# MMed-RAG: Versatile Multimodal RAG System for Medical Vision Language Models

arXiv: https://arxiv.org/abs/2410.13085 · HTML: https://mlsanity.com/paper/2410.13085/

## Key facts

- Cited by 85 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 64 of its 82 references that are in the map.
- First posted on arXiv 16 Oct 2024.

## Placed in

- Multimodal LLMs / vision-language models / [Medical vision-language models](https://mlsanity.com/mllm/medical-vision-language-models/)
- Retrieval-augmented generation / [Medical and biomedical RAG](https://mlsanity.com/rag/medical-and-biomedical-rag/)

## Builds on (most cited first, 30 of 64)

- [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)
- [LoRA: Low-Rank Adaptation of Large Language Models](https://mlsanity.com/paper/2106.09685/) (2021)
- [Llama 2: Open Foundation and Fine-Tuned Chat Models](https://mlsanity.com/paper/2307.09288/) (2023)
- [Direct Preference Optimization: Your Language Model is Secretly a Reward Model](https://mlsanity.com/paper/2305.18290/) (2023)
- [Visual Instruction Tuning](https://mlsanity.com/paper/2304.08485/) (2023)
- [Improved Baselines with Visual Instruction Tuning](https://mlsanity.com/paper/2310.03744/) (2023)
- [Outrageously Large Neural Networks: The Sparsely-Gated Mixture-of-Experts Layer](https://mlsanity.com/paper/1701.06538/) (2017)
- [Gemini 1.5: Unlocking multimodal understanding across millions of tokens of context](https://mlsanity.com/paper/2403.05530/) (2024)
- [Sequence to Sequence Learning with Neural Networks](https://mlsanity.com/paper/1409.3215/) (2014)
- [Qwen-VL: A Versatile Vision-Language Model for Understanding, Localization, Text Reading, and Beyond](https://mlsanity.com/paper/2308.12966/) (2023)
- [Retrieval-Augmented Generation for Large Language Models: A Survey](https://mlsanity.com/paper/2312.10997/) (2023)
- [LLaVA-Med: Training a Large Language-and-Vision Assistant for Biomedicine in One Day](https://mlsanity.com/paper/2306.00890/) (2023)
- [How Far Are We to GPT-4V? Closing the Gap to Commercial Multimodal Models with Open-Source Suites](https://mlsanity.com/paper/2404.16821/) (2024)
- [Publicly Available Clinical BERT Embeddings](https://mlsanity.com/paper/1904.03323/) (2019)
- [Scaling Vision with Sparse Mixture of Experts](https://mlsanity.com/paper/2106.05974/) (2021)
- [Mitigating Object Hallucinations in Large Vision-Language Models through Visual Contrastive Decoding](https://mlsanity.com/paper/2311.16922/) (2023)
- [MIMIC-CXR-JPG, a large publicly available database of labeled chest radiographs](https://mlsanity.com/paper/1901.07042/) (2019)
- [Self-Play Fine-Tuning Converts Weak Language Models to Strong Language Models](https://mlsanity.com/paper/2401.01335/) (2024)
- [BiomedCLIP: a multimodal biomedical foundation model pretrained from fifteen million scientific image-text pairs](https://mlsanity.com/paper/2303.00915/) (2023)
- [OPERA: Alleviating Hallucination in Multi-Modal Large Language Models via Over-Trust Penalty and Retrospection-Allocation](https://mlsanity.com/paper/2311.17911/) (2023)
- [Med-Flamingo: a Multimodal Medical Few-shot Learner](https://mlsanity.com/paper/2307.15189/) (2023)
- [DoLa: Decoding by Contrasting Layers Improves Factuality in Large Language Models](https://mlsanity.com/paper/2309.03883/) (2023)
- [PMC-VQA: Visual Instruction Tuning for Medical Visual Question Answering](https://mlsanity.com/paper/2305.10415/) (2023)
- [Analyzing and Mitigating Object Hallucination in Large Vision-Language Models](https://mlsanity.com/paper/2310.00754/) (2023)
- [Towards Generalist Biomedical AI](https://mlsanity.com/paper/2307.14334/) (2023)
- [RAGTruth: A Hallucination Corpus for Developing Trustworthy Retrieval-Augmented Language Models](https://mlsanity.com/paper/2401.00396/) (2023)
- [On the Automatic Generation of Medical Imaging Reports](https://mlsanity.com/paper/1711.08195/) (2017)
- [PMC-CLIP: Contrastive Language-Image Pre-training using Biomedical Documents](https://mlsanity.com/paper/2303.07240/) (2023)
- [HuatuoGPT-Vision, Towards Injecting Medical Visual Knowledge into Multimodal LLMs at Scale](https://mlsanity.com/paper/2406.19280/) (2024)

## Built on by (most cited first, 30 of 85)

- [Words or Vision: Do Vision-Language Models Have Blind Faith in Text?](https://mlsanity.com/paper/2503.02199/) (2025)
- [MDocAgent: A Multi-Modal Multi-Agent Framework for Document Understanding](https://mlsanity.com/paper/2503.13964/) (2025)
- [Advancing Multimodal Reasoning: From Optimized Cold Start to Staged Reinforcement Learning](https://mlsanity.com/paper/2506.04207/) (2025)
- [MMedAgent-RL: Optimizing Multi-Agent Collaboration for Multimodal Medical Reasoning](https://mlsanity.com/paper/2506.00555/) (2025)
- [Retrieval Augmented Generation and Understanding in Vision: A Survey and New Outlook](https://mlsanity.com/paper/2503.18016/) (2025)
- [VISA: Retrieval Augmented Generation with Visual Source Attribution](https://mlsanity.com/paper/2412.14457/) (2024)
- [DecAlign: Hierarchical Cross-Modal Alignment for Decoupled Multimodal Representation Learning](https://mlsanity.com/paper/2503.11892/) (2025)
- [Retrieval-Augmented Perception: High-Resolution Image Perception Meets Visual RAG](https://mlsanity.com/paper/2503.01222/) (2025)
- [A Survey on Agentic Multimodal Large Language Models](https://mlsanity.com/paper/2510.10991/) (2025)
- [MMedPO: Aligning Medical Vision-Language Models with Clinical-Aware Multimodal Preference Optimization](https://mlsanity.com/paper/2412.06141/) (2024)
- [Silent Leaks: Implicit Knowledge Extraction Attack on RAG Systems through Benign Queries](https://mlsanity.com/paper/2505.15420/) (2025)
- [Orion-MSP: Multi-Scale Sparse Attention for Tabular In-Context Learning](https://mlsanity.com/paper/2511.02818/) (2025)
- [Benchmarking Poisoning Attacks against Retrieval-Augmented Generation](https://mlsanity.com/paper/2505.18543/) (2025)
- [MMGraphRAG: Bridging Vision and Language with Interpretable Multimodal Knowledge Graphs](https://mlsanity.com/paper/2507.20804/) (2025)
- [EndoBench: A Comprehensive Evaluation of Multi-Modal Large Language Models for Endoscopy Analysis](https://mlsanity.com/paper/2505.23601/) (2025)
- [Agentic Medical Knowledge Graphs Enhance Medical Question Answering: Bridging the Gap Between LLMs and Evolving Medical Knowledge](https://mlsanity.com/paper/2502.13010/) (2025)
- [Poisoned-MRAG: Knowledge Poisoning Attacks to Multimodal Retrieval Augmented Generation](https://mlsanity.com/paper/2503.06254/) (2025)
- [Who Taught the Lie? Responsibility Attribution for Poisoned Knowledge in Retrieval-Augmented Generation](https://mlsanity.com/paper/2509.13772/) (2025)
- [End-to-End Agentic RAG System Training for Traceable Diagnostic Reasoning](https://mlsanity.com/paper/2508.15746/) (2025)
- [Towards Interpretable Radiology Report Generation via Concept Bottlenecks using a Multi-Agentic RAG](https://mlsanity.com/paper/2412.16086/) (2024)
- [Multi-Modal Foundation Models for Computational Pathology: A Survey](https://mlsanity.com/paper/2503.09091/) (2025)
- [From Illusion to Intention: Visual Rationale Learning for Vision-Language Reasoning](https://mlsanity.com/paper/2511.23031/) (2025)
- [A Multimodal Multi-Agent Framework for Radiology Report Generation](https://mlsanity.com/paper/2505.09787/) (2025)
- [QuRe: Query-Relevant Retrieval through Hard Negative Sampling in Composed Image Retrieval](https://mlsanity.com/paper/2507.12416/) (2025)
- [Integrating Chain-of-Thought and Retrieval Augmented Generation Enhances Rare Disease Diagnosis from Clinical Notes](https://mlsanity.com/paper/2503.12286/) (2025)
- [MoMA: A Mixture-of-Multimodal-Agents Architecture for Enhancing Clinical Prediction Modelling](https://mlsanity.com/paper/2508.05492/) (2025)
- [Evo-MedAgent: Beyond One-Shot Diagnosis with Agents That Remember, Reflect, and Improve](https://mlsanity.com/paper/2604.14475/) (2026)
- [Beyond Text: Unveiling Privacy Vulnerabilities in Multi-modal Retrieval-Augmented Generation](https://mlsanity.com/paper/2505.13957/) (2025)
- [Visual Alignment of Medical Vision-Language Models for Grounded Radiology Report Generation](https://mlsanity.com/paper/2512.16201/) (2025)
- [OmniRAG-Agent: Agentic Omnimodal Reasoning for Low-Resource Long Audio-Video Question Answering](https://mlsanity.com/paper/2602.03707/) (2026)

## Abstract (arXiv)

Artificial Intelligence (AI) has demonstrated significant potential in healthcare, particularly in disease diagnosis and treatment planning. Recent progress in Medical Large Vision-Language Models (Med-LVLMs) has opened up new possibilities for interactive diagnostic tools. However, these models often suffer from factual hallucination, which can lead to incorrect diagnoses. Fine-tuning and retrieval-augmented generation (RAG) have emerged as methods to address these issues. However, the amount of high-quality data and distribution shifts between training data and deployment data limit the application of fine-tuning methods. Although RAG is lightweight and effective, existing RAG-based approaches are not sufficiently general to different medical domains and can potentially cause misalignment issues, both between modalities and between the model and the ground truth. In this paper, we propose a versatile multimodal RAG system, MMed-RAG, designed to enhance the factuality of Med-LVLMs. Our approach introduces a domain-aware retrieval mechanism, an adaptive retrieved contexts selection method, and a provable RAG-based preference fine-tuning strategy. These innovations make the RAG process sufficiently general and reliable, significantly improving alignment when introducing retrieved contexts. Experimental results across five medical datasets (involving radiology, ophthalmology, pathology) on medical VQA and report generation demonstrate that MMed-RAG can achieve an average improvement of 43.8% in the factual accuracy of Med-LVLMs. Our data and code are available in https://github.com/richard-peng-xia/MMed-RAG.