Multi-OphthaLingua: A Multilingual Benchmark for Assessing and Debiasing LLM Ophthalmological QA in LMICs

Current ophthalmology clinical workflows are plagued by over-referrals, long waits, and complex and heterogeneous medical records. Large language models (LLMs) present a promising solution to automate various procedures such as triaging, preliminary tests like visual acuity assessment, and report summaries. However, LLMs have demonstrated significantly varied performance across different languages in natural language question-answering tasks, potentially exacerbating healthcare disparities in Low and Middle-Income Countries (LMICs). This study introduces the first multilingual ophthalmological question-answering benchmark with manually curated questions parallel across languages, allowing for direct cross-lingual comparisons. Our evaluation of 6 popular LLMs across 7 different languages reveals substantial bias across different languages, highlighting risks for clinical deployment of LLMs in LMICs. Existing debiasing methods such as Translation Chain-of-Thought or Retrieval-augmented generation (RAG) by themselves fall short of closing this performance gap, often failing to improve performance across all languages and lacking specificity for the medical domain. To address this issue, We propose CLARA (Cross-Lingual Reflective Agentic system), a novel inference time de-biasing method leveraging retrieval augmented generation and self-verification. Our approach not only improves performance across all languages but also significantly reduces the multilingual bias gap, facilitating equitable LLM application across the globe.

Latent Space Disentanglement in Diffusion Transformers Enables Zero-shot Fine-grained Semantic Editing

Diffusion Transformers (DiTs) have achieved remarkable success in diverse and high-quality text-to-image(T2I) generation. However, how text and image latents individually and jointly contribute to the semantics of generated images, remain largely unexplored. Through our investigation of DiT's latent space, we have uncovered key findings that unlock the potential for zero-shot fine-grained semantic editing: (1) Both the text and image spaces in DiTs are inherently decomposable. (2) These spaces collectively form a disentangled semantic representation space, enabling precise and fine-grained semantic control. (3) Effective image editing requires the combined use of both text and image latent spaces. Leveraging these insights, we propose a simple and effective Extract-Manipulate-Sample (EMS) framework for zero-shot fine-grained image editing. Our approach first utilizes a multi-modal Large Language Model to convert input images and editing targets into text descriptions. We then linearly manipulate text embeddings based on the desired editing degree and employ constrained score distillation sampling to manipulate image embeddings. We quantify the disentanglement degree of the latent space of diffusion models by proposing a new metric. To evaluate fine-grained editing performance, we introduce a comprehensive benchmark incorporating both human annotations, manual evaluation, and automatic metrics. We have conducted extensive experimental results and in-depth analysis to thoroughly uncover the semantic disentanglement properties of the diffusion transformer, as well as the effectiveness of our proposed method. Our annotated benchmark dataset is publicly available at https://anonymous.com/anonymous/EMS-Benchmark, facilitating reproducible research in this domain.