# Pragmatic Radiology Report Generation

arXiv: https://arxiv.org/abs/2311.17154 · HTML: https://mlsanity.com/paper/2311.17154/

## Key facts

- Cited by 12 papers in the map (data through 14 Oct 2026).
- Builds on 17 of its 29 references that are in the map.
- First posted on arXiv 28 Nov 2023.

## Builds on (most cited first, 17 of 17)

- [Deep Residual Learning for Image Recognition](https://mlsanity.com/paper/1512.03385/) (2015)
- [LLaMA: Open and Efficient Foundation Language Models](https://mlsanity.com/paper/2302.13971/) (2023)
- [BERTScore: Evaluating Text Generation with BERT](https://mlsanity.com/paper/1904.09675/) (2019)
- [Survey of Hallucination in Natural Language Generation](https://mlsanity.com/paper/2202.03629/) (2022)
- [CheXpert: A Large Chest Radiograph Dataset with Uncertainty Labels and Expert Comparison](https://mlsanity.com/paper/1901.07031/) (2019)
- [The Flan Collection: Designing Data and Methods for Effective Instruction Tuning](https://mlsanity.com/paper/2301.13688/) (2023)
- [Generating Radiology Reports via Memory-driven Transformer](https://mlsanity.com/paper/2010.16056/) (2020)
- [CheXbert: Combining Automatic Labelers and Expert Annotations for Accurate Radiology Report Labeling Using BERT](https://mlsanity.com/paper/2004.09167/) (2020)
- [RadGraph: Extracting Clinical Entities and Relations from Radiology Reports](https://mlsanity.com/paper/2106.14463/) (2021)
- [Towards Generalist Biomedical AI](https://mlsanity.com/paper/2307.14334/) (2023)
- [On the Automatic Generation of Medical Imaging Reports](https://mlsanity.com/paper/1711.08195/) (2017)
- [Improving Factual Completeness and Consistency of Image-to-Text Radiology Report Generation](https://mlsanity.com/paper/2010.10042/) (2020)
- [TieNet: Text-Image Embedding Network for Common Thorax Disease Classification and Reporting in Chest X-rays](https://mlsanity.com/paper/1801.04334/) (2018)
- [Clinically Accurate Chest X-Ray Report Generation](https://mlsanity.com/paper/1904.02633/) (2019)
- [XrayGPT: Chest Radiographs Summarization using Medical Vision-Language Models](https://mlsanity.com/paper/2306.07971/) (2023)
- [Automatic Radiology Report Generation based on Multi-view Image Fusion and Medical Concept Enrichment](https://mlsanity.com/paper/1907.09085/) (2019)
- [Improving Radiology Report Generation Systems by Removing Hallucinated References to Non-existent Priors](https://mlsanity.com/paper/2210.06340/) (2022)

## Built on by (most cited first, 12 of 12)

- [MAIRA-2: Grounded Radiology Report Generation](https://mlsanity.com/paper/2406.04449/) (2024)
- [Automated Radiology Report Generation: A Review of Recent Advances](https://mlsanity.com/paper/2405.10842/) (2024)
- [An X-Ray Is Worth 15 Features: Sparse Autoencoders for Interpretable Radiology Report Generation](https://mlsanity.com/paper/2410.03334/) (2024)
- [Structural Entities Extraction and Patient Indications Incorporation for Chest X-ray Report Generation](https://mlsanity.com/paper/2405.14905/) (2024)
- [UniMedVL: Unifying Medical Multimodal Understanding and Generation through Observation-Knowledge-Analysis](https://mlsanity.com/paper/2510.15710/) (2025)
- [GPT-4V Cannot Generate Radiology Reports Yet](https://mlsanity.com/paper/2407.12176/) (2024)
- [EVOKE: Elevating Chest X-ray Report Generation via Multi-View Contrastive Learning and Patient-Specific Knowledge](https://mlsanity.com/paper/2411.10224/) (2024)
- [LaB-RAG: Label Boosted Retrieval Augmented Generation for Radiology Report Generation](https://mlsanity.com/paper/2411.16523/) (2024)
- [From Attribution to Abstention: Training-Free Attention-Based Auditing for Clinical Summarization](https://mlsanity.com/paper/2601.16397/) (2026)
- [LLaMA-XR: A Novel Framework for Radiology Report Generation using LLaMA and QLoRA Fine Tuning](https://mlsanity.com/paper/2506.03178/) (2025)
- [CXRMate-2: Structured Multimodal Temporal Embeddings and Tractable Reinforcement Learning for Clinically Acceptable Chest X-ray Radiology Report Generation](https://mlsanity.com/paper/2604.18967/) (2026)
- [PDD-RRG: Posterior Diagnostic Decision for Study-level Radiology Report Generation](https://mlsanity.com/paper/2608.03055/) (2026)

## Abstract (arXiv)

When pneumonia is not found on a chest X-ray, should the report describe this negative observation or omit it? We argue that this question cannot be answered from the X-ray alone and requires a pragmatic perspective, which captures the communicative goal that radiology reports serve between radiologists and patients. However, the standard image-to-text formulation for radiology report generation fails to incorporate such pragmatic intents. Following this pragmatic perspective, we demonstrate that the indication, which describes why a patient comes for an X-ray, drives the mentions of negative observations and introduce indications as additional input to report generation. With respect to the output, we develop a framework to identify uninferable information from the image as a source of model hallucinations, and limit them by cleaning groundtruth reports. Finally, we use indications and cleaned groundtruth reports to develop pragmatic models, and show that they outperform existing methods not only in new pragmatics-inspired metrics (+4.3 Negative F1) but also in standard metrics (+6.3 Positive F1 and +11.0 BLEU-2).