Bringing CLIP to the Clinic: Dynamic Soft Labels and Negation-Aware Learning for Medical Analysis
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Abstract (arXiv)
The development of large-scale image-text pair datasets has significantly advanced self-supervised learning in Vision-Language Processing (VLP). However, directly applying general-domain architectures such as CLIP to medical data presents challenges, particularly in handling negations and addressing the inherent data imbalance of medical datasets. To address these issues, we propose a novel approach that integrates clinically-enhanced dynamic soft labels and medical graphical alignment, thereby improving clinical comprehension and the applicability of contrastive loss in medical contexts. Furthermore, we introduce negation-based hard negatives to deepen the model's understanding of the complexities of clinical language. Our approach is easily integrated into the medical CLIP training pipeline and achieves state-of-the-art performance across multiple tasks, including zero-shot, fine-tuned classification, and report retrieval. To comprehensively evaluate our model's capacity for understanding clinical language, we introduce CXR-Align, a benchmark uniquely designed to evaluate the understanding of negation and clinical information within chest X-ray (CXR) datasets. Experimental results demonstrate that our proposed methods are straightforward to implement and generalize effectively across contrastive learning frameworks, enhancing medical VLP capabilities and advancing clinical language understanding in medical imaging.
Key facts. Cited by 10 papers in the map (data through 14 Oct 2026). Builds on 30 of its 45 references that are in the map. First posted on arXiv 28 May 2025.
Builds on
30 of 45 references.
References · 30
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- 2018Representation Learning with Contrastive Predictive Codingcited by 7,777
- 2019Publicly Available Clinical BERT Embeddingscited by 1,002
- 2017ChestX-ray8: Hospital-scale Chest X-ray Database and Benchmarks on Weakly-Supervised Classification and Localization of Common Thorax Diseasescited by 972
- 2020Contrastive Learning of Medical Visual Representations from Paired Images and Textcited by 641
- 2022When and why vision-language models behave like bags-of-words, and what to do about it?cited by 610
- 2021Supervision Exists Everywhere: A Data Efficient Contrastive Language-Image Pre-training Paradigmcited by 405
- 2024LLM2Vec: Large Language Models Are Secretly Powerful Text Encoderscited by 404
- 2018Graph Convolutional Networks for Text Classificationcited by 345
- 2022Making the Most of Text Semantics to Improve Biomedical Vision--Language Processingcited by 339
18 more
- 2020CheXbert: Combining Automatic Labelers and Expert Annotations for Accurate Radiology Report Labeling Using BERTcited by 337
- 2021RadGraph: Extracting Clinical Entities and Relations from Radiology Reportscited by 319
- 2023SugarCrepe: Fixing Hackable Benchmarks for Vision-Language Compositionalitycited by 243
- 2020VinDr-CXR: An open dataset of chest X-rays with radiologist's annotationscited by 239
- 2023Improving CLIP Training with Language Rewritescited by 217
- 2023Learning to Exploit Temporal Structure for Biomedical Vision-Language Processingcited by 211
- 2022CREPE: Can Vision-Language Foundation Models Reason Compositionally?cited by 181
- 2023MedKLIP: Medical Knowledge Enhanced Language-Image Pre-Training in Radiologycited by 149
- 2024MAIRA-2: Grounded Radiology Report Generationcited by 145
- 2022PyramidCLIP: Hierarchical Feature Alignment for Vision-language Model Pretrainingcited by 104
- 2023CXR-CLIP: Toward Large Scale Chest X-ray Language-Image Pre-trainingcited by 82
- 2023SoftCLIP: Softer Cross-modal Alignment Makes CLIP Strongercited by 56
- 2024Learn "No" to Say "Yes" Better: Improving Vision-Language Models via Negationscited by 46
- 2024CARZero: Cross-Attention Alignment for Radiology Zero-Shot Classificationcited by 40
- 2023Exploring Vision-Language Models for Imbalanced Learningcited by 35
- 2024MLIP: Enhancing Medical Visual Representation with Divergence Encoder and Knowledge-guided Contrastive Learningcited by 23
- 2024Worse than Random? An Embarrassingly Simple Probing Evaluation of Large Multimodal Models in Medical VQAcited by 19
- 2024ReXamine-Global: A Framework for Uncovering Inconsistencies in Radiology Report Generation Metricscited by 5
Built on by
Citing papers per year: 2025: 4; 2026: 6.
10 papers.
- 2025Logic Unseen: Revealing the Logical Blindspots of Vision-Language Modelscited by 7
- 2026Not Just What's There: Enabling CLIP to Comprehend Negated Visual Descriptions Without Fine-tuningcited by 5
- 2025X-WIN: Building Chest Radiograph World Model via Predictive Sensingcited by 2
- 2025Exploring the Capabilities of Large Language Model Encoders for Image-Text Retrieval in Chest X-rayscited by 1
- 2026Temporal Inversion for Learning Interval Change in Chest X-Rayscited by 1
- 2025The Effect of Negation on CLIP in Medical Imaging: Limitations of Contrastive Language-Image Pretrainingcited by 0
- 2026NAST: Improving Negation Handling in Medical Vision-Language Models through Negation-Aware Selective Trainingcited by 0
- 2026Rethinking Text-Based Image Retrieval in Specific Domaincited by 0
- 2026Benchmarking MLLMs via Cognitive Expected Scene Graph for Safety-Critical Visual Negation Understandingcited by 0
- 2026Absence is Presence: Understanding Visual Scene Negative Events Under Safety Cognitive Constraintcited by 0
- 2026Absence is Presence: Understanding Visual Scene Negative Events Under Safety Cognitive Constraint17 Sep 2026
- 2026Benchmarking MLLMs via Cognitive Expected Scene Graph for Safety-Critical Visual Negation Understanding17 Sep 2026
- 2026Rethinking Text-Based Image Retrieval in Specific Domain11 Aug 2026
- 2026Temporal Inversion for Learning Interval Change in Chest X-Rays6 Apr 2026
- 2026Not Just What's There: Enabling CLIP to Comprehend Negated Visual Descriptions Without Fine-tuning24 Feb 2026
- 2026NAST: Improving Negation Handling in Medical Vision-Language Models through Negation-Aware Selective Training13 Feb 2026
- 2025The Effect of Negation on CLIP in Medical Imaging: Limitations of Contrastive Language-Image Pretraining18 Dec 2025
- 2025X-WIN: Building Chest Radiograph World Model via Predictive Sensing18 Nov 2025
- 2025Exploring the Capabilities of Large Language Model Encoders for Image-Text Retrieval in Chest X-rays17 Sep 2025
- 2025Logic Unseen: Revealing the Logical Blindspots of Vision-Language Models15 Aug 2025