# CLARIFID: Improving Radiology Report Generation by Reinforcing Clinically Accurate Impressions and Enforcing Detailed Findings

arXiv: https://arxiv.org/abs/2507.17234 · HTML: https://mlsanity.com/paper/2507.17234/

## Key facts

- Cited by 1 papers in the map (data through 14 Oct 2026).
- Builds on 48 of its 61 references that are in the map.
- First posted on arXiv 23 Jul 2025.

## Builds on (most cited first, 30 of 48)

- [Microsoft COCO: Common Objects in Context](https://mlsanity.com/paper/1405.0312/) (2014)
- [Training language models to follow instructions with human feedback](https://mlsanity.com/paper/2203.02155/) (2022)
- [Proximal Policy Optimization Algorithms](https://mlsanity.com/paper/1707.06347/) (2017)
- [Chain-of-Thought Prompting Elicits Reasoning in Large Language Models](https://mlsanity.com/paper/2201.11903/) (2022)
- [Training Verifiers to Solve Math Word Problems](https://mlsanity.com/paper/2110.14168/) (2021)
- [Direct Preference Optimization: Your Language Model is Secretly a Reward Model](https://mlsanity.com/paper/2305.18290/) (2023)
- [Grad-CAM: Visual Explanations from Deep Networks via Gradient-based Localization](https://mlsanity.com/paper/1610.02391/) (2016)
- [DeepSeek-R1: Incentivizing Reasoning Capability in LLMs via Reinforcement Learning](https://mlsanity.com/paper/2501.12948/) (2025)
- [Self-Consistency Improves Chain of Thought Reasoning in Language Models](https://mlsanity.com/paper/2203.11171/) (2022)
- [Reflexion: Language Agents with Verbal Reinforcement Learning](https://mlsanity.com/paper/2303.11366/) (2023)
- [Self-Refine: Iterative Refinement with Self-Feedback](https://mlsanity.com/paper/2303.17651/) (2023)
- [High-Dimensional Continuous Control Using Generalized Advantage Estimation](https://mlsanity.com/paper/1506.02438/) (2015)
- [Competition-Level Code Generation with AlphaCode](https://mlsanity.com/paper/2203.07814/) (2022)
- [s1: Simple test-time scaling](https://mlsanity.com/paper/2501.19393/) (2025)
- [Swin Transformer V2: Scaling Up Capacity and Resolution](https://mlsanity.com/paper/2111.09883/) (2021)
- [Large Language Monkeys: Scaling Inference Compute with Repeated Sampling](https://mlsanity.com/paper/2407.21787/) (2024)
- [RLAIF vs. RLHF: Scaling Reinforcement Learning from Human Feedback with AI Feedback](https://mlsanity.com/paper/2309.00267/) (2023)
- [MIMIC-CXR-JPG, a large publicly available database of labeled chest radiographs](https://mlsanity.com/paper/1901.07042/) (2019)
- [VLM-R1: A Stable and Generalizable R1-style Large Vision-Language Model](https://mlsanity.com/paper/2504.07615/) (2025)
- [Generating Radiology Reports via Memory-driven Transformer](https://mlsanity.com/paper/2010.16056/) (2020)
- [CheXbert: Combining Automatic Labelers and Expert Annotations for Accurate Radiology Report Labeling Using BERT](https://mlsanity.com/paper/2004.09167/) (2020)
- [RadGraph: Extracting Clinical Entities and Relations from Radiology Reports](https://mlsanity.com/paper/2106.14463/) (2021)
- [Quiet-STaR: Language Models Can Teach Themselves to Think Before Speaking](https://mlsanity.com/paper/2403.09629/) (2024)
- [Logic-RL: Unleashing LLM Reasoning with Rule-Based Reinforcement Learning](https://mlsanity.com/paper/2502.14768/) (2025)
- [Cross-modal Memory Networks for Radiology Report Generation](https://mlsanity.com/paper/2204.13258/) (2022)
- [Exploring and Distilling Posterior and Prior Knowledge for Radiology Report Generation](https://mlsanity.com/paper/2106.06963/) (2021)
- [Teaching Large Language Models to Reason with Reinforcement Learning](https://mlsanity.com/paper/2403.04642/) (2024)
- [Multi-Granularity Cross-modal Alignment for Generalized Medical Visual Representation Learning](https://mlsanity.com/paper/2210.06044/) (2022)
- [When Radiology Report Generation Meets Knowledge Graph](https://mlsanity.com/paper/2002.08277/) (2020)
- [Improving Factual Completeness and Consistency of Image-to-Text Radiology Report Generation](https://mlsanity.com/paper/2010.10042/) (2020)

## Built on by (most cited first, 1 of 1)

- [Multi-Modal Multi-Agent Reinforcement Learning for Radiology Report Generation](https://mlsanity.com/paper/2603.16876/) (2026)

## Abstract (arXiv)

Automatic generation of radiology reports has the potential to alleviate radiologists' significant workload, yet current methods struggle to deliver clinically reliable conclusions. In particular, most prior approaches focus on producing fluent text without effectively ensuring the factual correctness of the reports and often rely on single-view images, limiting diagnostic comprehensiveness. We propose CLARIFID, a novel framework that directly optimizes diagnostic correctness by mirroring the two-step workflow of experts. Specifically, CLARIFID (1) learns the logical flow from Findings to Impression through section-aware pretraining, (2) is fine-tuned with Proximal Policy Optimization in which the CheXbert F1 score of the Impression section serves as the reward, (3) employs controlled decoding that completes "Findings" before synthesizing the "Impression", and (4) fuses multiple chest X-ray views via a vision-transformer-based multi-view encoder. During inference, we apply a next-token forcing strategy followed by report-level re-ranking, ensuring that the model first produces a comprehensive "Findings" section before synthesizing the "Impression" and thereby preserving coherent clinical reasoning. Experimental results on the MIMIC-CXR dataset demonstrate that our method achieves superior clinical efficacy and outperforms existing baselines on clinical efficacy scores.