# A Vision-Language Foundation Model to Enhance Efficiency of Chest X-ray Interpretation

arXiv: https://arxiv.org/abs/2401.12208 · HTML: https://mlsanity.com/paper/2401.12208/

## Key facts

- Cited by 81 papers in the map (data through 14 Oct 2026).
- First posted on arXiv 22 Jan 2024.

## Built on by (most cited first, 30 of 81)

- [MAIRA-2: Grounded Radiology Report Generation](https://mlsanity.com/paper/2406.04449/) (2024)
- [GREEN: Generative Radiology Report Evaluation and Error Notation](https://mlsanity.com/paper/2405.03595/) (2024)
- [CheXpert Plus: Augmenting a Large Chest X-ray Dataset with Text Radiology Reports, Patient Demographics and Additional Image Formats](https://mlsanity.com/paper/2405.19538/) (2024)
- [A Review of Large Language Models and Autonomous Agents in Chemistry](https://mlsanity.com/paper/2407.01603/) (2024)
- [MedRAX: Medical Reasoning Agent for Chest X-ray](https://mlsanity.com/paper/2502.02673/) (2025)
- [MedImageInsight: An Open-Source Embedding Model for General Domain Medical Imaging](https://mlsanity.com/paper/2410.06542/) (2024)
- [MiniGPT-Med: Large Language Model as a General Interface for Radiology Diagnosis](https://mlsanity.com/paper/2407.04106/) (2024)
- [An X-Ray Is Worth 15 Features: Sparse Autoencoders for Interpretable Radiology Report Generation](https://mlsanity.com/paper/2410.03334/) (2024)
- [RadVLM: A Multitask Conversational Vision-Language Model for Radiology](https://mlsanity.com/paper/2502.03333/) (2025)
- [Fact-Aware Multimodal Retrieval Augmentation for Accurate Medical Radiology Report Generation](https://mlsanity.com/paper/2407.15268/) (2024)
- [MedVH: Towards Systematic Evaluation of Hallucination for Large Vision Language Models in the Medical Context](https://mlsanity.com/paper/2407.02730/) (2024)
- [Has Multimodal Learning Delivered Universal Intelligence in Healthcare? A Comprehensive Survey](https://mlsanity.com/paper/2408.12880/) (2024)
- [Self-eXplainable AI for Medical Image Analysis: A Survey and New Outlooks](https://mlsanity.com/paper/2410.02331/) (2024)
- [A Survey on Trustworthiness in Foundation Models for Medical Image Analysis](https://mlsanity.com/paper/2407.15851/) (2024)
- [M4CXR: Exploring Multi-task Potentials of Multi-modal Large Language Models for Chest X-ray Interpretation](https://mlsanity.com/paper/2408.16213/) (2024)
- [A Spectrum Evaluation Benchmark for Medical Multi-Modal Large Language Models](https://mlsanity.com/paper/2402.11217/) (2024)
- [EchoFM: Foundation Model for Generalizable Echocardiogram Analysis](https://mlsanity.com/paper/2410.23413/) (2024)
- [LLM-RG4: Flexible and Factual Radiology Report Generation across Diverse Input Contexts](https://mlsanity.com/paper/2412.12001/) (2024)
- [CXR-Agent: Vision-language models for chest X-ray interpretation with uncertainty aware radiology reporting](https://mlsanity.com/paper/2407.08811/) (2024)
- [Medical MLLM is Vulnerable: Cross-Modality Jailbreak and Mismatched Attacks on Medical Multimodal Large Language Models](https://mlsanity.com/paper/2405.20775/) (2024)
- [Ophiuchus: Incentivizing Tool-augmented "Think with Images" for Joint Medical Segmentation, Understanding and Reasoning](https://mlsanity.com/paper/2512.14157/) (2025)
- [Lunguage: A Benchmark for Structured and Sequential Chest X-ray Interpretation](https://mlsanity.com/paper/2505.21190/) (2025)
- [ReEvalMed: Rethinking Medical Report Evaluation by Aligning Metrics with Real-World Clinical Judgment](https://mlsanity.com/paper/2510.00280/) (2025)
- [Uncovering Knowledge Gaps in Radiology Report Generation Models through Knowledge Graphs](https://mlsanity.com/paper/2408.14397/) (2024)
- [Improving Performance, Robustness, and Fairness of Radiographic AI Models with Finely-Controllable Synthetic Data](https://mlsanity.com/paper/2508.16783/) (2025)
- [Chest X-ray Foundation Model with Global and Local Representations Integration](https://mlsanity.com/paper/2502.05142/) (2025)
- [MedHallTune: An Instruction-Tuning Benchmark for Mitigating Medical Hallucination in Vision-Language Models](https://mlsanity.com/paper/2502.20780/) (2025)
- [CXReasonBench: A Benchmark for Evaluating Structured Diagnostic Reasoning in Chest X-rays](https://mlsanity.com/paper/2505.18087/) (2025)
- [Specialized curricula for training vision-language models in retinal image analysis](https://mlsanity.com/paper/2407.08410/) (2024)
- [Fool Me Once? Contrasting Textual and Visual Explanations in a Clinical Decision-Support Setting](https://mlsanity.com/paper/2410.12284/) (2024)

## Abstract (arXiv)

Over 1.4 billion chest X-rays (CXRs) are performed annually due to their cost-effectiveness as an initial diagnostic test. This scale of radiological studies provides a significant opportunity to streamline CXR interpretation and documentation. While foundation models are a promising solution, the lack of publicly available large-scale datasets and benchmarks inhibits their iterative development and real-world evaluation. To overcome these challenges, we constructed a large-scale dataset (CheXinstruct), which we utilized to train a vision-language foundation model (CheXagent). We systematically demonstrated competitive performance across eight distinct task types on our novel evaluation benchmark (CheXbench). Beyond technical validation, we assessed the real-world utility of CheXagent in directly drafting radiology reports. Our clinical assessment with eight radiologists revealed a 36% time saving for residents using CheXagent-drafted reports, while attending radiologists showed no significant time difference editing resident-drafted or CheXagent-drafted reports. The CheXagent-drafted reports improved the writing efficiency of both radiology residents and attending radiologists in 81% and 61% of cases, respectively, without loss of quality. Overall, we demonstrate that CheXagent can effectively perform a variety of CXR interpretation tasks and holds potential to assist radiologists in routine clinical workflows.