Daily Papers

Radiology reports are one of the main forms of communication between radiologists and other clinicians and contain important information for patient care. In order to use this information for research and automated patient care programs, it is necessary to convert the raw text into structured data suitable for analysis. State-of-the-art natural language processing (NLP) domain-specific contextual word embeddings have been shown to achieve impressive accuracy for these tasks in medicine, but have yet to be utilized for section structure segmentation. In this work, we pre-trained a contextual embedding BERT model using breast radiology reports and developed a classifier that incorporated the embedding with auxiliary global textual features in order to perform section segmentation. This model achieved a 98% accuracy at segregating free text reports sentence by sentence into sections of information outlined in the Breast Imaging Reporting and Data System (BI-RADS) lexicon, a significant improvement over the Classic BERT model without auxiliary information. We then evaluated whether using section segmentation improved the downstream extraction of clinically relevant information such as modality/procedure, previous cancer, menopausal status, the purpose of the exam, breast density, and breast MRI background parenchymal enhancement. Using the BERT model pre-trained on breast radiology reports combined with section segmentation resulted in an overall accuracy of 95.9% in the field extraction tasks. This is a 17% improvement compared to an overall accuracy of 78.9% for field extraction with models using Classic BERT embeddings and not using section segmentation. Our work shows the strength of using BERT in radiology report analysis and the advantages of section segmentation in identifying key features of patient factors recorded in breast radiology reports.

Multi-modal models have shown a promising capability to effectively integrate information from various sources, yet meanwhile, they are found vulnerable to pervasive perturbations, such as uni-modal attacks and missing conditions. To counter these perturbations, robust multi-modal representations are highly expected, which are positioned well away from the discriminative multi-modal decision boundary. In this paper, different from conventional empirical studies, we focus on a commonly used joint multi-modal framework and theoretically discover that larger uni-modal representation margins and more reliable integration for modalities are essential components for achieving higher robustness. This discovery can further explain the limitation of multi-modal robustness and the phenomenon that multi-modal models are often vulnerable to attacks on the specific modality. Moreover, our analysis reveals how the widespread issue, that the model has different preferences for modalities, limits the multi-modal robustness by influencing the essential components and could lead to attacks on the specific modality highly effective. Inspired by our theoretical finding, we introduce a training procedure called Certifiable Robust Multi-modal Training (CRMT), which can alleviate this influence from modality preference and explicitly regulate essential components to significantly improve robustness in a certifiable manner. Our method demonstrates substantial improvements in performance and robustness compared with existing methods. Furthermore, our training procedure can be easily extended to enhance other robust training strategies, highlighting its credibility and flexibility.

Weakly-supervised audio-visual violence detection aims to distinguish snippets containing multimodal violence events with video-level labels. Many prior works perform audio-visual integration and interaction in an early or intermediate manner, yet overlooking the modality heterogeneousness over the weakly-supervised setting. In this paper, we analyze the modality asynchrony and undifferentiated instances phenomena of the multiple instance learning (MIL) procedure, and further investigate its negative impact on weakly-supervised audio-visual learning. To address these issues, we propose a modality-aware contrastive instance learning with self-distillation (MACIL-SD) strategy. Specifically, we leverage a lightweight two-stream network to generate audio and visual bags, in which unimodal background, violent, and normal instances are clustered into semi-bags in an unsupervised way. Then audio and visual violent semi-bag representations are assembled as positive pairs, and violent semi-bags are combined with background and normal instances in the opposite modality as contrastive negative pairs. Furthermore, a self-distillation module is applied to transfer unimodal visual knowledge to the audio-visual model, which alleviates noises and closes the semantic gap between unimodal and multimodal features. Experiments show that our framework outperforms previous methods with lower complexity on the large-scale XD-Violence dataset. Results also demonstrate that our proposed approach can be used as plug-in modules to enhance other networks. Codes are available at https://github.com/JustinYuu/MACIL_SD.

In the diverse field of medical imaging, automatic segmentation has numerous applications and must handle a wide variety of input domains, such as different types of Computed Tomography (CT) scans and Magnetic Resonance (MR) images. This heterogeneity challenges automatic segmentation algorithms to maintain consistent performance across different modalities due to the requirement for spatially aligned and paired images. Typically, segmentation models are trained using a single modality, which limits their ability to generalize to other types of input data without employing transfer learning techniques. Additionally, leveraging complementary information from different modalities to enhance segmentation precision often necessitates substantial modifications to popular encoder-decoder designs, such as introducing multiple branched encoding or decoding paths for each modality. In this work, we propose a simple Multi-Modal Segmentation (MulModSeg) strategy to enhance medical image segmentation across multiple modalities, specifically CT and MR. It incorporates two key designs: a modality-conditioned text embedding framework via a frozen text encoder that adds modality awareness to existing segmentation frameworks without significant structural modifications or computational overhead, and an alternating training procedure that facilitates the integration of essential features from unpaired CT and MR inputs. Through extensive experiments with both Fully Convolutional Network and Transformer-based backbones, MulModSeg consistently outperforms previous methods in segmenting abdominal multi-organ and cardiac substructures for both CT and MR modalities. The code is available in this {https://github.com/ChengyinLee/MulModSeg_2024{link}}.

Extracting key information from scientific papers has the potential to help researchers work more efficiently and accelerate the pace of scientific progress. Over the last few years, research on Scientific Information Extraction (SciIE) witnessed the release of several new systems and benchmarks. However, existing paper-focused datasets mostly focus only on specific parts of a manuscript (e.g., abstracts) and are single-modality (i.e., text- or table-only), due to complex processing and expensive annotations. Moreover, core information can be present in either text or tables or across both. To close this gap in data availability and enable cross-modality IE, while alleviating labeling costs, we propose a semi-supervised pipeline for annotating entities in text, as well as entities and relations in tables, in an iterative procedure. Based on this pipeline, we release novel resources for the scientific community, including a high-quality benchmark, a large-scale corpus, and a semi-supervised annotation pipeline. We further report the performance of state-of-the-art IE models on the proposed benchmark dataset, as a baseline. Lastly, we explore the potential capability of large language models such as ChatGPT for the current task. Our new dataset, results, and analysis validate the effectiveness and efficiency of our semi-supervised pipeline, and we discuss its remaining limitations.

Multimodal models are becoming increasingly effective, in part due to unified components, such as the Transformer architecture. However, multimodal models still often consist of many task- and modality-specific pieces and training procedures. For example, CLIP (Radford et al., 2021) trains independent text and image towers via a contrastive loss. We explore an additional unification: the use of a pure pixel-based model to perform image, text, and multimodal tasks. Our model is trained with contrastive loss alone, so we call it CLIP-Pixels Only (CLIPPO). CLIPPO uses a single encoder that processes both regular images and text rendered as images. CLIPPO performs image-based tasks such as retrieval and zero-shot image classification almost as well as CLIP, with half the number of parameters and no text-specific tower or embedding. When trained jointly via image-text contrastive learning and next-sentence contrastive learning, CLIPPO can perform well on natural language understanding tasks, without any word-level loss (language modelling or masked language modelling), outperforming pixel-based prior work. Surprisingly, CLIPPO can obtain good accuracy in visual question answering, simply by rendering the question and image together. Finally, we exploit the fact that CLIPPO does not require a tokenizer to show that it can achieve strong performance on multilingual multimodal retrieval without

Modality is the linguistic ability to describe events with added information such as how desirable, plausible, or feasible they are. Modality is important for many NLP downstream tasks such as the detection of hedging, uncertainty, speculation, and more. Previous studies that address modality detection in NLP often restrict modal expressions to a closed syntactic class, and the modal sense labels are vastly different across different studies, lacking an accepted standard. Furthermore, these senses are often analyzed independently of the events that they modify. This work builds on the theoretical foundations of the Georgetown Gradable Modal Expressions (GME) work by Rubinstein et al. (2013) to propose an event-based modality detection task where modal expressions can be words of any syntactic class and sense labels are drawn from a comprehensive taxonomy which harmonizes the modal concepts contributed by the different studies. We present experiments on the GME corpus aiming to detect and classify fine-grained modal concepts and associate them with their modified events. We show that detecting and classifying modal expressions is not only feasible, but also improves the detection of modal events in their own right.

Quantification of real-time informal feedback delivered by an experienced surgeon to a trainee during surgery is important for skill improvements in surgical training. Such feedback in the live operating room is inherently multimodal, consisting of verbal conversations (e.g., questions and answers) as well as non-verbal elements (e.g., through visual cues like pointing to anatomic elements). In this work, we leverage a clinically-validated five-category classification of surgical feedback: "Anatomic", "Technical", "Procedural", "Praise" and "Visual Aid". We then develop a multi-label machine learning model to classify these five categories of surgical feedback from inputs of text, audio, and video modalities. The ultimate goal of our work is to help automate the annotation of real-time contextual surgical feedback at scale. Our automated classification of surgical feedback achieves AUCs ranging from 71.5 to 77.6 with the fusion improving performance by 3.1%. We also show that high-quality manual transcriptions of feedback audio from experts improve AUCs to between 76.5 and 96.2, which demonstrates a clear path toward future improvements. Empirically, we find that the Staged training strategy, with first pre-training each modality separately and then training them jointly, is more effective than training different modalities altogether. We also present intuitive findings on the importance of modalities for different feedback categories. This work offers an important first look at the feasibility of automated classification of real-world live surgical feedback based on text, audio, and video modalities.

Procedures are inherently hierarchical. To "make videos", one may need to "purchase a camera", which in turn may require one to "set a budget". While such hierarchical knowledge is critical for reasoning about complex procedures, most existing work has treated procedures as shallow structures without modeling the parent-child relation. In this work, we attempt to construct an open-domain hierarchical knowledge-base (KB) of procedures based on wikiHow, a website containing more than 110k instructional articles, each documenting the steps to carry out a complex procedure. To this end, we develop a simple and efficient method that links steps (e.g., "purchase a camera") in an article to other articles with similar goals (e.g., "how to choose a camera"), recursively constructing the KB. Our method significantly outperforms several strong baselines according to automatic evaluation, human judgment, and application to downstream tasks such as instructional video retrieval. A demo with partial data can be found at https://wikihow-hierarchy.github.io. The code and the data are at https://github.com/shuyanzhou/wikihow_hierarchy.

Recent advances in learning multi-modal representation have witnessed the success in biomedical domains. While established techniques enable handling multi-modal information, the challenges are posed when extended to various clinical modalities and practical modalitymissing setting due to the inherent modality gaps. To tackle these, we propose an innovative Modality-prompted Heterogeneous Graph for Omnimodal Learning (GTP-4o), which embeds the numerous disparate clinical modalities into a unified representation, completes the deficient embedding of missing modality and reformulates the cross-modal learning with a graph-based aggregation. Specially, we establish a heterogeneous graph embedding to explicitly capture the diverse semantic properties on both the modality-specific features (nodes) and the cross-modal relations (edges). Then, we design a modality-prompted completion that enables completing the inadequate graph representation of missing modality through a graph prompting mechanism, which generates hallucination graphic topologies to steer the missing embedding towards the intact representation. Through the completed graph, we meticulously develop a knowledge-guided hierarchical cross-modal aggregation consisting of a global meta-path neighbouring to uncover the potential heterogeneous neighbors along the pathways driven by domain knowledge, and a local multi-relation aggregation module for the comprehensive cross-modal interaction across various heterogeneous relations. We assess the efficacy of our methodology on rigorous benchmarking experiments against prior state-of-the-arts. In a nutshell, GTP-4o presents an initial foray into the intriguing realm of embedding, relating and perceiving the heterogeneous patterns from various clinical modalities holistically via a graph theory. Project page: https://gtp-4-o.github.io/.

Contrastive learning methods, such as CLIP, leverage naturally paired data-for example, images and their corresponding text captions-to learn general representations that transfer efficiently to downstream tasks. While such approaches are generally applied to two modalities, domains such as robotics, healthcare, and video need to support many types of data at once. We show that the pairwise application of CLIP fails to capture joint information between modalities, thereby limiting the quality of the learned representations. To address this issue, we present Symile, a simple contrastive learning approach that captures higher-order information between any number of modalities. Symile provides a flexible, architecture-agnostic objective for learning modality-specific representations. To develop Symile's objective, we derive a lower bound on total correlation, and show that Symile representations for any set of modalities form a sufficient statistic for predicting the remaining modalities. Symile outperforms pairwise CLIP, even with modalities missing in the data, on cross-modal classification and retrieval across several experiments including on an original multilingual dataset of 33M image, text and audio samples and a clinical dataset of chest X-rays, electrocardiograms, and laboratory measurements. All datasets and code used in this work are publicly available at https://github.com/rajesh-lab/symile.

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

This book is the result of a seminar in which we reviewed multimodal approaches and attempted to create a solid overview of the field, starting with the current state-of-the-art approaches in the two subfields of Deep Learning individually. Further, modeling frameworks are discussed where one modality is transformed into the other, as well as models in which one modality is utilized to enhance representation learning for the other. To conclude the second part, architectures with a focus on handling both modalities simultaneously are introduced. Finally, we also cover other modalities as well as general-purpose multi-modal models, which are able to handle different tasks on different modalities within one unified architecture. One interesting application (Generative Art) eventually caps off this booklet.

Recently, the newly emerged multimodal models, which leverage both visual and linguistic modalities to train powerful encoders, have gained increasing attention. However, learning from a large-scale unlabeled dataset also exposes the model to the risk of potential poisoning attacks, whereby the adversary aims to perturb the model's training data to trigger malicious behaviors in it. In contrast to previous work, only poisoning visual modality, in this work, we take the first step to studying poisoning attacks against multimodal models in both visual and linguistic modalities. Specially, we focus on answering two questions: (1) Is the linguistic modality also vulnerable to poisoning attacks? and (2) Which modality is most vulnerable? To answer the two questions, we propose three types of poisoning attacks against multimodal models. Extensive evaluations on different datasets and model architectures show that all three attacks can achieve significant attack performance while maintaining model utility in both visual and linguistic modalities. Furthermore, we observe that the poisoning effect differs between different modalities. To mitigate the attacks, we propose both pre-training and post-training defenses. We empirically show that both defenses can significantly reduce the attack performance while preserving the model's utility.

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.

Large Multimodal Models (LMMs) have shown remarkable progress in the field of medical Visual Question Answering (Med-VQA), achieving high accuracy on existing benchmarks. However, their reliability under robust evaluation is questionable. This study reveals that state-of-the-art models, when subjected to simple probing evaluation, perform worse than random guessing on medical diagnosis questions. To address this critical evaluation problem, we introduce the Probing Evaluation for Medical Diagnosis (ProbMed) dataset to rigorously assess LMM performance in medical imaging through probing evaluation and procedural diagnosis. Particularly, probing evaluation features pairing original questions with negation questions with hallucinated attributes, while procedural diagnosis requires reasoning across various diagnostic dimensions for each image, including modality recognition, organ identification, clinical findings, abnormalities, and positional grounding. Our evaluation reveals that top-performing models like GPT-4V and Gemini Pro perform worse than random guessing on specialized diagnostic questions, indicating significant limitations in handling fine-grained medical inquiries. Besides, models like LLaVA-Med struggle even with more general questions, and results from CheXagent demonstrate the transferability of expertise across different modalities of the same organ, showing that specialized domain knowledge is still crucial for improving performance. This study underscores the urgent need for more robust evaluation to ensure the reliability of LMMs in critical fields like medical diagnosis, and current LMMs are still far from applicable to those fields.

Embodied agents have achieved prominent performance in following human instructions to complete tasks. However, the potential of providing instructions informed by texts and images to assist humans in completing tasks remains underexplored. To uncover this capability, we present the multimodal procedural planning (MPP) task, in which models are given a high-level goal and generate plans of paired text-image steps, providing more complementary and informative guidance than unimodal plans. The key challenges of MPP are to ensure the informativeness, temporal coherence,and accuracy of plans across modalities. To tackle this, we propose Text-Image Prompting (TIP), a dual-modality prompting method that jointly leverages zero-shot reasoning ability in large language models (LLMs) and compelling text-to-image generation ability from diffusion-based models. TIP improves the interaction in the dual modalities using Text-to-Image Bridge and Image-to-Text Bridge, allowing LLMs to guide the textual-grounded image plan generation and leveraging the descriptions of image plans to ground the textual plan reversely. To address the lack of relevant datasets, we collect WIKIPLAN and RECIPEPLAN as a testbed for MPP. Our results show compelling human preferences and automatic scores against unimodal and multimodal baselines on WIKIPLAN and RECIPEPLAN in terms of informativeness, temporal coherence, and plan accuracy. Our code and data: https://github.com/YujieLu10/MPP.

Problem: Effective patient-centered communication is a core competency for physicians. However, both seasoned providers and medical trainees report decreased confidence in leading conversations on sensitive topics such as goals of care or end-of-life discussions. The significant administrative burden and the resources required to provide dedicated training in leading difficult conversations has been a long-standing problem in medical education. Approach: In this work, we present a novel educational tool designed to facilitate interactive, real-time simulations of difficult conversations in a video-based format through the use of multimodal generative artificial intelligence (AI). Leveraging recent advances in language modeling, computer vision, and generative audio, this tool creates realistic, interactive scenarios with avatars, or "synthetic patients." These synthetic patients interact with users throughout various stages of medical care using a custom-built video chat application, offering learners the chance to practice conversations with patients from diverse belief systems, personalities, and ethnic backgrounds. Outcomes: While the development of this platform demanded substantial upfront investment in labor, it offers a highly-realistic simulation experience with minimal financial investment. For medical trainees, this educational tool can be implemented within programs to simulate patient-provider conversations and can be incorporated into existing palliative care curriculum to provide a scalable, high-fidelity simulation environment for mastering difficult conversations. Next Steps: Future developments will explore enhancing the authenticity of these encounters by working with patients to incorporate their histories and personalities, as well as employing the use of AI-generated evaluations to offer immediate, constructive feedback to learners post-simulation.

Segment Anything Model (SAM) has gained significant attention because of its ability to segment a variety of objects in images given a prompt. The recently developed SAM 2 has extended this ability to video inputs. This opens an opportunity to apply SAM to 3D images, one of the fundamental tasks in the medical imaging field. In this paper, we provide an extensive evaluation of SAM 2's ability to segment both 2D and 3D medical images. We collect 18 medical imaging datasets, including common 3D modalities such as computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography (PET) as well as 2D modalities such as X-ray and ultrasound. We consider two evaluation pipelines of SAM 2: (1) multi-frame 3D segmentation, where prompts are provided to one or multiple slice(s) selected from the volume, and (2) single-frame 2D segmentation, where prompts are provided to each slice. The former is only applicable to 3D modalities, while the latter applies to both 2D and 3D modalities. We learn that SAM 2 exhibits similar performance as SAM under single-frame 2D segmentation, and has variable performance under multi-frame 3D segmentation depending on the choices of slices to annotate, the direction of the propagation, the predictions utilized during the propagation, etc.

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

Colonoscopy is currently one of the most sensitive screening methods for colorectal cancer. This study investigates the frontiers of intelligent colonoscopy techniques and their prospective implications for multimodal medical applications. With this goal, we begin by assessing the current data-centric and model-centric landscapes through four tasks for colonoscopic scene perception, including classification, detection, segmentation, and vision-language understanding. This assessment enables us to identify domain-specific challenges and reveals that multimodal research in colonoscopy remains open for further exploration. To embrace the coming multimodal era, we establish three foundational initiatives: a large-scale multimodal instruction tuning dataset ColonINST, a colonoscopy-designed multimodal language model ColonGPT, and a multimodal benchmark. To facilitate ongoing monitoring of this rapidly evolving field, we provide a public website for the latest updates: https://github.com/ai4colonoscopy/IntelliScope.

A common practice in deep learning involves training large neural networks on massive datasets to achieve high accuracy across various domains and tasks. While this approach works well in many application areas, it often fails drastically when processing data from a new modality with a significant distribution shift from the data used to pre-train the model. This paper focuses on adapting a large object detection model trained on RGB images to new data extracted from IR images with a substantial modality shift. We propose Modality Translator (ModTr) as an alternative to the common approach of fine-tuning a large model to the new modality. ModTr adapts the IR input image with a small transformation network trained to directly minimize the detection loss. The original RGB model can then work on the translated inputs without any further changes or fine-tuning to its parameters. Experimental results on translating from IR to RGB images on two well-known datasets show that our simple approach provides detectors that perform comparably or better than standard fine-tuning, without forgetting the knowledge of the original model. This opens the door to a more flexible and efficient service-based detection pipeline, where a unique and unaltered server, such as an RGB detector, runs constantly while being queried by different modalities, such as IR with the corresponding translations model. Our code is available at: https://github.com/heitorrapela/ModTr.

We propose to improve transformers of a specific modality with irrelevant data from other modalities, e.g., improve an ImageNet model with audio or point cloud datasets. We would like to highlight that the data samples of the target modality are irrelevant to the other modalities, which distinguishes our method from other works utilizing paired (e.g., CLIP) or interleaved data of different modalities. We propose a methodology named Multimodal Pathway - given a target modality and a transformer designed for it, we use an auxiliary transformer trained with data of another modality and construct pathways to connect components of the two models so that data of the target modality can be processed by both models. In this way, we utilize the universal sequence-to-sequence modeling abilities of transformers obtained from two modalities. As a concrete implementation, we use a modality-specific tokenizer and task-specific head as usual but utilize the transformer blocks of the auxiliary model via a proposed method named Cross-Modal Re-parameterization, which exploits the auxiliary weights without any inference costs. On the image, point cloud, video, and audio recognition tasks, we observe significant and consistent performance improvements with irrelevant data from other modalities. The code and models are available at https://github.com/AILab-CVC/M2PT.

Multimodal foundation models that can holistically process text alongside images, video, audio, and other sensory modalities are increasingly used in a variety of real-world applications. However, it is challenging to characterize and study progress in multimodal foundation models, given the range of possible modeling decisions, tasks, and domains. In this paper, we introduce Holistic Evaluation of Multimodal Models (HEMM) to systematically evaluate the capabilities of multimodal foundation models across a set of 3 dimensions: basic skills, information flow, and real-world use cases. Basic multimodal skills are internal abilities required to solve problems, such as learning interactions across modalities, fine-grained alignment, multi-step reasoning, and the ability to handle external knowledge. Information flow studies how multimodal content changes during a task through querying, translation, editing, and fusion. Use cases span domain-specific challenges introduced in real-world multimedia, affective computing, natural sciences, healthcare, and human-computer interaction applications. Through comprehensive experiments across the 30 tasks in HEMM, we (1) identify key dataset dimensions (e.g., basic skills, information flows, and use cases) that pose challenges to today's models, and (2) distill performance trends regarding how different modeling dimensions (e.g., scale, pre-training data, multimodal alignment, pre-training, and instruction tuning objectives) influence performance. Our conclusions regarding challenging multimodal interactions, use cases, and tasks requiring reasoning and external knowledge, the benefits of data and model scale, and the impacts of instruction tuning yield actionable insights for future work in multimodal foundation models.

Multimodal models have gained significant success in recent years. Standard multimodal approaches often assume unchanged modalities from training stage to inference stage. In practice, however, many scenarios fail to satisfy such assumptions with missing modalities during inference, leading to limitations on where multimodal models can be applied. While existing methods mitigate the problem through reconstructing the missing modalities, it increases unnecessary computational cost, which could be just as critical, especially for large, deployed systems. To solve the problem from both sides, we propose a novel guidance network that promotes knowledge sharing during training, taking advantage of the multimodal representations to train better single-modality models for inference. Real-life experiment in violence detection shows that our proposed framework trains single-modality models that significantly outperform its traditionally trained counterparts while maintaining the same inference cost.

Multimodal large language models (MLLMs) can simultaneously process visual, textual, and auditory data, capturing insights that complement human analysis. However, existing video question-answering (VidQA) benchmarks and datasets often exhibit a bias toward a single modality, despite the goal of requiring advanced reasoning skills that integrate diverse modalities to answer the queries. In this work, we introduce the modality importance score (MIS) to identify such bias. It is designed to assess which modality embeds the necessary information to answer the question. Additionally, we propose an innovative method using state-of-the-art MLLMs to estimate the modality importance, which can serve as a proxy for human judgments of modality perception. With this MIS, we demonstrate the presence of unimodal bias and the scarcity of genuinely multimodal questions in existing datasets. We further validate the modality importance score with multiple ablation studies to evaluate the performance of MLLMs on permuted feature sets. Our results indicate that current models do not effectively integrate information due to modality imbalance in existing datasets. Our proposed MLLM-derived MIS can guide the curation of modality-balanced datasets that advance multimodal learning and enhance MLLMs' capabilities to understand and utilize synergistic relations across modalities.

The field of computer vision applied to videos of minimally invasive surgery is ever-growing. Workflow recognition pertains to the automated recognition of various aspects of a surgery: including which surgical steps are performed; and which surgical instruments are used. This information can later be used to assist clinicians when learning the surgery; during live surgery; and when writing operation notes. The Pituitary Vision (PitVis) 2023 Challenge tasks the community to step and instrument recognition in videos of endoscopic pituitary surgery. This is a unique task when compared to other minimally invasive surgeries due to the smaller working space, which limits and distorts vision; and higher frequency of instrument and step switching, which requires more precise model predictions. Participants were provided with 25-videos, with results presented at the MICCAI-2023 conference as part of the Endoscopic Vision 2023 Challenge in Vancouver, Canada, on 08-Oct-2023. There were 18-submissions from 9-teams across 6-countries, using a variety of deep learning models. A commonality between the top performing models was incorporating spatio-temporal and multi-task methods, with greater than 50% and 10% macro-F1-score improvement over purely spacial single-task models in step and instrument recognition respectively. The PitVis-2023 Challenge therefore demonstrates state-of-the-art computer vision models in minimally invasive surgery are transferable to a new dataset, with surgery specific techniques used to enhance performance, progressing the field further. Benchmark results are provided in the paper, and the dataset is publicly available at: https://doi.org/10.5522/04/26531686.

Medicine is inherently multimodal, with rich data modalities spanning text, imaging, genomics, and more. Generalist biomedical artificial intelligence (AI) systems that flexibly encode, integrate, and interpret this data at scale can potentially enable impactful applications ranging from scientific discovery to care delivery. To enable the development of these models, we first curate MultiMedBench, a new multimodal biomedical benchmark. MultiMedBench encompasses 14 diverse tasks such as medical question answering, mammography and dermatology image interpretation, radiology report generation and summarization, and genomic variant calling. We then introduce Med-PaLM Multimodal (Med-PaLM M), our proof of concept for a generalist biomedical AI system. Med-PaLM M is a large multimodal generative model that flexibly encodes and interprets biomedical data including clinical language, imaging, and genomics with the same set of model weights. Med-PaLM M reaches performance competitive with or exceeding the state of the art on all MultiMedBench tasks, often surpassing specialist models by a wide margin. We also report examples of zero-shot generalization to novel medical concepts and tasks, positive transfer learning across tasks, and emergent zero-shot medical reasoning. To further probe the capabilities and limitations of Med-PaLM M, we conduct a radiologist evaluation of model-generated (and human) chest X-ray reports and observe encouraging performance across model scales. In a side-by-side ranking on 246 retrospective chest X-rays, clinicians express a pairwise preference for Med-PaLM M reports over those produced by radiologists in up to 40.50% of cases, suggesting potential clinical utility. While considerable work is needed to validate these models in real-world use cases, our results represent a milestone towards the development of generalist biomedical AI systems.

Machine learning systems are often deployed in domains that entail data from multiple modalities, for example, phenotypic and genotypic characteristics describe patients in healthcare. Previous works have developed multimodal variational autoencoders (VAEs) that generate several modalities. We consider subjective data, where single datapoints from one modality (such as class labels) describe multiple datapoints from another modality (such as images). We theoretically and empirically demonstrate that multimodal VAEs with a mixture of experts posterior can struggle to capture variability in such surjective data.

Though the success of CLIP-based training recipes in vision-language models, their scalability to more modalities (e.g., 3D, audio, etc.) is limited to large-scale data, which is expensive or even inapplicable for rare modalities. In this paper, we present ViT-Lens that facilitates efficient omni-modal representation learning by perceiving novel modalities with a pretrained ViT and aligning to a pre-defined space. Specifically, the modality-specific lens is tuned to project multimodal signals to the shared embedding space, which are then processed by a strong ViT that carries pre-trained image knowledge. The encoded multimodal representations are optimized toward aligning with the modal-independent space, pre-defined by off-the-shelf foundation models. A well-trained lens with a ViT backbone has the potential to serve as one of these foundation models, supervising the learning of subsequent modalities. ViT-Lens provides a unified solution for representation learning of increasing modalities with two appealing benefits: (i) Exploiting the pretrained ViT across tasks and domains effectively with efficient data regime; (ii) Emergent downstream capabilities of novel modalities are demonstrated due to the modality alignment space. We evaluate ViT-Lens in the context of 3D as an initial verification. In zero-shot 3D classification, ViT-Lens achieves substantial improvements over previous state-of-the-art, showing 52.0% accuracy on Objaverse-LVIS, 87.4% on ModelNet40, and 60.6% on ScanObjectNN. Furthermore, we enable zero-shot 3D question-answering by simply integrating the trained 3D lens into the InstructBLIP model without any adaptation. We will release the results of ViT-Lens on more modalities in the near future.

Due to the remarkable capabilities of powerful Large Language Models (LLMs) in effectively following instructions, there has been a growing number of assistants in the community to assist humans. Recently, significant progress has been made in the development of Vision Language Models (VLMs), expanding the capabilities of LLMs and enabling them to execute more diverse instructions. However, it is foreseeable that models will likely need to handle tasks involving additional modalities such as speech, video, and others. This poses a particularly prominent challenge of dealing with the complexity of mixed modalities. To address this, we introduce a novel architecture called PILL: Plug Into LLM with adapter expert and attention gate to better decouple these complex modalities and leverage efficient fine-tuning. We introduce two modules: Firstly, utilizing Mixture-of-Modality-Adapter-Expert to independently handle different modalities, enabling better adaptation to downstream tasks while preserving the expressive capability of the original model. Secondly, by introducing Modality-Attention-Gating, which enables adaptive control of the contribution of modality tokens to the overall representation. In addition, we have made improvements to the Adapter to enhance its learning and expressive capabilities. Experimental results demonstrate that our approach exhibits competitive performance compared to other mainstream methods for modality fusion. For researchers interested in our work, we provide free access to the code and models at https://github.com/DsaltYfish/PILL.

In medical vision, different imaging modalities provide complementary information. However, in practice, not all modalities may be available during inference or even training. Previous approaches, e.g., knowledge distillation or image synthesis, often assume the availability of full modalities for all patients during training; this is unrealistic and impractical due to the variability in data collection across sites. We propose a novel approach to learn enhanced modality-agnostic representations by employing a meta-learning strategy in training, even when only limited full modality samples are available. Meta-learning enhances partial modality representations to full modality representations by meta-training on partial modality data and meta-testing on limited full modality samples. Additionally, we co-supervise this feature enrichment by introducing an auxiliary adversarial learning branch. More specifically, a missing modality detector is used as a discriminator to mimic the full modality setting. Our segmentation framework significantly outperforms state-of-the-art brain tumor segmentation techniques in missing modality scenarios.

Multimodal learning is a rapidly growing research field that has revolutionized multitasking and generative modeling in AI. While much of the research has focused on dealing with unstructured data (e.g., language, images, audio, or video), structured data (e.g., tabular data, time series, or signals) has received less attention. However, many industry-relevant use cases involve or can be benefited from both types of data. In this work, we propose a modular, end-to-end multimodal learning method called MAGNUM, which can natively handle both structured and unstructured data. MAGNUM is flexible enough to employ any specialized unimodal module to extract, compress, and fuse information from all available modalities.

Computed Tomography (CT) is one of the most popular modalities for medical imaging. By far, CT images have contributed to the largest publicly available datasets for volumetric medical segmentation tasks, covering full-body anatomical structures. Large amounts of full-body CT images provide the opportunity to pre-train powerful models, e.g., STU-Net pre-trained in a supervised fashion, to segment numerous anatomical structures. However, it remains unclear in which conditions these pre-trained models can be transferred to various downstream medical segmentation tasks, particularly segmenting the other modalities and diverse targets. To address this problem, a large-scale benchmark for comprehensive evaluation is crucial for finding these conditions. Thus, we collected 87 public datasets varying in modality, target, and sample size to evaluate the transfer ability of full-body CT pre-trained models. We then employed a representative model, STU-Net with multiple model scales, to conduct transfer learning across modalities and targets. Our experimental results show that (1) there may be a bottleneck effect concerning the dataset size in fine-tuning, with more improvement on both small- and large-scale datasets than medium-size ones. (2) Models pre-trained on full-body CT demonstrate effective modality transfer, adapting well to other modalities such as MRI. (3) Pre-training on the full-body CT not only supports strong performance in structure detection but also shows efficacy in lesion detection, showcasing adaptability across target tasks. We hope that this large-scale open evaluation of transfer learning can direct future research in volumetric medical image segmentation.

This study investigates self-supervised learning techniques to obtain representations of Event Sequences. It is a key modality in various applications, including but not limited to banking, e-commerce, and healthcare. We perform a comprehensive study of generative and contrastive approaches in self-supervised learning, applying them both independently. We find that there is no single supreme method. Consequently, we explore the potential benefits of combining these approaches. To achieve this goal, we introduce a novel method that aligns generative and contrastive embeddings as distinct modalities, drawing inspiration from contemporary multimodal research. Generative and contrastive approaches are often treated as mutually exclusive, leaving a gap for their combined exploration. Our results demonstrate that this aligned model performs at least on par with, and mostly surpasses, existing methods and is more universal across a variety of tasks. Furthermore, we demonstrate that self-supervised methods consistently outperform the supervised approach on our datasets.

We introduce OmnixR, an evaluation suite designed to benchmark SoTA Omni-modality Language Models, such as GPT-4o and Gemini. Evaluating OLMs, which integrate multiple modalities such as text, vision, and audio, presents unique challenges. Particularly, the user message might often consist of multiple modalities, such that OLMs have to establish holistic understanding and reasoning across modalities to accomplish the task. Existing benchmarks are limited to single modality or dual-modality tasks, overlooking comprehensive multi-modal assessments of model reasoning. To address this, OmnixR offers two evaluation variants: (1)synthetic subset: a synthetic dataset generated automatically by translating text into multiple modalities--audio, images, video, and hybrids (Omnify). (2)realistic subset: a real-world dataset, manually curated and annotated by experts, for evaluating cross-modal reasoning in natural settings. OmnixR presents a unique evaluation towards assessing OLMs over a diverse mix of modalities, such as a question that involves video, audio, and text, providing a rigorous cross-modal reasoning testbed unlike any existing benchmarks. Our experiments find that all state-of-the-art OLMs struggle with OmnixR questions that require integrating information from multiple modalities to answer. Further analysis highlights differences in reasoning behavior, underscoring the challenges of omni-modal AI alignment.

Drug discovery typically consists of multiple steps, including identifying a target protein key to a disease's etiology, validating that interacting with this target could prevent symptoms or cure the disease, discovering a small molecule or biologic therapeutic to interact with it, and optimizing the candidate molecule through a complex landscape of required properties. Drug discovery related tasks often involve prediction and generation while considering multiple entities that potentially interact, which poses a challenge for typical AI models. For this purpose we present MAMMAL - Molecular Aligned Multi-Modal Architecture and Language - a method that we applied to create a versatile multi-task foundation model ibm/biomed.omics.bl.sm.ma-ted-458m that learns from large-scale biological datasets (2 billion samples) across diverse modalities, including proteins, small molecules, and genes. We introduce a prompt syntax that supports a wide range of classification, regression, and generation tasks. It allows combining different modalities and entity types as inputs and/or outputs. Our model handles combinations of tokens and scalars and enables the generation of small molecules and proteins, property prediction, and transcriptomic lab test predictions. We evaluated the model on 11 diverse downstream tasks spanning different steps within a typical drug discovery pipeline, where it reaches new SOTA in 9 tasks and is comparable to SOTA in 2 tasks. This performance is achieved while using a unified architecture serving all tasks, in contrast to the original SOTA performance achieved using tailored architectures. The model code and pretrained weights are publicly available at https://github.com/BiomedSciAI/biomed-multi-alignment and https://huggingface.co/ibm/biomed.omics.bl.sm.ma-ted-458m.

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.

We present Composable Diffusion (CoDi), a novel generative model capable of generating any combination of output modalities, such as language, image, video, or audio, from any combination of input modalities. Unlike existing generative AI systems, CoDi can generate multiple modalities in parallel and its input is not limited to a subset of modalities like text or image. Despite the absence of training datasets for many combinations of modalities, we propose to align modalities in both the input and output space. This allows CoDi to freely condition on any input combination and generate any group of modalities, even if they are not present in the training data. CoDi employs a novel composable generation strategy which involves building a shared multimodal space by bridging alignment in the diffusion process, enabling the synchronized generation of intertwined modalities, such as temporally aligned video and audio. Highly customizable and flexible, CoDi achieves strong joint-modality generation quality, and outperforms or is on par with the unimodal state-of-the-art for single-modality synthesis. The project page with demonstrations and code is at https://codi-gen.github.io

In this work, we introduce Multiple Embedding Model for EHR (MEME), an approach that views Electronic Health Records (EHR) as multimodal data. This approach incorporates "pseudo-notes", textual representations of tabular EHR concepts such as diagnoses and medications, and allows us to effectively employ Large Language Models (LLMs) for EHR representation. This framework also adopts a multimodal approach, embedding each EHR modality separately. We demonstrate the effectiveness of MEME by applying it to several tasks within the Emergency Department across multiple hospital systems. Our findings show that MEME surpasses the performance of both single modality embedding methods and traditional machine learning approaches. However, we also observe notable limitations in generalizability across hospital institutions for all tested models.

In this paper, we propose a multi-modal search engine for interior design that combines visual and textual queries. The goal of our engine is to retrieve interior objects, e.g. furniture or wall clocks, that share visual and aesthetic similarities with the query. Our search engine allows the user to take a photo of a room and retrieve with a high recall a list of items identical or visually similar to those present in the photo. Additionally, it allows to return other items that aesthetically and stylistically fit well together. To achieve this goal, our system blends the results obtained using textual and visual modalities. Thanks to this blending strategy, we increase the average style similarity score of the retrieved items by 11%. Our work is implemented as a Web-based application and it is planned to be opened to the public.

Reinforcement learning from human feedback (RLHF) has proven effective in enhancing the instruction-following capabilities of large language models; however, it remains underexplored in the cross-modality domain. As the number of modalities increases, aligning all-modality models with human intentions -- such as instruction following -- becomes a pressing challenge. In this work, we make the first attempt to fine-tune all-modality models (i.e. input and output with any modality, also named any-to-any models) using human preference data across all modalities (including text, image, audio, and video), ensuring its behavior aligns with human intentions. This endeavor presents several challenges. First, there is no large-scale all-modality human preference data in existing open-source resources, as most datasets are limited to specific modalities, predominantly text and image. Secondly, the effectiveness of binary preferences in RLHF for post-training alignment in complex all-modality scenarios remains an unexplored area. Finally, there is a lack of a systematic framework to evaluate the capabilities of all-modality models, particularly regarding modality selection and synergy. To address these challenges, we propose the align-anything framework, which includes meticulously annotated 200k all-modality human preference data. Then, we introduce an alignment method that learns from unified language feedback, effectively capturing complex modality-specific human preferences and enhancing the model's instruction-following capabilities. Furthermore, to assess performance improvements in all-modality models after post-training alignment, we construct a challenging all-modality capability evaluation framework -- eval-anything. All data, models, and code frameworks have been open-sourced for the community. For more details, please refer to https://github.com/PKU-Alignment/align-anything.

We introduce X-VILA, an omni-modality model designed to extend the capabilities of large language models (LLMs) by incorporating image, video, and audio modalities. By aligning modality-specific encoders with LLM inputs and diffusion decoders with LLM outputs, X-VILA achieves cross-modality understanding, reasoning, and generation. To facilitate this cross-modality alignment, we curate an effective interleaved any-to-any modality instruction-following dataset. Furthermore, we identify a significant problem with the current cross-modality alignment method, which results in visual information loss. To address the issue, we propose a visual alignment mechanism with a visual embedding highway module. We then introduce a resource-efficient recipe for training X-VILA, that exhibits proficiency in any-to-any modality conversation, surpassing previous approaches by large margins. X-VILA also showcases emergent properties across modalities even in the absence of similar training data. The project will be made open-source.

Information retrieval is an ever-evolving and crucial research domain. The substantial demand for high-quality human motion data especially in online acquirement has led to a surge in human motion research works. Prior works have mainly concentrated on dual-modality learning, such as text and motion tasks, but three-modality learning has been rarely explored. Intuitively, an extra introduced modality can enrich a model's application scenario, and more importantly, an adequate choice of the extra modality can also act as an intermediary and enhance the alignment between the other two disparate modalities. In this work, we introduce LAVIMO (LAnguage-VIdeo-MOtion alignment), a novel framework for three-modality learning integrating human-centric videos as an additional modality, thereby effectively bridging the gap between text and motion. Moreover, our approach leverages a specially designed attention mechanism to foster enhanced alignment and synergistic effects among text, video, and motion modalities. Empirically, our results on the HumanML3D and KIT-ML datasets show that LAVIMO achieves state-of-the-art performance in various motion-related cross-modal retrieval tasks, including text-to-motion, motion-to-text, video-to-motion and motion-to-video.

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

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

The automated generation of imaging reports proves invaluable in alleviating the workload of radiologists. A clinically applicable reports generation algorithm should demonstrate its effectiveness in producing reports that accurately describe radiology findings and attend to patient-specific indications. In this paper, we introduce a novel method, Structural Entities extraction and patient indications Incorporation (SEI) for chest X-ray report generation. Specifically, we employ a structural entities extraction (SEE) approach to eliminate presentation-style vocabulary in reports and improve the quality of factual entity sequences. This reduces the noise in the following cross-modal alignment module by aligning X-ray images with factual entity sequences in reports, thereby enhancing the precision of cross-modal alignment and further aiding the model in gradient-free retrieval of similar historical cases. Subsequently, we propose a cross-modal fusion network to integrate information from X-ray images, similar historical cases, and patient-specific indications. This process allows the text decoder to attend to discriminative features of X-ray images, assimilate historical diagnostic information from similar cases, and understand the examination intention of patients. This, in turn, assists in triggering the text decoder to produce high-quality reports. Experiments conducted on MIMIC-CXR validate the superiority of SEI over state-of-the-art approaches on both natural language generation and clinical efficacy metrics.

Image modality is not perfect as it often fails in certain conditions, e.g., night and fast motion. This significantly limits the robustness and versatility of existing multi-modal (i.e., Image+X) semantic segmentation methods when confronting modality absence or failure, as often occurred in real-world applications. Inspired by the open-world learning capability of multi-modal vision-language models (MVLMs), we explore a new direction in learning the modality-agnostic representation via knowledge distillation (KD) from MVLMs. Intuitively, we propose Any2Seg, a novel framework that can achieve robust segmentation from any combination of modalities in any visual conditions. Specifically, we first introduce a novel language-guided semantic correlation distillation (LSCD) module to transfer both inter-modal and intra-modal semantic knowledge in the embedding space from MVLMs, e.g., LanguageBind. This enables us to minimize the modality gap and alleviate semantic ambiguity to combine any modalities in any visual conditions. Then, we introduce a modality-agnostic feature fusion (MFF) module that reweights the multi-modal features based on the inter-modal correlation and selects the fine-grained feature. This way, our Any2Seg finally yields an optimal modality-agnostic representation. Extensive experiments on two benchmarks with four modalities demonstrate that Any2Seg achieves the state-of-the-art under the multi-modal setting (+3.54 mIoU) and excels in the challenging modality-incomplete setting(+19.79 mIoU).

In this paper, we introduce a novel Multi-Modal Contrastive Pre-training Framework that synergistically combines X-rays, electrocardiograms (ECGs), and radiology/cardiology reports. Our approach leverages transformers to encode these diverse modalities into a unified representation space, aiming to enhance diagnostic accuracy and facilitate comprehensive patient assessments. We utilize LoRA-Peft to significantly reduce trainable parameters in the LLM and incorporate recent linear attention dropping strategy in the Vision Transformer(ViT) for smoother attention. Furthermore, we provide novel multimodal attention explanations and retrieval for our model. To the best of our knowledge, we are the first to propose an integrated model that combines X-ray, ECG, and Radiology/Cardiology Report with this approach. By utilizing contrastive loss, MoRE effectively aligns modality-specific features into a coherent embedding, which supports various downstream tasks such as zero-shot classification and multimodal retrieval. Employing our proposed methodology, we achieve state-of-the-art (SOTA) on the Mimic-IV, CheXpert, Edema Severity, and PtbXl downstream datasets, surpassing existing multimodal approaches. Our proposed framework shows significant improvements in capturing intricate inter-modal relationships and its robustness in medical diagnosis that establishes a framework for future research in multimodal learning in the healthcare sector.

Computed tomography and magnetic resonance imaging are two widely used clinical imaging modalities for non-invasive diagnosis. However, both of these modalities come with certain problems. CT uses harmful ionising radiation, and MRI suffers from slow acquisition speed. Both problems can be tackled by undersampling, such as sparse sampling. However, such undersampled data leads to lower resolution and introduces artefacts. Several techniques, including deep learning based methods, have been proposed to reconstruct such data. However, the undersampled reconstruction problem for these two modalities was always considered as two different problems and tackled separately by different research works. This paper proposes a unified solution for both sparse CT and undersampled radial MRI reconstruction, achieved by applying Fourier transform-based pre-processing on the radial MRI and then finally reconstructing both modalities using sinogram upsampling combined with filtered back-projection. The Primal-Dual network is a deep learning based method for reconstructing sparsely-sampled CT data. This paper introduces Primal-Dual UNet, which improves the Primal-Dual network in terms of accuracy and reconstruction speed. The proposed method resulted in an average SSIM of 0.932\textpm0.021 while performing sparse CT reconstruction for fan-beam geometry with a sparsity level of 16, achieving a statistically significant improvement over the previous model, which resulted in 0.919\textpm0.016. Furthermore, the proposed model resulted in 0.903\textpm0.019 and 0.957\textpm0.023 average SSIM while reconstructing undersampled brain and abdominal MRI data with an acceleration factor of 16, respectively - statistically significant improvements over the original model, which resulted in 0.867\textpm0.025 and 0.949\textpm0.025.

The multifaceted nature of human perception and comprehension indicates that, when we think, our body can naturally take any combination of senses, a.k.a., modalities and form a beautiful picture in our brain. For example, when we see a cattery and simultaneously perceive the cat's purring sound, our brain can construct a picture of a cat in the cattery. Intuitively, generative AI models should hold the versatility of humans and be capable of generating images from any combination of modalities efficiently and collaboratively. This paper presents ImgAny, a novel end-to-end multi-modal generative model that can mimic human reasoning and generate high-quality images. Our method serves as the first attempt in its capacity of efficiently and flexibly taking any combination of seven modalities, ranging from language, audio to vision modalities, including image, point cloud, thermal, depth, and event data. Our key idea is inspired by human-level cognitive processes and involves the integration and harmonization of multiple input modalities at both the entity and attribute levels without specific tuning across modalities. Accordingly, our method brings two novel training-free technical branches: 1) Entity Fusion Branch ensures the coherence between inputs and outputs. It extracts entity features from the multi-modal representations powered by our specially constructed entity knowledge graph; 2) Attribute Fusion Branch adeptly preserves and processes the attributes. It efficiently amalgamates distinct attributes from diverse input modalities via our proposed attribute knowledge graph. Lastly, the entity and attribute features are adaptively fused as the conditional inputs to the pre-trained Stable Diffusion model for image generation. Extensive experiments under diverse modality combinations demonstrate its exceptional capability for visual content creation.

Image matching for both cross-view and cross-modality plays a critical role in multimodal perception. In practice, the modality gap caused by different imaging systems/styles poses great challenges to the matching task. Existing works try to extract invariant features for specific modalities and train on limited datasets, showing poor generalization. In this paper, we present MINIMA, a unified image matching framework for multiple cross-modal cases. Without pursuing fancy modules, our MINIMA aims to enhance universal performance from the perspective of data scaling up. For such purpose, we propose a simple yet effective data engine that can freely produce a large dataset containing multiple modalities, rich scenarios, and accurate matching labels. Specifically, we scale up the modalities from cheap but rich RGB-only matching data, by means of generative models. Under this setting, the matching labels and rich diversity of the RGB dataset are well inherited by the generated multimodal data. Benefiting from this, we construct MD-syn, a new comprehensive dataset that fills the data gap for general multimodal image matching. With MD-syn, we can directly train any advanced matching pipeline on randomly selected modality pairs to obtain cross-modal ability. Extensive experiments on in-domain and zero-shot matching tasks, including 19 cross-modal cases, demonstrate that our MINIMA can significantly outperform the baselines and even surpass modality-specific methods. The dataset and code are available at https://github.com/LSXI7/MINIMA .

Recent progress in 3D object generation has been fueled by the strong priors offered by diffusion models. However, existing models are tailored to specific tasks, accommodating only one modality at a time and necessitating retraining to change modalities. Given an image-to-3D model and a text prompt, a naive approach is to convert text prompts to images and then use the image-to-3D model for generation. This approach is both time-consuming and labor-intensive, resulting in unavoidable information loss during modality conversion. To address this, we introduce XBind, a unified framework for any-to-3D generation using cross-modal pre-alignment techniques. XBind integrates an multimodal-aligned encoder with pre-trained diffusion models to generate 3D objects from any modalities, including text, images, and audio. We subsequently present a novel loss function, termed Modality Similarity (MS) Loss, which aligns the embeddings of the modality prompts and the rendered images, facilitating improved alignment of the 3D objects with multiple modalities. Additionally, Hybrid Diffusion Supervision combined with a Three-Phase Optimization process improves the quality of the generated 3D objects. Extensive experiments showcase XBind's broad generation capabilities in any-to-3D scenarios. To our knowledge, this is the first method to generate 3D objects from any modality prompts. Project page: https://zeroooooooow1440.github.io/.

How do we most effectively treat a disease or condition? Ideally, we could consult a database of evidence gleaned from clinical trials to answer such questions. Unfortunately, no such database exists; clinical trial results are instead disseminated primarily via lengthy natural language articles. Perusing all such articles would be prohibitively time-consuming for healthcare practitioners; they instead tend to depend on manually compiled systematic reviews of medical literature to inform care. NLP may speed this process up, and eventually facilitate immediate consult of published evidence. The Evidence Inference dataset was recently released to facilitate research toward this end. This task entails inferring the comparative performance of two treatments, with respect to a given outcome, from a particular article (describing a clinical trial) and identifying supporting evidence. For instance: Does this article report that chemotherapy performed better than surgery for five-year survival rates of operable cancers? In this paper, we collect additional annotations to expand the Evidence Inference dataset by 25\%, provide stronger baseline models, systematically inspect the errors that these make, and probe dataset quality. We also release an abstract only (as opposed to full-texts) version of the task for rapid model prototyping. The updated corpus, documentation, and code for new baselines and evaluations are available at http://evidence-inference.ebm-nlp.com/.

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

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

Motivated by in-context learning (ICL) capabilities of Large Language models (LLMs), multimodal LLMs with additional visual modality are also exhibited with similar ICL abilities when multiple image-text pairs are provided as demonstrations. However, relatively less work has been done to investigate the principles behind how and why multimodal ICL works. We conduct a systematic and principled evaluation of multimodal ICL for models of different scales on a broad spectrum of new yet critical tasks. Through perturbations over different modality information, we show that modalities matter differently across tasks in multimodal ICL. Considering such modality impact, we further utilize modality-driven demonstration strategies to boost ICL performance. We also identify that demonstration selection is closely related to the models' ability to capture task inductive biases from multimodal ICL. Our principled analysis provides a comprehensive way of understanding the role of demonstrations in multimodal in-context learning, and sheds light on effectively improving multimodal ICL on a wide range of tasks even if those tasks are not seen in or even contradict pretraining data.

Standard multi-modal models assume the use of the same modalities in training and inference stages. However, in practice, the environment in which multi-modal models operate may not satisfy such assumption. As such, their performances degrade drastically if any modality is missing in the inference stage. We ask: how can we train a model that is robust to missing modalities? This paper seeks a set of good practices for multi-modal action recognition, with a particular interest in circumstances where some modalities are not available at an inference time. First, we study how to effectively regularize the model during training (e.g., data augmentation). Second, we investigate on fusion methods for robustness to missing modalities: we find that transformer-based fusion shows better robustness for missing modality than summation or concatenation. Third, we propose a simple modular network, ActionMAE, which learns missing modality predictive coding by randomly dropping modality features and tries to reconstruct them with the remaining modality features. Coupling these good practices, we build a model that is not only effective in multi-modal action recognition but also robust to modality missing. Our model achieves the state-of-the-arts on multiple benchmarks and maintains competitive performances even in missing modality scenarios. Codes are available at https://github.com/sangminwoo/ActionMAE.

Recent advancements in multimodal large language models (MLLMs) have aimed to integrate and interpret data across diverse modalities. However, the capacity of these models to concurrently process and reason about multiple modalities remains inadequately explored, partly due to the lack of comprehensive modality-wise benchmarks. We introduce OmniBench, a novel benchmark designed to rigorously evaluate models' ability to recognize, interpret, and reason across visual, acoustic, and textual inputs simultaneously. We define models capable of such tri-modal processing as omni-language models (OLMs). OmniBench is distinguished by high-quality human annotations, ensuring that accurate responses require integrated understanding and reasoning across all three modalities. Our main findings reveal that: i) open-source OLMs exhibit critical limitations in instruction-following and reasoning capabilities within tri-modal contexts; and ii) the baseline models perform poorly (below 50% accuracy) even when provided with alternative textual representations of images and audio. These results suggest that the ability to construct a consistent context from text, image, and audio is often overlooked in existing MLLM training paradigms. We advocate for future research to focus on developing more robust tri-modal integration techniques and training strategies to enhance OLM performance across diverse modalities. The codes and live leaderboard could be found at https://m-a-p.ai/OmniBench.

Extracting causal relationships from observed correlations is a growing area in probabilistic reasoning, originating with the seminal work of Pearl and others from the early 1990s. This paper develops a new, categorically oriented view based on a clear distinction between syntax (string diagrams) and semantics (stochastic matrices), connected via interpretations as structure-preserving functors. A key notion in the identification of causal effects is that of an intervention, whereby a variable is forcefully set to a particular value independent of any prior propensities. We represent the effect of such an intervention as an endofunctor which performs `string diagram surgery' within the syntactic category of string diagrams. This diagram surgery in turn yields a new, interventional distribution via the interpretation functor. While in general there is no way to compute interventional distributions purely from observed data, we show that this is possible in certain special cases using a calculational tool called comb disintegration. We demonstrate the use of this technique on a well-known toy example, where we predict the causal effect of smoking on cancer in the presence of a confounding common cause. After developing this specific example, we show this technique provides simple sufficient conditions for computing interventions which apply to a wide variety of situations considered in the causal inference literature.

The ability to provide fine-grained control for generating and editing visual imagery has profound implications for computer vision and its applications. Previous works have explored extending controllability in two directions: instruction tuning with text-based prompts and multi-modal conditioning. However, these works make one or more unnatural assumptions on the number and/or type of modality inputs used to express controllability. We propose InstructAny2Pix, a flexible multi-modal instruction-following system that enables users to edit an input image using instructions involving audio, images, and text. InstructAny2Pix consists of three building blocks that facilitate this capability: a multi-modal encoder that encodes different modalities such as images and audio into a unified latent space, a diffusion model that learns to decode representations in this latent space into images, and a multi-modal LLM that can understand instructions involving multiple images and audio pieces and generate a conditional embedding of the desired output, which can be used by the diffusion decoder. Additionally, to facilitate training efficiency and improve generation quality, we include an additional refinement prior module that enhances the visual quality of LLM outputs. These designs are critical to the performance of our system. We demonstrate that our system can perform a series of novel instruction-guided editing tasks. The code is available at https://github.com/jacklishufan/InstructAny2Pix.git

We address a challenging and practical task of labeling questions in speech in real time during telephone calls to emergency medical services in English, which embeds within a broader decision support system for emergency call-takers. We propose a novel multimodal approach to real-time sequence labeling in speech. Our model treats speech and its own textual representation as two separate modalities or views, as it jointly learns from streamed audio and its noisy transcription into text via automatic speech recognition. Our results show significant gains of jointly learning from the two modalities when compared to text or audio only, under adverse noise and limited volume of training data. The results generalize to medical symptoms detection where we observe a similar pattern of improvements with multimodal learning.

Building an intelligent and efficient medical assistant is still a challenging AI problem. The major limitation comes from the data modality scarceness, which reduces comprehensive patient perception. This demo paper presents the GigaPevt, the first multimodal medical assistant that combines the dialog capabilities of large language models with specialized medical models. Such an approach shows immediate advantages in dialog quality and metric performance, with a 1.18% accuracy improvement in the question-answering task.

Online medical consultation (OMC) restricts doctors to gathering patient information solely through inquiries, making the already complex sequential decision-making process of diagnosis even more challenging. Recently, the rapid advancement of large language models has demonstrated a significant potential to transform OMC. However, most studies have primarily focused on improving diagnostic accuracy under conditions of relatively sufficient information, while paying limited attention to the "inquiry" phase of the consultation process. This lack of focus has left the relationship between "inquiry" and "diagnosis" insufficiently explored. In this paper, we first extract real patient interaction strategies from authentic doctor-patient conversations and use these strategies to guide the training of a patient simulator that closely mirrors real-world behavior. By inputting medical records into our patient simulator to simulate patient responses, we conduct extensive experiments to explore the relationship between "inquiry" and "diagnosis" in the consultation process. Experimental results demonstrate that inquiry and diagnosis adhere to the Liebig's law: poor inquiry quality limits the effectiveness of diagnosis, regardless of diagnostic capability, and vice versa. Furthermore, the experiments reveal significant differences in the inquiry performance of various models. To investigate this phenomenon, we categorize the inquiry process into four types: (1) chief complaint inquiry; (2) specification of known symptoms; (3) inquiry about accompanying symptoms; and (4) gathering family or medical history. We analyze the distribution of inquiries across the four types for different models to explore the reasons behind their significant performance differences. We plan to open-source the weights and related code of our patient simulator at https://github.com/LIO-H-ZEN/PatientSimulator.

Textual health records of cancer patients are usually protracted and highly unstructured, making it very time-consuming for health professionals to get a complete overview of the patient's therapeutic course. As such limitations can lead to suboptimal and/or inefficient treatment procedures, healthcare providers would greatly benefit from a system that effectively summarizes the information of those records. With the advent of deep neural models, this objective has been partially attained for English clinical texts, however, the research community still lacks an effective solution for languages with limited resources. In this paper, we present the approach we developed to extract procedures, drugs, and diseases from oncology health records written in European Portuguese. This project was conducted in collaboration with the Portuguese Institute for Oncology which, besides holding over 10 years of duly protected medical records, also provided oncologist expertise throughout the development of the project. Since there is no annotated corpus for biomedical entity extraction in Portuguese, we also present the strategy we followed in annotating the corpus for the development of the models. The final models, which combined a neural architecture with entity linking, achieved F_1 scores of 88.6, 95.0, and 55.8 per cent in the mention extraction of procedures, drugs, and diseases, respectively.

In an effort to create a more efficient AI system, we introduce a new multi-modality learning framework that leverages a modality-agnostic concept space possessing abstract knowledge and a set of modality-specific projection models tailored to process distinct modality inputs and map them onto the concept space. Decoupled from specific modalities and their associated projection models, the concept space focuses on learning abstract knowledge that is universally applicable across modalities. Subsequently, the knowledge embedded into the concept space streamlines the learning processes of modality-specific projection models. We evaluate our framework on two popular tasks: Image-Text Matching and Visual Question Answering. Our framework achieves performance on par with benchmark models while demonstrating more efficient learning curves.

Clinical diagnosis is critical in medical practice, typically requiring a continuous and evolving process that includes primary diagnosis, differential diagnosis, and final diagnosis. However, most existing clinical diagnostic tasks are single-step processes, which does not align with the complex multi-step diagnostic procedures found in real-world clinical settings. In this paper, we propose a multi-step diagnostic task and annotate a clinical diagnostic dataset (MSDiagnosis). This dataset includes primary diagnosis, differential diagnosis, and final diagnosis questions. Additionally, we propose a novel and effective framework. This framework combines forward inference, backward inference, reflection, and refinement, enabling the LLM to self-evaluate and adjust its diagnostic results. To assess the effectiveness of our proposed method, we design and conduct extensive experiments. The experimental results demonstrate the effectiveness of the proposed method. We also provide a comprehensive experimental analysis and suggest future research directions for this task.

Videos serve as a powerful medium to convey ideas, tell stories, and provide detailed instructions, especially through long-format tutorials. Such tutorials are valuable for learning new skills at one's own pace, yet they can be overwhelming due to their length and dense content. Viewers often seek specific information, like precise measurements or step-by-step execution details, making it essential to extract and summarize key segments efficiently. An intelligent, time-sensitive video assistant capable of summarizing and detecting highlights in long videos is highly sought after. Recent advancements in Multimodal Large Language Models offer promising solutions to develop such an assistant. Our research explores the use of multimodal models to enhance video summarization and step-by-step instruction generation within specific domains. These models need to understand temporal events and relationships among actions across video frames. Our approach focuses on fine-tuning TimeChat to improve its performance in specific domains: cooking and medical procedures. By training the model on domain-specific datasets like Tasty for cooking and MedVidQA for medical procedures, we aim to enhance its ability to generate concise, accurate summaries of instructional videos. We curate and restructure these datasets to create high-quality video-centric instruction data. Our findings indicate that when finetuned on domain-specific procedural data, TimeChat can significantly improve the extraction and summarization of key instructional steps in long-format videos. This research demonstrates the potential of specialized multimodal models to assist with practical tasks by providing personalized, step-by-step guidance tailored to the unique aspects of each domain.

We introduce Radiology-GPT, a large language model for radiology. Using an instruction tuning approach on an extensive dataset of radiology domain knowledge, Radiology-GPT demonstrates superior performance compared to general language models such as StableLM, Dolly and LLaMA. It exhibits significant versatility in radiological diagnosis, research, and communication. This work serves as a catalyst for future developments in clinical NLP. The successful implementation of Radiology-GPT is indicative of the potential of localizing generative large language models, specifically tailored for distinctive medical specialties, while ensuring adherence to privacy standards such as HIPAA. The prospect of developing individualized, large-scale language models that cater to specific needs of various hospitals presents a promising direction. The fusion of conversational competence and domain-specific knowledge in these models is set to foster future development in healthcare AI. A demo of Radiology-GPT is available at https://huggingface.co/spaces/allen-eric/radiology-gpt.

Medical vision-and-language pre-training (Med-VLP) has received considerable attention owing to its applicability to extracting generic vision-and-language representations from medical images and texts. Most existing methods mainly contain three elements: uni-modal encoders (i.e., a vision encoder and a language encoder), a multi-modal fusion module, and pretext tasks, with few studies considering the importance of medical domain expert knowledge and explicitly exploiting such knowledge to facilitate Med-VLP. Although there exist knowledge-enhanced vision-and-language pre-training (VLP) methods in the general domain, most require off-the-shelf toolkits (e.g., object detectors and scene graph parsers), which are unavailable in the medical domain. In this paper, we propose a systematic and effective approach to enhance Med-VLP by structured medical knowledge from three perspectives. First, considering knowledge can be regarded as the intermediate medium between vision and language, we align the representations of the vision encoder and the language encoder through knowledge. Second, we inject knowledge into the multi-modal fusion model to enable the model to perform reasoning using knowledge as the supplementation of the input image and text. Third, we guide the model to put emphasis on the most critical information in images and texts by designing knowledge-induced pretext tasks. To perform a comprehensive evaluation and facilitate further research, we construct a medical vision-and-language benchmark including three tasks. Experimental results illustrate the effectiveness of our approach, where state-of-the-art performance is achieved on all downstream tasks. Further analyses explore the effects of different components of our approach and various settings of pre-training.

State-of-the-art vision and vision-and-language models rely on large-scale visio-linguistic pretraining for obtaining good performance on a variety of downstream tasks. Generally, such models are often either cross-modal (contrastive) or multi-modal (with earlier fusion) but not both; and they often only target specific modalities or tasks. A promising direction would be to use a single holistic universal model, as a "foundation", that targets all modalities at once -- a true vision and language foundation model should be good at vision tasks, language tasks, and cross- and multi-modal vision and language tasks. We introduce FLAVA as such a model and demonstrate impressive performance on a wide range of 35 tasks spanning these target modalities.

Multimodal sentiment analysis (MSA) and emotion recognition in conversation (ERC) are key research topics for computers to understand human behaviors. From a psychological perspective, emotions are the expression of affect or feelings during a short period, while sentiments are formed and held for a longer period. However, most existing works study sentiment and emotion separately and do not fully exploit the complementary knowledge behind the two. In this paper, we propose a multimodal sentiment knowledge-sharing framework (UniMSE) that unifies MSA and ERC tasks from features, labels, and models. We perform modality fusion at the syntactic and semantic levels and introduce contrastive learning between modalities and samples to better capture the difference and consistency between sentiments and emotions. Experiments on four public benchmark datasets, MOSI, MOSEI, MELD, and IEMOCAP, demonstrate the effectiveness of the proposed method and achieve consistent improvements compared with state-of-the-art methods.

While the field of multi-modal learning keeps growing fast, the deficiency of the standard joint training paradigm has become clear through recent studies. They attribute the sub-optimal performance of the jointly trained model to the modality competition phenomenon. Existing works attempt to improve the jointly trained model by modulating the training process. Despite their effectiveness, those methods can only apply to late fusion models. More importantly, the mechanism of the modality competition remains unexplored. In this paper, we first propose an adaptive gradient modulation method that can boost the performance of multi-modal models with various fusion strategies. Extensive experiments show that our method surpasses all existing modulation methods. Furthermore, to have a quantitative understanding of the modality competition and the mechanism behind the effectiveness of our modulation method, we introduce a novel metric to measure the competition strength. This metric is built on the mono-modal concept, a function that is designed to represent the competition-less state of a modality. Through systematic investigation, our results confirm the intuition that the modulation encourages the model to rely on the more informative modality. In addition, we find that the jointly trained model typically has a preferred modality on which the competition is weaker than other modalities. However, this preferred modality need not dominate others. Our code will be available at https://github.com/lihong2303/AGM_ICCV2023.

Recent advancements in mixed-modal generative models have enabled flexible integration of information across image-text content. These models have opened new avenues for developing unified biomedical assistants capable of analyzing biomedical images, answering complex questions about them, and predicting the impact of medical procedures on a patient's health. However, existing resources face challenges such as limited data availability, narrow domain coverage, and restricted sources (e.g., medical papers). To address these gaps, we present MedMax, the first large-scale multimodal biomedical instruction-tuning dataset for mixed-modal foundation models. With 1.47 million instances, MedMax encompasses a diverse range of tasks, including multimodal content generation (interleaved image-text data), biomedical image captioning and generation, visual chatting, and report understanding. These tasks span diverse medical domains such as radiology and histopathology. Subsequently, we fine-tune a mixed-modal foundation model on the MedMax dataset, achieving significant performance improvements: a 26% gain over the Chameleon model and an 18.3% improvement over GPT-4o across 12 downstream biomedical visual question-answering tasks. Additionally, we introduce a unified evaluation suite for biomedical tasks, providing a robust framework to guide the development of next-generation mixed-modal biomedical AI assistants.

Multi-modality image fusion is a technique that combines information from different sensors or modalities, enabling the fused image to retain complementary features from each modality, such as functional highlights and texture details. However, effective training of such fusion models is challenging due to the scarcity of ground truth fusion data. To tackle this issue, we propose the Equivariant Multi-Modality imAge fusion (EMMA) paradigm for end-to-end self-supervised learning. Our approach is rooted in the prior knowledge that natural imaging responses are equivariant to certain transformations. Consequently, we introduce a novel training paradigm that encompasses a fusion module, a pseudo-sensing module, and an equivariant fusion module. These components enable the net training to follow the principles of the natural sensing-imaging process while satisfying the equivariant imaging prior. Extensive experiments confirm that EMMA yields high-quality fusion results for infrared-visible and medical images, concurrently facilitating downstream multi-modal segmentation and detection tasks. The code is available at https://github.com/Zhaozixiang1228/MMIF-EMMA.

Recent text and image foundation models are incredibly impressive, and these models are attracting an ever-increasing portion of research resources. In this position piece we aim to shift the ML research community's priorities ever so slightly to a different modality: tabular data. Tabular data is the dominant modality in many fields, yet it is given hardly any research attention and significantly lags behind in terms of scale and power. We believe the time is now to start developing tabular foundation models, or what we coin a Large Tabular Model (LTM). LTMs could revolutionise the way science and ML use tabular data: not as single datasets that are analyzed in a vacuum, but contextualized with respect to related datasets. The potential impact is far-reaching: from few-shot tabular models to automating data science; from out-of-distribution synthetic data to empowering multidisciplinary scientific discovery. We intend to excite reflections on the modalities we study, and convince some researchers to study large tabular models.

Magnetic resonance imaging (MRI) is a central modality for stroke imaging. It is used upon patient admission to make treatment decisions such as selecting patients for intravenous thrombolysis or endovascular therapy. MRI is later used in the duration of hospital stay to predict outcome by visualizing infarct core size and location. Furthermore, it may be used to characterize stroke etiology, e.g. differentiation between (cardio)-embolic and non-embolic stroke. Computer based automated medical image processing is increasingly finding its way into clinical routine. Previous iterations of the Ischemic Stroke Lesion Segmentation (ISLES) challenge have aided in the generation of identifying benchmark methods for acute and sub-acute ischemic stroke lesion segmentation. Here we introduce an expert-annotated, multicenter MRI dataset for segmentation of acute to subacute stroke lesions. This dataset comprises 400 multi-vendor MRI cases with high variability in stroke lesion size, quantity and location. It is split into a training dataset of n=250 and a test dataset of n=150. All training data will be made publicly available. The test dataset will be used for model validation only and will not be released to the public. This dataset serves as the foundation of the ISLES 2022 challenge with the goal of finding algorithmic methods to enable the development and benchmarking of robust and accurate segmentation algorithms for ischemic stroke.

Humans use different modalities, such as speech, text, images, videos, etc., to communicate their intent and goals with teammates. For robots to become better assistants, we aim to endow them with the ability to follow instructions and understand tasks specified by their human partners. Most robotic policy learning methods have focused on one single modality of task specification while ignoring the rich cross-modal information. We present MUTEX, a unified approach to policy learning from multimodal task specifications. It trains a transformer-based architecture to facilitate cross-modal reasoning, combining masked modeling and cross-modal matching objectives in a two-stage training procedure. After training, MUTEX can follow a task specification in any of the six learned modalities (video demonstrations, goal images, text goal descriptions, text instructions, speech goal descriptions, and speech instructions) or a combination of them. We systematically evaluate the benefits of MUTEX in a newly designed dataset with 100 tasks in simulation and 50 tasks in the real world, annotated with multiple instances of task specifications in different modalities, and observe improved performance over methods trained specifically for any single modality. More information at https://ut-austin-rpl.github.io/MUTEX/

This article presents the Cogni-CISMeF project, which aims at improving medical information search in the CISMeF system (Catalog and Index of French-language health resources) by including a conversational agent to interact with the user in natural language. To study the cognitive processes involved during the information search, a bottom-up methodology was adopted. Experimentation has been set up to obtain human dialogs between a user (playing the role of patient) dealing with medical information search and a CISMeF expert refining the request. The analysis of these dialogs underlined the use of discursive evidence: vocabulary, reformulation, implicit or explicit expression of user intentions, conversational sequences, etc. A model of artificial agent is proposed. It leads the user in its information search by proposing to him examples, assistance and choices. This model was implemented and integrated in the CISMeF system. ---- Cet article d\'ecrit le projet Cogni-CISMeF qui propose un module de dialogue Homme-Machine \`a int\'egrer dans le syst\`eme d'indexation de connaissances m\'edicales CISMeF (Catalogue et Index des Sites M\'edicaux Francophones). Nous avons adopt\'e une d\'emarche de mod\'elisation cognitive en proc\'edant \`a un recueil de corpus de dialogues entre un utilisateur (jouant le r\^ole d'un patient) d\'esirant une information m\'edicale et un expert CISMeF af inant cette demande pour construire la requ\^ete. Nous avons analys\'e la structure des dialogues ainsi obtenus et avons \'etudi\'e un certain nombre d'indices discursifs : vocabulaire employ\'e, marques de reformulation, commentaires m\'eta et \'epilinguistiques, expression implicite ou explicite des intentions de l'utilisateur, encha\^inement conversationnel, etc. De cette analyse, nous avons construit un mod\`ele d'agent artificiel dot\'e de capacit\'es cognitives capables d'aider l'utilisateur dans sa t\^ache de recherche d'information. Ce mod\`ele a \'et\'e impl\'ement\'e et int\'egr\'e dans le syst\`eme CISMeF.

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

We discuss an algorithm which produces the meaning of a sentence given meanings of its words, and its resemblance to quantum teleportation. In fact, this protocol was the main source of inspiration for this algorithm which has many applications in the area of Natural Language Processing.

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.

As information exists in various modalities in real world, effective interaction and fusion among multimodal information plays a key role for the creation and perception of multimodal data in computer vision and deep learning research. With superb power in modeling the interaction among multimodal information, multimodal image synthesis and editing has become a hot research topic in recent years. Instead of providing explicit guidance for network training, multimodal guidance offers intuitive and flexible means for image synthesis and editing. On the other hand, this field is also facing several challenges in alignment of multimodal features, synthesis of high-resolution images, faithful evaluation metrics, etc. In this survey, we comprehensively contextualize the advance of the recent multimodal image synthesis and editing and formulate taxonomies according to data modalities and model types. We start with an introduction to different guidance modalities in image synthesis and editing, and then describe multimodal image synthesis and editing approaches extensively according to their model types. After that, we describe benchmark datasets and evaluation metrics as well as corresponding experimental results. Finally, we provide insights about the current research challenges and possible directions for future research. A project associated with this survey is available at https://github.com/fnzhan/Generative-AI.

We present Any-Modality Augmented Language Model (AnyMAL), a unified model that reasons over diverse input modality signals (i.e. text, image, video, audio, IMU motion sensor), and generates textual responses. AnyMAL inherits the powerful text-based reasoning abilities of the state-of-the-art LLMs including LLaMA-2 (70B), and converts modality-specific signals to the joint textual space through a pre-trained aligner module. To further strengthen the multimodal LLM's capabilities, we fine-tune the model with a multimodal instruction set manually collected to cover diverse topics and tasks beyond simple QAs. We conduct comprehensive empirical analysis comprising both human and automatic evaluations, and demonstrate state-of-the-art performance on various multimodal tasks.

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.

Multimodal learning is defined as learning over multiple heterogeneous input modalities such as video, audio, and text. In this work, we are concerned with understanding how models behave as the type of modalities differ between training and deployment, a situation that naturally arises in many applications of multimodal learning to hardware platforms. We present a multimodal robustness framework to provide a systematic analysis of common multimodal representation learning methods. Further, we identify robustness short-comings of these approaches and propose two intervention techniques leading to 1.5times-4times robustness improvements on three datasets, AudioSet, Kinetics-400 and ImageNet-Captions. Finally, we demonstrate that these interventions better utilize additional modalities, if present, to achieve competitive results of 44.2 mAP on AudioSet 20K.

Large language models (LLMs) have shown remarkable progress in encoding clinical knowledge and responding to complex medical queries with appropriate clinical reasoning. However, their applicability in subspecialist or complex medical settings remains underexplored. In this work, we probe the performance of AMIE, a research conversational diagnostic AI system, in the subspecialist domain of breast oncology care without specific fine-tuning to this challenging domain. To perform this evaluation, we curated a set of 50 synthetic breast cancer vignettes representing a range of treatment-naive and treatment-refractory cases and mirroring the key information available to a multidisciplinary tumor board for decision-making (openly released with this work). We developed a detailed clinical rubric for evaluating management plans, including axes such as the quality of case summarization, safety of the proposed care plan, and recommendations for chemotherapy, radiotherapy, surgery and hormonal therapy. To improve performance, we enhanced AMIE with the inference-time ability to perform web search retrieval to gather relevant and up-to-date clinical knowledge and refine its responses with a multi-stage self-critique pipeline. We compare response quality of AMIE with internal medicine trainees, oncology fellows, and general oncology attendings under both automated and specialist clinician evaluations. In our evaluations, AMIE outperformed trainees and fellows demonstrating the potential of the system in this challenging and important domain. We further demonstrate through qualitative examples, how systems such as AMIE might facilitate conversational interactions to assist clinicians in their decision making. However, AMIE's performance was overall inferior to attending oncologists suggesting that further research is needed prior to consideration of prospective uses.

Generative models hold promise for revolutionizing medical education, robot-assisted surgery, and data augmentation for medical AI development. Diffusion models can now generate realistic images from text prompts, while recent advancements have demonstrated their ability to create diverse, high-quality videos. However, these models often struggle with generating accurate representations of medical procedures and detailed anatomical structures. This paper introduces Bora, the first spatio-temporal diffusion probabilistic model designed for text-guided biomedical video generation. Bora leverages Transformer architecture and is pre-trained on general-purpose video generation tasks. It is fine-tuned through model alignment and instruction tuning using a newly established medical video corpus, which includes paired text-video data from various biomedical fields. To the best of our knowledge, this is the first attempt to establish such a comprehensive annotated biomedical video dataset. Bora is capable of generating high-quality video data across four distinct biomedical domains, adhering to medical expert standards and demonstrating consistency and diversity. This generalist video generative model holds significant potential for enhancing medical consultation and decision-making, particularly in resource-limited settings. Additionally, Bora could pave the way for immersive medical training and procedure planning. Extensive experiments on distinct medical modalities such as endoscopy, ultrasound, MRI, and cell tracking validate the effectiveness of our model in understanding biomedical instructions and its superior performance across subjects compared to state-of-the-art generation models.

Recent advancements in large multimodal models (LMMs) have significantly enhanced performance across diverse tasks, with ongoing efforts to further integrate additional modalities such as video and audio. However, most existing LMMs remain vulnerable to hallucinations, the discrepancy between the factual multimodal input and the generated textual output, which has limited their applicability in various real-world scenarios. This paper presents the first systematic investigation of hallucinations in LMMs involving the three most common modalities: language, visual, and audio. Our study reveals two key contributors to hallucinations: overreliance on unimodal priors and spurious inter-modality correlations. To address these challenges, we introduce the benchmark The Curse of Multi-Modalities (CMM), which comprehensively evaluates hallucinations in LMMs, providing a detailed analysis of their underlying issues. Our findings highlight key vulnerabilities, including imbalances in modality integration and biases from training data, underscoring the need for balanced cross-modal learning and enhanced hallucination mitigation strategies. Based on our observations and findings, we suggest potential research directions that could enhance the reliability of LMMs.

Predicting multiple real-world tasks in a single model often requires a particularly diverse feature space. Multimodal (MM) models aim to extract the synergistic predictive potential of multiple data types to create a shared feature space with aligned semantic meaning across inputs of drastically varying sizes (i.e. images, text, sound). Most current MM architectures fuse these representations in parallel, which not only limits their interpretability but also creates a dependency on modality availability. We present MultiModN, a multimodal, modular network that fuses latent representations in a sequence of any number, combination, or type of modality while providing granular real-time predictive feedback on any number or combination of predictive tasks. MultiModN's composable pipeline is interpretable-by-design, as well as innately multi-task and robust to the fundamental issue of biased missingness. We perform four experiments on several benchmark MM datasets across 10 real-world tasks (predicting medical diagnoses, academic performance, and weather), and show that MultiModN's sequential MM fusion does not compromise performance compared with a baseline of parallel fusion. By simulating the challenging bias of missing not-at-random (MNAR), this work shows that, contrary to MultiModN, parallel fusion baselines erroneously learn MNAR and suffer catastrophic failure when faced with different patterns of MNAR at inference. To the best of our knowledge, this is the first inherently MNAR-resistant approach to MM modeling. In conclusion, MultiModN provides granular insights, robustness, and flexibility without compromising performance.

Effective root cause analysis (RCA) is vital for swiftly restoring services, minimizing losses, and ensuring the smooth operation and management of complex systems. Previous data-driven RCA methods, particularly those employing causal discovery techniques, have primarily focused on constructing dependency or causal graphs for backtracking the root causes. However, these methods often fall short as they rely solely on data from a single modality, thereby resulting in suboptimal solutions. In this work, we propose Mulan, a unified multi-modal causal structure learning method for root cause localization. We leverage a log-tailored language model to facilitate log representation learning, converting log sequences into time-series data. To explore intricate relationships across different modalities, we propose a contrastive learning-based approach to extract modality-invariant and modality-specific representations within a shared latent space. Additionally, we introduce a novel key performance indicator-aware attention mechanism for assessing modality reliability and co-learning a final causal graph. Finally, we employ random walk with restart to simulate system fault propagation and identify potential root causes. Extensive experiments on three real-world datasets validate the effectiveness of our proposed framework.

This paper presents OmniDataComposer, an innovative approach for multimodal data fusion and unlimited data generation with an intent to refine and uncomplicate interplay among diverse data modalities. Coming to the core breakthrough, it introduces a cohesive data structure proficient in processing and merging multimodal data inputs, which include video, audio, and text. Our crafted algorithm leverages advancements across multiple operations such as video/image caption extraction, dense caption extraction, Automatic Speech Recognition (ASR), Optical Character Recognition (OCR), Recognize Anything Model(RAM), and object tracking. OmniDataComposer is capable of identifying over 6400 categories of objects, substantially broadening the spectrum of visual information. It amalgamates these diverse modalities, promoting reciprocal enhancement among modalities and facilitating cross-modal data correction. The final output metamorphoses each video input into an elaborate sequential document, virtually transmuting videos into thorough narratives, making them easier to be processed by large language models. Future prospects include optimizing datasets for each modality to encourage unlimited data generation. This robust base will offer priceless insights to models like ChatGPT, enabling them to create higher quality datasets for video captioning and easing question-answering tasks based on video content. OmniDataComposer inaugurates a new stage in multimodal learning, imparting enormous potential for augmenting AI's understanding and generation of complex, real-world data.

LLMs have demonstrated remarkable abilities at interacting with humans through language, especially with the usage of instruction-following data. Recent advancements in LLMs, such as MiniGPT-4, LLaVA, and X-LLM, further enlarge their abilities by incorporating multi-modal inputs, including image, video, and speech. Despite their effectiveness at generating precise and detailed language understanding of the given modality signal, these LLMs give up the ability to ground specific parts of inputs, thus only constructing a coarse-grained mapping. However, explicit and informative correspondence between text and other modalities will not only improve the user experience but also help to expand the application scenario of multi-modal LLMs. Therefore, we propose BuboGPT, a multi-modal LLM with visual grounding that can perform cross-modal interaction between vision, audio and language, providing fine-grained understanding of visual objects and other given modalities. As a result, BuboGPT is able to point out the specific location of an object in the image, when it is generating response or description for that object. Our contributions are two-fold: 1) An off-the-shelf visual grounding module based on SAM that extracts entities in a sentence and find corresponding masks in the image. 2) A two-stage training scheme and instruction dataset to endow joint text-image-audio understanding. Our experiments show that BuboGPT achieves impressive multi-modality understanding and visual grounding abilities during the interaction with human. It performs consistently well when provided by arbitrary modality combinations (either aligned or unaligned). Our code, model and dataset are available at https://bubo-gpt.github.io .

The ability to automatically detect and track surgical instruments in endoscopic videos can enable transformational interventions. Assessing surgical performance and efficiency, identifying skilled tool use and choreography, and planning operational and logistical aspects of OR resources are just a few of the applications that could benefit. Unfortunately, obtaining the annotations needed to train machine learning models to identify and localize surgical tools is a difficult task. Annotating bounding boxes frame-by-frame is tedious and time-consuming, yet large amounts of data with a wide variety of surgical tools and surgeries must be captured for robust training. Moreover, ongoing annotator training is needed to stay up to date with surgical instrument innovation. In robotic-assisted surgery, however, potentially informative data like timestamps of instrument installation and removal can be programmatically harvested. The ability to rely on tool installation data alone would significantly reduce the workload to train robust tool-tracking models. With this motivation in mind we invited the surgical data science community to participate in the challenge, SurgToolLoc 2022. The goal was to leverage tool presence data as weak labels for machine learning models trained to detect tools and localize them in video frames with bounding boxes. We present the results of this challenge along with many of the team's efforts. We conclude by discussing these results in the broader context of machine learning and surgical data science. The training data used for this challenge consisting of 24,695 video clips with tool presence labels is also being released publicly and can be accessed at https://console.cloud.google.com/storage/browser/isi-surgtoolloc-2022.

Large-language models have recently demonstrated impressive zero-shot capabilities in a variety of natural language tasks such as summarization, dialogue generation, and question-answering. Despite many promising applications in clinical medicine, adoption of these models in real-world settings has been largely limited by their tendency to generate incorrect and sometimes even toxic statements. In this study, we develop Almanac, a large language model framework augmented with retrieval capabilities for medical guideline and treatment recommendations. Performance on a novel dataset of clinical scenarios (n = 130) evaluated by a panel of 5 board-certified and resident physicians demonstrates significant increases in factuality (mean of 18% at p-value < 0.05) across all specialties, with improvements in completeness and safety. Our results demonstrate the potential for large language models to be effective tools in the clinical decision-making process, while also emphasizing the importance of careful testing and deployment to mitigate their shortcomings.

Images and structured tables are essential parts of real-world databases. Though tabular-image representation learning is promising to create new insights, it remains a challenging task, as tabular data is typically heterogeneous and incomplete, presenting significant modality disparities with images. Earlier works have mainly focused on simple modality fusion strategies in complete data scenarios, without considering the missing data issue, and thus are limited in practice. In this paper, we propose TIP, a novel tabular-image pre-training framework for learning multimodal representations robust to incomplete tabular data. Specifically, TIP investigates a novel self-supervised learning (SSL) strategy, including a masked tabular reconstruction task for tackling data missingness, and image-tabular matching and contrastive learning objectives to capture multimodal information. Moreover, TIP proposes a versatile tabular encoder tailored for incomplete, heterogeneous tabular data and a multimodal interaction module for inter-modality representation learning. Experiments are performed on downstream multimodal classification tasks using both natural and medical image datasets. The results show that TIP outperforms state-of-the-art supervised/SSL image/multimodal algorithms in both complete and incomplete data scenarios. Our code is available at https://github.com/siyi-wind/TIP.

Electronic Health Records (EHRs), which contain patients' medical histories in various multi-modal formats, often overlook the potential for joint reasoning across imaging and table modalities underexplored in current EHR Question Answering (QA) systems. In this paper, we introduce EHRXQA, a novel multi-modal question answering dataset combining structured EHRs and chest X-ray images. To develop our dataset, we first construct two uni-modal resources: 1) The MIMIC- CXR-VQA dataset, our newly created medical visual question answering (VQA) benchmark, specifically designed to augment the imaging modality in EHR QA, and 2) EHRSQL (MIMIC-IV), a refashioned version of a previously established table-based EHR QA dataset. By integrating these two uni-modal resources, we successfully construct a multi-modal EHR QA dataset that necessitates both uni-modal and cross-modal reasoning. To address the unique challenges of multi-modal questions within EHRs, we propose a NeuralSQL-based strategy equipped with an external VQA API. This pioneering endeavor enhances engagement with multi-modal EHR sources and we believe that our dataset can catalyze advances in real-world medical scenarios such as clinical decision-making and research. EHRXQA is available at https://github.com/baeseongsu/ehrxqa.

The Segment Anything Model (SAM) has demonstrated outstanding adaptation to medical image segmentation but still faces three major challenges. Firstly, the huge computational costs of SAM limit its real-world applicability. Secondly, SAM depends on manual annotations (e.g., points, boxes) as prompts, which are laborious and impractical in clinical scenarios. Thirdly, SAM handles all segmentation targets equally, which is suboptimal for diverse medical modalities with inherent heterogeneity. To address these issues, we propose an Efficient Self-Prompting SAM for universal medical image segmentation, named ESP-MedSAM. We devise a Multi-Modal Decoupled Knowledge Distillation (MMDKD) strategy to distil common image knowledge and domain-specific medical knowledge from the foundation model to train a lightweight image encoder and a modality controller. Further, they combine with the additionally introduced Self-Patch Prompt Generator (SPPG) and Query-Decoupled Modality Decoder (QDMD) to construct ESP-MedSAM. Specifically, SPPG aims to generate a set of patch prompts automatically and QDMD leverages a one-to-one strategy to provide an independent decoding channel for every modality. Extensive experiments indicate that ESP-MedSAM outperforms state-of-the-arts in diverse medical imaging segmentation takes, displaying superior zero-shot learning and modality transfer ability. Especially, our framework uses only 31.4% parameters compared to SAM-Base.

Accurate segmentation of tumors in PET/CT images is important in computer-aided diagnosis and treatment of cancer. The key issue of such a segmentation problem lies in the effective integration of complementary information from PET and CT images. However, the quality of PET and CT images varies widely in clinical settings, which leads to uncertainty in the modality information extracted by networks. To take the uncertainty into account in multi-modal information fusion, this paper proposes a novel Multi-modal Evidential Fusion Network (MEFN) comprising a Cross-Modal Feature Learning (CFL) module and a Multi-modal Trusted Fusion (MTF) module. The CFL module reduces the domain gap upon modality conversion and highlights common tumor features, thereby alleviating the needs of the segmentation module to handle modality specificity. The MTF module utilizes mutual attention mechanisms and an uncertainty calibrator to fuse modality features based on modality uncertainty and then fuse the segmentation results under the guidance of Dempster-Shafer Theory. Besides, a new uncertainty perceptual loss is introduced to force the model focusing on uncertain features and hence improve its ability to extract trusted modality information. Extensive comparative experiments are conducted on two publicly available PET/CT datasets to evaluate the performance of our proposed method whose results demonstrate that our MEFN significantly outperforms state-of-the-art methods with improvements of 2.15% and 3.23% in DSC scores on the AutoPET dataset and the Hecktor dataset, respectively. More importantly, our model can provide radiologists with credible uncertainty of the segmentation results for their decision in accepting or rejecting the automatic segmentation results, which is particularly important for clinical applications. Our code will be available at https://github.com/QPaws/MEFN.

Recently, ChatGPT, along with DALL-E-2 and Codex,has been gaining significant attention from society. As a result, many individuals have become interested in related resources and are seeking to uncover the background and secrets behind its impressive performance. In fact, ChatGPT and other Generative AI (GAI) techniques belong to the category of Artificial Intelligence Generated Content (AIGC), which involves the creation of digital content, such as images, music, and natural language, through AI models. The goal of AIGC is to make the content creation process more efficient and accessible, allowing for the production of high-quality content at a faster pace. AIGC is achieved by extracting and understanding intent information from instructions provided by human, and generating the content according to its knowledge and the intent information. In recent years, large-scale models have become increasingly important in AIGC as they provide better intent extraction and thus, improved generation results. With the growth of data and the size of the models, the distribution that the model can learn becomes more comprehensive and closer to reality, leading to more realistic and high-quality content generation. This survey provides a comprehensive review on the history of generative models, and basic components, recent advances in AIGC from unimodal interaction and multimodal interaction. From the perspective of unimodality, we introduce the generation tasks and relative models of text and image. From the perspective of multimodality, we introduce the cross-application between the modalities mentioned above. Finally, we discuss the existing open problems and future challenges in AIGC.

Connecting text and visual modalities plays an essential role in generative intelligence. For this reason, inspired by the success of large language models, significant research efforts are being devoted to the development of Multimodal Large Language Models (MLLMs). These models can seamlessly integrate visual and textual modalities, both as input and output, while providing a dialogue-based interface and instruction-following capabilities. In this paper, we provide a comprehensive review of recent visual-based MLLMs, analyzing their architectural choices, multimodal alignment strategies, and training techniques. We also conduct a detailed analysis of these models across a wide range of tasks, including visual grounding, image generation and editing, visual understanding, and domain-specific applications. Additionally, we compile and describe training datasets and evaluation benchmarks, conducting comparisons among existing models in terms of performance and computational requirements. Overall, this survey offers a comprehensive overview of the current state of the art, laying the groundwork for future MLLMs.

Current multimodal and multitask foundation models like 4M or UnifiedIO show promising results, but in practice their out-of-the-box abilities to accept diverse inputs and perform diverse tasks are limited by the (usually rather small) number of modalities and tasks they are trained on. In this paper, we expand upon the capabilities of them by training a single model on tens of highly diverse modalities and by performing co-training on large-scale multimodal datasets and text corpora. This includes training on several semantic and geometric modalities, feature maps from recent state of the art models like DINOv2 and ImageBind, pseudo labels of specialist models like SAM and 4DHumans, and a range of new modalities that allow for novel ways to interact with the model and steer the generation, for example image metadata or color palettes. A crucial step in this process is performing discrete tokenization on various modalities, whether they are image-like, neural network feature maps, vectors, structured data like instance segmentation or human poses, or data that can be represented as text. Through this, we expand on the out-of-the-box capabilities of multimodal models and specifically show the possibility of training one model to solve at least 3x more tasks/modalities than existing ones and doing so without a loss in performance. This enables more fine-grained and controllable multimodal generation capabilities and allows us to study the distillation of models trained on diverse data and objectives into a unified model. We successfully scale the training to a three billion parameter model using tens of modalities and different datasets. The resulting models and training code are open sourced at 4m.epfl.ch.

In this work we propose a blackbox intervention method for visual dialog models, with the aim of assessing the contribution of individual linguistic or visual components. Concretely, we conduct structured or randomized interventions that aim to impair an individual component of the model, and observe changes in task performance. We reproduce a state-of-the-art visual dialog model and demonstrate that our methodology yields surprising insights, namely that both dialog and image information have minimal contributions to task performance. The intervention method presented here can be applied as a sanity check for the strength and robustness of each component in visual dialog systems.

With the rapid advances in high-throughput sequencing technologies, the focus of survival analysis has shifted from examining clinical indicators to incorporating genomic profiles with pathological images. However, existing methods either directly adopt a straightforward fusion of pathological features and genomic profiles for survival prediction, or take genomic profiles as guidance to integrate the features of pathological images. The former would overlook intrinsic cross-modal correlations. The latter would discard pathological information irrelevant to gene expression. To address these issues, we present a Cross-Modal Translation and Alignment (CMTA) framework to explore the intrinsic cross-modal correlations and transfer potential complementary information. Specifically, we construct two parallel encoder-decoder structures for multi-modal data to integrate intra-modal information and generate cross-modal representation. Taking the generated cross-modal representation to enhance and recalibrate intra-modal representation can significantly improve its discrimination for comprehensive survival analysis. To explore the intrinsic crossmodal correlations, we further design a cross-modal attention module as the information bridge between different modalities to perform cross-modal interactions and transfer complementary information. Our extensive experiments on five public TCGA datasets demonstrate that our proposed framework outperforms the state-of-the-art methods.

Urban region profiling from web-sourced data is of utmost importance for urban planning and sustainable development. We are witnessing a rising trend of LLMs for various fields, especially dealing with multi-modal data research such as vision-language learning, where the text modality serves as a supplement information for the image. Since textual modality has never been introduced into modality combinations in urban region profiling, we aim to answer two fundamental questions in this paper: i) Can textual modality enhance urban region profiling? ii) and if so, in what ways and with regard to which aspects? To answer the questions, we leverage the power of Large Language Models (LLMs) and introduce the first-ever LLM-enhanced framework that integrates the knowledge of textual modality into urban imagery profiling, named LLM-enhanced Urban Region Profiling with Contrastive Language-Image Pretraining (UrbanCLIP). Specifically, it first generates a detailed textual description for each satellite image by an open-source Image-to-Text LLM. Then, the model is trained on the image-text pairs, seamlessly unifying natural language supervision for urban visual representation learning, jointly with contrastive loss and language modeling loss. Results on predicting three urban indicators in four major Chinese metropolises demonstrate its superior performance, with an average improvement of 6.1% on R^2 compared to the state-of-the-art methods. Our code and the image-language dataset will be released upon paper notification.

Multi-modal large language models have garnered significant interest recently. Though, most of the works focus on vision-language multi-modal models providing strong capabilities in following vision-and-language instructions. However, we claim that speech is also an important modality through which humans interact with the world. Hence, it is crucial for a general-purpose assistant to be able to follow multi-modal speech-and-language instructions. In this work, we propose Large Language and Speech Model (LLaSM). LLaSM is an end-to-end trained large multi-modal speech-language model with cross-modal conversational abilities, capable of following speech-and-language instructions. Our early experiments show that LLaSM demonstrates a more convenient and natural way for humans to interact with artificial intelligence. Specifically, we also release a large Speech Instruction Following dataset LLaSM-Audio-Instructions. Code and demo are available at https://github.com/LinkSoul-AI/LLaSM and https://huggingface.co/spaces/LinkSoul/LLaSM. The LLaSM-Audio-Instructions dataset is available at https://huggingface.co/datasets/LinkSoul/LLaSM-Audio-Instructions.

Alzheimer's Disease (AD) is the most common form of dementia and often difficult to diagnose due to the multifactorial etiology of dementia. Recent works on neuroimaging-based computer-aided diagnosis with deep neural networks (DNNs) showed that fusing structural magnetic resonance images (sMRI) and fluorodeoxyglucose positron emission tomography (FDG-PET) leads to improved accuracy in a study population of healthy controls and subjects with AD. However, this result conflicts with the established clinical knowledge that FDG-PET better captures AD-specific pathologies than sMRI. Therefore, we propose a framework for the systematic evaluation of multi-modal DNNs and critically re-evaluate single- and multi-modal DNNs based on FDG-PET and sMRI for binary healthy vs. AD, and three-way healthy/mild cognitive impairment/AD classification. Our experiments demonstrate that a single-modality network using FDG-PET performs better than MRI (accuracy 0.91 vs 0.87) and does not show improvement when combined. This conforms with the established clinical knowledge on AD biomarkers, but raises questions about the true benefit of multi-modal DNNs. We argue that future work on multi-modal fusion should systematically assess the contribution of individual modalities following our proposed evaluation framework. Finally, we encourage the community to go beyond healthy vs. AD classification and focus on differential diagnosis of dementia, where fusing multi-modal image information conforms with a clinical need.

In-context learning (ICL) involves reasoning from given contextual examples. As more modalities comes, this procedure is becoming more challenging as the interleaved input modalities convolutes the understanding process. This is exemplified by the observation that multimodal models often struggle to effectively extrapolate from contextual examples to perform ICL. To address these challenges, we introduce MultiModal In-conteXt Tuning (M^2IXT), a lightweight module to enhance the ICL capabilities of multimodal unified models. The proposed M^2IXT module perceives an expandable context window to incorporate various labeled examples of multiple modalities (e.g., text, image, and coordinates). It can be prepended to various multimodal unified models (e.g., OFA, Unival, LLaVA) of different architectures and trained via a mixed-tasks strategy to enable rapid few-shot adaption on multiple tasks and datasets. When tuned on as little as 50K multimodal data, M^2IXT can boost the few-shot ICL performance significantly (e.g., 18\% relative increase for OFA), and obtained state-of-the-art results across an array of tasks including visual question answering, image captioning, visual grounding, and visual entailment, while being considerably small in terms of model parameters (e.g., sim20times smaller than Flamingo or MMICL), highlighting the flexibility and effectiveness of M^2IXT as a multimodal in-context learner.

Every day, countless surgeries are performed worldwide, each within the distinct settings of operating rooms (ORs) that vary not only in their setups but also in the personnel, tools, and equipment used. This inherent diversity poses a substantial challenge for achieving a holistic understanding of the OR, as it requires models to generalize beyond their initial training datasets. To reduce this gap, we introduce ORacle, an advanced vision-language model designed for holistic OR domain modeling, which incorporates multi-view and temporal capabilities and can leverage external knowledge during inference, enabling it to adapt to previously unseen surgical scenarios. This capability is further enhanced by our novel data augmentation framework, which significantly diversifies the training dataset, ensuring ORacle's proficiency in applying the provided knowledge effectively. In rigorous testing, in scene graph generation, and downstream tasks on the 4D-OR dataset, ORacle not only demonstrates state-of-the-art performance but does so requiring less data than existing models. Furthermore, its adaptability is displayed through its ability to interpret unseen views, actions, and appearances of tools and equipment. This demonstrates ORacle's potential to significantly enhance the scalability and affordability of OR domain modeling and opens a pathway for future advancements in surgical data science. We will release our code and data upon acceptance.

Large language models (LLMs) have shown impressive performance on complex reasoning by leveraging chain-of-thought (CoT) prompting to generate intermediate reasoning chains as the rationale to infer the answer. However, existing CoT studies have focused on the language modality. We propose Multimodal-CoT that incorporates language (text) and vision (images) modalities into a two-stage framework that separates rationale generation and answer inference. In this way, answer inference can leverage better generated rationales that are based on multimodal information. With Multimodal-CoT, our model under 1 billion parameters outperforms the previous state-of-the-art LLM (GPT-3.5) by 16 percentage points (75.17%->91.68% accuracy) on the ScienceQA benchmark and even surpasses human performance. Code is publicly available available at https://github.com/amazon-science/mm-cot.

While language-guided image manipulation has made remarkable progress, the challenge of how to instruct the manipulation process faithfully reflecting human intentions persists. An accurate and comprehensive description of a manipulation task using natural language is laborious and sometimes even impossible, primarily due to the inherent uncertainty and ambiguity present in linguistic expressions. Is it feasible to accomplish image manipulation without resorting to external cross-modal language information? If this possibility exists, the inherent modality gap would be effortlessly eliminated. In this paper, we propose a novel manipulation methodology, dubbed ImageBrush, that learns visual instructions for more accurate image editing. Our key idea is to employ a pair of transformation images as visual instructions, which not only precisely captures human intention but also facilitates accessibility in real-world scenarios. Capturing visual instructions is particularly challenging because it involves extracting the underlying intentions solely from visual demonstrations and then applying this operation to a new image. To address this challenge, we formulate visual instruction learning as a diffusion-based inpainting problem, where the contextual information is fully exploited through an iterative process of generation. A visual prompting encoder is carefully devised to enhance the model's capacity in uncovering human intent behind the visual instructions. Extensive experiments show that our method generates engaging manipulation results conforming to the transformations entailed in demonstrations. Moreover, our model exhibits robust generalization capabilities on various downstream tasks such as pose transfer, image translation and video inpainting.

Multimodal learning typically relies on the assumption that all modalities are fully available during both the training and inference phases. However, in real-world scenarios, consistently acquiring complete multimodal data presents significant challenges due to various factors. This often leads to the issue of missing modalities, where data for certain modalities are absent, posing considerable obstacles not only for the availability of multimodal pretrained models but also for their fine-tuning and the preservation of robustness in downstream tasks. To address these challenges, we propose a novel framework integrating parameter-efficient fine-tuning of unimodal pretrained models with a self-supervised joint-embedding learning method. This framework enables the model to predict the embedding of a missing modality in the representation space during inference. Our method effectively predicts the missing embedding through prompt tuning, leveraging information from available modalities. We evaluate our approach on several multimodal benchmark datasets and demonstrate its effectiveness and robustness across various scenarios of missing modalities.

In clinical radiology reports, doctors capture important information about the patient's health status. They convey their observations from raw medical imaging data about the inner structures of a patient. As such, formulating reports requires medical experts to possess wide-ranging knowledge about anatomical regions with their normal, healthy appearance as well as the ability to recognize abnormalities. This explicit grasp on both the patient's anatomy and their appearance is missing in current medical image-processing systems as annotations are especially difficult to gather. This renders the models to be narrow experts e.g. for identifying specific diseases. In this work, we recover this missing link by adding human anatomy into the mix and enable the association of content in medical reports to their occurrence in associated imagery (medical phrase grounding). To exploit anatomical structures in this scenario, we present a sophisticated automatic pipeline to gather and integrate human bodily structures from computed tomography datasets, which we incorporate in our PAXRay: A Projected dataset for the segmentation of Anatomical structures in X-Ray data. Our evaluation shows that methods that take advantage of anatomical information benefit heavily in visually grounding radiologists' findings, as our anatomical segmentations allow for up to absolute 50% better grounding results on the OpenI dataset as compared to commonly used region proposals. The PAXRay dataset is available at https://constantinseibold.github.io/paxray/.

During surgical training, real-time feedback from trainers to trainees is important for preventing errors and enhancing long-term skill acquisition. Accurately predicting the effectiveness of this feedback, specifically whether it leads to a change in trainee behavior, is crucial for developing methods for improving surgical training and education. However, relying on human annotations to assess feedback effectiveness is laborious and prone to biases, underscoring the need for an automated, scalable, and objective method. Creating such an automated system poses challenges, as it requires an understanding of both the verbal feedback delivered by the trainer and the visual context of the real-time surgical scene. To address this, we propose a method that integrates information from transcribed verbal feedback and corresponding surgical video to predict feedback effectiveness. Our findings show that both transcribed feedback and surgical video are individually predictive of trainee behavior changes, and their combination achieves an AUROC of 0.70+/-0.02, improving prediction accuracy by up to 6.6%. Additionally, we introduce self-supervised fine-tuning as a strategy for enhancing surgical video representation learning, which is scalable and further enhances prediction performance. Our results demonstrate the potential of multi-modal learning to advance the automated assessment of surgical feedback.

Recent advances in generative AI have brought incredible breakthroughs in several areas, including medical imaging. These generative models have tremendous potential not only to help safely share medical data via synthetic datasets but also to perform an array of diverse applications, such as anomaly detection, image-to-image translation, denoising, and MRI reconstruction. However, due to the complexity of these models, their implementation and reproducibility can be difficult. This complexity can hinder progress, act as a use barrier, and dissuade the comparison of new methods with existing works. In this study, we present MONAI Generative Models, a freely available open-source platform that allows researchers and developers to easily train, evaluate, and deploy generative models and related applications. Our platform reproduces state-of-art studies in a standardised way involving different architectures (such as diffusion models, autoregressive transformers, and GANs), and provides pre-trained models for the community. We have implemented these models in a generalisable fashion, illustrating that their results can be extended to 2D or 3D scenarios, including medical images with different modalities (like CT, MRI, and X-Ray data) and from different anatomical areas. Finally, we adopt a modular and extensible approach, ensuring long-term maintainability and the extension of current applications for future features.

Negotiation is one of the crucial abilities in human communication, and there has been a resurgent research interest in negotiation dialogue systems recently, which goal is to empower intelligent agents with such ability that can efficiently help humans resolve conflicts or reach beneficial agreements. Although there have been many explorations in negotiation dialogue systems, a systematic review of this task has to date remained notably absent. To this end, we aim to fill this gap by reviewing contemporary studies in the emerging field of negotiation dialogue systems, covering benchmarks, evaluations, and methodologies. Furthermore, we also discuss potential future directions, including multi-modal, multi-party, and cross-cultural negotiation scenarios. Our goal is to provide the community with a systematic overview of negotiation dialogue systems and to inspire future research.

The potential for agents, whether embodied or software, to learn by observing other agents performing procedures involving objects and actions is rich. Current research on automatic procedure learning heavily relies on action labels or video subtitles, even during the evaluation phase, which makes them infeasible in real-world scenarios. This leads to our question: can the human-consensus structure of a procedure be learned from a large set of long, unconstrained videos (e.g., instructional videos from YouTube) with only visual evidence? To answer this question, we introduce the problem of procedure segmentation--to segment a video procedure into category-independent procedure segments. Given that no large-scale dataset is available for this problem, we collect a large-scale procedure segmentation dataset with procedure segments temporally localized and described; we use cooking videos and name the dataset YouCook2. We propose a segment-level recurrent network for generating procedure segments by modeling the dependencies across segments. The generated segments can be used as pre-processing for other tasks, such as dense video captioning and event parsing. We show in our experiments that the proposed model outperforms competitive baselines in procedure segmentation.

Despite growing interest in using large language models (LLMs) in healthcare, current explorations do not assess the real-world utility and safety of LLMs in clinical settings. Our objective was to determine whether two LLMs can serve information needs submitted by physicians as questions to an informatics consultation service in a safe and concordant manner. Sixty six questions from an informatics consult service were submitted to GPT-3.5 and GPT-4 via simple prompts. 12 physicians assessed the LLM responses' possibility of patient harm and concordance with existing reports from an informatics consultation service. Physician assessments were summarized based on majority vote. For no questions did a majority of physicians deem either LLM response as harmful. For GPT-3.5, responses to 8 questions were concordant with the informatics consult report, 20 discordant, and 9 were unable to be assessed. There were 29 responses with no majority on "Agree", "Disagree", and "Unable to assess". For GPT-4, responses to 13 questions were concordant, 15 discordant, and 3 were unable to be assessed. There were 35 responses with no majority. Responses from both LLMs were largely devoid of overt harm, but less than 20% of the responses agreed with an answer from an informatics consultation service, responses contained hallucinated references, and physicians were divided on what constitutes harm. These results suggest that while general purpose LLMs are able to provide safe and credible responses, they often do not meet the specific information need of a given question. A definitive evaluation of the usefulness of LLMs in healthcare settings will likely require additional research on prompt engineering, calibration, and custom-tailoring of general purpose models.

The integration of Computer-Assisted Diagnosis (CAD) with Large Language Models (LLMs) holds great potential in clinical applications, specifically in the roles of virtual family doctors and clinic assistants. However, current works in this field are plagued by limitations, specifically a restricted scope of applicable image domains and the provision of unreliable medical advice. This restricts their overall processing capabilities. Furthermore, the mismatch in writing style between LLMs and radiologists undermines their practical usefulness. To tackle these challenges, we introduce ChatCAD+, which is designed to be universal and reliable. It is capable of handling medical images from diverse domains and leveraging up-to-date information from reputable medical websites to provide reliable medical advice. Additionally, it incorporates a template retrieval system that improves report generation performance via exemplar reports. This approach ensures greater consistency with the expertise of human professionals. The source code is available at https://github.com/zhaozh10/ChatCAD.

Multimodal LLMs (MLLMs) have emerged as an extension of Large Language Models (LLMs), enabling the integration of various modalities. However, Any-to-Any MLLMs are limited to generating pairwise modalities 'Text + X' within a single response, such as Text + {Image or Audio or Video}. To address this limitation, we introduce Spider, a novel efficient Any-to-Many Modalities Generation (AMMG) framework, which can generate an arbitrary combination of modalities 'Text + Xs', such as Text + {Image and Audio and Video}. To achieve efficient AMMG, our Spider integrates three core components: a Base Model for basic X-to-X (i.e., Any-to-Any) modality processing, a novel Efficient Decoders-Controller for controlling multimodal Decoders to generate Xs (many-modal) contents, and an Any-to-Many Instruction Template designed for producing Xs signal prompts. To train Spider, we constructed a novel Text-formatted Many-Modal (TMM) dataset, which facilitates the learning of the X-to-Xs (i.e., Any-to-Many) capability necessary for AMMG. Ultimately, the well-trained Spider generates a pseudo X-to-Xs dataset, the first-ever X-to-Xs many-modal dataset, enhancing the potential for AMMG task in future research. Overall, this work not only pushes the boundary of multimodal interaction but also provides rich data support for advancing the field.

Automatic radiology report generation is booming due to its huge application potential for the healthcare industry. However, existing computer vision and natural language processing approaches to tackle this problem are limited in two aspects. First, when extracting image features, most of them neglect multi-view reasoning in vision and model single-view structure of medical images, such as space-view or channel-view. However, clinicians rely on multi-view imaging information for comprehensive judgment in daily clinical diagnosis. Second, when generating reports, they overlook context reasoning with multi-modal information and focus on pure textual optimization utilizing retrieval-based methods. We aim to address these two issues by proposing a model that better simulates clinicians' perspectives and generates more accurate reports. Given the above limitation in feature extraction, we propose a Globally-intensive Attention (GIA) module in the medical image encoder to simulate and integrate multi-view vision perception. GIA aims to learn three types of vision perception: depth view, space view, and pixel view. On the other hand, to address the above problem in report generation, we explore how to involve multi-modal signals to generate precisely matched reports, i.e., how to integrate previously predicted words with region-aware visual content in next word prediction. Specifically, we design a Visual Knowledge-guided Decoder (VKGD), which can adaptively consider how much the model needs to rely on visual information and previously predicted text to assist next word prediction. Hence, our final Intensive Vision-guided Network (IVGN) framework includes a GIA-guided Visual Encoder and the VKGD. Experiments on two commonly-used datasets IU X-Ray and MIMIC-CXR demonstrate the superior ability of our method compared with other state-of-the-art approaches.

Medical visual question answering (Med-VQA) has tremendous potential in healthcare. However, the development of this technology is hindered by the lacking of publicly-available and high-quality labeled datasets for training and evaluation. In this paper, we present a large bilingual dataset, SLAKE, with comprehensive semantic labels annotated by experienced physicians and a new structural medical knowledge base for Med-VQA. Besides, SLAKE includes richer modalities and covers more human body parts than the currently available dataset. We show that SLAKE can be used to facilitate the development and evaluation of Med-VQA systems. The dataset can be downloaded from http://www.med-vqa.com/slake.

Medical imaging is critical to the diagnosis and treatment of numerous medical problems, including many forms of cancer. Medical imaging reports distill the findings and observations of radiologists, creating an unstructured textual representation of unstructured medical images. Large-scale use of this text-encoded information requires converting the unstructured text to a structured, semantic representation. We explore the extraction and normalization of anatomical information in radiology reports that is associated with radiological findings. We investigate this extraction and normalization task using a span-based relation extraction model that jointly extracts entities and relations using BERT. This work examines the factors that influence extraction and normalization performance, including the body part/organ system, frequency of occurrence, span length, and span diversity. It discusses approaches for improving performance and creating high-quality semantic representations of radiological phenomena.

Recent advances in large language models, particularly following GPT-4o, have sparked increasing interest in developing omni-modal models capable of understanding more modalities. While some open-source alternatives have emerged, there is still a notable lag behind specialized single-modality models in performance. In this paper, we present Ola, an Omni-modal language model that achieves competitive performance across image, video, and audio understanding compared to specialized counterparts. The core design of Ola lies in its progressive modality alignment strategy that extends the supporting modality of the language model progressively. Our training pipeline begins with the most distinct modalities: image and text, then gradually expands the skill sets of the model using speech data that connects language and audio knowledge, and video data that connects all modalities. The progressive learning pipeline also enables us to maintain a relatively small size of the cross-modal alignment data, making developing omni-modal from existing vision-language models easy and less costly. Moreover, to unlock an advanced interactive experience like GPT-4o, we further design a sentence-wise decoding solution for streaming speech generation. Extensive experiments demonstrate that Ola surpasses existing open omni-modal LLMs across all modalities while achieving highly competitive performance compared to state-of-the-art specialized models of similar sizes. We aim to make Ola a fully open omni-modal understanding solution to advance future research in this emerging field. Model weights, code, and data are open-sourced at https://github.com/Ola-Omni/Ola.

Foundation models (FMs) have exhibited remarkable performance across a wide range of downstream tasks in many domains. Nevertheless, general-purpose FMs often face challenges when confronted with domain-specific problems, due to their limited access to the proprietary training data in a particular domain. In biomedicine, there are various biological modalities, such as molecules, proteins, and cells, which are encoded by the language of life and exhibit significant modality gaps with human natural language. In this paper, we introduce BioMedGPT, an open multimodal generative pre-trained transformer (GPT) for biomedicine, to bridge the gap between the language of life and human natural language. BioMedGPT allows users to easily ``communicate'' with diverse biological modalities through free text, which is the first of its kind. BioMedGPT aligns different biological modalities with natural language via a large generative language model, namely, BioMedGPT-LM. We publish BioMedGPT-10B, which unifies the feature spaces of molecules, proteins, and natural language via encoding and alignment. Through fine-tuning, BioMedGPT-10B outperforms or is on par with human and significantly larger general-purpose foundation models on the biomedical QA task. It also demonstrates promising performance in the molecule QA and protein QA tasks, which could greatly accelerate the discovery of new drugs and therapeutic targets. In addition, BioMedGPT-LM-7B is the first large generative language model based on Llama2 in the biomedical domain, therefore is commercial friendly. Both BioMedGPT-10B and BioMedGPT-LM-7B are open-sourced to the research community. In addition, we publish the datasets that are meticulously curated for the alignment of multi-modalities, i.e., PubChemQA and UniProtQA. All the models, codes, and datasets are available at https://github.com/PharMolix/OpenBioMed.

Recent years have witnessed a big convergence of language, vision, and multi-modal pretraining. In this work, we present mPLUG-2, a new unified paradigm with modularized design for multi-modal pretraining, which can benefit from modality collaboration while addressing the problem of modality entanglement. In contrast to predominant paradigms of solely relying on sequence-to-sequence generation or encoder-based instance discrimination, mPLUG-2 introduces a multi-module composition network by sharing common universal modules for modality collaboration and disentangling different modality modules to deal with modality entanglement. It is flexible to select different modules for different understanding and generation tasks across all modalities including text, image, and video. Empirical study shows that mPLUG-2 achieves state-of-the-art or competitive results on a broad range of over 30 downstream tasks, spanning multi-modal tasks of image-text and video-text understanding and generation, and uni-modal tasks of text-only, image-only, and video-only understanding. Notably, mPLUG-2 shows new state-of-the-art results of 48.0 top-1 accuracy and 80.3 CIDEr on the challenging MSRVTT video QA and video caption tasks with a far smaller model size and data scale. It also demonstrates strong zero-shot transferability on vision-language and video-language tasks. Code and models will be released in https://github.com/alibaba/AliceMind.

Cancer has relational information residing at varying scales, modalities, and resolutions of the acquired data, such as radiology, pathology, genomics, proteomics, and clinical records. Integrating diverse data types can improve the accuracy and reliability of cancer diagnosis and treatment. There can be disease-related information that is too subtle for humans or existing technological tools to discern visually. Traditional methods typically focus on partial or unimodal information about biological systems at individual scales and fail to encapsulate the complete spectrum of the heterogeneous nature of data. Deep neural networks have facilitated the development of sophisticated multimodal data fusion approaches that can extract and integrate relevant information from multiple sources. Recent deep learning frameworks such as Graph Neural Networks (GNNs) and Transformers have shown remarkable success in multimodal learning. This review article provides an in-depth analysis of the state-of-the-art in GNNs and Transformers for multimodal data fusion in oncology settings, highlighting notable research studies and their findings. We also discuss the foundations of multimodal learning, inherent challenges, and opportunities for integrative learning in oncology. By examining the current state and potential future developments of multimodal data integration in oncology, we aim to demonstrate the promising role that multimodal neural networks can play in cancer prevention, early detection, and treatment through informed oncology practices in personalized settings.

Multimodal reasoning is a challenging task that requires models to reason across multiple modalities to answer questions. Existing approaches have made progress by incorporating language and visual modalities into a two-stage reasoning framework, separating rationale generation from answer inference. However, these approaches often fall short due to the inadequate quality of the generated rationales. In this work, we delve into the importance of rationales in model reasoning. We observe that when rationales are completely accurate, the model's accuracy significantly improves, highlighting the need for high-quality rationale generation. Motivated by this, we propose MC-CoT, a self-consistency training strategy that generates multiple rationales and answers, subsequently selecting the most accurate through a voting process. This approach not only enhances the quality of generated rationales but also leads to more accurate and robust answers. Through extensive experiments, we demonstrate that our approach significantly improves model performance across various benchmarks. Remarkably, we show that even smaller base models, when equipped with our proposed approach, can achieve results comparable to those of larger models, illustrating the potential of our approach in harnessing the power of rationales for improved multimodal reasoning. The code is available at https://github.com/chengtan9907/mc-cot.

Large language models (LLMs) represent a transformative class of AI tools capable of revolutionizing various aspects of healthcare by generating human-like responses across diverse contexts and adapting to novel tasks following human instructions. Their potential application spans a broad range of medical tasks, such as clinical documentation, matching patients to clinical trials, and answering medical questions. In this primer paper, we propose an actionable guideline to help healthcare professionals more efficiently utilize LLMs in their work, along with a set of best practices. This approach consists of several main phases, including formulating the task, choosing LLMs, prompt engineering, fine-tuning, and deployment. We start with the discussion of critical considerations in identifying healthcare tasks that align with the core capabilities of LLMs and selecting models based on the selected task and data, performance requirements, and model interface. We then review the strategies, such as prompt engineering and fine-tuning, to adapt standard LLMs to specialized medical tasks. Deployment considerations, including regulatory compliance, ethical guidelines, and continuous monitoring for fairness and bias, are also discussed. By providing a structured step-by-step methodology, this tutorial aims to equip healthcare professionals with the tools necessary to effectively integrate LLMs into clinical practice, ensuring that these powerful technologies are applied in a safe, reliable, and impactful manner.

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.

This research paper addresses the challenge of modality mismatch in multimodal learning, where the modalities available during inference differ from those available at training. We propose the Text-centric Alignment for Multi-Modality Learning (TAMML) approach, an innovative method that utilizes Large Language Models (LLMs) with in-context learning and foundation models to enhance the generalizability of multimodal systems under these conditions. By leveraging the unique properties of text as a unified semantic space, TAMML demonstrates significant improvements in handling unseen, diverse, and unpredictable modality combinations. TAMML not only adapts to varying modalities but also maintains robust performance, showcasing the potential of foundation models in overcoming the limitations of traditional fixed-modality frameworks in embedding representations. This study contributes to the field by offering a flexible, effective solution for real-world applications where modality availability is dynamic and uncertain.

We introduce Baichuan-Omni-1.5, an omni-modal model that not only has omni-modal understanding capabilities but also provides end-to-end audio generation capabilities. To achieve fluent and high-quality interaction across modalities without compromising the capabilities of any modality, we prioritized optimizing three key aspects. First, we establish a comprehensive data cleaning and synthesis pipeline for multimodal data, obtaining about 500B high-quality data (text, audio, and vision). Second, an audio-tokenizer (Baichuan-Audio-Tokenizer) has been designed to capture both semantic and acoustic information from audio, enabling seamless integration and enhanced compatibility with MLLM. Lastly, we designed a multi-stage training strategy that progressively integrates multimodal alignment and multitask fine-tuning, ensuring effective synergy across all modalities. Baichuan-Omni-1.5 leads contemporary models (including GPT4o-mini and MiniCPM-o 2.6) in terms of comprehensive omni-modal capabilities. Notably, it achieves results comparable to leading models such as Qwen2-VL-72B across various multimodal medical benchmarks.

GPT-4o, an all-encompassing model, represents a milestone in the development of large multi-modal language models. It can understand visual, auditory, and textual modalities, directly output audio, and support flexible duplex interaction. Models from the open-source community often achieve some functionalities of GPT-4o, such as visual understanding and voice chat. Nevertheless, training a unified model that incorporates all modalities is challenging due to the complexities of multi-modal data, intricate model architectures, and training processes. In this paper, we introduce Mini-Omni2, a visual-audio assistant capable of providing real-time, end-to-end voice responses to visoin and audio queries. By integrating pretrained visual and auditory encoders, Mini-Omni2 maintains performance in individual modalities. We propose a three-stage training process to align modalities, allowing the language model to handle multi-modal inputs and outputs after training on a limited dataset. For interaction, we introduce a command-based interruption mechanism, enabling more flexible interaction with users. To the best of our knowledge, Mini-Omni2 is one of the closest reproductions of GPT-4o, which have similar form of functionality, and we hope it can offer valuable insights for subsequent research.

Large Language Models (LLMs), primarily trained on text-based datasets, exhibit exceptional proficiencies in understanding and executing complex linguistic instructions via text outputs. However, they falter when requests to generate non-text ones. Concurrently, modality conversion models, such as text-to-image, despite generating high-quality images, suffer from a lack of extensive textual pretraining. As a result, these models are only capable of accommodating specific image descriptions rather than comprehending more complex instructions. To bridge this gap, we propose a novel approach, \methodname, from a modality conversion perspective that evolves a text-based LLM into a multi-modal one. We specifically employ a minimal dataset to instruct LLMs to recognize the intended output modality as directed by the instructions. Consequently, the adapted LLM can effectively summon various off-the-shelf modality conversion models from the model zoos to generate non-text responses. This circumvents the necessity for complicated pretraining that typically requires immense quantities of paired multi-modal data, while simultaneously inheriting the extensive knowledge of LLMs and the ability of high-quality generative models. To evaluate and compare the adapted multi-modal LLM with its traditional counterparts, we have constructed a multi-modal instruction benchmark that solicits diverse modality outputs. The experiment results reveal that, with minimal training, LLMs can be conveniently adapted to comprehend requests for non-text responses, thus achieving higher flexibility in multi-modal scenarios. Code and data will be made available at https://github.com/xinke-wang/SwitchGPT.

Conditional inference on joint textual and visual clues is a multi-modal reasoning task that textual clues provide prior permutation or external knowledge, which are complementary with visual content and pivotal to deducing the correct option. Previous methods utilizing pretrained vision-language models (VLMs) have achieved impressive performances, yet they show a lack of multimodal context reasoning capability, especially for text-modal information. To address this issue, we propose a Multi-modal Context Reasoning approach, named ModCR. Compared to VLMs performing reasoning via cross modal semantic alignment, it regards the given textual abstract semantic and objective image information as the pre-context information and embeds them into the language model to perform context reasoning. Different from recent vision-aided language models used in natural language processing, ModCR incorporates the multi-view semantic alignment information between language and vision by introducing the learnable alignment prefix between image and text in the pretrained language model. This makes the language model well-suitable for such multi-modal reasoning scenario on joint textual and visual clues. We conduct extensive experiments on two corresponding data sets and experimental results show significantly improved performance (exact gain by 4.8% on PMR test set) compared to previous strong baselines. Code Link: https://github.com/YunxinLi/Multimodal-Context-Reasoning.

Automatic disease diagnosis has become increasingly valuable in clinical practice. The advent of large language models (LLMs) has catalyzed a paradigm shift in artificial intelligence, with growing evidence supporting the efficacy of LLMs in diagnostic tasks. Despite the increasing attention in this field, a holistic view is still lacking. Many critical aspects remain unclear, such as the diseases and clinical data to which LLMs have been applied, the LLM techniques employed, and the evaluation methods used. In this article, we perform a comprehensive review of LLM-based methods for disease diagnosis. Our review examines the existing literature across various dimensions, including disease types and associated clinical specialties, clinical data, LLM techniques, and evaluation methods. Additionally, we offer recommendations for applying and evaluating LLMs for diagnostic tasks. Furthermore, we assess the limitations of current research and discuss future directions. To our knowledge, this is the first comprehensive review for LLM-based disease diagnosis.

This work introduces the first framework for reconstructing surgical dialogue from unstructured real-world recordings, which is crucial for characterizing teaching tasks. In surgical training, the formative verbal feedback that trainers provide to trainees during live surgeries is crucial for ensuring safety, correcting behavior immediately, and facilitating long-term skill acquisition. However, analyzing and quantifying this feedback is challenging due to its unstructured and specialized nature. Automated systems are essential to manage these complexities at scale, allowing for the creation of structured datasets that enhance feedback analysis and improve surgical education. Our framework integrates voice activity detection, speaker diarization, and automated speech recaognition, with a novel enhancement that 1) removes hallucinations (non-existent utterances generated during speech recognition fueled by noise in the operating room) and 2) separates speech from trainers and trainees using few-shot voice samples. These aspects are vital for reconstructing accurate surgical dialogues and understanding the roles of operating room participants. Using data from 33 real-world surgeries, we demonstrated the system's capability to reconstruct surgical teaching dialogues and detect feedback instances effectively (F1 score of 0.79+/-0.07). Moreover, our hallucination removal step improves feedback detection performance by ~14%. Evaluation on downstream clinically relevant tasks of predicting Behavioral Adjustment of trainees and classifying Technical feedback, showed performances comparable to manual annotations with F1 scores of 0.82+/0.03 and 0.81+/0.03 respectively. These results highlight the effectiveness of our framework in supporting clinically relevant tasks and improving over manual methods.

Depression has proven to be a significant public health issue, profoundly affecting the psychological well-being of individuals. If it remains undiagnosed, depression can lead to severe health issues, which can manifest physically and even lead to suicide. Generally, Diagnosing depression or any other mental disorder involves conducting semi-structured interviews alongside supplementary questionnaires, including variants of the Patient Health Questionnaire (PHQ) by Clinicians and mental health professionals. This approach places significant reliance on the experience and judgment of trained physicians, making the diagnosis susceptible to personal biases. Given that the underlying mechanisms causing depression are still being actively researched, physicians often face challenges in diagnosing and treating the condition, particularly in its early stages of clinical presentation. Recently, significant strides have been made in Artificial neural computing to solve problems involving text, image, and speech in various domains. Our analysis has aimed to leverage these state-of-the-art (SOTA) models in our experiments to achieve optimal outcomes leveraging multiple modalities. The experiments were performed on the Extended Distress Analysis Interview Corpus Wizard of Oz dataset (E-DAIC) corpus presented in the Audio/Visual Emotion Challenge (AVEC) 2019 Challenge. The proposed solutions demonstrate better results achieved by Proprietary and Open-source Large Language Models (LLMs), which achieved a Root Mean Square Error (RMSE) score of 3.98 on Textual Modality, beating the AVEC 2019 challenge baseline results and current SOTA regression analysis architectures. Additionally, the proposed solution achieved an accuracy of 71.43% in the classification task. The paper also includes a novel audio-visual multi-modal network that predicts PHQ-8 scores with an RMSE of 6.51.

From the Specific-MLLM, which excels in single-modal tasks, to the Omni-MLLM, which extends the range of general modalities, this evolution aims to achieve understanding and generation of multimodal information. Omni-MLLM treats the features of different modalities as different "foreign languages," enabling cross-modal interaction and understanding within a unified space. To promote the advancement of related research, we have compiled 47 relevant papers to provide the community with a comprehensive introduction to Omni-MLLM. We first explain the four core components of Omni-MLLM for unified modeling and interaction of multiple modalities. Next, we introduce the effective integration achieved through "alignment pretraining" and "instruction fine-tuning," and discuss open-source datasets and testing of interaction capabilities. Finally, we summarize the main challenges facing current Omni-MLLM and outline future directions.

We present Eir Thai Medical LLM, a large language model with 8 billion parameters, specifically designed to enhance the accuracy of handling medical tasks in the Thai language. This model focuses on providing clear and easy-to-understand answers for both healthcare professionals and patients, thereby improving the efficiency of diagnosis and treatment processes. Human evaluation was conducted to ensure that the model adheres to care standards and provides unbiased answers. To prioritize data security, the model is deployed within the hospital's internal network, ensuring both high security and faster processing speeds. The internal API connection is secured with encryption and strict authentication measures to prevent data leaks and unauthorized access. We evaluated several open-source large language models with 8 billion parameters on four medical benchmarks: MedQA, MedMCQA, PubMedQA, and the medical subset of MMLU. The best-performing baselines were used to develop Eir Thai Medical LLM. Our evaluation employed multiple questioning strategies, including zero-shot, few-shot, chain-of-thought reasoning, and ensemble/self-consistency voting methods. Our model outperformed commercially available Thai-language large language models by more than 10%. In addition, we developed enhanced model testing tailored for clinical use in Thai across 18 clinical tasks, where our model exceeded GPT-4o performance by more than 11%

This study aims to explore the implementation of Natural Language Processing (NLP) and machine learning (ML) techniques to automate the coding of medical letters with visualised explainability and light-weighted local computer settings. Currently in clinical settings, coding is a manual process that involves assigning codes to each condition, procedure, and medication in a patient's paperwork (e.g., 56265001 heart disease using SNOMED CT code). There are preliminary research on automatic coding in this field using state-of-the-art ML models; however, due to the complexity and size of the models, the real-world deployment is not achieved. To further facilitate the possibility of automatic coding practice, we explore some solutions in a local computer setting; in addition, we explore the function of explainability for transparency of AI models. We used the publicly available MIMIC-III database and the HAN/HLAN network models for ICD code prediction purposes. We also experimented with the mapping between ICD and SNOMED CT knowledge bases. In our experiments, the models provided useful information for 97.98\% of codes. The result of this investigation can shed some light on implementing automatic clinical coding in practice, such as in hospital settings, on the local computers used by clinicians , project page https://github.com/Glenj01/Medical-Coding.

Medical image analysis is essential to clinical diagnosis and treatment, which is increasingly supported by multi-modal large language models (MLLMs). However, previous research has primarily focused on 2D medical images, leaving 3D images under-explored, despite their richer spatial information. This paper aims to advance 3D medical image analysis with MLLMs. To this end, we present a large-scale 3D multi-modal medical dataset, M3D-Data, comprising 120K image-text pairs and 662K instruction-response pairs specifically tailored for various 3D medical tasks, such as image-text retrieval, report generation, visual question answering, positioning, and segmentation. Additionally, we propose M3D-LaMed, a versatile multi-modal large language model for 3D medical image analysis. Furthermore, we introduce a new 3D multi-modal medical benchmark, M3D-Bench, which facilitates automatic evaluation across eight tasks. Through comprehensive evaluation, our method proves to be a robust model for 3D medical image analysis, outperforming existing solutions. All code, data, and models are publicly available at: https://github.com/BAAI-DCAI/M3D.

Clinicians spend a significant amount of time reviewing medical images and transcribing their findings regarding patient diagnosis, referral and treatment in text form. Vision-language models (VLMs), which automatically interpret images and summarize their findings as text, have enormous potential to alleviate clinical workloads and increase patient access to high-quality medical care. While foundational models have stirred considerable interest in the medical community, it is unclear whether their general capabilities translate to real-world clinical utility. In this work, we show that foundation VLMs markedly underperform compared to practicing ophthalmologists on specialist tasks crucial to the care of patients with age-related macular degeneration (AMD). To address this, we initially identified the essential capabilities required for image-based clinical decision-making, and then developed a curriculum to selectively train VLMs in these skills. The resulting model, RetinaVLM, can be instructed to write reports that significantly outperform those written by leading foundation medical VLMs in disease staging (F1 score of 0.63 vs. 0.11) and patient referral (0.67 vs. 0.39), and approaches the diagnostic performance of junior ophthalmologists (who achieve 0.77 and 0.78 on the respective tasks). Furthermore, in a reader study involving two senior ophthalmologists with up to 32 years of experience, RetinaVLM's reports were found to be similarly correct (78.6% vs. 82.1%) and complete (both 78.6%) as reports written by junior ophthalmologists with up to 10 years of experience. These results demonstrate that our curriculum-based approach provides a blueprint for specializing generalist foundation medical VLMs to handle real-world clinical tasks.

This paper introduces Workflow Intention, a novel framework for identifying and encoding process objectives within complex business environments. Workflow Intention is the alignment of Input, Process and Output elements defining a Workflow's transformation objective interpreted from Workflow Signal inside Business Artefacts. It specifies how Input is processed to achieve desired Output, incorporating quality standards, business rules, compliance requirements and constraints. We adopt an end-to-end Business Artefact Encoder and Workflow Signal interpretation methodology involving four steps: Modality-Specific Encoding, Intra-Modality Attention, Inter-Modality Fusion Attention then Intention Decoding. We provide training procedures and critical loss function definitions. In this paper we introduce the concepts of Workflow Signal and Workflow Intention, where Workflow Signal decomposed into Input, Process and Output elements is interpreted from Business Artefacts, and Workflow Intention is a complete triple of these elements. We introduce a mathematical framework for representing Workflow Signal as a vector and Workflow Intention as a tensor, formalizing properties of these objects. Finally, we propose a modular, scalable, trainable, attention-based multimodal generative system to resolve Workflow Intention from Business Artefacts.

In many machine learning systems that jointly learn from multiple modalities, a core research question is to understand the nature of multimodal interactions: the emergence of new task-relevant information during learning from both modalities that was not present in either alone. We study this challenge of interaction quantification in a semi-supervised setting with only labeled unimodal data and naturally co-occurring multimodal data (e.g., unlabeled images and captions, video and corresponding audio) but when labeling them is time-consuming. Using a precise information-theoretic definition of interactions, our key contributions are the derivations of lower and upper bounds to quantify the amount of multimodal interactions in this semi-supervised setting. We propose two lower bounds based on the amount of shared information between modalities and the disagreement between separately trained unimodal classifiers, and derive an upper bound through connections to approximate algorithms for min-entropy couplings. We validate these estimated bounds and show how they accurately track true interactions. Finally, two semi-supervised multimodal applications are explored based on these theoretical results: (1) analyzing the relationship between multimodal performance and estimated interactions, and (2) self-supervised learning that embraces disagreement between modalities beyond agreement as is typically done.

Detecting out-of-distribution (OOD) samples is important for deploying machine learning models in safety-critical applications such as autonomous driving and robot-assisted surgery. Existing research has mainly focused on unimodal scenarios on image data. However, real-world applications are inherently multimodal, which makes it essential to leverage information from multiple modalities to enhance the efficacy of OOD detection. To establish a foundation for more realistic Multimodal OOD Detection, we introduce the first-of-its-kind benchmark, MultiOOD, characterized by diverse dataset sizes and varying modality combinations. We first evaluate existing unimodal OOD detection algorithms on MultiOOD, observing that the mere inclusion of additional modalities yields substantial improvements. This underscores the importance of utilizing multiple modalities for OOD detection. Based on the observation of Modality Prediction Discrepancy between in-distribution (ID) and OOD data, and its strong correlation with OOD performance, we propose the Agree-to-Disagree (A2D) algorithm to encourage such discrepancy during training. Moreover, we introduce a novel outlier synthesis method, NP-Mix, which explores broader feature spaces by leveraging the information from nearest neighbor classes and complements A2D to strengthen OOD detection performance. Extensive experiments on MultiOOD demonstrate that training with A2D and NP-Mix improves existing OOD detection algorithms by a large margin. Our source code and MultiOOD benchmark are available at https://github.com/donghao51/MultiOOD.

Multimodal entity linking (MEL) aims to link ambiguous mentions within multimodal contexts to corresponding entities in a multimodal knowledge base. Most existing approaches to MEL are based on representation learning or vision-and-language pre-training mechanisms for exploring the complementary effect among multiple modalities. However, these methods suffer from two limitations. On the one hand, they overlook the possibility of considering negative samples from the same modality. On the other hand, they lack mechanisms to capture bidirectional cross-modal interaction. To address these issues, we propose a Multi-level Matching network for Multimodal Entity Linking (M3EL). Specifically, M3EL is composed of three different modules: (i) a Multimodal Feature Extraction module, which extracts modality-specific representations with a multimodal encoder and introduces an intra-modal contrastive learning sub-module to obtain better discriminative embeddings based on uni-modal differences; (ii) an Intra-modal Matching Network module, which contains two levels of matching granularity: Coarse-grained Global-to-Global and Fine-grained Global-to-Local, to achieve local and global level intra-modal interaction; (iii) a Cross-modal Matching Network module, which applies bidirectional strategies, Textual-to-Visual and Visual-to-Textual matching, to implement bidirectional cross-modal interaction. Extensive experiments conducted on WikiMEL, RichpediaMEL, and WikiDiverse datasets demonstrate the outstanding performance of M3EL when compared to the state-of-the-art baselines.