# Multimodal Integrated Knowledge Transfer to Large Language Models through Preference Optimization with Biomedical Applications

arXiv: https://arxiv.org/abs/2505.05736 · HTML: https://mlsanity.com/paper/2505.05736/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Placed in Medical LLM alignment, one of 10 directions in LLM alignment / RLHF / preference optimisation.
- Builds on 34 of its 82 references that are in the map.
- First posted on arXiv 9 May 2025.

## Placed in

- LLM alignment / RLHF / preference optimisation / [Medical LLM alignment](https://mlsanity.com/alignment/medical-llm-alignment/)

## Builds on (most cited first, 30 of 34)

- [Attention Is All You Need](https://mlsanity.com/paper/1706.03762/) (2017)
- [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)
- [The Llama 3 Herd of Models](https://mlsanity.com/paper/2407.21783/) (2024)
- [LoRA: Low-Rank Adaptation of Large Language Models](https://mlsanity.com/paper/2106.09685/) (2021)
- [Training Verifiers to Solve Math Word Problems](https://mlsanity.com/paper/2110.14168/) (2021)
- [Retrieval-Augmented Generation for Knowledge-Intensive NLP Tasks](https://mlsanity.com/paper/2005.11401/) (2020)
- [Direct Preference Optimization: Your Language Model is Secretly a Reward Model](https://mlsanity.com/paper/2305.18290/) (2023)
- [Measuring Massive Multitask Language Understanding](https://mlsanity.com/paper/2009.03300/) (2020)
- [HellaSwag: Can a Machine Really Finish Your Sentence?](https://mlsanity.com/paper/1905.07830/) (2019)
- [TruthfulQA: Measuring How Models Mimic Human Falsehoods](https://mlsanity.com/paper/2109.07958/) (2021)
- [Retrieval-Augmented Generation for Large Language Models: A Survey](https://mlsanity.com/paper/2312.10997/) (2023)
- [ViLT: Vision-and-Language Transformer Without Convolution or Region Supervision](https://mlsanity.com/paper/2102.03334/) (2021)
- [Fine-tuning Aligned Language Models Compromises Safety, Even When Users Do Not Intend To!](https://mlsanity.com/paper/2310.03693/) (2023)
- [Domain-Specific Language Model Pretraining for Biomedical Natural Language Processing](https://mlsanity.com/paper/2007.15779/) (2020)
- [The Surprising Effectiveness of PPO in Cooperative, Multi-Agent Games](https://mlsanity.com/paper/2103.01955/) (2021)
- [SEED-Bench: Benchmarking Multimodal LLMs with Generative Comprehension](https://mlsanity.com/paper/2307.16125/) (2023)
- [Robust fine-tuning of zero-shot models](https://mlsanity.com/paper/2109.01903/) (2021)
- [ORPO: Monolithic Preference Optimization without Reference Model](https://mlsanity.com/paper/2403.07691/) (2024)
- [Active Retrieval Augmented Generation](https://mlsanity.com/paper/2305.06983/) (2023)
- [The Reversal Curse: LLMs trained on "A is B" fail to learn "B is A"](https://mlsanity.com/paper/2309.12288/) (2023)
- [Detecting Pretraining Data from Large Language Models](https://mlsanity.com/paper/2310.16789/) (2023)
- [Supervised Contrastive Learning for Pre-trained Language Model Fine-tuning](https://mlsanity.com/paper/2011.01403/) (2020)
- [WinoGrande: An Adversarial Winograd Schema Challenge at Scale](https://mlsanity.com/paper/1907.10641/) (2019)
- [Implementation Matters in Deep Policy Gradients: A Case Study on PPO and TRPO](https://mlsanity.com/paper/2005.12729/) (2020)
- [Adversarial Robustness: From Self-Supervised Pre-Training to Fine-Tuning](https://mlsanity.com/paper/2003.12862/) (2020)
- [D4: Improving LLM Pretraining via Document De-Duplication and Diversification](https://mlsanity.com/paper/2308.12284/) (2023)
- [PanNuke Dataset Extension, Insights and Baselines](https://mlsanity.com/paper/2003.10778/) (2020)
- [Harmful Fine-tuning Attacks and Defenses for Large Language Models: A Survey](https://mlsanity.com/paper/2409.18169/) (2024)
- [Towards a Theoretical Understanding of the 'Reversal Curse' via Training Dynamics](https://mlsanity.com/paper/2405.04669/) (2024)

## Abstract (arXiv)

The scarcity of high-quality multimodal biomedical data limits the ability to effectively fine-tune pretrained Large Language Models (LLMs) for specialized biomedical tasks. To address this challenge, we introduce MINT (Multimodal Integrated kNowledge Transfer), a framework that aligns unimodal large decoder models with domain-specific decision patterns from multimodal biomedical data through preference optimization. While MINT supports different optimization techniques, we primarily implement it with the Odds Ratio Preference Optimization (ORPO) framework as its backbone. This strategy enables the aligned LLMs to perform predictive tasks using text-only or image-only inputs while retaining knowledge learnt from multimodal data. MINT leverages an upstream multimodal machine learning (MML) model trained on high-quality multimodal data to transfer domain-specific insights to downstream text-only or image-only LLMs. We demonstrate its effectiveness through two key applications: (1) Rare genetic disease prediction from texts, where MINT uses a multimodal encoder model, trained on facial photos and clinical notes, to generate a preference dataset for aligning a lightweight Llama 3.2-3B-Instruct. Despite relying on text input only, the MINT-derived model outperforms models trained with SFT, RAG, or DPO, and even outperforms Llama 3.1-405B-Instruct. (2) Tissue type classification using cell nucleus images, where MINT uses a vision-language foundation model as the preference generator, containing knowledge learnt from both text and histopathological images to align downstream image-only models. The resulting MINT-derived model significantly improves the performance of Llama 3.2-Vision-11B-Instruct on tissue type classification. In summary, MINT provides an effective strategy to align unimodal LLMs with high-quality multimodal expertise through preference optimization.