Yang Bai

Kai Yu, Yang Zhou, Yang Bai et al.

Retinal foundation models aim to learn generalizable representations from diverse retinal images, facilitating label-efficient model adaptation across various ophthalmic tasks. Despite their success, current retinal foundation models are generally restricted to a single imaging modality, such as Color Fundus Photography (CFP) or Optical Coherence Tomography (OCT), limiting their versatility. Moreover, these models may struggle to fully leverage expert annotations and overlook the valuable domain knowledge essential for domain-specific representation learning. To overcome these limitations, we introduce UrFound, a retinal foundation model designed to learn universal representations from both multimodal retinal images and domain knowledge. UrFound is equipped with a modality-agnostic image encoder and accepts either CFP or OCT images as inputs. To integrate domain knowledge into representation learning, we encode expert annotation in text supervision and propose a knowledge-guided masked modeling strategy for model pre-training. It involves reconstructing randomly masked patches of retinal images while predicting masked text tokens conditioned on the corresponding retinal image. This approach aligns multimodal images and textual expert annotations within a unified latent space, facilitating generalizable and domain-specific representation learning. Experimental results demonstrate that UrFound exhibits strong generalization ability and data efficiency when adapting to various tasks in retinal image analysis. By training on ~180k retinal images, UrFound significantly outperforms the state-of-the-art retinal foundation model trained on up to 1.6 million unlabelled images across 8 public retinal datasets. Our code and data are available at https://github.com/yukkai/UrFound.

Wei Liu, Yang Bai, Chengcheng Han et al.

Direct Preference Optimization (DPO) is widely utilized in the Reinforcement Learning from Human Feedback (RLHF) phase to align Large Language Models (LLMs) with human preferences, thereby enhancing both their harmlessness and efficacy. However, it has been observed that DPO tends to over-optimize for verbosity, which can detrimentally affect both performance and user experience. In this paper, we conduct an in-depth theoretical analysis of DPO's optimization objective and reveal a strong correlation between its implicit reward and data length. This correlation misguides the optimization direction, resulting in length sensitivity during the DPO training and leading to verbosity. To address this issue, we propose a length-desensitization improvement method for DPO, termed LD-DPO. The proposed method aims to desensitize DPO to data length by decoupling explicit length preference, which is relatively insignificant, from the other implicit preferences, thereby enabling more effective learning of the intrinsic preferences. We utilized two settings (Base and Instruct) of Llama2-13B, Llama3-8B, and Qwen2-7B for experimental validation on various benchmarks including MT-Bench and AlpacaEval 2. The experimental results indicate that LD-DPO consistently outperforms DPO and other baseline methods, achieving more concise responses with a 10-40% reduction in length compared to DPO. We conducted in-depth experimental analyses to demonstrate that LD-DPO can indeed achieve length desensitization and align the model more closely with human-like preferences.

Yutong Zhang, Lixing Chen, Shenghong Li et al.

Large language models (LLMs) have demonstrated exceptional performance across a wide variety of domains. Nonetheless, generalist LLMs continue to fall short in reasoning tasks necessitating specialized knowledge. Prior investigations into specialized LLMs focused on domain-specific training, which entails substantial efforts in domain data acquisition and model parameter fine-tuning. To address these challenges, this paper proposes the Way-to-Specialist (WTS) framework, which synergizes retrieval-augmented generation with knowledge graphs (KGs) to enhance the specialized capability of LLMs in the absence of specialized training. In distinction to existing paradigms that merely utilize external knowledge from general KGs or static domain KGs to prompt LLM for enhanced domain-specific reasoning, WTS proposes an innovative "LLM$\circlearrowright$KG" paradigm, which achieves bidirectional enhancement between specialized LLM and domain knowledge graph (DKG). The proposed paradigm encompasses two closely coupled components: the DKG-Augmented LLM and the LLM-Assisted DKG Evolution. The former retrieves question-relevant domain knowledge from DKG and uses it to prompt LLM to enhance the reasoning capability for domain-specific tasks; the latter leverages LLM to generate new domain knowledge from processed tasks and use it to evolve DKG. WTS closes the loop between DKG-Augmented LLM and LLM-Assisted DKG Evolution, enabling continuous improvement in the domain specialization as it progressively answers and learns from domain-specific questions. We validate the performance of WTS on 6 datasets spanning 5 domains. The experimental results show that WTS surpasses the previous SOTA in 4 specialized domains and achieves a maximum performance improvement of 11.3%.

Yang Bai, Haoran Cheng, Yang Zhou et al.

Despite the promise of foundation models in medical AI, current systems remain limited - they are modality-specific and lack transparent reasoning processes, hindering clinical adoption. To address this gap, we present EVLF-FM, a multimodal vision-language foundation model (VLM) designed to unify broad diagnostic capability with fine-grain explainability. The development and testing of EVLF-FM encompassed over 1.3 million total samples from 23 global datasets across eleven imaging modalities related to six clinical specialties: dermatology, hepatology, ophthalmology, pathology, pulmonology, and radiology. External validation employed 8,884 independent test samples from 10 additional datasets across five imaging modalities. Technically, EVLF-FM is developed to assist with multiple disease diagnosis and visual question answering with pixel-level visual grounding and reasoning capabilities. In internal validation for disease diagnostics, EVLF-FM achieved the highest average accuracy (0.858) and F1-score (0.797), outperforming leading generalist and specialist models. In medical visual grounding, EVLF-FM also achieved stellar performance across nine modalities with average mIOU of 0.743 and Acc@0.5 of 0.837. External validations further confirmed strong zero-shot and few-shot performance, with competitive F1-scores despite a smaller model size. Through a hybrid training strategy combining supervised and visual reinforcement fine-tuning, EVLF-FM not only achieves state-of-the-art accuracy but also exhibits step-by-step reasoning, aligning outputs with visual evidence. EVLF-FM is an early multi-disease VLM model with explainability and reasoning capabilities that could advance adoption of and trust in foundation models for real-world clinical deployment.

Yang Zhou, Chrystie Wan Ning Quek, Jun Zhou et al.

Current artificial intelligence models for medical imaging are predominantly single modality and single disease. Attempts to create multimodal and multi-disease models have resulted in inconsistent clinical accuracy. Furthermore, training these models typically requires large, labour-intensive, well-labelled datasets. We developed MerMED-FM, a state-of-the-art multimodal, multi-specialty foundation model trained using self-supervised learning and a memory module. MerMED-FM was trained on 3.3 million medical images from over ten specialties and seven modalities, including computed tomography (CT), chest X-rays (CXR), ultrasound (US), pathology patches, color fundus photography (CFP), optical coherence tomography (OCT) and dermatology images. MerMED-FM was evaluated across multiple diseases and compared against existing foundational models. Strong performance was achieved across all modalities, with AUROCs of 0.988 (OCT); 0.982 (pathology); 0.951 (US); 0.943 (CT); 0.931 (skin); 0.894 (CFP); 0.858 (CXR). MerMED-FM has the potential to be a highly adaptable, versatile, cross-specialty foundation model that enables robust medical imaging interpretation across diverse medical disciplines.

Xiaofeng Lei, Yih-Chung Tham, Jocelyn Hui Lin Goh et al.

Community vision screening plays a crucial role in identifying individuals with vision loss and preventing avoidable blindness, particularly in rural communities where access to eye care services is limited. Currently, there is a pressing need for a simple and efficient process to screen and refer individuals with significant eye disease-related vision loss to tertiary eye care centers for further care. An ideal solution should seamlessly and readily integrate with existing workflows, providing comprehensive initial screening results to service providers, thereby enabling precise patient referrals for timely treatment. This paper introduces the Enhancing Community Vision Screening (ECVS) solution, which addresses the aforementioned concerns with a novel and feasible solution based on simple, non-invasive retinal photography for the detection of pathology-based visual impairment. Our study employs four distinct deep learning models: RETinal photo Quality Assessment (RETQA), Pathology Visual Impairment detection (PVI), Eye Disease Diagnosis (EDD) and Visualization of Lesion Regions of the eye (VLR). We conducted experiments on over 10 datasets, totaling more than 80,000 fundus photos collected from various sources. The models integrated into ECVS achieved impressive AUC scores of 0.98 for RETQA, 0.95 for PVI, and 0.90 for EDD, along with a DICE coefficient of 0.48 for VLR. These results underscore the promising capabilities of ECVS as a straightforward and scalable method for community-based vision screening.