arXiv:2508.02669cs.CV2025-08中稿 · ML4H'25被引 28

开源简单基线,让医疗多模态模型更会思考。

MedVLThinker: Simple Baselines for Multimodal Medical Reasoning

  • 用分级推理难度数据+两种训练法,构建可复现的医疗推理基线。
  • 强化学习奖励机制比传统微调显著提效,文本数据效果优于图文数据。
  • 7B模型达开源新纪录,32B媲美GPT-4o,适合医疗AI研究者使用。

大型推理模型通过思维链推理实现了‘先思考再回答’的新范式。然而,缺乏公开可复现的医疗多模态大模型构建方法,制约了社区研究与比较。本文提出MedVLThinker,一套简单但强大的基线方案:(1) 按推理难度分级筛选文本与图文医疗数据;(2) 采用监督微调(SFT)和基于答案正确性的可验证奖励强化学习(RLVR)两种训练范式。在Qwen2.5-VL系列模型(3B、7B)及六个医疗问答基准上实验发现,RLVR始终显著优于SFT。更关键的是,在RLVR框架下,仅用文本推理数据训练的效果远超图文数据。最佳开源7B模型在现有公开视觉问答基准上达到新纪录,超越所有此前开源医疗多模态模型。扩展至32B后性能与专有模型GPT-4o相当。本文开放全部数据、模型与代码,为多模态医疗推理研究提供坚实开源基础。

原文摘要 · Abstract (English)

Large Reasoning Models (LRMs) have introduced a new paradigm in AI by enabling models to ``think before responding" via chain-of-thought reasoning. However, the absence of open and reproducible recipes for building reasoning-centric medical LMMs hinders community-wide research, analysis, and comparison. In this paper, we present MedVLThinker, a suite of simple yet strong baselines. Our fully open recipe consists of: (1) systematic data curation for both text-only and image-text medical data, filtered according to varying levels of reasoning difficulty, and (2) two training paradigms: Supervised Fine-Tuning (SFT) on distilled reasoning traces and Reinforcement Learning with Verifiable Rewards (RLVR) based on final answer correctness. Across extensive experiments on the Qwen2.5-VL model family (3B, 7B) and six medical QA benchmarks, we find that RLVR consistently and significantly outperforms SFT. Additionally, under the RLVR framework, a key, counter-intuitive finding is that training on our curated text-only reasoning data provides a more substantial performance boost than training on multimodal image-text data. Our best open 7B model, trained using the RLVR recipe on text-only data, establishes a new state-of-the-art on existing public VQA benchmarks, surpassing all previous open-source medical LMMs. Furthermore, scaling our model to 32B achieves performance on par with the proprietary GPT-4o. We release all curated data, models, and code to provide the community with a strong, open foundation for future research in multimodal medical reasoning.

医疗AI多模态推理模型开源

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