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With the rapid growth of large language models (LLMs) and vision-language models (VLMs) in medicine, simply integrating clinical text and medical imaging does not guarantee reliable reasoning. Existing multimodal models often produce…

Artificial Intelligence · Computer Science 2025-12-29 Zelin Zang , Wenyi Gu , Siqi Ma , Dan Yang , Yue Shen , Zhu Zhang , Guohui Fan , Wing-Kuen Ling , Fuji Yang

Reasoning is a critical frontier for advancing medical image analysis, where transparency and trustworthiness play a central role in both clinician trust and regulatory approval. Although Medical Visual Language Models (VLMs) show promise…

Computer Vision and Pattern Recognition · Computer Science 2025-03-20 Jiazhen Pan , Che Liu , Junde Wu , Fenglin Liu , Jiayuan Zhu , Hongwei Bran Li , Chen Chen , Cheng Ouyang , Daniel Rueckert

Medical vision-language models (VLMs) achieve strong performance in diagnostic reporting and image-text alignment, yet their underlying reasoning mechanisms remain fundamentally correlational, exhibiting reliance on superficial statistical…

Machine Learning · Computer Science 2026-01-27 Weiqin Yang , Haowen Xue , Qingyi Peng , Hexuan Hu , Qian Huang , Tingbo Zhang

Large visual language models (VLMs) have shown strong multi-modal medical reasoning ability, but most operate as end-to-end black boxes, diverging from clinicians' evidence-based, staged workflows and hindering clinical accountability.…

Artificial Intelligence · Computer Science 2026-03-12 Yuexi Du , Jinglu Wang , Shujie Liu , Nicha C. Dvornek , Yan Lu

Reasoning in vision-language models (VLMs) has recently attracted significant attention due to its broad applicability across diverse downstream tasks. However, it remains unclear whether the superior performance of VLMs stems from genuine…

Computer Vision and Pattern Recognition · Computer Science 2026-04-20 Yige Xu , Yongjie Wang , Zizhuo Wu , Kaisong Song , Jun Lin , Zhiqi Shen

Vision-language models (VLMs) often produce chain-of-thought (CoT) explanations that sound plausible yet fail to reflect the underlying decision process, undermining trust in high-stakes clinical use. Existing evaluations rarely catch this…

Multimodal large language models (MLLMs) that integrate visual and textual reasoning leverage chain-of-thought (CoT) prompting to tackle complex visual tasks, yet continue to exhibit visual hallucinations and an over-reliance on textual…

Computer Vision and Pattern Recognition · Computer Science 2025-10-24 Jing Bi , Guangyu Sun , Ali Vosoughi , Chen Chen , Chenliang Xu

Conditional inference on joint textual and visual clues is a multi-modal reasoning task that textual clues provide prior permutation or external knowledge, which are complementary with visual content and pivotal to deducing the correct…

Computation and Language · Computer Science 2023-05-09 Yunxin Li , Baotian Hu , Xinyu Chen , Yuxin Ding , Lin Ma , Min Zhang

Large language models (LLMs) have shown remarkable ability in various language tasks, especially with their emergent in-context learning capability. Extending LLMs to incorporate visual inputs, large vision-language models (LVLMs) have…

Machine Learning · Computer Science 2025-10-13 Aneesh Komanduri , Karuna Bhaila , Xintao Wu

Multimodal Large Language Models (MLLMs) have shown strong potential for radiology report generation, yet their clinical translation is hindered by architectural heterogeneity and the prevalence of factual hallucinations. Standard…

Machine Learning · Computer Science 2026-01-13 Kun Zhao , Siyuan Dai , Pan Wang , Jifeng Song , Hui Ji , Chenghua Lin , Liang Zhan , Haoteng Tang

Vision-language models (VLMs) have shown strong promise for medical image analysis, but most remain opaque, offering predictions without the transparent, stepwise reasoning clinicians rely on. We present a framework that brings…

Computer Vision and Pattern Recognition · Computer Science 2025-10-31 Andriy Myronenko , Dong Yang , Baris Turkbey , Mariam Aboian , Sena Azamat , Esra Akcicek , Hongxu Yin , Pavlo Molchanov , Marc Edgar , Yufan He , Pengfei Guo , Yucheng Tang , Daguang Xu

Despite recent advancements in Multi-modal Large Language Models (MLLMs) on diverse understanding tasks, these models struggle to solve problems which require extensive multi-step reasoning. This is primarily due to the progressive dilution…

Computer Vision and Pattern Recognition · Computer Science 2026-05-13 Byungwoo Jeon , Yoonwoo Jeong , Hyunseok Lee , Minsu Cho , Jinwoo Shin

Recent advances in vision language models (VLMs) offer reasoning capabilities, yet how these unfold and integrate visual and textual information remains unclear. We analyze reasoning dynamics in 18 VLMs covering instruction-tuned and…

Computation and Language · Computer Science 2026-04-28 Danae Sánchez Villegas , Samuel Lewis-Lim , Nikolaos Aletras , Desmond Elliott

Vision-language models (VLMs) are increasingly proposed for clinical decision support, yet their reliability in real-world scenarios that require integrating both visual and textual context from medical records remains poorly characterized.…

Computer Vision and Pattern Recognition · Computer Science 2026-05-19 David Restrepo , Ira Ktena , Maria Vakalopoulou , Stergios Christodoulidis , Enzo Ferrante

Vision-Language Models (VLMs) have achieved remarkable progress in multimodal reasoning tasks through enhanced chain-of-thought capabilities. However, this advancement also introduces novel safety risks, as these models become increasingly…

Computer Vision and Pattern Recognition · Computer Science 2025-10-22 Yinan Xia , Yilei Jiang , Yingshui Tan , Xiaoyong Zhu , Xiangyu Yue , Bo Zheng

Large language models (LLMs) have demonstrated immense capabilities in understanding textual data and are increasingly being adopted to help researchers accelerate scientific discovery through knowledge extraction (information retrieval),…

Computer Vision and Pattern Recognition · Computer Science 2025-05-30 Robinson Umeike , Neil Getty , Fangfang Xia , Rick Stevens

Vision-language models (VLMs) show promise in drafting radiology reports, yet they frequently suffer from logical inconsistencies, generating diagnostic impressions unsupported by their own perceptual findings or missing logically entailed…

Computer Vision and Pattern Recognition · Computer Science 2026-03-02 Vikash Singh , Debargha Ganguly , Haotian Yu , Chengwei Zhou , Prerna Singh , Brandon Lee , Vipin Chaudhary , Gourav Datta

Medical vision--language models (VLMs) have shown strong potential for medical visual question answering (VQA), yet their reasoning remains largely text-centric: images are encoded once as static context, and subsequent inference is…

Computer Vision and Pattern Recognition · Computer Science 2026-04-14 Suyang Xi , Songtao Hu , Yuxiang Lai , Wangyun Dan , Yaqi Liu , Shansong Wang , Xiaofeng Yang

Large language models (LLMs) have achieved strong performance on medical exam-style tasks, motivating growing interest in their deployment in real-world clinical settings. However, clinical decision-making is inherently safety-critical,…

Computation and Language · Computer Science 2026-04-13 Xiaohan Ren , Chenxiao Fan , Wenyin Ma , Hongliang He , Chongming Gao , Xiaoyan Zhao , Fuli Feng

Accurate and interpretable multi-disease diagnosis remains a critical challenge in medical research, particularly when leveraging heterogeneous multimodal medical data. Current approaches often rely on single-modal data, limiting their…

Image and Video Processing · Electrical Eng. & Systems 2025-06-25 Yuting Zhang , Kaishen Yuan , Hao Lu , Yutao Yue , Jintai Chen , Kaishun Wu
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