A ChatGPT Aided Explainable Framework for Zero-Shot Medical Image Diagnosis
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Abstract (arXiv)
Zero-shot medical image classification is a critical process in real-world scenarios where we have limited access to all possible diseases or large-scale annotated data. It involves computing similarity scores between a query medical image and possible disease categories to determine the diagnostic result. Recent advances in pretrained vision-language models (VLMs) such as CLIP have shown great performance for zero-shot natural image recognition and exhibit benefits in medical applications. However, an explainable zero-shot medical image recognition framework with promising performance is yet under development. In this paper, we propose a novel CLIP-based zero-shot medical image classification framework supplemented with ChatGPT for explainable diagnosis, mimicking the diagnostic process performed by human experts. The key idea is to query large language models (LLMs) with category names to automatically generate additional cues and knowledge, such as disease symptoms or descriptions other than a single category name, to help provide more accurate and explainable diagnosis in CLIP. We further design specific prompts to enhance the quality of generated texts by ChatGPT that describe visual medical features. Extensive results on one private dataset and four public datasets along with detailed analysis demonstrate the effectiveness and explainability of our training-free zero-shot diagnosis pipeline, corroborating the great potential of VLMs and LLMs for medical applications.
Key facts. Cited by 31 papers in the map (data through 14 Oct 2026). Builds on 20 of its 33 references that are in the map. First posted on arXiv 5 Jul 2023.
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20 of 33 references.
References · 20
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- 2021Learning Transferable Visual Models From Natural Language Supervisioncited by 33,744
- 2020Language Models are Few-Shot Learnerscited by 32,419
- 2022Training language models to follow instructions with human feedbackcited by 15,971
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- 2022Visual Classification via Description from Large Language Modelscited by 336
8 more
- 2021How Much Can CLIP Benefit Vision-and-Language Tasks?cited by 321
- 2021Generic Attention-model Explainability for Interpreting Bi-Modal and Encoder-Decoder Transformerscited by 320
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- 2023Multimodal C4: An Open, Billion-scale Corpus of Images Interleaved with Textcited by 208
- 2021Does CLIP Benefit Visual Question Answering in the Medical Domain as Much as it Does in the General Domain?cited by 85
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Citing papers per year: 2023: 6; 2024: 16; 2025: 9.
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- 2023Explainability for Large Language Models: A Surveycited by 333
- 2023CLIPN for Zero-Shot OOD Detection: Teaching CLIP to Say Nocited by 130
- 2023Large language models in healthcare and medical domain: A reviewcited by 127
- 2023Open-Set Image Tagging with Multi-Grained Text Supervisioncited by 67
- 2024Large Language Model Safety: A Holistic Surveycited by 59
- 2024MedCoT: Medical Chain of Thought via Hierarchical Expertcited by 46
- 2024LLM as Dataset Analyst: Subpopulation Structure Discovery with Large Language Modelcited by 44
- 2023CLIP in Medical Imaging: A Surveycited by 40
- 2024MedCLIP-SAMv2: Towards Universal Text-Driven Medical Image Segmentationcited by 39
- 2024BiomedCoOp: Learning to Prompt for Biomedical Vision-Language Modelscited by 28
- 2025A Comprehensive Survey on the Trustworthiness of Large Language Models in Healthcarecited by 27
- 20253D-RAD: A Comprehensive 3D Radiology Med-VQA Dataset with Multi-Temporal Analysis and Diverse Diagnostic Taskscited by 26
19 more
- 2024Residual-based Language Models are Free Boosters for Biomedical Imagingcited by 24
- 2024Adaptive Ensembles of Fine-Tuned Transformers for LLM-Generated Text Detectioncited by 22
- 2024R-LLaVA: Improving Med-VQA Understanding through Visual Region of Interestcited by 21
- 2024Self-eXplainable AI for Medical Image Analysis: A Survey and New Outlookscited by 18
- 2024A Survey on Trustworthiness in Foundation Models for Medical Image Analysiscited by 17
- 2024MedThink: Explaining Medical Visual Question Answering via Multimodal Decision-Making Rationalecited by 14
- 2024A Survey of Medical Vision-and-Language Applications and Their Techniquescited by 11
- 2024MultiEYE: Dataset and Benchmark for OCT-Enhanced Retinal Disease Recognition from Fundus Imagescited by 9
- 2024Aligning Medical Images with General Knowledge from Large Language Modelscited by 8
- 2025Fair-MoE: Fairness-Oriented Mixture of Experts in Vision-Language Modelscited by 6
- 2025Enhancing Concept Localization in CLIP-based Concept Bottleneck Modelscited by 6
- 2025Prompt as Knowledge Bank: Boost Vision-language model via Structural Representation for zero-shot medical detectioncited by 3
- 2023Representing visual classification as a linear combination of wordscited by 1
- 2024A Multimodal Approach For Endoscopic VCE Image Classification Using BiomedCLIP-PubMedBERTcited by 1
- 2024Towards Explainable Evolution Strategies with Large Language Modelscited by 0
- 2025Leveraging Pretrained Diffusion Models for Zero-Shot Part Assemblycited by 0
- 2025GRIT: Graph-Regularized Logit Refinement for Zero-shot Cell Type Annotationcited by 0
- 2025Evaluating Fundus-Specific Foundation Models for Diabetic Macular Edema Detectioncited by 0
- 2025Evaluating ChatGPT's Performance in Classifying Pneumonia from Chest X-Ray Imagescited by 0
- 2025Evaluating ChatGPT's Performance in Classifying Pneumonia from Chest X-Ray Images22 Oct 2025
- 2025Evaluating Fundus-Specific Foundation Models for Diabetic Macular Edema Detection8 Oct 2025
- 2025Enhancing Concept Localization in CLIP-based Concept Bottleneck Models8 Oct 2025
- 2025GRIT: Graph-Regularized Logit Refinement for Zero-shot Cell Type Annotation6 Aug 2025
- 20253D-RAD: A Comprehensive 3D Radiology Med-VQA Dataset with Multi-Temporal Analysis and Diverse Diagnostic Tasks11 Jun 2025
- 2025Leveraging Pretrained Diffusion Models for Zero-Shot Part Assembly1 May 2025
- 2025Prompt as Knowledge Bank: Boost Vision-language model via Structural Representation for zero-shot medical detection22 Feb 2025
- 2025A Comprehensive Survey on the Trustworthiness of Large Language Models in Healthcare21 Feb 2025
- 2025Fair-MoE: Fairness-Oriented Mixture of Experts in Vision-Language Models10 Feb 2025
- 2024Large Language Model Safety: A Holistic Survey23 Dec 2024
- 2024MedCoT: Medical Chain of Thought via Hierarchical Expert18 Dec 2024
- 2024MultiEYE: Dataset and Benchmark for OCT-Enhanced Retinal Disease Recognition from Fundus Images12 Dec 2024
19 more
- 2024BiomedCoOp: Learning to Prompt for Biomedical Vision-Language Models21 Nov 2024
- 2024A Survey of Medical Vision-and-Language Applications and Their Techniques19 Nov 2024
- 2024R-LLaVA: Improving Med-VQA Understanding through Visual Region of Interest27 Oct 2024
- 2024A Multimodal Approach For Endoscopic VCE Image Classification Using BiomedCLIP-PubMedBERT25 Oct 2024
- 2024Self-eXplainable AI for Medical Image Analysis: A Survey and New Outlooks3 Oct 2024
- 2024MedCLIP-SAMv2: Towards Universal Text-Driven Medical Image Segmentation28 Sep 2024
- 2024Aligning Medical Images with General Knowledge from Large Language Models31 Aug 2024
- 2024Towards Explainable Evolution Strategies with Large Language Models11 Jul 2024
- 2024A Survey on Trustworthiness in Foundation Models for Medical Image Analysis3 Jul 2024
- 2024LLM as Dataset Analyst: Subpopulation Structure Discovery with Large Language Model3 May 2024
- 2024MedThink: Explaining Medical Visual Question Answering via Multimodal Decision-Making Rationale18 Apr 2024
- 2024Residual-based Language Models are Free Boosters for Biomedical Imaging26 Mar 2024
- 2024Adaptive Ensembles of Fine-Tuned Transformers for LLM-Generated Text Detection20 Mar 2024
- 2023Large language models in healthcare and medical domain: A review12 Dec 2023
- 2023CLIP in Medical Imaging: A Survey12 Dec 2023
- 2023Representing visual classification as a linear combination of words18 Nov 2023
- 2023Open-Set Image Tagging with Multi-Grained Text Supervision23 Oct 2023
- 2023Explainability for Large Language Models: A Survey2 Sep 2023
- 2023CLIPN for Zero-Shot OOD Detection: Teaching CLIP to Say No23 Aug 2023
- 2024BiomedCoOp: Learning to Prompt for Biomedical Vision-Language Modelscited by 28
- 2024Aligning Medical Images with General Knowledge from Large Language Modelscited by 8
- 2025Fair-MoE: Fairness-Oriented Mixture of Experts in Vision-Language Modelscited by 6
- 2025Prompt as Knowledge Bank: Boost Vision-language model via Structural Representation for zero-shot medical detectioncited by 3
- 2025Prompt as Knowledge Bank: Boost Vision-language model via Structural Representation for zero-shot medical detection22 Feb 2025
- 2025Fair-MoE: Fairness-Oriented Mixture of Experts in Vision-Language Models10 Feb 2025
- 2024BiomedCoOp: Learning to Prompt for Biomedical Vision-Language Models21 Nov 2024
- 2024Aligning Medical Images with General Knowledge from Large Language Models31 Aug 2024
- 2024Large Language Model Safety: A Holistic Surveycited by 59
- 2024Large Language Model Safety: A Holistic Survey23 Dec 2024
- 2023Explainability for Large Language Models: A Surveycited by 333
- 2023CLIPN for Zero-Shot OOD Detection: Teaching CLIP to Say Nocited by 130
- 2023Large language models in healthcare and medical domain: A reviewcited by 127
- 2023Open-Set Image Tagging with Multi-Grained Text Supervisioncited by 67
- 2024LLM as Dataset Analyst: Subpopulation Structure Discovery with Large Language Modelcited by 44
- 2023CLIP in Medical Imaging: A Surveycited by 40
- 2024MedCLIP-SAMv2: Towards Universal Text-Driven Medical Image Segmentationcited by 39
- 2025A Comprehensive Survey on the Trustworthiness of Large Language Models in Healthcarecited by 27
- 20253D-RAD: A Comprehensive 3D Radiology Med-VQA Dataset with Multi-Temporal Analysis and Diverse Diagnostic Taskscited by 26
- 2024Residual-based Language Models are Free Boosters for Biomedical Imagingcited by 24
- 2024Adaptive Ensembles of Fine-Tuned Transformers for LLM-Generated Text Detectioncited by 22
- 2024R-LLaVA: Improving Med-VQA Understanding through Visual Region of Interestcited by 21
12 most cited of 23 All 23 (JSON)
- 2025Evaluating ChatGPT's Performance in Classifying Pneumonia from Chest X-Ray Images22 Oct 2025
- 2025Evaluating Fundus-Specific Foundation Models for Diabetic Macular Edema Detection8 Oct 2025
- 2025Enhancing Concept Localization in CLIP-based Concept Bottleneck Models8 Oct 2025
- 2025GRIT: Graph-Regularized Logit Refinement for Zero-shot Cell Type Annotation6 Aug 2025
- 20253D-RAD: A Comprehensive 3D Radiology Med-VQA Dataset with Multi-Temporal Analysis and Diverse Diagnostic Tasks11 Jun 2025
- 2025A Comprehensive Survey on the Trustworthiness of Large Language Models in Healthcare21 Feb 2025
- 2024MultiEYE: Dataset and Benchmark for OCT-Enhanced Retinal Disease Recognition from Fundus Images12 Dec 2024
- 2024A Survey of Medical Vision-and-Language Applications and Their Techniques19 Nov 2024
- 2024R-LLaVA: Improving Med-VQA Understanding through Visual Region of Interest27 Oct 2024
- 2024A Multimodal Approach For Endoscopic VCE Image Classification Using BiomedCLIP-PubMedBERT25 Oct 2024
- 2024Self-eXplainable AI for Medical Image Analysis: A Survey and New Outlooks3 Oct 2024
- 2024MedCLIP-SAMv2: Towards Universal Text-Driven Medical Image Segmentation28 Sep 2024
12 newest of 23 All 23 (JSON)
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- 2025KPL: Training-Free Medical Knowledge Mining of Vision-Language Models
- 2025LLaVA-RadZ: Can Multimodal Large Language Models Effectively Tackle Zero-shot Radiology Recognition?
- 2025Test-Time-Scaling for Zero-Shot Diagnosis with Visual-Language Reasoning
- 2024Pseudo-Prompt Generating in Pre-trained Vision-Language Models for Multi-Label Medical Image Classification
- 2024Decomposing Disease Descriptions for Enhanced Pathology Detection: A Multi-Aspect Vision-Language Pre-training Framework
- 2023Xplainer: From X-Ray Observations to Explainable Zero-Shot Diagnosis
- 2025Unifying Biomedical Vision-Language Expertise: Towards a Generalist Foundation Model via Multi-CLIP Knowledge Distillation
- 2025IQE-CLIP: Instance-aware Query Embedding for Zero-/Few-shot Anomaly Detection in Medical Domain