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byAK and the research community

Jul 31

Specialist vision-language models for clinical ophthalmology

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.

Prism: A Framework for Decoupling and Assessing the Capabilities of VLMs

Vision Language Models (VLMs) demonstrate remarkable proficiency in addressing a wide array of visual questions, which requires strong perception and reasoning faculties. Assessing these two competencies independently is crucial for model refinement, despite the inherent difficulty due to the intertwined nature of seeing and reasoning in existing VLMs. To tackle this issue, we present Prism, an innovative framework designed to disentangle the perception and reasoning processes involved in visual question solving. Prism comprises two distinct stages: a perception stage that utilizes a VLM to extract and articulate visual information in textual form, and a reasoning stage that formulates responses based on the extracted visual information using a Large Language Model (LLM). This modular design enables the systematic comparison and assessment of both proprietary and open-source VLM for their perception and reasoning strengths. Our analytical framework provides several valuable insights, underscoring Prism's potential as a cost-effective solution for vision-language tasks. By combining a streamlined VLM focused on perception with a powerful LLM tailored for reasoning, Prism achieves superior results in general vision-language tasks while substantially cutting down on training and operational expenses. Quantitative evaluations show that Prism, when configured with a vanilla 2B LLaVA and freely accessible GPT-3.5, delivers performance on par with VLMs 10 times larger on the rigorous multimodal benchmark MMStar. The project is released at: https://github.com/SparksJoe/Prism.