ZALM3: Zero-Shot Enhancement of Vision-Language Alignment via In-Context Information in Multi-Turn Multimodal Medical Dialogue

The rocketing prosperity of large language models (LLMs) in recent years has boosted the prevalence of vision-language models (VLMs) in the medical sector. In our online medical consultation scenario, a doctor responds to the texts and images provided by a patient in multiple rounds to diagnose her/his health condition, forming a multi-turn multimodal medical dialogue format. Unlike high-quality images captured by professional equipment in traditional medical visual question answering (Med-VQA), the images in our case are taken by patients' mobile phones. These images have poor quality control, with issues such as excessive background elements and the lesion area being significantly off-center, leading to degradation of vision-language alignment in the model training phase. In this paper, we propose ZALM3, a Zero-shot strategy to improve vision-language ALignment in Multi-turn Multimodal Medical dialogue. Since we observe that the preceding text conversations before an image can infer the regions of interest (RoIs) in the image, ZALM3 employs an LLM to summarize the keywords from the preceding context and a visual grounding model to extract the RoIs. The updated images eliminate unnecessary background noise and provide more effective vision-language alignment. To better evaluate our proposed method, we design a new subjective assessment metric for multi-turn unimodal/multimodal medical dialogue to provide a fine-grained performance comparison. Our experiments across three different clinical departments remarkably demonstrate the efficacy of ZALM3 with statistical significance.

OphGLM: Training an Ophthalmology Large Language-and-Vision Assistant based on Instructions and Dialogue

Large multimodal language models (LMMs) have achieved significant success in general domains. However, due to the significant differences between medical images and text and general web content, the performance of LMMs in medical scenarios is limited. In ophthalmology, clinical diagnosis relies on multiple modalities of medical images, but unfortunately, multimodal ophthalmic large language models have not been explored to date. In this paper, we study and construct an ophthalmic large multimodal model. Firstly, we use fundus images as an entry point to build a disease assessment and diagnosis pipeline to achieve common ophthalmic disease diagnosis and lesion segmentation. Then, we establish a new ophthalmic multimodal instruction-following and dialogue fine-tuning dataset based on disease-related knowledge data and publicly available real-world medical dialogue. We introduce visual ability into the large language model to complete the ophthalmic large language and vision assistant (OphGLM). Our experimental results demonstrate that the OphGLM model performs exceptionally well, and it has the potential to revolutionize clinical applications in ophthalmology. The dataset, code, and models will be made publicly available at https://github.com/ML-AILab/OphGLM.