Daily Papers

Large-scale video generation models are increasingly viewed as a promising path toward world models, yet their ability to capture causally coherent physical dynamics remains poorly understood. Existing evaluations largely emphasize visual quality, prompt adherence, or broad physical plausibility, leaving open whether a model can faithfully realize a complete causal cascade, in which an initiating event propagates through causally dependent interactions to a terminal outcome. We introduce CausalCascade, a simulator-grounded benchmark centered on 50 event-rich Blender scenes with structured event graphs, graph-grounded diagnostic VQA, three levels of future-event specification, and 2,832 controlled counterfactual variants, and use it to evaluate nine image-to-video models with complementary motion-, event-, and counterfactual-level diagnostics. Across the evaluated models, generated motion is more reliably localized spatially than realized with correct spatiotemporal evolution, while richer future-event specification improves event recovery but leaves physical realization limited. Counterfactual evaluation further reveals weak selective responsiveness to physical interventions, while most audited failures are foundational, arising at scene consistency or event occurrence. Together, these results position causal cascade generation as a process-level test of world modeling and highlight the need to jointly recover the intended future, faithfully realize its physical evolution, selectively respond to physical interventions, and maintain a coherent physical world over time. Code and dataset are available at https://github.com/SJTU-DeepDeltaLab/CausalCascade .

Vision-language models (VLMs) excel on visual question answering and multimodal reasoning benchmarks. Yet their capability on ultra-resolution images - where critical evidence is tiny, subtle, spatially distant, or distributed - remains unclear. Existing evaluations largely report final-answer accuracy, offering limited insight into whether models acquire and integrate the necessary visual evidence. We introduce UltraVR, a diagnostic benchmark for evidence-grounded visual reasoning over ultra-resolution images. UltraVR spans four high-value scenarios: CCTV surveillance, remote sensing (RS), whole-slide image (WSI) pathology, and industrial anomaly detection (AD). These domains pose complementary challenges: fine-grained object grounding in crowded CCTV scenes, long-range spatial comparison in RS, multi-scale evidence navigation in WSI, and subtle irregularity detection in repetitive industrial layouts. Beyond standard QA triples, each instance includes a structured ground-truth chain of thought with step-level questions, intermediate answers, and reasoning labels. These labels decompose reasoning into evidence grounding, local perception, quantification, evidence integration, and decision inference, enabling process-level diagnosis over black-box scoring. Using UltraVR, we evaluate frontier VLMs and show that current models remain far from reliable on ultra-resolution reasoning. Importantly, the structured annotations allow us to localize failures across the visual-to-decision pipeline: errors concentrate in evidence grounding and local perception, while downstream inference often recovers when intermediate visual facts are supplied. These findings demonstrate UltraVR as a diagnostic testbed for measuring not only whether VLMs answer correctly, but where their ultra-resolution reasoning process breaks.

Medical Visual Question Answering (Med-VQA) holds significant potential for clinical decision support, yet existing efforts primarily focus on 2D imaging with limited task diversity. This paper presents 3D-RAD, a large-scale dataset designed to advance 3D Med-VQA using radiology CT scans. The 3D-RAD dataset encompasses six diverse VQA tasks: anomaly detection, image observation, medical computation, existence detection, static temporal diagnosis, and longitudinal temporal diagnosis. It supports both open- and closed-ended questions while introducing complex reasoning challenges, including computational tasks and multi-stage temporal analysis, to enable comprehensive benchmarking. Extensive evaluations demonstrate that existing vision-language models (VLMs), especially medical VLMs exhibit limited generalization, particularly in multi-temporal tasks, underscoring the challenges of real-world 3D diagnostic reasoning. To drive future advancements, we release a high-quality training set 3D-RAD-T of 136,195 expert-aligned samples, showing that fine-tuning on this dataset could significantly enhance model performance. Our dataset and code, aiming to catalyze multimodal medical AI research and establish a robust foundation for 3D medical visual understanding, are publicly available at https://github.com/Tang-xiaoxiao/3D-RAD.

We present VinDr-CXR-VQA, a large-scale chest X-ray dataset for explainable Medical Visual Question Answering (Med-VQA) with spatial grounding. The dataset contains 17,597 question-answer pairs across 4,394 images, each annotated with radiologist-verified bounding boxes and clinical reasoning explanations. Our question taxonomy spans six diagnostic types-Where, What, Is there, How many, Which, and Yes/No-capturing diverse clinical intents. To improve reliability, we construct a balanced distribution of 41.7% positive and 58.3% negative samples, mitigating hallucinations in normal cases. Benchmarking with MedGemma-4B-it demonstrates improved performance (F1 = 0.624, +11.8% over baseline) while enabling lesion localization. VinDr-CXR-VQA aims to advance reproducible and clinically grounded Med-VQA research. The dataset and evaluation tools are publicly available at huggingface.co/datasets/Dangindev/VinDR-CXR-VQA.

Vision-Language Models (VLMs) often struggle with robust 3D spatial reasoning. Prevailing methods that rely on fine-tuning with 3D visual question-answering (VQA) datasets may overfit dataset-specific biases, while integrating specialized 3D visual encoders is often inflexible and cumbersome. In this paper, we argue that genuine spatial understanding should emerge from learning fundamental geometric priors, not only from high-level VQA supervision. We propose GASP (Geometric-Aware Spatial Priors), a framework that injects these priors directly into the LLM's transformer layers. GASP employs a small correspondence head, applied as a deep supervision signal across all layers, and is trained with a dual objective leveraging ground-truth geometry from large-scale video scenes: a contrastive loss on ground-truth point correspondences enforces 2D view-invariance, while a depth consistency supervision resolves 3D geometric ambiguities. Our analysis first provides a diagnostic showing that standard VLMs' internal correspondence matching accuracy is very low (often below 5%). We then demonstrate that our training substantially improves this behavior, boosting peak layer-wise correspondence to over 70% and maintaining over 85% temporal robustness while baselines remain below 5%. These internal improvements translate to significant gains on downstream spatial benchmarks including +18.2% on All-Angles Bench and +29.0% on VSI-Bench, all without training on any 3D VQA data. Our findings indicate that learning from fundamental geometric priors is a promising and generalizable pathway towards VLMs with more reliable 3D spatial reasoning.

Vision-language models (VLMs) are increasingly used to detect whether AI-generated images contain visible artifacts, yet their ability to analyze such artifacts remains poorly understood. A correct image-level decision can still hide important failures: a model may correctly flag an artifact while relying on the wrong visual cue, selecting the wrong region, or describing a defect that the image does not support. To evaluate these behaviors directly, we introduce SalArt-VQA, a diagnostic benchmark for fine-grained SALient ARTifact understanding in AI-generated images. SalArt-VQA contains 950 images and 3,681 human-authored multiple-choice questions spanning artifact images, matched real reference images, and paired generated reference images. Four aligned question types evaluate presence detection, semantic localization, spatial grounding, and evidence-grounded defect identification, while the reference splits test calibration and abstention when the annotated defect is absent. Across 20 VLMs, SalArt-VQA reveals failures that image-level detection accuracy hides: the strongest model reaches 99.37% detection recall on artifact images but answers all four artifact-side questions correctly on only 53.26% of images. Comparing artifact images with artifact-free references reveals a sensitivity-calibration tradeoff: sensitive models often make unsupported artifact claims, while conservative models avoid false alarms largely by missing real artifacts. These results show that high artifact detection accuracy alone does not imply grounded artifact understanding. SalArt-VQA exposes these hidden failure modes and provides a fine-grained evaluation of whether VLM artifact claims are supported by local visual evidence.

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

Although modern neural networks often generalize to new combinations of familiar concepts, the conditions that enable such compositionality have long been an open question. In this work, we study the systematicity gap in visual question answering: the performance difference between reasoning on previously seen and unseen combinations of object attributes. To test, we introduce a novel diagnostic dataset, CLEVR-HOPE. We find that the systematicity gap is not reduced by increasing the quantity of training data, but is reduced by increasing the diversity of training data. In particular, our experiments suggest that the more distinct attribute type combinations are seen during training, the more systematic we can expect the resulting model to be.

The application of Large Language Models (LLMs) to diagnostic decision-making has garnered growing interest. However, existing benchmarks largely focus on textual reasoning or isolated visual question-answering (VQA) tasks, lacking holistic integration of clinical narratives and medical imaging, and thus failing to assess the multimodal diagnostic synthesis capability central to expert clinical judgment. To bridge this gap, we introduce MedReaMM, a benchmark specifically designed to evaluate models' ability to synthesize heterogeneous clinical evidence consisting of detailed patient histories alongside multiple medical images into accurate differential diagnoses under a complete-information paradigm. Constructed from case reports sourced from top-tier medical journals and curated clinical case databases, MedReaMM comprises 625 expert-validated cases with an average of 2.79 medical images per case and a total of 1,042 standardized diagnoses annotated with ICD-11 codes. These cases predominantly represent rare, atypical, or multi-system presentations that demand expert-level evidence integration beyond routine pattern recognition. We evaluate 23 Large Multimodal Models (LMMs) and find that most achieve diagnostic accuracy scores below 50%, underscoring a substantial gap in multimodal diagnostic synthesis capability. Further analysis reveals that medical knowledge proficiency, medical image understanding, and evidence integration are all highly correlated with diagnostic performance.

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.

Recent advancements in vision-language systems have improved the accuracy of Radiological Visual Question Answering (VQA) Models. However, some challenges remain across each stage of model development: limited expert-labeled images hinders data procurement at scale; the intricate and nuanced patterns of radiological images make modeling inherently difficult; and the lack of evaluation evaluation efforts makes it difficult to identify cases where the model might be ill-conditioned. In this study, we fine-tune a lightweight 3B parameter vision-language model for Radiological VQA, demonstrating that small models, when appropriately tuned with curated data, can achieve robust performance across both open- and closed-ended questions. We propose a cost-effective training pipeline from synthetic question-answer pair generation to multi-stage fine-tuning on specialised radiological domain-targeted datasets (e.g., ROCO v2.0, MedPix v2.0). Our results show that despite operating at a fraction of the scale of state-of-the-art models such as LLaVA-Med, our model achieves promising performance given its small parameter size and the limited scale of training data. We introduce a lightweight saliency-based diagnostic tool that enables domain experts to inspect VQA model performance and identify ill-conditioned failure modes through saliency analysis.

Chain-of-thought (CoT) reasoning has advanced medical visual question answering (VQA), yet most existing CoT rationales are free-form and fail to capture the structured reasoning process clinicians actually follow. This work asks: Can traceable, multi-step reasoning supervision improve reasoning accuracy and the interpretability of Medical VQA? To this end, we introduce Step-CoT, a large-scale medical reasoning dataset with expert-curated, structured multi-step CoT aligned to clinical diagnostic workflows, implicitly grounding the model's reasoning in radiographic evidence. Step-CoT comprises more than 10K real clinical cases and 70K VQA pairs organized around diagnostic workflows, providing supervised intermediate steps that guide models to follow valid reasoning trajectories. To effectively learn from Step-CoT, we further introduce a teacher-student framework with a dynamic graph-structured focusing mechanism that prioritizes diagnostically informative steps while filtering out less relevant contexts. Our experiments show that using Step-CoT can improve reasoning accuracy and interpretability. Benchmark: github.com/hahaha111111/Step-CoT. Dataset Card: huggingface.co/datasets/fl-15o/Step-CoT

Recent advances in Large Vision-Language Models (LVLMs) have shown strong potential for multi-modal radiological reasoning, particularly in tasks like diagnostic visual question answering (VQA) and radiology report generation. However, most existing approaches for 3D CT analysis largely rely on static, single-pass inference. In practice, clinical interpretation is a dynamic, tool-mediated workflow where radiologists iteratively review slices and use measurement, radiomics, and segmentation tools to refine findings. To bridge this gap, we propose CT-Flow, an agentic framework designed for interoperable volumetric interpretation. By leveraging the Model Context Protocol (MCP), CT-Flow shifts from closed-box inference to an open, tool-aware paradigm. We curate CT-FlowBench, the first large-scale instruction-tuning benchmark tailored for 3D CT tool-use and multi-step reasoning. Built upon this, CT-Flow functions as a clinical orchestrator capable of decomposing complex natural language queries into automated tool-use sequences. Experimental evaluations on CT-FlowBench and standard 3D VQA datasets demonstrate that CT-Flow achieves state-of-the-art performance, surpassing baseline models by 41% in diagnostic accuracy and achieving a 95% success rate in autonomous tool invocation. This work provides a scalable foundation for integrating autonomous, agentic intelligence into real-world clinical radiology.

Long-form image captioning exposes a reward granularity problem in RL: captions are judged as whole sequences, while the important errors occur at the level of individual visual claims. A good dense caption should be both faithful and informative, avoiding hallucination without omitting salient details. Yet pairwise preferences, reference-based metrics, and holistic scalar rewards compress these local errors into a single sequence-level signal, obscuring the tradeoff between factuality and coverage. We introduce ClaimDiff-RL, a framework that uses reference-conditioned atomic claim differences as the reward unit for caption RL. Given an image, an actor caption, and a reference caption, a multimodal judge enumerates visually grounded differences, verifies each difference against the image, assigns open-vocabulary error types and severity levels, and produces per-difference statistics for reward composition. This makes hallucinated claims and omitted salient facts separately measurable and tunable. Experiments show that holistic scalar rewards can reduce hallucination by increasing missing facts, while ClaimDiff-RL exposes this faithfulness and coverage tradeoff and enables more balanced operating points. On a 160-image human-labeled diagnostic benchmark, public captioning benchmarks, and VQA benchmarks, ClaimDiff-RL improves the hallucination--missing-fact balance, preserves general capability, and even surpasses Gemini-3-Pro-Preview on several fine-grained Capability dimensions such as object counting, spatial relations, and scene recognition. These results suggest that typed, verifiable claim differences are an effective reward unit for fine-grained and diagnosable caption RL.

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

Pathological diagnosis is inherently multi-scale, requiring the integration of global tissue architecture at low magnification with cellular morphology at higher magnification. However, existing pathology benchmarks and vision-language models (VLMs) are still largely developed under single-scale settings, limiting their ability to learn clinically meaningful multi-magnification reasoning. Moreover, naively constructed visual question answering (VQA) tasks may be susceptible to text-only or superficial visual shortcuts, leading to unreliable assessments of visual understanding. To address these limitations, we introduce a benchmark and training framework for shortcut-resistant cross-scale pathology reasoning. We design an Adversarial Text-only Screening strategy for semantic reasoning questions and a Structure-controlled Distractor Sampling strategy for visual grounding questions, encouraging models to rely on cross-scale visual evidence. Based on this pipeline, we construct PathScale-VQA, a high-quality cross-scale pathology VQA benchmark with 10,373 multiple-choice questions grounded in 1,368 diagnostic paths across multiple magnification levels. Building on the semantic reasoning set, PathScale-R1 is optimized through Difficulty-driven Reasoning Distillation supervised fine-tuning followed by reinforcement learning with a Scale-aware Reasoning Structure reward, which encourages the use of evidence across magnifications. Extensive experiments demonstrate state-of-the-art performance of PathScale-R1 on cross-scale reasoning tasks and effective transfer to conventional single-scale pathology VQA. Our code is available at https://github.com/iMVR-PL/PathScale-R1.

Vision-Language Models (VLMs) have shown promise in various 2D visual tasks, yet their readiness for 3D clinical diagnosis remains unclear due to stringent demands for recognition precision, reasoning ability, and domain knowledge. To systematically evaluate these dimensions, we present DeepTumorVQA, a diagnostic visual question answering (VQA) benchmark targeting abdominal tumors in CT scans. It comprises 9,262 CT volumes (3.7M slices) from 17 public datasets, with 395K expert-level questions spanning four categories: Recognition, Measurement, Visual Reasoning, and Medical Reasoning. DeepTumorVQA introduces unique challenges, including small tumor detection and clinical reasoning across 3D anatomy. Benchmarking four advanced VLMs (RadFM, M3D, Merlin, CT-CHAT), we find current models perform adequately on measurement tasks but struggle with lesion recognition and reasoning, and are still not meeting clinical needs. Two key insights emerge: (1) large-scale multimodal pretraining plays a crucial role in DeepTumorVQA testing performance, making RadFM stand out among all VLMs. (2) Our dataset exposes critical differences in VLM components, where proper image preprocessing and design of vision modules significantly affect 3D perception. To facilitate medical multimodal research, we have released DeepTumorVQA as a rigorous benchmark: https://github.com/Schuture/DeepTumorVQA.

Recent advancements in Multimodal Large Language Models (MLLMs) have demonstrated impressive performance on standard visual reasoning benchmarks. However, there is growing concern that these models rely excessively on linguistic shortcuts rather than genuine visual grounding, a phenomenon we term Text Bias. In this paper, we investigate the fundamental tension between visual perception and linguistic priors. We decouple the sources of this bias into two dimensions: Internal Corpus Bias, stemming from statistical correlations in pretraining, and External Instruction Bias, arising from the alignment-induced tendency toward sycophancy. To quantify this effect, we introduce V-FAT (Visual Fidelity Against Text-bias), a diagnostic benchmark comprising 4,026 VQA instances across six semantic domains. V-FAT employs a Three-Level Evaluation Framework that systematically increases the conflict between visual evidence and textual information: (L1) internal bias from atypical images, (L2) external bias from misleading instructions, and (L3) synergistic bias where both coincide. We introduce the Visual Robustness Score (VRS), a metric designed to penalize "lucky" linguistic guesses and reward true visual fidelity. Our evaluation of 12 frontier MLLMs reveals that while models excel in existing benchmarks, they experience significant visual collapse under high linguistic dominance.

Video generation models aspire to simulate dynamic environments, and several benchmarks now evaluate memory consistency across frames. However, most assess consistency only while the target remains in view, and the few that force objects out of view evaluate static scenes where nothing changes during occlusion. To bridge this gap, we introduce MemoBench, a diagnostic benchmark built around the disappear-and-reappear paradigm in dynamically changing environments: a target object undergoes a physical process, disappears from view, and must be correctly recovered in its updated state upon reappearance. We curate 360 ground-truth clips spanning synthetic and real-world scenes, and design an evaluation suite combining automated metrics with VQA-based assessment across four diagnostic pillars. Evaluation of eight state-of-the-art models reveals key insights and open challenges regarding memory consistency under the disappear-and-reappear paradigm.

Medical Anomaly Detection (MedAD) presents a significant opportunity to enhance diagnostic accuracy using Large Multimodal Models (LMMs) to interpret and answer questions based on medical images. However, the reliance on Supervised Fine-Tuning (SFT) on simplistic and fragmented datasets has hindered the development of models capable of plausible reasoning and robust multimodal generalization. To overcome this, we introduce MedAD-38K, the first large-scale, multi-modal, and multi-center benchmark for MedAD featuring diagnostic Chain-of-Thought (CoT) annotations alongside structured Visual Question-Answering (VQA) pairs. On this foundation, we propose a two-stage training framework. The first stage, Cognitive Injection, uses SFT to instill foundational medical knowledge and align the model with a structured think-then-answer paradigm. Given that standard policy optimization can produce reasoning that is disconnected from the final answer, the second stage incorporates Consistency Group Relative Policy Optimization (Con-GRPO). This novel algorithm incorporates a crucial consistency reward to ensure the generated reasoning process is relevant and logically coherent with the final diagnosis. Our proposed model, MedAD-R1, achieves state-of-the-art (SOTA) performance on the MedAD-38K benchmark, outperforming strong baselines by more than 10\%. This superior performance stems from its ability to generate transparent and logically consistent reasoning pathways, offering a promising approach to enhancing the trustworthiness and interpretability of AI for clinical decision support.

Medical visual question answering (VQA) aims to answer clinically relevant questions regarding input medical images. This technique has the potential to improve the efficiency of medical professionals while relieving the burden on the public health system, particularly in resource-poor countries. Existing medical VQA methods tend to encode medical images and learn the correspondence between visual features and questions without exploiting the spatial, semantic, or medical knowledge behind them. This is partially because of the small size of the current medical VQA dataset, which often includes simple questions. Therefore, we first collected a comprehensive and large-scale medical VQA dataset, focusing on chest X-ray images. The questions involved detailed relationships, such as disease names, locations, levels, and types in our dataset. Based on this dataset, we also propose a novel baseline method by constructing three different relationship graphs: spatial relationship, semantic relationship, and implicit relationship graphs on the image regions, questions, and semantic labels. The answer and graph reasoning paths are learned for different questions.

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

Visual Question Answering (VQA) is a challenging task of natural language processing (NLP) and computer vision (CV), attracting significant attention from researchers. English is a resource-rich language that has witnessed various developments in datasets and models for visual question answering. Visual question answering in other languages also would be developed for resources and models. In addition, there is no multilingual dataset targeting the visual content of a particular country with its own objects and cultural characteristics. To address the weakness, we provide the research community with a benchmark dataset named EVJVQA, including 33,000+ pairs of question-answer over three languages: Vietnamese, English, and Japanese, on approximately 5,000 images taken from Vietnam for evaluating multilingual VQA systems or models. EVJVQA is used as a benchmark dataset for the challenge of multilingual visual question answering at the 9th Workshop on Vietnamese Language and Speech Processing (VLSP 2022). This task attracted 62 participant teams from various universities and organizations. In this article, we present details of the organization of the challenge, an overview of the methods employed by shared-task participants, and the results. The highest performances are 0.4392 in F1-score and 0.4009 in BLUE on the private test set. The multilingual QA systems proposed by the top 2 teams use ViT for the pre-trained vision model and mT5 for the pre-trained language model, a powerful pre-trained language model based on the transformer architecture. EVJVQA is a challenging dataset that motivates NLP and CV researchers to further explore the multilingual models or systems for visual question answering systems. We released the challenge on the Codalab evaluation system for further research.

Visual Question Answering (VQA) is a multimodal task requiring reasoning across textual and visual inputs, which becomes particularly challenging in low-resource languages like Vietnamese due to linguistic variability and the lack of high-quality datasets. Traditional methods often rely heavily on extensive annotated datasets, computationally expensive pipelines, and large pre-trained models, specifically in the domain of Vietnamese VQA, limiting their applicability in such scenarios. To address these limitations, we propose a training framework that combines a paraphrase-based feature augmentation module with a dynamic curriculum learning strategy. Explicitly, augmented samples are considered "easy" while raw samples are regarded as "hard". The framework then utilizes a mechanism that dynamically adjusts the ratio of easy to hard samples during training, progressively modifying the same dataset to increase its difficulty level. By enabling gradual adaptation to task complexity, this approach helps the Vietnamese VQA model generalize well, thus improving overall performance. Experimental results show consistent improvements on the OpenViVQA dataset and mixed outcomes on the ViVQA dataset, highlighting both the potential and challenges of our approach in advancing VQA for Vietnamese language.

Artificial intelligence has advanced in Medical Visual Question Answering (Med-VQA), but prevalent research tends to focus on the accuracy of the answers, often overlooking the reasoning paths and interpretability, which are crucial in clinical settings. Besides, current Med-VQA algorithms, typically reliant on singular models, lack the robustness needed for real-world medical diagnostics which usually require collaborative expert evaluation. To address these shortcomings, this paper presents MedCoT, a novel hierarchical expert verification reasoning chain method designed to enhance interpretability and accuracy in biomedical imaging inquiries. MedCoT is predicated on two principles: The necessity for explicit reasoning paths in Med-VQA and the requirement for multi-expert review to formulate accurate conclusions. The methodology involves an Initial Specialist proposing diagnostic rationales, followed by a Follow-up Specialist who validates these rationales, and finally, a consensus is reached through a vote among a sparse Mixture of Experts within the locally deployed Diagnostic Specialist, which then provides the definitive diagnosis. Experimental evaluations on four standard Med-VQA datasets demonstrate that MedCoT surpasses existing state-of-the-art approaches, providing significant improvements in performance and interpretability.

Visual Question Answering (VQA) is a complicated task that requires the capability of simultaneously processing natural language and images. Initially, this task was researched, focusing on methods to help machines understand objects and scene contexts in images. However, some text appearing in the image that carries explicit information about the full content of the image is not mentioned. Along with the continuous development of the AI era, there have been many studies on the reading comprehension ability of VQA models in the world. As a developing country, conditions are still limited, and this task is still open in Vietnam. Therefore, we introduce the first large-scale dataset in Vietnamese specializing in the ability to understand text appearing in images, we call it ViTextVQA (Vietnamese Text-based Visual Question Answering dataset) which contains over 16,000 images and over 50,000 questions with answers. Through meticulous experiments with various state-of-the-art models, we uncover the significance of the order in which tokens in OCR text are processed and selected to formulate answers. This finding helped us significantly improve the performance of the baseline models on the ViTextVQA dataset. Our dataset is available at this https://github.com/minhquan6203/ViTextVQA-Dataset{link} for research purposes.

Visual Question Answering (VQA) is a fundamental multimodal task that requires models to jointly understand visual and textual information. Early VQA systems relied heavily on language biases, motivating subsequent work to emphasize visual grounding and balanced datasets. With the success of large-scale pre-trained transformers for both text and vision domains -- such as PhoBERT for Vietnamese language understanding and Vision Transformers (ViT) for image representation learning -- multimodal fusion has achieved remarkable progress. For Vietnamese VQA, several datasets have been introduced to promote research in low-resource multimodal learning, including ViVQA, OpenViVQA, and the recently proposed ViTextVQA. These resources enable benchmarking of models that integrate linguistic and visual features in the Vietnamese context. Evaluation of VQA systems often employs automatic metrics originally designed for image captioning or machine translation, such as BLEU, METEOR, CIDEr, Recall, Precision, and F1-score. However, recent research suggests that large language models can further improve the alignment between automatic evaluation and human judgment in VQA tasks. In this work, we explore Vietnamese Visual Question Answering using transformer-based architectures, leveraging both textual and visual pre-training while systematically comparing automatic evaluation metrics under multilingual settings.

Traditionally, AI research in medical diagnosis has largely centered on image analysis. While this has led to notable advancements, the absence of patient-reported symptoms continues to hinder diagnostic accuracy. To address this, we propose a Pre-Consultation Dialogue Framework (PCDF) that mimics real-world diagnostic procedures, where doctors iteratively query patients before reaching a conclusion. Specifically, we simulate diagnostic dialogues between two vision-language models (VLMs): a DocVLM, which generates follow-up questions based on the image and dialogue history, and a PatientVLM, which responds using a symptom profile derived from the ground-truth diagnosis. We additionally conducted a small-scale clinical validation of the synthetic symptoms generated by our framework, with licensed clinicians confirming their clinical relevance, symptom coverage, and overall realism. These findings indicate that the resulting DocVLM-PatientVLM interactions form coherent, multi-turn consultations paired with images and diagnoses, which we then use to fine-tune the DocVLM. This dialogue-based supervision leads to substantial gains over image-only training, highlighting the value of realistic symptom elicitation for diagnosis.

This paper presents a state-of-the-art model for visual question answering (VQA), which won the first place in the 2017 VQA Challenge. VQA is a task of significant importance for research in artificial intelligence, given its multimodal nature, clear evaluation protocol, and potential real-world applications. The performance of deep neural networks for VQA is very dependent on choices of architectures and hyperparameters. To help further research in the area, we describe in detail our high-performing, though relatively simple model. Through a massive exploration of architectures and hyperparameters representing more than 3,000 GPU-hours, we identified tips and tricks that lead to its success, namely: sigmoid outputs, soft training targets, image features from bottom-up attention, gated tanh activations, output embeddings initialized using GloVe and Google Images, large mini-batches, and smart shuffling of training data. We provide a detailed analysis of their impact on performance to assist others in making an appropriate selection.

Medical visual question answering (VQA) is a challenging multimodal task, where Vision-Language Pre-training (VLP) models can effectively improve the generalization performance. However, most methods in the medical field treat VQA as an answer classification task which is difficult to transfer to practical application scenarios. Additionally, due to the privacy of medical images and the expensive annotation process, large-scale medical image-text pairs datasets for pretraining are severely lacking. In this paper, we propose a large-scale MultI-task Self-Supervised learning based framework (MISS) for medical VQA tasks. Unlike existing methods, we treat medical VQA as a generative task. We unify the text encoder and multimodal encoder and align image-text features through multi-task learning. Furthermore, we propose a Transfer-and-Caption method that extends the feature space of single-modal image datasets using large language models (LLMs), enabling those traditional medical vision field task data to be applied to VLP. Experiments show that our method achieves excellent results with fewer multimodal datasets and demonstrates the advantages of generative VQA models. The code and model weights will be released upon the paper's acceptance.

Vision Language Models (VLMs) are increasingly used for tasks like medical report generation and visual question answering. However, fluent diagnostic text does not guarantee safe visual understanding. In clinical practice, interpretation begins with pre-diagnostic sanity checks: verifying that the input is valid to read (correct modality and anatomy, plausible viewpoint and orientation, and no obvious integrity violations). Existing benchmarks largely assume this step is solved, and therefore miss a critical failure mode: a model can produce plausible narratives even when the input is inconsistent or invalid. We introduce MedObvious, a 1,880-task benchmark that isolates input validation as a set-level consistency capability over small multi-panel image sets: the model must identify whether any panel violates expected coherence. MedObvious spans five progressive tiers, from basic orientation/modality mismatches to clinically motivated anatomy/viewpoint verification and triage-style cues, and includes five evaluation formats to test robustness across interfaces. Evaluating 17 different VLMs, we find that sanity checking remains unreliable: several models hallucinate anomalies on normal (negative-control) inputs, performance degrades when scaling to larger image sets, and measured accuracy varies substantially between multiple-choice and open-ended settings. These results show that pre-diagnostic verification remains unsolved for medical VLMs and should be treated as a distinct, safety-critical capability before deployment.

In this paper, we focus on the problem of Medical Visual Question Answering (MedVQA), which is crucial in efficiently interpreting medical images with vital clinic-relevant information. Firstly, we reframe the problem of MedVQA as a generation task that naturally follows the human-machine interaction, we propose a generative-based model for medical visual understanding by aligning visual information from a pre-trained vision encoder with a large language model. Secondly, we establish a scalable pipeline to construct a large-scale medical visual question-answering dataset, named PMC-VQA, which contains 227k VQA pairs of 149k images that cover various modalities or diseases. Thirdly, we pre-train our proposed model on PMC-VQA and then fine-tune it on multiple public benchmarks, e.g., VQA-RAD and SLAKE, outperforming existing work by a large margin. Additionally, we propose a test set that has undergone manual verification, which is significantly more challenging, even the best models struggle to solve.

This paper presents a comprehensive evaluation of GPT-4V's capabilities across diverse medical imaging tasks, including Radiology Report Generation, Medical Visual Question Answering (VQA), and Visual Grounding. While prior efforts have explored GPT-4V's performance in medical image analysis, to the best of our knowledge, our study represents the first quantitative evaluation on publicly available benchmarks. Our findings highlight GPT-4V's potential in generating descriptive reports for chest X-ray images, particularly when guided by well-structured prompts. Meanwhile, its performance on the MIMIC-CXR dataset benchmark reveals areas for improvement in certain evaluation metrics, such as CIDEr. In the domain of Medical VQA, GPT-4V demonstrates proficiency in distinguishing between question types but falls short of the VQA-RAD benchmark in terms of accuracy. Furthermore, our analysis finds the limitations of conventional evaluation metrics like the BLEU scores, advocating for the development of more semantically robust assessment methods. In the field of Visual Grounding, GPT-4V exhibits preliminary promise in recognizing bounding boxes, but its precision is lacking, especially in identifying specific medical organs and signs. Our evaluation underscores the significant potential of GPT-4V in the medical imaging domain, while also emphasizing the need for targeted refinements to fully unlock its capabilities.

In this work, we introduce RadImageNet-VQA, a large-scale dataset designed to advance radiologic visual question answering (VQA) on CT and MRI exams. Existing medical VQA datasets are limited in scale, dominated by X-ray imaging or biomedical illustrations, and often prone to text-based shortcuts. RadImageNet-VQA is built from expert-curated annotations and provides 750K images paired with 7.5M question-answer samples. It covers three key tasks - abnormality detection, anatomy recognition, and pathology identification - spanning eight anatomical regions and 97 pathology categories, and supports open-ended, closed-ended, and multiple-choice questions. Extensive experiments show that state-of-the-art vision-language models still struggle with fine-grained pathology identification, particularly in open-ended settings and even after fine-tuning. Text-only analysis further reveals that model performance collapses to near-random without image inputs, confirming that RadImageNet-VQA is free from linguistic shortcuts. The full dataset and benchmark are publicly available at https://huggingface.co/datasets/raidium/RadImageNet-VQA.

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

Medical Visual Question Answering (MedVQA) is a promising field for developing clinical decision support systems, yet progress is often limited by the available datasets, which can lack clinical complexity and visual diversity. To address these gaps, we introduce Kvasir-VQA-x1, a new, large-scale dataset for gastrointestinal (GI) endoscopy. Our work significantly expands upon the original Kvasir-VQA by incorporating 159,549 new question-answer pairs that are designed to test deeper clinical reasoning. We developed a systematic method using large language models to generate these questions, which are stratified by complexity to better assess a model's inference capabilities. To ensure our dataset prepares models for real-world clinical scenarios, we have also introduced a variety of visual augmentations that mimic common imaging artifacts. The dataset is structured to support two main evaluation tracks: one for standard VQA performance and another to test model robustness against these visual perturbations. By providing a more challenging and clinically relevant benchmark, Kvasir-VQA-x1 aims to accelerate the development of more reliable and effective multimodal AI systems for use in clinical settings. The dataset is fully accessible and adheres to FAIR data principles, making it a valuable resource for the wider research community. Code and data: https://github.com/Simula/Kvasir-VQA-x1 and https://huggingface.co/datasets/SimulaMet/Kvasir-VQA-x1

In this paper, we critically evaluate the capabilities of the state-of-the-art multimodal large language model, i.e., GPT-4 with Vision (GPT-4V), on Visual Question Answering (VQA) task. Our experiments thoroughly assess GPT-4V's proficiency in answering questions paired with images using both pathology and radiology datasets from 11 modalities (e.g. Microscopy, Dermoscopy, X-ray, CT, etc.) and fifteen objects of interests (brain, liver, lung, etc.). Our datasets encompass a comprehensive range of medical inquiries, including sixteen distinct question types. Throughout our evaluations, we devised textual prompts for GPT-4V, directing it to synergize visual and textual information. The experiments with accuracy score conclude that the current version of GPT-4V is not recommended for real-world diagnostics due to its unreliable and suboptimal accuracy in responding to diagnostic medical questions. In addition, we delineate seven unique facets of GPT-4V's behavior in medical VQA, highlighting its constraints within this complex arena. The complete details of our evaluation cases are accessible at https://github.com/ZhilingYan/GPT4V-Medical-Report.

Visual Question Answering (VQA) has become an important benchmark for assessing how large multimodal models (LMMs) interpret images. However, most VQA datasets focus on real-world images or simple diagrammatic analysis, with few focused on interpreting complex scientific charts. Indeed, many VQA datasets that analyze charts do not contain the underlying data behind those charts or assume a 1-to-1 correspondence between chart marks and underlying data. In reality, charts are transformations (i.e. analysis, simplification, modification) of data. This distinction introduces a reasoning challenge in VQA that the current datasets do not capture. In this paper, we argue for a dedicated VQA benchmark for scientific charts where there is no 1-to-1 correspondence between chart marks and underlying data. To do so, we survey existing VQA datasets and highlight limitations of the current field. We then generate synthetic histogram charts based on ground truth data, and ask both humans and a large reasoning model questions where precise answers depend on access to the underlying data. We release the open-source dataset, including figures, underlying data, distribution parameters used to generate the data, and bounding boxes for all figure marks and text for future research.

We introduce a Polish-language medical visual question answering (VQA) benchmark, built from Polish Board Certification Examination questions for licensed physicians and dentists pursuing specialist certification. The benchmark comprises image-containing questions spanning diverse medical specialties and visual domains, together with a text-only question answering (QA) control set. We evaluate Polish-oriented, general-purpose open-weight, and commercial vision-language models. The task remains challenging: the best model achieves 79.0\% accuracy on the full VQA set, and only GPT-5.6 surpasses the approximate human reference on the subset with available candidate responses; all other evaluated models perform worse than humans. To assess visual grounding, we compare complete inputs with configurations omitting the image, the question, or both, and categorize questions by image importance. Models derive more useful information from the question text than from the image and perform worse on image-dominant questions. Across both QA and VQA, they nevertheless achieve above-chance accuracy from the answer choices alone, showing that non-trivial performance can persist even when key task components are missing.

The reasoning gap between large and compact vision-language models (VLMs) limits the deployment of medical AI on portable clinical devices. Compact VLMs of 2--4B parameters can run on resource-constrained hardware but lack the multi-step reasoning capacity needed for interpretable clinical decision support. Existing knowledge distillation methods transfer answers without the reasoning process behind them. Medical visual question answering (VQA) serves as a testbed for this problem, as it requires models to integrate visual evidence with clinical knowledge through structured reasoning chains. We introduce LiteMedCoT-VL, a pipeline that transfers chain-of-thought reasoning from a 235B teacher model to 2B student models through LoRA-based fine-tuning on explanation-enriched training data. All inference is conducted without image captions by default, simulating the clinical scenario in which a physician interprets a medical image directly without an accompanying radiology report. On the PMC-VQA benchmark, LiteMedCoT-VL achieves 64.9% accuracy, exceeding the zero-shot Qwen3-VL-4B baseline of 53.9% by 11.0 percentage points and outperforming all published baselines. This result indicates that a 2B model with reasoning distillation can match or exceed models with twice the parameters. Visual grounding analysis shows that the model relies on image content rather than exploiting textual priors. Our code is publicly available at https://anonymous.4open.science/r/LiteMedCoT-VL.

Computed Tomography (CT) scan, which produces 3D volumetric medical data that can be viewed as hundreds of cross-sectional images (a.k.a. slices), provides detailed anatomical information for diagnosis. For radiologists, creating CT radiology reports is time-consuming and error-prone. A visual question answering (VQA) system that can answer radiologists' questions about some anatomical regions on the CT scan and even automatically generate a radiology report is urgently needed. However, existing VQA systems cannot adequately handle the CT radiology question answering (CTQA) task for: (1) anatomic complexity makes CT images difficult to understand; (2) spatial relationship across hundreds slices is difficult to capture. To address these issues, this paper proposes CT-Agent, a multimodal agentic framework for CTQA. CT-Agent adopts anatomically independent tools to break down the anatomic complexity; furthermore, it efficiently captures the across-slice spatial relationship with a global-local token compression strategy. Experimental results on two 3D chest CT datasets, CT-RATE and RadGenome-ChestCT, verify the superior performance of CT-Agent.

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

Is it possible to develop an "AI Pathologist" to pass the board-certified examination of the American Board of Pathology? To achieve this goal, the first step is to create a visual question answering (VQA) dataset where the AI agent is presented with a pathology image together with a question and is asked to give the correct answer. Our work makes the first attempt to build such a dataset. Different from creating general-domain VQA datasets where the images are widely accessible and there are many crowdsourcing workers available and capable of generating question-answer pairs, developing a medical VQA dataset is much more challenging. First, due to privacy concerns, pathology images are usually not publicly available. Second, only well-trained pathologists can understand pathology images, but they barely have time to help create datasets for AI research. To address these challenges, we resort to pathology textbooks and online digital libraries. We develop a semi-automated pipeline to extract pathology images and captions from textbooks and generate question-answer pairs from captions using natural language processing. We collect 32,799 open-ended questions from 4,998 pathology images where each question is manually checked to ensure correctness. To our best knowledge, this is the first dataset for pathology VQA. Our dataset will be released publicly to promote research in medical VQA.

Cancer screening is a reasoning task. A radiologist observes findings, compares them to prior scans, integrates clinical context, and reaches a diagnostic conclusion confirmed by pathology. We present RadThinking, a Visual Question Answering (VQA) dataset that makes this reasoning explicit and trainable. RadThinking releases VQA pairs at three difficulty tiers. Foundation VQAs are atomic perception questions. Single-step reasoning VQAs apply one clinical rule. Compositional VQAs require multi-step chain-of-thought to reach a guideline category such as LI-RADS-5. For every compositional VQA, we release the chain of foundation VQAs that solves it. The chain follows the rules of the governing clinical reporting standard. The dataset spans 20,362 CT scans from 9,131 patients across 43 cancer groups, plus 2,077 verified healthy controls with >1-year follow-up. To our knowledge, RadThinking is the first cancer-screening VQA corpus that stratifies questions by reasoning depth and grounds compositions in clinical reporting standards. The foundation tier supplies atomic perception supervision. The compositional tier supplies chain-of-thought data and verifiable rewards for reinforcement-learning recipes such as DeepSeek-R1 and OpenAI o1. RadThinking enables systematic training and evaluation of whether AI systems can reason about cancer, not merely detect it.

Vision-language models (VLMs) have shown increasing potential for medical image understanding, yet their capabilities in ophthalmic imaging remain insufficiently characterized. Existing ophthalmic datasets are typically designed for individual diseases or specialized tasks, making it difficult to systematically evaluate whether VLMs can move beyond disease recognition toward comparative reasoning and fine-grained spatial grounding. We introduce EyeVQA, a unified visual question answering benchmark for comprehensive evaluation of ophthalmic VLMs. EyeVQA is constructed from 21 available ophthalmic datasets and contains 20,000 question-answer pairs spanning six disease groups and seven question types: Single-Choice, Multi-Select, Variable-Select, True-False, Ranking, Point Location, and Bounding Box. Gold answers are deterministically derived from source-provided diagnoses, severity grades, clinical findings, segmentation masks, bounding boxes, and anatomical landmarks, enabling reproducible evaluation without relying on model-generated annotations. Notably, 44.5% of the questions require reasoning across multiple images, extending evaluation beyond conventional single-image medical VQA. We benchmark fourteen representative general-purpose, scientific, and medically specialized VLMs under a unified zero-shot protocol. The best-performing model only achieves an overall score of 62.8, while substantial gaps remain in spatial grounding and cross-task generalization. These results highlight the limitations of current VLMs in comprehensive ophthalmic visual understanding and establish EyeVQA as a diagnostic benchmark for developing more reliable and spatially grounded ophthalmic multimodal models. The project page is available at https://github.com/PKUTHM/EyeVQA.

Medical visual question answering (Med-VQA) has strong potential for clinical decision support by enabling AI models to interpret medical images and answer clinically relevant queries. Recent approaches typically connect off-the-shelf vision encoders with large language models (LLMs) through lightweight mapping networks to reduce computational cost. However, these methods often overlook the importance of handling noise and small irrelevant changes in visual representations. To address these challenges, we propose a noise-aware Med-VQA framework that incorporates a denoising autoencoder before visual embeddings are mapped into the input space of an LLM. The denoising autoencoder is pretrained to reconstruct clean visual embeddings from corrupted inputs, encouraging the model to learn robust visual representations that are less sensitive to noise. The resulting embeddings are then projected into the language model embedding space using a multi-layer perceptron (MLP), forming visual prefix tokens that provide image information to the LLM. To enable efficient adaptation without full retraining, we employ parameter-efficient fine-tuning using low-rank adaptation (LoRA). The proposed method is evaluated on the SLAKE and PathVQA benchmarks. Experimental results show improved robustness to noisy input embeddings while maintaining competitive clean performance across multiple evaluation criteria. These findings suggest that learning more robust visual representations can enhance Med-VQA performance and robustness.

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

Pathology vision-language models (VLMs) have recently progressed rapidly and are commonly evaluated by answer accuracy on pathology VQA benchmarks. However, we dig into current evaluations and identify three overlooked issues: 1) Visual evidence is not always necessary. For instance, Gemini-3-Pro achieves 53.5% average accuracy across 5 VQA benchmarks without any visual input. 2) Domain training can improve accuracy without proportional gains in visual binding. Compared with Qwen2.5-VL-7B, Patho-R1-7B exhibits a 5.8-point lower multimodal gain and a 3.7-point lower attention IoU. 3) Entity-level attention is diffuse and weakly query-specific. On PathVG, attention maps remain highly correlated across different entity queries. These issues can lead to substantial misjudgments of pathology VLMs' actual multimodal capabilities. To this end, we present PathBind, a benchmark comprising 2,600 samples: PathBind-VQA with 1,500 questions across six dimensions, PathBind-PTA with 600 questions from a private pathology teaching atlas, and PathBind-Grounding with 500 expert-curated region-level samples. Each component undergoes task-specific automated filtering and expert review to reduce textual shortcuts and improve entity-region correspondence. We evaluate 18 representative VLMs on VQA samples of PathBind and five existing pathology VQA benchmarks, and further evaluate 10 VLMs on PathBind-Grounding and PathVG. Results show that current pathology VLMs still exhibit a substantial gap between answer-side performance and visual-semantic binding.

This paper describes our approach to Subtask 1 of the ImageCLEFmed MEDVQA 2025 Challenge, which targets visual question answering (VQA) for gastrointestinal endoscopy. We adopt the Florence model-a large-scale multimodal foundation model-as the backbone of our VQA pipeline, pairing a powerful vision encoder with a text encoder to interpret endoscopic images and produce clinically relevant answers. To improve generalization, we apply domain-specific augmentations that preserve medical features while increasing training diversity. Experiments on the KASVIR dataset show that fine-tuning Florence yields accurate responses on the official challenge metrics. Our results highlight the potential of large multimodal models in medical VQA and provide a strong baseline for future work on explainability, robustness, and clinical integration. The code is publicly available at: https://github.com/TiwariLaxuu/VQA-Florence.git

We propose the task of free-form and open-ended Visual Question Answering (VQA). Given an image and a natural language question about the image, the task is to provide an accurate natural language answer. Mirroring real-world scenarios, such as helping the visually impaired, both the questions and answers are open-ended. Visual questions selectively target different areas of an image, including background details and underlying context. As a result, a system that succeeds at VQA typically needs a more detailed understanding of the image and complex reasoning than a system producing generic image captions. Moreover, VQA is amenable to automatic evaluation, since many open-ended answers contain only a few words or a closed set of answers that can be provided in a multiple-choice format. We provide a dataset containing ~0.25M images, ~0.76M questions, and ~10M answers (www.visualqa.org), and discuss the information it provides. Numerous baselines and methods for VQA are provided and compared with human performance. Our VQA demo is available on CloudCV (http://cloudcv.org/vqa).

Recent advancements in Large Language Models (LLMs) and Large Vision Language Models (LVLMs) have enabled general-purpose systems to demonstrate promising capabilities in complex reasoning tasks, including those in the medical domain. Medical Visual Question Answering (MedVQA) has particularly benefited from these developments. However, despite Bangla being one of the most widely spoken languages globally, there exists no established MedVQA benchmark for it. To address this gap, we introduce BanglaMedVQA, a dataset comprising clinically validated image-question-answer pairs, along with a comprehensive evaluation of current foundation models on this resource. Consistent with prior findings that report low performance of current models on English MedVQA benchmarks, our analysis reveals that Bangla performance is substantially lower, reflecting the challenges inherent to low-resource languages. Even top-performing models such as Gemini and GPT-4.1 mini fail to accurately answer specialized diagnostic questions, indicating severe limitations in fine-grained medical reasoning. Although certain open-source models, such as Gemma-3, occasionally outperform these models in general categories, they too struggle with clinically complex questions, underscoring the urgent need for top-notch evaluation method.

Traditional approaches for Visual Question Answering (VQA) require large amount of labeled data for training. Unfortunately, such large scale data is usually not available for medical domain. In this paper, we propose a novel medical VQA framework that overcomes the labeled data limitation. The proposed framework explores the use of the unsupervised Denoising Auto-Encoder (DAE) and the supervised Meta-Learning. The advantage of DAE is to leverage the large amount of unlabeled images while the advantage of Meta-Learning is to learn meta-weights that quickly adapt to VQA problem with limited labeled data. By leveraging the advantages of these techniques, it allows the proposed framework to be efficiently trained using a small labeled training set. The experimental results show that our proposed method significantly outperforms the state-of-the-art medical VQA.

Ultrasound imaging has become the preferred imaging modality for early cancer screening due to its advantages of non-ionizing radiation, low cost, and real-time imaging capabilities. However, conventional ultrasound diagnosis heavily relies on physician expertise, presenting challenges of high subjectivity and low diagnostic efficiency. Vision-language models (VLMs) offer promising solutions for this issue, but existing general-purpose models demonstrate limited knowledge in ultrasound medical tasks, with poor generalization in multi-organ lesion recognition and low efficiency across multi-task diagnostics. To address these limitations, we propose EchoVLM, a vision-language model specifically designed for ultrasound medical imaging. The model employs a Mixture of Experts (MoE) architecture trained on data spanning seven anatomical regions. This design enables the model to perform multiple tasks, including ultrasound report generation, diagnosis and visual question-answering (VQA). The experimental results demonstrated that EchoVLM achieved significant improvements of 10.15 and 4.77 points in BLEU-1 scores and ROUGE-1 scores respectively compared to Qwen2-VL on the ultrasound report generation task. These findings suggest that EchoVLM has substantial potential to enhance diagnostic accuracy in ultrasound imaging, thereby providing a viable technical solution for future clinical applications. Source code and model weights are available at https://github.com/Asunatan/EchoVLM.

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

Optical Character Recognition - Visual Question Answering (OCR-VQA) is the task of answering text information contained in images that have just been significantly developed in the English language in recent years. However, there are limited studies of this task in low-resource languages such as Vietnamese. To this end, we introduce a novel dataset, ViOCRVQA (Vietnamese Optical Character Recognition - Visual Question Answering dataset), consisting of 28,000+ images and 120,000+ question-answer pairs. In this dataset, all the images contain text and questions about the information relevant to the text in the images. We deploy ideas from state-of-the-art methods proposed for English to conduct experiments on our dataset, revealing the challenges and difficulties inherent in a Vietnamese dataset. Furthermore, we introduce a novel approach, called VisionReader, which achieved 0.4116 in EM and 0.6990 in the F1-score on the test set. Through the results, we found that the OCR system plays a very important role in VQA models on the ViOCRVQA dataset. In addition, the objects in the image also play a role in improving model performance. We open access to our dataset at link (https://github.com/qhnhynmm/ViOCRVQA.git) for further research in OCR-VQA task in Vietnamese.

Multimodal/vision language models (VLMs) are increasingly being deployed in healthcare settings worldwide, necessitating robust benchmarks to ensure their safety, efficacy, and fairness. Multiple-choice question and answer (QA) datasets derived from national medical examinations have long served as valuable evaluation tools, but existing datasets are largely text-only and available in a limited subset of languages and countries. To address these challenges, we present WorldMedQA-V, an updated multilingual, multimodal benchmarking dataset designed to evaluate VLMs in healthcare. WorldMedQA-V includes 568 labeled multiple-choice QAs paired with 568 medical images from four countries (Brazil, Israel, Japan, and Spain), covering original languages and validated English translations by native clinicians, respectively. Baseline performance for common open- and closed-source models are provided in the local language and English translations, and with and without images provided to the model. The WorldMedQA-V benchmark aims to better match AI systems to the diverse healthcare environments in which they are deployed, fostering more equitable, effective, and representative applications.

Visual Question Answering (VQA) is a core task for evaluating the capabilities of Vision-Language Models (VLMs). Existing VQA benchmarks primarily feature clear and unambiguous image-question pairs, whereas real-world scenarios often involve varying degrees of ambiguity that require nuanced reasoning and context-appropriate response strategies. Although recent studies have begun to address ambiguity in VQA, they lack (1) a systematic categorization of ambiguity levels and (2) datasets and models that support strategy-aware responses. In this paper, we introduce Ambiguous Visual Question Answering (AQuA), a fine-grained dataset that classifies ambiguous VQA instances into four levels according to the nature and degree of ambiguity, along with the optimal response strategy for each case. Our evaluation of diverse open-source and proprietary VLMs shows that most models fail to adapt their strategy to the ambiguity type, frequently producing overconfident answers rather than seeking clarification or acknowledging uncertainty. To address this challenge, we fine-tune VLMs on AQuA, enabling them to adaptively choose among multiple response strategies, such as directly answering, inferring intent from contextual cues, listing plausible alternatives, or requesting clarification. VLMs trained on AQuA achieve strategic response generation for ambiguous VQA, demonstrating the ability to recognize ambiguity, manage uncertainty, and respond with context-appropriate strategies, while outperforming both open-source and closed-source baselines.

Visual Question Answering (VQA) is an important task in multimodal AI, and it is often used to test the ability of vision-language models to understand and reason on knowledge present in both visual and textual data. However, most of the current VQA models use datasets that are primarily focused on English and a few major world languages, with images that are typically Western-centric. While recent efforts have tried to increase the number of languages covered on VQA datasets, they still lack diversity in low-resource languages. More importantly, although these datasets often extend their linguistic range via translation or some other approaches, they usually keep images the same, resulting in narrow cultural representation. To address these limitations, we construct CVQA, a new Culturally-diverse multilingual Visual Question Answering benchmark, designed to cover a rich set of languages and cultures, where we engage native speakers and cultural experts in the data collection process. As a result, CVQA includes culturally-driven images and questions from across 28 countries on four continents, covering 26 languages with 11 scripts, providing a total of 9k questions. We then benchmark several Multimodal Large Language Models (MLLMs) on CVQA, and show that the dataset is challenging for the current state-of-the-art models. This benchmark can serve as a probing evaluation suite for assessing the cultural capability and bias of multimodal models and hopefully encourage more research efforts toward increasing cultural awareness and linguistic diversity in this field.

Modern surgical AI increasingly requires multimodal understanding rather than isolated perception, yet existing datasets remain largely limited to single-task supervision such as recognition or templated question answering. Current medical VQA resources often rely on synthetic templates, lack natural descriptive supervision, or provide sparse annotations that hinder reasoning about spatial relations and procedural context. We introduce MIS-VQA, a surgical vision-language dataset generated through an annotation-driven pipeline that converts heterogeneous surgical annotations into structured textual scene representations. Using EndoVis18 and CholecT50, we transform phase, instrument, interaction, triplet, and segmentation labels into unified contexts that guide large language models to generate clinically coherent question-answer pairs. MIS-VQA supports four response types-concise and detailed descriptions, perception-level grounding, and multi-step reasoning-enabling hierarchical evaluation from atomic visual grounding to compositional reasoning. To address annotation sparsity, we incorporate confidence-filtered segmentation and cross-annotation consistency checks, enabling spatially grounded supervision at scale. MIS-VQA establishes a unified benchmark for surgical vision-language understanding with spatial supervision and multi-tier reasoning evaluation. To demonstrate its utility, we introduce LLaVA-SurgXpert, a family of surgical vision-language models with visual encoders to analyze how visual representations influence multimodal reasoning. Experiments show consistent improvements over existing surgical VQA baselines while revealing capability gaps between perceptual grounding and higher-level reasoning hidden in prior benchmarks.

Large Multimodal Models (LMMs) are increasingly capable of answering medical questions that require joint reasoning over images and text, yet training general medical VQA systems is impeded by the lack of large, openly usable, high-quality corpora. We present MedVLSynther, a rubric-guided generator-verifier framework that synthesizes high-quality multiple-choice VQA items directly from open biomedical literature by conditioning on figures, captions, and in-text references. The generator produces self-contained stems and parallel, mutually exclusive options under a machine-checkable JSON schema; a multi-stage verifier enforces essential gates (self-containment, single correct answer, clinical validity, image-text consistency), awards fine-grained positive points, and penalizes common failure modes before acceptance. Applying this pipeline to PubMed Central yields MedSynVQA: 13,087 audited questions over 14,803 images spanning 13 imaging modalities and 28 anatomical regions. Training open-weight LMMs with reinforcement learning using verifiable rewards improves accuracy across six medical VQA benchmarks, achieving averages of 55.85 (3B) and 58.15 (7B), with up to 77.57 on VQA-RAD and 67.76 on PathVQA, outperforming strong medical LMMs. A Ablations verify that both generation and verification are necessary and that more verified data consistently helps, and a targeted contamination analysis detects no leakage from evaluation suites. By operating entirely on open literature and open-weight models, MedVLSynther offers an auditable, reproducible, and privacy-preserving path to scalable medical VQA training data.

Visual Question Answering (VQA) is one of the most important tasks in autonomous driving, which requires accurate recognition and complex situation evaluations. However, datasets annotated in a QA format, which guarantees precise language generation and scene recognition from driving scenes, have not been established yet. In this work, we introduce Markup-QA, a novel dataset annotation technique in which QAs are enclosed within markups. This approach facilitates the simultaneous evaluation of a model's capabilities in sentence generation and VQA. Moreover, using this annotation methodology, we designed the NuScenes-MQA dataset. This dataset empowers the development of vision language models, especially for autonomous driving tasks, by focusing on both descriptive capabilities and precise QA. The dataset is available at https://github.com/turingmotors/NuScenes-MQA.

In recent years, visual question answering (VQA) has attracted attention from the research community because of its highly potential applications (such as virtual assistance on intelligent cars, assistant devices for blind people, or information retrieval from document images using natural language as queries) and challenge. The VQA task requires methods that have the ability to fuse the information from questions and images to produce appropriate answers. Neural visual question answering models have achieved tremendous growth on large-scale datasets which are mostly for resource-rich languages such as English. However, available datasets narrow the VQA task as the answers selection task or answer classification task. We argue that this form of VQA is far from human ability and eliminates the challenge of the answering aspect in the VQA task by just selecting answers rather than generating them. In this paper, we introduce the OpenViVQA (Open-domain Vietnamese Visual Question Answering) dataset, the first large-scale dataset for VQA with open-ended answers in Vietnamese, consists of 11,000+ images associated with 37,000+ question-answer pairs (QAs). Moreover, we proposed FST, QuMLAG, and MLPAG which fuse information from images and answers, then use these fused features to construct answers as humans iteratively. Our proposed methods achieve results that are competitive with SOTA models such as SAAA, MCAN, LORA, and M4C. The dataset is available to encourage the research community to develop more generalized algorithms including transformers for low-resource languages such as Vietnamese.

High-resolution visual question answering (HR-VQA) is often treated as a problem of insufficient evidence acquisition, where failing multimodal large language models must inspect images again through cropping, re-encoding, or multi-round search. We show that this view is incomplete: in many cases, fine-grained evidence has already survived visual encoding and become identifiable and influential within an intermediate-layer routing window, but is later diluted before answer generation. We propose Thinking-Once, a training-free, single-visual-pass evidence-routing method that reconstructs question-conditioned attention at this window, preserves core entity tokens and compact background context, and routes this evidence to later layers without extra visual encoding. Across five base models, Thinking-Once consistently improves or matches the corresponding base setting, increasing the average scores on V^*Bench, HRBench-4K, and HRBench-8K by +3.1, +3.0, and +2.7 points while reducing the average peak memory by about 4,GB. On Qwen2.5-VL-7B, it improves the three benchmarks by +9.9, +4.6, and +5.5 points, raising the cross-benchmark mean from 72.5 to 79.1. With the ZwZ-8B base model, Thinking-Once reaches a mean score of 82.7. Against 11 open-source HR-VQA baselines, it obtains the best or tied-best score on all three benchmark averages and the best overall mean; for example, compared with DeepScan, it reduces V^*Bench inference time by 97.2\% while improving the cross-benchmark mean from 77.8 to 79.1. These results show that HR-VQA can be improved by routing already encoded evidence rather than repeatedly acquiring new visual inputs. Code is available in the appendix.

Visual Question Answering (VQA) has emerged as a pivotal task in the intersection of computer vision and natural language processing, requiring models to understand and reason about visual content in response to natural language questions. Analyzing VQA datasets is essential for developing robust models that can handle the complexities of multimodal reasoning. Several approaches have been developed to examine these datasets, each offering distinct perspectives on question diversity, answer distribution, and visual-textual correlations. Despite significant progress, existing VQA models face challenges related to dataset bias, limited model complexity, commonsense reasoning gaps, rigid evaluation methods, and generalization to real world scenarios. This paper offers a detailed study of the original VQA dataset, baseline models and methods along with a comparative study of five advanced VQA models, ABC-CNN, KICNLE, Masked Vision and Language Modeling, BLIP-2, and OFA, each employing distinct methods to address these ongoing challenges.

Visual Question Answering (VQA) research seeks to create AI systems to answer natural language questions in images, yet VQA methods often yield overly simplistic and short answers. This paper aims to advance the field by introducing Visual Question Explanation (VQE), which enhances the ability of VQA to provide detailed explanations rather than brief responses and address the need for more complex interaction with visual content. We first created an MLVQE dataset from a 14-week streamed video machine learning course, including 885 slide images, 110,407 words of transcripts, and 9,416 designed question-answer (QA) pairs. Next, we proposed a novel SparrowVQE, a small 3 billion parameters multimodal model. We trained our model with a three-stage training mechanism consisting of multimodal pre-training (slide images and transcripts feature alignment), instruction tuning (tuning the pre-trained model with transcripts and QA pairs), and domain fine-tuning (fine-tuning slide image and QA pairs). Eventually, our SparrowVQE can understand and connect visual information using the SigLIP model with transcripts using the Phi-2 language model with an MLP adapter. Experimental results demonstrate that our SparrowVQE achieves better performance in our developed MLVQE dataset and outperforms state-of-the-art methods in the other five benchmark VQA datasets. The source code is available at https://github.com/YoushanZhang/SparrowVQE.

Visual question answering (VQA) is known as an AI-complete task as it requires understanding, reasoning, and inferring about the vision and the language content. Over the past few years, numerous neural architectures have been suggested for the VQA problem. However, achieving success in zero-shot VQA remains a challenge due to its requirement for advanced generalization and reasoning skills. This study explores the impact of incorporating image captioning as an intermediary process within the VQA pipeline. Specifically, we explore the efficacy of utilizing image captions instead of images and leveraging large language models (LLMs) to establish a zero-shot setting. Since image captioning is the most crucial step in this process, we compare the impact of state-of-the-art image captioning models on VQA performance across various question types in terms of structure and semantics. We propose a straightforward and efficient question-driven image captioning approach within this pipeline to transfer contextual information into the question-answering (QA) model. This method involves extracting keywords from the question, generating a caption for each image-question pair using the keywords, and incorporating the question-driven caption into the LLM prompt. We evaluate the efficacy of using general-purpose and question-driven image captions in the VQA pipeline. Our study highlights the potential of employing image captions and harnessing the capabilities of LLMs to achieve competitive performance on GQA under the zero-shot setting. Our code is available at https://github.com/ovguyo/captions-in-VQA.

Visual Question Answering (VQA) entails answering questions about images. We introduce the first VQA dataset in which all contents originate from an authentic use case. Sourced from online question answering community forums, we call it VQAonline. We then characterize our dataset and how it relates to eight other VQA datasets. Observing that answers in our dataset tend to be much longer (e.g., with a mean of 173 words) and thus incompatible with standard VQA evaluation metrics, we next analyze which of the six popular metrics for longer text evaluation align best with human judgments. We then use the best-suited metrics to evaluate six state-of-the-art vision and language foundation models on VQAonline and reveal where they struggle most. We will release the dataset soon to facilitate future extensions.

Pathology vision-language models (VLMs) have shown strong visual perception ability, but their robustness in the language domain remains poorly characterized. Existing pathology VLM benchmarks largely rely on canonical closed-set prompts or perturb only generic templates, treating language as a fixed evaluation component rather than a variable axis of model behavior. In clinical practice, however, diagnostic language varies across reports, institutions, and candidate diagnoses. We introduce PathLang, a language-centered and clinically grounded zero-shot benchmark. PathLang holds the underlying slides, ground-truth labels, and image-text evaluation direction fixed while systematically varying only the diagnostic language, so that performance differences reflect how a diagnosis is phrased rather than what is imaged. The language variation follows how pathologists actually rephrase diagnoses (terminology, specificity, and reporting style), and all prompts and candidate pools are validated by six board-certified pathologists. PathLang covers four task families: (1) zero-shot classification with image-text alignment analysis, (2) cross-modal retrieval, (3) paraphrase robustness, including semantic-equivalence paraphrases, length and reporting-style variation, and prompt ensembling, and (4) open-vocabulary diagnosis retrieval over four candidate pools with distinct forms of semantic competition. Across nine VLMs and five public datasets spanning four organs, we find that performance is highly sensitive to clinically equivalent paraphrases, varies substantially across forms of semantic competition, and that image-text alignment quality does not necessarily translate into inter-class separability. We release the prompt corpus, candidate pools, pre-computed text embeddings, and evaluation code at https://anonymous.4open.science/r/PathLang.

Vietnamese medical research has become an increasingly vital domain, particularly with the rise of intelligent technologies aimed at reducing time and resource burdens in clinical diagnosis. Recent advances in vision-language models (VLMs), such as Gemini and GPT-4V, have sparked a growing interest in applying AI to healthcare. However, most existing VLMs lack exposure to Vietnamese medical data, limiting their ability to generate accurate and contextually appropriate diagnostic outputs for Vietnamese patients. To address this challenge, we introduce ViX-Ray, a novel dataset comprising 5,400 Vietnamese chest X-ray images annotated with expert-written findings and impressions from physicians at a major Vietnamese hospital. We analyze linguistic patterns within the dataset, including the frequency of mentioned body parts and diagnoses, to identify domain-specific linguistic characteristics of Vietnamese radiology reports. Furthermore, we fine-tune five state-of-the-art open-source VLMs on ViX-Ray and compare their performance to leading proprietary models, GPT-4V and Gemini. Our results show that while several models generate outputs partially aligned with clinical ground truths, they often suffer from low precision and excessive hallucination, especially in impression generation. These findings not only demonstrate the complexity and challenge of our dataset but also establish ViX-Ray as a valuable benchmark for evaluating and advancing vision-language models in the Vietnamese clinical domain.

Surgical procedures are inherently complex and risky, requiring extensive expertise and constant focus to navigate evolving intraoperative scenes. Computer-assisted systems such as surgical visual question answering (VQA) offer promises for education and intraoperative support. Current surgical VQA research largely focuses on static frame analysis, overlooking rich temporal semantics. Surgical video question answering is further challenged by low visual contrast, its highly knowledge-driven nature, diverse analytical needs spanning scattered temporal windows, and the hierarchy from basic perception to high-level intraoperative assessment. To address these challenges, we propose SurgTEMP, a multimodal LLM framework featuring (i) a query-guided token selection module that builds hierarchical visual memory (spatial and temporal memory banks) and (ii) a Surgical Competency Progression (SCP) training scheme. Together, they enable effective modeling of variable-length surgical videos while preserving procedure-relevant cues and temporal coherence, and better support diverse downstream assessment tasks. To support model development, we introduce CholeVidQA-32K, a surgical video question answering dataset comprising 32K open-ended QA pairs and 3,855 video segments (approximately 128 h total) from laparoscopic cholecystectomy. The dataset is organized into a three-level hierarchy -- Perception, Assessment, and Reasoning -- spanning 11 tasks from instrument/action/anatomy perception to Critical View of Safety (CVS), intraoperative difficulty, skill proficiency, and adverse event assessment. In comprehensive evaluations against state-of-the-art open-source multimodal and video LLMs (fine-tuned and zero-shot), SurgTEMP achieves substantial performance improvements, advancing the state of video-based surgical VQA. The project page is available at: https://camma-public.github.io/SurgTEMP/

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.

We describe our submission to the MedReason 2026 challenge, covering multiple-choice (MCQ) and open-ended (OE) medical visual question answering (VQA) under fully offline, containerized inference. Our first finding is that MCQ retrieval must compare answer semantics rather than answer labels: labels are independently assigned per question, so copying a retrieved neighbor's label transfers no useful information, whereas scoring each current option's text against correct-answer text from similar training cases raises retrieval-only accuracy from 20.0\% to 57.5\% on a 200-case retrieval-excluded development holdout. Our second finding attributes the submitted system's accuracy: holding the task-specific MCQ Low-Rank Adaptation (LoRA) adapter fixed and varying the number \(k\) of in-prompt retrieved examples changes accuracy by at most one case --- 187/200 (93.5\%) at both \(k=0\) and the adapter's training-time \(k=1\), 188/200 (94.0\%) at the packaged runtime's default \(k=3\) --- and the submitted confidence-gated override adds no net accuracy on top of \(k=3\), selecting the VLM in 198/200 cases. With the final MCQ adapter fixed, retrieval changes accuracy by at most one case, and gating provides no net gain. On 20 OE cases, token-F1 and RaTEScore~zhao2024ratescore decrease as \(k\) grows, but paired sign tests on token-F1 differences are nonsignificant (\(p \ge 0.29\)); a single-annotator comparison found 6/20 wrong-anchor errors for the final configuration and 14/20 for an earlier configuration that jointly differed in routing, adapter, and prompting. The system reaches 94.0\% MCQ accuracy on the development holdout and 93.20\% on the organizer's official pre-evaluation, versus 29.43\% for the off-the-shelf reference baseline, while both of the organizer's open-ended scores are lower than that baseline's (ground-truth agreement 1.245 versus 1.588, visual accuracy 1.995 versus 2.696, each out of 4).

Vision-Language (VL) models have gained significant research focus, enabling remarkable advances in multimodal reasoning. These architectures typically comprise a vision encoder, a Large Language Model (LLM), and a projection module that aligns visual features with the LLM's representation space. Despite their success, a critical limitation persists: the vision encoding process remains decoupled from user queries, often in the form of image-related questions. Consequently, the resulting visual features may not be optimally attuned to the query-specific elements of the image. To address this, we introduce QA-ViT, a Question Aware Vision Transformer approach for multimodal reasoning, which embeds question awareness directly within the vision encoder. This integration results in dynamic visual features focusing on relevant image aspects to the posed question. QA-ViT is model-agnostic and can be incorporated efficiently into any VL architecture. Extensive experiments demonstrate the effectiveness of applying our method to various multimodal architectures, leading to consistent improvement across diverse tasks and showcasing its potential for enhancing visual and scene-text understanding.

We present ReXVQA, the largest and most comprehensive benchmark for visual question answering (VQA) in chest radiology, comprising approximately 696,000 questions paired with 160,000 chest X-rays studies across training, validation, and test sets. Unlike prior efforts that rely heavily on template based queries, ReXVQA introduces a diverse and clinically authentic task suite reflecting five core radiological reasoning skills: presence assessment, location analysis, negation detection, differential diagnosis, and geometric reasoning. We evaluate eight state-of-the-art multimodal large language models, including MedGemma-4B-it, Qwen2.5-VL, Janus-Pro-7B, and Eagle2-9B. The best-performing model (MedGemma) achieves 83.24% overall accuracy. To bridge the gap between AI performance and clinical expertise, we conducted a comprehensive human reader study involving 3 radiology residents on 200 randomly sampled cases. Our evaluation demonstrates that MedGemma achieved superior performance (83.84% accuracy) compared to human readers (best radiology resident: 77.27%), representing a significant milestone where AI performance exceeds expert human evaluation on chest X-ray interpretation. The reader study reveals distinct performance patterns between AI models and human experts, with strong inter-reader agreement among radiologists while showing more variable agreement patterns between human readers and AI models. ReXVQA establishes a new standard for evaluating generalist radiological AI systems, offering public leaderboards, fine-grained evaluation splits, structured explanations, and category-level breakdowns. This benchmark lays the foundation for next-generation AI systems capable of mimicking expert-level clinical reasoning beyond narrow pathology classification. Our dataset will be open-sourced at https://huggingface.co/datasets/rajpurkarlab/ReXVQA

Current vision-language models (VLMs) in medicine are primarily designed for categorical question answering (e.g., "Is this normal or abnormal?") or qualitative descriptive tasks. However, clinical decision-making often relies on quantitative assessments, such as measuring the size of a tumor or the angle of a joint, from which physicians draw their own diagnostic conclusions. This quantitative reasoning capability remains underexplored and poorly supported in existing VLMs. In this work, we introduce MedVision, a large-scale dataset and benchmark specifically designed to evaluate and improve VLMs on quantitative medical image analysis. MedVision spans 22 public datasets covering diverse anatomies and modalities, with 30.8 million image-annotation pairs. We focus on three representative quantitative tasks: (1) detection of anatomical structures and abnormalities, (2) tumor/lesion (T/L) size estimation, and (3) angle/distance (A/D) measurement. Our benchmarks show that current off-the-shelf VLMs perform poorly on these tasks. However, with supervised fine-tuning on MedVision, we significantly enhance their performance across detection, T/L estimation, and A/D measurement, demonstrating reduced error rates and improved precision. This work provides a foundation for developing VLMs with robust quantitative reasoning capabilities in medical imaging. Code and data are available at https://medvision-vlm.github.io.

Visual Question-Answering (VQA) has become a key use-case in several applications to aid user experience, particularly after Vision-Language Models (VLMs) achieving good results in zero-shot inference. But evaluating different VLMs for an application requirement using a standardized framework in practical settings is still challenging. This paper introduces a comprehensive framework for evaluating VLMs tailored to VQA tasks in practical settings. We present a novel dataset derived from established VQA benchmarks, annotated with task types, application domains, and knowledge types, three key practical aspects on which tasks can vary. We also introduce GoEval, a multimodal evaluation metric developed using GPT-4o, achieving a correlation factor of 56.71% with human judgments. Our experiments with ten state-of-the-art VLMs reveals that no single model excelling universally, making appropriate selection a key design decision. Proprietary models such as Gemini-1.5-Pro and GPT-4o-mini generally outperform others, though open-source models like InternVL-2-8B and CogVLM-2-Llama-3-19B demonstrate competitive strengths in specific contexts, while providing additional advantages. This study guides the selection of VLMs based on specific task requirements and resource constraints, and can also be extended to other vision-language tasks.

Visual question answering (VQA) is a challenging task that requires the ability to comprehend and reason with visual information. While recent vision-language models have made strides, they continue to struggle with zero-shot VQA, particularly in handling complex compositional questions and adapting to new domains i.e. knowledge-based reasoning. This paper explores the use of various prompting strategies, focusing on the BLIP2 model, to enhance zero-shot VQA performance. We conduct a comprehensive investigation across several VQA datasets, examining the effectiveness of different question templates, the role of few-shot exemplars, the impact of chain-of-thought (CoT) reasoning, and the benefits of incorporating image captions as additional visual cues. Despite the varied outcomes, our findings demonstrate that carefully designed question templates and the integration of additional visual cues, like image captions, can contribute to improved VQA performance, especially when used in conjunction with few-shot examples. However, we also identify a limitation in the use of chain-of-thought rationalization, which negatively affects VQA accuracy. Our study thus provides critical insights into the potential of prompting for improving zero-shot VQA performance.

Medical vision-language models (VLMs) and AI agents have made significant progress in learning to analyze and reason about clinical images. However, existing medical visual question answering (VQA) benchmarks collapse model capabilities into a single accuracy score, obscuring where and why models fail. We propose DeepTumorVQA, a hierarchical benchmark that follows the multi-stage evidence chain in tumor diagnosis and decomposes 3D CT reasoning into four stages: recognition, measurement, visual reasoning, and medical reasoning. Higher-level questions remain independently scorable, while their ground-truth evidence chains are defined over lower-level primitives. The benchmark contains 476K questions across 42 clinical subtypes on 9,262 3D CT volumes. In addition to a direct reasoning mode for VLMs, DeepTumorVQA provides tool-interaction environments for agent evaluation, where a model can call external tools, including segmentation models, measurement programs, and medical knowledge modules, before answering the question. Evaluating over 30 model configurations, we find that reliable quantitative measurement is the primary bottleneck, making later-stage visual and medical reasoning harder for VLMs, while tool augmentation substantially mitigates this issue. When tools are available, leveraging medical knowledge and tools to reason about medical images becomes a new challenge. We further show that ground-truth step-by-step tool-use traces from DeepTumorVQA can supervise agents and reduce tool-use and reasoning failures. This stage-wise progression from recognition to measurement to visual and medical reasoning provides a concrete roadmap for future medical VLM and AI agent studies. All data and code are released at https://github.com/Schuture/DeepTumorVQA.

Visual question answering (VQA) is the task of providing accurate answers to natural language questions based on visual input. Programmatic VQA (PVQA) models have been gaining attention recently. These use large language models (LLMs) to formulate executable programs that address questions requiring complex visual reasoning. However, there are challenges in enabling LLMs to comprehend the usage of image processing modules and generate relevant code. To overcome these challenges, this paper introduces PyramidCoder, a novel prompting framework for PVQA models. PyramidCoder consists of three hierarchical levels, each serving a distinct purpose: query rephrasing, code generation, and answer aggregation. Notably, PyramidCoder utilizes a single frozen LLM and pre-defined prompts at each level, eliminating the need for additional training and ensuring flexibility across various LLM architectures. Compared to the state-of-the-art PVQA model, our approach improves accuracy by at least 0.5% on the GQA dataset, 1.4% on the VQAv2 dataset, and 2.9% on the NLVR2 dataset.

With the advent of multi-modal large language models (MLLMs), datasets used for visual question answering (VQA) and referring expression comprehension have seen a resurgence. However, the most popular datasets used to evaluate MLLMs are some of the earliest ones created, and they have many known problems, including extreme bias, spurious correlations, and an inability to permit fine-grained analysis. In this paper, we pioneer evaluating recent MLLMs (LLaVA 1.5, LLaVA-NeXT, BLIP2, InstructBLIP, GPT-4V, and GPT-4o) on datasets designed to address weaknesses in earlier ones. We assess three VQA datasets: 1) TDIUC, which permits fine-grained analysis on 12 question types; 2) TallyQA, which has simple and complex counting questions; and 3) DVQA, which requires optical character recognition for chart understanding. We also study VQDv1, a dataset that requires identifying all image regions that satisfy a given query. Our experiments reveal the weaknesses of many MLLMs that have not previously been reported. Our code is integrated into the widely used LAVIS framework for MLLM evaluation, enabling the rapid assessment of future MLLMs. Project webpage: https://kevinlujian.github.io/MLLM_Evaluations/

Vision-Language Models (VLMs) have great potential in medical tasks, like Visual Question Answering (VQA), where they could act as interactive assistants for both patients and clinicians. Yet their robustness to distribution shifts on unseen data remains a key concern for safe deployment. Evaluating such robustness requires a controlled experimental setup that allows for systematic insights into the model's behavior. However, we demonstrate that current setups fail to offer sufficiently thorough evaluations. To address this gap, we introduce a novel framework, called SURE-VQA, centered around three key requirements to overcome current pitfalls and systematically analyze VLM robustness: 1) Since robustness on synthetic shifts does not necessarily translate to real-world shifts, it should be measured on real-world shifts that are inherent to the VQA data; 2) Traditional token-matching metrics often fail to capture underlying semantics, necessitating the use of large language models (LLMs) for more accurate semantic evaluation; 3) Model performance often lacks interpretability due to missing sanity baselines, thus meaningful baselines should be reported that allow assessing the multimodal impact on the VLM. To demonstrate the relevance of this framework, we conduct a study on the robustness of various Fine-Tuning (FT) methods across three medical datasets with four types of distribution shifts. Our study highlights key insights into robustness: 1) No FT method consistently outperforms others in robustness, and 2) robustness trends are more stable across FT methods than across distribution shifts. Additionally, we find that simple sanity baselines that do not use the image data can perform surprisingly well and confirm LoRA as the best-performing FT method on in-distribution data. Code is provided at https://github.com/IML-DKFZ/sure-vqa.

Text-based VQA aims at answering questions by reading the text present in the images. It requires a large amount of scene-text relationship understanding compared to the VQA task. Recent studies have shown that the question-answer pairs in the dataset are more focused on the text present in the image but less importance is given to visual features and some questions do not require understanding the image. The models trained on this dataset predict biased answers due to the lack of understanding of visual context. For example, in questions like "What is written on the signboard?", the answer predicted by the model is always "STOP" which makes the model to ignore the image. To address these issues, we propose a method to learn visual features (making V matter in TextVQA) along with the OCR features and question features using VQA dataset as external knowledge for Text-based VQA. Specifically, we combine the TextVQA dataset and VQA dataset and train the model on this combined dataset. Such a simple, yet effective approach increases the understanding and correlation between the image features and text present in the image, which helps in the better answering of questions. We further test the model on different datasets and compare their qualitative and quantitative results.

Vision Language Models (VLMs) are typically evaluated with Visual Question Answering (VQA) tasks which assess a model's understanding of scenes. Good VQA performance is taken as evidence that the model will perform well on a broader range of tasks that require both visual and language inputs. However, scene-aware VQA does not fully capture input biases or assess hallucinations caused by a misalignment between modalities. To address this, we propose a Cross-modal Alignment Similarity Test (CAST) to probe VLMs for self-consistency across modalities. This test involves asking the models to identify similarities between two scenes through text-only, image-only, or both and then assess the truthfulness of the similarities they generate. Since there is no ground-truth to compare against, this evaluation does not focus on objective accuracy but rather on whether VLMs are internally consistent in their outputs. We argue that while not all self-consistent models are capable or accurate, all capable VLMs must be self-consistent.

We introduce Kvasir-VQA, an extended dataset derived from the HyperKvasir and Kvasir-Instrument datasets, augmented with question-and-answer annotations to facilitate advanced machine learning tasks in Gastrointestinal (GI) diagnostics. This dataset comprises 6,500 annotated images spanning various GI tract conditions and surgical instruments, and it supports multiple question types including yes/no, choice, location, and numerical count. The dataset is intended for applications such as image captioning, Visual Question Answering (VQA), text-based generation of synthetic medical images, object detection, and classification. Our experiments demonstrate the dataset's effectiveness in training models for three selected tasks, showcasing significant applications in medical image analysis and diagnostics. We also present evaluation metrics for each task, highlighting the usability and versatility of our dataset. The dataset and supporting artifacts are available at https://datasets.simula.no/kvasir-vqa.

Bar charts are an effective way to convey numeric information, but today's algorithms cannot parse them. Existing methods fail when faced with even minor variations in appearance. Here, we present DVQA, a dataset that tests many aspects of bar chart understanding in a question answering framework. Unlike visual question answering (VQA), DVQA requires processing words and answers that are unique to a particular bar chart. State-of-the-art VQA algorithms perform poorly on DVQA, and we propose two strong baselines that perform considerably better. Our work will enable algorithms to automatically extract numeric and semantic information from vast quantities of bar charts found in scientific publications, Internet articles, business reports, and many other areas.

Medical Visual Language Models have shown great potential in various healthcare applications, including medical image captioning and diagnostic assistance. However, most existing models rely on text-based instructions, limiting their usability in real-world clinical environments especially in scenarios such as surgery, text-based interaction is often impractical for physicians. In addition, current medical image analysis models typically lack comprehensive reasoning behind their predictions, which reduces their reliability for clinical decision-making. Given that medical diagnosis errors can have life-changing consequences, there is a critical need for interpretable and rational medical assistance. To address these challenges, we introduce an end-to-end speech-driven medical VLM, SilVar-Med, a multimodal medical image assistant that integrates speech interaction with VLMs, pioneering the task of voice-based communication for medical image analysis. In addition, we focus on the interpretation of the reasoning behind each prediction of medical abnormalities with a proposed reasoning dataset. Through extensive experiments, we demonstrate a proof-of-concept study for reasoning-driven medical image interpretation with end-to-end speech interaction. We believe this work will advance the field of medical AI by fostering more transparent, interactive, and clinically viable diagnostic support systems. Our code and dataset are publicly available at SiVar-Med.

With the rapid advancement of video generation models such as Sora, video quality assessment (VQA) is becoming increasingly crucial for selecting high-quality videos from large-scale datasets used in pre-training. Traditional VQA methods, typically producing single numerical scores, often lack comprehensiveness and interpretability. To address these challenges, we introduce MVQA-68K, a novel multi-dimensional VQA dataset comprising over 68,000 carefully annotated videos, covering seven essential quality dimensions: overall aesthetics, camera movement, dynamic degree, texture detail, composition, visual quality, and factual consistency. Each annotation includes detailed chain-of-thought reasoning to facilitate interpretability and comprehensive understanding. Extensive experiments demonstrate that MVQA-68K significantly enhances the performance of various multimodal large language models (MLLMs) on the VQA task, achieving state-of-the-art results not only on our internal test set (Fig.1) but also on public benchmarks including LSVQ-test, LSVQ-1080p, and LIVE-VQC. Meantime, incorporating explicit reasoning process during VQA training substantially boosts the zero-shot generalization. Code and dataset will be available at github: https://github.com/Controller01-ai/MVQA-68K

Developing 3D vision-language models with robust clinical reasoning remains a challenge due to the inherent complexity of volumetric medical imaging, the tendency of models to overfit superficial report patterns, and the lack of interpretability-aware reward designs. In this paper, we propose Med3D-R1, a reinforcement learning framework with a two-stage training process: Supervised Fine-Tuning (SFT) and Reinforcement Learning (RL). During SFT stage, we introduce a residual alignment mechanism to bridge the gap between high-dimensional 3D features and textual embeddings, and an abnormality re-weighting strategy to emphasize clinically informative tokens and reduce structural bias in reports. In RL stage, we redesign the consistency reward to explicitly promote coherent, step-by-step diagnostic reasoning. We evaluate our method on medical multiple-choice visual question answering using two 3D diagnostic benchmarks, CT-RATE and RAD-ChestCT, where our model attains state-of-the-art accuracies of 41.92\% on CT-RATE and 44.99\% on RAD-ChestCT. These results indicate improved abnormality diagnosis and clinical reasoning and outperform prior methods on both benchmarks. Overall, our approach holds promise for enhancing real-world diagnostic workflows by enabling more reliable and transparent 3D medical vision-language systems.

Unified vision-language models (VLMs) that tokenize images through a vector-quantized (VQ) codebook routinely hallucinate objects on grounded yes/no benchmarks, yet existing decoding-time fixes treat this as generic miscalibration without an architectural account. Using activation patching across twenty-five models spanning eight LLM families, we identify an early-layer (L_0) attention routing circuit shared across VQ-tokenized VLMs and propose a three-gate diagnostic that distinguishes the models carrying it from those that do not. The diagnostic isolates ten positive models (five natural unified-VQ VLMs across three LLM families and five induced variants) and rejects the remaining fifteen. A single-variable architectural swap (LLaVA-1.6 CLIP+MLP rightarrow VQ+Linear) installs the circuit, while a matched-compute MLP control on identical data does not, isolating vector quantization as the source of the pathological signal; the routing pathway that carries it is one that the backbone already provides. Against tuned VCD and DoLA baselines, tuned DoLA wins on binary calibration, but only L_0 ablation reduces object hallucination in open-ended generation (CHAIR_i reduces by 31,% relatively, whereas tuned DoLA and VCD leave it unchanged or worsen it). These results recast object hallucination in unified VQ VLMs as a property of architecture and pretraining, and yield a targeted intervention that mechanism-agnostic decoding cannot replicate.

8 years after the visual question answering (VQA) task was proposed, accuracy remains the primary metric for automatic evaluation. VQA Accuracy has been effective so far in the IID evaluation setting. However, our community is undergoing a shift towards open-ended generative models and OOD evaluation. In this new paradigm, the existing VQA Accuracy metric is overly stringent and underestimates the performance of VQA systems. Thus, there is a need to develop more robust automatic VQA metrics that serve as a proxy for human judgment. In this work, we propose to leverage the in-context learning capabilities of instruction-tuned large language models (LLMs) to build a better VQA metric. We formulate VQA evaluation as an answer-rating task where the LLM is instructed to score the accuracy of a candidate answer given a set of reference answers. We demonstrate the proposed metric better correlates with human judgment compared to existing metrics across several VQA models and benchmarks. We hope wide adoption of our metric will contribute to better estimating the research progress on the VQA task. We plan to release the evaluation code and collected human judgments.

Brain MRI interpretation is a longitudinal clinical reasoning problem: radiologists compare serial studies, integrate information across MRI sequences, localize findings within volumetric anatomy, and translate this evidence into report-grounded assessments. Existing medical VQA and 3D imaging benchmarks capture important parts of this workflow, but often evaluate brain MRI through isolated images, static volumes, or ungrounded report-style answers, thereby obscuring failures in the evidence chain that support clinical validity. We introduce BrainTRACE, a report-grounded benchmark for evaluating whether vision-language models can trace the evidence structure required for longitudinal brain MRI interpretation. BrainTRACE contains 7,273 scored VQA instances derived from 1,778 longitudinal patients, 7,299 MRI studies, and approximately 29k co-registered 3D MRI sequence volumes. The benchmark is organized by five levels of clinical reasoning, from acquisition recognition to case-level synthesis, and by evidence demands covering longitudinal comparison, report-grounded references, multi-sequence integration, and volumetric spatial evidence. BrainTRACE supports rendered inputs compatible with standard VLM interfaces, a 3D-evidence condition, and a decomposed case-reasoning track that audits six steps in a longitudinal evidence chain. Evaluation of 20 VLM configurations shows that current systems can identify isolated visual cues but rarely compose them into grounded longitudinal interpretations. We release the benchmark specification, evaluation lists, scoring implementation, scoring rubrics, and audit-record format to support reproducible progress in brain MRI VLM evaluation.

Chest X-ray plays a central role in thoracic diagnosis, and its interpretation inherently requires multi-step, evidence-grounded reasoning. However, large vision-language models (LVLMs) often generate plausible responses that are not faithfully grounded in diagnostic evidence and provide limited visual evidence for verification, while also requiring costly retraining to support new diagnostic tasks, limiting their reliability and adaptability in clinical settings. To address these limitations, we present CXReasonAgent, a diagnostic agent that integrates a large language model (LLM) with clinically grounded diagnostic tools to perform evidence-grounded diagnostic reasoning using image-derived diagnostic and visual evidence. To evaluate these capabilities, we introduce CXReasonDial, a multi-turn dialogue benchmark with 1,946 dialogues across 12 diagnostic tasks, and show that CXReasonAgent produces faithfully grounded responses, enabling more reliable and verifiable diagnostic reasoning than LVLMs. These findings highlight the importance of integrating clinically grounded diagnostic tools, particularly in safety-critical clinical settings.

Infographic Visual Question Answering (InfographicVQA) evaluates a model's ability to read and reason over data-rich, layout-heavy visuals that combine text, charts, icons, and design elements. Compared with scene-text or natural-image VQA, infographics require stronger integration of OCR, layout understanding, and numerical and semantic reasoning. We introduce ViInfographicVQA, the first benchmark for Vietnamese InfographicVQA, comprising over 6747 real-world infographics and 20409 human-verified question-answer pairs across economics, healthcare, education, and more. The benchmark includes two evaluation settings. The Single-image task follows the traditional setup in which each question is answered using a single infographic. The Multi-image task requires synthesizing evidence across multiple semantically related infographics and is, to our knowledge, the first Vietnamese evaluation of cross-image reasoning in VQA. We evaluate a range of recent vision-language models on this benchmark, revealing substantial performance disparities, with the most significant errors occurring on Multi-image questions that involve cross-image integration and non-span reasoning. ViInfographicVQA contributes benchmark results for Vietnamese InfographicVQA and sheds light on the limitations of current multimodal models in low-resource contexts, encouraging future exploration of layout-aware and cross-image reasoning methods.

We introduce EXAMS-V, a new challenging multi-discipline multimodal multilingual exam benchmark for evaluating vision language models. It consists of 20,932 multiple-choice questions across 20 school disciplines covering natural science, social science, and other miscellaneous studies, e.g., religion, fine arts, business, etc. EXAMS-V includes a variety of multimodal features such as text, images, tables, figures, diagrams, maps, scientific symbols, and equations. The questions come in 11 languages from 7 language families. Unlike existing benchmarks, EXAMS-V is uniquely curated by gathering school exam questions from various countries, with a variety of education systems. This distinctive approach calls for intricate reasoning across diverse languages and relies on region-specific knowledge. Solving the problems in the dataset requires advanced perception and joint reasoning over the text and the visual content of the image. Our evaluation results demonstrate that this is a challenging dataset, which is difficult even for advanced vision-text models such as GPT-4V and Gemini; this underscores the inherent complexity of the dataset and its significance as a future benchmark.

The Visual Question Answering (VQA) task aspires to provide a meaningful testbed for the development of AI models that can jointly reason over visual and natural language inputs. Despite a proliferation of VQA datasets, this goal is hindered by a set of common limitations. These include a reliance on relatively simplistic questions that are repetitive in both concepts and linguistic structure, little world knowledge needed outside of the paired image, and limited reasoning required to arrive at the correct answer. We introduce A-OKVQA, a crowdsourced dataset composed of a diverse set of about 25K questions requiring a broad base of commonsense and world knowledge to answer. In contrast to the existing knowledge-based VQA datasets, the questions generally cannot be answered by simply querying a knowledge base, and instead require some form of commonsense reasoning about the scene depicted in the image. We demonstrate the potential of this new dataset through a detailed analysis of its contents and baseline performance measurements over a variety of state-of-the-art vision-language models. Project page: http://a-okvqa.allenai.org/

Modern operating room is becoming increasingly complex, requiring innovative intra-operative support systems. While the focus of surgical data science has largely been on video analysis, integrating surgical computer vision with language capabilities is emerging as a necessity. Our work aims to advance Visual Question Answering (VQA) in the surgical context with scene graph knowledge, addressing two main challenges in the current surgical VQA systems: removing question-condition bias in the surgical VQA dataset and incorporating scene-aware reasoning in the surgical VQA model design. First, we propose a Surgical Scene Graph-based dataset, SSG-QA, generated by employing segmentation and detection models on publicly available datasets. We build surgical scene graphs using spatial and action information of instruments and anatomies. These graphs are fed into a question engine, generating diverse QA pairs. Our SSG-QA dataset provides a more complex, diverse, geometrically grounded, unbiased, and surgical action-oriented dataset compared to existing surgical VQA datasets. We then propose SSG-QA-Net, a novel surgical VQA model incorporating a lightweight Scene-embedded Interaction Module (SIM), which integrates geometric scene knowledge in the VQA model design by employing cross-attention between the textual and the scene features. Our comprehensive analysis of the SSG-QA dataset shows that SSG-QA-Net outperforms existing methods across different question types and complexities. We highlight that the primary limitation in the current surgical VQA systems is the lack of scene knowledge to answer complex queries. We present a novel surgical VQA dataset and model and show that results can be significantly improved by incorporating geometric scene features in the VQA model design. The source code and the dataset will be made publicly available at: https://github.com/CAMMA-public/SSG-QA

Recent progress has been made in region-aware vision-language modeling, particularly with the emergence of the Describe Anything Model (DAM). DAM is capable of generating detailed descriptions of any specific image areas or objects without the need for additional localized image-text alignment supervision. We hypothesize that such region-level descriptive capability is beneficial for the task of Visual Question Answering (VQA), especially in challenging scenarios involving images with dense text. In such settings, the fine-grained extraction of textual information is crucial to producing correct answers. Motivated by this, we introduce DAM-QA, a framework with a tailored evaluation protocol, developed to investigate and harness the region-aware capabilities from DAM for the text-rich VQA problem that requires reasoning over text-based information within images. DAM-QA incorporates a mechanism that aggregates answers from multiple regional views of image content, enabling more effective identification of evidence that may be tied to text-related elements. Experiments on six VQA benchmarks show that our approach consistently outperforms the baseline DAM, with a notable 7+ point gain on DocVQA. DAM-QA also achieves the best overall performance among region-aware models with fewer parameters, significantly narrowing the gap with strong generalist VLMs. These results highlight the potential of DAM-like models for text-rich and broader VQA tasks when paired with efficient usage and integration strategies. Our code is publicly available at https://github.com/Linvyl/DAM-QA.git.

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

When building artificial intelligence systems that can reason and answer questions about visual data, we need diagnostic tests to analyze our progress and discover shortcomings. Existing benchmarks for visual question answering can help, but have strong biases that models can exploit to correctly answer questions without reasoning. They also conflate multiple sources of error, making it hard to pinpoint model weaknesses. We present a diagnostic dataset that tests a range of visual reasoning abilities. It contains minimal biases and has detailed annotations describing the kind of reasoning each question requires. We use this dataset to analyze a variety of modern visual reasoning systems, providing novel insights into their abilities and limitations.

Document Visual Question Answering (DocVQA) is a fundamental task for multimodal document understanding and a key testbed for vision language reasoning. However, most existing DocVQA datasets are limited to the page level and lack fine grained spatial grounding, constraining the interpretability and reasoning capability of Vision Language Models (VLMs). To address this gap, we introduce BBox DocVQA a large scale, bounding box grounded dataset designed to enhance spatial reasoning and evidence localization in visual documents. We further present an automated construction pipeline, Segment Judge and Generate, which integrates a segment model for region segmentation, a VLM for semantic judgment, and another advanced VLM for question answer generation, followed by human verification for quality assurance. The resulting dataset contains 3.6 K diverse documents and 32 K QA pairs, encompassing single and multi region as well as single and multi page scenarios. Each QA instance is grounded on explicit bounding boxes, enabling fine grained evaluation of spatial semantic alignment. Benchmarking multiple state of the art VLMs (e.g., GPT 5, Qwen2.5 VL, and InternVL) on BBox DocVQA reveals persistent challenges in spatial grounding and reasoning accuracy. Furthermore, fine tuning on BBox DocVQA substantially improves both bounding box localization and answer generation, validating its effectiveness for enhancing the reasoning ability of VLMs. Our dataset and code will be publicly released to advance research on interpretable and spatially grounded vision language reasoning.

Biomedical visual question answering (VQA) has been widely studied and has demonstrated significant application value and potential in fields such as assistive medical diagnosis. Despite their success, current biomedical VQA models perform multimodal information interaction only at the model level within large language models (LLMs), leading to suboptimal multimodal semantic alignment when dealing with complex tasks. To address this issue, we propose BioD2C: a novel Dual-level Semantic Consistency Constraint Framework for Biomedical VQA, which achieves dual-level semantic interaction alignment at both the model and feature levels, enabling the model to adaptively learn visual features based on the question. Specifically, we firstly integrate textual features into visual features via an image-text fusion mechanism as feature-level semantic interaction, obtaining visual features conditioned on the given text; and then introduce a text-queue-based cross-modal soft semantic loss function to further align the image semantics with the question semantics. Specifically, in this work, we establish a new dataset, BioVGQ, to address inherent biases in prior datasets by filtering manually-altered images and aligning question-answer pairs with multimodal context, and train our model on this dataset. Extensive experimental results demonstrate that BioD2C achieves state-of-the-art (SOTA) performance across multiple downstream datasets, showcasing its robustness, generalizability, and potential to advance biomedical VQA research.

Vision-language pre-training (VLP) has great potential for developing multifunctional and general medical diagnostic capabilities. However, aligning medical images with a low signal-to-noise ratio (SNR) to reports with a high SNR presents a semantic density gap, leading to visual alignment bias. In this paper, we propose boosting vision semantic density to improve alignment effectiveness. On one hand, we enhance visual semantics through disease-level vision contrastive learning, which strengthens the model's ability to differentiate between normal and abnormal samples for each anatomical structure. On the other hand, we introduce an anatomical normality modeling method to model the distribution of normal samples for each anatomy, leveraging VQ-VAE for reconstructing normal vision embeddings in the latent space. This process amplifies abnormal signals by leveraging distribution shifts in abnormal samples, enhancing the model's perception and discrimination of abnormal attributes. The enhanced visual representation effectively captures the diagnostic-relevant semantics, facilitating more efficient and accurate alignment with the diagnostic report. We conduct extensive experiments on two chest CT datasets, CT-RATE and Rad-ChestCT, and an abdominal CT dataset, MedVL-CT69K, and comprehensively evaluate the diagnosis performance across multiple tasks in the chest and abdominal CT scenarios, achieving state-of-the-art zero-shot performance. Notably, our method achieved an average AUC of 84.9% across 54 diseases in 15 organs, significantly surpassing existing methods. Additionally, we demonstrate the superior transfer learning capabilities of our pre-trained model. Code is available at https://github.com/alibaba-damo-academy/ViSD-Boost.

Visual Question Answering (VQA) in its ideal form lets us study reasoning in the joint space of vision and language and serves as a proxy for the AI task of scene understanding. However, most VQA benchmarks to date are focused on questions such as simple counting, visual attributes, and object detection that do not require reasoning or knowledge beyond what is in the image. In this paper, we address the task of knowledge-based visual question answering and provide a benchmark, called OK-VQA, where the image content is not sufficient to answer the questions, encouraging methods that rely on external knowledge resources. Our new dataset includes more than 14,000 questions that require external knowledge to answer. We show that the performance of the state-of-the-art VQA models degrades drastically in this new setting. Our analysis shows that our knowledge-based VQA task is diverse, difficult, and large compared to previous knowledge-based VQA datasets. We hope that this dataset enables researchers to open up new avenues for research in this domain. See http://okvqa.allenai.org to download and browse the dataset.

Visual Question Answering (VQA) task has showcased a new stage of interaction between language and vision, two of the most pivotal components of artificial intelligence. However, it has mostly focused on generating short and repetitive answers, mostly single words, which fall short of rich linguistic capabilities of humans. We introduce Full-Sentence Visual Question Answering (FSVQA) dataset, consisting of nearly 1 million pairs of questions and full-sentence answers for images, built by applying a number of rule-based natural language processing techniques to original VQA dataset and captions in the MS COCO dataset. This poses many additional complexities to conventional VQA task, and we provide a baseline for approaching and evaluating the task, on top of which we invite the research community to build further improvements.

Pathological images are inherently multi-scale, requiring pathologists to integrate evidence from global tissue architecture at low magnification to cellular morphology at higher magnification for accurate diagnosis. While existing pathological datasets for vision-language models (VLMs) include various scales, they often lack explicit cross-scale reasoning objectives. This limitation prevents VLMs from capturing essential cross-scale representations and learning evidence-based reasoning. To bridge this gap, we introduce the first cross-scale training and evaluation paradigm that formulates pathology interpretation as multi-magnification reasoning. However, creating such a task reveals a critical challenge: multi-image visual question answering (VQA) is prone to text-only shortcuts, which allow models to guess answers using magnification-dependent artifacts rather than visual evidence. To address this, we propose a leakage-aware curation pipeline that combines adversarial text-only screening with constraint-guided question design. Using this pipeline, we construct Scale-VQA, a high-quality benchmark with 4,685 multiple-choice questions grounded in 2,537 pathology images across multiple magnification levels. Finally, we present ScaleReasoner-R1, a model trained via reinforcement learning to optimize performance on cross-scale VQA tasks. ScaleReasoner-R1 achieves state-of-the-art performance on our cross-scale reasoning benchmark and generalizes to SOTA performance on established single-scale benchmarks. Findings suggest that even the limited cross-scale supervision can significantly improve pathological understanding. Code is available at https://github.com/iMVR-PL/ScaleReasoner-R1.

Brain tumor diagnosis is largely dependent on Magnetic Resonance Imaging (MRI) evaluation, which requires radiologists to synthesize thousands of images across multiple 3D sequences and longitudinal studies. This process requires advanced neuro-radiology training, poses substantial cognitive load, and is highly time-consuming. Despite increasing demands in radiology, this expertise is difficult to scale, straining the current health systems. Vision-Language Models (VLMs) provide an opportunity to reduce this burden through a semi-automated, interactive interpretation of complex brain MRIs. However, they are currently underutilized in neuro-oncology due to a lack of specialized benchmarks for evaluating them. We introduce a clinically relevant visual question answering (VQA) benchmark -- the UCSF-PDGM-VQA dataset -- consisting of 2,387 QA pairs from 473 glioma-related MRI studies in the public UCSF-PDGM dataset. We further establish a performance baseline for six state-of-the-art vision-language models (VLMs) and one large language model on this dataset. We find that current models are incapable of effectively processing multi-sequence, 3-dimensional MRI scans, thus resulting in a suppression of visual features and over-reliance on language priors, causing modality collapse. These findings underscore a critical deficiency in current model reliability and safety within clinical settings, necessitating the development of robust, domain-specific VLMs.

This paper presents final results of ICDAR 2019 Scene Text Visual Question Answering competition (ST-VQA). ST-VQA introduces an important aspect that is not addressed by any Visual Question Answering system up to date, namely the incorporation of scene text to answer questions asked about an image. The competition introduces a new dataset comprising 23,038 images annotated with 31,791 question/answer pairs where the answer is always grounded on text instances present in the image. The images are taken from 7 different public computer vision datasets, covering a wide range of scenarios. The competition was structured in three tasks of increasing difficulty, that require reading the text in a scene and understanding it in the context of the scene, to correctly answer a given question. A novel evaluation metric is presented, which elegantly assesses both key capabilities expected from an optimal model: text recognition and image understanding. A detailed analysis of results from different participants is showcased, which provides insight into the current capabilities of VQA systems that can read. We firmly believe the dataset proposed in this challenge will be an important milestone to consider towards a path of more robust and general models that can exploit scene text to achieve holistic image understanding.

Document Visual Question Answering (VQA) aims to understand visually-rich documents to answer questions in natural language, which is an emerging research topic for both Natural Language Processing and Computer Vision. In this work, we introduce a new Document VQA dataset, named TAT-DQA, which consists of 3,067 document pages comprising semi-structured table(s) and unstructured text as well as 16,558 question-answer pairs by extending the TAT-QA dataset. These documents are sampled from real-world financial reports and contain lots of numbers, which means discrete reasoning capability is demanded to answer questions on this dataset. Based on TAT-DQA, we further develop a novel model named MHST that takes into account the information in multi-modalities, including text, layout and visual image, to intelligently address different types of questions with corresponding strategies, i.e., extraction or reasoning. Extensive experiments show that the MHST model significantly outperforms the baseline methods, demonstrating its effectiveness. However, the performance still lags far behind that of expert humans. We expect that our new TAT-DQA dataset would facilitate the research on deep understanding of visually-rich documents combining vision and language, especially for scenarios that require discrete reasoning. Also, we hope the proposed model would inspire researchers to design more advanced Document VQA models in future. Our dataset will be publicly available for non-commercial use at https://nextplusplus.github.io/TAT-DQA/.

Vision evaluations are typically done through multi-step processes. In most contemporary fields, experts analyze images using structured, evidence-based adaptive questioning. In plant pathology, botanists inspect leaf images, identify visual cues, infer diagnostic intent, and probe further with targeted questions that adapt to species, symptoms, and severity. This structured probing is crucial for accurate disease diagnosis and treatment formulation. Yet current vision-language models are evaluated on single-turn question answering. To address this gap, we introduce PlantInquiryVQA, a benchmark for studying multi-step, intent-driven visual reasoning in botanical diagnosis. We formalize a Chain of Inquiry framework modeling diagnostic trajectories as ordered question-answer sequences conditioned on grounded visual cues and explicit epistemic intent. We release a dataset of 24,950 expert-curated plant images and 138,068 question-answer pairs annotated with visual grounding, severity labels, and domain-specific reasoning templates. Evaluations on top-tier Multimodal Large Language Models reveal that while they describe visual symptoms adequately, they struggle with safe clinical reasoning and accurate diagnosis. Importantly, structured question-guided inquiry significantly improves diagnostic correctness, reduces hallucination, and increases reasoning efficiency. We hope PlantInquiryVQA serves as a foundational benchmark in advancing research to train diagnostic agents to reason like expert botanists rather than static classifiers.

Studies have shown that a dominant class of questions asked by visually impaired users on images of their surroundings involves reading text in the image. But today's VQA models can not read! Our paper takes a first step towards addressing this problem. First, we introduce a new "TextVQA" dataset to facilitate progress on this important problem. Existing datasets either have a small proportion of questions about text (e.g., the VQA dataset) or are too small (e.g., the VizWiz dataset). TextVQA contains 45,336 questions on 28,408 images that require reasoning about text to answer. Second, we introduce a novel model architecture that reads text in the image, reasons about it in the context of the image and the question, and predicts an answer which might be a deduction based on the text and the image or composed of the strings found in the image. Consequently, we call our approach Look, Read, Reason & Answer (LoRRA). We show that LoRRA outperforms existing state-of-the-art VQA models on our TextVQA dataset. We find that the gap between human performance and machine performance is significantly larger on TextVQA than on VQA 2.0, suggesting that TextVQA is well-suited to benchmark progress along directions complementary to VQA 2.0.

Infographics are documents designed to effectively communicate information using a combination of textual, graphical and visual elements. In this work, we explore the automatic understanding of infographic images by using Visual Question Answering technique.To this end, we present InfographicVQA, a new dataset that comprises a diverse collection of infographics along with natural language questions and answers annotations. The collected questions require methods to jointly reason over the document layout, textual content, graphical elements, and data visualizations. We curate the dataset with emphasis on questions that require elementary reasoning and basic arithmetic skills. Finally, we evaluate two strong baselines based on state of the art multi-modal VQA models, and establish baseline performance for the new task. The dataset, code and leaderboard will be made available at http://docvqa.org

Video text-based visual question answering (Video TextVQA) is a practical task that aims to answer questions by jointly reasoning textual and visual information in a given video. Inspired by the development of TextVQA in image domain, existing Video TextVQA approaches leverage a language model (e.g. T5) to process text-rich multiple frames and generate answers auto-regressively. Nevertheless, the spatio-temporal relationships among visual entities (including scene text and objects) will be disrupted and models are susceptible to interference from unrelated information, resulting in irrational reasoning and inaccurate answering. To tackle these challenges, we propose the TEA (stands for ``Track thE Answer'') method that better extends the generative TextVQA framework from image to video. TEA recovers the spatio-temporal relationships in a complementary way and incorporates OCR-aware clues to enhance the quality of reasoning questions. Extensive experiments on several public Video TextVQA datasets validate the effectiveness and generalization of our framework. TEA outperforms existing TextVQA methods, video-language pretraining methods and video large language models by great margins.

Vision-language models (VLMs) have great potential for medical image understanding, particularly in Visual Report Generation (VRG) and Visual Question Answering (VQA), but they may generate hallucinated responses that contradict visual evidence, limiting clinical deployment. Although uncertainty-based hallucination detection methods are intuitive and effective, they are limited in medical VLMs. Specifically, Semantic Entropy (SE), effective in text-only LLMs, becomes less reliable in medical VLMs due to their overconfidence from strong language priors. To address this challenge, we propose UniVRSE, a Unified Vision-conditioned Response Semantic Entropy framework for hallucination detection in medical VLMs. UniVRSE strengthens visual guidance during uncertainty estimation by contrasting the semantic predictive distributions derived from an original image-text pair and a visually distorted counterpart, with higher entropy indicating hallucination risk. For VQA, UniVRSE works on the image-question pair, while for VRG, it decomposes the report into claims, generates verification questions, and applies vision-conditioned entropy estimation at the claim level. To evaluate hallucination detection, we propose a unified pipeline that generates responses on medical datasets and derives hallucination labels via factual consistency assessment. However, current evaluation methods rely on subjective criteria or modality-specific rules. To improve reliability, we introduce Alignment Ratio of Atomic Facts (ALFA), a novel method that quantifies fine-grained factual consistency. ALFA-derived labels provide ground truth for robust benchmarking. Experiments on six medical VQA/VRG datasets and three VLMs show UniVRSE significantly outperforms existing methods with strong cross-modal generalization.

Recent progress in Vision Language Models (VLMs) has raised the question of whether they can reliably perform nonverbal reasoning. To this end, we introduce VRIQ (Visual Reasoning IQ), a novel benchmark designed to assess and analyze the visual reasoning ability of VLMs. We evaluate models on two sets of tasks: abstract puzzle-style and natural-image reasoning tasks. We find that on abstract puzzles, performance remains near random with an average accuracy of around 28%, while natural tasks yield better but still weak results with 45% accuracy. We also find that tool-augmented reasoning demonstrates only modest improvements. To uncover the source of this weakness, we introduce diagnostic probes targeting perception and reasoning. Our analysis demonstrates that around 56% of failures arise from perception alone, 43% from both perception and reasoning, and only a mere 1% from reasoning alone. This motivates us to design fine-grained diagnostic probe questions targeting specific perception categories (e.g., shape, count, position, 3D/depth), revealing that certain categories cause more failures than others. Our benchmark and analysis establish that current VLMs, even with visual reasoning tools, remain unreliable abstract reasoners, mostly due to perception limitations, and offer a principled basis for improving visual reasoning in multimodal systems.

Large Vision-Language Models (LVLMs) have demonstrated remarkable capabilities in various multimodal tasks. However, their potential in the medical domain remains largely unexplored. A significant challenge arises from the scarcity of diverse medical images spanning various modalities and anatomical regions, which is essential in real-world medical applications. To solve this problem, in this paper, we introduce OmniMedVQA, a novel comprehensive medical Visual Question Answering (VQA) benchmark. This benchmark is collected from 75 different medical datasets, including 12 different modalities and covering more than 20 distinct anatomical regions. Importantly, all images in this benchmark are sourced from authentic medical scenarios, ensuring alignment with the requirements of the medical field and suitability for evaluating LVLMs. Through our extensive experiments, we have found that existing LVLMs struggle to address these medical VQA problems effectively. Moreover, what surprises us is that medical-specialized LVLMs even exhibit inferior performance to those general-domain models, calling for a more versatile and robust LVLM in the biomedical field. The evaluation results not only reveal the current limitations of LVLM in understanding real medical images but also highlight our dataset's significance. Our dataset will be made publicly available.

Diagnosing and managing oral diseases necessitate advanced visual interpretation across diverse imaging modalities and integrated information synthesis. While current AI models excel at isolated tasks, they often fall short in addressing the complex, multimodal requirements of comprehensive clinical dental practice. Here we introduce DentVLM, a multimodal vision-language model engineered for expert-level oral disease diagnosis. DentVLM was developed using a comprehensive, large-scale, bilingual dataset of 110,447 images and 2.46 million visual question-answering (VQA) pairs. The model is capable of interpreting seven 2D oral imaging modalities across 36 diagnostic tasks, significantly outperforming leading proprietary and open-source models by 19.6% higher accuracy for oral diseases and 27.9% for malocclusions. In a clinical study involving 25 dentists, evaluating 1,946 patients and encompassing 3,105 QA pairs, DentVLM surpassed the diagnostic performance of 13 junior dentists on 21 of 36 tasks and exceeded that of 12 senior dentists on 12 of 36 tasks. When integrated into a collaborative workflow, DentVLM elevated junior dentists' performance to senior levels and reduced diagnostic time for all practitioners by 15-22%. Furthermore, DentVLM exhibited promising performance across three practical utility scenarios, including home-based dental health management, hospital-based intelligent diagnosis and multi-agent collaborative interaction. These findings establish DentVLM as a robust clinical decision support tool, poised to enhance primary dental care, mitigate provider-patient imbalances, and democratize access to specialized medical expertise within the field of dentistry.

Choropleth maps are a common visual representation for region-specific tabular data and are used in a number of different venues (newspapers, articles, etc). These maps are human-readable but are often challenging to deal with when trying to extract data for screen readers, analyses, or other related tasks. Recent research into Visual-Question Answering (VQA) has studied question answering on human-generated charts (ChartQA), such as bar, line, and pie charts. However, little work has paid attention to understanding maps; general VQA models, and ChartQA models, suffer when asked to perform this task. To facilitate and encourage research in this area, we present MapQA, a large-scale dataset of ~800K question-answer pairs over ~60K map images. Our task tests various levels of map understanding, from surface questions about map styles to complex questions that require reasoning on the underlying data. We present the unique challenges of MapQA that frustrate most strong baseline algorithms designed for ChartQA and general VQA tasks. We also present a novel algorithm, Visual Multi-Output Data Extraction based QA (V-MODEQA) for MapQA. V-MODEQA extracts the underlying structured data from a map image with a multi-output model and then performs reasoning on the extracted data. Our experimental results show that V-MODEQA has better overall performance and robustness on MapQA than the state-of-the-art ChartQA and VQA algorithms by capturing the unique properties in map question answering.

Medical vision--language models (VLMs) have shown strong potential for medical visual question answering (VQA), yet their reasoning remains largely text-centric: images are encoded once as static context, and subsequent inference is dominated by language. This paradigm is fundamentally limited in clinical scenarios, where accurate answers often depend on subtle, localized visual evidence that cannot be reliably preserved in static embeddings. We propose MedLVR, a latent visual reasoning framework that introduces an explicit visual evidence state into autoregressive decoding. Instead of relying solely on text-based intermediate reasoning, MedLVR interleaves a short latent reasoning segment within the decoder by reusing hidden states as continuous latent steps, enabling iterative preservation and refinement of query-relevant visual evidence before answer generation. To support effective visual supervision, we adopt a two-stage training strategy: region of interest (ROI)-supervised fine-tuning aligns latent states with clinically relevant image evidence, and Visual-Latent Policy Optimization (VLPO) further optimizes latent reasoning and answer generation under outcome-level rewards. Experiments on OmniMedVQA and five external medical VQA benchmarks show that MedLVR consistently outperforms recent reasoning baselines and improves the average score over the Qwen2.5-VL-7B backbone from 48.3\% to 53.4\%. These results show that latent visual reasoning provides an effective mechanism for preserving diagnostically relevant visual evidence and improving the reliability of medical VQA.

Accurate and interpretable multi-disease diagnosis remains a critical challenge in medical research, particularly when leveraging heterogeneous multimodal medical data. Current approaches often rely on single-modal data, limiting their ability to comprehensively understand complex diseases. To address this, we propose MedTVT-R1, a novel Multimodal Large Language Model (MLLM) framework designed to integrate clinical multimodal data for reasoning and diagnosing multiple diseases. We construct MedTVT-QA, a curated instruction dataset that provides question-answer pairs for physiological-level interpretations and disease-level diagnoses with a Chain of Evidence approach. MedTVT-R1 incorporates a modality perception layer to capture inter-modal dependencies and adaptively weight modality contributions. Additionally, we employ Group Relative Policy Optimization (GRPO)-based Reinforcement Fine-Tuning with a Jaccard Reward function to enhance diagnostic reasoning. Experimental results demonstrate MedTVT-R1's superiority in multimodal feature utilization and multi-disease diagnosis, offering significant potential for clinical applications such as diagnostic report generation and comorbidity reasoning. The dataset and code are available at https://github.com/keke-nice/MedTVT-R1.

We introduce a novel visual question answering (VQA) task in the context of autonomous driving, aiming to answer natural language questions based on street-view clues. Compared to traditional VQA tasks, VQA in autonomous driving scenario presents more challenges. Firstly, the raw visual data are multi-modal, including images and point clouds captured by camera and LiDAR, respectively. Secondly, the data are multi-frame due to the continuous, real-time acquisition. Thirdly, the outdoor scenes exhibit both moving foreground and static background. Existing VQA benchmarks fail to adequately address these complexities. To bridge this gap, we propose NuScenes-QA, the first benchmark for VQA in the autonomous driving scenario, encompassing 34K visual scenes and 460K question-answer pairs. Specifically, we leverage existing 3D detection annotations to generate scene graphs and design question templates manually. Subsequently, the question-answer pairs are generated programmatically based on these templates. Comprehensive statistics prove that our NuScenes-QA is a balanced large-scale benchmark with diverse question formats. Built upon it, we develop a series of baselines that employ advanced 3D detection and VQA techniques. Our extensive experiments highlight the challenges posed by this new task. Codes and dataset are available at https://github.com/qiantianwen/NuScenes-QA.