# MedPromptX: Grounded Multimodal Prompting for Chest X-ray Diagnosis

arXiv: https://arxiv.org/abs/2403.15585 · HTML: https://mlsanity.com/paper/2403.15585/

## Key facts

- Cited by 3 papers in the map (data through 14 Oct 2026).
- Builds on 20 of its 25 references that are in the map.
- First posted on arXiv 22 Mar 2024.

## Builds on (most cited first, 20 of 20)

- [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)
- [Language Models are Few-Shot Learners](https://mlsanity.com/paper/2005.14165/) (2020)
- [LLaMA: Open and Efficient Foundation Language Models](https://mlsanity.com/paper/2302.13971/) (2023)
- [Swin Transformer: Hierarchical Vision Transformer using Shifted Windows](https://mlsanity.com/paper/2103.14030/) (2021)
- [Flamingo: a Visual Language Model for Few-Shot Learning](https://mlsanity.com/paper/2204.14198/) (2022)
- [Grounding DINO: Marrying DINO with Grounded Pre-Training for Open-Set Object Detection](https://mlsanity.com/paper/2303.05499/) (2023)
- [DINO: DETR with Improved DeNoising Anchor Boxes for End-to-End Object Detection](https://mlsanity.com/paper/2203.03605/) (2022)
- [Grounded Language-Image Pre-training](https://mlsanity.com/paper/2112.03857/) (2021)
- [MIMIC-CXR-JPG, a large publicly available database of labeled chest radiographs](https://mlsanity.com/paper/1901.07042/) (2019)
- [OpenFlamingo: An Open-Source Framework for Training Large Autoregressive Vision-Language Models](https://mlsanity.com/paper/2308.01390/) (2023)
- [Med-Flamingo: a Multimodal Medical Few-shot Learner](https://mlsanity.com/paper/2307.15189/) (2023)
- [An Empirical Study of GPT-3 for Few-Shot Knowledge-Based VQA](https://mlsanity.com/paper/2109.05014/) (2021)
- [Towards Generalist Biomedical AI](https://mlsanity.com/paper/2307.14334/) (2023)
- [Woodpecker: Hallucination Correction for Multimodal Large Language Models](https://mlsanity.com/paper/2310.16045/) (2023)
- [BiomedGPT: A Generalist Vision-Language Foundation Model for Diverse Biomedical Tasks](https://mlsanity.com/paper/2305.17100/) (2023)
- [Integrated multimodal artificial intelligence framework for healthcare applications](https://mlsanity.com/paper/2202.12998/) (2022)
- [A Systematic Evaluation of GPT-4V's Multimodal Capability for Medical Image Analysis](https://mlsanity.com/paper/2310.20381/) (2023)
- [CPLLM: Clinical Prediction with Large Language Models](https://mlsanity.com/paper/2309.11295/) (2023)
- [Secondary Use of Electronic Health Record: Opportunities and Challenges](https://mlsanity.com/paper/2001.09479/) (2020)

## Built on by (most cited first, 3 of 3)

- [A Survey on Trustworthiness in Foundation Models for Medical Image Analysis](https://mlsanity.com/paper/2407.15851/) (2024)
- [MOTOR: Multimodal Optimal Transport via Grounded Retrieval in Medical Visual Question Answering](https://mlsanity.com/paper/2506.22900/) (2025)
- [Multimodal Carotid Risk Stratification with Large Vision-Language Models: Benchmarking, Fine-Tuning, and Clinical Insights](https://mlsanity.com/paper/2510.02922/) (2025)

## Abstract (arXiv)

Chest X-ray images are commonly used for predicting acute and chronic cardiopulmonary conditions, but efforts to integrate them with structured clinical data face challenges due to incomplete electronic health records (EHR). This paper introduces MedPromptX, the first clinical decision support system that integrates multimodal large language models (MLLMs), few-shot prompting (FP) and visual grounding (VG) to combine imagery with EHR data for chest X-ray diagnosis. A pre-trained MLLM is utilized to complement the missing EHR information, providing a comprehensive understanding of patients' medical history. Additionally, FP reduces the necessity for extensive training of MLLMs while effectively tackling the issue of hallucination. Nevertheless, the process of determining the optimal number of few-shot examples and selecting high-quality candidates can be burdensome, yet it profoundly influences model performance. Hence, we propose a new technique that dynamically refines few-shot data for real-time adjustment to new patient scenarios. Moreover, VG narrows the search area in X-ray images, thereby enhancing the identification of abnormalities. We also release MedPromptX-VQA, a new in-context visual question answering dataset encompassing interleaved images and EHR data derived from MIMIC-IV and MIMIC-CXR-JPG databases. Results demonstrate the SOTA performance of MedPromptX, achieving an 11% improvement in F1-score compared to the baselines. Code and data are publicly available on https://github.com/BioMedIA-MBZUAI/MedPromptX.