# TemMed-Bench: Evaluating Temporal Medical Image Reasoning in Vision-Language Models

arXiv: https://arxiv.org/abs/2509.25143 · HTML: https://mlsanity.com/paper/2509.25143/

## Key facts

- Cited by 2 papers in the map (data through 14 Oct 2026).
- Placed in Clinical and biomedical applications, one of 17 directions in LLM reasoning.
- Builds on 8 of its 44 references that are in the map.
- First posted on arXiv 29 Sep 2025.

## Placed in

- LLM reasoning / [Clinical and biomedical applications](https://mlsanity.com/lr/clinical-and-biomedical-applications/)
- Multimodal LLMs / vision-language models / [Medical vision-language models](https://mlsanity.com/mllm/medical-vision-language-models/)

## Builds on (most cited first, 8 of 8)

- [GPT-4o System Card](https://mlsanity.com/paper/2410.21276/) (2024)
- [LLaVA-OneVision: Easy Visual Task Transfer](https://mlsanity.com/paper/2408.03326/) (2024)
- [PathVQA: 30000+ Questions for Medical Visual Question Answering](https://mlsanity.com/paper/2003.10286/) (2020)
- [PMC-VQA: Visual Instruction Tuning for Medical Visual Question Answering](https://mlsanity.com/paper/2305.10415/) (2023)
- [HealthGPT: A Medical Large Vision-Language Model for Unifying Comprehension and Generation via Heterogeneous Knowledge Adaptation](https://mlsanity.com/paper/2502.09838/) (2025)
- [CheXpert Plus: Augmenting a Large Chest X-ray Dataset with Text Radiology Reports, Patient Demographics and Additional Image Formats](https://mlsanity.com/paper/2405.19538/) (2024)
- [MedFrameQA: A Multi-Image Medical VQA Benchmark for Clinical Reasoning](https://mlsanity.com/paper/2505.16964/) (2025)
- [Benchmarking Retrieval-Augmented Generation in Multi-Modal Contexts](https://mlsanity.com/paper/2502.17297/) (2025)

## Built on by (most cited first, 2 of 2)

- [MI-CXR: A Benchmark for Longitudinal Reasoning over Multi-Interval Chest X-rays](https://mlsanity.com/paper/2605.15574/) (2026)
- [How Good are Foundation Models in Longitudinal MRI Disease Progression Reasoning?](https://mlsanity.com/paper/2608.13309/) (2026)

## Abstract (arXiv)

Existing medical reasoning benchmarks for vision-language models primarily focus on analyzing a patient's condition based on an image from a single visit. However, this setting deviates significantly from real-world clinical practice, where doctors typically refer to a patient's historical conditions to provide a comprehensive assessment by tracking their changes over time. In this paper, we introduce TEMMED-BENCH, a multi-task benchmark designed for analyzing changes in patients' conditions between different clinical visits, which challenges large vision-language models (LVLMs) to reason over temporal medical images. TEMMED-BENCH consists of a test set comprising three tasks - visual question-answering (VQA), report generation, and image-pair selection - and a supplementary knowledge corpus of over 17,000 instances. With TEMMED-BENCH, we conduct an evaluation of twelve LVLMs, comprising six proprietary and six open-source models. Our results show that most LVLMs lack the ability to analyze patients' condition changes over temporal medical images, and a large proportion perform only at a random-guessing level in the closed-book setting. To enhance the tracking of condition changes, we explore augmenting the input with both retrieved visual and textual modalities in the medical domain. We also show that multi-modal retrieval augmentation yields notably higher performance gains than no retrieval and textual retrieval alone across most models on our benchmark, with the VQA task showing an average improvement of 2.59%. Overall, we compose a benchmark grounded on real-world clinical practice, and it reveals LVLMs' limitations in temporal medical image reasoning, as well as highlighting the use of multi-modal retrieval augmentation as a potentially promising direction worth exploring to address this challenge.