# Bridging the Semantic Gaps: Improving Medical VQA Consistency with LLM-Augmented Question Sets

arXiv: https://arxiv.org/abs/2504.11777 · HTML: https://mlsanity.com/paper/2504.11777/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 14 of its 30 references that are in the map.
- First posted on arXiv 16 Apr 2025.

## Builds on (most cited first, 14 of 14)

- [Language Models are Few-Shot Learners](https://mlsanity.com/paper/2005.14165/) (2020)
- [VQA: Visual Question Answering](https://mlsanity.com/paper/1505.00468/) (2015)
- [Survey of Hallucination in Natural Language Generation](https://mlsanity.com/paper/2202.03629/) (2022)
- [MIMIC-CXR-JPG, a large publicly available database of labeled chest radiographs](https://mlsanity.com/paper/1901.07042/) (2019)
- [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)
- [Med-BERT: pre-trained contextualized embeddings on large-scale structured electronic health records for disease prediction](https://mlsanity.com/paper/2005.12833/) (2020)
- [BiomedGPT: A Generalist Vision-Language Foundation Model for Diverse Biomedical Tasks](https://mlsanity.com/paper/2305.17100/) (2023)
- [OmniMedVQA: A New Large-Scale Comprehensive Evaluation Benchmark for Medical LVLM](https://mlsanity.com/paper/2402.09181/) (2024)
- [Deep Learning for Identifying Metastatic Breast Cancer](https://mlsanity.com/paper/1606.05718/) (2016)
- [Consistency and Uncertainty: Identifying Unreliable Responses From Black-Box Vision-Language Models for Selective Visual Question Answering](https://mlsanity.com/paper/2404.10193/) (2024)
- [Self-supervised vision-language pretraining for Medical visual question answering](https://mlsanity.com/paper/2211.13594/) (2022)
- [Masked Vision and Language Pre-training with Unimodal and Multimodal Contrastive Losses for Medical Visual Question Answering](https://mlsanity.com/paper/2307.05314/) (2023)
- [Prompt-Reverse Inconsistency: LLM Self-Inconsistency Beyond Generative Randomness and Prompt Paraphrasing](https://mlsanity.com/paper/2504.01282/) (2025)

## Abstract (arXiv)

Medical Visual Question Answering (MVQA) systems can interpret medical images in response to natural language queries. However, linguistic variability in question phrasing often undermines the consistency of these systems. To address this challenge, we propose a Semantically Equivalent Question Augmentation (SEQA) framework, which leverages large language models (LLMs) to generate diverse yet semantically equivalent rephrasings of questions. Specifically, this approach enriches linguistic diversity while preserving semantic meaning. We further introduce an evaluation metric, Total Agreement Rate with Semantically Equivalent Input and Correct Answer (TAR-SC), which assesses a model's capability to generate consistent and correct responses to semantically equivalent linguistic variations. In addition, we also propose three other diversity metrics - average number of QA items per image (ANQI), average number of questions per image with the same answer (ANQA), and average number of open-ended questions per image with the same semantics (ANQS). Using the SEQA framework, we augmented the benchmarked MVQA public datasets of SLAKE, VQA-RAD, and PathVQA. As a result, all three datasets achieved significant improvements by incorporating more semantically equivalent questions: ANQI increased by an average of 86.1, ANQA by 85.1, and ANQS by 46. Subsequent experiments evaluate three MVQA models (M2I2, MUMC, and BiomedGPT) under both zero-shot and fine-tuning settings on the enhanced datasets. Experimental results in MVQA datasets show that fine-tuned models achieve an average accuracy improvement of 19.35%, while our proposed TAR-SC metric shows an average improvement of 11. 61%, indicating a substantial enhancement in model consistency.