# GazeVaLM: A Multi-Observer Eye-Tracking Benchmark for Evaluating Clinical Realism in AI-Generated X-Rays

arXiv: https://arxiv.org/abs/2604.11653 · HTML: https://mlsanity.com/paper/2604.11653/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 8 of its 29 references that are in the map.
- First posted on arXiv 13 Apr 2026.

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

- [Denoising Diffusion Probabilistic Models](https://mlsanity.com/paper/2006.11239/) (2020)
- [A Survey on Deep Learning in Medical Image Analysis](https://mlsanity.com/paper/1702.05747/) (2017)
- [A note on the evaluation of generative models](https://mlsanity.com/paper/1511.01844/) (2015)
- [Pros and Cons of GAN Evaluation Measures](https://mlsanity.com/paper/1802.03446/) (2018)
- [How to Fool Radiologists with Generative Adversarial Networks? A Visual Turing Test for Lung Cancer Diagnosis](https://mlsanity.com/paper/1710.09762/) (2017)
- [REFLACX, a dataset of reports and eye-tracking data for localization of abnormalities in chest x-rays](https://mlsanity.com/paper/2109.14187/) (2021)
- [The Llama 4 Herd: Architecture, Training, Evaluation, and Deployment Notes](https://mlsanity.com/paper/2601.11659/) (2026)
- [Eye-gaze Guided Multi-modal Alignment for Medical Representation Learning](https://mlsanity.com/paper/2403.12416/) (2024)

## Abstract (arXiv)

We introduce GazeVaLM, a public eye-tracking dataset for studying clinical perception during chest radiograph authenticity assessment. The dataset comprises 960 gaze recordings from 16 expert radiologists interpreting 30 real and 30 synthetic chest X-rays (generated by diffusion based generative AI) under two conditions: diagnostic assessment and real-fake classification (Visual Turing test). For each image-observer pair, we provide raw gaze samples, fixation maps, scanpaths, saliency density maps, structured diagnostic labels, and authenticity judgments. We extend the protocol to 6 state-of-the-art multimodal LLMs, releasing their predicted diagnoses, authenticity labels, and confidence scores under matched conditions - enabling direct human-AI comparison at both decision and uncertainty levels. We further provide analyses of gaze agreement, inter-observer consistency, and benchmarking of radiologists versus LLMs in diagnostic accuracy and authenticity detection. GazeVaLM supports research in gaze modeling, clinical decision-making, human-AI comparison, generative image realism assessment, and uncertainty quantification. By jointly releasing visual attention data, clinical labels, and model predictions, we aim to facilitate reproducible research on how experts and AI systems perceive, interpret, and evaluate medical images. The dataset is available at https://huggingface.co/datasets/davidcwong/GazeVaLM.