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Abstract:Medical Visual Question Answering (VQA) is an essential technology that integrates computer vision and natural language processing to automatically respond to clinical inquiries about medical images. However, current medical VQA datasets exhibit two significant limitations: (1) they often lack visual and textual explanations for answers, which impedes their ability to satisfy the comprehension needs of patients and junior doctors; (2) they typically offer a narrow range of question formats, inadequately reflecting the diverse requirements encountered in clinical scenarios. These limitations pose significant challenges to the development of a reliable and user-friendly Med-VQA system. To address these challenges, we introduce a large-scale, Groundable, and Explainable Medical VQA benchmark for chest X-ray diagnosis (GEMeX), featuring several innovative components: (1) A multi-modal explainability mechanism that offers detailed visual and textual explanations for each question-answer pair, thereby enhancing answer comprehensibility; (2) Four distinct question types, open-ended, closed-ended, single-choice, and multiple-choice, that better reflect diverse clinical needs. We evaluated 10 representative large vision language models on GEMeX and found that they underperformed, highlighting the dataset's complexity. However, after fine-tuning a baseline model using the training set, we observed a significant performance improvement, demonstrating the dataset's effectiveness. The project is available at www.med-vqa.com/GEMeX.