提升医学视觉问答的鲁棒性,让模型对同义问题回答更一致。
Knowing or Guessing? Robust Medical Visual Question Answering via Joint Consistency and Contrastive Learning
- 通过一致性与对比学习联合优化模型推理路径
- 在新数据集上使答案一致性提升50%,性能下降减少40%
- 适合关注医疗AI可靠性的研究者和开发者
在高风险医疗场景中,对同一问题的不同表述保持一致回答至关重要。然而我们发现,当前医学视觉语言模型在面对语义等价的问题重述时,回答波动剧烈。原因在于:(1)医学概念对齐不足,导致推理路径发散;(2)训练数据存在隐藏偏见,偏好语法捷径而非语义理解。为此,我们构建了RoMed数据集,基于原始VQA数据集包含14.4万条经词级、句级、语义级扰动的问题。在该数据集上评估LLaVA-Med等先进模型时,召回率出现高达40%的下降,暴露出严重鲁棒性缺陷。为此提出一致性与对比学习(CCL)框架,包含两项关键机制:(1)知识锚定的一致性学习,引导模型依据医学知识而非浅层特征模式;(2)偏见感知的对比学习,通过区分性表征优化缓解数据特异性先验。CCL在三个主流VQA基准上达到最先进水平,并在挑战性RoMed测试集上将答案一致性提升50%,显著增强模型鲁棒性。代码将公开。
原文摘要 · Abstract (English)
In high-stakes medical applications, consistent answering across diverse question phrasings is essential for reliable diagnosis. However, we reveal that current Medical Vision-Language Models (Med-VLMs) exhibit concerning fragility in Medical Visual Question Answering, as their answers fluctuate significantly when faced with semantically equivalent rephrasings of medical questions. We attribute this to two limitations: (1) insufficient alignment of medical concepts, leading to divergent reasoning patterns, and (2) hidden biases in training data that prioritize syntactic shortcuts over semantic understanding. To address these challenges, we construct RoMed, a dataset built upon original VQA datasets containing 144k questions with variations spanning word-level, sentence-level, and semantic-level perturbations. When evaluating state-of-the-art (SOTA) models like LLaVA-Med on RoMed, we observe alarming performance drops (e.g., a 40\% decline in Recall) compared to original VQA benchmarks, exposing critical robustness gaps. To bridge this gap, we propose Consistency and Contrastive Learning (CCL), which integrates two key components: (1) knowledge-anchored consistency learning, aligning Med-VLMs with medical knowledge rather than shallow feature patterns, and (2) bias-aware contrastive learning, mitigating data-specific priors through discriminative representation refinement. CCL achieves SOTA performance on three popular VQA benchmarks and notably improves answer consistency by 50\% on the challenging RoMed test set, demonstrating significantly enhanced robustness. Code will be released.
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