# Med-UniC: Unifying Cross-Lingual Medical Vision-Language Pre-Training by Diminishing Bias

arXiv: https://arxiv.org/abs/2305.19894 · HTML: https://mlsanity.com/paper/2305.19894/

## Key facts

- Cited by 57 papers in the map (data through 14 Oct 2026).
- Placed in Medical vision-language models, one of 16 directions in Multimodal LLMs / vision-language models.
- Builds on 36 of its 57 references that are in the map.
- First posted on arXiv 31 May 2023.

## Placed in

- Multimodal LLMs / vision-language models / [Medical vision-language models](https://mlsanity.com/mllm/medical-vision-language-models/)

## Builds on (most cited first, 30 of 36)

- [Deep Residual Learning for Image Recognition](https://mlsanity.com/paper/1512.03385/) (2015)
- [BERT: Pre-training of Deep Bidirectional Transformers for Language Understanding](https://mlsanity.com/paper/1810.04805/) (2018)
- [Learning Transferable Visual Models From Natural Language Supervision](https://mlsanity.com/paper/2103.00020/) (2021)
- [An Image is Worth 16x16 Words: Transformers for Image Recognition at Scale](https://mlsanity.com/paper/2010.11929/) (2020)
- [U-Net: Convolutional Networks for Biomedical Image Segmentation](https://mlsanity.com/paper/1505.04597/) (2015)
- [GPT-4 Technical Report](https://mlsanity.com/paper/2303.08774/) (2023)
- [Segment Anything](https://mlsanity.com/paper/2304.02643/) (2023)
- [DINOv2: Learning Robust Visual Features without Supervision](https://mlsanity.com/paper/2304.07193/) (2023)
- [Representation Learning with Contrastive Predictive Coding](https://mlsanity.com/paper/1807.03748/) (2018)
- [Masked Autoencoders Are Scalable Vision Learners](https://mlsanity.com/paper/2111.06377/) (2021)
- [Grad-CAM: Visual Explanations from Deep Networks via Gradient-based Localization](https://mlsanity.com/paper/1610.02391/) (2016)
- [YOLOv3: An Incremental Improvement](https://mlsanity.com/paper/1804.02767/) (2018)
- [Barlow Twins: Self-Supervised Learning via Redundancy Reduction](https://mlsanity.com/paper/2103.03230/) (2021)
- [CheXpert: A Large Chest Radiograph Dataset with Uncertainty Labels and Expert Comparison](https://mlsanity.com/paper/1901.07031/) (2019)
- [Rethinking Semantic Segmentation from a Sequence-to-Sequence Perspective with Transformers](https://mlsanity.com/paper/2012.15840/) (2020)
- [An Empirical Investigation of Catastrophic Forgetting in Gradient-Based Neural Networks](https://mlsanity.com/paper/1312.6211/) (2013)
- [Contrastive Learning of Medical Visual Representations from Paired Images and Text](https://mlsanity.com/paper/2010.00747/) (2020)
- [MIMIC-CXR-JPG, a large publicly available database of labeled chest radiographs](https://mlsanity.com/paper/1901.07042/) (2019)
- [SLIP: Self-supervision meets Language-Image Pre-training](https://mlsanity.com/paper/2112.12750/) (2021)
- [Making the Most of Text Semantics to Improve Biomedical Vision--Language Processing](https://mlsanity.com/paper/2204.09817/) (2022)
- [PadChest: A large chest x-ray image dataset with multi-label annotated reports](https://mlsanity.com/paper/1901.07441/) (2019)
- [COVID-Net: A Tailored Deep Convolutional Neural Network Design for Detection of COVID-19 Cases from Chest X-Ray Images](https://mlsanity.com/paper/2003.09871/) (2020)
- [Cross-Lingual Ability of Multilingual BERT: An Empirical Study](https://mlsanity.com/paper/1912.07840/) (2019)
- [Multi-Granularity Cross-modal Alignment for Generalized Medical Visual Representation Learning](https://mlsanity.com/paper/2210.06044/) (2022)
- [MedKLIP: Medical Knowledge Enhanced Language-Image Pre-Training in Radiology](https://mlsanity.com/paper/2301.02228/) (2023)
- [CyCLIP: Cyclic Contrastive Language-Image Pretraining](https://mlsanity.com/paper/2205.14459/) (2022)
- [Segment Anything Is Not Always Perfect: An Investigation of SAM on Different Real-world Applications](https://mlsanity.com/paper/2304.05750/) (2023)
- [Advancing Radiograph Representation Learning with Masked Record Modeling](https://mlsanity.com/paper/2301.13155/) (2023)
- [Machine learning with data assimilation and uncertainty quantification for dynamical systems: a review](https://mlsanity.com/paper/2303.10462/) (2023)
- [UC2: Universal Cross-lingual Cross-modal Vision-and-Language Pre-training](https://mlsanity.com/paper/2104.00332/) (2021)

## Built on by (most cited first, 30 of 57)

- [Efficient Large Language Models: A Survey](https://mlsanity.com/paper/2312.03863/) (2023)
- [Exploring scalable medical image encoders beyond text supervision](https://mlsanity.com/paper/2401.10815/) (2024)
- [A Comprehensive Survey of Scientific Large Language Models and Their Applications in Scientific Discovery](https://mlsanity.com/paper/2406.10833/) (2024)
- [LOOK-M: Look-Once Optimization in KV Cache for Efficient Multimodal Long-Context Inference](https://mlsanity.com/paper/2406.18139/) (2024)
- [Detecting Multimedia Generated by Large AI Models: A Survey](https://mlsanity.com/paper/2402.00045/) (2024)
- [Zero-Shot ECG Classification with Multimodal Learning and Test-time Clinical Knowledge Enhancement](https://mlsanity.com/paper/2403.06659/) (2024)
- [Generative Text-Guided 3D Vision-Language Pretraining for Unified Medical Image Segmentation](https://mlsanity.com/paper/2306.04811/) (2023)
- [M-FLAG: Medical Vision-Language Pre-training with Frozen Language Models and Latent Space Geometry Optimization](https://mlsanity.com/paper/2307.08347/) (2023)
- [CLIP in Medical Imaging: A Survey](https://mlsanity.com/paper/2312.07353/) (2023)
- [Enhancing Representation in Radiography-Reports Foundation Model: A Granular Alignment Algorithm Using Masked Contrastive Learning](https://mlsanity.com/paper/2309.05904/) (2023)
- [D2O: Dynamic Discriminative Operations for Efficient Long-Context Inference of Large Language Models](https://mlsanity.com/paper/2406.13035/) (2024)
- [ETP: Learning Transferable ECG Representations via ECG-Text Pre-training](https://mlsanity.com/paper/2309.07145/) (2023)
- [MEIT: Multimodal Electrocardiogram Instruction Tuning on Large Language Models for Report Generation](https://mlsanity.com/paper/2403.04945/) (2024)
- [Fine-Grained Image-Text Alignment in Medical Imaging Enables Explainable Cyclic Image-Report Generation](https://mlsanity.com/paper/2312.08078/) (2023)
- [ECG Semantic Integrator (ESI): A Foundation ECG Model Pretrained with LLM-Enhanced Cardiological Text](https://mlsanity.com/paper/2405.19366/) (2024)
- [IMITATE: Clinical Prior Guided Hierarchical Vision-Language Pre-training](https://mlsanity.com/paper/2310.07355/) (2023)
- [MMedPO: Aligning Medical Vision-Language Models with Clinical-Aware Multimodal Preference Optimization](https://mlsanity.com/paper/2412.06141/) (2024)
- [Has Multimodal Learning Delivered Universal Intelligence in Healthcare? A Comprehensive Survey](https://mlsanity.com/paper/2408.12880/) (2024)
- [Learning Multiscale Consistency for Self-supervised Electron Microscopy Instance Segmentation](https://mlsanity.com/paper/2308.09917/) (2023)
- [Utilizing Synthetic Data for Medical Vision-Language Pre-training: Bypassing the Need for Real Images](https://mlsanity.com/paper/2310.07027/) (2023)
- [T3D: Advancing 3D Medical Vision-Language Pre-training by Learning Multi-View Visual Consistency](https://mlsanity.com/paper/2312.01529/) (2023)
- [Unlocking the Power of Spatial and Temporal Information in Medical Multimodal Pre-training](https://mlsanity.com/paper/2405.19654/) (2024)
- [G2D: From Global to Dense Radiography Representation Learning via Vision-Language Pre-training](https://mlsanity.com/paper/2312.01522/) (2023)
- [Open Challenges and Opportunities in Federated Foundation Models Towards Biomedical Healthcare](https://mlsanity.com/paper/2405.06784/) (2024)
- [Robustness in Large Language Models: A Survey of Mitigation Strategies and Evaluation Metrics](https://mlsanity.com/paper/2505.18658/) (2025)
- [A Survey of Medical Vision-and-Language Applications and Their Techniques](https://mlsanity.com/paper/2411.12195/) (2024)
- [Multi-View and Multi-Scale Alignment for Contrastive Language-Image Pre-training in Mammography](https://mlsanity.com/paper/2409.18119/) (2024)
- [Foundation Models in Medical Imaging: A Review and Outlook](https://mlsanity.com/paper/2506.09095/) (2025)
- [MLIP: Efficient Multi-Perspective Language-Image Pretraining with Exhaustive Data Utilization](https://mlsanity.com/paper/2406.01460/) (2024)
- [SuPreME: A Supervised Pre-training Framework for Multimodal ECG Representation Learning](https://mlsanity.com/paper/2502.19668/) (2025)

## Abstract (arXiv)

The scarcity of data presents a critical obstacle to the efficacy of medical visionlanguage pre-training (VLP). A potential solution lies in the combination of datasets from various language communities. Nevertheless, the main challenge stems from the complexity of integrating diverse syntax and semantics, language-specific medical terminology, and culture-specific implicit knowledge. Therefore, one crucial aspect to consider is the presence of community bias caused by different languages. This paper presents a novel framework named Unifying Cross-Lingual Medical Vision-Language Pre-Training (Med-UniC), designed to integrate multimodal medical data from the two most prevalent languages, English and Spanish. Specifically, we propose Cross-lingual Text Alignment Regularization (CTR) to explicitly unify cross-lingual semantic representations of medical reports originating from diverse language communities. CTR is optimized through latent language disentanglement, rendering our optimization objective to not depend on negative samples, thereby significantly mitigating the bias from determining positive-negative sample pairs within analogous medical reports. Furthermore, it ensures that the cross-lingual representation is not biased toward any specific language community. Med-UniC reaches superior performance across 5 medical image tasks and 10 datasets encompassing over 30 diseases, offering a versatile framework for unifying multi-modal medical data within diverse linguistic communities. The experimental outcomes highlight the presence of community bias in cross-lingual VLP. Reducing this bias enhances the performance not only in vision-language tasks but also in uni-modal visual tasks.