Daily Papers

Safety moderation is pivotal for identifying harmful content. Despite the success of textual safety moderation, its multimodal counterparts remain hindered by a dual sparsity of data and supervision. Conventional reliance on binary labels lead to shortcut learning, which obscures the intrinsic classification boundaries necessary for effective multimodal discrimination. Hence, we propose a novel learning paradigm (UniMod) that transitions from sparse decision-making to dense reasoning traces. By constructing structured trajectories encompassing evidence grounding, modality assessment, risk mapping, policy decision, and response generation, we reformulate monolithic decision tasks into a multi-dimensional boundary learning process. This approach forces the model to ground its decision in explicit safety semantics, preventing the model from converging on superficial shortcuts. To facilitate this paradigm, we develop a multi-head scalar reward model (UniRM). UniRM provides multi-dimensional supervision by assigning attribute-level scores to the response generation stage. Furthermore, we introduce specialized optimization strategies to decouple task-specific parameters and rebalance training dynamics, effectively resolving interference between diverse objectives in multi-task learning. Empirical results show UniMod achieves competitive textual moderation performance and sets a new multimodal benchmark using less than 40\% of the training data used by leading baselines. Ablations further validate our multi-attribute trajectory reasoning, offering an effective and efficient framework for multimodal moderation. Supplementary materials are available at https://trustworthylab.github.io/UniMod/{project website}.

Image Aesthetic Assessment (IAA) is a long-standing and challenging research task. However, its subset, Human Image Aesthetic Assessment (HIAA), has been scarcely explored, even though HIAA is widely used in social media, AI workflows, and related domains. To bridge this research gap, our work pioneers a holistic implementation framework tailored for HIAA. Specifically, we introduce HumanBeauty, the first dataset purpose-built for HIAA, which comprises 108k high-quality human images with manual annotations. To achieve comprehensive and fine-grained HIAA, 50K human images are manually collected through a rigorous curation process and annotated leveraging our trailblazing 12-dimensional aesthetic standard, while the remaining 58K with overall aesthetic labels are systematically filtered from public datasets. Based on the HumanBeauty database, we propose HumanAesExpert, a powerful Vision Language Model for aesthetic evaluation of human images. We innovatively design an Expert head to incorporate human knowledge of aesthetic sub-dimensions while jointly utilizing the Language Modeling (LM) and Regression head. This approach empowers our model to achieve superior proficiency in both overall and fine-grained HIAA. Furthermore, we introduce a MetaVoter, which aggregates scores from all three heads, to effectively balance the capabilities of each head, thereby realizing improved assessment precision. Extensive experiments demonstrate that our HumanAesExpert models deliver significantly better performance in HIAA than other state-of-the-art models. Our datasets, models, and codes are publicly released to advance the HIAA community. Project webpage: https://humanaesexpert.github.io/HumanAesExpert/

Recent advancements in Multi-modality Large Language Models (MLLMs) have demonstrated remarkable capabilities in complex high-level vision tasks. However, the exploration of MLLM potential in visual quality assessment, a vital aspect of low-level vision, remains limited. To address this gap, we introduce Q-Boost, a novel strategy designed to enhance low-level MLLMs in image quality assessment (IQA) and video quality assessment (VQA) tasks, which is structured around two pivotal components: 1) Triadic-Tone Integration: Ordinary prompt design simply oscillates between the binary extremes of positive and negative. Q-Boost innovates by incorporating a `middle ground' approach through neutral prompts, allowing for a more balanced and detailed assessment. 2) Multi-Prompt Ensemble: Multiple quality-centric prompts are used to mitigate bias and acquire more accurate evaluation. The experimental results show that the low-level MLLMs exhibit outstanding zeros-shot performance on the IQA/VQA tasks equipped with the Q-Boost strategy.

Multimodal Large Language Models (MLLMs) suffer from cross-modal hallucinations, where one modality inappropriately influences generation about another, leading to fabricated output. This exposes a more fundamental deficiency in modality-interaction control. To address this, we propose Modality-Adaptive Decoding (MAD), a training-free method that adaptively weights modality-specific decoding branches based on task requirements. MAD leverages the model's inherent ability to self-assess modality relevance by querying which modalities are needed for each task. The extracted modality probabilities are then used to adaptively weight contrastive decoding branches, enabling the model to focus on relevant information while suppressing cross-modal interference. Extensive experiments on CMM and AVHBench demonstrate that MAD significantly reduces cross-modal hallucinations across multiple audio-visual language models (7.8\% and 2.0\% improvements for VideoLLaMA2-AV, 8.7\% and 4.7\% improvements for Qwen2.5-Omni). Our approach demonstrates that explicit modality awareness through self-assessment is crucial for robust multimodal reasoning, offering a principled extension to existing contrastive decoding methods. Our code is available at https://github.com/top-yun/MAD{https://github.com/top-yun/MAD}

Large language models (LLMs), renowned for their powerful conversational abilities, are widely recognized as exceptional tools in the field of education, particularly in the context of automated intelligent instruction systems for language learning. In this paper, we propose a scoring system based on LLMs, motivated by their positive impact on text-related scoring tasks. Specifically, the speech encoder first maps the learner's speech into contextual features. The adapter layer then transforms these features to align with the text embedding in latent space. The assessment task-specific prefix and prompt text are embedded and concatenated with the features generated by the modality adapter layer, enabling the LLMs to predict accuracy and fluency scores. Our experiments demonstrate that the proposed scoring systems achieve competitive results compared to the baselines on the Speechocean762 datasets. Moreover, we also conducted an ablation study to better understand the contributions of the prompt text and training strategy in the proposed scoring system.

Recent advances of large multi-modality models (LMM) have greatly improved the ability of image quality assessment (IQA) method to evaluate and explain the quality of visual content. However, these advancements are mostly focused on overall quality assessment, and the detailed examination of local quality, which is crucial for comprehensive visual understanding, is still largely unexplored. In this work, we introduce Q-Ground, the first framework aimed at tackling fine-scale visual quality grounding by combining large multi-modality models with detailed visual quality analysis. Central to our contribution is the introduction of the QGround-100K dataset, a novel resource containing 100k triplets of (image, quality text, distortion segmentation) to facilitate deep investigations into visual quality. The dataset comprises two parts: one with human-labeled annotations for accurate quality assessment, and another labeled automatically by LMMs such as GPT4V, which helps improve the robustness of model training while also reducing the costs of data collection. With the QGround-100K dataset, we propose a LMM-based method equipped with multi-scale feature learning to learn models capable of performing both image quality answering and distortion segmentation based on text prompts. This dual-capability approach not only refines the model's understanding of region-aware image quality but also enables it to interactively respond to complex, text-based queries about image quality and specific distortions. Q-Ground takes a step towards sophisticated visual quality analysis in a finer scale, establishing a new benchmark for future research in the area. Codes and dataset are available at https://github.com/Q-Future/Q-Ground.

Glaucoma is one of the leading causes of irreversible but preventable blindness in working age populations. Color fundus photography (CFP) is the most cost-effective imaging modality to screen for retinal disorders. However, its application to glaucoma has been limited to the computation of a few related biomarkers such as the vertical cup-to-disc ratio. Deep learning approaches, although widely applied for medical image analysis, have not been extensively used for glaucoma assessment due to the limited size of the available data sets. Furthermore, the lack of a standardize benchmark strategy makes difficult to compare existing methods in a uniform way. In order to overcome these issues we set up the Retinal Fundus Glaucoma Challenge, REFUGE (https://refuge.grand-challenge.org), held in conjunction with MICCAI 2018. The challenge consisted of two primary tasks, namely optic disc/cup segmentation and glaucoma classification. As part of REFUGE, we have publicly released a data set of 1200 fundus images with ground truth segmentations and clinical glaucoma labels, currently the largest existing one. We have also built an evaluation framework to ease and ensure fairness in the comparison of different models, encouraging the development of novel techniques in the field. 12 teams qualified and participated in the online challenge. This paper summarizes their methods and analyzes their corresponding results. In particular, we observed that two of the top-ranked teams outperformed two human experts in the glaucoma classification task. Furthermore, the segmentation results were in general consistent with the ground truth annotations, with complementary outcomes that can be further exploited by ensembling the results.

We introduce OmnixR, an evaluation suite designed to benchmark SoTA Omni-modality Language Models, such as GPT-4o and Gemini. Evaluating OLMs, which integrate multiple modalities such as text, vision, and audio, presents unique challenges. Particularly, the user message might often consist of multiple modalities, such that OLMs have to establish holistic understanding and reasoning across modalities to accomplish the task. Existing benchmarks are limited to single modality or dual-modality tasks, overlooking comprehensive multi-modal assessments of model reasoning. To address this, OmnixR offers two evaluation variants: (1)synthetic subset: a synthetic dataset generated automatically by translating text into multiple modalities--audio, images, video, and hybrids (Omnify). (2)realistic subset: a real-world dataset, manually curated and annotated by experts, for evaluating cross-modal reasoning in natural settings. OmnixR presents a unique evaluation towards assessing OLMs over a diverse mix of modalities, such as a question that involves video, audio, and text, providing a rigorous cross-modal reasoning testbed unlike any existing benchmarks. Our experiments find that all state-of-the-art OLMs struggle with OmnixR questions that require integrating information from multiple modalities to answer. Further analysis highlights differences in reasoning behavior, underscoring the challenges of omni-modal AI alignment.

The rapid advancement of educational applications, artistic creation, and AI-generated content (AIGC) technologies has substantially increased practical requirements for comprehensive Image Aesthetics Assessment (IAA), particularly demanding methods capable of delivering both quantitative scoring and professional understanding. Multimodal Large Language Model (MLLM)-based IAA methods demonstrate stronger perceptual and generalization capabilities compared to traditional approaches, yet they suffer from modality bias (score-only or text-only) and lack fine-grained attribute decomposition, thereby failing to support further aesthetic assessment. In this paper, we present:(1) ArtiMuse, an innovative MLLM-based IAA model with Joint Scoring and Expert-Level Understanding capabilities; (2) ArtiMuse-10K, the first expert-curated image aesthetic dataset comprising 10,000 images spanning 5 main categories and 15 subcategories, each annotated by professional experts with 8-dimensional attributes analysis and a holistic score. Both the model and dataset will be made public to advance the field.

Accurate and reliable personality assessment plays a vital role in many fields, such as emotional intelligence, mental health diagnostics, and personalized education. Unlike fleeting emotions, personality traits are stable, often subconsciously leaked through language, facial expressions, and body behaviors, with asynchronous patterns across modalities. It was hard to model personality semantics with traditional superficial features and seemed impossible to achieve effective cross-modal understanding. To address these challenges, we propose a novel personality assessment framework called \textbf{Traits Run Deep}. It employs \textbf{psychology-informed prompts} to elicit high-level personality-relevant semantic representations. Besides, it devises a \textbf{Text-Centric Trait Fusion Network} that anchors rich text semantics to align and integrate asynchronous signals from other modalities. To be specific, such fusion module includes a Chunk-Wise Projector to decrease dimensionality, a Cross-Modal Connector and a Text Feature Enhancer for effective modality fusion and an ensemble regression head to improve generalization in data-scarce situations. To our knowledge, we are the first to apply personality-specific prompts to guide large language models (LLMs) in extracting personality-aware semantics for improved representation quality. Furthermore, extracting and fusing audio-visual apparent behavior features further improves the accuracy. Experimental results on the AVI validation set have demonstrated the effectiveness of the proposed components, i.e., approximately a 45\% reduction in mean squared error (MSE). Final evaluations on the test set of the AVI Challenge 2025 confirm our method's superiority, ranking first in the Personality Assessment track. The source code will be made available at https://github.com/MSA-LMC/TraitsRunDeep.

The explosive growth of videos on streaming media platforms has underscored the urgent need for effective video quality assessment (VQA) algorithms to monitor and perceptually optimize the quality of streaming videos. However, VQA remains an extremely challenging task due to the diverse video content and the complex spatial and temporal distortions, thus necessitating more advanced methods to address these issues. Nowadays, large multimodal models (LMMs), such as GPT-4V, have exhibited strong capabilities for various visual understanding tasks, motivating us to leverage the powerful multimodal representation ability of LMMs to solve the VQA task. Therefore, we propose the first Large Multi-Modal Video Quality Assessment (LMM-VQA) model, which introduces a novel spatiotemporal visual modeling strategy for quality-aware feature extraction. Specifically, we first reformulate the quality regression problem into a question and answering (Q&A) task and construct Q&A prompts for VQA instruction tuning. Then, we design a spatiotemporal vision encoder to extract spatial and temporal features to represent the quality characteristics of videos, which are subsequently mapped into the language space by the spatiotemporal projector for modality alignment. Finally, the aligned visual tokens and the quality-inquired text tokens are aggregated as inputs for the large language model (LLM) to generate the quality score and level. Extensive experiments demonstrate that LMM-VQA achieves state-of-the-art performance across five VQA benchmarks, exhibiting an average improvement of 5% in generalization ability over existing methods. Furthermore, due to the advanced design of the spatiotemporal encoder and projector, LMM-VQA also performs exceptionally well on general video understanding tasks, further validating its effectiveness. Our code will be released at https://github.com/Sueqk/LMM-VQA.

The task of Composed Image Retrieval (CoIR) involves queries that combine image and text modalities, allowing users to express their intent more effectively. However, current CoIR datasets are orders of magnitude smaller compared to other vision and language (V&L) datasets. Additionally, some of these datasets have noticeable issues, such as queries containing redundant modalities. To address these shortcomings, we introduce the Large Scale Composed Image Retrieval (LaSCo) dataset, a new CoIR dataset which is ten times larger than existing ones. Pre-training on our LaSCo, shows a noteworthy improvement in performance, even in zero-shot. Furthermore, we propose a new approach for analyzing CoIR datasets and methods, which detects modality redundancy or necessity, in queries. We also introduce a new CoIR baseline, the Cross-Attention driven Shift Encoder (CASE). This baseline allows for early fusion of modalities using a cross-attention module and employs an additional auxiliary task during training. Our experiments demonstrate that this new baseline outperforms the current state-of-the-art methods on established benchmarks like FashionIQ and CIRR.

Color fundus photography and Optical Coherence Tomography (OCT) are the two most cost-effective tools for glaucoma screening. Both two modalities of images have prominent biomarkers to indicate glaucoma suspected. Clinically, it is often recommended to take both of the screenings for a more accurate and reliable diagnosis. However, although numerous algorithms are proposed based on fundus images or OCT volumes in computer-aided diagnosis, there are still few methods leveraging both of the modalities for the glaucoma assessment. Inspired by the success of Retinal Fundus Glaucoma Challenge (REFUGE) we held previously, we set up the Glaucoma grAding from Multi-Modality imAges (GAMMA) Challenge to encourage the development of fundus \& OCT-based glaucoma grading. The primary task of the challenge is to grade glaucoma from both the 2D fundus images and 3D OCT scanning volumes. As part of GAMMA, we have publicly released a glaucoma annotated dataset with both 2D fundus color photography and 3D OCT volumes, which is the first multi-modality dataset for glaucoma grading. In addition, an evaluation framework is also established to evaluate the performance of the submitted methods. During the challenge, 1272 results were submitted, and finally, top-10 teams were selected to the final stage. We analysis their results and summarize their methods in the paper. Since all these teams submitted their source code in the challenge, a detailed ablation study is also conducted to verify the effectiveness of the particular modules proposed. We find many of the proposed techniques are practical for the clinical diagnosis of glaucoma. As the first in-depth study of fundus \& OCT multi-modality glaucoma grading, we believe the GAMMA Challenge will be an essential starting point for future research.

With the increasing awareness of health and the growing desire for aesthetic physique, fitness has become a prevailing trend. However, the potential risks associated with fitness training, especially with weight-loaded fitness actions, cannot be overlooked. Action Quality Assessment (AQA), a technology that quantifies the quality of human action and provides feedback, holds the potential to assist fitness enthusiasts of varying skill levels in achieving better training outcomes. Nevertheless, current AQA methodologies and datasets are limited to single-view competitive sports scenarios and RGB modality and lack professional assessment and guidance of fitness actions. To address this gap, we propose the FLEX dataset, the first multi-modal, multi-action, large-scale dataset that incorporates surface electromyography (sEMG) signals into AQA. FLEX utilizes high-precision MoCap to collect 20 different weight-loaded actions performed by 38 subjects across 3 different skill levels for 10 repetitions each, containing 5 different views of the RGB video, 3D pose, sEMG, and physiological information. Additionally, FLEX incorporates knowledge graphs into AQA, constructing annotation rules in the form of penalty functions that map weight-loaded actions, action keysteps, error types, and feedback. We conducted various baseline methodologies on FLEX, demonstrating that multimodal data, multiview data, and fine-grained annotations significantly enhance model performance. FLEX not only advances AQA methodologies and datasets towards multi-modal and multi-action scenarios but also fosters the integration of artificial intelligence within the fitness domain. Dataset and code are available at https://haoyin116.github.io/FLEX_Dataset.

The explosion of visual content available online underscores the requirement for an accurate machine assessor to robustly evaluate scores across diverse types of visual contents. While recent studies have demonstrated the exceptional potentials of large multi-modality models (LMMs) on a wide range of related fields, in this work, we explore how to teach them for visual rating aligned with human opinions. Observing that human raters only learn and judge discrete text-defined levels in subjective studies, we propose to emulate this subjective process and teach LMMs with text-defined rating levels instead of scores. The proposed Q-Align achieves state-of-the-art performance on image quality assessment (IQA), image aesthetic assessment (IAA), as well as video quality assessment (VQA) tasks under the original LMM structure. With the syllabus, we further unify the three tasks into one model, termed the OneAlign. In our experiments, we demonstrate the advantage of the discrete-level-based syllabus over direct-score-based variants for LMMs. Our code and the pre-trained weights are released at https://github.com/Q-Future/Q-Align.

Recent advances in large language models have catalyzed the development of multimodal LLMs (MLLMs) that integrate text, speech, and vision within unified frameworks. As MLLMs evolve from narrow, monolingual, task-specific systems to general-purpose instruction-following models, a key frontier lies in evaluating their multilingual and multimodal capabilities over both long and short contexts. However, existing benchmarks fall short in evaluating these dimensions jointly: they are often limited to English, mostly focus on one single modality at a time, rely on short-form contexts, or lack human annotations -- hindering comprehensive assessment of model performance across languages, modalities, and task complexity. To address these gaps, we introduce MCIF (Multimodal Crosslingual Instruction Following), the first multilingual human-annotated benchmark based on scientific talks that is designed to evaluate instruction-following in crosslingual, multimodal settings over both short- and long-form inputs. MCIF spans three core modalities -- speech, vision, and text -- and four diverse languages (English, German, Italian, and Chinese), enabling a comprehensive evaluation of MLLMs' abilities to interpret instructions across languages and combine them with multimodal contextual information. MCIF is released under a CC-BY 4.0 license to encourage open research and progress in MLLMs development.

The rapid evolution of Multi-modality Large Language Models (MLLMs) has catalyzed a shift in computer vision from specialized models to general-purpose foundation models. Nevertheless, there is still an inadequacy in assessing the abilities of MLLMs on low-level visual perception and understanding. To address this gap, we present Q-Bench, a holistic benchmark crafted to systematically evaluate potential abilities of MLLMs on three realms: low-level visual perception, low-level visual description, and overall visual quality assessment. a) To evaluate the low-level perception ability, we construct the LLVisionQA dataset, consisting of 2,990 diverse-sourced images, each equipped with a human-asked question focusing on its low-level attributes. We then measure the correctness of MLLMs on answering these questions. b) To examine the description ability of MLLMs on low-level information, we propose the LLDescribe dataset consisting of long expert-labelled golden low-level text descriptions on 499 images, and a GPT-involved comparison pipeline between outputs of MLLMs and the golden descriptions. c) Besides these two tasks, we further measure their visual quality assessment ability to align with human opinion scores. Specifically, we design a softmax-based strategy that enables MLLMs to predict quantifiable quality scores, and evaluate them on various existing image quality assessment (IQA) datasets. Our evaluation across the three abilities confirms that MLLMs possess preliminary low-level visual skills. However, these skills are still unstable and relatively imprecise, indicating the need for specific enhancements on MLLMs towards these abilities. We hope that our benchmark can encourage the research community to delve deeper to discover and enhance these untapped potentials of MLLMs. Project Page: https://vqassessment.github.io/Q-Bench.

Recently, multimodal large language models (MLLMs) have achieved significant advancements across various domains, and corresponding evaluation benchmarks have been continuously refined and improved. In this process, benchmarks in the scientific domain have played an important role in assessing the reasoning capabilities of MLLMs. However, existing benchmarks still face three key challenges: 1) Insufficient evaluation of models' reasoning abilities in multilingual scenarios; 2) Inadequate assessment of MLLMs' comprehensive modality coverage; 3) Lack of fine-grained annotation of scientific knowledge points. To address these gaps, we propose MME-SCI, a comprehensive and challenging benchmark. We carefully collected 1,019 high-quality question-answer pairs, which involve 3 distinct evaluation modes. These pairs cover four subjects, namely mathematics, physics, chemistry, and biology, and support five languages: Chinese, English, French, Spanish, and Japanese. We conducted extensive experiments on 16 open-source models and 4 closed-source models, and the results demonstrate that MME-SCI is widely challenging for existing MLLMs. For instance, under the Image-only evaluation mode, o4-mini achieved accuracy of only 52.11%, 24.73%, 36.57%, and 29.80% in mathematics, physics, chemistry, and biology, respectively, indicating a significantly higher difficulty level compared to existing benchmarks. More importantly, using MME-SCI's multilingual and fine-grained knowledge attributes, we analyzed existing models' performance in depth and identified their weaknesses in specific domains. The Data and Evaluation Code are available at https://github.com/JCruan519/MME-SCI.

Our experience of the world is multimodal - we see objects, hear sounds, feel texture, smell odors, and taste flavors. Modality refers to the way in which something happens or is experienced and a research problem is characterized as multimodal when it includes multiple such modalities. In order for Artificial Intelligence to make progress in understanding the world around us, it needs to be able to interpret such multimodal signals together. Multimodal machine learning aims to build models that can process and relate information from multiple modalities. It is a vibrant multi-disciplinary field of increasing importance and with extraordinary potential. Instead of focusing on specific multimodal applications, this paper surveys the recent advances in multimodal machine learning itself and presents them in a common taxonomy. We go beyond the typical early and late fusion categorization and identify broader challenges that are faced by multimodal machine learning, namely: representation, translation, alignment, fusion, and co-learning. This new taxonomy will enable researchers to better understand the state of the field and identify directions for future research.

Multimodal large language models (MLLMs) can simultaneously process visual, textual, and auditory data, capturing insights that complement human analysis. However, existing video question-answering (VidQA) benchmarks and datasets often exhibit a bias toward a single modality, despite the goal of requiring advanced reasoning skills that integrate diverse modalities to answer the queries. In this work, we introduce the modality importance score (MIS) to identify such bias. It is designed to assess which modality embeds the necessary information to answer the question. Additionally, we propose an innovative method using state-of-the-art MLLMs to estimate the modality importance, which can serve as a proxy for human judgments of modality perception. With this MIS, we demonstrate the presence of unimodal bias and the scarcity of genuinely multimodal questions in existing datasets. We further validate the modality importance score with multiple ablation studies to evaluate the performance of MLLMs on permuted feature sets. Our results indicate that current models do not effectively integrate information due to modality imbalance in existing datasets. Our proposed MLLM-derived MIS can guide the curation of modality-balanced datasets that advance multimodal learning and enhance MLLMs' capabilities to understand and utilize synergistic relations across modalities.

Modality is the linguistic ability to describe events with added information such as how desirable, plausible, or feasible they are. Modality is important for many NLP downstream tasks such as the detection of hedging, uncertainty, speculation, and more. Previous studies that address modality detection in NLP often restrict modal expressions to a closed syntactic class, and the modal sense labels are vastly different across different studies, lacking an accepted standard. Furthermore, these senses are often analyzed independently of the events that they modify. This work builds on the theoretical foundations of the Georgetown Gradable Modal Expressions (GME) work by Rubinstein et al. (2013) to propose an event-based modality detection task where modal expressions can be words of any syntactic class and sense labels are drawn from a comprehensive taxonomy which harmonizes the modal concepts contributed by the different studies. We present experiments on the GME corpus aiming to detect and classify fine-grained modal concepts and associate them with their modified events. We show that detecting and classifying modal expressions is not only feasible, but also improves the detection of modal events in their own right.

Quantification of real-time informal feedback delivered by an experienced surgeon to a trainee during surgery is important for skill improvements in surgical training. Such feedback in the live operating room is inherently multimodal, consisting of verbal conversations (e.g., questions and answers) as well as non-verbal elements (e.g., through visual cues like pointing to anatomic elements). In this work, we leverage a clinically-validated five-category classification of surgical feedback: "Anatomic", "Technical", "Procedural", "Praise" and "Visual Aid". We then develop a multi-label machine learning model to classify these five categories of surgical feedback from inputs of text, audio, and video modalities. The ultimate goal of our work is to help automate the annotation of real-time contextual surgical feedback at scale. Our automated classification of surgical feedback achieves AUCs ranging from 71.5 to 77.6 with the fusion improving performance by 3.1%. We also show that high-quality manual transcriptions of feedback audio from experts improve AUCs to between 76.5 and 96.2, which demonstrates a clear path toward future improvements. Empirically, we find that the Staged training strategy, with first pre-training each modality separately and then training them jointly, is more effective than training different modalities altogether. We also present intuitive findings on the importance of modalities for different feedback categories. This work offers an important first look at the feasibility of automated classification of real-world live surgical feedback based on text, audio, and video modalities.

Large Multimodal Models (LMMs) have shown remarkable progress in the field of medical Visual Question Answering (Med-VQA), achieving high accuracy on existing benchmarks. However, their reliability under robust evaluation is questionable. This study reveals that state-of-the-art models, when subjected to simple probing evaluation, perform worse than random guessing on medical diagnosis questions. To address this critical evaluation problem, we introduce the Probing Evaluation for Medical Diagnosis (ProbMed) dataset to rigorously assess LMM performance in medical imaging through probing evaluation and procedural diagnosis. Particularly, probing evaluation features pairing original questions with negation questions with hallucinated attributes, while procedural diagnosis requires reasoning across various diagnostic dimensions for each image, including modality recognition, organ identification, clinical findings, abnormalities, and positional grounding. Our evaluation reveals that top-performing models like GPT-4V and Gemini Pro perform worse than random guessing on specialized diagnostic questions, indicating significant limitations in handling fine-grained medical inquiries. Besides, models like LLaVA-Med struggle even with more general questions, and results from CheXagent demonstrate the transferability of expertise across different modalities of the same organ, showing that specialized domain knowledge is still crucial for improving performance. This study underscores the urgent need for more robust evaluation to ensure the reliability of LMMs in critical fields like medical diagnosis, and current LMMs are still far from applicable to those fields.

Clinical diagnosis is a highly specialized discipline requiring both domain expertise and strict adherence to rigorous guidelines. While current AI-driven medical research predominantly focuses on knowledge graphs or natural text pretraining paradigms to incorporate medical knowledge, these approaches primarily rely on implicitly encoded knowledge within model parameters, neglecting task-specific knowledge required by diverse downstream tasks. To address this limitation, we propose Retrieval-Augmented Diagnosis (RAD), a novel framework that explicitly injects external knowledge into multimodal models directly on downstream tasks. Specifically, RAD operates through three key mechanisms: retrieval and refinement of disease-centered knowledge from multiple medical sources, a guideline-enhanced contrastive loss that constrains the latent distance between multi-modal features and guideline knowledge, and the dual transformer decoder that employs guidelines as queries to steer cross-modal fusion, aligning the models with clinical diagnostic workflows from guideline acquisition to feature extraction and decision-making. Moreover, recognizing the lack of quantitative evaluation of interpretability for multimodal diagnostic models, we introduce a set of criteria to assess the interpretability from both image and text perspectives. Extensive evaluations across four datasets with different anatomies demonstrate RAD's generalizability, achieving state-of-the-art performance. Furthermore, RAD enables the model to concentrate more precisely on abnormal regions and critical indicators, ensuring evidence-based, trustworthy diagnosis. Our code is available at https://github.com/tdlhl/RAD.

Multimodal Large Language Models have demonstrated impressive capabilities across tasks, yet they often exhibit difficulty in distinguishing task-relevant from irrelevant signals -- particularly in tasks like Visual Question Answering -- which can lead to susceptibility to misleading or spurious inputs. We refer to this broader limitation as the Cross-Modality Competency Problem -- the model's inability to fairly evaluate all modalities. This vulnerability becomes more evident in modality-specific tasks -- such as image classification or pure text question answering -- where models are expected to rely solely on one modality. In such tasks, spurious information from irrelevant modalities often leads to significant performance degradation. We refer to this failure as Modality Interference, which serves as a concrete and measurable instance of the cross-modality competency problem, and we further design a perturbation-based causal diagnostic experiment to verify and quantify this problem. To mitigate modality interference, we propose a novel framework to finetune MLLMs, including perturbation-based data augmentations with both heuristic perturbations and adversarial perturbations, and a consistency regularization strategy applying on model outputs with original and perturbed inputs. Experiments on multiple benchmark datasets (image-heavy, text-heavy and multimodal tasks) and multiple model families with different scales demonstrate significant improvements in robustness and cross-modality competency, indicating our method's effectiveness in boosting unimodal reasoning ability while enhancing performance on multimodal tasks.

The accelerating development of general medical artificial intelligence (GMAI), powered by multimodal large language models (MLLMs), offers transformative potential for addressing persistent healthcare challenges, including workforce deficits and escalating costs. The parallel development of systematic evaluation benchmarks emerges as a critical imperative to enable performance assessment and provide technological guidance. Meanwhile, as an invaluable knowledge source, the potential of medical textbooks for benchmark development remains underexploited. Here, we present MedBookVQA, a systematic and comprehensive multimodal benchmark derived from open-access medical textbooks. To curate this benchmark, we propose a standardized pipeline for automated extraction of medical figures while contextually aligning them with corresponding medical narratives. Based on this curated data, we generate 5,000 clinically relevant questions spanning modality recognition, disease classification, anatomical identification, symptom diagnosis, and surgical procedures. A multi-tier annotation system categorizes queries through hierarchical taxonomies encompassing medical imaging modalities (42 categories), body anatomies (125 structures), and clinical specialties (31 departments), enabling nuanced analysis across medical subdomains. We evaluate a wide array of MLLMs, including proprietary, open-sourced, medical, and reasoning models, revealing significant performance disparities across task types and model categories. Our findings highlight critical capability gaps in current GMAI systems while establishing textbook-derived multimodal benchmarks as essential evaluation tools. MedBookVQA establishes textbook-derived benchmarking as a critical paradigm for advancing clinical AI, exposing limitations in GMAI systems while providing anatomically structured performance metrics across specialties.

Depression has proven to be a significant public health issue, profoundly affecting the psychological well-being of individuals. If it remains undiagnosed, depression can lead to severe health issues, which can manifest physically and even lead to suicide. Generally, Diagnosing depression or any other mental disorder involves conducting semi-structured interviews alongside supplementary questionnaires, including variants of the Patient Health Questionnaire (PHQ) by Clinicians and mental health professionals. This approach places significant reliance on the experience and judgment of trained physicians, making the diagnosis susceptible to personal biases. Given that the underlying mechanisms causing depression are still being actively researched, physicians often face challenges in diagnosing and treating the condition, particularly in its early stages of clinical presentation. Recently, significant strides have been made in Artificial neural computing to solve problems involving text, image, and speech in various domains. Our analysis has aimed to leverage these state-of-the-art (SOTA) models in our experiments to achieve optimal outcomes leveraging multiple modalities. The experiments were performed on the Extended Distress Analysis Interview Corpus Wizard of Oz dataset (E-DAIC) corpus presented in the Audio/Visual Emotion Challenge (AVEC) 2019 Challenge. The proposed solutions demonstrate better results achieved by Proprietary and Open-source Large Language Models (LLMs), which achieved a Root Mean Square Error (RMSE) score of 3.98 on Textual Modality, beating the AVEC 2019 challenge baseline results and current SOTA regression analysis architectures. Additionally, the proposed solution achieved an accuracy of 71.43% in the classification task. The paper also includes a novel audio-visual multi-modal network that predicts PHQ-8 scores with an RMSE of 6.51.

Multimodal large language models (MLLMs) have achieved remarkable performance on complex tasks with multimodal context. However, it is still understudied whether they exhibit modality preference when processing multimodal contexts. To study this question, we first build a MC\textsuperscript{2} benchmark under controlled evidence conflict scenarios to systematically evaluate modality preference, which is the tendency to favor one modality over another when making decisions based on multimodal conflicting evidence. Our extensive evaluation reveals that all 18 tested MLLMs generally demonstrate clear modality bias, and modality preference can be influenced by external interventions. An in-depth analysis reveals that the preference direction can be captured within the latent representations of MLLMs. Built on this, we propose a probing and steering method based on representation engineering to explicitly control modality preference without additional fine-tuning or carefully crafted prompts. Our method effectively amplifies modality preference toward a desired direction and applies to downstream tasks such as hallucination mitigation and multimodal machine translation, yielding promising improvements.

Omni-modal large language models (OLLMs) aim to unify audio, vision, and text understanding within a single framework. While existing benchmarks primarily evaluate general cross-modal question-answering ability, it remains unclear whether OLLMs achieve modality-invariant reasoning or exhibit modality-specific biases. We introduce XModBench, a large-scale tri-modal benchmark explicitly designed to measure cross-modal consistency. XModBench comprises 60,828 multiple-choice questions spanning five task families and systematically covers all six modality compositions in question-answer pairs, enabling fine-grained diagnosis of an OLLM's modality-invariant reasoning, modality disparity, and directional imbalance. Experiments show that even the strongest model, Gemini 2.5 Pro, (i) struggles with spatial and temporal reasoning, achieving less than 60% accuracy, (ii) reveals persistent modality disparities, with performance dropping substantially when the same semantic content is conveyed through audio rather than text, and (iii) shows systematic directional imbalance, exhibiting lower consistency when vision serves as context compared to text. These findings indicate that current OLLMs remain far from truly modality-invariant reasoning and position XModBench as a fundamental diagnostic tool for evaluating and improving cross-modal competence. All data and evaluation tools will be available at https://xingruiwang.github.io/projects/XModBench/.

We present the Modality Integration Rate (MIR), an effective, robust, and generalized metric to indicate the multi-modal pre-training quality of Large Vision Language Models (LVLMs). Large-scale pre-training plays a critical role in building capable LVLMs, while evaluating its training quality without the costly supervised fine-tuning stage is under-explored. Loss, perplexity, and in-context evaluation results are commonly used pre-training metrics for Large Language Models (LLMs), while we observed that these metrics are less indicative when aligning a well-trained LLM with a new modality. Due to the lack of proper metrics, the research of LVLMs in the critical pre-training stage is hindered greatly, including the training data choice, efficient module design, etc. In this paper, we propose evaluating the pre-training quality from the inter-modal distribution distance perspective and present MIR, the Modality Integration Rate, which is 1) Effective to represent the pre-training quality and show a positive relation with the benchmark performance after supervised fine-tuning. 2) Robust toward different training/evaluation data. 3) Generalize across training configurations and architecture choices. We conduct a series of pre-training experiments to explore the effectiveness of MIR and observe satisfactory results that MIR is indicative about training data selection, training strategy schedule, and model architecture design to get better pre-training results. We hope MIR could be a helpful metric for building capable LVLMs and inspire the following research about modality alignment in different areas. Our code is at: https://github.com/shikiw/Modality-Integration-Rate.

The rapid progress of Multimodal Large Language Models(MLLMs) has transformed the AI landscape. These models combine pre-trained LLMs with various modality encoders. This integration requires a systematic understanding of how different modalities connect to the language backbone. Our survey presents an LLM-centric analysis of current approaches. We examine methods for transforming and aligning diverse modal inputs into the language embedding space. This addresses a significant gap in existing literature. We propose a classification framework for MLLMs based on three key dimensions. First, we examine architectural strategies for modality integration. This includes both the specific integration mechanisms and the fusion level. Second, we categorize representation learning techniques as either joint or coordinate representations. Third, we analyze training paradigms, including training strategies and objective functions. By examining 125 MLLMs developed between 2021 and 2025, we identify emerging patterns in the field. Our taxonomy provides researchers with a structured overview of current integration techniques. These insights aim to guide the development of more robust multimodal integration strategies for future models built on pre-trained foundations.

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 ability to comprehensively understand complex diseases. To address this, we propose MedTVT-R1, a novel Multimodal Large Language Model (MLLM) framework designed to integrate clinical multimodal data for reasoning and diagnosing multiple diseases. We construct MedTVT-QA, a curated instruction dataset that provides question-answer pairs for physiological-level interpretations and disease-level diagnoses with a Chain of Evidence approach. MedTVT-R1 incorporates a modality perception layer to capture inter-modal dependencies and adaptively weight modality contributions. Additionally, we employ Group Relative Policy Optimization (GRPO)-based Reinforcement Fine-Tuning with a Jaccard Reward function to enhance diagnostic reasoning. Experimental results demonstrate MedTVT-R1's superiority in multimodal feature utilization and multi-disease diagnosis, offering significant potential for clinical applications such as diagnostic report generation and comorbidity reasoning. The dataset and code are available at https://github.com/keke-nice/MedTVT-R1.

Retrieval-augmented generation (RAG) improves large language models (LLMs) by using external knowledge to guide response generation, reducing hallucinations. However, RAG, particularly multi-modal RAG, can introduce new hallucination sources: (i) the retrieval process may select irrelevant pieces (e.g., documents, images) as raw context from the database, and (ii) retrieved images are processed into text-based context via vision-language models (VLMs) or directly used by multi-modal language models (MLLMs) like GPT-4o, which may hallucinate. To address this, we propose a novel framework to evaluate the reliability of multi-modal RAG using two performance measures: (i) the relevancy score (RS), assessing the relevance of retrieved entries to the query, and (ii) the correctness score (CS), evaluating the accuracy of the generated response. We train RS and CS models using a ChatGPT-derived database and human evaluator samples. Results show that both models achieve ~88% accuracy on test data. Additionally, we construct a 5000-sample human-annotated database evaluating the relevancy of retrieved pieces and the correctness of response statements. Our RS model aligns with human preferences 20% more often than CLIP in retrieval, and our CS model matches human preferences ~91% of the time. Finally, we assess various RAG systems' selection and generation performances using RS and CS.

Multimodal information retrieval (MIR) faces inherent challenges due to the heterogeneity of data sources and the complexity of cross-modal alignment. While previous studies have identified modal gaps in feature spaces, a systematic approach to address these challenges remains unexplored. In this work, we introduce UNITE, a universal framework that tackles these challenges through two critical yet underexplored aspects: data curation and modality-aware training configurations. Our work provides the first comprehensive analysis of how modality-specific data properties influence downstream task performance across diverse scenarios. Moreover, we propose Modal-Aware Masked Contrastive Learning (MAMCL) to mitigate the competitive relationships among the instances of different modalities. Our framework achieves state-of-the-art results on multiple multimodal retrieval benchmarks, outperforming existing methods by notable margins. Through extensive experiments, we demonstrate that strategic modality curation and tailored training protocols are pivotal for robust cross-modal representation learning. This work not only advances MIR performance but also provides a foundational blueprint for future research in multimodal systems. Our project is available at https://friedrichor.github.io/projects/UNITE.

Evaluating the truthfulness of online content is critical for combating misinformation. This study examines the efficiency and effectiveness of crowdsourced truthfulness assessments through a comparative analysis of two approaches: one involving full-length webpages as evidence for each claim, and another using summaries for each evidence document generated with a large language model. Using an A/B testing setting, we engage a diverse pool of participants tasked with evaluating the truthfulness of statements under these conditions. Our analysis explores both the quality of assessments and the behavioral patterns of participants. The results reveal that relying on summarized evidence offers comparable accuracy and error metrics to the Standard modality while significantly improving efficiency. Workers in the Summary setting complete a significantly higher number of assessments, reducing task duration and costs. Additionally, the Summary modality maximizes internal agreement and maintains consistent reliance on and perceived usefulness of evidence, demonstrating its potential to streamline large-scale truthfulness evaluations.

Spoken language identification refers to the task of automatically predicting the spoken language in a given utterance. Conventionally, it is modeled as a speech-based language identification task. Prior techniques have been constrained to a single modality; however in the case of video data there is a wealth of other metadata that may be beneficial for this task. In this work, we propose MuSeLI, a Multimodal Spoken Language Identification method, which delves into the use of various metadata sources to enhance language identification. Our study reveals that metadata such as video title, description and geographic location provide substantial information to identify the spoken language of the multimedia recording. We conduct experiments using two diverse public datasets of YouTube videos, and obtain state-of-the-art results on the language identification task. We additionally conduct an ablation study that describes the distinct contribution of each modality for language recognition.

Multimodal Large Language Models (MLLMs) have demonstrated remarkable capabilities across a diverse range of multimodal tasks. However, these models suffer from a core problem known as text dominance: they depend heavily on text for their inference, while underutilizing other modalities. While prior work has acknowledged this phenomenon in vision-language tasks, often attributing it to data biases or model architectures. In this paper, we conduct the first systematic investigation of text dominance across diverse data modalities, including images, videos, audio, time-series, and graphs. To measure this imbalance, we propose two evaluation metrics: the Modality Dominance Index (MDI) and the Attention Efficiency Index (AEI). Our comprehensive analysis reveals that text dominance is both significant and pervasive across all tested modalities. Our in-depth analysis identifies three underlying causes: attention dilution from severe token redundancy in non-textual modalities, the influence of fusion architecture design, and task formulations that implicitly favor textual inputs. Furthermore, we propose a simple token compression method that effectively rebalances model attention. Applying this method to LLaVA-7B, for instance, drastically reduces its MDI from 10.23 to a well-balanced value of 0.86. Our analysis and methodological framework offer a foundation for the development of more equitable and comprehensive multimodal language models.

M-SENA is an open-sourced platform for Multimodal Sentiment Analysis. It aims to facilitate advanced research by providing flexible toolkits, reliable benchmarks, and intuitive demonstrations. The platform features a fully modular video sentiment analysis framework consisting of data management, feature extraction, model training, and result analysis modules. In this paper, we first illustrate the overall architecture of the M-SENA platform and then introduce features of the core modules. Reliable baseline results of different modality features and MSA benchmarks are also reported. Moreover, we use model evaluation and analysis tools provided by M-SENA to present intermediate representation visualization, on-the-fly instance test, and generalization ability test results. The source code of the platform is publicly available at https://github.com/thuiar/M-SENA.

This book is the result of a seminar in which we reviewed multimodal approaches and attempted to create a solid overview of the field, starting with the current state-of-the-art approaches in the two subfields of Deep Learning individually. Further, modeling frameworks are discussed where one modality is transformed into the other, as well as models in which one modality is utilized to enhance representation learning for the other. To conclude the second part, architectures with a focus on handling both modalities simultaneously are introduced. Finally, we also cover other modalities as well as general-purpose multi-modal models, which are able to handle different tasks on different modalities within one unified architecture. One interesting application (Generative Art) eventually caps off this booklet.

Multimodal question answering (QA) often requires identifying which video, audio, or sensor tokens are relevant to the question. Yet modality disagreements are common: off-camera speech, background noise, or motion outside the field of view often mislead fusion models that weight all streams equally. We present RAVEN, a unified QA architecture whose core is QuART, a query-conditioned cross-modal gating module that assigns scalar relevance scores to each token across modalities, enabling the model to amplify informative signals and suppress distractors before fusion. RAVEN is trained through a three-stage pipeline comprising unimodal pretraining, query-aligned fusion, and disagreement-oriented fine-tuning -- each stage targeting a distinct challenge in multi-modal reasoning: representation quality, cross-modal relevance, and robustness to modality mismatch. To support training and evaluation, we release AVS-QA, a dataset of 300K synchronized Audio--Video-Sensor streams paired with automatically generated question-answer pairs. Experimental results on seven multi-modal QA benchmarks -- including egocentric and exocentric tasks -- show that RAVEN achieves up to 14.5\% and 8.0\% gains in accuracy compared to state-of-the-art multi-modal large language models, respectively. Incorporating sensor data provides an additional 16.4\% boost, and the model remains robust under modality corruption, outperforming SOTA baselines by 50.23\%. Our code and dataset are available at https://github.com/BASHLab/RAVEN.

We propose to improve transformers of a specific modality with irrelevant data from other modalities, e.g., improve an ImageNet model with audio or point cloud datasets. We would like to highlight that the data samples of the target modality are irrelevant to the other modalities, which distinguishes our method from other works utilizing paired (e.g., CLIP) or interleaved data of different modalities. We propose a methodology named Multimodal Pathway - given a target modality and a transformer designed for it, we use an auxiliary transformer trained with data of another modality and construct pathways to connect components of the two models so that data of the target modality can be processed by both models. In this way, we utilize the universal sequence-to-sequence modeling abilities of transformers obtained from two modalities. As a concrete implementation, we use a modality-specific tokenizer and task-specific head as usual but utilize the transformer blocks of the auxiliary model via a proposed method named Cross-Modal Re-parameterization, which exploits the auxiliary weights without any inference costs. On the image, point cloud, video, and audio recognition tasks, we observe significant and consistent performance improvements with irrelevant data from other modalities. The code and models are available at https://github.com/AILab-CVC/M2PT.

Machine learning advances in the last decade have relied significantly on large-scale datasets that continue to grow in size. Increasingly, those datasets also contain different data modalities. However, large multi-modal datasets are hard to annotate, and annotations may contain biases that we are often unaware of. Deep-net-based classifiers, in turn, are prone to exploit those biases and to find shortcuts. To study and quantify this concern, we introduce the perceptual score, a metric that assesses the degree to which a model relies on the different subsets of the input features, i.e., modalities. Using the perceptual score, we find a surprisingly consistent trend across four popular datasets: recent, more accurate state-of-the-art multi-modal models for visual question-answering or visual dialog tend to perceive the visual data less than their predecessors. This trend is concerning as answers are hence increasingly inferred from textual cues only. Using the perceptual score also helps to analyze model biases by decomposing the score into data subset contributions. We hope to spur a discussion on the perceptiveness of multi-modal models and also hope to encourage the community working on multi-modal classifiers to start quantifying perceptiveness via the proposed perceptual score.

Reinforcement learning from human feedback (RLHF) has proven effective in enhancing the instruction-following capabilities of large language models; however, it remains underexplored in the cross-modality domain. As the number of modalities increases, aligning all-modality models with human intentions -- such as instruction following -- becomes a pressing challenge. In this work, we make the first attempt to fine-tune all-modality models (i.e. input and output with any modality, also named any-to-any models) using human preference data across all modalities (including text, image, audio, and video), ensuring its behavior aligns with human intentions. This endeavor presents several challenges. First, there is no large-scale all-modality human preference data in existing open-source resources, as most datasets are limited to specific modalities, predominantly text and image. Secondly, the effectiveness of binary preferences in RLHF for post-training alignment in complex all-modality scenarios remains an unexplored area. Finally, there is a lack of a systematic framework to evaluate the capabilities of all-modality models, particularly regarding modality selection and synergy. To address these challenges, we propose the align-anything framework, which includes meticulously annotated 200k all-modality human preference data. Then, we introduce an alignment method that learns from unified language feedback, effectively capturing complex modality-specific human preferences and enhancing the model's instruction-following capabilities. Furthermore, to assess performance improvements in all-modality models after post-training alignment, we construct a challenging all-modality capability evaluation framework -- eval-anything. All data, models, and code frameworks have been open-sourced for the community. For more details, please refer to https://github.com/PKU-Alignment/align-anything.

Urban region profiling from web-sourced data is of utmost importance for urban planning and sustainable development. We are witnessing a rising trend of LLMs for various fields, especially dealing with multi-modal data research such as vision-language learning, where the text modality serves as a supplement information for the image. Since textual modality has never been introduced into modality combinations in urban region profiling, we aim to answer two fundamental questions in this paper: i) Can textual modality enhance urban region profiling? ii) and if so, in what ways and with regard to which aspects? To answer the questions, we leverage the power of Large Language Models (LLMs) and introduce the first-ever LLM-enhanced framework that integrates the knowledge of textual modality into urban imagery profiling, named LLM-enhanced Urban Region Profiling with Contrastive Language-Image Pretraining (UrbanCLIP). Specifically, it first generates a detailed textual description for each satellite image by an open-source Image-to-Text LLM. Then, the model is trained on the image-text pairs, seamlessly unifying natural language supervision for urban visual representation learning, jointly with contrastive loss and language modeling loss. Results on predicting three urban indicators in four major Chinese metropolises demonstrate its superior performance, with an average improvement of 6.1% on R^2 compared to the state-of-the-art methods. Our code and the image-language dataset will be released upon paper notification.

Current Vision Language Models (VLMs) demonstrate a critical gap between surface-level recognition and deep narrative reasoning when processing sequential visual storytelling. Through a comprehensive investigation of manga narrative understanding, we reveal that while recent large multimodal models excel at individual panel interpretation, they systematically fail at temporal causality and cross-panel cohesion, core requirements for coherent story comprehension. We introduce a novel evaluation framework that combines fine-grained multimodal annotation, cross-modal embedding analysis, and retrieval-augmented assessment to systematically characterize these limitations. Our methodology includes (i) a rigorous annotation protocol linking visual elements to narrative structure through aligned light novel text, (ii) comprehensive evaluation across multiple reasoning paradigms, including direct inference and retrieval-augmented generation, and (iii) cross-modal similarity analysis revealing fundamental misalignments in current VLMs' joint representations. Applying this framework to Re:Zero manga across 11 chapters with 308 annotated panels, we conduct the first systematic study of long-form narrative understanding in VLMs through three core evaluation axes: generative storytelling, contextual dialogue grounding, and temporal reasoning. Our findings demonstrate that current models lack genuine story-level intelligence, struggling particularly with non-linear narratives, character consistency, and causal inference across extended sequences. This work establishes both the foundation and practical methodology for evaluating narrative intelligence, while providing actionable insights into the capability of deep sequential understanding of Discrete Visual Narratives beyond basic recognition in Multimodal Models. Project Page: https://re-verse.vercel.app

Developers and quality assurance testers often rely on manual testing to test accessibility features throughout the product lifecycle. Unfortunately, manual testing can be tedious, often has an overwhelming scope, and can be difficult to schedule amongst other development milestones. Recently, Large Language Models (LLMs) have been used for a variety of tasks including automation of UIs, however to our knowledge no one has yet explored their use in controlling assistive technologies for the purposes of supporting accessibility testing. In this paper, we explore the requirements of a natural language based accessibility testing workflow, starting with a formative study. From this we build a system that takes as input a manual accessibility test (e.g., ``Search for a show in VoiceOver'') and uses an LLM combined with pixel-based UI Understanding models to execute the test and produce a chaptered, navigable video. In each video, to help QA testers we apply heuristics to detect and flag accessibility issues (e.g., Text size not increasing with Large Text enabled, VoiceOver navigation loops). We evaluate this system through a 10 participant user study with accessibility QA professionals who indicated that the tool would be very useful in their current work and performed tests similarly to how they would manually test the features. The study also reveals insights for future work on using LLMs for accessibility testing.

Retrieval augmented generation (RAG) has shown great power in improving Large Language Models (LLMs). However, most existing RAG-based LLMs are dedicated to retrieving single modality information, mainly text; while for many real-world problems, such as healthcare, information relevant to queries can manifest in various modalities such as knowledge graph, text (clinical notes), and complex molecular structure. Thus, being able to retrieve relevant multi-modality domain-specific information, and reason and synthesize diverse knowledge to generate an accurate response is important. To address the gap, we present BioMol-MQA, a new question-answering (QA) dataset on polypharmacy, which is composed of two parts (i) a multimodal knowledge graph (KG) with text and molecular structure for information retrieval; and (ii) challenging questions that designed to test LLM capabilities in retrieving and reasoning over multimodal KG to answer questions. Our benchmarks indicate that existing LLMs struggle to answer these questions and do well only when given the necessary background data, signaling the necessity for strong RAG frameworks.

Multimodal foundation models that can holistically process text alongside images, video, audio, and other sensory modalities are increasingly used in a variety of real-world applications. However, it is challenging to characterize and study progress in multimodal foundation models, given the range of possible modeling decisions, tasks, and domains. In this paper, we introduce Holistic Evaluation of Multimodal Models (HEMM) to systematically evaluate the capabilities of multimodal foundation models across a set of 3 dimensions: basic skills, information flow, and real-world use cases. Basic multimodal skills are internal abilities required to solve problems, such as learning interactions across modalities, fine-grained alignment, multi-step reasoning, and the ability to handle external knowledge. Information flow studies how multimodal content changes during a task through querying, translation, editing, and fusion. Use cases span domain-specific challenges introduced in real-world multimedia, affective computing, natural sciences, healthcare, and human-computer interaction applications. Through comprehensive experiments across the 30 tasks in HEMM, we (1) identify key dataset dimensions (e.g., basic skills, information flows, and use cases) that pose challenges to today's models, and (2) distill performance trends regarding how different modeling dimensions (e.g., scale, pre-training data, multimodal alignment, pre-training, and instruction tuning objectives) influence performance. Our conclusions regarding challenging multimodal interactions, use cases, and tasks requiring reasoning and external knowledge, the benefits of data and model scale, and the impacts of instruction tuning yield actionable insights for future work in multimodal foundation models.

In recent years, advancements in Natural Language Processing (NLP) techniques have revolutionized the field of accessibility and exclusivity of testing, particularly for visually impaired students (VIS). CBT has shown in years back its relevance in terms of administering exams electronically, making the test process easier, providing quicker and more accurate results, and offering greater flexibility and accessibility for candidates. Yet, its relevance was not felt by the visually impaired students as they cannot access printed documents. Hence, in this paper, we present an NLP-driven Computer-Based Test guide for visually impaired students. It employs a speech technology pre-trained methods to provide real-time assistance and support to visually impaired students. The system utilizes NLP technologies to convert the text-based questions and the associated options in a machine-readable format. Subsequently, the speech technology pre-trained model processes the converted text enabling the VIS to comprehend and analyze the content. Furthermore, we validated that this pre-trained model is not perverse by testing for accuracy using sample audio datasets labels (A, B, C, D, E, F, G) to compare with the voice recordings obtained from 20 VIS which is been predicted by the system to attain values for precision, recall, and F1-scores. These metrics are used to assess the performance of the pre-trained model and have indicated that it is proficient enough to give its better performance to the evaluated system. The methodology adopted for this system is Object Oriented Analysis and Design Methodology (OOADM) where Objects are discussed and built by modeling real-world instances.

The development of multimodal models has significantly advanced multimodal sentiment analysis and emotion recognition. However, in real-world applications, the presence of various missing modality cases often leads to a degradation in the model's performance. In this work, we propose a novel multimodal Transformer framework using prompt learning to address the issue of missing modalities. Our method introduces three types of prompts: generative prompts, missing-signal prompts, and missing-type prompts. These prompts enable the generation of missing modality features and facilitate the learning of intra- and inter-modality information. Through prompt learning, we achieve a substantial reduction in the number of trainable parameters. Our proposed method outperforms other methods significantly across all evaluation metrics. Extensive experiments and ablation studies are conducted to demonstrate the effectiveness and robustness of our method, showcasing its ability to effectively handle missing modalities.

Recent advancements in large multimodal models (LMMs) have significantly enhanced performance across diverse tasks, with ongoing efforts to further integrate additional modalities such as video and audio. However, most existing LMMs remain vulnerable to hallucinations, the discrepancy between the factual multimodal input and the generated textual output, which has limited their applicability in various real-world scenarios. This paper presents the first systematic investigation of hallucinations in LMMs involving the three most common modalities: language, visual, and audio. Our study reveals two key contributors to hallucinations: overreliance on unimodal priors and spurious inter-modality correlations. To address these challenges, we introduce the benchmark The Curse of Multi-Modalities (CMM), which comprehensively evaluates hallucinations in LMMs, providing a detailed analysis of their underlying issues. Our findings highlight key vulnerabilities, including imbalances in modality integration and biases from training data, underscoring the need for balanced cross-modal learning and enhanced hallucination mitigation strategies. Based on our observations and findings, we suggest potential research directions that could enhance the reliability of LMMs.

Motivated by in-context learning (ICL) capabilities of Large Language models (LLMs), multimodal LLMs with additional visual modality are also exhibited with similar ICL abilities when multiple image-text pairs are provided as demonstrations. However, relatively less work has been done to investigate the principles behind how and why multimodal ICL works. We conduct a systematic and principled evaluation of multimodal ICL for models of different scales on a broad spectrum of new yet critical tasks. Through perturbations over different modality information, we show that modalities matter differently across tasks in multimodal ICL. Considering such modality impact, we further utilize modality-driven demonstration strategies to boost ICL performance. We also identify that demonstration selection is closely related to the models' ability to capture task inductive biases from multimodal ICL. Our principled analysis provides a comprehensive way of understanding the role of demonstrations in multimodal in-context learning, and sheds light on effectively improving multimodal ICL on a wide range of tasks even if those tasks are not seen in or even contradict pretraining data.

Despite remarkable advancements in Multimodal Large Language Models (MLLMs), a fundamental question remains: are MLLMs robust to contradicting modalities? To rigorously study this, we introduce MMA-Bench comprising videos and tasks that probe a model's reliance on specific modalities. Using black-box and white-box interpretability techniques, we provide a critical analysis of the brittleness of both open- and closed-sourced MLLMs. We show that current MLLMs struggle under misaligned audio-visual pairs and simple misleading text, thereby lacking robust multi-modal reasoning. Building on these findings, we propose a modality alignment tuning strategy to teach the model when to prioritize, leverage, or ignore specific modality cues. Through extensive experiments and analysis, we show that our alignment tuning yields demonstrably stronger multimodal grounding. This work provides both interpretability tools and a clear path toward developing MLLMs with intrinsically reliable cross-modal reasoning. Code and dataset will be publicly available.

Brain MRI scans are often found in four modalities, consisting of T1-weighted with and without contrast enhancement (T1ce and T1w), T2-weighted imaging (T2w), and Flair. Leveraging complementary information from these different modalities enables models to learn richer, more discriminative features for understanding brain anatomy, which could be used in downstream tasks such as anomaly detection. However, in clinical practice, not all MRI modalities are always available due to various reasons. This makes missing modality generation a critical challenge in medical image analysis. In this paper, we propose SLaM-DiMM, a novel missing modality generation framework that harnesses the power of diffusion models to synthesize any of the four target MRI modalities from other available modalities. Our approach not only generates high-fidelity images but also ensures structural coherence across the depth of the volume through a dedicated coherence enhancement mechanism. Qualitative and quantitative evaluations on the BraTS-Lighthouse-2025 Challenge dataset demonstrate the effectiveness of the proposed approach in synthesizing anatomically plausible and structurally consistent results. Code is available at https://github.com/BheeshmSharma/SLaM-DiMM-MICCAI-BraTS-Challenge-2025.

In this paper, we critically evaluate the capabilities of the state-of-the-art multimodal large language model, i.e., GPT-4 with Vision (GPT-4V), on Visual Question Answering (VQA) task. Our experiments thoroughly assess GPT-4V's proficiency in answering questions paired with images using both pathology and radiology datasets from 11 modalities (e.g. Microscopy, Dermoscopy, X-ray, CT, etc.) and fifteen objects of interests (brain, liver, lung, etc.). Our datasets encompass a comprehensive range of medical inquiries, including sixteen distinct question types. Throughout our evaluations, we devised textual prompts for GPT-4V, directing it to synergize visual and textual information. The experiments with accuracy score conclude that the current version of GPT-4V is not recommended for real-world diagnostics due to its unreliable and suboptimal accuracy in responding to diagnostic medical questions. In addition, we delineate seven unique facets of GPT-4V's behavior in medical VQA, highlighting its constraints within this complex arena. The complete details of our evaluation cases are accessible at https://github.com/ZhilingYan/GPT4V-Medical-Report.

Multimodal models have gained significant success in recent years. Standard multimodal approaches often assume unchanged modalities from training stage to inference stage. In practice, however, many scenarios fail to satisfy such assumptions with missing modalities during inference, leading to limitations on where multimodal models can be applied. While existing methods mitigate the problem through reconstructing the missing modalities, it increases unnecessary computational cost, which could be just as critical, especially for large, deployed systems. To solve the problem from both sides, we propose a novel guidance network that promotes knowledge sharing during training, taking advantage of the multimodal representations to train better single-modality models for inference. Real-life experiment in violence detection shows that our proposed framework trains single-modality models that significantly outperform its traditionally trained counterparts while maintaining the same inference cost.

Multimodal learning with incomplete modality is practical and challenging. Recently, researchers have focused on enhancing the robustness of pre-trained MultiModal Transformers (MMTs) under missing modality conditions by applying learnable prompts. However, these prompt-based methods face several limitations: (1) incomplete modalities provide restricted modal cues for task-specific inference, (2) dummy imputation for missing content causes information loss and introduces noise, and (3) static prompts are instance-agnostic, offering limited knowledge for instances with various missing conditions. To address these issues, we propose RAGPT, a novel Retrieval-AuGmented dynamic Prompt Tuning framework. RAGPT comprises three modules: (I) the multi-channel retriever, which identifies similar instances through a within-modality retrieval strategy, (II) the missing modality generator, which recovers missing information using retrieved contexts, and (III) the context-aware prompter, which captures contextual knowledge from relevant instances and generates dynamic prompts to largely enhance the MMT's robustness. Extensive experiments conducted on three real-world datasets show that RAGPT consistently outperforms all competitive baselines in handling incomplete modality problems. The code of our work and prompt-based baselines is available at https://github.com/Jian-Lang/RAGPT.

The opioid crisis represents a significant moment in public health that reveals systemic shortcomings across regulatory systems, healthcare practices, corporate governance, and public policy. Analyzing how these interconnected systems simultaneously failed to protect public health requires innovative analytic approaches for exploring the vast amounts of data and documents disclosed in the UCSF-JHU Opioid Industry Documents Archive (OIDA). The complexity, multimodal nature, and specialized characteristics of these healthcare-related legal and corporate documents necessitate more advanced methods and models tailored to specific data types and detailed annotations, ensuring the precision and professionalism in the analysis. In this paper, we tackle this challenge by organizing the original dataset according to document attributes and constructing a benchmark with 400k training documents and 10k for testing. From each document, we extract rich multimodal information-including textual content, visual elements, and layout structures-to capture a comprehensive range of features. Using multiple AI models, we then generate a large-scale dataset comprising 360k training QA pairs and 10k testing QA pairs. Building on this foundation, we develop domain-specific multimodal Large Language Models (LLMs) and explore the impact of multimodal inputs on task performance. To further enhance response accuracy, we incorporate historical QA pairs as contextual grounding for answering current queries. Additionally, we incorporate page references within the answers and introduce an importance-based page classifier, further improving the precision and relevance of the information provided. Preliminary results indicate the improvements with our AI assistant in document information extraction and question-answering tasks. The dataset is available at: https://huggingface.co/datasets/opioidarchive/oida-qa

Multimodal large language models (MLLMs) recently showed strong capacity in integrating data among multiple modalities, empowered by a generalizable attention architecture. Advanced methods predominantly focus on language-centric tuning while less exploring multimodal tokens mixed through attention, posing challenges in high-level tasks that require fine-grained cognition and emotion understanding. In this work, we identify the attention deficit disorder problem in multimodal learning, caused by inconsistent cross-modal attention and layer-by-layer decayed attention activation. To address this, we propose a novel attention mechanism, termed MOdular Duplex Attention (MODA), simultaneously conducting the inner-modal refinement and inter-modal interaction. MODA employs a correct-after-align strategy to effectively decouple modality alignment from cross-layer token mixing. In the alignment phase, tokens are mapped to duplex modality spaces based on the basis vectors, enabling the interaction between visual and language modality. Further, the correctness of attention scores is ensured through adaptive masked attention, which enhances the model's flexibility by allowing customizable masking patterns for different modalities. Extensive experiments on 21 benchmark datasets verify the effectiveness of MODA in perception, cognition, and emotion tasks. Source code and demo are available in https://zzcheng.top/MODA.

Retrieval-Augmented Generation (RAG) has shown substantial promise in improving factual accuracy by grounding model responses with external knowledge relevant to queries. However, most existing RAG approaches are limited to a text-only corpus, and while recent efforts have extended RAG to other modalities such as images and videos, they typically operate over a single modality-specific corpus. In contrast, real-world queries vary widely in the type of knowledge they require, which a single type of knowledge source cannot address. To address this, we introduce UniversalRAG, a novel RAG framework designed to retrieve and integrate knowledge from heterogeneous sources with diverse modalities and granularities. Specifically, motivated by the observation that forcing all modalities into a unified representation space derived from a single combined corpus causes a modality gap, where the retrieval tends to favor items from the same modality as the query, we propose a modality-aware routing mechanism that dynamically identifies the most appropriate modality-specific corpus and performs targeted retrieval within it. Also, beyond modality, we organize each modality into multiple granularity levels, enabling fine-tuned retrieval tailored to the complexity and scope of the query. We validate UniversalRAG on 8 benchmarks spanning multiple modalities, showing its superiority over modality-specific and unified baselines.

The integration of multimodal data including pathology images and gene profiles is widely applied in precise survival prediction. Despite recent advances in multimodal survival models, collecting complete modalities for multimodal fusion still poses a significant challenge, hindering their application in clinical settings. Current approaches tackling incomplete modalities often fall short, as they typically compensate for only a limited part of the knowledge of missing modalities. To address this issue, we propose a Distilled Prompt Learning framework (DisPro) to utilize the strong robustness of Large Language Models (LLMs) to missing modalities, which employs two-stage prompting for compensation of comprehensive information for missing modalities. In the first stage, Unimodal Prompting (UniPro) distills the knowledge distribution of each modality, preparing for supplementing modality-specific knowledge of the missing modality in the subsequent stage. In the second stage, Multimodal Prompting (MultiPro) leverages available modalities as prompts for LLMs to infer the missing modality, which provides modality-common information. Simultaneously, the unimodal knowledge acquired in the first stage is injected into multimodal inference to compensate for the modality-specific knowledge of the missing modality. Extensive experiments covering various missing scenarios demonstrated the superiority of the proposed method. The code is available at https://github.com/Innse/DisPro.

The advancement of Large Vision-Language Models (LVLMs) has propelled their application in the medical field. However, Medical LVLMs (Med-LVLMs) encounter factuality challenges due to modality misalignment, where the models prioritize textual knowledge over visual input, leading to hallucinations that contradict information in medical images. Previous attempts to enhance modality alignment in Med-LVLMs through preference optimization have inadequately mitigated clinical relevance in preference data, making these samples easily distinguishable and reducing alignment effectiveness. To address this challenge, we propose MMedPO, a novel multimodal medical preference optimization approach that considers the clinical relevance of preference samples to enhance Med-LVLM alignment. MMedPO curates multimodal preference data by introducing two types of dispreference: (1) plausible hallucinations injected through target Med-LVLMs or GPT-4o to produce medically inaccurate responses, and (2) lesion region neglect achieved through local lesion-noising, disrupting visual understanding of critical areas. We then calculate clinical relevance for each sample based on scores from multiple Med-LLMs and visual tools, and integrate these scores into the preference optimization process as weights, enabling effective alignment. Our experiments demonstrate that MMedPO significantly enhances factual accuracy in Med-LVLMs, achieving substantial improvements over existing preference optimization methods by averaging 14.2% and 51.7% across the Med-VQA and report generation tasks. Our code are available in https://github.com/aiming-lab/MMedPO.

Medical decision-making requires integrating diverse medical information, from imaging to clinical narratives. These medical modalities are often acquired in a many-to-many manner. However, current medical vision-language pretraining models (Med-VLPMs) fail to directly account for this many-to-many mapping in their model training and embeddings. To address this, we present Probabilistic Modality-Enhanced Diagnosis (ProbMED), a multimodal Med-VLPM that employs probabilistic contrastive learning to model distributions over embeddings rather than deterministic estimates. ProbMED aligns four distinct modalities -- chest X-rays, electrocardiograms, echocardiograms, and clinical text -- into a unified probabilistic embedding space. We use InfoNCE loss with Hellinger distance to integrate inter-modality distributions. We introduce a probabilistic synthetic sampling loss that captures modality-specific mean and variance to improve intra-modality binding. Extensive experiments across 13 medical datasets demonstrate that our model outperforms current Med-VLPMs in cross-modality retrieval, zero-shot, and few-shot classification. We also demonstrate the robust integration of multiple modalities for prognostication, showing improved intra- and inter-medical modality binding.

Medical vision-and-language pre-training (Med-VLP) has shown promising improvements on many downstream medical tasks owing to its applicability to extracting generic representations from medical images and texts. Practically, there exist two typical types, i.e., the fusion-encoder type and the dual-encoder type, depending on whether a heavy fusion module is used. The former is superior at multi-modal tasks owing to the sufficient interaction between modalities; the latter is good at uni-modal and cross-modal tasks due to the single-modality encoding ability. To take advantage of these two types, we propose an effective yet straightforward scheme named PTUnifier to unify the two types. We first unify the input format by introducing visual and textual prompts, which serve as a feature bank that stores the most representative images/texts. By doing so, a single model could serve as a foundation model that processes various tasks adopting different input formats (i.e., image-only, text-only, and image-text-pair). Furthermore, we construct a prompt pool (instead of static ones) to improve diversity and scalability. Experimental results show that our approach achieves state-of-the-art results on a broad range of tasks, spanning uni-modal tasks (i.e., image/text classification and text summarization), cross-modal tasks (i.e., image-to-text generation and image-text/text-image retrieval), and multi-modal tasks (i.e., visual question answering), demonstrating the effectiveness of our approach. Note that the adoption of prompts is orthogonal to most existing Med-VLP approaches and could be a beneficial and complementary extension to these approaches.

Depression and post traumatic stress disorder (PTSD) often co-occur with connected symptoms, complicating automated assessment, which is often binary and disorder specific. Clinically useful diagnosis needs severity aware cross disorder estimates and decision support explanations. Our unified tri modal affective severity framework synchronizes and fuses interview text with sentence level transformer embeddings, audio with log Mel statistics with deltas, and facial signals with action units, gaze, head and pose descriptors to output graded severities for diagnosing both depression (PHQ-8; 5 classes) and PTSD (3 classes). Standardized features are fused via a calibrated late fusion classifier, yielding per disorder probabilities and feature-level attributions. This severity aware tri-modal affective fusion approach is demoed on multi disorder concurrent depression and PTSD assessment. Stratified cross validation on DAIC derived corpora outperforms unimodal/ablation baselines. The fused model matches the strongest unimodal baseline on accuracy and weighted F1, while improving decision curve utility and robustness under noisy or missing modalities. For PTSD specifically, fusion reduces regression error and improves class concordance. Errors cluster between adjacent severities; extreme classes are identified reliably. Ablations show text contributes most to depression severity, audio and facial cues are critical for PTSD, whereas attributions align with linguistic and behavioral markers. Our approach offers reproducible evaluation and clinician in the loop support for affective clinical decision making.

This review paper explores recent advances in deep learning approaches for non-invasive cognitive impairment detection. We examine various non-invasive indicators of cognitive decline, including speech and language, facial, and motoric mobility. The paper provides an overview of relevant datasets, feature-extracting techniques, and deep-learning architectures applied to this domain. We have analyzed the performance of different methods across modalities and observed that speech and language-based methods generally achieved the highest detection performance. Studies combining acoustic and linguistic features tended to outperform those using a single modality. Facial analysis methods showed promise for visual modalities but were less extensively studied. Most papers focused on binary classification (impaired vs. non-impaired), with fewer addressing multi-class or regression tasks. Transfer learning and pre-trained language models emerged as popular and effective techniques, especially for linguistic analysis. Despite significant progress, several challenges remain, including data standardization and accessibility, model explainability, longitudinal analysis limitations, and clinical adaptation. Lastly, we propose future research directions, such as investigating language-agnostic speech analysis methods, developing multi-modal diagnostic systems, and addressing ethical considerations in AI-assisted healthcare. By synthesizing current trends and identifying key obstacles, this review aims to guide further development of deep learning-based cognitive impairment detection systems to improve early diagnosis and ultimately patient outcomes.

Multimodal learning is defined as learning over multiple heterogeneous input modalities such as video, audio, and text. In this work, we are concerned with understanding how models behave as the type of modalities differ between training and deployment, a situation that naturally arises in many applications of multimodal learning to hardware platforms. We present a multimodal robustness framework to provide a systematic analysis of common multimodal representation learning methods. Further, we identify robustness short-comings of these approaches and propose two intervention techniques leading to 1.5times-4times robustness improvements on three datasets, AudioSet, Kinetics-400 and ImageNet-Captions. Finally, we demonstrate that these interventions better utilize additional modalities, if present, to achieve competitive results of 44.2 mAP on AudioSet 20K.

Online video web content is richly multimodal: a single video blends vision, speech, ambient audio, and on-screen text. Retrieval systems typically treat these modalities as independent retrieval sources, which can lead to noisy and subpar retrieval. We explore multimodal video content retrieval, where relevance can be scored from one particular modality or jointly across multiple modalities simultaneously. Consequently, an effective retriever must dynamically choose which modality (or set of modalities) best addresses the query. We introduce CLaMR, a multimodal, late-interaction retriever that jointly indexes 4 modalities: video frames, transcribed speech, on-screen text, and metadata. CLaMR jointly encodes all modalities with a unified multimodal backbone for improved contextualization and is trained to enhance dynamic modality selection via two key innovations. First, given the lack of training data for multimodal retrieval, we introduce MultiVENT 2.0++, a large-scale synthetic training dataset built on MultiVENT 2.0 (event-centric videos in various languages paired with queries) with modality-targeted queries. Next, we propose a modality-aware loss that jointly trains according to a standard contrastive objective alongside an objective for learning correct modality usage. On the test sets of MultiVENT 2.0++ and MSRVTT, conventional aggregation strategies, such as averaging similarities for baseline retrievers, degrade performance by introducing noise from irrelevant modalities. In contrast, CLaMR consistently outperforms existing retrievers: on MultiVENT 2.0++, CLaMR improves nDCG@10 by 25.6 over the best single-modality retriever and by 35.4 over the best multi-modality retriever. We illustrate CLaMR's downstream utility on long-video QA, retrieving relevant frames and obtaining a 3.50% boost over LanguageBind on Video-MME and 1.42% over dense sampling on LongVideoBench.

In the era of modern healthcare, swiftly generating medical question summaries is crucial for informed and timely patient care. Despite the increasing complexity and volume of medical data, existing studies have focused solely on text-based summarization, neglecting the integration of visual information. Recognizing the untapped potential of combining textual queries with visual representations of medical conditions, we introduce the Multimodal Medical Question Summarization (MMQS) Dataset. This dataset, a major contribution to our work, pairs medical queries with visual aids, facilitating a richer and more nuanced understanding of patient needs. We also propose a framework, utilizing the power of Contrastive Language Image Pretraining(CLIP) and Large Language Models(LLMs), consisting of four modules that identify medical disorders, generate relevant context, filter medical concepts, and craft visually aware summaries. Our comprehensive framework harnesses the power of CLIP, a multimodal foundation model, and various general-purpose LLMs, comprising four main modules: the medical disorder identification module, the relevant context generation module, the context filtration module for distilling relevant medical concepts and knowledge, and finally, a general-purpose LLM to generate visually aware medical question summaries. Leveraging our MMQS dataset, we showcase how visual cues from images enhance the generation of medically nuanced summaries. This multimodal approach not only enhances the decision-making process in healthcare but also fosters a more nuanced understanding of patient queries, laying the groundwork for future research in personalized and responsive medical care

Audio-visual understanding is a rapidly evolving field that seeks to integrate and interpret information from both auditory and visual modalities. Despite recent advances in multi-modal learning, existing benchmarks often suffer from strong visual bias -- where answers can be inferred from visual data alone -- and provide only aggregate scores that conflate multiple sources of error. This makes it difficult to determine whether models struggle with visual understanding, audio interpretation, or audio-visual alignment. In this work, we introduce DAVE (Diagnostic Audio Visual Evaluation), a novel benchmark dataset designed to systematically evaluate audio-visual models across controlled challenges. DAVE alleviates existing limitations by (i) ensuring both modalities are necessary to answer correctly and (ii) decoupling evaluation into atomic subcategories. Our detailed analysis of state-of-the-art models reveals specific failure modes and provides targeted insights for improvement. By offering this standardized diagnostic framework, we aim to facilitate more robust development of audio-visual models. The dataset is released: https://github.com/gorjanradevski/dave

Alzheimer's Disease (AD) is the most common form of dementia and often difficult to diagnose due to the multifactorial etiology of dementia. Recent works on neuroimaging-based computer-aided diagnosis with deep neural networks (DNNs) showed that fusing structural magnetic resonance images (sMRI) and fluorodeoxyglucose positron emission tomography (FDG-PET) leads to improved accuracy in a study population of healthy controls and subjects with AD. However, this result conflicts with the established clinical knowledge that FDG-PET better captures AD-specific pathologies than sMRI. Therefore, we propose a framework for the systematic evaluation of multi-modal DNNs and critically re-evaluate single- and multi-modal DNNs based on FDG-PET and sMRI for binary healthy vs. AD, and three-way healthy/mild cognitive impairment/AD classification. Our experiments demonstrate that a single-modality network using FDG-PET performs better than MRI (accuracy 0.91 vs 0.87) and does not show improvement when combined. This conforms with the established clinical knowledge on AD biomarkers, but raises questions about the true benefit of multi-modal DNNs. We argue that future work on multi-modal fusion should systematically assess the contribution of individual modalities following our proposed evaluation framework. Finally, we encourage the community to go beyond healthy vs. AD classification and focus on differential diagnosis of dementia, where fusing multi-modal image information conforms with a clinical need.

Multimodal foundation models can process several modalities. However, since the space of possible modalities is large and evolving over time, training a model from scratch to encompass all modalities is unfeasible. Moreover, integrating a modality into a pre-existing foundation model currently requires a significant amount of paired data, which is often not available for low-resource modalities. In this paper, we introduce a method for sample-efficient modality integration (SEMI) into Large Language Models (LLMs). To this end, we devise a hypernetwork that can adapt a shared projector -- placed between modality-specific encoders and an LLM -- to any modality. The hypernetwork, trained on high-resource modalities (i.e., text, speech, audio, video), is conditioned on a few samples from any arbitrary modality at inference time to generate a suitable adapter. To increase the diversity of training modalities, we artificially multiply the number of encoders through isometric transformations. We find that SEMI achieves a significant boost in sample efficiency during few-shot integration of new modalities (i.e., satellite images, astronomical images, inertial measurements, and molecules) with encoders of arbitrary embedding dimensionality. For instance, to reach the same accuracy as 32-shot SEMI, training the projector from scratch needs 64times more data. As a result, SEMI holds promise to extend the modality coverage of foundation models.

Objectives: While Large Language Models (LLMs) have been widely used to assist clinicians and support patients, no existing work has explored dialogue systems for standard diagnostic interviews and assessments. This study aims to bridge the gap in mental healthcare accessibility by developing an LLM-powered dialogue system that replicates clinician behavior. Materials and Methods: We introduce TRUST, a framework of cooperative LLM modules capable of conducting formal diagnostic interviews and assessments for Post-Traumatic Stress Disorder (PTSD). To guide the generation of appropriate clinical responses, we propose a Dialogue Acts schema specifically designed for clinical interviews. Additionally, we develop a patient simulation approach based on real-life interview transcripts to replace time-consuming and costly manual testing by clinicians. Results: A comprehensive set of evaluation metrics is designed to assess the dialogue system from both the agent and patient simulation perspectives. Expert evaluations by conversation and clinical specialists show that TRUST performs comparably to real-life clinical interviews. Discussion: Our system performs at the level of average clinicians, with room for future enhancements in communication styles and response appropriateness. Conclusions: Our TRUST framework shows its potential to facilitate mental healthcare availability.

Medical image segmentation involves partitioning medical images into meaningful regions, with a focus on identifying anatomical structures and lesions. It has broad applications in healthcare, and deep learning methods have enabled significant advancements in automating this process. Recently, the introduction of the Segmentation Anything Model (SAM), the first foundation model for segmentation task, has prompted researchers to adapt it for the medical domain to improve performance across various tasks. However, SAM's large model size and high GPU requirements hinder its scalability and development in the medical domain. In this work, we propose MCP-MedSAM, a powerful and lightweight medical SAM model designed to be trainable on a single A100 GPU with 40GB of memory within one day while delivering superior segmentation performance. Recognizing the significant internal differences between modalities and the need for direct segmentation target information within bounding boxes, we introduce two kinds of prompts: the modality prompt and the content prompt. After passing through the prompt encoder, their embedding representations can further improve the segmentation performance by incorporating more relevant information without adding significant training overhead. Additionally, we adopt an effective modality-based data sampling strategy to address data imbalance between modalities, ensuring more balanced performance across all modalities. Our method was trained and evaluated using a large-scale challenge dataset, compared to top-ranking methods on the challenge leaderboard, MCP-MedSAM achieved superior performance while requiring only one day of training on a single GPU. The code is publicly available at blue{https://github.com/dong845/MCP-MedSAM}.}

Automatic evaluation metrics are crucial for advancing sign language translation (SLT). Current SLT evaluation metrics, such as BLEU and ROUGE, are only text-based, and it remains unclear to what extent text-based metrics can reliably capture the quality of SLT outputs. To address this gap, we investigate the limitations of text-based SLT evaluation metrics by analyzing six metrics, including BLEU, chrF, and ROUGE, as well as BLEURT on the one hand, and large language model (LLM)-based evaluators such as G-Eval and GEMBA zero-shot direct assessment on the other hand. Specifically, we assess the consistency and robustness of these metrics under three controlled conditions: paraphrasing, hallucinations in model outputs, and variations in sentence length. Our analysis highlights the limitations of lexical overlap metrics and demonstrates that while LLM-based evaluators better capture semantic equivalence often missed by conventional metrics, they can also exhibit bias toward LLM-paraphrased translations. Moreover, although all metrics are able to detect hallucinations, BLEU tends to be overly sensitive, whereas BLEURT and LLM-based evaluators are comparatively lenient toward subtle cases. This motivates the need for multimodal evaluation frameworks that extend beyond text-based metrics to enable a more holistic assessment of SLT outputs.

Alzheimer's disease (AD) is a common neurodegenerative disease among the elderly. Early prediction and timely intervention of its prodromal stage, mild cognitive impairment (MCI), can decrease the risk of advancing to AD. Combining information from various modalities can significantly improve predictive accuracy. However, challenges such as missing data and heterogeneity across modalities complicate multimodal learning methods as adding more modalities can worsen these issues. Current multimodal fusion techniques often fail to adapt to the complexity of medical data, hindering the ability to identify relationships between modalities. To address these challenges, we propose an innovative multimodal approach for predicting MCI conversion, focusing specifically on the issues of missing positron emission tomography (PET) data and integrating diverse medical information. The proposed incomplete triple-modal MCI conversion prediction network is tailored for this purpose. Through the missing modal generation module, we synthesize the missing PET data from the magnetic resonance imaging and extract features using specifically designed encoders. We also develop a channel aggregation module and a triple-modal co-attention fusion module to reduce feature redundancy and achieve effective multimodal data fusion. Furthermore, we design a loss function to handle missing modality issues and align cross-modal features. These components collectively harness multimodal data to boost network performance. Experimental results on the ADNI1 and ADNI2 datasets show that our method significantly surpasses existing unimodal and other multimodal models. Our code is available at https://github.com/justinhxy/ITFC.

Generative AI systems across modalities, ranging from text (including code), image, audio, and video, have broad social impacts, but there is no official standard for means of evaluating those impacts or for which impacts should be evaluated. In this paper, we present a guide that moves toward a standard approach in evaluating a base generative AI system for any modality in two overarching categories: what can be evaluated in a base system independent of context and what can be evaluated in a societal context. Importantly, this refers to base systems that have no predetermined application or deployment context, including a model itself, as well as system components, such as training data. Our framework for a base system defines seven categories of social impact: bias, stereotypes, and representational harms; cultural values and sensitive content; disparate performance; privacy and data protection; financial costs; environmental costs; and data and content moderation labor costs. Suggested methods for evaluation apply to listed generative modalities and analyses of the limitations of existing evaluations serve as a starting point for necessary investment in future evaluations. We offer five overarching categories for what can be evaluated in a broader societal context, each with its own subcategories: trustworthiness and autonomy; inequality, marginalization, and violence; concentration of authority; labor and creativity; and ecosystem and environment. Each subcategory includes recommendations for mitigating harm.

We introduce EXAMS-V, a new challenging multi-discipline multimodal multilingual exam benchmark for evaluating vision language models. It consists of 20,932 multiple-choice questions across 20 school disciplines covering natural science, social science, and other miscellaneous studies, e.g., religion, fine arts, business, etc. EXAMS-V includes a variety of multimodal features such as text, images, tables, figures, diagrams, maps, scientific symbols, and equations. The questions come in 11 languages from 7 language families. Unlike existing benchmarks, EXAMS-V is uniquely curated by gathering school exam questions from various countries, with a variety of education systems. This distinctive approach calls for intricate reasoning across diverse languages and relies on region-specific knowledge. Solving the problems in the dataset requires advanced perception and joint reasoning over the text and the visual content of the image. Our evaluation results demonstrate that this is a challenging dataset, which is difficult even for advanced vision-text models such as GPT-4V and Gemini; this underscores the inherent complexity of the dataset and its significance as a future benchmark.

Accessibility remains a critical concern in today's society, as many technologies are not developed to support the full range of user needs. Existing multi-agent systems (MAS) often cannot provide comprehensive assistance for users in need due to the lack of customization stemming from closed-source designs. Consequently, individuals with disabilities frequently encounter significant barriers when attempting to interact with digital environments. We introduce MATE, a multimodal accessibility MAS, which performs the modality conversions based on the user's needs. The system is useful for assisting people with disabilities by ensuring that data will be converted to an understandable format. For instance, if the user cannot see well and receives an image, the system converts this image to its audio description. MATE can be applied to a wide range of domains, industries, and areas, such as healthcare, and can become a useful assistant for various groups of users. The system supports multiple types of models, ranging from LLM API calling to using custom machine learning (ML) classifiers. This flexibility ensures that the system can be adapted to various needs and is compatible with a wide variety of hardware. Since the system is expected to run locally, it ensures the privacy and security of sensitive information. In addition, the framework can be effectively integrated with institutional technologies (e.g., digital healthcare service) for real-time user assistance. Furthermore, we introduce ModCon-Task-Identifier, a model that is capable of extracting the precise modality conversion task from the user input. Numerous experiments show that ModCon-Task-Identifier consistently outperforms other LLMs and statistical models on our custom data. Our code and data are publicly available at https://github.com/AlgazinovAleksandr/Multi-Agent-MATE.

Large Vision-Language Models (LVLMs) are increasingly being explored for applications in telemedicine, yet their ability to engage with diverse patient behaviors remains underexplored. We introduce 3MDBench (Medical Multimodal Multi-agent Dialogue Benchmark), an open-source evaluation framework designed to assess LLM-driven medical consultations. Unlike existing benchmarks, 3MDBench simulates real-world patient variability by incorporating four temperament-driven Patient Agents and an Assessor Agent that evaluates diagnostic accuracy and dialogue quality. The benchmark integrates textual and image-based patient data across 34 common diagnoses, mirroring real-world telemedicine interactions. Under different diagnostic strategies, we evaluate state-of-the-art LVLMs. Our findings demonstrate that incorporating dialogue improves the F1 score from 50.4 to 54.2 compared to non-dialogue settings, underscoring the value of context-driven, information-seeking questioning. Additionally, we demonstrate that multimodal inputs enhance diagnostic efficiency. Image-supported models outperform text-only counterparts by raising the diagnostic F1 score from 52.8 to 54.2 in a similar dialogue setting. Finally, we suggest an approach that improves the diagnostic F1-score to 70.3 by training the CNN model on the diagnosis prediction task and incorporating its top-3 predictions into the LVLM context. 3MDBench provides a reproducible and extendable evaluation framework for AI-driven medical assistants. It offers insights into how patient temperament, dialogue strategies, and multimodal reasoning influence diagnosis quality. By addressing real-world complexities in telemedicine, our benchmark paves the way for more empathetic, reliable, and context-aware AI-driven healthcare solutions. The source code of our benchmark is publicly available: https://github.com/univanxx/3mdbench

Recent advances in Multimodal Large Language Models (MLLMs) have shown promising results in integrating diverse modalities such as texts and images. MLLMs are heavily influenced by modality bias, often relying on language while under-utilizing other modalities like visual inputs. This position paper argues that MLLMs are deeply affected by modality bias. Firstly, we diagnose the current state of modality bias, highlighting its manifestations across various tasks. Secondly, we propose a systematic research road-map related to modality bias in MLLMs. Thirdly, we identify key factors of modality bias in MLLMs and offer actionable suggestions for future research to mitigate it. To substantiate these findings, we conduct experiments that demonstrate the influence of each factor: 1. Data Characteristics: Language data is compact and abstract, while visual data is redundant and complex, creating an inherent imbalance in learning dynamics. 2. Imbalanced Backbone Capabilities: The dominance of pretrained language models in MLLMs leads to overreliance on language and neglect of visual information. 3. Training Objectives: Current objectives often fail to promote balanced cross-modal alignment, resulting in shortcut learning biased toward language. These findings highlight the need for balanced training strategies and model architectures to better integrate multiple modalities in MLLMs. We call for interdisciplinary efforts to tackle these challenges and drive innovation in MLLM research. Our work provides a fresh perspective on modality bias in MLLMs and offers insights for developing more robust and generalizable multimodal systems-advancing progress toward Artificial General Intelligence.

Assessing scientific claims requires identifying, extracting, and reasoning with multimodal data expressed in information-rich figures in scientific literature. Despite the large body of work in scientific QA, figure captioning, and other multimodal reasoning tasks over chart-based data, there are no readily usable multimodal benchmarks that directly test claim verification abilities. To remedy this gap, we introduce a new benchmark MuSciClaims accompanied by diagnostics tasks. We automatically extract supported claims from scientific articles, which we manually perturb to produce contradicted claims. The perturbations are designed to test for a specific set of claim verification capabilities. We also introduce a suite of diagnostic tasks that help understand model failures. Our results show most vision-language models are poor (~0.3-0.5 F1), with even the best model only achieving 0.72 F1. They are also biased towards judging claims as supported, likely misunderstanding nuanced perturbations within the claims. Our diagnostics show models are bad at localizing correct evidence within figures, struggle with aggregating information across modalities, and often fail to understand basic components of the figure.

Evaluating generative foundation models on open-ended multimodal understanding (MMU) and generation (MMG) tasks across diverse modalities (e.g., images, audio, video) poses significant challenges due to the complexity of cross-modal interactions. To this end, the idea of utilizing Multimodal LLMs (MLLMs) as automated judges has emerged, with encouraging results in assessing vision-language understanding tasks. Moving further, this paper extends MLLM-as-a-Judge across modalities to a unified manner by introducing two benchmarks, TaskAnything and JudgeAnything, to respectively evaluate the overall performance and judging capabilities of MLLMs across any-to-any modality tasks. Specifically, TaskAnything evaluates the MMU and MMG capabilities across 15 any-to-any modality categories, employing 1,500 queries curated from well-established benchmarks. Furthermore, JudgeAnything evaluates the judging capabilities of 5 advanced (e.g., GPT-4o and Gemini-2.0-Flash) from the perspectives of Pair Comparison and Score Evaluation, providing a standardized testbed that incorporates human judgments and detailed rubrics. Our extensive experiments reveal that while these MLLMs show promise in assessing MMU (i.e., achieving an average of 66.55% in Pair Comparison setting and 42.79% in Score Evaluation setting), they encounter significant challenges with MMG tasks (i.e., averaging only 53.37% in Pair Comparison setting and 30.05% in Score Evaluation setting), exposing cross-modality biases and hallucination issues. To address this, we present OmniArena, an automated platform for evaluating omni-models and multimodal reward models. Our work highlights the need for fairer evaluation protocols and stronger alignment with human preferences. The source code and dataset are publicly available at: https://urrealhero.github.io/judgeanythingweb/.

Mixed modality search -- retrieving information across a heterogeneous corpus composed of images, texts, and multimodal documents -- is an important yet underexplored real-world application. In this work, we investigate how contrastive vision-language models, such as CLIP, perform on the mixed modality search task. Our analysis reveals a critical limitation: these models exhibit a pronounced modality gap in the embedding space, where image and text embeddings form distinct clusters, leading to intra-modal ranking bias and inter-modal fusion failure. To address this issue, we propose GR-CLIP, a lightweight post-hoc calibration method that removes the modality gap in CLIP's embedding space. Evaluated on MixBench -- the first benchmark specifically designed for mixed modality search -- GR-CLIP improves NDCG@10 by up to 26 percentage points over CLIP, surpasses recent vision-language generative embedding models by 4 percentage points, while using 75x less compute.

Healthcare data now span EHRs, medical imaging, genomics, and wearable sensors, but most diagnostic models still process these modalities in isolation. This limits their ability to capture early, cross-modal disease signatures. This paper introduces a multimodal foundation model built on a transformer architecture that integrates heterogeneous clinical data through modality-specific encoders and cross-modal attention. Each modality is mapped into a shared latent space and fused using multi-head attention with residual normalization. We implement the framework using a multimodal dataset that simulates early-stage disease patterns across EHR sequences, imaging patches, genomic profiles, and wearable signals, including missing-modality scenarios and label noise. The model is trained using supervised classification together with self-supervised reconstruction and contrastive alignment to improve robustness. Experimental evaluation demonstrates strong performance in early-detection settings, with stable classification metrics, reliable uncertainty estimates, and interpretable attention patterns. The approach moves toward a flexible, pretrain-and-fine-tune foundation model that supports precision diagnostics, handles incomplete inputs, and improves early disease detection across oncology, cardiology, and neurology applications.

Perceiving and generating diverse modalities are crucial for AI models to effectively learn from and engage with real-world signals, necessitating reliable evaluations for their development. We identify two major issues in current evaluations: (1) inconsistent standards, shaped by different communities with varying protocols and maturity levels; and (2) significant query, grading, and generalization biases. To address these, we introduce MixEval-X, the first any-to-any real-world benchmark designed to optimize and standardize evaluations across input and output modalities. We propose multi-modal benchmark mixture and adaptation-rectification pipelines to reconstruct real-world task distributions, ensuring evaluations generalize effectively to real-world use cases. Extensive meta-evaluations show our approach effectively aligns benchmark samples with real-world task distributions and the model rankings correlate strongly with that of crowd-sourced real-world evaluations (up to 0.98). We provide comprehensive leaderboards to rerank existing models and organizations and offer insights to enhance understanding of multi-modal evaluations and inform future research.

This research paper addresses the challenge of modality mismatch in multimodal learning, where the modalities available during inference differ from those available at training. We propose the Text-centric Alignment for Multi-Modality Learning (TAMML) approach, an innovative method that utilizes Large Language Models (LLMs) with in-context learning and foundation models to enhance the generalizability of multimodal systems under these conditions. By leveraging the unique properties of text as a unified semantic space, TAMML demonstrates significant improvements in handling unseen, diverse, and unpredictable modality combinations. TAMML not only adapts to varying modalities but also maintains robust performance, showcasing the potential of foundation models in overcoming the limitations of traditional fixed-modality frameworks in embedding representations. This study contributes to the field by offering a flexible, effective solution for real-world applications where modality availability is dynamic and uncertain.

Human perception integrates multiple modalities, such as vision, hearing, and language, into a unified understanding of the surrounding reality. While recent multimodal models have achieved significant progress by aligning pairs of modalities via contrastive learning, their solutions are unsuitable when scaling to multiple modalities. These models typically align each modality to a designated anchor without ensuring the alignment of all modalities with each other, leading to suboptimal performance in tasks requiring a joint understanding of multiple modalities. In this paper, we structurally rethink the pairwise conventional approach to multimodal learning and we present the novel Gramian Representation Alignment Measure (GRAM), which overcomes the above-mentioned limitations. GRAM learns and then aligns n modalities directly in the higher-dimensional space in which modality embeddings lie by minimizing the Gramian volume of the k-dimensional parallelotope spanned by the modality vectors, ensuring the geometric alignment of all modalities simultaneously. GRAM can replace cosine similarity in any downstream method, holding for 2 to n modalities and providing more meaningful alignment with respect to previous similarity measures. The novel GRAM-based contrastive loss function enhances the alignment of multimodal models in the higher-dimensional embedding space, leading to new state-of-the-art performance in downstream tasks such as video-audio-text retrieval and audio-video classification. The project page, the code, and the pretrained models are available at https://ispamm.github.io/GRAM/.

Despite growing interest in using large language models (LLMs) in healthcare, current explorations do not assess the real-world utility and safety of LLMs in clinical settings. Our objective was to determine whether two LLMs can serve information needs submitted by physicians as questions to an informatics consultation service in a safe and concordant manner. Sixty six questions from an informatics consult service were submitted to GPT-3.5 and GPT-4 via simple prompts. 12 physicians assessed the LLM responses' possibility of patient harm and concordance with existing reports from an informatics consultation service. Physician assessments were summarized based on majority vote. For no questions did a majority of physicians deem either LLM response as harmful. For GPT-3.5, responses to 8 questions were concordant with the informatics consult report, 20 discordant, and 9 were unable to be assessed. There were 29 responses with no majority on "Agree", "Disagree", and "Unable to assess". For GPT-4, responses to 13 questions were concordant, 15 discordant, and 3 were unable to be assessed. There were 35 responses with no majority. Responses from both LLMs were largely devoid of overt harm, but less than 20% of the responses agreed with an answer from an informatics consultation service, responses contained hallucinated references, and physicians were divided on what constitutes harm. These results suggest that while general purpose LLMs are able to provide safe and credible responses, they often do not meet the specific information need of a given question. A definitive evaluation of the usefulness of LLMs in healthcare settings will likely require additional research on prompt engineering, calibration, and custom-tailoring of general purpose models.

Ensuring the accuracy of responses provided by large language models (LLMs) is crucial, particularly in clinical settings where incorrect information may directly impact patient health. To address this challenge, we construct K-QA, a dataset containing 1,212 patient questions originating from real-world conversations held on K Health (an AI-driven clinical platform). We employ a panel of in-house physicians to answer and manually decompose a subset of K-QA into self-contained statements. Additionally, we formulate two NLI-based evaluation metrics approximating recall and precision: (1) comprehensiveness, measuring the percentage of essential clinical information in the generated answer and (2) hallucination rate, measuring the number of statements from the physician-curated response contradicted by the LLM answer. Finally, we use K-QA along with these metrics to evaluate several state-of-the-art models, as well as the effect of in-context learning and medically-oriented augmented retrieval schemes developed by the authors. Our findings indicate that in-context learning improves the comprehensiveness of the models, and augmented retrieval is effective in reducing hallucinations. We make K-QA available to to the community to spur research into medically accurate NLP applications.

Multimodal Large Language Models excel in various tasks, yet often struggle with modality bias, where the model tends to rely heavily on a single modality and overlook critical information in other modalities, which leads to incorrect focus and generating irrelevant responses. In this paper, we propose using the paradigm of preference optimization to solve the modality bias problem, including RLAIFVBias, a debiased preference optimization dataset, and a Noise Aware Preference Optimization algorithm. Specifically, we first construct the dataset by introducing perturbations to reduce the informational content of certain modalities, compelling the model to rely on a specific modality when generating negative responses. To address the inevitable noise in automatically constructed data, we combine the noise robust Mean Absolute Error with the Binary Cross Entropy in Direct Preference Optimization by a negative Box Cox transformation, and dynamically adjust the algorithm noise robustness based on the evaluated noise levels in the data. Extensive experiments validate our approach, demonstrating not only its effectiveness in mitigating modality bias but also its significant role in minimizing hallucinations.

In this paper, we introduce a novel Multi-Modal Contrastive Pre-training Framework that synergistically combines X-rays, electrocardiograms (ECGs), and radiology/cardiology reports. Our approach leverages transformers to encode these diverse modalities into a unified representation space, aiming to enhance diagnostic accuracy and facilitate comprehensive patient assessments. We utilize LoRA-Peft to significantly reduce trainable parameters in the LLM and incorporate recent linear attention dropping strategy in the Vision Transformer(ViT) for smoother attention. Furthermore, we provide novel multimodal attention explanations and retrieval for our model. To the best of our knowledge, we are the first to propose an integrated model that combines X-ray, ECG, and Radiology/Cardiology Report with this approach. By utilizing contrastive loss, MoRE effectively aligns modality-specific features into a coherent embedding, which supports various downstream tasks such as zero-shot classification and multimodal retrieval. Employing our proposed methodology, we achieve state-of-the-art (SOTA) on the Mimic-IV, CheXpert, Edema Severity, and PtbXl downstream datasets, surpassing existing multimodal approaches. Our proposed framework shows significant improvements in capturing intricate inter-modal relationships and its robustness in medical diagnosis that establishes a framework for future research in multimodal learning in the healthcare sector.

As large language models transition from text-based interfaces to audio interactions in clinical settings, they might introduce new vulnerabilities through paralinguistic cues in audio. We evaluated these models on 170 clinical cases, each synthesized into speech from 36 distinct voice profiles spanning variations in age, gender, and emotion. Our findings reveal a severe modality bias: surgical recommendations for audio inputs varied by as much as 35% compared to identical text-based inputs, with one model providing 80% fewer recommendations. Further analysis uncovered age disparities of up to 12% between young and elderly voices, which persisted in most models despite chain-of-thought prompting. While explicit reasoning successfully eliminated gender bias, the impact of emotion was not detected due to poor recognition performance. These results demonstrate that audio LLMs are susceptible to making clinical decisions based on a patient's voice characteristics rather than medical evidence, a flaw that risks perpetuating healthcare disparities. We conclude that bias-aware architectures are essential and urgently needed before the clinical deployment of these models.

Recently, the newly emerged multimodal models, which leverage both visual and linguistic modalities to train powerful encoders, have gained increasing attention. However, learning from a large-scale unlabeled dataset also exposes the model to the risk of potential poisoning attacks, whereby the adversary aims to perturb the model's training data to trigger malicious behaviors in it. In contrast to previous work, only poisoning visual modality, in this work, we take the first step to studying poisoning attacks against multimodal models in both visual and linguistic modalities. Specially, we focus on answering two questions: (1) Is the linguistic modality also vulnerable to poisoning attacks? and (2) Which modality is most vulnerable? To answer the two questions, we propose three types of poisoning attacks against multimodal models. Extensive evaluations on different datasets and model architectures show that all three attacks can achieve significant attack performance while maintaining model utility in both visual and linguistic modalities. Furthermore, we observe that the poisoning effect differs between different modalities. To mitigate the attacks, we propose both pre-training and post-training defenses. We empirically show that both defenses can significantly reduce the attack performance while preserving the model's utility.

We propose to build omni-modal intelligence, which is capable of understanding any modality and learning universal representations. In specific, we propose a scalable pretraining paradigm, named Multimodal Context (MiCo), which can scale up the numbers of modalities and amount of data, together with the model parameters, in the pretraining process. With MiCo, the pretrained models show significant emergent abilities in multimodal learning, which are evaluated on the following tasks: i) single-modality perception benchmarks of 10 different modalities, ii) 25 cross-modality understanding tasks of retrieval, question-answering, captioning, and iii) 18 multimodal large language model benchmarks. Our models establish 37 new records for state-of-the-art performance. We hope that our research could contribute to the development of omni-modal intelligence. Code and Models are at https://github.com/invictus717/MiCo

Omni-modal language models (OLMs) aim to integrate and reason over diverse input modalities--such as text, images, video, and audio--while maintaining strong language capabilities. Despite recent advancements, existing models, especially open-source ones, remain far from true omni-modality, struggling to generalize beyond the specific modality pairs they are trained on or to achieve strong performance when processing multi-modal inputs. We study the effect of extending modality, the dominant technique for training multimodal models, where an off-the-shelf language model is fine-tuned on target-domain and language data. Specifically, we investigate three key questions: (1) Does modality extension compromise core language abilities? (2) Can model merging effectively integrate independently fine-tuned modality-specific models to achieve omni-modality? (3) Does omni-modality extension lead to better knowledge sharing and generalization compared to sequential extension? Through extensive experiments, we analyze these trade-offs and provide insights into the feasibility of achieving true omni-modality using current approaches.

In recent years, there has been a growing emphasis on the intersection of audio, vision, and text modalities, driving forward the advancements in multimodal research. However, strong bias that exists in any modality can lead to the model neglecting the others. Consequently, the model's ability to effectively reason across these diverse modalities is compromised, impeding further advancement. In this paper, we meticulously review each question type from the original dataset, selecting those with pronounced answer biases. To counter these biases, we gather complementary videos and questions, ensuring that no answers have outstanding skewed distribution. In particular, for binary questions, we strive to ensure that both answers are almost uniformly spread within each question category. As a result, we construct a new dataset, named MUSIC-AVQA v2.0, which is more challenging and we believe could better foster the progress of AVQA task. Furthermore, we present a novel baseline model that delves deeper into the audio-visual-text interrelation. On MUSIC-AVQA v2.0, this model surpasses all the existing benchmarks, improving accuracy by 2% on MUSIC-AVQA v2.0, setting a new state-of-the-art performance.

Recent advances in learning multi-modal representation have witnessed the success in biomedical domains. While established techniques enable handling multi-modal information, the challenges are posed when extended to various clinical modalities and practical modalitymissing setting due to the inherent modality gaps. To tackle these, we propose an innovative Modality-prompted Heterogeneous Graph for Omnimodal Learning (GTP-4o), which embeds the numerous disparate clinical modalities into a unified representation, completes the deficient embedding of missing modality and reformulates the cross-modal learning with a graph-based aggregation. Specially, we establish a heterogeneous graph embedding to explicitly capture the diverse semantic properties on both the modality-specific features (nodes) and the cross-modal relations (edges). Then, we design a modality-prompted completion that enables completing the inadequate graph representation of missing modality through a graph prompting mechanism, which generates hallucination graphic topologies to steer the missing embedding towards the intact representation. Through the completed graph, we meticulously develop a knowledge-guided hierarchical cross-modal aggregation consisting of a global meta-path neighbouring to uncover the potential heterogeneous neighbors along the pathways driven by domain knowledge, and a local multi-relation aggregation module for the comprehensive cross-modal interaction across various heterogeneous relations. We assess the efficacy of our methodology on rigorous benchmarking experiments against prior state-of-the-arts. In a nutshell, GTP-4o presents an initial foray into the intriguing realm of embedding, relating and perceiving the heterogeneous patterns from various clinical modalities holistically via a graph theory. Project page: https://gtp-4-o.github.io/.

The explainability of a robot's actions is crucial to its acceptance in social spaces. Explaining why a robot fails to complete a given task is particularly important for non-expert users to be aware of the robot's capabilities and limitations. So far, research on explaining robot failures has only considered generating textual explanations, even though several studies have shown the benefits of multimodal ones. However, a simple combination of multiple modalities may lead to semantic incoherence between the information across different modalities - a problem that is not well-studied. An incoherent multimodal explanation can be difficult to understand, and it may even become inconsistent with what the robot and the human observe and how they perform reasoning with the observations. Such inconsistencies may lead to wrong conclusions about the robot's capabilities. In this paper, we introduce an approach to generate coherent multimodal explanations by checking the logical coherence of explanations from different modalities, followed by refinements as required. We propose a classification approach for coherence assessment, where we evaluate if an explanation logically follows another. Our experiments suggest that fine-tuning a neural network that was pre-trained to recognize textual entailment, performs well for coherence assessment of multimodal explanations. Code & data: https://pradippramanick.github.io/coherent-explain/.

In an effort to create a more efficient AI system, we introduce a new multi-modality learning framework that leverages a modality-agnostic concept space possessing abstract knowledge and a set of modality-specific projection models tailored to process distinct modality inputs and map them onto the concept space. Decoupled from specific modalities and their associated projection models, the concept space focuses on learning abstract knowledge that is universally applicable across modalities. Subsequently, the knowledge embedded into the concept space streamlines the learning processes of modality-specific projection models. We evaluate our framework on two popular tasks: Image-Text Matching and Visual Question Answering. Our framework achieves performance on par with benchmark models while demonstrating more efficient learning curves.

We present MEGA-Bench, an evaluation suite that scales multimodal evaluation to over 500 real-world tasks, to address the highly heterogeneous daily use cases of end users. Our objective is to optimize for a set of high-quality data samples that cover a highly diverse and rich set of multimodal tasks, while enabling cost-effective and accurate model evaluation. In particular, we collected 505 realistic tasks encompassing over 8,000 samples from 16 expert annotators to extensively cover the multimodal task space. Instead of unifying these problems into standard multi-choice questions (like MMMU, MMBench, and MMT-Bench), we embrace a wide range of output formats like numbers, phrases, code, \LaTeX, coordinates, JSON, free-form, etc. To accommodate these formats, we developed over 40 metrics to evaluate these tasks. Unlike existing benchmarks, MEGA-Bench offers a fine-grained capability report across multiple dimensions (e.g., application, input type, output format, skill), allowing users to interact with and visualize model capabilities in depth. We evaluate a wide variety of frontier vision-language models on MEGA-Bench to understand their capabilities across these dimensions.

The Multimodal Large Language Model (MLLM) is currently experiencing rapid growth, driven by the advanced capabilities of LLMs. Unlike earlier specialists, existing MLLMs are evolving towards a Multimodal Generalist paradigm. Initially limited to understanding multiple modalities, these models have advanced to not only comprehend but also generate across modalities. Their capabilities have expanded from coarse-grained to fine-grained multimodal understanding and from supporting limited modalities to arbitrary ones. While many benchmarks exist to assess MLLMs, a critical question arises: Can we simply assume that higher performance across tasks indicates a stronger MLLM capability, bringing us closer to human-level AI? We argue that the answer is not as straightforward as it seems. This project introduces General-Level, an evaluation framework that defines 5-scale levels of MLLM performance and generality, offering a methodology to compare MLLMs and gauge the progress of existing systems towards more robust multimodal generalists and, ultimately, towards AGI. At the core of the framework is the concept of Synergy, which measures whether models maintain consistent capabilities across comprehension and generation, and across multiple modalities. To support this evaluation, we present General-Bench, which encompasses a broader spectrum of skills, modalities, formats, and capabilities, including over 700 tasks and 325,800 instances. The evaluation results that involve over 100 existing state-of-the-art MLLMs uncover the capability rankings of generalists, highlighting the challenges in reaching genuine AI. We expect this project to pave the way for future research on next-generation multimodal foundation models, providing a robust infrastructure to accelerate the realization of AGI. Project page: https://generalist.top/

Automatic evaluation metrics are a crucial component of dialog systems research. Standard language evaluation metrics are known to be ineffective for evaluating dialog. As such, recent research has proposed a number of novel, dialog-specific metrics that correlate better with human judgements. Due to the fast pace of research, many of these metrics have been assessed on different datasets and there has as yet been no time for a systematic comparison between them. To this end, this paper provides a comprehensive assessment of recently proposed dialog evaluation metrics on a number of datasets. In this paper, 23 different automatic evaluation metrics are evaluated on 10 different datasets. Furthermore, the metrics are assessed in different settings, to better qualify their respective strengths and weaknesses. Metrics are assessed (1) on both the turn level and the dialog level, (2) for different dialog lengths, (3) for different dialog qualities (e.g., coherence, engaging), (4) for different types of response generation models (i.e., generative, retrieval, simple models and state-of-the-art models), (5) taking into account the similarity of different metrics and (6) exploring combinations of different metrics. This comprehensive assessment offers several takeaways pertaining to dialog evaluation metrics in general. It also suggests how to best assess evaluation metrics and indicates promising directions for future work.

We present VLMEvalKit: an open-source toolkit for evaluating large multi-modality models based on PyTorch. The toolkit aims to provide a user-friendly and comprehensive framework for researchers and developers to evaluate existing multi-modality models and publish reproducible evaluation results. In VLMEvalKit, we implement over 70 different large multi-modality models, including both proprietary APIs and open-source models, as well as more than 20 different multi-modal benchmarks. By implementing a single interface, new models can be easily added to the toolkit, while the toolkit automatically handles the remaining workloads, including data preparation, distributed inference, prediction post-processing, and metric calculation. Although the toolkit is currently mainly used for evaluating large vision-language models, its design is compatible with future updates that incorporate additional modalities, such as audio and video. Based on the evaluation results obtained with the toolkit, we host OpenVLM Leaderboard, a comprehensive leaderboard to track the progress of multi-modality learning research. The toolkit is released at https://github.com/open-compass/VLMEvalKit and is actively maintained.

We present Any-Modality Augmented Language Model (AnyMAL), a unified model that reasons over diverse input modality signals (i.e. text, image, video, audio, IMU motion sensor), and generates textual responses. AnyMAL inherits the powerful text-based reasoning abilities of the state-of-the-art LLMs including LLaMA-2 (70B), and converts modality-specific signals to the joint textual space through a pre-trained aligner module. To further strengthen the multimodal LLM's capabilities, we fine-tune the model with a multimodal instruction set manually collected to cover diverse topics and tasks beyond simple QAs. We conduct comprehensive empirical analysis comprising both human and automatic evaluations, and demonstrate state-of-the-art performance on various multimodal tasks.

Emotion recognition is involved in several real-world applications. With an increase in available modalities, automatic understanding of emotions is being performed more accurately. The success in Multimodal Emotion Recognition (MER), primarily relies on the supervised learning paradigm. However, data annotation is expensive, time-consuming, and as emotion expression and perception depends on several factors (e.g., age, gender, culture) obtaining labels with a high reliability is hard. Motivated by these, we focus on unsupervised feature learning for MER. We consider discrete emotions, and as modalities text, audio and vision are used. Our method, as being based on contrastive loss between pairwise modalities, is the first attempt in MER literature. Our end-to-end feature learning approach has several differences (and advantages) compared to existing MER methods: i) it is unsupervised, so the learning is lack of data labelling cost; ii) it does not require data spatial augmentation, modality alignment, large number of batch size or epochs; iii) it applies data fusion only at inference; and iv) it does not require backbones pre-trained on emotion recognition task. The experiments on benchmark datasets show that our method outperforms several baseline approaches and unsupervised learning methods applied in MER. Particularly, it even surpasses a few supervised MER state-of-the-art.

Audio often serves as an auxiliary modality in video understanding tasks of audio-visual large language models (LLMs), merely assisting in the comprehension of visual information. However, a thorough understanding of videos significantly depends on auditory information, as audio offers critical context, emotional cues, and semantic meaning that visual data alone often lacks. This paper proposes an audio-centric video understanding benchmark (AVUT) to evaluate the video comprehension capabilities of multimodal LLMs with a particular focus on auditory information. AVUT introduces a suite of carefully designed audio-centric tasks, holistically testing the understanding of both audio content and audio-visual interactions in videos. Moreover, this work points out the text shortcut problem that largely exists in other benchmarks where the correct answer can be found from question text alone without needing videos. AVUT addresses this problem by proposing a answer permutation-based filtering mechanism. A thorough evaluation across a diverse range of open-source and proprietary multimodal LLMs is performed, followed by the analyses of deficiencies in audio-visual LLMs. Demos and data are available at https://github.com/lark-png/AVUT.

Responding with multi-modal content has been recognized as an essential capability for an intelligent conversational agent. In this paper, we introduce the MMDialog dataset to better facilitate multi-modal conversation. MMDialog is composed of a curated set of 1.08 million real-world dialogues with 1.53 million unique images across 4,184 topics. MMDialog has two main and unique advantages. First, it is the largest multi-modal conversation dataset by the number of dialogues by 88x. Second, it contains massive topics to generalize the open-domain. To build engaging dialogue system with this dataset, we propose and normalize two response producing tasks based on retrieval and generative scenarios. In addition, we build two baselines for above tasks with state-of-the-art techniques and report their experimental performance. We also propose a novel evaluation metric MM-Relevance to measure the multi-modal responses. Our dataset and scripts are available in https://github.com/victorsungo/MMDialog.

Contrastive learning methods, such as CLIP, leverage naturally paired data-for example, images and their corresponding text captions-to learn general representations that transfer efficiently to downstream tasks. While such approaches are generally applied to two modalities, domains such as robotics, healthcare, and video need to support many types of data at once. We show that the pairwise application of CLIP fails to capture joint information between modalities, thereby limiting the quality of the learned representations. To address this issue, we present Symile, a simple contrastive learning approach that captures higher-order information between any number of modalities. Symile provides a flexible, architecture-agnostic objective for learning modality-specific representations. To develop Symile's objective, we derive a lower bound on total correlation, and show that Symile representations for any set of modalities form a sufficient statistic for predicting the remaining modalities. Symile outperforms pairwise CLIP, even with modalities missing in the data, on cross-modal classification and retrieval across several experiments including on an original multilingual dataset of 33M image, text and audio samples and a clinical dataset of chest X-rays, electrocardiograms, and laboratory measurements. All datasets and code used in this work are publicly available at https://github.com/rajesh-lab/symile.

Retrieval-augmented generation (RAG) enhances large language models (LLMs) by incorporating external knowledge to generate a response within a context with improved accuracy and reduced hallucinations. However, multi-modal RAG systems face unique challenges: (i) the retrieval process may select irrelevant entries to user query (e.g., images, documents), and (ii) vision-language models or multi-modal language models like GPT-4o may hallucinate when processing these entries to generate RAG output. In this paper, we aim to address the first challenge, i.e, improving the selection of relevant context from the knowledge-base in retrieval phase of the multi-modal RAG. Specifically, we leverage the relevancy score (RS) measure designed in our previous work for evaluating the RAG performance to select more relevant entries in retrieval process. The retrieval based on embeddings, say CLIP-based embedding, and cosine similarity usually perform poorly particularly for multi-modal data. We show that by using a more advanced relevancy measure, one can enhance the retrieval process by selecting more relevant pieces from the knowledge-base and eliminate the irrelevant pieces from the context by adaptively selecting up-to-k entries instead of fixed number of entries. Our evaluation using COCO dataset demonstrates significant enhancement in selecting relevant context and accuracy of the generated response.

Multimodal Sentiment Analysis (MSA) leverages heterogeneous modalities, such as language, vision, and audio, to enhance the understanding of human sentiment. While existing models often focus on extracting shared information across modalities or directly fusing heterogeneous modalities, such approaches can introduce redundancy and conflicts due to equal treatment of all modalities and the mutual transfer of information between modality pairs. To address these issues, we propose a Disentangled-Language-Focused (DLF) multimodal representation learning framework, which incorporates a feature disentanglement module to separate modality-shared and modality-specific information. To further reduce redundancy and enhance language-targeted features, four geometric measures are introduced to refine the disentanglement process. A Language-Focused Attractor (LFA) is further developed to strengthen language representation by leveraging complementary modality-specific information through a language-guided cross-attention mechanism. The framework also employs hierarchical predictions to improve overall accuracy. Extensive experiments on two popular MSA datasets, CMU-MOSI and CMU-MOSEI, demonstrate the significant performance gains achieved by the proposed DLF framework. Comprehensive ablation studies further validate the effectiveness of the feature disentanglement module, language-focused attractor, and hierarchical predictions. Our code is available at https://github.com/pwang322/DLF.

Skin carcinoma is the most prevalent form of cancer globally, accounting for over $8 billion in annual healthcare expenditures. In clinical settings, physicians document patient visits using detailed SOAP (Subjective, Objective, Assessment, and Plan) notes. However, manually generating these notes is labor-intensive and contributes to clinician burnout. In this work, we propose a weakly supervised multimodal framework to generate clinically structured SOAP notes from limited inputs, including lesion images and sparse clinical text. Our approach reduces reliance on manual annotations, enabling scalable, clinically grounded documentation while alleviating clinician burden and reducing the need for large annotated data. Our method achieves performance comparable to GPT-4o, Claude, and DeepSeek Janus Pro across key clinical relevance metrics. To evaluate clinical quality, we introduce two novel metrics MedConceptEval and Clinical Coherence Score (CCS) which assess semantic alignment with expert medical concepts and input features, respectively.

Multimodal language models (MLMs) show promise for clinical decision support and diagnostic reasoning, raising the prospect of end-to-end automated medical image interpretation. However, clinicians are highly selective in adopting AI tools; a model that makes errors on seemingly simple perception tasks such as determining image orientation or identifying whether a CT scan is contrast-enhance are unlikely to be adopted for clinical tasks. We introduce Medblink, a benchmark designed to probe these models for such perceptual abilities. Medblink spans eight clinically meaningful tasks across multiple imaging modalities and anatomical regions, totaling 1,429 multiple-choice questions over 1,605 images. We evaluate 19 state-of-the-art MLMs, including general purpose (GPT4o, Claude 3.5 Sonnet) and domain specific (Med Flamingo, LLaVA Med, RadFM) models. While human annotators achieve 96.4% accuracy, the best-performing model reaches only 65%. These results show that current MLMs frequently fail at routine perceptual checks, suggesting the need to strengthen their visual grounding to support clinical adoption. Data is available on our project page.

Due to the remarkable capabilities of powerful Large Language Models (LLMs) in effectively following instructions, there has been a growing number of assistants in the community to assist humans. Recently, significant progress has been made in the development of Vision Language Models (VLMs), expanding the capabilities of LLMs and enabling them to execute more diverse instructions. However, it is foreseeable that models will likely need to handle tasks involving additional modalities such as speech, video, and others. This poses a particularly prominent challenge of dealing with the complexity of mixed modalities. To address this, we introduce a novel architecture called PILL: Plug Into LLM with adapter expert and attention gate to better decouple these complex modalities and leverage efficient fine-tuning. We introduce two modules: Firstly, utilizing Mixture-of-Modality-Adapter-Expert to independently handle different modalities, enabling better adaptation to downstream tasks while preserving the expressive capability of the original model. Secondly, by introducing Modality-Attention-Gating, which enables adaptive control of the contribution of modality tokens to the overall representation. In addition, we have made improvements to the Adapter to enhance its learning and expressive capabilities. Experimental results demonstrate that our approach exhibits competitive performance compared to other mainstream methods for modality fusion. For researchers interested in our work, we provide free access to the code and models at https://github.com/DsaltYfish/PILL.

Medical conversational AI (AI) plays a pivotal role in the development of safer and more effective medical dialogue systems. However, existing benchmarks and evaluation frameworks for assessing the information-gathering and diagnostic reasoning abilities of medical large language models (LLMs) have not been rigorously evaluated. To address these gaps, we present MedDialogRubrics, a novel benchmark comprising 5,200 synthetically constructed patient cases and over 60,000 fine-grained evaluation rubrics generated by LLMs and subsequently refined by clinical experts, specifically designed to assess the multi-turn diagnostic capabilities of LLM. Our framework employs a multi-agent system to synthesize realistic patient records and chief complaints from underlying disease knowledge without accessing real-world electronic health records, thereby mitigating privacy and data-governance concerns. We design a robust Patient Agent that is limited to a set of atomic medical facts and augmented with a dynamic guidance mechanism that continuously detects and corrects hallucinations throughout the dialogue, ensuring internal coherence and clinical plausibility of the simulated cases. Furthermore, we propose a structured LLM-based and expert-annotated rubric-generation pipeline that retrieves Evidence-Based Medicine (EBM) guidelines and utilizes the reject sampling to derive a prioritized set of rubric items ("must-ask" items) for each case. We perform a comprehensive evaluation of state-of-the-art models and demonstrate that, across multiple assessment dimensions, current models face substantial challenges. Our results indicate that improving medical dialogue will require advances in dialogue management architectures, not just incremental tuning of the base-model.

Cross-modal reasoning (CMR), the intricate process of synthesizing and drawing inferences across divergent sensory modalities, is increasingly recognized as a crucial capability in the progression toward more sophisticated and anthropomorphic artificial intelligence systems. Large Language Models (LLMs) represent a class of AI algorithms specifically engineered to parse, produce, and engage with human language on an extensive scale. The recent trend of deploying LLMs to tackle CMR tasks has marked a new mainstream of approaches for enhancing their effectiveness. This survey offers a nuanced exposition of current methodologies applied in CMR using LLMs, classifying these into a detailed three-tiered taxonomy. Moreover, the survey delves into the principal design strategies and operational techniques of prototypical models within this domain. Additionally, it articulates the prevailing challenges associated with the integration of LLMs in CMR and identifies prospective research directions. To sum up, this survey endeavors to expedite progress within this burgeoning field by endowing scholars with a holistic and detailed vista, showcasing the vanguard of current research whilst pinpointing potential avenues for advancement. An associated GitHub repository that collects the relevant papers can be found at https://github.com/ZuyiZhou/Awesome-Cross-modal-Reasoning-with-LLMs

Multimodal large language models (MLLMs) must resolve conflicts when different modalities provide contradictory information, a process we term modality following. Prior work measured this behavior only with coarse dataset-level statistics, overlooking the influence of model's confidence in unimodal reasoning. In this paper, we introduce a new framework that decomposes modality following into two fundamental factors: relative reasoning uncertainty (the case-specific confidence gap between unimodal predictions) and inherent modality preference( a model's stable bias when uncertainties are balanced). To validate this framework, we construct a controllable dataset that systematically varies the reasoning difficulty of visual and textual inputs. Using entropy as a fine-grained uncertainty metric, we uncover a universal law: the probability of following a modality decreases monotonically as its relative uncertainty increases. At the relative difficulty level where the model tends to follow both modalities with comparable probability what we call the balance point, a practical indicator of the model's inherent preference. Unlike traditional macro-level ratios, this measure offers a more principled and less confounded way to characterize modality bias, disentangling it from unimodal capabilities and dataset artifacts. Further, by probing layer-wise predictions, we reveal the internal mechanism of oscillation: in ambiguous regions near the balance point, models vacillate between modalities across layers, explaining externally observed indecision. Together, these findings establish relative uncertainty and inherent preference as the two governing principles of modality following, offering both a quantitative framework and mechanistic insight into how MLLMs resolve conflicting information.

Modality following serves as the capacity of multimodal large language models (MLLMs) to selectively utilize multimodal contexts based on user instructions. It is fundamental to ensuring safety and reliability in real-world deployments. However, the underlying mechanisms governing this decision-making process remain poorly understood. In this paper, we investigate its working mechanism through an information flow lens. Our findings reveal that instruction tokens function as structural anchors for modality arbitration: Shallow attention layers perform non-selective information transfer, routing multimodal cues to these anchors as a latent buffer; Modality competition is resolved within deep attention layers guided by the instruction intent, while MLP layers exhibit semantic inertia, acting as an adversarial force. Furthermore, we identify a sparse set of specialized attention heads that drive this arbitration. Causal interventions demonstrate that manipulating a mere 5% of these critical heads can decrease the modality-following ratio by 60% through blocking, or increase it by 60% through targeted amplification of failed samples. Our work provides a substantial step toward model transparency and offers a principled framework for the orchestration of multimodal information in MLLMs.

Despite rapid progress in multimodal large language models (MLLMs) and emerging omni-modal architectures, current benchmarks remain limited in scope and integration, suffering from incomplete modality coverage, restricted interaction to text-centric outputs, and weak interdependence and complementarity among modalities. To bridge these gaps, we introduce FysicsWorld, the first unified full-modality benchmark that supports bidirectional input-output across image, video, audio, and text, enabling comprehensive any-to-any evaluation across understanding, generation, and reasoning. FysicsWorld encompasses 16 primary tasks and 3,268 curated samples, aggregated from over 40 high-quality sources and covering a rich set of open-domain categories with diverse question types. We also propose the Cross-Modal Complementarity Screening (CMCS) strategy integrated in a systematic data construction framework that produces omni-modal data for spoken interaction and fusion-dependent cross-modal reasoning. Through a comprehensive evaluation of over 30 state-of-the-art baselines, spanning MLLMs, modality-specific models, unified understanding-generation models, and omni-modal language models, FysicsWorld exposes the performance disparities and limitations across models in understanding, generation, and reasoning. Our benchmark establishes a unified foundation and strong baselines for evaluating and advancing next-generation full-modality architectures.

Text-to-image (T2I) generation models have significantly advanced in recent years. However, effective interaction with these models is challenging for average users due to the need for specialized prompt engineering knowledge and the inability to perform multi-turn image generation, hindering a dynamic and iterative creation process. Recent attempts have tried to equip Multi-modal Large Language Models (MLLMs) with T2I models to bring the user's natural language instructions into reality. Hence, the output modality of MLLMs is extended, and the multi-turn generation quality of T2I models is enhanced thanks to the strong multi-modal comprehension ability of MLLMs. However, many of these works face challenges in identifying correct output modalities and generating coherent images accordingly as the number of output modalities increases and the conversations go deeper. Therefore, we propose DialogGen, an effective pipeline to align off-the-shelf MLLMs and T2I models to build a Multi-modal Interactive Dialogue System (MIDS) for multi-turn Text-to-Image generation. It is composed of drawing prompt alignment, careful training data curation, and error correction. Moreover, as the field of MIDS flourishes, comprehensive benchmarks are urgently needed to evaluate MIDS fairly in terms of output modality correctness and multi-modal output coherence. To address this issue, we introduce the Multi-modal Dialogue Benchmark (DialogBen), a comprehensive bilingual benchmark designed to assess the ability of MLLMs to generate accurate and coherent multi-modal content that supports image editing. It contains two evaluation metrics to measure the model's ability to switch modalities and the coherence of the output images. Our extensive experiments on DialogBen and user study demonstrate the effectiveness of DialogGen compared with other State-of-the-Art models.