# Prompting Medical Large Vision-Language Models to Diagnose Pathologies by Visual Question Answering

arXiv: https://arxiv.org/abs/2407.21368 · HTML: https://mlsanity.com/paper/2407.21368/

## Key facts

- Cited by 6 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 41 of its 53 references that are in the map.
- First posted on arXiv 31 Jul 2024.

## 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 41)

- [Deep Residual Learning for Image Recognition](https://mlsanity.com/paper/1512.03385/) (2015)
- [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)
- [GPT-4 Technical Report](https://mlsanity.com/paper/2303.08774/) (2023)
- [LLaMA: Open and Efficient Foundation Language Models](https://mlsanity.com/paper/2302.13971/) (2023)
- [Visual Instruction Tuning](https://mlsanity.com/paper/2304.08485/) (2023)
- [BLIP-2: Bootstrapping Language-Image Pre-training with Frozen Image Encoders and Large Language Models](https://mlsanity.com/paper/2301.12597/) (2023)
- [Fast R-CNN](https://mlsanity.com/paper/1504.08083/) (2015)
- [MiniGPT-4: Enhancing Vision-Language Understanding with Advanced Large Language Models](https://mlsanity.com/paper/2304.10592/) (2023)
- [Large Language Models Encode Clinical Knowledge](https://mlsanity.com/paper/2212.13138/) (2022)
- [Improving Factuality and Reasoning in Language Models through Multiagent Debate](https://mlsanity.com/paper/2305.14325/) (2023)
- [Evaluating Object Hallucination in Large Vision-Language Models](https://mlsanity.com/paper/2305.10355/) (2023)
- [CheXpert: A Large Chest Radiograph Dataset with Uncertainty Labels and Expert Comparison](https://mlsanity.com/paper/1901.07031/) (2019)
- [LLaVA-Med: Training a Large Language-and-Vision Assistant for Biomedicine in One Day](https://mlsanity.com/paper/2306.00890/) (2023)
- [LLaMA-Adapter: Efficient Fine-tuning of Language Models with Zero-init Attention](https://mlsanity.com/paper/2303.16199/) (2023)
- [Aligning Large Multimodal Models with Factually Augmented RLHF](https://mlsanity.com/paper/2309.14525/) (2023)
- [Mitigating Object Hallucinations in Large Vision-Language Models through Visual Contrastive Decoding](https://mlsanity.com/paper/2311.16922/) (2023)
- [Object Hallucination in Image Captioning](https://mlsanity.com/paper/1809.02156/) (2018)
- [Contrastive Learning of Medical Visual Representations from Paired Images and Text](https://mlsanity.com/paper/2010.00747/) (2020)
- [MedCLIP: Contrastive Learning from Unpaired Medical Images and Text](https://mlsanity.com/paper/2210.10163/) (2022)
- [BiomedCLIP: a multimodal biomedical foundation model pretrained from fifteen million scientific image-text pairs](https://mlsanity.com/paper/2303.00915/) (2023)
- [PathVQA: 30000+ Questions for Medical Visual Question Answering](https://mlsanity.com/paper/2003.10286/) (2020)
- [SLAKE: A Semantically-Labeled Knowledge-Enhanced Dataset for Medical Visual Question Answering](https://mlsanity.com/paper/2102.09542/) (2021)
- [Mitigating Hallucination in Large Multi-Modal Models via Robust Instruction Tuning](https://mlsanity.com/paper/2306.14565/) (2023)
- [Towards Expert-Level Medical Question Answering with Large Language Models](https://mlsanity.com/paper/2305.09617/) (2023)
- [A Survey on Hallucination in Large Vision-Language Models](https://mlsanity.com/paper/2402.00253/) (2024)
- [Check Your Facts and Try Again: Improving Large Language Models with External Knowledge and Automated Feedback](https://mlsanity.com/paper/2302.12813/) (2023)
- [FreshLLMs: Refreshing Large Language Models with Search Engine Augmentation](https://mlsanity.com/paper/2310.03214/) (2023)
- [Analyzing and Mitigating Object Hallucination in Large Vision-Language Models](https://mlsanity.com/paper/2310.00754/) (2023)
- [Towards Understanding Chain-of-Thought Prompting: An Empirical Study of What Matters](https://mlsanity.com/paper/2212.10001/) (2022)

## Built on by (most cited first, 6 of 6)

- [LLaDA-MedV: Exploring Large Language Diffusion Models for Biomedical Image Understanding](https://mlsanity.com/paper/2508.01617/) (2025)
- [MoMA: A Mixture-of-Multimodal-Agents Architecture for Enhancing Clinical Prediction Modelling](https://mlsanity.com/paper/2508.05492/) (2025)
- [MRGAgents: A Multi-Agent Framework for Improved Medical Report Generation with Med-LVLMs](https://mlsanity.com/paper/2505.18530/) (2025)
- [Adaptive Diagnostic Reasoning Framework for Pathology with Multimodal Large Language Models](https://mlsanity.com/paper/2511.12008/) (2025)
- [Med-R2: An Adversarial Benchmark for Evidence-Grounded Reasoning in Medical VLMs](https://mlsanity.com/paper/2605.24492/) (2026)
- [COMPASS: Membership Inference Attack Against Vision Large Language Models via Adaptive Noise Calibration](https://mlsanity.com/paper/2610.17332/) (2026)

## Abstract (arXiv)

Large Vision-Language Models (LVLMs) have achieved significant success in recent years, and they have been extended to the medical domain. Although demonstrating satisfactory performance on medical Visual Question Answering (VQA) tasks, Medical LVLMs (MLVLMs) suffer from the hallucination problem, which makes them fail to diagnose complex pathologies. Moreover, they readily fail to learn minority pathologies due to imbalanced training data. We propose two prompting strategies for MLVLMs that reduce hallucination and improve VQA performance. In the first strategy, we provide a detailed explanation of the queried pathology. In the second strategy, we fine-tune a cheap, weak learner to achieve high performance on a specific metric, and textually provide its judgment to the MLVLM. Tested on the MIMIC-CXR-JPG and Chexpert datasets, our methods significantly improve the diagnostic F1 score, with the highest increase being 0.27. We also demonstrate that our prompting strategies can be extended to general LVLM domains. Based on POPE metrics, it effectively suppresses the false negative predictions of existing LVLMs and improves Recall by approximately 0.07.