arXiv:2508.17394cs.CV2025-08ACL被引 1

轻量级多模态检索提升通用大模型医学诊断准确率

LVLM-Aware Multimodal Retrieval for RAG-Based Medical Diagnosis with General-Purpose Models

  • 用轻量微调训练能引导大模型正确判断的图文检索器
  • 在小数据下表现媲美专业医疗模型,临床分类与问答任务均达标
  • 发现并缓解检索结果不一致导致的诊断错误,适合医疗AI研发者

从医学文献和病历中检索图文信息可提升临床图像诊断的准确性,但多模态检索增强诊断仍具挑战。本文提出一种轻量级机制,通过训练一个面向大视觉语言模型(LVLM)的多模态检索器,使其返回能引导LVLM做出正确预测的图像与文本。在低资源设置下,仅采用少量数据进行轻量微调,并使用通用基础模型,其在临床分类和视觉问答(VQA)任务上的表现已媲美需大量训练的医疗专用模型。我们首次揭示一类未被关注的错误——不一致检索预测:同一目标因不同顶排检索图像产生不同诊断结论。此类问题对所有模型均具挑战性,而我们的检索优化机制显著优于标准RAG。但分析也暴露了LVLM利用检索信息进行临床判断的能力仍有不足。代码与模型见:https://github.com/Nirmaz/CLARE。

原文摘要 · Abstract (English)

Retrieving visual and textual information from medical literature and hospital records can enhance diagnostic accuracy for clinical image interpretation. However, multimodal retrieval-augmented diagnosis is highly challenging. We explore a lightweight mechanism for enhancing diagnostic performance of retrieval-augmented LVLMs. We train a lightweight LVLM-aware multimodal retriever, such that the retriever learns to return images and texts that guide the LVLM toward correct predictions. In our low-resource setting, we perform only lightweight fine-tuning with small amounts of data, and use only general-purpose backbone models, achieving competitive results in clinical classification and VQA tasks compared to medically pre-trained models with extensive training. In a novel analysis, we highlight a previously unexplored class of errors that we term inconsistent retrieval predictions: cases where different top-retrieved images yield different predictions for the same target. We find that these cases are challenging for all models, even for non-retrieval models, and that our retrieval optimization mechanism significantly improves these cases over standard RAG. However, our analysis also sheds light on gaps in the ability of LVLMs to utilize retrieved information for clinical predictions. Code and models available at: https://github.com/Nirmaz/CLARE.

多模态检索医疗AI大模型RAG

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