patient cases across various diseases, with each case containing 5,090 to 6,754 words. The benchmark challenges LLMs with 400 multiple-choice questions in three categories: information extraction, negation, and sorting, challenging LLMs to extract and interpret information from large clinical documents. Results: We evaluated nine open-source LLMs with a minimum of 16,000 tokens and also included OpenAI's proprietary and cost-efficient GPT-3.5 Turbo for comparison. The highest accuracy was observed for Mixtral-8x7B-Instruct-v0.1, particularly in tasks focused on information retrieval from single and multiple patient documents. However, all models struggled significantly in tasks requiring the identification of missing information, highlighting a critical area for improvement in clinical data interpretation. Conclusion: While LLMs show considerable potential for processing long clinical documents, their current accuracy levels are insufficient for reliable clinical use, especially in scenarios requiring the identification of missing information. The LongHealth benchmark provides a more realistic assessment of LLMs in a healthcare setting and highlights the need for further model refinement for safe and effective clinical application. We make the benchmark and evaluation code publicly available.

  • 10 authors
·
Jan 25, 2024

VM14K: First Vietnamese Medical Benchmark

Medical benchmarks are indispensable for evaluating the capabilities of language models in healthcare for non-English-speaking communities,therefore help ensuring the quality of real-life applications. However, not every community has sufficient resources and standardized methods to effectively build and design such benchmark, and available non-English medical data is normally fragmented and difficult to verify. We developed an approach to tackle this problem and applied it to create the first Vietnamese medical question benchmark, featuring 14,000 multiple-choice questions across 34 medical specialties. Our benchmark was constructed using various verifiable sources, including carefully curated medical exams and clinical records, and eventually annotated by medical experts. The benchmark includes four difficulty levels, ranging from foundational biological knowledge commonly found in textbooks to typical clinical case studies that require advanced reasoning. This design enables assessment of both the breadth and depth of language models' medical understanding in the target language thanks to its extensive coverage and in-depth subject-specific expertise. We release the benchmark in three parts: a sample public set (4k questions), a full public set (10k questions), and a private set (2k questions) used for leaderboard evaluation. Each set contains all medical subfields and difficulty levels. Our approach is scalable to other languages, and we open-source our data construction pipeline to support the development of future multilingual benchmarks in the medical domain.

  • 9 authors
·
Jun 2

Rethinking Benchmarks for Cross-modal Image-text Retrieval

Image-text retrieval, as a fundamental and important branch of information retrieval, has attracted extensive research attentions. The main challenge of this task is cross-modal semantic understanding and matching. Some recent works focus more on fine-grained cross-modal semantic matching. With the prevalence of large scale multimodal pretraining models, several state-of-the-art models (e.g. X-VLM) have achieved near-perfect performance on widely-used image-text retrieval benchmarks, i.e. MSCOCO-Test-5K and Flickr30K-Test-1K. In this paper, we review the two common benchmarks and observe that they are insufficient to assess the true capability of models on fine-grained cross-modal semantic matching. The reason is that a large amount of images and texts in the benchmarks are coarse-grained. Based on the observation, we renovate the coarse-grained images and texts in the old benchmarks and establish the improved benchmarks called MSCOCO-FG and Flickr30K-FG. Specifically, on the image side, we enlarge the original image pool by adopting more similar images. On the text side, we propose a novel semi-automatic renovation approach to refine coarse-grained sentences into finer-grained ones with little human effort. Furthermore, we evaluate representative image-text retrieval models on our new benchmarks to demonstrate the effectiveness of our method. We also analyze the capability of models on fine-grained semantic comprehension through extensive experiments. The results show that even the state-of-the-art models have much room for improvement in fine-grained semantic understanding, especially in distinguishing attributes of close objects in images. Our code and improved benchmark datasets are publicly available at: https://github.com/cwj1412/MSCOCO-Flikcr30K_FG, which we hope will inspire further in-depth research on cross-modal retrieval.

  • 3 authors
·
Apr 21, 2023

Benchmarking Retrieval-Augmented Multimomal Generation for Document Question Answering

Document Visual Question Answering (DocVQA) faces dual challenges in processing lengthy multimodal documents (text, images, tables) and performing cross-modal reasoning. Current document retrieval-augmented generation (DocRAG) methods remain limited by their text-centric approaches, frequently missing critical visual information. The field also lacks robust benchmarks for assessing multimodal evidence selection and integration. We introduce MMDocRAG, a comprehensive benchmark featuring 4,055 expert-annotated QA pairs with multi-page, cross-modal evidence chains. Our framework introduces innovative metrics for evaluating multimodal quote selection and enables answers that interleave text with relevant visual elements. Through large-scale experiments with 60 VLM/LLM models and 14 retrieval systems, we identify persistent challenges in multimodal evidence retrieval, selection, and integration.Key findings reveal advanced proprietary LVMs show superior performance than open-sourced alternatives. Also, they show moderate advantages using multimodal inputs over text-only inputs, while open-source alternatives show significant performance degradation. Notably, fine-tuned LLMs achieve substantial improvements when using detailed image descriptions. MMDocRAG establishes a rigorous testing ground and provides actionable insights for developing more robust multimodal DocVQA systems. Our benchmark and code are available at https://mmdocrag.github.io/MMDocRAG/.

  • 6 authors
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May 22

Towards Evaluating and Building Versatile Large Language Models for Medicine

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

  • 8 authors
·
Aug 22, 2024

MRAMG-Bench: A BeyondText Benchmark for Multimodal Retrieval-Augmented Multimodal Generation

Recent advancements in Retrieval-Augmented Generation (RAG) have shown remarkable performance in enhancing response accuracy and relevance by integrating external knowledge into generative models. However, existing RAG methods primarily focus on providing text-only answers, even in multimodal retrieval-augmented generation scenarios. In this work, we introduce the Multimodal Retrieval-Augmented Multimodal Generation (MRAMG) task, which aims to generate answers that combine both text and images, fully leveraging the multimodal data within a corpus. Despite the importance of this task, there is a notable absence of a comprehensive benchmark to effectively evaluate MRAMG performance. To bridge this gap, we introduce the MRAMG-Bench, a carefully curated, human-annotated dataset comprising 4,346 documents, 14,190 images, and 4,800 QA pairs, sourced from three categories: Web Data, Academic Papers, and Lifestyle. The dataset incorporates diverse difficulty levels and complex multi-image scenarios, providing a robust foundation for evaluating multimodal generation tasks. To facilitate rigorous evaluation, our MRAMG-Bench incorporates a comprehensive suite of both statistical and LLM-based metrics, enabling a thorough analysis of the performance of popular generative models in the MRAMG task. Besides, we propose an efficient multimodal answer generation framework that leverages both LLMs and MLLMs to generate multimodal responses. Our datasets are available at: https://huggingface.co/MRAMG.

  • 6 authors
·
Feb 6

Multimodal Needle in a Haystack: Benchmarking Long-Context Capability of Multimodal Large Language Models

Multimodal Large Language Models (MLLMs) have shown significant promise in various applications, leading to broad interest from researchers and practitioners alike. However, a comprehensive evaluation of their long-context capabilities remains underexplored. To address these gaps, we introduce the MultiModal Needle-in-a-haystack (MMNeedle) benchmark, specifically designed to assess the long-context capabilities of MLLMs. Besides multi-image input, we employ image stitching to further increase the input context length, and develop a protocol to automatically generate labels for sub-image level retrieval. Essentially, MMNeedle evaluates MLLMs by stress-testing their capability to locate a target sub-image (needle) within a set of images (haystack) based on textual instructions and descriptions of image contents. This setup necessitates an advanced understanding of extensive visual contexts and effective information retrieval within long-context image inputs. With this benchmark, we evaluate state-of-the-art MLLMs, encompassing both API-based and open-source models. The findings reveal that GPT-4o consistently surpasses other models in long-context scenarios, but suffers from hallucination problems in negative samples, i.e., when needles are not in the haystacks. Our comprehensive long-context evaluation of MLLMs also sheds lights on the considerable performance gap between API-based and open-source models. All the code, data, and instructions required to reproduce the main results are available at https://github.com/Wang-ML-Lab/multimodal-needle-in-a-haystack.

  • 9 authors
·
Jun 17, 2024 1

MedAgentsBench: Benchmarking Thinking Models and Agent Frameworks for Complex Medical Reasoning

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

  • 12 authors
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Mar 10 3

MLLM4PUE: Toward Universal Embeddings in Computational Pathology through Multimodal LLMs

Pathology plays a critical role in diagnosing a wide range of diseases, yet existing approaches often rely heavily on task-specific models trained on extensive, well-labeled datasets. These methods face sustainability challenges due to the diversity of pathologies and the labor-intensive nature of data collection. To address these limitations, we highlight the need for universal multimodal embeddings that can support multiple downstream tasks. Previous approaches often involve fine-tuning CLIP-based models, which handle images and text separately, limiting their ability to capture complex multimodal relationships. Additionally, these models are evaluated across diverse datasets without a unified benchmark for assessing multimodal embeddings in pathology. To address these challenges, we propose MLLM4PUE, a novel framework that leverages Multimodal Large Language Models (MLLMs) to generate Pathology Universal Embeddings. The MLLM4PUE framework not only facilitates robust integration of images and text but also enhances understanding and fusion capabilities across various tasks. We further introduce the Pathology Multimodal Embedding Benchmark (PMEB), a comprehensive benchmark designed to assess the quality of pathology multimodal embeddings. PMEB comprises 15 original tasks drawn from 14 datasets, organized into three meta-tasks: retrieval, classification, and composed retrieval. Experimental results demonstrate the superiority of MLLM4PUE, illustrating MLLM-based models can effectively support a wide range of downstream tasks and unify the research direction for foundation models in pathology.

  • 7 authors
·
Feb 10

MMed-RAG: Versatile Multimodal RAG System for Medical Vision Language Models

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.

  • 9 authors
·
Oct 16, 2024 3

BRIGHT: A Realistic and Challenging Benchmark for Reasoning-Intensive Retrieval

Existing retrieval benchmarks primarily consist of information-seeking queries (e.g., aggregated questions from search engines) where keyword or semantic-based retrieval is usually sufficient. However, many complex real-world queries require in-depth reasoning to identify relevant documents that go beyond surface form matching. For example, finding documentation for a coding question requires understanding the logic and syntax of the functions involved. To better benchmark retrieval on such challenging queries, we introduce BRIGHT, the first text retrieval benchmark that requires intensive reasoning to retrieve relevant documents. BRIGHT is constructed from the 1,398 real-world queries collected from diverse domains (such as economics, psychology, robotics, software engineering, earth sciences, etc.), sourced from naturally occurring or carefully curated human data. Extensive evaluation reveals that even state-of-the-art retrieval models perform poorly on BRIGHT. The leading model on the MTEB leaderboard [38 ], which achieves a score of 59.0 nDCG@10,2 produces a score of nDCG@10 of 18.0 on BRIGHT. We further demonstrate that augmenting queries with Chain-of-Thought reasoning generated by large language models (LLMs) improves performance by up to 12.2 points. Moreover, BRIGHT is robust against data leakage during pretraining of the benchmarked models as we validate by showing similar performance even when documents from the benchmark are included in the training data. We believe that BRIGHT paves the way for future research on retrieval systems in more realistic and challenging settings. Our code and data are available at https://brightbenchmark.github.io.

  • 15 authors
·
Jul 16, 2024 2

POLYRAG: Integrating Polyviews into Retrieval-Augmented Generation for Medical Applications

Large language models (LLMs) have become a disruptive force in the industry, introducing unprecedented capabilities in natural language processing, logical reasoning and so on. However, the challenges of knowledge updates and hallucination issues have limited the application of LLMs in medical scenarios, where retrieval-augmented generation (RAG) can offer significant assistance. Nevertheless, existing retrieve-then-read approaches generally digest the retrieved documents, without considering the timeliness, authoritativeness and commonality of retrieval. We argue that these approaches can be suboptimal, especially in real-world applications where information from different sources might conflict with each other and even information from the same source in different time scale might be different, and totally relying on this would deteriorate the performance of RAG approaches. We propose PolyRAG that carefully incorporate judges from different perspectives and finally integrate the polyviews for retrieval augmented generation in medical applications. Due to the scarcity of real-world benchmarks for evaluation, to bridge the gap we propose PolyEVAL, a benchmark consists of queries and documents collected from real-world medical scenarios (including medical policy, hospital & doctor inquiry and healthcare) with multiple tagging (e.g., timeliness, authoritativeness) on them. Extensive experiments and analysis on PolyEVAL have demonstrated the superiority of PolyRAG.

  • 8 authors
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Apr 21

Towards Unifying Medical Vision-and-Language Pre-training via Soft Prompts

Medical vision-and-language pre-training (Med-VLP) has shown promising improvements on many downstream medical tasks owing to its applicability to extracting generic representations from medical images and texts. Practically, there exist two typical types, i.e., the fusion-encoder type and the dual-encoder type, depending on whether a heavy fusion module is used. The former is superior at multi-modal tasks owing to the sufficient interaction between modalities; the latter is good at uni-modal and cross-modal tasks due to the single-modality encoding ability. To take advantage of these two types, we propose an effective yet straightforward scheme named PTUnifier to unify the two types. We first unify the input format by introducing visual and textual prompts, which serve as a feature bank that stores the most representative images/texts. By doing so, a single model could serve as a foundation model that processes various tasks adopting different input formats (i.e., image-only, text-only, and image-text-pair). Furthermore, we construct a prompt pool (instead of static ones) to improve diversity and scalability. Experimental results show that our approach achieves state-of-the-art results on a broad range of tasks, spanning uni-modal tasks (i.e., image/text classification and text summarization), cross-modal tasks (i.e., image-to-text generation and image-text/text-image retrieval), and multi-modal tasks (i.e., visual question answering), demonstrating the effectiveness of our approach. Note that the adoption of prompts is orthogonal to most existing Med-VLP approaches and could be a beneficial and complementary extension to these approaches.

  • 5 authors
·
Feb 17, 2023

SORCE: Small Object Retrieval in Complex Environments

Text-to-Image Retrieval (T2IR) is a highly valuable task that aims to match a given textual query to images in a gallery. Existing benchmarks primarily focus on textual queries describing overall image semantics or foreground salient objects, possibly overlooking inconspicuous small objects, especially in complex environments. Such small object retrieval is crucial, as in real-world applications, the targets of interest are not always prominent in the image. Thus, we introduce SORCE (Small Object Retrieval in Complex Environments), a new subfield of T2IR, focusing on retrieving small objects in complex images with textual queries. We propose a new benchmark, SORCE-1K, consisting of images with complex environments and textual queries describing less conspicuous small objects with minimal contextual cues from other salient objects. Preliminary analysis on SORCE-1K finds that existing T2IR methods struggle to capture small objects and encode all the semantics into a single embedding, leading to poor retrieval performance on SORCE-1K. Therefore, we propose to represent each image with multiple distinctive embeddings. We leverage Multimodal Large Language Models (MLLMs) to extract multiple embeddings for each image instructed by a set of Regional Prompts (ReP). Experimental results show that our multi-embedding approach through MLLM and ReP significantly outperforms existing T2IR methods on SORCE-1K. Our experiments validate the effectiveness of SORCE-1K for benchmarking SORCE performances, highlighting the potential of multi-embedding representation and text-customized MLLM features for addressing this task.

  • 7 authors
·
May 30

GMAI-MMBench: A Comprehensive Multimodal Evaluation Benchmark Towards General Medical AI

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/

  • 18 authors
·
Aug 6, 2024 2

MMSearch: Benchmarking the Potential of Large Models as Multi-modal Search Engines

The advent of Large Language Models (LLMs) has paved the way for AI search engines, e.g., SearchGPT, showcasing a new paradigm in human-internet interaction. However, most current AI search engines are limited to text-only settings, neglecting the multimodal user queries and the text-image interleaved nature of website information. Recently, Large Multimodal Models (LMMs) have made impressive strides. Yet, whether they can function as AI search engines remains under-explored, leaving the potential of LMMs in multimodal search an open question. To this end, we first design a delicate pipeline, MMSearch-Engine, to empower any LMMs with multimodal search capabilities. On top of this, we introduce MMSearch, a comprehensive evaluation benchmark to assess the multimodal search performance of LMMs. The curated dataset contains 300 manually collected instances spanning 14 subfields, which involves no overlap with the current LMMs' training data, ensuring the correct answer can only be obtained within searching. By using MMSearch-Engine, the LMMs are evaluated by performing three individual tasks (requery, rerank, and summarization), and one challenging end-to-end task with a complete searching process. We conduct extensive experiments on closed-source and open-source LMMs. Among all tested models, GPT-4o with MMSearch-Engine achieves the best results, which surpasses the commercial product, Perplexity Pro, in the end-to-end task, demonstrating the effectiveness of our proposed pipeline. We further present error analysis to unveil current LMMs still struggle to fully grasp the multimodal search tasks, and conduct ablation study to indicate the potential of scaling test-time computation for AI search engine. We hope MMSearch may provide unique insights to guide the future development of multimodal AI search engine. Project Page: https://mmsearch.github.io

  • 13 authors
·
Sep 19, 2024 2

UNIDOC-BENCH: A Unified Benchmark for Document-Centric Multimodal RAG

Multimodal retrieval-augmented generation (MM-RAG) is a key approach for applying large language models (LLMs) and agents to real-world knowledge bases, yet current evaluations are fragmented, focusing on either text or images in isolation or on simplified multimodal setups that fail to capture document-centric multimodal use cases. In this paper, we introduce UniDoc-Bench, the first large-scale, realistic benchmark for MM-RAG built from 70k real-world PDF pages across eight domains. Our pipeline extracts and links evidence from text, tables, and figures, then generates 1,600 multimodal QA pairs spanning factual retrieval, comparison, summarization, and logical reasoning queries. To ensure reliability, 20% of QA pairs are validated by multiple annotators and expert adjudication. UniDoc-Bench supports apples-to-apples comparison across four paradigms: (1) text-only, (2) image-only, (3) multimodal text-image fusion, and (4) multimodal joint retrieval -- under a unified protocol with standardized candidate pools, prompts, and evaluation metrics. Our experiments show that multimodal text-image fusion RAG systems consistently outperform both unimodal and jointly multimodal embedding-based retrieval, indicating that neither text nor images alone are sufficient and that current multimodal embeddings remain inadequate. Beyond benchmarking, our analysis reveals when and how visual context complements textual evidence, uncovers systematic failure modes, and offers actionable guidance for developing more robust MM-RAG pipelines.

Salesforce Salesforce
·
Oct 4 4

BRIDGE: Benchmarking Large Language Models for Understanding Real-world Clinical Practice Text

Large language models (LLMs) hold great promise for medical applications and are evolving rapidly, with new models being released at an accelerated pace. However, current evaluations of LLMs in clinical contexts remain limited. Most existing benchmarks rely on medical exam-style questions or PubMed-derived text, failing to capture the complexity of real-world electronic health record (EHR) data. Others focus narrowly on specific application scenarios, limiting their generalizability across broader clinical use. To address this gap, we present BRIDGE, a comprehensive multilingual benchmark comprising 87 tasks sourced from real-world clinical data sources across nine languages. We systematically evaluated 52 state-of-the-art LLMs (including DeepSeek-R1, GPT-4o, Gemini, and Llama 4) under various inference strategies. With a total of 13,572 experiments, our results reveal substantial performance variation across model sizes, languages, natural language processing tasks, and clinical specialties. Notably, we demonstrate that open-source LLMs can achieve performance comparable to proprietary models, while medically fine-tuned LLMs based on older architectures often underperform versus updated general-purpose models. The BRIDGE and its corresponding leaderboard serve as a foundational resource and a unique reference for the development and evaluation of new LLMs in real-world clinical text understanding.

  • 17 authors
·
Apr 28

SemiHVision: Enhancing Medical Multimodal Models with a Semi-Human Annotated Dataset and Fine-Tuned Instruction Generation

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.

  • 7 authors
·
Oct 18, 2024

A Survey of Medical Vision-and-Language Applications and Their Techniques

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.

  • 12 authors
·
Nov 18, 2024

Evaluating Interpolation and Extrapolation Performance of Neural Retrieval Models

A retrieval model should not only interpolate the training data but also extrapolate well to the queries that are different from the training data. While neural retrieval models have demonstrated impressive performance on ad-hoc search benchmarks, we still know little about how they perform in terms of interpolation and extrapolation. In this paper, we demonstrate the importance of separately evaluating the two capabilities of neural retrieval models. Firstly, we examine existing ad-hoc search benchmarks from the two perspectives. We investigate the distribution of training and test data and find a considerable overlap in query entities, query intent, and relevance labels. This finding implies that the evaluation on these test sets is biased toward interpolation and cannot accurately reflect the extrapolation capacity. Secondly, we propose a novel evaluation protocol to separately evaluate the interpolation and extrapolation performance on existing benchmark datasets. It resamples the training and test data based on query similarity and utilizes the resampled dataset for training and evaluation. Finally, we leverage the proposed evaluation protocol to comprehensively revisit a number of widely-adopted neural retrieval models. Results show models perform differently when moving from interpolation to extrapolation. For example, representation-based retrieval models perform almost as well as interaction-based retrieval models in terms of interpolation but not extrapolation. Therefore, it is necessary to separately evaluate both interpolation and extrapolation performance and the proposed resampling method serves as a simple yet effective evaluation tool for future IR studies.

  • 7 authors
·
Apr 25, 2022

MultiMed: Massively Multimodal and Multitask Medical Understanding

Biomedical data is inherently multimodal, consisting of electronic health records, medical imaging, digital pathology, genome sequencing, wearable sensors, and more. The application of artificial intelligence tools to these multifaceted sensing technologies has the potential to revolutionize the prognosis, diagnosis, and management of human health and disease. However, current approaches to biomedical AI typically only train and evaluate with one or a small set of medical modalities and tasks. This limitation hampers the development of comprehensive tools that can leverage the rich interconnected information across many heterogeneous biomedical sensors. To address this challenge, we present MultiMed, a benchmark designed to evaluate and enable large-scale learning across a wide spectrum of medical modalities and tasks. MultiMed consists of 2.56 million samples across ten medical modalities such as medical reports, pathology, genomics, and protein data, and is structured into eleven challenging tasks, including disease prognosis, protein structure prediction, and medical question answering. Using MultiMed, we conduct comprehensive experiments benchmarking state-of-the-art unimodal, multimodal, and multitask models. Our analysis highlights the advantages of training large-scale medical models across many related modalities and tasks. Moreover, MultiMed enables studies of generalization across related medical concepts, robustness to real-world noisy data and distribution shifts, and novel modality combinations to improve prediction performance. MultiMed will be publicly available and regularly updated and welcomes inputs from the community.

  • 2 authors
·
Aug 22, 2024

MM-R5: MultiModal Reasoning-Enhanced ReRanker via Reinforcement Learning for Document Retrieval

Multimodal document retrieval systems enable information access across text, images, and layouts, benefiting various domains like document-based question answering, report analysis, and interactive content summarization. Rerankers improve retrieval precision by reordering retrieved candidates. However, current multimodal reranking methods remain underexplored, with significant room for improvement in both training strategies and overall effectiveness. Moreover, the lack of explicit reasoning makes it difficult to analyze and optimize these methods further. In this paper, We propose MM-R5, a MultiModal Reasoning-Enhanced ReRanker via Reinforcement Learning for Document Retrieval, aiming to provide a more effective and reliable solution for multimodal reranking tasks. MM-R5 is trained in two stages: supervised fine-tuning (SFT) and reinforcement learning (RL). In the SFT stage, we focus on improving instruction-following and guiding the model to generate complete and high-quality reasoning chains. To support this, we introduce a novel data construction strategy that produces rich, high-quality reasoning data. In the RL stage, we design a task-specific reward framework, including a reranking reward tailored for multimodal candidates and a composite template-based reward to further refine reasoning quality. We conduct extensive experiments on MMDocIR, a challenging public benchmark spanning multiple domains. MM-R5 achieves state-of-the-art performance on most metrics and delivers comparable results to much larger models on the remaining ones. Moreover, compared to the best retrieval-only method, MM-R5 improves recall@1 by over 4%. These results validate the effectiveness of our reasoning-enhanced training pipeline.

  • 8 authors
·
Jun 14

Are We on the Right Way for Assessing Document Retrieval-Augmented Generation?

Retrieval-Augmented Generation (RAG) systems using Multimodal Large Language Models (MLLMs) show great promise for complex document understanding, yet their development is critically hampered by inadequate evaluation. Current benchmarks often focus on specific part of document RAG system and use synthetic data with incomplete ground truth and evidence labels, therefore failing to reflect real-world bottlenecks and challenges. To overcome these limitations, we introduce Double-Bench: a new large-scale, multilingual, and multimodal evaluation system that is able to produce fine-grained assessment to each component within document RAG systems. It comprises 3,276 documents (72,880 pages) and 5,168 single- and multi-hop queries across 6 languages and 4 document types with streamlined dynamic update support for potential data contamination issues. Queries are grounded in exhaustively scanned evidence pages and verified by human experts to ensure maximum quality and completeness. Our comprehensive experiments across 9 state-of-the-art embedding models, 4 MLLMs and 4 end-to-end document RAG frameworks demonstrate the gap between text and visual embedding models is narrowing, highlighting the need in building stronger document retrieval models. Our findings also reveal the over-confidence dilemma within current document RAG frameworks that tend to provide answer even without evidence support. We hope our fully open-source Double-Bench provide a rigorous foundation for future research in advanced document RAG systems. We plan to retrieve timely corpus and release new benchmarks on an annual basis.

CLaMR: Contextualized Late-Interaction for Multimodal Content Retrieval

Online video web content is richly multimodal: a single video blends vision, speech, ambient audio, and on-screen text. Retrieval systems typically treat these modalities as independent retrieval sources, which can lead to noisy and subpar retrieval. We explore multimodal video content retrieval, where relevance can be scored from one particular modality or jointly across multiple modalities simultaneously. Consequently, an effective retriever must dynamically choose which modality (or set of modalities) best addresses the query. We introduce CLaMR, a multimodal, late-interaction retriever that jointly indexes 4 modalities: video frames, transcribed speech, on-screen text, and metadata. CLaMR jointly encodes all modalities with a unified multimodal backbone for improved contextualization and is trained to enhance dynamic modality selection via two key innovations. First, given the lack of training data for multimodal retrieval, we introduce MultiVENT 2.0++, a large-scale synthetic training dataset built on MultiVENT 2.0 (event-centric videos in various languages paired with queries) with modality-targeted queries. Next, we propose a modality-aware loss that jointly trains according to a standard contrastive objective alongside an objective for learning correct modality usage. On the test sets of MultiVENT 2.0++ and MSRVTT, conventional aggregation strategies, such as averaging similarities for baseline retrievers, degrade performance by introducing noise from irrelevant modalities. In contrast, CLaMR consistently outperforms existing retrievers: on MultiVENT 2.0++, CLaMR improves nDCG@10 by 25.6 over the best single-modality retriever and by 35.4 over the best multi-modality retriever. We illustrate CLaMR's downstream utility on long-video QA, retrieving relevant frames and obtaining a 3.50% boost over LanguageBind on Video-MME and 1.42% over dense sampling on LongVideoBench.

  • 5 authors
·
Jun 6

M-Longdoc: A Benchmark For Multimodal Super-Long Document Understanding And A Retrieval-Aware Tuning Framework

The ability to understand and answer questions over documents can be useful in many business and practical applications. However, documents often contain lengthy and diverse multimodal contents such as texts, figures, and tables, which are very time-consuming for humans to read thoroughly. Hence, there is an urgent need to develop effective and automated methods to aid humans in this task. In this work, we introduce M-LongDoc, a benchmark of 851 samples, and an automated framework to evaluate the performance of large multimodal models. We further propose a retrieval-aware tuning approach for efficient and effective multimodal document reading. Compared to existing works, our benchmark consists of more recent and lengthy documents with hundreds of pages, while also requiring open-ended solutions and not just extractive answers. To our knowledge, our training framework is the first to directly address the retrieval setting for multimodal long documents. To enable tuning open-source models, we construct a training corpus in a fully automatic manner for the question-answering task over such documents. Experiments show that our tuning approach achieves a relative improvement of 4.6% for the correctness of model responses, compared to the baseline open-source models. Our data, code, and models are available at https://multimodal-documents.github.io.

  • 8 authors
·
Nov 9, 2024 2