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Apr 13

Capabilities of Gemini Models in Medicine

Excellence in a wide variety of medical applications poses considerable challenges for AI, requiring advanced reasoning, access to up-to-date medical knowledge and understanding of complex multimodal data. Gemini models, with strong general capabilities in multimodal and long-context reasoning, offer exciting possibilities in medicine. Building on these core strengths of Gemini, we introduce Med-Gemini, a family of highly capable multimodal models that are specialized in medicine with the ability to seamlessly use web search, and that can be efficiently tailored to novel modalities using custom encoders. We evaluate Med-Gemini on 14 medical benchmarks, establishing new state-of-the-art (SoTA) performance on 10 of them, and surpass the GPT-4 model family on every benchmark where a direct comparison is viable, often by a wide margin. On the popular MedQA (USMLE) benchmark, our best-performing Med-Gemini model achieves SoTA performance of 91.1% accuracy, using a novel uncertainty-guided search strategy. On 7 multimodal benchmarks including NEJM Image Challenges and MMMU (health & medicine), Med-Gemini improves over GPT-4V by an average relative margin of 44.5%. We demonstrate the effectiveness of Med-Gemini's long-context capabilities through SoTA performance on a needle-in-a-haystack retrieval task from long de-identified health records and medical video question answering, surpassing prior bespoke methods using only in-context learning. Finally, Med-Gemini's performance suggests real-world utility by surpassing human experts on tasks such as medical text summarization, alongside demonstrations of promising potential for multimodal medical dialogue, medical research and education. Taken together, our results offer compelling evidence for Med-Gemini's potential, although further rigorous evaluation will be crucial before real-world deployment in this safety-critical domain.

  • 66 authors
·
Apr 29, 2024 3

SurgViVQA: Temporally-Grounded Video Question Answering for Surgical Scene Understanding

Video Question Answering (VideoQA) in the surgical domain aims to enhance intraoperative understanding by enabling AI models to reason over temporally coherent events rather than isolated frames. Current approaches are limited to static image features, and available datasets often lack temporal annotations, ignoring the dynamics critical for accurate procedural interpretation. We propose SurgViVQA, a surgical VideoQA model that extends visual reasoning from static images to dynamic surgical scenes. It uses a Masked Video--Text Encoder to fuse video and question features, capturing temporal cues such as motion and tool--tissue interactions, which a fine-tuned large language model (LLM) then decodes into coherent answers. To evaluate its performance, we curated REAL-Colon-VQA, a colonoscopic video dataset that includes motion-related questions and diagnostic attributes, as well as out-of-template questions with rephrased or semantically altered formulations to assess model robustness. Experimental validation on REAL-Colon-VQA and the public EndoVis18-VQA dataset shows that SurgViVQA outperforms existing image-based VQA benchmark models, particularly in keyword accuracy, improving over PitVQA by +11\% on REAL-Colon-VQA and +9\% on EndoVis18-VQA. A perturbation study on the questions further confirms improved generalizability and robustness to variations in question phrasing. SurgViVQA and the REAL-Colon-VQA dataset provide a framework for temporally-aware understanding in surgical VideoQA, enabling AI models to interpret dynamic procedural contexts more effectively. Code and dataset available at https://github.com/madratak/SurgViVQA.

  • 10 authors
·
Nov 5, 2025

Self-supervised pre-training and contrastive representation learning for multiple-choice video QA

Video Question Answering (Video QA) requires fine-grained understanding of both video and language modalities to answer the given questions. In this paper, we propose novel training schemes for multiple-choice video question answering with a self-supervised pre-training stage and a supervised contrastive learning in the main stage as an auxiliary learning. In the self-supervised pre-training stage, we transform the original problem format of predicting the correct answer into the one that predicts the relevant question to provide a model with broader contextual inputs without any further dataset or annotation. For contrastive learning in the main stage, we add a masking noise to the input corresponding to the ground-truth answer, and consider the original input of the ground-truth answer as a positive sample, while treating the rest as negative samples. By mapping the positive sample closer to the masked input, we show that the model performance is improved. We further employ locally aligned attention to focus more effectively on the video frames that are particularly relevant to the given corresponding subtitle sentences. We evaluate our proposed model on highly competitive benchmark datasets related to multiple-choice video QA: TVQA, TVQA+, and DramaQA. Experimental results show that our model achieves state-of-the-art performance on all datasets. We also validate our approaches through further analyses.

  • 5 authors
·
Sep 16, 2020

Open-vocabulary Video Question Answering: A New Benchmark for Evaluating the Generalizability of Video Question Answering Models

Video Question Answering (VideoQA) is a challenging task that entails complex multi-modal reasoning. In contrast to multiple-choice VideoQA which aims to predict the answer given several options, the goal of open-ended VideoQA is to answer questions without restricting candidate answers. However, the majority of previous VideoQA models formulate open-ended VideoQA as a classification task to classify the video-question pairs into a fixed answer set, i.e., closed-vocabulary, which contains only frequent answers (e.g., top-1000 answers). This leads the model to be biased toward only frequent answers and fail to generalize on out-of-vocabulary answers. We hence propose a new benchmark, Open-vocabulary Video Question Answering (OVQA), to measure the generalizability of VideoQA models by considering rare and unseen answers. In addition, in order to improve the model's generalization power, we introduce a novel GNN-based soft verbalizer that enhances the prediction on rare and unseen answers by aggregating the information from their similar words. For evaluation, we introduce new baselines by modifying the existing (closed-vocabulary) open-ended VideoQA models and improve their performances by further taking into account rare and unseen answers. Our ablation studies and qualitative analyses demonstrate that our GNN-based soft verbalizer further improves the model performance, especially on rare and unseen answers. We hope that our benchmark OVQA can serve as a guide for evaluating the generalizability of VideoQA models and inspire future research. Code is available at https://github.com/mlvlab/OVQA.

  • 6 authors
·
Aug 18, 2023

LeAdQA: LLM-Driven Context-Aware Temporal Grounding for Video Question Answering

Video Question Answering (VideoQA) requires identifying sparse critical moments in long videos and reasoning about their causal relationships to answer semantically complex questions. While recent advances in multimodal learning have improved alignment and fusion, current approaches remain limited by two prevalent but fundamentally flawed strategies: (1) task-agnostic sampling indiscriminately processes all frames, overwhelming key events with irrelevant content; and (2) heuristic retrieval captures superficial patterns but misses causal-temporal structures needed for complex reasoning. To address these challenges, we introduce LeAdQA, an innovative approach that bridges these gaps through synergizing causal-aware query refinement with fine-grained visual grounding. Our method first leverages LLMs to reformulate question-option pairs, resolving causal ambiguities and sharpening temporal focus. These refined queries subsequently direct a temporal grounding model to precisely retrieve the most salient segments, complemented by an adaptive fusion mechanism dynamically integrating the evidence to maximize relevance. The integrated visual-textual cues are then processed by an MLLM to generate accurate, contextually-grounded answers. Experiments on NExT-QA, IntentQA, and NExT-GQA demonstrate that our method's precise visual grounding substantially enhances the understanding of video-question relationships, achieving state-of-the-art (SOTA) performance on complex reasoning tasks while maintaining computational efficiency.

  • 7 authors
·
Jul 19, 2025

GEMeX: A Large-Scale, Groundable, and Explainable Medical VQA Benchmark for Chest X-ray Diagnosis

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

  • 10 authors
·
Nov 25, 2024

VideoEspresso: A Large-Scale Chain-of-Thought Dataset for Fine-Grained Video Reasoning via Core Frame Selection

The advancement of Large Vision Language Models (LVLMs) has significantly improved multimodal understanding, yet challenges remain in video reasoning tasks due to the scarcity of high-quality, large-scale datasets. Existing video question-answering (VideoQA) datasets often rely on costly manual annotations with insufficient granularity or automatic construction methods with redundant frame-by-frame analysis, limiting their scalability and effectiveness for complex reasoning. To address these challenges, we introduce VideoEspresso, a novel dataset that features VideoQA pairs preserving essential spatial details and temporal coherence, along with multimodal annotations of intermediate reasoning steps. Our construction pipeline employs a semantic-aware method to reduce redundancy, followed by generating QA pairs using GPT-4o. We further develop video Chain-of-Thought (CoT) annotations to enrich reasoning processes, guiding GPT-4o in extracting logical relationships from QA pairs and video content. To exploit the potential of high-quality VideoQA pairs, we propose a Hybrid LVLMs Collaboration framework, featuring a Frame Selector and a two-stage instruction fine-tuned reasoning LVLM. This framework adaptively selects core frames and performs CoT reasoning using multimodal evidence. Evaluated on our proposed benchmark with 14 tasks against 9 popular LVLMs, our method outperforms existing baselines on most tasks, demonstrating superior video reasoning capabilities. Our code and dataset will be released at: https://github.com/hshjerry/VideoEspresso

  • 10 authors
·
Nov 22, 2024 3

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, 2025

STAIR: Spatial-Temporal Reasoning with Auditable Intermediate Results for Video Question Answering

Recently we have witnessed the rapid development of video question answering models. However, most models can only handle simple videos in terms of temporal reasoning, and their performance tends to drop when answering temporal-reasoning questions on long and informative videos. To tackle this problem we propose STAIR, a Spatial-Temporal Reasoning model with Auditable Intermediate Results for video question answering. STAIR is a neural module network, which contains a program generator to decompose a given question into a hierarchical combination of several sub-tasks, and a set of lightweight neural modules to complete each of these sub-tasks. Though neural module networks are already widely studied on image-text tasks, applying them to videos is a non-trivial task, as reasoning on videos requires different abilities. In this paper, we define a set of basic video-text sub-tasks for video question answering and design a set of lightweight modules to complete them. Different from most prior works, modules of STAIR return intermediate outputs specific to their intentions instead of always returning attention maps, which makes it easier to interpret and collaborate with pre-trained models. We also introduce intermediate supervision to make these intermediate outputs more accurate. We conduct extensive experiments on several video question answering datasets under various settings to show STAIR's performance, explainability, compatibility with pre-trained models, and applicability when program annotations are not available. Code: https://github.com/yellow-binary-tree/STAIR

  • 4 authors
·
Jan 8, 2024

Learning to Answer Visual Questions from Web Videos

Recent methods for visual question answering rely on large-scale annotated datasets. Manual annotation of questions and answers for videos, however, is tedious, expensive and prevents scalability. In this work, we propose to avoid manual annotation and generate a large-scale training dataset for video question answering making use of automatic cross-modal supervision. We leverage a question generation transformer trained on text data and use it to generate question-answer pairs from transcribed video narrations. Given narrated videos, we then automatically generate the HowToVQA69M dataset with 69M video-question-answer triplets. To handle the open vocabulary of diverse answers in this dataset, we propose a training procedure based on a contrastive loss between a video-question multi-modal transformer and an answer transformer. We introduce the zero-shot VideoQA task and the VideoQA feature probe evaluation setting and show excellent results, in particular for rare answers. Furthermore, our method achieves competitive results on MSRVTT-QA, ActivityNet-QA, MSVD-QA and How2QA datasets. We also show that our VideoQA dataset generation approach generalizes to another source of web video and text data. We use our method to generate the WebVidVQA3M dataset from the WebVid dataset, i.e., videos with alt-text annotations, and show its benefits for training VideoQA models. Finally, for a detailed evaluation we introduce iVQA, a new VideoQA dataset with reduced language bias and high-quality manual annotations. Code, datasets and trained models are available at https://antoyang.github.io/just-ask.html

  • 5 authors
·
May 10, 2022

MedGRPO: Multi-Task Reinforcement Learning for Heterogeneous Medical Video Understanding

Large vision-language models struggle with medical video understanding, where spatial precision, temporal reasoning, and clinical semantics are critical. To address this, we first introduce MedVidBench, a large-scale benchmark of 531,850 video-instruction pairs across 8 medical sources spanning video, segment, and frame-level tasks, curated through a rigorous quality assurance pipeline with expert-guided prompting and dual-model validation. While supervised fine-tuning on MedVidBench yields noticeable gains, standard Reinforcement Learning (RL) fails due to imbalanced reward scales across datasets, which destabilizes optimization and leads to training collapse. To overcome this, we introduce MedGRPO, a novel RL framework for balanced multi-dataset training with two key innovations: (1) cross-dataset reward normalization that maps each dataset's median performance to a common reward value, ensuring fair optimization regardless of difficulty, and (2) a medical LLM judge that evaluates caption quality on five clinical dimensions through comparative similarity scoring. Supervised fine-tuning Qwen2.5-VL-7B on MedVidBench substantially outperforms GPT-4.1 and Gemini-2.5-Flash across all tasks, demonstrating MedVidBench's efficacy, while our MedGRPO framework further improves upon the SFT baseline across grounding and captioning tasks. Our work establishes a foundational benchmark and robust training methodology for advancing vision-language models in medical domains. Our project website is available at https://yuhaosu.github.io/MedGRPO/.

  • 11 authors
·
Dec 6, 2025

MedThink: Explaining Medical Visual Question Answering via Multimodal Decision-Making Rationale

Medical Visual Question Answering (MedVQA), which offers language responses to image-based medical inquiries, represents a challenging task and significant advancement in healthcare. It assists medical experts to swiftly interpret medical images, thereby enabling faster and more accurate diagnoses. However, the model interpretability and transparency of existing MedVQA solutions are often limited, posing challenges in understanding their decision-making processes. To address this issue, we devise a semi-automated annotation process to streamline data preparation and build new benchmark MedVQA datasets R-RAD, R-SLAKE and R-Path. These datasets provide intermediate medical decision-making rationales generated by multimodal large language models and human annotations for question-answering pairs in existing MedVQA datasets, i.e., VQA-RAD, SLAKE and PathVQA. Moreover, we design a novel framework, MedThink, which finetunes lightweight pretrained generative models by incorporating medical decision-making rationales. MedThink includes three distinct strategies to generate decision outcomes and corresponding rationales, thereby clearly showcasing the medical decision-making process during reasoning. Our comprehensive experiments show that our method achieves an accuracy of 83.5% on R-RAD, 86.3% on R-SLAKE and 87.2% on R-Path. These results significantly exceed those of existing state-of-the-art models with comparable parameters. Datasets and code will be released.

  • 6 authors
·
Apr 18, 2024

InViC: Intent-aware Visual Cues for Medical Visual Question Answering

Medical visual question answering (Med-VQA) aims to answer clinically relevant questions grounded in medical images. However, existing multimodal large language models (MLLMs) often exhibit shortcut answering, producing plausible responses by exploiting language priors or dataset biases while insufficiently attending to visual evidence. This behavior undermines clinical reliability, especially when subtle imaging findings are decisive. We propose a lightweight plug-in framework, termed Intent-aware Visual Cues (InViC), to explicitly enhance image-based answer generation in medical VQA. InViC introduces a Cue Tokens Extraction (CTE) module that distills dense visual tokens into a compact set of K question-conditioned cue tokens, which serve as structured visual intermediaries injected into the LLM decoder to promote intent-aligned visual evidence. To discourage bypassing of visual information, we further design a two-stage fine-tuning strategy with a cue-bottleneck attention mask. In Stage I, we employ an attention mask to block the LLM's direct view of raw visual features, thereby funneling all visual evidence through the cue pathway. In Stage II, standard causal attention is restored to train the LLM to jointly exploit the visual and cue tokens. We evaluate InViC on three public Med-VQA benchmarks (VQA-RAD, SLAKE, and ImageCLEF VQA-Med 2019) across multiple representative MLLMs. InViC consistently improves over zero-shot inference and standard LoRA fine-tuning, demonstrating that intent-aware visual cues with bottlenecked training is a practical and effective strategy for improving trustworthy Med-VQA.

  • 6 authors
·
Mar 17

TVBench: Redesigning Video-Language Evaluation

Large language models have demonstrated impressive performance when integrated with vision models even enabling video understanding. However, evaluating these video models presents its own unique challenges, for which several benchmarks have been proposed. In this paper, we show that the currently most used video-language benchmarks can be solved without requiring much temporal reasoning. We identified three main issues in existing datasets: (i) static information from single frames is often sufficient to solve the tasks (ii) the text of the questions and candidate answers is overly informative, allowing models to answer correctly without relying on any visual input (iii) world knowledge alone can answer many of the questions, making the benchmarks a test of knowledge replication rather than visual reasoning. In addition, we found that open-ended question-answering benchmarks for video understanding suffer from similar issues while the automatic evaluation process with LLMs is unreliable, making it an unsuitable alternative. As a solution, we propose TVBench, a novel open-source video multiple-choice question-answering benchmark, and demonstrate through extensive evaluations that it requires a high level of temporal understanding. Surprisingly, we find that most recent state-of-the-art video-language models perform similarly to random performance on TVBench, with only Gemini-Pro and Tarsier clearly surpassing this baseline.

  • 5 authors
·
Oct 10, 2024 2

An Image Grid Can Be Worth a Video: Zero-shot Video Question Answering Using a VLM

Stimulated by the sophisticated reasoning capabilities of recent Large Language Models (LLMs), a variety of strategies for bridging video modality have been devised. A prominent strategy involves Video Language Models (VideoLMs), which train a learnable interface with video data to connect advanced vision encoders with LLMs. Recently, an alternative strategy has surfaced, employing readily available foundation models, such as VideoLMs and LLMs, across multiple stages for modality bridging. In this study, we introduce a simple yet novel strategy where only a single Vision Language Model (VLM) is utilized. Our starting point is the plain insight that a video comprises a series of images, or frames, interwoven with temporal information. The essence of video comprehension lies in adeptly managing the temporal aspects along with the spatial details of each frame. Initially, we transform a video into a single composite image by arranging multiple frames in a grid layout. The resulting single image is termed as an image grid. This format, while maintaining the appearance of a solitary image, effectively retains temporal information within the grid structure. Therefore, the image grid approach enables direct application of a single high-performance VLM without necessitating any video-data training. Our extensive experimental analysis across ten zero-shot video question answering benchmarks, including five open-ended and five multiple-choice benchmarks, reveals that the proposed Image Grid Vision Language Model (IG-VLM) surpasses the existing methods in nine out of ten benchmarks.

  • 4 authors
·
Mar 27, 2024

Hierarchical Modeling for Medical Visual Question Answering with Cross-Attention Fusion

Medical Visual Question Answering (Med-VQA) answers clinical questions using medical images, aiding diagnosis. Designing the MedVQA system holds profound importance in assisting clinical diagnosis and enhancing diagnostic accuracy. Building upon this foundation, Hierarchical Medical VQA extends Medical VQA by organizing medical questions into a hierarchical structure and making level-specific predictions to handle fine-grained distinctions. Recently, many studies have proposed hierarchical MedVQA tasks and established datasets, However, several issues still remain: (1) imperfect hierarchical modeling leads to poor differentiation between question levels causing semantic fragmentation across hierarchies. (2) Excessive reliance on implicit learning in Transformer-based cross-modal self-attention fusion methods, which obscures crucial local semantic correlations in medical scenarios. To address these issues, this study proposes a HiCA-VQA method, including two modules: Hierarchical Prompting for fine-grained medical questions and Hierarchical Answer Decoders. The hierarchical prompting module pre-aligns hierarchical text prompts with image features to guide the model in focusing on specific image regions according to question types, while the hierarchical decoder performs separate predictions for questions at different levels to improve accuracy across granularities. The framework also incorporates a cross-attention fusion module where images serve as queries and text as key-value pairs. Experiments on the Rad-Restruct benchmark demonstrate that the HiCA-VQA framework better outperforms existing state-of-the-art methods in answering hierarchical fine-grained questions. This study provides an effective pathway for hierarchical visual question answering systems, advancing medical image understanding.

  • 4 authors
·
Apr 3, 2025

Breaking Down Video LLM Benchmarks: Knowledge, Spatial Perception, or True Temporal Understanding?

Existing video understanding benchmarks often conflate knowledge-based and purely image-based questions, rather than clearly isolating a model's temporal reasoning ability, which is the key aspect that distinguishes video understanding from other modalities. We identify two major limitations that obscure whether higher scores truly indicate stronger understanding of the dynamic content in videos: (1) strong language priors, where models can answer questions without watching the video; and (2) shuffling invariance, where models maintain similar performance on certain questions even when video frames are temporally shuffled. To alleviate these issues, we propose VBenchComp, an automated pipeline that categorizes questions into different domains: LLM-Answerable, Semantic, and Temporal. Specifically, LLM-Answerable questions can be answered without viewing the video; Semantic questions remain answerable even when the video frames are shuffled; and Temporal questions require understanding the correct temporal order of frames. The rest of the questions are labeled as Others. This can enable fine-grained evaluation of different capabilities of a video LLM. Our analysis reveals nuanced model weaknesses that are hidden by traditional overall scores, and we offer insights and recommendations for designing future benchmarks that more accurately assess video LLMs.

  • 7 authors
·
May 20, 2025 2

LongVideoBench: A Benchmark for Long-context Interleaved Video-Language Understanding

Large multimodal models (LMMs) are processing increasingly longer and richer inputs. Albeit the progress, few public benchmark is available to measure such development. To mitigate this gap, we introduce LongVideoBench, a question-answering benchmark that features video-language interleaved inputs up to an hour long. Our benchmark includes 3,763 varying-length web-collected videos with their subtitles across diverse themes, designed to comprehensively evaluate LMMs on long-term multimodal understanding. To achieve this, we interpret the primary challenge as to accurately retrieve and reason over detailed multimodal information from long inputs. As such, we formulate a novel video question-answering task termed referring reasoning. Specifically, as part of the question, it contains a referring query that references related video contexts, called referred context. The model is then required to reason over relevant video details from the referred context. Following the paradigm of referring reasoning, we curate 6,678 human-annotated multiple-choice questions in 17 fine-grained categories, establishing one of the most comprehensive benchmarks for long-form video understanding. Evaluations suggest that the LongVideoBench presents significant challenges even for the most advanced proprietary models (e.g. GPT-4o, Gemini-1.5-Pro, GPT-4-Turbo), while their open-source counterparts show an even larger performance gap. In addition, our results indicate that model performance on the benchmark improves only when they are capable of processing more frames, positioning LongVideoBench as a valuable benchmark for evaluating future-generation long-context LMMs.

  • 4 authors
·
Jul 22, 2024 4

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

Effective Transfer Learning for Identifying Similar Questions: Matching User Questions to COVID-19 FAQs

People increasingly search online for answers to their medical questions but the rate at which medical questions are asked online significantly exceeds the capacity of qualified people to answer them. This leaves many questions unanswered or inadequately answered. Many of these questions are not unique, and reliable identification of similar questions would enable more efficient and effective question answering schema. COVID-19 has only exacerbated this problem. Almost every government agency and healthcare organization has tried to meet the informational need of users by building online FAQs, but there is no way for people to ask their question and know if it is answered on one of these pages. While many research efforts have focused on the problem of general question similarity, these approaches do not generalize well to domains that require expert knowledge to determine semantic similarity, such as the medical domain. In this paper, we show how a double fine-tuning approach of pretraining a neural network on medical question-answer pairs followed by fine-tuning on medical question-question pairs is a particularly useful intermediate task for the ultimate goal of determining medical question similarity. While other pretraining tasks yield an accuracy below 78.7% on this task, our model achieves an accuracy of 82.6% with the same number of training examples, an accuracy of 80.0% with a much smaller training set, and an accuracy of 84.5% when the full corpus of medical question-answer data is used. We also describe a currently live system that uses the trained model to match user questions to COVID-related FAQs.

  • 5 authors
·
Aug 4, 2020

A Simple LLM Framework for Long-Range Video Question-Answering

We present LLoVi, a language-based framework for long-range video question-answering (LVQA). Unlike prior long-range video understanding methods, which are often costly and require specialized long-range video modeling design (e.g., memory queues, state-space layers, etc.), our approach uses a frame/clip-level visual captioner (e.g., BLIP2, LaViLa, LLaVA) coupled with a Large Language Model (GPT-3.5, GPT-4) leading to a simple yet surprisingly effective LVQA framework. Specifically, we decompose short and long-range modeling aspects of LVQA into two stages. First, we use a short-term visual captioner to generate textual descriptions of short video clips (0.5-8s in length) densely sampled from a long input video. Afterward, an LLM aggregates the densely extracted short-term captions to perform long-range temporal reasoning needed to understand the whole video and answer a question. To analyze what makes our simple framework so effective, we thoroughly evaluate various components of our system. Our empirical analysis reveals that the choice of the visual captioner and LLM is critical for good LVQA performance. Furthermore, we show that a specialized prompt that asks the LLM first to summarize the noisy short-term visual captions and then answer a given input question leads to a significant LVQA performance boost. On EgoSchema, which is best known as a very long-form video question-answering benchmark, our method achieves 50.3% accuracy, outperforming the previous best-performing approach by 18.1% (absolute gain). In addition, our approach outperforms the previous state-of-the-art by 4.1% and 3.1% on NeXT-QA and IntentQA. We also extend LLoVi to grounded LVQA and show that it outperforms all prior methods on the NeXT-GQA dataset. We will release our code at https://github.com/CeeZh/LLoVi.

  • 7 authors
·
Dec 28, 2023

Does CLIP Benefit Visual Question Answering in the Medical Domain as Much as it Does in the General Domain?

Contrastive Language--Image Pre-training (CLIP) has shown remarkable success in learning with cross-modal supervision from extensive amounts of image--text pairs collected online. Thus far, the effectiveness of CLIP has been investigated primarily in general-domain multimodal problems. This work evaluates the effectiveness of CLIP for the task of Medical Visual Question Answering (MedVQA). To this end, we present PubMedCLIP, a fine-tuned version of CLIP for the medical domain based on PubMed articles. Our experiments are conducted on two MedVQA benchmark datasets and investigate two MedVQA methods, MEVF (Mixture of Enhanced Visual Features) and QCR (Question answering via Conditional Reasoning). For each of these, we assess the merits of visual representation learning using PubMedCLIP, the original CLIP, and state-of-the-art MAML (Model-Agnostic Meta-Learning) networks pre-trained only on visual data. We open source the code for our MedVQA pipeline and pre-training PubMedCLIP. CLIP and PubMedCLIP achieve improvements in comparison to MAML's visual encoder. PubMedCLIP achieves the best results with gains in the overall accuracy of up to 3%. Individual examples illustrate the strengths of PubMedCLIP in comparison to the previously widely used MAML networks. Visual representation learning with language supervision in PubMedCLIP leads to noticeable improvements for MedVQA. Our experiments reveal distributional differences in the two MedVQA benchmark datasets that have not been imparted in previous work and cause different back-end visual encoders in PubMedCLIP to exhibit different behavior on these datasets. Moreover, we witness fundamental performance differences of VQA in general versus medical domains.

  • 3 authors
·
Dec 27, 2021

HERBench: A Benchmark for Multi-Evidence Integration in Video Question Answering

Video Large Language Models (Video-LLMs) are rapidly improving, yet current Video Question Answering (VideoQA) benchmarks often allow questions to be answered from a single salient cue, under-testing reasoning that must aggregate multiple, temporally separated visual evidence. We present HERBench, a VideoQA benchmark purpose-built to assess multi-evidence integration across time. Each question requires aggregating at least three non-overlapping evidential cues across distinct video segments, so neither language priors nor a single snapshot can suffice. HERBench comprises 26K five-way multiple-choice questions organized into twelve compositional tasks that probe identity binding, cross-entity relations, temporal ordering, co-occurrence verification, and counting. To make evidential demand measurable, we introduce the Minimum Required Frame-Set (MRFS), the smallest number of frames a model must fuse to answer correctly, and show that HERBench imposes substantially higher demand than prior datasets (mean MRFS 5.5 vs. 2.6-4.2). Evaluating 13 state-of-the-art Video-LLMs on HERBench reveals pervasive failures: accuracies of 31-42% are only slightly above the 20% random-guess baseline. We disentangle this failure into two critical bottlenecks: (1) a retrieval deficit, where frame selectors overlook key evidence, and (2) a fusion deficit, where models fail to integrate information even when all necessary evidence is provided. By making cross-time evidence both unavoidable and quantifiable, HERBench establishes a principled target for advancing robust, compositional video understanding.

Insight-bgu INSIGHT Lab
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Dec 16, 2025 3

LLM-MedQA: Enhancing Medical Question Answering through Case Studies in Large Language Models

Accurate and efficient question-answering systems are essential for delivering high-quality patient care in the medical field. While Large Language Models (LLMs) have made remarkable strides across various domains, they continue to face significant challenges in medical question answering, particularly in understanding domain-specific terminologies and performing complex reasoning. These limitations undermine their effectiveness in critical medical applications. To address these issues, we propose a novel approach incorporating similar case generation within a multi-agent medical question-answering (MedQA) system. Specifically, we leverage the Llama3.1:70B model, a state-of-the-art LLM, in a multi-agent architecture to enhance performance on the MedQA dataset using zero-shot learning. Our method capitalizes on the model's inherent medical knowledge and reasoning capabilities, eliminating the need for additional training data. Experimental results show substantial performance gains over existing benchmark models, with improvements of 7% in both accuracy and F1-score across various medical QA tasks. Furthermore, we examine the model's interpretability and reliability in addressing complex medical queries. This research not only offers a robust solution for medical question answering but also establishes a foundation for broader applications of LLMs in the medical domain.

  • 9 authors
·
Dec 31, 2024

FriendsQA: A New Large-Scale Deep Video Understanding Dataset with Fine-grained Topic Categorization for Story Videos

Video question answering (VideoQA) aims to answer natural language questions according to the given videos. Although existing models perform well in the factoid VideoQA task, they still face challenges in deep video understanding (DVU) task, which focuses on story videos. Compared to factoid videos, the most significant feature of story videos is storylines, which are composed of complex interactions and long-range evolvement of core story topics including characters, actions and locations. Understanding these topics requires models to possess DVU capability. However, existing DVU datasets rarely organize questions according to these story topics, making them difficult to comprehensively assess VideoQA models' DVU capability of complex storylines. Additionally, the question quantity and video length of these dataset are limited by high labor costs of handcrafted dataset building method. In this paper, we devise a large language model based multi-agent collaboration framework, StoryMind, to automatically generate a new large-scale DVU dataset. The dataset, FriendsQA, derived from the renowned sitcom Friends with an average episode length of 1,358 seconds, contains 44.6K questions evenly distributed across 14 fine-grained topics. Finally, We conduct comprehensive experiments on 10 state-of-the-art VideoQA models using the FriendsQA dataset.

  • 6 authors
·
Dec 22, 2024

JMLR: Joint Medical LLM and Retrieval Training for Enhancing Reasoning and Professional Question Answering Capability

Large Language Models (LLMs) have demonstrated a remarkable potential in medical knowledge acquisition and question-answering. However, LLMs can potentially hallucinate and yield factually incorrect outcomes, even with domain-specific pretraining. Previously, retrieval augmented generation (RAG) has limited success in addressing hallucinations. Unlike previous methods in RAG where the retrieval model was trained separately from the LLM, we introduce JMLR (for Jointly trains LLM and information Retrieval) during the fine-tuning phase. The synchronized training mechanism enhances JMLR's ability to retrieve clinical guidelines and leverage medical knowledge to reason and answer questions and reduces the demand for computational resources. We evaluated JMLR on the important medical question-answering application. Our experimental results demonstrate that JMLR-13B (70.5%) outperforms a previous state-of-the-art open-source model using conventional pre-training and fine-tuning Meditron-70B (68.9%) and Llama2-13B with RAG (67.7%) on a medical question-answering dataset. Comprehensive evaluations reveal JMLR-13B enhances reasoning quality and reduces hallucinations better than Claude3-Opus. Additionally, JMLR-13B (148 GPU hours) also trains much faster than Meditron-70B (42630 GPU hours). Through this work, we provide a new and efficient knowledge enhancement method for healthcare, demonstrating the potential of integrating retrieval and LLM training for medical question-answering systems.

  • 4 authors
·
Feb 27, 2024

VideoLLM Knows When to Speak: Enhancing Time-Sensitive Video Comprehension with Video-Text Duet Interaction Format

Recent researches on video large language models (VideoLLM) predominantly focus on model architectures and training datasets, leaving the interaction format between the user and the model under-explored. In existing works, users often interact with VideoLLMs by using the entire video and a query as input, after which the model generates a response. This interaction format constrains the application of VideoLLMs in scenarios such as live-streaming comprehension where videos do not end and responses are required in a real-time manner, and also results in unsatisfactory performance on time-sensitive tasks that requires localizing video segments. In this paper, we focus on a video-text duet interaction format. This interaction format is characterized by the continuous playback of the video, and both the user and the model can insert their text messages at any position during the video playback. When a text message ends, the video continues to play, akin to the alternative of two performers in a duet. We construct MMDuetIT, a video-text training dataset designed to adapt VideoLLMs to video-text duet interaction format. We also introduce the Multi-Answer Grounded Video Question Answering (MAGQA) task to benchmark the real-time response ability of VideoLLMs. Trained on MMDuetIT, MMDuet demonstrates that adopting the video-text duet interaction format enables the model to achieve significant improvements in various time-sensitive tasks (76% CIDEr on YouCook2 dense video captioning, 90\% mAP on QVHighlights highlight detection and 25% R@0.5 on Charades-STA temporal video grounding) with minimal training efforts, and also enable VideoLLMs to reply in a real-time manner as the video plays. Code, data and demo are available at: https://github.com/yellow-binary-tree/MMDuet.

  • 7 authors
·
Nov 26, 2024 2

CLIPSyntel: CLIP and LLM Synergy for Multimodal Question Summarization in Healthcare

In the era of modern healthcare, swiftly generating medical question summaries is crucial for informed and timely patient care. Despite the increasing complexity and volume of medical data, existing studies have focused solely on text-based summarization, neglecting the integration of visual information. Recognizing the untapped potential of combining textual queries with visual representations of medical conditions, we introduce the Multimodal Medical Question Summarization (MMQS) Dataset. This dataset, a major contribution to our work, pairs medical queries with visual aids, facilitating a richer and more nuanced understanding of patient needs. We also propose a framework, utilizing the power of Contrastive Language Image Pretraining(CLIP) and Large Language Models(LLMs), consisting of four modules that identify medical disorders, generate relevant context, filter medical concepts, and craft visually aware summaries. Our comprehensive framework harnesses the power of CLIP, a multimodal foundation model, and various general-purpose LLMs, comprising four main modules: the medical disorder identification module, the relevant context generation module, the context filtration module for distilling relevant medical concepts and knowledge, and finally, a general-purpose LLM to generate visually aware medical question summaries. Leveraging our MMQS dataset, we showcase how visual cues from images enhance the generation of medically nuanced summaries. This multimodal approach not only enhances the decision-making process in healthcare but also fosters a more nuanced understanding of patient queries, laying the groundwork for future research in personalized and responsive medical care

  • 6 authors
·
Dec 15, 2023

CG-Bench: Clue-grounded Question Answering Benchmark for Long Video Understanding

Most existing video understanding benchmarks for multimodal large language models (MLLMs) focus only on short videos. The limited number of benchmarks for long video understanding often rely solely on multiple-choice questions (MCQs). However, because of the inherent limitation of MCQ-based evaluation and the increasing reasoning ability of MLLMs, models can give the current answer purely by combining short video understanding with elimination, without genuinely understanding the video content. To address this gap, we introduce CG-Bench, a novel benchmark designed for clue-grounded question answering in long videos. CG-Bench emphasizes the model's ability to retrieve relevant clues for questions, enhancing evaluation credibility. It features 1,219 manually curated videos categorized by a granular system with 14 primary categories, 171 secondary categories, and 638 tertiary categories, making it the largest benchmark for long video analysis. The benchmark includes 12,129 QA pairs in three major question types: perception, reasoning, and hallucination. Compensating the drawbacks of pure MCQ-based evaluation, we design two novel clue-based evaluation methods: clue-grounded white box and black box evaluations, to assess whether the model generates answers based on the correct understanding of the video. We evaluate multiple closed-source and open-source MLLMs on CG-Bench. Results indicate that current models significantly underperform in understanding long videos compared to short ones, and a significant gap exists between open-source and commercial models. We hope CG-Bench can advance the development of more trustworthy and capable MLLMs for long video understanding. All annotations and video data are released at https://cg-bench.github.io/leaderboard/.

  • 9 authors
·
Dec 16, 2024

MovieRecapsQA: A Multimodal Open-Ended Video Question-Answering Benchmark

Understanding real-world videos such as movies requires integrating visual and dialogue cues to answer complex questions. Yet existing VideoQA benchmarks struggle to capture this multimodal reasoning and are largely not open-ended, given the difficulty of evaluating free-form answers. In this paper, we introduce a novel open-ended multi-modal VideoQA benchmark, MovieRecapsQA created using movie recap videos--a distinctive type of YouTube content that summarizes a film by presenting its key events through synchronized visual (recap video) and textual (recap summary) modalities. Using the recap summary, we generate approx 8.2 K question-answer (QA) pairs (aligned with movie-subtitles) and provide the necessary "facts" needed to verify an answer in a reference-free manner. To our knowledge, this is the first open-ended VideoQA benchmark that supplies explicit textual context of the input (video and/or text); which we use for evaluation. Our benchmark provides videos of multiple lengths (i.e., recap-segments, movie-segments) and categorizations of questions (by modality and type) to enable fine-grained analysis. We evaluate the performance of seven state-of-the-art MLLMs using our benchmark and observe that: 1) visual-only questions remain the most challenging; 2) models default to textual inputs whenever available; 3) extracting factually accurate information from video content is still difficult for all models; and 4) proprietary and open-source models perform comparably on video-dependent questions.

  • 5 authors
·
Jan 5

Medical Adaptation of Large Language and Vision-Language Models: Are We Making Progress?

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.

  • 4 authors
·
Nov 6, 2024

AutoEval-Video: An Automatic Benchmark for Assessing Large Vision Language Models in Open-Ended Video Question Answering

We propose a novel and challenging benchmark, AutoEval-Video, to comprehensively evaluate large vision-language models in open-ended video question answering. The comprehensiveness of AutoEval-Video is demonstrated in two aspects: 1) AutoEval-Video constructs open-ended video-questions across 9 skill dimensions, addressing capabilities of perception, comprehension, and generation. 2) AutoEval-Video contains newly collected videos that cover over 40 distinct themes. To efficiently evaluate responses to the open-ended questions, we employ an LLM-based evaluation approach, but instead of merely providing a reference answer, we annotate unique evaluation rules for every single instance (video-question pair). To maximize the robustness of these rules, we develop a novel adversarial annotation mechanism. By using instance-specific rules as prompt, GPT-4, as an automatic evaluator, can achieve a stable evaluation accuracy of around 97.0\%, comparable to the 94.9\% - 97.5\% accuracy of a human evaluator. Furthermore, we assess the performance of eight large vision-language models on AutoEval-Video. Among them, GPT-4V(ision) significantly outperforms other models, achieving an accuracy of 32.2\%. However, there is still substantial room for improvement compared to human accuracy of 72.8\%. By conducting an extensive case study, we uncover several drawbacks of GPT-4V, such as limited temporal and dynamic comprehension, and overly general responses. Code is available at https://github.com/Xiuyuan-Chen/AutoEval-Video{magentahttps://github.com/Xiuyuan-Chen/AutoEval-Video}.

  • 4 authors
·
Nov 24, 2023

Video-MTR: Reinforced Multi-Turn Reasoning for Long Video Understanding

Long-form video understanding, characterized by long-range temporal dependencies and multiple events, remains a challenge. Existing methods often rely on static reasoning or external visual-language models (VLMs), which face issues like complexity and sub-optimal performance due to the lack of end-to-end training. In this paper, we propose Video-MTR, a reinforced multi-turn reasoning framework designed to enable iterative key video segment selection and question comprehension. Unlike traditional video reasoning pipeline, which generate predictions in a single turn, Video-MTR performs reasoning in multiple turns, selecting video segments progressively based on the evolving understanding of previously processed segments and the current question. This iterative process allows for a more refined and contextually aware analysis of the video. To ensure intermediate reasoning process, we introduce a novel gated bi-level reward system, combining trajectory-level rewards based on answer correctness and turn-level rewards emphasizing frame-query relevance. This system optimizes both video segment selection and question comprehension, eliminating the need for external VLMs and allowing end-to-end training. Extensive experiments on benchmarks like VideoMME, MLVU, and EgoSchema demonstrate that Video-MTR outperforms existing methods in both accuracy and efficiency, advancing the state-of-the-art in long video understanding.

  • 4 authors
·
Aug 28, 2025 2

PVChat: Personalized Video Chat with One-Shot Learning

Video large language models (ViLLMs) excel in general video understanding, e.g., recognizing activities like talking and eating, but struggle with identity-aware comprehension, such as "Wilson is receiving chemotherapy" or "Tom is discussing with Sarah", limiting their applicability in smart healthcare and smart home environments. To address this limitation, we propose a one-shot learning framework PVChat, the first personalized ViLLM that enables subject-aware question answering (QA) from a single video for each subject. Our approach optimizes a Mixture-of-Heads (MoH) enhanced ViLLM on a synthetically augmented video-QA dataset, leveraging a progressive image-to-video learning strategy. Specifically, we introduce an automated augmentation pipeline that synthesizes identity-preserving positive samples and retrieves hard negatives from existing video corpora, generating a diverse training dataset with four QA types: existence, appearance, action, and location inquiries. To enhance subject-specific learning, we propose a ReLU Routing MoH attention mechanism, alongside two novel objectives: (1) Smooth Proximity Regularization for progressive learning through exponential distance scaling and (2) Head Activation Enhancement for balanced attention routing. Finally, we adopt a two-stage training strategy, transitioning from image pre-training to video fine-tuning, enabling a gradual learning process from static attributes to dynamic representations. We evaluate PVChat on diverse datasets covering medical scenarios, TV series, anime, and real-world footage, demonstrating its superiority in personalized feature understanding after learning from a single video, compared to state-of-the-art ViLLMs.

  • 9 authors
·
Mar 21, 2025 2

Map the Flow: Revealing Hidden Pathways of Information in VideoLLMs

Video Large Language Models (VideoLLMs) extend the capabilities of vision-language models to spatiotemporal inputs, enabling tasks such as video question answering (VideoQA). Despite recent advances in VideoLLMs, their internal mechanisms on where and how they extract and propagate video and textual information remain less explored. In this study, we investigate the internal information flow of VideoLLMs using mechanistic interpretability techniques. Our analysis reveals consistent patterns across diverse VideoQA tasks: (1) temporal reasoning in VideoLLMs initiates with active cross-frame interactions in early-to-middle layers, (2) followed by progressive video-language integration in middle layers. This is facilitated by alignment between video representations and linguistic embeddings containing temporal concepts. (3) Upon completion of this integration, the model is ready to generate correct answers in middle-to-late layers. (4) Based on our analysis, we show that VideoLLMs can retain their VideoQA performance by selecting these effective information pathways while suppressing a substantial amount of attention edges, e.g., 58% in LLaVA-NeXT-7B-Video-FT. These findings provide a blueprint on how VideoLLMs perform temporal reasoning and offer practical insights for improving model interpretability and downstream generalization. Our project page with the source code is available at https://map-the-flow.github.io

  • 3 authors
·
Oct 15, 2025 1

AVATAAR: Agentic Video Answering via Temporal Adaptive Alignment and Reasoning

With the increasing prevalence of video content, effectively understanding and answering questions about long form videos has become essential for numerous applications. Although large vision language models (LVLMs) have enhanced performance, they often face challenges with nuanced queries that demand both a comprehensive understanding and detailed analysis. To overcome these obstacles, we introduce AVATAAR, a modular and interpretable framework that combines global and local video context, along with a Pre Retrieval Thinking Agent and a Rethink Module. AVATAAR creates a persistent global summary and establishes a feedback loop between the Rethink Module and the Pre Retrieval Thinking Agent, allowing the system to refine its retrieval strategies based on partial answers and replicate human-like iterative reasoning. On the CinePile benchmark, AVATAAR demonstrates significant improvements over a baseline, achieving relative gains of +5.6% in temporal reasoning, +5% in technical queries, +8% in theme-based questions, and +8.2% in narrative comprehension. Our experiments confirm that each module contributes positively to the overall performance, with the feedback loop being crucial for adaptability. These findings highlight AVATAAR's effectiveness in enhancing video understanding capabilities. Ultimately, AVATAAR presents a scalable solution for long-form Video Question Answering (QA), merging accuracy, interpretability, and extensibility.

  • 3 authors
·
Nov 19, 2025

Tem-adapter: Adapting Image-Text Pretraining for Video Question Answer

Video-language pre-trained models have shown remarkable success in guiding video question-answering (VideoQA) tasks. However, due to the length of video sequences, training large-scale video-based models incurs considerably higher costs than training image-based ones. This motivates us to leverage the knowledge from image-based pretraining, despite the obvious gaps between image and video domains. To bridge these gaps, in this paper, we propose Tem-Adapter, which enables the learning of temporal dynamics and complex semantics by a visual Temporal Aligner and a textual Semantic Aligner. Unlike conventional pretrained knowledge adaptation methods that only concentrate on the downstream task objective, the Temporal Aligner introduces an extra language-guided autoregressive task aimed at facilitating the learning of temporal dependencies, with the objective of predicting future states based on historical clues and language guidance that describes event progression. Besides, to reduce the semantic gap and adapt the textual representation for better event description, we introduce a Semantic Aligner that first designs a template to fuse question and answer pairs as event descriptions and then learns a Transformer decoder with the whole video sequence as guidance for refinement. We evaluate Tem-Adapter and different pre-train transferring methods on two VideoQA benchmarks, and the significant performance improvement demonstrates the effectiveness of our method.

  • 7 authors
·
Aug 16, 2023

Goldfish: Vision-Language Understanding of Arbitrarily Long Videos

Most current LLM-based models for video understanding can process videos within minutes. However, they struggle with lengthy videos due to challenges such as "noise and redundancy", as well as "memory and computation" constraints. In this paper, we present Goldfish, a methodology tailored for comprehending videos of arbitrary lengths. We also introduce the TVQA-long benchmark, specifically designed to evaluate models' capabilities in understanding long videos with questions in both vision and text content. Goldfish approaches these challenges with an efficient retrieval mechanism that initially gathers the top-k video clips relevant to the instruction before proceeding to provide the desired response. This design of the retrieval mechanism enables the Goldfish to efficiently process arbitrarily long video sequences, facilitating its application in contexts such as movies or television series. To facilitate the retrieval process, we developed MiniGPT4-Video that generates detailed descriptions for the video clips. In addressing the scarcity of benchmarks for long video evaluation, we adapted the TVQA short video benchmark for extended content analysis by aggregating questions from entire episodes, thereby shifting the evaluation from partial to full episode comprehension. We attained a 41.78% accuracy rate on the TVQA-long benchmark, surpassing previous methods by 14.94%. Our MiniGPT4-Video also shows exceptional performance in short video comprehension, exceeding existing state-of-the-art methods by 3.23%, 2.03%, 16.5% and 23.59% on the MSVD, MSRVTT, TGIF, and TVQA short video benchmarks, respectively. These results indicate that our models have significant improvements in both long and short-video understanding. Our models and code have been made publicly available at https://vision-cair.github.io/Goldfish_website/

  • 9 authors
·
Jul 17, 2024 2

VQA^2: Visual Question Answering for Video Quality Assessment

The advent and proliferation of large multi-modal models (LMMs) have introduced new paradigms to computer vision, transforming various tasks into a unified visual question answering framework. Video Quality Assessment (VQA), a classic field in low-level visual perception, focused initially on quantitative video quality scoring. However, driven by advances in LMMs, it is now progressing toward more holistic visual quality understanding tasks. Recent studies in the image domain have demonstrated that Visual Question Answering (VQA) can markedly enhance low-level visual quality evaluation. Nevertheless, related work has not been explored in the video domain, leaving substantial room for improvement. To address this gap, we introduce the VQA2 Instruction Dataset - the first visual question answering instruction dataset that focuses on video quality assessment. This dataset consists of 3 subsets and covers various video types, containing 157,755 instruction question-answer pairs. Then, leveraging this foundation, we present the VQA2 series models. The VQA2 series models interleave visual and motion tokens to enhance the perception of spatial-temporal quality details in videos. We conduct extensive experiments on video quality scoring and understanding tasks, and results demonstrate that the VQA2series models achieve excellent performance in both tasks. Notably, our final model, the VQA2-Assistant, exceeds the renowned GPT-4o in visual quality understanding tasks while maintaining strong competitiveness in quality scoring tasks. Our work provides a foundation and feasible approach for integrating low-level video quality assessment and understanding with LMMs.

  • 10 authors
·
Nov 6, 2024

HORNet: Task-Guided Frame Selection for Video Question Answering with Vision-Language Models

Video question answering (VQA) with vision-language models (VLMs) depends critically on which frames are selected from the input video, yet most systems rely on uniform or heuristic sampling that cannot be optimized for downstream answering quality. We introduce HORNet, a lightweight frame selection policy trained with Group Relative Policy Optimization (GRPO) to learn which frames a frozen VLM needs to answer questions correctly. With fewer than 1M trainable parameters, HORNet reduces input frames by up to 99\% and VLM processing time by up to 93\%, while improving answer quality on short-form benchmarks (+1.7\% F1 on MSVD-QA) and achieving strong performance on temporal reasoning tasks (+7.3 points over uniform sampling on NExT-QA). We formalize this as Select Any Frames (SAF), a task that decouples visual input curation from VLM reasoning, and show that GRPO-trained selection generalizes better out-of-distribution than supervised and PPO alternatives. HORNet's policy further transfers across VLM answerers without retraining, yielding an additional 8.5\% relative gain when paired with a stronger model. Evaluated across six benchmarks spanning 341,877 QA pairs and 114.2 hours of video, our results demonstrate that optimizing what a VLM sees is a practical and complementary alternative to optimizing what it generates while improving efficiency. Code is available at https://github.com/ostadabbas/HORNet.

  • 3 authors
·
Mar 19

KorMedMCQA-V: A Multimodal Benchmark for Evaluating Vision-Language Models on the Korean Medical Licensing Examination

We introduce KorMedMCQA-V, a Korean medical licensing-exam-style multimodal multiple-choice question answering benchmark for evaluating vision-language models (VLMs). The dataset consists of 1,534 questions with 2,043 associated images from Korean Medical Licensing Examinations (2012-2023), with about 30% containing multiple images requiring cross-image evidence integration. Images cover clinical modalities including X-ray, computed tomography (CT), electrocardiography (ECG), ultrasound, endoscopy, and other medical visuals. We benchmark over 50 VLMs across proprietary and open-source categories-spanning general-purpose, medical-specialized, and Korean-specialized families-under a unified zero-shot evaluation protocol. The best proprietary model (Gemini-3.0-Pro) achieves 96.9% accuracy, the best open-source model (Qwen3-VL-32B-Thinking) 83.7%, and the best Korean-specialized model (VARCO-VISION-2.0-14B) only 43.2%. We further find that reasoning-oriented model variants gain up to +20 percentage points over instruction-tuned counterparts, medical domain specialization yields inconsistent gains over strong general-purpose baselines, all models degrade on multi-image questions, and performance varies notably across imaging modalities. By complementing the text-only KorMedMCQA benchmark, KorMedMCQA-V forms a unified evaluation suite for Korean medical reasoning across text-only and multimodal conditions. The dataset is available via Hugging Face Datasets: https://huggingface.co/datasets/seongsubae/KorMedMCQA-V.

  • 4 authors
·
Feb 14

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

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, 2025

Frozen in Time: A Joint Video and Image Encoder for End-to-End Retrieval

Our objective in this work is video-text retrieval - in particular a joint embedding that enables efficient text-to-video retrieval. The challenges in this area include the design of the visual architecture and the nature of the training data, in that the available large scale video-text training datasets, such as HowTo100M, are noisy and hence competitive performance is achieved only at scale through large amounts of compute. We address both these challenges in this paper. We propose an end-to-end trainable model that is designed to take advantage of both large-scale image and video captioning datasets. Our model is an adaptation and extension of the recent ViT and Timesformer architectures, and consists of attention in both space and time. The model is flexible and can be trained on both image and video text datasets, either independently or in conjunction. It is trained with a curriculum learning schedule that begins by treating images as 'frozen' snapshots of video, and then gradually learns to attend to increasing temporal context when trained on video datasets. We also provide a new video-text pretraining dataset WebVid-2M, comprised of over two million videos with weak captions scraped from the internet. Despite training on datasets that are an order of magnitude smaller, we show that this approach yields state-of-the-art results on standard downstream video-retrieval benchmarks including MSR-VTT, MSVD, DiDeMo and LSMDC.

  • 4 authors
·
Apr 1, 2021 1

MedExpQA: Multilingual Benchmarking of Large Language Models for Medical Question Answering

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

  • 3 authors
·
Apr 8, 2024

MedScope: Incentivizing "Think with Videos" for Clinical Reasoning via Coarse-to-Fine Tool Calling

Long-form clinical videos are central to visual evidence-based decision-making, with growing importance for applications such as surgical robotics and related settings. However, current multimodal large language models typically process videos with passive sampling or weakly grounded inspection, which limits their ability to iteratively locate, verify, and justify predictions with temporally targeted evidence. To close this gap, we propose MedScope, a tool-using clinical video reasoning model that performs coarse-to-fine evidence seeking over long-form procedures. By interleaving intermediate reasoning with targeted tool calls and verification on retrieved observations, MedScope produces more accurate and trustworthy predictions that are explicitly grounded in temporally localized visual evidence. To address the lack of high-fidelity supervision, we build ClinVideoSuite, an evidence-centric, fine-grained clinical video suite. We then optimize MedScope with Grounding-Aware Group Relative Policy Optimization (GA-GRPO), which directly reinforces tool use with grounding-aligned rewards and evidence-weighted advantages. On full and fine-grained video understanding benchmarks, MedScope achieves state-of-the-art performance in both in-domain and out-of-domain evaluations. Our approach illuminates a path toward medical AI agents that can genuinely "think with videos" through tool-integrated reasoning. We will release our code, models, and data.

  • 14 authors
·
Feb 11

MedSumm: A Multimodal Approach to Summarizing Code-Mixed Hindi-English Clinical Queries

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.

  • 10 authors
·
Jan 3, 2024

Trying Bilinear Pooling in Video-QA

Bilinear pooling (BLP) refers to a family of operations recently developed for fusing features from different modalities predominantly developed for VQA models. A bilinear (outer-product) expansion is thought to encourage models to learn interactions between two feature spaces and has experimentally outperformed `simpler' vector operations (concatenation and element-wise-addition/multiplication) on VQA benchmarks. Successive BLP techniques have yielded higher performance with lower computational expense and are often implemented alongside attention mechanisms. However, despite significant progress in VQA, BLP methods have not been widely applied to more recently explored video question answering (video-QA) tasks. In this paper, we begin to bridge this research gap by applying BLP techniques to various video-QA benchmarks, namely: TVQA, TGIF-QA, Ego-VQA and MSVD-QA. We share our results on the TVQA baseline model, and the recently proposed heterogeneous-memory-enchanced multimodal attention (HME) model. Our experiments include both simply replacing feature concatenation in the existing models with BLP, and a modified version of the TVQA baseline to accommodate BLP we name the `dual-stream' model. We find that our relatively simple integration of BLP does not increase, and mostly harms, performance on these video-QA benchmarks. Using recently proposed theoretical multimodal fusion taxonomies, we offer insight into why BLP-driven performance gain for video-QA benchmarks may be more difficult to achieve than in earlier VQA models. We suggest a few additional `best-practices' to consider when applying BLP to video-QA. We stress that video-QA models should carefully consider where the complex representational potential from BLP is actually needed to avoid computational expense on `redundant' fusion.

  • 4 authors
·
Dec 18, 2020

LongVT: Incentivizing "Thinking with Long Videos" via Native Tool Calling

Large multimodal models (LMMs) have shown great potential for video reasoning with textual Chain-of-Thought. However, they remain vulnerable to hallucinations, especially when processing long-form videos where evidence is sparse and temporally dispersed. Inspired by how humans comprehend long videos - by first skimming globally and then examining relevant clips for details - we introduce LongVT, an end-to-end agentic framework that enables "Thinking with Long Videos" via interleaved Multimodal Chain-of-Tool-Thought. Specifically, we exploit LMMs' inherent temporal grounding ability as a native video cropping tool to zoom in on a specific video clip and resample finer-grained video frames. This global-to-local reasoning loop continues until answers are grounded in retrieved visual evidence. Given the scarcity of fine-grained question-answering (QA) data for the long video reasoning task, we curate and will release a data suite named VideoSIAH to facilitate both training and evaluation. Specifically, our training dataset consists of 247.9K samples for tool-integrated cold-start supervised fine-tuning, 1.6K samples for agentic reinforcement learning, and 15.4K samples for agentic reinforcement fine-tuning, respectively. Our evaluation benchmark consists of 1,280 QA pairs that are carefully curated through a semi-automatic data pipeline with human-in-the-loop validation. With a meticulously designed three-stage training strategy and extensive empirical validation, LongVT consistently outperforms existing strong baselines across four challenging long-video understanding and reasoning benchmarks. Our codes, data, and model checkpoints are publicly available at https://github.com/EvolvingLMMs-Lab/LongVT .

lmms-lab LMMs-Lab
·
Nov 25, 2025 7

The Limited Impact of Medical Adaptation of Large Language and Vision-Language Models

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.

  • 5 authors
·
Nov 13, 2024

EgoSchema: A Diagnostic Benchmark for Very Long-form Video Language Understanding

We introduce EgoSchema, a very long-form video question-answering dataset, and benchmark to evaluate long video understanding capabilities of modern vision and language systems. Derived from Ego4D, EgoSchema consists of over 5000 human curated multiple choice question answer pairs, spanning over 250 hours of real video data, covering a very broad range of natural human activity and behavior. For each question, EgoSchema requires the correct answer to be selected between five given options based on a three-minute-long video clip. While some prior works have proposed video datasets with long clip lengths, we posit that merely the length of the video clip does not truly capture the temporal difficulty of the video task that is being considered. To remedy this, we introduce temporal certificate sets, a general notion for capturing the intrinsic temporal understanding length associated with a broad range of video understanding tasks & datasets. Based on this metric, we find EgoSchema to have intrinsic temporal lengths over 5.7x longer than the second closest dataset and 10x to 100x longer than any other video understanding dataset. Further, our evaluation of several current state-of-the-art video and language models shows them to be severely lacking in long-term video understanding capabilities. Even models with several billions of parameters achieve QA accuracy less than 33% (random is 20%) on the EgoSchema multi-choice question answering task, while humans achieve about 76% accuracy. We posit that {}, with its long intrinsic temporal structures and diverse complexity, would serve as a valuable evaluation probe for developing effective long-term video understanding systems in the future. Data and Zero-shot model evaluation code are open-sourced for both public and commercial use under the Ego4D license at http://egoschema.github.io

  • 3 authors
·
Aug 17, 2023