mlsanityData to 14 Oct 2026

MC-CoT: A Modular Collaborative CoT Framework for Zero-shot Medical-VQA with LLM and MLLM Integration

arXiv 2410.04521 ↗First posted 6 Oct 2024cs.CVcited by 21

On the map: Multimodal LLMs / vision-language models → Medical vision-language models

Abstract (arXiv)

In recent advancements, multimodal large language models (MLLMs) have been fine-tuned on specific medical image datasets to address medical visual question answering (Med-VQA) tasks. However, this common approach of task-specific fine-tuning is costly and necessitates separate models for each downstream task, limiting the exploration of zero-shot capabilities. In this paper, we introduce MC-CoT, a modular cross-modal collaboration Chain-of-Thought (CoT) framework designed to enhance the zero-shot performance of MLLMs in Med-VQA by leveraging large language models (LLMs). MC-CoT improves reasoning and information extraction by integrating medical knowledge and task-specific guidance, where LLM provides various complex medical reasoning chains and MLLM provides various observations of medical images based on instructions of the LLM. Our experiments on datasets such as SLAKE, VQA-RAD, and PATH-VQA show that MC-CoT surpasses standalone MLLMs and various multimodality CoT frameworks in recall rate and accuracy. These findings highlight the importance of incorporating background information and detailed guidance in addressing complex zero-shot Med-VQA tasks.

Key facts. Cited by 21 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 40 of its 55 references that are in the map. First posted on arXiv 6 Oct 2024.

Builds on

40 of 55 references.

Closest ancestors · 1

Same direction, newest first

  1. 2023LLaVA-Med: Training a Large Language-and-Vision Assistant for Biomedicine in One Day1 Jun

Other references · 39

  1. 2021Learning Transferable Visual Models From Natural Language Supervisioncited by 33,744
  2. 2020Language Models are Few-Shot Learnerscited by 32,419
  3. 2023GPT-4 Technical Reportcited by 18,396
  4. 2023LLaMA: Open and Efficient Foundation Language Modelscited by 14,132
  5. 2022PaLM: Scaling Language Modeling with Pathwayscited by 5,326
  6. 2023Improved Baselines with Visual Instruction Tuningcited by 4,418
  7. 2022Large Language Models are Zero-Shot Reasonerscited by 4,374
  8. 2022BLIP: Bootstrapping Language-Image Pre-training for Unified Vision-Language Understanding and Generationcited by 4,322
  9. 2024Gemini 1.5: Unlocking multimodal understanding across millions of tokens of contextcited by 3,224
  10. 2015VQA: Visual Question Answeringcited by 2,506
  11. 2022Rethinking the Role of Demonstrations: What Makes In-Context Learning Work?cited by 1,434
  12. 2019PubMedQA: A Dataset for Biomedical Research Question Answeringcited by 1,288
27 more
  1. 2019OK-VQA: A Visual Question Answering Benchmark Requiring External Knowledgecited by 1,121
  2. 2024ChatGLM: A Family of Large Language Models from GLM-130B to GLM-4 All Toolscited by 1,121
  3. 2023Graph of Thoughts: Solving Elaborate Problems with Large Language Modelscited by 886
  4. 2024DeepSeek-VL: Towards Real-World Vision-Language Understandingcited by 733
  5. 2022A Survey on In-context Learningcited by 721
  6. 2022A-OKVQA: A Benchmark for Visual Question Answering using World Knowledgecited by 710
  7. 2023BiomedCLIP: a multimodal biomedical foundation model pretrained from fifteen million scientific image-text pairscited by 520
  8. 2020PathVQA: 30000+ Questions for Medical Visual Question Answeringcited by 475
  9. 2021SLAKE: A Semantically-Labeled Knowledge-Enhanced Dataset for Medical Visual Question Answeringcited by 449
  10. 2023Med-Flamingo: a Multimodal Medical Few-shot Learnercited by 392
  11. 2023MedAgents: Large Language Models as Collaborators for Zero-shot Medical Reasoningcited by 316
  12. 2023Compositional Chain-of-Thought Prompting for Large Multimodal Modelscited by 164
  13. 2023DDCoT: Duty-Distinct Chain-of-Thought Prompting for Multimodal Reasoning in Language Modelscited by 128
  14. 2021Medical Visual Question Answering: A Surveycited by 93
  15. 2023DISC-MedLLM: Bridging General Large Language Models and Real-World Medical Consultationcited by 90
  16. 2021Does CLIP Benefit Visual Question Answering in the Medical Domain as Much as it Does in the General Domain?cited by 85
  17. 2023DISC-FinLLM: A Chinese Financial Large Language Model based on Multiple Experts Fine-tuningcited by 64
  18. 2023Open-Ended Medical Visual Question Answering Through Prefix Tuning of Language Modelscited by 58
  19. 2021Multiple Meta-model Quantifying for Medical Visual Question Answeringcited by 54
  20. 2023Better Zero-Shot Reasoning with Self-Adaptive Promptingcited by 52
  21. 2022A Benchmark for Automatic Medical Consultation System: Frameworks, Tasks and Datasetscited by 45
  22. 2024Cantor: Inspiring Multimodal Chain-of-Thought of MLLMcited by 34
  23. 2024Enhancing Visual Question Answering through Question-Driven Image Captions as Promptscited by 18
  24. 2022DxFormer: A Decoupled Automatic Diagnostic System Based on Decoder-Encoder Transformer with Dense Symptom Representationscited by 10
  25. 2023Good Questions Help Zero-Shot Image Reasoningcited by 8
  26. 2023Reverse Multi-Choice Dialogue Commonsense Inference with Graph-of-Thoughtcited by 7
  27. 2023KNSE: A Knowledge-aware Natural Language Inference Framework for Dialogue Symptom Status Recognitioncited by 5

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Cited by year (2026 to 14 Oct)

Citing papers per year: 2024: 1; 2025: 13; 2026: 7.

21 papers.

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  1. 2025Multimodal Chain-of-Thought Reasoning: A Comprehensive Surveycited by 182
  2. 2025A Survey on (M)LLM-Based GUI Agentscited by 62
  3. 2024VILA-M3: Enhancing Vision-Language Models with Medical Expert Knowledgecited by 50
  4. 2025Self-Evolving Multi-Agent Simulations for Realistic Clinical Interactionscited by 40
  5. 2025Latent Chain-of-Thought for Visual Reasoningcited by 29
  6. 2025Chiron-o1: Igniting Multimodal Large Language Models towards Generalizable Medical Reasoning via Mentor-Intern Collaborative Searchcited by 16
  7. 2025S-Chain: Structured Visual Chain-of-Thought For Medicinecited by 11
  8. 2025Medical Reasoning in the Era of LLMs: A Systematic Review of Enhancement Techniques and Applicationscited by 10
  9. 2025GoViG: Goal-Conditioned Visual Navigation Instruction Generation via Multimodal Reasoningcited by 6
  10. 2025Reasoning LLMs in the Medical Domain: A Literature Surveycited by 6
  11. 2025CapGeo-Bench: Decoupling Visual Perception from Reasoning and Evaluating Geometric Understandingcited by 5
  12. 2025PathCoT: Chain-of-Thought Prompting for Zero-shot Pathology Visual Reasoningcited by 2
9 more
  1. 2026SPD-Faith Bench: Diagnosing and Improving Faithfulness in Chain-of-Thought for Multimodal Large Language Modelscited by 2
  2. 2026Scaffolding Minds: Optimizing Latent Visual Target Representations for Multimodal Reasoningcited by 2
  3. 2025Second Opinion Matters: Towards Adaptive Clinical AI via the Consensus of Expert Model Ensemblecited by 1
  4. 2025AMANDA: Agentic Medical Knowledge Augmentation for Data-Efficient Medical Visual Question Answeringcited by 1
  5. 2026COFT: Counterfactual-Conformal Decoding for Fair Chain-of-Thought Reasoning in Large Language Modelscited by 1
  6. 2026RGBX-R1: Visual Modality Chain-of-Thought Guided Reinforcement Learning for Multimodal Groundingcited by 0
  7. 2026Towards Enhancing 3D Spatial Reasoning in Medical Multimodal Large Language Modelscited by 0
  8. 2026MedReaMM: Evaluating Large Multimodal Models on Expert-Level Clinical Diagnostic Synthesiscited by 0
  9. 2026OPERA: A Unified Omnimodal Progressive Spatio-Temporal Reasoning Agent for Referring Video Segmentationcited by 0

Similar, not cited

Close in wording, no citation either way

  1. 2025CoTBox-TTT: Grounding Medical VQA with Visual Chain-of-Thought Boxes During Test-time Training
  2. 2025MedCLM: Learning to Localize and Reason via a CoT-Curriculum in Medical Vision-Language Models
  3. 2025Med-GRIM: Enhanced Zero-Shot Medical VQA using prompt-embedded Multimodal Graph RAG
  4. 2025ClinKD: Cross-Modal Clinical Knowledge Distiller For Multi-Task Medical Images
  5. 2026MedFG-VQA: Low-Frequency Memory and Graph Attention for Lightweight Medical VQA
  6. 2025A Lightweight Large Vision-language Model for Multimodal Medical Images
  7. 2024Fusion of Domain-Adapted Vision and Language Models for Medical Visual Question Answering
  8. 2026Step-CoT: Stepwise Visual Chain-of-Thought for Medical Visual Question Answering