Prompting Medical Large Vision-Language Models to Diagnose Pathologies by Visual Question Answering

Large Vision-Language Models (LVLMs) have achieved significant success in recent years, and they have been extended to the medical domain. Although demonstrating satisfactory performance on medical Visual Question Answering (VQA) tasks, Medical LVLMs (MLVLMs) suffer from the hallucination problem, which makes them fail to diagnose complex pathologies. Moreover, they readily fail to learn minority pathologies due to imbalanced training data. We propose two prompting strategies for MLVLMs that reduce hallucination and improve VQA performance. In the first strategy, we provide a detailed explanation of the queried pathology. In the second strategy, we fine-tune a cheap, weak learner to achieve high performance on a specific metric, and textually provide its judgment to the MLVLM. Tested on the MIMIC-CXR-JPG and Chexpert datasets, our methods significantly improve the diagnostic F1 score, with the highest increase being 0.27. We also demonstrate that our prompting strategies can be extended to general LVLM domains. Based on POPE metrics, it effectively suppresses the false negative predictions of existing LVLMs and improves Recall by approximately 0.07.

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Publication Details

Journal
The Journal of Machine Learning for Biomedical Imaging
Published
2025-03-14
DOI
https://doi.org/10.59275/j.melba.2025-1a8b
Citations
7
Primary Topic
Multimodal Machine Learning Applications
Type
article
Field-Weighted Citation Impact
8.93
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article

Prompting Medical Large Vision-Language Models to Diagnose Pathologies by Visual Question Answering

Demetri Terzopoulos, Danfeng Guo
7 citations
The Journal of Machine Learning for Biomedical Imaging
Multimodal Machine Learning Applications
8.93
article

Prompting Medical Large Vision-Language Models to Diagnose Pathologies by Visual Question Answering

Demetri Terzopoulos, Danfeng Guo
article en
7 citations

Abstract

Large Vision-Language Models (LVLMs) have achieved significant success in recent years, and they have been extended to the medical domain. Although demonstrating satisfactory performance on medical Visual Question Answering (VQA) tasks, Medical LVLMs (MLVLMs) suffer from the hallucination problem, which makes them fail to diagnose complex pathologies. Moreover, they readily fail to learn minority pathologies due to imbalanced training data. We propose two prompting strategies for MLVLMs that reduce hallucination and improve VQA performance. In the first strategy, we provide a detailed explanation of the queried pathology. In the second strategy, we fine-tune a cheap, weak learner to achieve high performance on a specific metric, and textually provide its judgment to the MLVLM. Tested on the MIMIC-CXR-JPG and Chexpert datasets, our methods significantly improve the diagnostic F1 score, with the highest increase being 0.27. We also demonstrate that our prompting strategies can be extended to general LVLM domains. Based on POPE metrics, it effectively suppresses the false negative predictions of existing LVLMs and improves Recall by approximately 0.07.

The Journal of Machine Learning for Biomedical ImagingVol. 3(March 2025)
University of California, Los Angeles (US)
Openalex Percentile: Top 2%
Multimodal Machine Learning Applications
8.93
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