Daily Papers

The gigapixel scale of whole slide images (WSIs) poses a challenge for histopathology multi-modal chatbots, requiring a global WSI analysis for diagnosis, compounding evidence from different WSI patches. Current visual instruction datasets, generated through large language models, focus on creating question/answer pairs for individual image patches, which may lack diagnostic capacity on their own in histopathology, further complicated by the absence of spatial grounding in histopathology image captions. To bridge this gap, we introduce Quilt-Instruct, a large-scale dataset of 107,131 histopathology-specific instruction question/answer pairs, that is collected by leveraging educational histopathology videos from YouTube, which provides spatial localization of captions by automatically extracting narrators' cursor movements. In addition, we provide contextual reasoning by extracting diagnosis and supporting facts from the entire video content to guide the extrapolative reasoning of GPT-4. Using Quilt-Instruct, we train Quilt-LLaVA, which can reason beyond the given single image patch, enabling diagnostic reasoning and the capability of spatial awareness. To evaluate Quilt-LLaVA, we propose a comprehensive evaluation dataset created from 985 images and 1283 human-generated question-answers. We also thoroughly evaluate Quilt-LLaVA using public histopathology datasets, where Quilt-LLaVA significantly outperforms SOTA by over 10% on relative GPT-4 score and 4% and 9% on open and closed set VQA. Our code, data, and model are publicly available at quilt-llava.github.io.

Recent accelerations in multi-modal applications have been made possible with the plethora of image and text data available online. However, the scarcity of analogous data in the medical field, specifically in histopathology, has halted comparable progress. To enable similar representation learning for histopathology, we turn to YouTube, an untapped resource of videos, offering 1,087 hours of valuable educational histopathology videos from expert clinicians. From YouTube, we curate Quilt: a large-scale vision-language dataset consisting of 768,826 image and text pairs. Quilt was automatically curated using a mixture of models, including large language models, handcrafted algorithms, human knowledge databases, and automatic speech recognition. In comparison, the most comprehensive datasets curated for histopathology amass only around 200K samples. We combine Quilt with datasets from other sources, including Twitter, research papers, and the internet in general, to create an even larger dataset: Quilt-1M, with 1M paired image-text samples, marking it as the largest vision-language histopathology dataset to date. We demonstrate the value of Quilt-1M by fine-tuning a pre-trained CLIP model. Our model outperforms state-of-the-art models on both zero-shot and linear probing tasks for classifying new histopathology images across 13 diverse patch-level datasets of 8 different sub-pathologies and cross-modal retrieval tasks.

As advances in large language models (LLMs) and multimodal techniques continue to mature, the development of general-purpose multimodal large language models (MLLMs) has surged, offering significant applications in interpreting natural images. However, the field of pathology has largely remained untapped, particularly in gathering high-quality data and designing comprehensive model frameworks. To bridge the gap in pathology MLLMs, we present PathAsst, a multimodal generative foundation AI assistant to revolutionize diagnostic and predictive analytics in pathology. The development of PathAsst involves three pivotal steps: data acquisition, CLIP model adaptation, and the training of PathAsst's multimodal generative capabilities. Firstly, we collect over 207K high-quality pathology image-text pairs from authoritative sources. Leveraging the advanced power of ChatGPT, we generate over 180K instruction-following samples. Furthermore, we devise additional instruction-following data specifically tailored for invoking eight pathology-specific sub-models we prepared, allowing the PathAsst to effectively collaborate with these models, enhancing its diagnostic ability. Secondly, by leveraging the collected data, we construct PathCLIP, a pathology-dedicated CLIP, to enhance PathAsst's capabilities in interpreting pathology images. Finally, we integrate PathCLIP with the Vicuna-13b and utilize pathology-specific instruction-tuning data to enhance the multimodal generation capacity of PathAsst and bolster its synergistic interactions with sub-models. The experimental results of PathAsst show the potential of harnessing AI-powered generative foundation model to improve pathology diagnosis and treatment processes.

The accelerated adoption of digital pathology and advances in deep learning have enabled the development of powerful models for various pathology tasks across a diverse array of diseases and patient cohorts. However, model training is often difficult due to label scarcity in the medical domain and the model's usage is limited by the specific task and disease for which it is trained. Additionally, most models in histopathology leverage only image data, a stark contrast to how humans teach each other and reason about histopathologic entities. We introduce CONtrastive learning from Captions for Histopathology (CONCH), a visual-language foundation model developed using diverse sources of histopathology images, biomedical text, and notably over 1.17 million image-caption pairs via task-agnostic pretraining. Evaluated on a suite of 13 diverse benchmarks, CONCH can be transferred to a wide range of downstream tasks involving either or both histopathology images and text, achieving state-of-the-art performance on histology image classification, segmentation, captioning, text-to-image and image-to-text retrieval. CONCH represents a substantial leap over concurrent visual-language pretrained systems for histopathology, with the potential to directly facilitate a wide array of machine learning-based workflows requiring minimal or no further supervised fine-tuning.

Pathology text mining is a challenging task given the reporting variability and constant new findings in cancer sub-type definitions. However, successful text mining of a large pathology database can play a critical role to advance 'big data' cancer research like similarity-based treatment selection, case identification, prognostication, surveillance, clinical trial screening, risk stratification, and many others. While there is a growing interest in developing language models for more specific clinical domains, no pathology-specific language space exist to support the rapid data-mining development in pathology space. In literature, a few approaches fine-tuned general transformer models on specialized corpora while maintaining the original tokenizer, but in fields requiring specialized terminology, these models often fail to perform adequately. We propose PathologyBERT - a pre-trained masked language model which was trained on 347,173 histopathology specimen reports and publicly released in the Huggingface repository. Our comprehensive experiments demonstrate that pre-training of transformer model on pathology corpora yields performance improvements on Natural Language Understanding (NLU) and Breast Cancer Diagnose Classification when compared to nonspecific language models.

Despite the progress made by multimodal large language models (MLLMs) in computational pathology, they remain limited by a predominant focus on patch-level analysis, missing essential contextual information at the whole-slide level. The lack of large-scale instruction datasets and the gigapixel scale of whole slide images (WSIs) pose significant developmental challenges. In this paper, we present SlideChat, the first vision-language assistant capable of understanding gigapixel whole-slide images, exhibiting excellent multimodal conversational capability and response complex instruction across diverse pathology scenarios. To support its development, we created SlideInstruction, the largest instruction-following dataset for WSIs consisting of 4.2K WSI captions and 176K VQA pairs with multiple categories. Furthermore, we propose SlideBench, a multimodal benchmark that incorporates captioning and VQA tasks to assess SlideChat's capabilities in varied clinical settings such as microscopy, diagnosis. Compared to both general and specialized MLLMs, SlideChat exhibits exceptional capabilities achieving state-of-the-art performance on 18 of 22 tasks. For example, it achieved an overall accuracy of 81.17% on SlideBench-VQA (TCGA), and 54.15% on SlideBench-VQA (BCNB). We will fully release SlideChat, SlideInstruction and SlideBench as open-source resources to facilitate research and development in computational pathology.

This paper presents the development of a specialized chatbot for materials science, leveraging the Llama-2 language model, and continuing pre-training on the expansive research articles in the materials science domain from the S2ORC dataset. The methodology involves an initial pretraining phase on over one million domain-specific papers, followed by an instruction-tuning process to refine the chatbot's capabilities. The chatbot is designed to assist researchers, educators, and students by providing instant, context-aware responses to queries in the field of materials science. We make the four trained checkpoints (7B, 13B, with or without chat ability) freely available to the research community at https://github.com/Xianjun-Yang/Quokka.

Recent advancements in machine learning and natural language processing have led to the rapid development of artificial intelligence (AI) as a valuable tool in the healthcare industry. Using large language models (LLMs) as conversational agents or chatbots has the potential to assist doctors in diagnosing patients, detecting early symptoms of diseases, and providing health advice to patients. This paper focuses on the role of chatbots in healthcare and explores the use of avatars to make AI interactions more appealing to patients. A framework of a general-purpose AI avatar application is demonstrated by using a three-category prompt dictionary and prompt improvement mechanism. A two-phase approach is suggested to fine-tune a general-purpose AI language model and create different AI avatars to discuss medical issues with users. Prompt engineering enhances the chatbot's conversational abilities and personality traits, fostering a more human-like interaction with patients. Ultimately, the injection of personality into the chatbot could potentially increase patient engagement. Future directions for research include investigating ways to improve chatbots' understanding of context and ensuring the accuracy of their outputs through fine-tuning with specialized medical data sets.

Digital pathology enables automatic analysis of histopathological sections using artificial intelligence (AI). Automatic evaluation could improve diagnostic efficiency and help find associations between morphological features and clinical outcome. For development of such prediction models, identifying invasive epithelial cells, and separating these from benign epithelial cells and in situ lesions would be the first step. In this study, we aimed to develop an AI model for segmentation of epithelial cells in sections from breast cancer. We generated epithelial ground truth masks by restaining hematoxylin and eosin (HE) sections with cytokeratin (CK) AE1/AE3, and by pathologists' annotations. HE/CK image pairs were used to train a convolutional neural network, and data augmentation was used to make the model more robust. Tissue microarrays (TMAs) from 839 patients, and whole slide images from two patients were used for training and evaluation of the models. The sections were derived from four cohorts of breast cancer patients. TMAs from 21 patients from a fifth cohort was used as a second test set. In quantitative evaluation, a mean Dice score of 0.70, 0.79, and 0.75 for invasive epithelial cells, benign epithelial cells, and in situ lesions, respectively, were achieved. In qualitative scoring (0-5) by pathologists, results were best for all epithelium and invasive epithelium, with scores of 4.7 and 4.4. Scores for benign epithelium and in situ lesions were 3.7 and 2.0. The proposed model segmented epithelial cells in HE stained breast cancer slides well, but further work is needed for accurate division between the classes. Immunohistochemistry, together with pathologists' annotations, enabled the creation of accurate ground truths. The model is made freely available in FastPathology and the code is available at https://github.com/AICAN-Research/breast-epithelium-segmentation

Histopathology plays a central role in clinical medicine and biomedical research. While artificial intelligence shows promising results on many pathological tasks, generalization and dealing with rare diseases, where training data is scarce, remains a challenge. Distilling knowledge from unlabeled data into a foundation model before learning from, potentially limited, labeled data provides a viable path to address these challenges. In this work, we extend the state of the art of foundation models for digital pathology whole slide images by semi-automated data curation and incorporating pathologist domain knowledge. Specifically, we combine computational and pathologist domain knowledge (1) to curate a diverse dataset of 103k slides corresponding to 750 million image patches covering data from different fixation, staining, and scanning protocols as well as data from different indications and labs across the EU and US, (2) for grouping semantically similar slides and tissue patches, and (3) to augment the input images during training. We evaluate the resulting model on a set of public and internal benchmarks and show that although our foundation model is trained with an order of magnitude less slides, it performs on par or better than competing models. We expect that scaling our approach to more data and larger models will further increase its performance and capacity to deal with increasingly complex real world tasks in diagnostics and biomedical research.

Traditional applications of natural language processing (NLP) in healthcare have predominantly focused on patient-centered services, enhancing patient interactions and care delivery, such as through medical dialogue systems. However, the potential of NLP to benefit inexperienced doctors, particularly in areas such as communicative medical coaching, remains largely unexplored. We introduce ``ChatCoach,'' an integrated human-AI cooperative framework. Within this framework, both a patient agent and a coaching agent collaboratively support medical learners in practicing their medical communication skills during consultations. Unlike traditional dialogue systems, ChatCoach provides a simulated environment where a human doctor can engage in medical dialogue with a patient agent. Simultaneously, a coaching agent provides real-time feedback to the doctor. To construct the ChatCoach system, we developed a dataset and integrated Large Language Models such as ChatGPT and Llama2, aiming to assess their effectiveness in communicative medical coaching tasks. Our comparative analysis demonstrates that instruction-tuned Llama2 significantly outperforms ChatGPT's prompting-based approaches.

Recent advances in multi-modal algorithms have driven and been driven by the increasing availability of large image-text datasets, leading to significant strides in various fields, including computational pathology. However, in most existing medical image-text datasets, the text typically provides high-level summaries that may not sufficiently describe sub-tile regions within a large pathology image. For example, an image might cover an extensive tissue area containing cancerous and healthy regions, but the accompanying text might only specify that this image is a cancer slide, lacking the nuanced details needed for in-depth analysis. In this study, we introduce STimage-1K4M, a novel dataset designed to bridge this gap by providing genomic features for sub-tile images. STimage-1K4M contains 1,149 images derived from spatial transcriptomics data, which captures gene expression information at the level of individual spatial spots within a pathology image. Specifically, each image in the dataset is broken down into smaller sub-image tiles, with each tile paired with 15,000-30,000 dimensional gene expressions. With 4,293,195 pairs of sub-tile images and gene expressions, STimage-1K4M offers unprecedented granularity, paving the way for a wide range of advanced research in multi-modal data analysis an innovative applications in computational pathology, and beyond.

To facilitate the research on intelligent and human-like chatbots with multi-modal context, we introduce a new video-based multi-modal dialogue dataset, called TikTalk. We collect 38K videos from a popular video-sharing platform, along with 367K conversations posted by users beneath them. Users engage in spontaneous conversations based on their multi-modal experiences from watching videos, which helps recreate real-world chitchat context. Compared to previous multi-modal dialogue datasets, the richer context types in TikTalk lead to more diverse conversations, but also increase the difficulty in capturing human interests from intricate multi-modal information to generate personalized responses. Moreover, external knowledge is more frequently evoked in our dataset. These facts reveal new challenges for multi-modal dialogue models. We quantitatively demonstrate the characteristics of TikTalk, propose a video-based multi-modal chitchat task, and evaluate several dialogue baselines. Experimental results indicate that the models incorporating large language models (LLM) can generate more diverse responses, while the model utilizing knowledge graphs to introduce external knowledge performs the best overall. Furthermore, no existing model can solve all the above challenges well. There is still a large room for future improvements, even for LLM with visual extensions. Our dataset is available at https://ruc-aimind.github.io/projects/TikTalk/.

This paper proposes a chatbot framework that adopts a hybrid model which consists of a knowledge graph and a text similarity model. Based on this chatbot framework, we build HHH, an online question-and-answer (QA) Healthcare Helper system for answering complex medical questions. HHH maintains a knowledge graph constructed from medical data collected from the Internet. HHH also implements a novel text representation and similarity deep learning model, Hierarchical BiLSTM Attention Model (HBAM), to find the most similar question from a large QA dataset. We compare HBAM with other state-of-the-art language models such as bidirectional encoder representation from transformers (BERT) and Manhattan LSTM Model (MaLSTM). We train and test the models with a subset of the Quora duplicate questions dataset in the medical area. The experimental results show that our model is able to achieve a superior performance than these existing methods.

Pathology plays a critical role in diagnosing a wide range of diseases, yet existing approaches often rely heavily on task-specific models trained on extensive, well-labeled datasets. These methods face sustainability challenges due to the diversity of pathologies and the labor-intensive nature of data collection. To address these limitations, we highlight the need for universal multimodal embeddings that can support multiple downstream tasks. Previous approaches often involve fine-tuning CLIP-based models, which handle images and text separately, limiting their ability to capture complex multimodal relationships. Additionally, these models are evaluated across diverse datasets without a unified benchmark for assessing multimodal embeddings in pathology. To address these challenges, we propose MLLM4PUE, a novel framework that leverages Multimodal Large Language Models (MLLMs) to generate Pathology Universal Embeddings. The MLLM4PUE framework not only facilitates robust integration of images and text but also enhances understanding and fusion capabilities across various tasks. We further introduce the Pathology Multimodal Embedding Benchmark (PMEB), a comprehensive benchmark designed to assess the quality of pathology multimodal embeddings. PMEB comprises 15 original tasks drawn from 14 datasets, organized into three meta-tasks: retrieval, classification, and composed retrieval. Experimental results demonstrate the superiority of MLLM4PUE, illustrating MLLM-based models can effectively support a wide range of downstream tasks and unify the research direction for foundation models in pathology.

Chatbots are intelligent conversational computer systems designed to mimic human conversation to enable automated online guidance and support. The increased benefits of chatbots led to their wide adoption by many industries in order to provide virtual assistance to customers. Chatbots utilise methods and algorithms from two Artificial Intelligence domains: Natural Language Processing and Machine Learning. However, there are many challenges and limitations in their application. In this survey we review recent advances on chatbots, where Artificial Intelligence and Natural Language processing are used. We highlight the main challenges and limitations of current work and make recommendations for future research investigation.

Metadata are general characteristics of the data in a well-curated and condensed format, and have been proven to be useful for decision making, knowledge discovery, and also heterogeneous data organization of biobank. Among all data types in the biobank, pathology is the key component of the biobank and also serves as the gold standard of diagnosis. To maximize the utility of biobank and allow the rapid progress of biomedical science, it is essential to organize the data with well-populated pathology metadata. However, manual annotation of such information is tedious and time-consuming. In the study, we develop a multimodal multitask learning framework to predict four major slide-level metadata of pathology images. The framework learns generalizable representations across tissue slides, pathology reports, and case-level structured data. We demonstrate improved performance across all four tasks with the proposed method compared to a single modal single task baseline on two test sets, one external test set from a distinct data source (TCGA) and one internal held-out test set (TTH). In the test sets, the performance improvements on the averaged area under receiver operating characteristic curve across the four tasks are 16.48% and 9.05% on TCGA and TTH, respectively. Such pathology metadata prediction system may be adopted to mitigate the effort of expert annotation and ultimately accelerate the data-driven research by better utilization of the pathology biobank.

Cancer has relational information residing at varying scales, modalities, and resolutions of the acquired data, such as radiology, pathology, genomics, proteomics, and clinical records. Integrating diverse data types can improve the accuracy and reliability of cancer diagnosis and treatment. There can be disease-related information that is too subtle for humans or existing technological tools to discern visually. Traditional methods typically focus on partial or unimodal information about biological systems at individual scales and fail to encapsulate the complete spectrum of the heterogeneous nature of data. Deep neural networks have facilitated the development of sophisticated multimodal data fusion approaches that can extract and integrate relevant information from multiple sources. Recent deep learning frameworks such as Graph Neural Networks (GNNs) and Transformers have shown remarkable success in multimodal learning. This review article provides an in-depth analysis of the state-of-the-art in GNNs and Transformers for multimodal data fusion in oncology settings, highlighting notable research studies and their findings. We also discuss the foundations of multimodal learning, inherent challenges, and opportunities for integrative learning in oncology. By examining the current state and potential future developments of multimodal data integration in oncology, we aim to demonstrate the promising role that multimodal neural networks can play in cancer prevention, early detection, and treatment through informed oncology practices in personalized settings.

Vision Language Models (VLMs) like CLIP have attracted substantial attention in pathology, serving as backbones for applications such as zero-shot image classification and Whole Slide Image (WSI) analysis. Additionally, they can function as vision encoders when combined with large language models (LLMs) to support broader capabilities. Current efforts to train pathology VLMs rely on pathology image-text pairs from platforms like PubMed, YouTube, and Twitter, which provide limited, unscalable data with generally suboptimal image quality. In this work, we leverage large-scale WSI datasets like TCGA to extract numerous high-quality image patches. We then train a large multimodal model to generate captions for these images, creating PathGen-1.6M, a dataset containing 1.6 million high-quality image-caption pairs. Our approach involves multiple agent models collaborating to extract representative WSI patches, generating and refining captions to obtain high-quality image-text pairs. Extensive experiments show that integrating these generated pairs with existing datasets to train a pathology-specific CLIP model, PathGen-CLIP, significantly enhances its ability to analyze pathological images, with substantial improvements across nine pathology-related zero-shot image classification tasks and three whole-slide image tasks. Furthermore, we construct 200K instruction-tuning data based on PathGen-1.6M and integrate PathGen-CLIP with the Vicuna LLM to create more powerful multimodal models through instruction tuning. Overall, we provide a scalable pathway for high-quality data generation in pathology, paving the way for next-generation general pathology models.

Recent advancements in mixed-modal generative models have enabled flexible integration of information across image-text content. These models have opened new avenues for developing unified biomedical assistants capable of analyzing biomedical images, answering complex questions about them, and predicting the impact of medical procedures on a patient's health. However, existing resources face challenges such as limited data availability, narrow domain coverage, and restricted sources (e.g., medical papers). To address these gaps, we present MedMax, the first large-scale multimodal biomedical instruction-tuning dataset for mixed-modal foundation models. With 1.47 million instances, MedMax encompasses a diverse range of tasks, including multimodal content generation (interleaved image-text data), biomedical image captioning and generation, visual chatting, and report understanding. These tasks span diverse medical domains such as radiology and histopathology. Subsequently, we fine-tune a mixed-modal foundation model on the MedMax dataset, achieving significant performance improvements: a 26% gain over the Chameleon model and an 18.3% improvement over GPT-4o across 12 downstream biomedical visual question-answering tasks. Additionally, we introduce a unified evaluation suite for biomedical tasks, providing a robust framework to guide the development of next-generation mixed-modal biomedical AI assistants.

Conversation agents powered by large language models are revolutionizing the way we interact with visual data. Recently, large vision-language models (LVLMs) have been extensively studied for both images and videos. However, these studies typically focus on common scenarios. In this work, we introduce an LVLM specifically designed for surgical scenarios. We integrate visual representations of surgical images and videos into the language feature space. Consequently, we establish a LVLM model, Surgical-LLaVA, fine-tuned on instruction following data of surgical scenarios. Our experiments demonstrate that Surgical-LLaVA exhibits impressive multi-modal chat abilities in surgical contexts, occasionally displaying multi-modal behaviors on unseen instructions. We conduct a quantitative evaluation of visual question-answering datasets for surgical scenarios. The results show superior performance compared to previous works, indicating the potential of our model to tackle more complex surgery scenarios.

This paper presents our team's participation in the MEDIQA-ClinicalNLP2024 shared task B. We present a novel approach to diagnosing clinical dermatology cases by integrating large multimodal models, specifically leveraging the capabilities of GPT-4V under a retriever and a re-ranker framework. Our investigation reveals that GPT-4V, when used as a retrieval agent, can accurately retrieve the correct skin condition 85% of the time using dermatological images and brief patient histories. Additionally, we empirically show that Naive Chain-of-Thought (CoT) works well for retrieval while Medical Guidelines Grounded CoT is required for accurate dermatological diagnosis. Further, we introduce a Multi-Agent Conversation (MAC) framework and show its superior performance and potential over the best CoT strategy. The experiments suggest that using naive CoT for retrieval and multi-agent conversation for critique-based diagnosis, GPT-4V can lead to an early and accurate diagnosis of dermatological conditions. The implications of this work extend to improving diagnostic workflows, supporting dermatological education, and enhancing patient care by providing a scalable, accessible, and accurate diagnostic tool.

Advancing AI in computational pathology requires large, high-quality, and diverse datasets, yet existing public datasets are often limited in organ diversity, class coverage, or annotation quality. To bridge this gap, we introduce SPIDER (Supervised Pathology Image-DEscription Repository), the largest publicly available patch-level dataset covering multiple organ types, including Skin, Colorectal, and Thorax, with comprehensive class coverage for each organ. SPIDER provides high-quality annotations verified by expert pathologists and includes surrounding context patches, which enhance classification performance by providing spatial context. Alongside the dataset, we present baseline models trained on SPIDER using the Hibou-L foundation model as a feature extractor combined with an attention-based classification head. The models achieve state-of-the-art performance across multiple tissue categories and serve as strong benchmarks for future digital pathology research. Beyond patch classification, the model enables rapid identification of significant areas, quantitative tissue metrics, and establishes a foundation for multimodal approaches. Both the dataset and trained models are publicly available to advance research, reproducibility, and AI-driven pathology development. Access them at: https://github.com/HistAI/SPIDER

The rise of large language models (LLMs) has revolutionized user interactions with knowledge-based systems, enabling chatbots to synthesize vast amounts of information and assist with complex, exploratory tasks. However, LLM-based chatbots often struggle to provide personalized support, particularly when users start with vague queries or lack sufficient contextual information. This paper introduces the Collaborative Assistant for Personalized Exploration (CARE), a system designed to enhance personalization in exploratory tasks by combining a multi-agent LLM framework with a structured user interface. CARE's interface consists of a Chat Panel, Solution Panel, and Needs Panel, enabling iterative query refinement and dynamic solution generation. The multi-agent framework collaborates to identify both explicit and implicit user needs, delivering tailored, actionable solutions. In a within-subject user study with 22 participants, CARE was consistently preferred over a baseline LLM chatbot, with users praising its ability to reduce cognitive load, inspire creativity, and provide more tailored solutions. Our findings highlight CARE's potential to transform LLM-based systems from passive information retrievers to proactive partners in personalized problem-solving and exploration.

The emergence of large multimodal models has unlocked remarkable potential in AI, particularly in pathology. However, the lack of specialized, high-quality benchmark impeded their development and precise evaluation. To address this, we introduce PathMMU, the largest and highest-quality expert-validated pathology benchmark for LMMs. It comprises 33,573 multimodal multi-choice questions and 21,599 images from various sources, and an explanation for the correct answer accompanies each question. The construction of PathMMU capitalizes on the robust capabilities of GPT-4V, utilizing approximately 30,000 gathered image-caption pairs to generate Q\&As. Significantly, to maximize PathMMU's authority, we invite six pathologists to scrutinize each question under strict standards in PathMMU's validation and test sets, while simultaneously setting an expert-level performance benchmark for PathMMU. We conduct extensive evaluations, including zero-shot assessments of 14 open-sourced and three closed-sourced LMMs and their robustness to image corruption. We also fine-tune representative LMMs to assess their adaptability to PathMMU. The empirical findings indicate that advanced LMMs struggle with the challenging PathMMU benchmark, with the top-performing LMM, GPT-4V, achieving only a 51.7\% zero-shot performance, significantly lower than the 71.4\% demonstrated by human pathologists. After fine-tuning, even open-sourced LMMs can surpass GPT-4V with a performance of over 60\%, but still fall short of the expertise shown by pathologists. We hope that the PathMMU will offer valuable insights and foster the development of more specialized, next-generation LLMs for pathology.

The field of computational pathology has been transformed with recent advances in foundation models that encode histopathology region-of-interests (ROIs) into versatile and transferable feature representations via self-supervised learning (SSL). However, translating these advancements to address complex clinical challenges at the patient and slide level remains constrained by limited clinical data in disease-specific cohorts, especially for rare clinical conditions. We propose TITAN, a multimodal whole slide foundation model pretrained using 335,645 WSIs via visual self-supervised learning and vision-language alignment with corresponding pathology reports and 423,122 synthetic captions generated from a multimodal generative AI copilot for pathology. Without any finetuning or requiring clinical labels, TITAN can extract general-purpose slide representations and generate pathology reports that generalize to resource-limited clinical scenarios such as rare disease retrieval and cancer prognosis. We evaluate TITAN on diverse clinical tasks and find that TITAN outperforms both ROI and slide foundation models across machine learning settings such as linear probing, few-shot and zero-shot classification, rare cancer retrieval and cross-modal retrieval, and pathology report generation.

As Large Language Models (LLMs) rapidly evolve, their influence in science is becoming increasingly prominent. The emerging capabilities of LLMs in task generalization and free-form dialogue can significantly advance fields like chemistry and biology. However, the field of single-cell biology, which forms the foundational building blocks of living organisms, still faces several challenges. High knowledge barriers and limited scalability in current methods restrict the full exploitation of LLMs in mastering single-cell data, impeding direct accessibility and rapid iteration. To this end, we introduce ChatCell, which signifies a paradigm shift by facilitating single-cell analysis with natural language. Leveraging vocabulary adaptation and unified sequence generation, ChatCell has acquired profound expertise in single-cell biology and the capability to accommodate a diverse range of analysis tasks. Extensive experiments further demonstrate ChatCell's robust performance and potential to deepen single-cell insights, paving the way for more accessible and intuitive exploration in this pivotal field. Our project homepage is available at https://zjunlp.github.io/project/ChatCell.

Biomedical data is inherently multimodal, consisting of electronic health records, medical imaging, digital pathology, genome sequencing, wearable sensors, and more. The application of artificial intelligence tools to these multifaceted sensing technologies has the potential to revolutionize the prognosis, diagnosis, and management of human health and disease. However, current approaches to biomedical AI typically only train and evaluate with one or a small set of medical modalities and tasks. This limitation hampers the development of comprehensive tools that can leverage the rich interconnected information across many heterogeneous biomedical sensors. To address this challenge, we present MultiMed, a benchmark designed to evaluate and enable large-scale learning across a wide spectrum of medical modalities and tasks. MultiMed consists of 2.56 million samples across ten medical modalities such as medical reports, pathology, genomics, and protein data, and is structured into eleven challenging tasks, including disease prognosis, protein structure prediction, and medical question answering. Using MultiMed, we conduct comprehensive experiments benchmarking state-of-the-art unimodal, multimodal, and multitask models. Our analysis highlights the advantages of training large-scale medical models across many related modalities and tasks. Moreover, MultiMed enables studies of generalization across related medical concepts, robustness to real-world noisy data and distribution shifts, and novel modality combinations to improve prediction performance. MultiMed will be publicly available and regularly updated and welcomes inputs from the community.

In this paper, we propose MPC (Modular Prompted Chatbot), a new approach for creating high-quality conversational agents without the need for fine-tuning. Our method utilizes pre-trained large language models (LLMs) as individual modules for long-term consistency and flexibility, by using techniques such as few-shot prompting, chain-of-thought (CoT), and external memory. Our human evaluation results show that MPC is on par with fine-tuned chatbot models in open-domain conversations, making it an effective solution for creating consistent and engaging chatbots.

Deep learning models have shown promise in histopathology image analysis, but their opaque decision-making process poses challenges in high-risk medical scenarios. Here we introduce HIPPO, an explainable AI method that interrogates attention-based multiple instance learning (ABMIL) models in computational pathology by generating counterfactual examples through tissue patch modifications in whole slide images. Applying HIPPO to ABMIL models trained to detect breast cancer metastasis reveals that they may overlook small tumors and can be misled by non-tumor tissue, while attention mapsx2014widely used for interpretationx2014often highlight regions that do not directly influence predictions. By interpreting ABMIL models trained on a prognostic prediction task, HIPPO identified tissue areas with stronger prognostic effects than high-attention regions, which sometimes showed counterintuitive influences on risk scores. These findings demonstrate HIPPO's capacity for comprehensive model evaluation, bias detection, and quantitative hypothesis testing. HIPPO greatly expands the capabilities of explainable AI tools to assess the trustworthy and reliable development, deployment, and regulation of weakly-supervised models in computational pathology.

Enterprise chatbots, powered by generative AI, are emerging as key applications to enhance employee productivity. Retrieval Augmented Generation (RAG), Large Language Models (LLMs), and orchestration frameworks like Langchain and Llamaindex are crucial for building these chatbots. However, creating effective enterprise chatbots is challenging and requires meticulous RAG pipeline engineering. This includes fine-tuning embeddings and LLMs, extracting documents from vector databases, rephrasing queries, reranking results, designing prompts, honoring document access controls, providing concise responses, including references, safeguarding personal information, and building orchestration agents. We present a framework for building RAG-based chatbots based on our experience with three NVIDIA chatbots: for IT/HR benefits, financial earnings, and general content. Our contributions are three-fold: introducing the FACTS framework (Freshness, Architectures, Cost, Testing, Security), presenting fifteen RAG pipeline control points, and providing empirical results on accuracy-latency tradeoffs between large and small LLMs. To the best of our knowledge, this is the first paper of its kind that provides a holistic view of the factors as well as solutions for building secure enterprise-grade chatbots."

Foundation models in computational pathology promise to unlock the development of new clinical decision support systems and models for precision medicine. However, there is a mismatch between most clinical analysis, which is defined at the level of one or more whole slide images, and foundation models to date, which process the thousands of image tiles contained in a whole slide image separately. The requirement to train a network to aggregate information across a large number of tiles in multiple whole slide images limits these models' impact. In this work, we present a slide-level foundation model for H&E-stained histopathology, PRISM, that builds on Virchow tile embeddings and leverages clinical report text for pre-training. Using the tile embeddings, PRISM produces slide-level embeddings with the ability to generate clinical reports, resulting in several modes of use. Using text prompts, PRISM achieves zero-shot cancer detection and sub-typing performance approaching and surpassing that of a supervised aggregator model. Using the slide embeddings with linear classifiers, PRISM surpasses supervised aggregator models. Furthermore, we demonstrate that fine-tuning of the PRISM slide encoder yields label-efficient training for biomarker prediction, a task that typically suffers from low availability of training data; an aggregator initialized with PRISM and trained on as little as 10% of the training data can outperform a supervised baseline that uses all of the data.

Pathology is the study of microscopic inspection of tissue, and a pathology diagnosis is often the medical gold standard to diagnose disease. Pathology images provide a unique challenge for computer-vision-based analysis: a single pathology Whole Slide Image (WSI) is gigapixel-sized and often contains hundreds of thousands to millions of objects of interest across multiple resolutions. In this work, we propose PathoLogy Universal TransfOrmer (PLUTO): a light-weight pathology FM that is pre-trained on a diverse dataset of 195 million image tiles collected from multiple sites and extracts meaningful representations across multiple WSI scales that enable a large variety of downstream pathology tasks. In particular, we design task-specific adaptation heads that utilize PLUTO's output embeddings for tasks which span pathology scales ranging from subcellular to slide-scale, including instance segmentation, tile classification, and slide-level prediction. We compare PLUTO's performance to other state-of-the-art methods on a diverse set of external and internal benchmarks covering multiple biologically relevant tasks, tissue types, resolutions, stains, and scanners. We find that PLUTO matches or outperforms existing task-specific baselines and pathology-specific foundation models, some of which use orders-of-magnitude larger datasets and model sizes when compared to PLUTO. Our findings present a path towards a universal embedding to power pathology image analysis, and motivate further exploration around pathology foundation models in terms of data diversity, architectural improvements, sample efficiency, and practical deployability in real-world applications.

With the rapid advances in high-throughput sequencing technologies, the focus of survival analysis has shifted from examining clinical indicators to incorporating genomic profiles with pathological images. However, existing methods either directly adopt a straightforward fusion of pathological features and genomic profiles for survival prediction, or take genomic profiles as guidance to integrate the features of pathological images. The former would overlook intrinsic cross-modal correlations. The latter would discard pathological information irrelevant to gene expression. To address these issues, we present a Cross-Modal Translation and Alignment (CMTA) framework to explore the intrinsic cross-modal correlations and transfer potential complementary information. Specifically, we construct two parallel encoder-decoder structures for multi-modal data to integrate intra-modal information and generate cross-modal representation. Taking the generated cross-modal representation to enhance and recalibrate intra-modal representation can significantly improve its discrimination for comprehensive survival analysis. To explore the intrinsic crossmodal correlations, we further design a cross-modal attention module as the information bridge between different modalities to perform cross-modal interactions and transfer complementary information. Our extensive experiments on five public TCGA datasets demonstrate that our proposed framework outperforms the state-of-the-art methods.

This paper presents the first few-shot LLM-based chatbot that almost never hallucinates and has high conversationality and low latency. WikiChat is grounded on the English Wikipedia, the largest curated free-text corpus. WikiChat generates a response from an LLM, retains only the grounded facts, and combines them with additional information it retrieves from the corpus to form factual and engaging responses. We distill WikiChat based on GPT-4 into a 7B-parameter LLaMA model with minimal loss of quality, to significantly improve its latency, cost and privacy, and facilitate research and deployment. Using a novel hybrid human-and-LLM evaluation methodology, we show that our best system achieves 97.3% factual accuracy in simulated conversations. It significantly outperforms all retrieval-based and LLM-based baselines, and by 3.9%, 38.6% and 51.0% on head, tail and recent knowledge compared to GPT-4. Compared to previous state-of-the-art retrieval-based chatbots, WikiChat is also significantly more informative and engaging, just like an LLM. WikiChat achieves 97.9% factual accuracy in conversations with human users about recent topics, 55.0% better than GPT-4, while receiving significantly higher user ratings and more favorable comments.

Medicine is inherently multimodal, with rich data modalities spanning text, imaging, genomics, and more. Generalist biomedical artificial intelligence (AI) systems that flexibly encode, integrate, and interpret this data at scale can potentially enable impactful applications ranging from scientific discovery to care delivery. To enable the development of these models, we first curate MultiMedBench, a new multimodal biomedical benchmark. MultiMedBench encompasses 14 diverse tasks such as medical question answering, mammography and dermatology image interpretation, radiology report generation and summarization, and genomic variant calling. We then introduce Med-PaLM Multimodal (Med-PaLM M), our proof of concept for a generalist biomedical AI system. Med-PaLM M is a large multimodal generative model that flexibly encodes and interprets biomedical data including clinical language, imaging, and genomics with the same set of model weights. Med-PaLM M reaches performance competitive with or exceeding the state of the art on all MultiMedBench tasks, often surpassing specialist models by a wide margin. We also report examples of zero-shot generalization to novel medical concepts and tasks, positive transfer learning across tasks, and emergent zero-shot medical reasoning. To further probe the capabilities and limitations of Med-PaLM M, we conduct a radiologist evaluation of model-generated (and human) chest X-ray reports and observe encouraging performance across model scales. In a side-by-side ranking on 246 retrospective chest X-rays, clinicians express a pairwise preference for Med-PaLM M reports over those produced by radiologists in up to 40.50% of cases, suggesting potential clinical utility. While considerable work is needed to validate these models in real-world use cases, our results represent a milestone towards the development of generalist biomedical AI systems.

The increasing interest in developing Artificial Intelligence applications in the medical domain, suffers from the lack of high-quality dataset, mainly due to privacy-related issues. Moreover, the recent rising of Multimodal Large Language Models (MLLM) leads to a need for multimodal medical datasets, where clinical reports and findings are attached to the corresponding CT or MR scans. This paper illustrates the entire workflow for building the data set MedPix 2.0. Starting from the well-known multimodal dataset MedPix\textregistered, mainly used by physicians, nurses and healthcare students for Continuing Medical Education purposes, a semi-automatic pipeline was developed to extract visual and textual data followed by a manual curing procedure where noisy samples were removed, thus creating a MongoDB database. Along with the dataset, we developed a GUI aimed at navigating efficiently the MongoDB instance, and obtaining the raw data that can be easily used for training and/or fine-tuning MLLMs. To enforce this point, we also propose a CLIP-based model trained on MedPix 2.0 for scan classification tasks.

This paper introduces MedTrinity-25M, a comprehensive, large-scale multimodal dataset for medicine, covering over 25 million images across 10 modalities, with multigranular annotations for more than 65 diseases. These enriched annotations encompass both global textual information, such as disease/lesion type, modality, region-specific descriptions, and inter-regional relationships, as well as detailed local annotations for regions of interest (ROIs), including bounding boxes, segmentation masks. Unlike existing approach which is limited by the availability of image-text pairs, we have developed the first automated pipeline that scales up multimodal data by generating multigranular visual and texual annotations (in the form of image-ROI-description triplets) without the need for any paired text descriptions. Specifically, data from over 90 different sources have been collected, preprocessed, and grounded using domain-specific expert models to identify ROIs related to abnormal regions. We then build a comprehensive knowledge base and prompt multimodal large language models to perform retrieval-augmented generation with the identified ROIs as guidance, resulting in multigranular texual descriptions. Compared to existing datasets, MedTrinity-25M provides the most enriched annotations, supporting a comprehensive range of multimodal tasks such as captioning and report generation, as well as vision-centric tasks like classification and segmentation. Pretraining on MedTrinity-25M, our model achieves state-of-the-art performance on VQA-RAD and PathVQA, surpassing both multimodal large language models and other representative SoTA approaches. This dataset can also be utilized to support large-scale pre-training of multimodal medical AI models, contributing to the development of future foundation models in the medical domain.

With the rapid development of computational pathology, many AI-assisted diagnostic tasks have emerged. Cellular nuclei segmentation can segment various types of cells for downstream analysis, but it relies on predefined categories and lacks flexibility. Moreover, pathology visual question answering can perform image-level understanding but lacks region-level detection capability. To address this, we propose a new benchmark called Pathology Visual Grounding (PathVG), which aims to detect regions based on expressions with different attributes. To evaluate PathVG, we create a new dataset named RefPath which contains 27,610 images with 33,500 language-grounded boxes. Compared to visual grounding in other domains, PathVG presents pathological images at multi-scale and contains expressions with pathological knowledge. In the experimental study, we found that the biggest challenge was the implicit information underlying the pathological expressions. Based on this, we proposed Pathology Knowledge-enhanced Network (PKNet) as the baseline model for PathVG. PKNet leverages the knowledge-enhancement capabilities of Large Language Models (LLMs) to convert pathological terms with implicit information into explicit visual features, and fuses knowledge features with expression features through the designed Knowledge Fusion Module (KFM). The proposed method achieves state-of-the-art performance on the PathVG benchmark.

Conversational generative AI has demonstrated remarkable promise for empowering biomedical practitioners, but current investigations focus on unimodal text. Multimodal conversational AI has seen rapid progress by leveraging billions of image-text pairs from the public web, but such general-domain vision-language models still lack sophistication in understanding and conversing about biomedical images. In this paper, we propose a cost-efficient approach for training a vision-language conversational assistant that can answer open-ended research questions of biomedical images. The key idea is to leverage a large-scale, broad-coverage biomedical figure-caption dataset extracted from PubMed Central, use GPT-4 to self-instruct open-ended instruction-following data from the captions, and then fine-tune a large general-domain vision-language model using a novel curriculum learning method. Specifically, the model first learns to align biomedical vocabulary using the figure-caption pairs as is, then learns to master open-ended conversational semantics using GPT-4 generated instruction-following data, broadly mimicking how a layperson gradually acquires biomedical knowledge. This enables us to train a Large Language and Vision Assistant for BioMedicine (LLaVA-Med) in less than 15 hours (with eight A100s). LLaVA-Med exhibits excellent multimodal conversational capability and can follow open-ended instruction to assist with inquiries about a biomedical image. On three standard biomedical visual question answering datasets, LLaVA-Med outperforms previous supervised state-of-the-art on certain metrics. To facilitate biomedical multimodal research, we will release our instruction-following data and the LLaVA-Med model.

Large language models (LLMs) have shown remarkable progress in encoding clinical knowledge and responding to complex medical queries with appropriate clinical reasoning. However, their applicability in subspecialist or complex medical settings remains underexplored. In this work, we probe the performance of AMIE, a research conversational diagnostic AI system, in the subspecialist domain of breast oncology care without specific fine-tuning to this challenging domain. To perform this evaluation, we curated a set of 50 synthetic breast cancer vignettes representing a range of treatment-naive and treatment-refractory cases and mirroring the key information available to a multidisciplinary tumor board for decision-making (openly released with this work). We developed a detailed clinical rubric for evaluating management plans, including axes such as the quality of case summarization, safety of the proposed care plan, and recommendations for chemotherapy, radiotherapy, surgery and hormonal therapy. To improve performance, we enhanced AMIE with the inference-time ability to perform web search retrieval to gather relevant and up-to-date clinical knowledge and refine its responses with a multi-stage self-critique pipeline. We compare response quality of AMIE with internal medicine trainees, oncology fellows, and general oncology attendings under both automated and specialist clinician evaluations. In our evaluations, AMIE outperformed trainees and fellows demonstrating the potential of the system in this challenging and important domain. We further demonstrate through qualitative examples, how systems such as AMIE might facilitate conversational interactions to assist clinicians in their decision making. However, AMIE's performance was overall inferior to attending oncologists suggesting that further research is needed prior to consideration of prospective uses.

Radiology reporting generative AI holds significant potential to alleviate clinical workloads and streamline medical care. However, achieving high clinical accuracy is challenging, as radiological images often feature subtle lesions and intricate structures. Existing systems often fall short, largely due to their reliance on fixed size, patch-level image features and insufficient incorporation of pathological information. This can result in the neglect of such subtle patterns and inconsistent descriptions of crucial pathologies. To address these challenges, we propose an innovative approach that leverages pathology-aware regional prompts to explicitly integrate anatomical and pathological information of various scales, significantly enhancing the precision and clinical relevance of generated reports. We develop an anatomical region detector that extracts features from distinct anatomical areas, coupled with a novel multi-label lesion detector that identifies global pathologies. Our approach emulates the diagnostic process of radiologists, producing clinically accurate reports with comprehensive diagnostic capabilities. Experimental results show that our model outperforms previous state-of-the-art methods on most natural language generation and clinical efficacy metrics, with formal expert evaluations affirming its potential to enhance radiology practice.

Developing accurate machine learning models for oncology requires large-scale, high-quality multimodal datasets. However, creating such datasets remains challenging due to the complexity and heterogeneity of medical data. To address this challenge, we introduce HoneyBee, a scalable modular framework for building multimodal oncology datasets that leverages foundational models to generate representative embeddings. HoneyBee integrates various data modalities, including clinical records, imaging data, and patient outcomes. It employs data preprocessing techniques and transformer-based architectures to generate embeddings that capture the essential features and relationships within the raw medical data. The generated embeddings are stored in a structured format using Hugging Face datasets and PyTorch dataloaders for accessibility. Vector databases enable efficient querying and retrieval for machine learning applications. We demonstrate the effectiveness of HoneyBee through experiments assessing the quality and representativeness of the embeddings. The framework is designed to be extensible to other medical domains and aims to accelerate oncology research by providing high-quality, machine learning-ready datasets. HoneyBee is an ongoing open-source effort, and the code, datasets, and models are available at the project repository.

Building an intelligent and efficient medical assistant is still a challenging AI problem. The major limitation comes from the data modality scarceness, which reduces comprehensive patient perception. This demo paper presents the GigaPevt, the first multimodal medical assistant that combines the dialog capabilities of large language models with specialized medical models. Such an approach shows immediate advantages in dialog quality and metric performance, with a 1.18% accuracy improvement in the question-answering task.

This paper presents ChatCounselor, a large language model (LLM) solution designed to provide mental health support. Unlike generic chatbots, ChatCounselor is distinguished by its foundation in real conversations between consulting clients and professional psychologists, enabling it to possess specialized knowledge and counseling skills in the field of psychology. The training dataset, Psych8k, was constructed from 260 in-depth interviews, each spanning an hour. To assess the quality of counseling responses, the counseling Bench was devised. Leveraging GPT-4 and meticulously crafted prompts based on seven metrics of psychological counseling assessment, the model underwent evaluation using a set of real-world counseling questions. Impressively, ChatCounselor surpasses existing open-source models in the counseling Bench and approaches the performance level of ChatGPT, showcasing the remarkable enhancement in model capability attained through high-quality domain-specific data.

Chatbots are designed to carry out human-like conversations across different domains, such as general chit-chat, knowledge exchange, and persona-grounded conversations. To measure the quality of such conversational agents, a dialogue evaluator is expected to conduct assessment across domains as well. However, most of the state-of-the-art automatic dialogue evaluation metrics (ADMs) are not designed for multi-domain evaluation. We are motivated to design a general and robust framework, MDD-Eval, to address the problem. Specifically, we first train a teacher evaluator with human-annotated data to acquire a rating skill to tell good dialogue responses from bad ones in a particular domain and then, adopt a self-training strategy to train a new evaluator with teacher-annotated multi-domain data, that helps the new evaluator to generalize across multiple domains. MDD-Eval is extensively assessed on six dialogue evaluation benchmarks. Empirical results show that the MDD-Eval framework achieves a strong performance with an absolute improvement of 7% over the state-of-the-art ADMs in terms of mean Spearman correlation scores across all the evaluation benchmarks.

In the field of natural language processing, open-domain chatbots have emerged as an important research topic. However, a major limitation of existing open-domain chatbot research is its singular focus on short single-session dialogue, neglecting the potential need for understanding contextual information in multiple consecutive sessions that precede an ongoing dialogue. Among the elements that compose the context in multi-session conversation settings, the time intervals between sessions and the relationships between speakers would be particularly important. Despite their importance, current research efforts have not sufficiently addressed these dialogical components. In this paper, we introduce a new 1M multi-session dialogue dataset, called Conversation Chronicles, for implementing a long-term conversation setup in which time intervals and fine-grained speaker relationships are incorporated. Following recent works, we exploit a large language model to produce the data. The extensive human evaluation shows that dialogue episodes in Conversation Chronicles reflect those properties while maintaining coherent and consistent interactions across all the sessions. We also propose a dialogue model, called ReBot, which consists of chronological summarization and dialogue generation modules using only around 630M parameters. When trained on Conversation Chronicles, ReBot demonstrates long-term context understanding with a high human engagement score.

In this paper we present a hybrid method for the automatic detection of dermatological pathologies in medical reports. We use a large language model combined with medical ontologies to predict, given a first appointment or follow-up medical report, the pathology a person may suffer from. The results show that teaching the model to learn the type, severity and location on the body of a dermatological pathology, as well as in which order it has to learn these three features, significantly increases its accuracy. The article presents the demonstration of state-of-the-art results for classification of medical texts with a precision of 0.84, micro and macro F1-score of 0.82 and 0.75, and makes both the method and the data set used available to the community.

Persuasion plays a pivotal role in a wide range of applications from health intervention to the promotion of social good. Persuasive chatbots can accelerate the positive effects of persuasion in such applications. Existing methods rely on fine-tuning persuasive chatbots with task-specific training data which is costly, if not infeasible, to collect. To address this issue, we propose a method to leverage the generalizability and inherent persuasive abilities of large language models (LLMs) in creating effective and truthful persuasive chatbot for any given domain in a zero-shot manner. Unlike previous studies which used pre-defined persuasion strategies, our method first uses an LLM to generate responses, then extracts the strategies used on the fly, and replaces any unsubstantiated claims in the response with retrieved facts supporting the strategies. We applied our chatbot, PersuaBot, to three significantly different domains needing persuasion skills: donation solicitation, recommendations, and health intervention. Our experiments on simulated and human conversations show that our zero-shot approach is more persuasive than prior work, while achieving factual accuracy surpassing state-of-the-art knowledge-oriented chatbots. Our study demonstrated that when persuasive chatbots are employed responsibly for social good, it is an enabler of positive individual and social change.

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.

Documentation burden is a major contributor to clinician burnout, which is rising nationally and is an urgent threat to our ability to care for patients. Artificial intelligence (AI) chatbots, such as ChatGPT, could reduce clinician burden by assisting with documentation. Although many hospitals are actively integrating such systems into electronic medical record systems, AI chatbots utility and impact on clinical decision-making have not been studied for this intended use. We are the first to examine the utility of large language models in assisting clinicians draft responses to patient questions. In our two-stage cross-sectional study, 6 oncologists responded to 100 realistic synthetic cancer patient scenarios and portal messages developed to reflect common medical situations, first manually, then with AI assistance. We find AI-assisted responses were longer, less readable, but provided acceptable drafts without edits 58% of time. AI assistance improved efficiency 77% of time, with low harm risk (82% safe). However, 7.7% unedited AI responses could severely harm. In 31% cases, physicians thought AI drafts were human-written. AI assistance led to more patient education recommendations, fewer clinical actions than manual responses. Results show promise for AI to improve clinician efficiency and patient care through assisting documentation, if used judiciously. Monitoring model outputs and human-AI interaction remains crucial for safe implementation.

Large Language Models (LLMs), such as ChatGPT, are becoming increasingly sophisticated, demonstrating capabilities that closely resemble those of humans. These AI models are playing an essential role in assisting humans with a wide array of tasks in daily life. A significant application of AI is its use as a chat agent, responding to human inquiries across various domains. Current LLMs have shown proficiency in answering general questions. However, basic question-answering dialogue often falls short in complex diagnostic scenarios, such as legal or medical consultations. These scenarios typically necessitate Task-Oriented Dialogue (TOD), wherein an AI chat agent needs to proactively pose questions and guide users towards specific task completion. Previous fine-tuning models have underperformed in TOD, and current LLMs do not inherently possess this capability. In this paper, we introduce DiagGPT (Dialogue in Diagnosis GPT), an innovative method that extends LLMs to TOD scenarios. Our experiments reveal that DiagGPT exhibits outstanding performance in conducting TOD with users, demonstrating its potential for practical applications.

Educational chatbots are a promising tool for assisting student learning. However, the development of effective chatbots in education has been challenging, as high-quality data is seldom available in this domain. In this paper, we propose a framework for generating synthetic teacher-student interactions grounded in a set of textbooks. Our approaches capture one aspect of learning interactions where curious students with partial knowledge interactively ask a teacher questions about the material in the textbook. We highlight various quality criteria that such dialogues should fulfill and compare several approaches relying on either prompting or fine-tuning large language models. We use synthetic dialogues to train educational chatbots and show benefits of further fine-tuning in different educational domains. However, human evaluation shows that our best data synthesis method still suffers from hallucinations and tends to reiterate information from previous conversations. Our findings offer insights for future efforts in synthesizing conversational data that strikes a balance between size and quality. We will open-source our data and code.

Building open-domain chatbots is a challenging area for machine learning research. While prior work has shown that scaling neural models in the number of parameters and the size of the data they are trained on gives improved results, we show that other ingredients are important for a high-performing chatbot. Good conversation requires a number of skills that an expert conversationalist blends in a seamless way: providing engaging talking points and listening to their partners, and displaying knowledge, empathy and personality appropriately, while maintaining a consistent persona. We show that large scale models can learn these skills when given appropriate training data and choice of generation strategy. We build variants of these recipes with 90M, 2.7B and 9.4B parameter models, and make our models and code publicly available. Human evaluations show our best models are superior to existing approaches in multi-turn dialogue in terms of engagingness and humanness measurements. We then discuss the limitations of this work by analyzing failure cases of our models.

Despite the success of Large Language Models (LLMs) in general image tasks, a gap persists in the medical field for a multimodal large model adept at handling the nuanced diversity of medical images. Addressing this, we propose MedXChat, a unified multimodal large model designed for seamless interactions between medical assistants and users. MedXChat encompasses three key functionalities: CXR(Chest X-ray)-to-Report generation, CXR-based visual question-answering (VQA), and Text-to-CXR synthesis. Our contributions are as follows. Firstly, our model showcases exceptional cross-task adaptability, displaying adeptness across all three defined tasks and outperforming the benchmark models on the MIMIC dataset in medical multimodal applications. Secondly, we introduce an innovative Text-to-CXR synthesis approach that utilizes instruction-following capabilities within the Stable Diffusion (SD) architecture. This technique integrates smoothly with the existing model framework, requiring no extra parameters, thereby maintaining the SD's generative strength while also bestowing upon it the capacity to render fine-grained medical images with high fidelity. Comprehensive experiments validate MedXChat's synergistic enhancement across all tasks. Our instruction data and model will be open-sourced.

Deep learning has enabled the development of highly robust foundation models for various pathological tasks across diverse diseases and patient cohorts. Among these models, vision-language pre-training, which leverages large-scale paired data to align pathology image and text embedding spaces, and provides a novel zero-shot paradigm for downstream tasks. However, existing models have been primarily data-driven and lack the incorporation of domain-specific knowledge, which limits their performance in cancer diagnosis, especially for rare tumor subtypes. To address this limitation, we establish a Knowledge-enhanced Pathology (KEEP) foundation model that harnesses disease knowledge to facilitate vision-language pre-training. Specifically, we first construct a disease knowledge graph (KG) that covers 11,454 human diseases with 139,143 disease attributes, including synonyms, definitions, and hypernym relations. We then systematically reorganize the millions of publicly available noisy pathology image-text pairs, into 143K well-structured semantic groups linked through the hierarchical relations of the disease KG. To derive more nuanced image and text representations, we propose a novel knowledge-enhanced vision-language pre-training approach that integrates disease knowledge into the alignment within hierarchical semantic groups instead of unstructured image-text pairs. Validated on 18 diverse benchmarks with more than 14,000 whole slide images (WSIs), KEEP achieves state-of-the-art performance in zero-shot cancer diagnostic tasks. Notably, for cancer detection, KEEP demonstrates an average sensitivity of 89.8% at a specificity of 95.0% across 7 cancer types. For cancer subtyping, KEEP achieves a median balanced accuracy of 0.456 in subtyping 30 rare brain cancers, indicating strong generalizability for diagnosing rare tumors.

Human readers or radiologists routinely perform full-body multi-organ multi-disease detection and diagnosis in clinical practice, while most medical AI systems are built to focus on single organs with a narrow list of a few diseases. This might severely limit AI's clinical adoption. A certain number of AI models need to be assembled non-trivially to match the diagnostic process of a human reading a CT scan. In this paper, we construct a Unified Tumor Transformer (UniT) model to detect (tumor existence and location) and diagnose (tumor characteristics) eight major cancer-prevalent organs in CT scans. UniT is a query-based Mask Transformer model with the output of multi-organ and multi-tumor semantic segmentation. We decouple the object queries into organ queries, detection queries and diagnosis queries, and further establish hierarchical relationships among the three groups. This clinically-inspired architecture effectively assists inter- and intra-organ representation learning of tumors and facilitates the resolution of these complex, anatomically related multi-organ cancer image reading tasks. UniT is trained end-to-end using a curated large-scale CT images of 10,042 patients including eight major types of cancers and occurring non-cancer tumors (all are pathology-confirmed with 3D tumor masks annotated by radiologists). On the test set of 631 patients, UniT has demonstrated strong performance under a set of clinically relevant evaluation metrics, substantially outperforming both multi-organ segmentation methods and an assembly of eight single-organ expert models in tumor detection, segmentation, and diagnosis. Such a unified multi-cancer image reading model (UniT) can significantly reduce the number of false positives produced by combined multi-system models. This moves one step closer towards a universal high-performance cancer screening tool.

Large Language Models(LLMs)have become effective tools for natural language processing and have been used in many different fields. This essay offers a succinct summary of various LLM subcategories. The survey emphasizes recent developments and efforts made for various LLM kinds, including task-based financial LLMs, multilingual language LLMs, biomedical and clinical LLMs, vision language LLMs, and code language models. The survey gives a general summary of the methods, attributes, datasets, transformer models, and comparison metrics applied in each category of LLMs. Furthermore, it highlights unresolved problems in the field of developing chatbots and virtual assistants, such as boosting natural language processing, enhancing chatbot intelligence, and resolving moral and legal dilemmas. The purpose of this study is to provide readers, developers, academics, and users interested in LLM-based chatbots and virtual intelligent assistant technologies with useful information and future directions.

The emergence of pretrained large language models has led to the deployment of a range of social chatbots for chitchat. Although these chatbots demonstrate language ability and fluency, they are not guaranteed to be engaging and can struggle to retain users. This work investigates the development of social chatbots that prioritize user engagement to enhance retention, specifically examining the use of human feedback to efficiently develop highly engaging chatbots. The proposed approach uses automatic pseudo-labels collected from user interactions to train a reward model that can be used to reject low-scoring sample responses generated by the chatbot model at inference time. Intuitive evaluation metrics, such as mean conversation length (MCL), are introduced as proxies to measure the level of engagement of deployed chatbots. A/B testing on groups of 10,000 new daily chatbot users on the Chai Research platform shows that this approach increases the MCL by up to 70%, which translates to a more than 30% increase in user retention for a GPT-J 6B model. Future work aims to use the reward model to realise a data fly-wheel, where the latest user conversations can be used to alternately fine-tune the language model and the reward model.

The recent success of ChatGPT and GPT-4 has drawn widespread attention to multimodal dialogue systems. However, the academia community lacks a dataset that can validate the multimodal generation capabilities of Visual Language Models (VLMs) in textual-visual chat tasks. In this paper, we construct two new multimodal datasets: the synthetic CLEVR-ATVC dataset (620K) and the manually pictured Fruit-ATVC dataset (50K), both featuring visual and text-based inputs and outputs. Additionally, to enable the multimodal system to reject human requests (i.e., demonstrate accountability), as in language-based ChatGPT conversations, we develop and incorporate specific rules into the datasets as supervisory signals. This allows the trained VLM to provide a yes or no answer after visual and textual reasoning, accompanied by a language explanation as to why the human instruction cannot be excuted. In our method, we propose a two-state training procedure to train the image auto-encoder and auto-regressive transformer from scratch. The first state involves a discrete variational autoencoder (dVAE) to compress each image into short tokens, which are then concatenated with text tokens as a single data stream to be fed into the decoder-based transformer for generating visual re-creation and textual feedback in the second state. We provide comprehensive analyses of experimental results in terms of re-created image quality, answer accuracy, and the model behavior when faced with uncertainty and imperfect user queries. We hope our explorations and findings contribute valuable insights regarding the accountability of textual-visual generative models.

This paper presents UMASS_BioNLP team participation in the MEDIQA-Chat 2023 shared task for Task-A and Task-C. We focus especially on Task-C and propose a novel LLMs cooperation system named a doctor-patient loop to generate high-quality conversation data sets. The experiment results demonstrate that our approaches yield reasonable performance as evaluated by automatic metrics such as ROUGE, medical concept recall, BLEU, and Self-BLEU. Furthermore, we conducted a comparative analysis between our proposed method and ChatGPT and GPT-4. This analysis also investigates the potential of utilizing cooperation LLMs to generate high-quality datasets.

This paper describes the systems submitted by team6 for ChatEval, the DSTC 11 Track 4 competition. We present three different approaches to predicting turn-level qualities of chatbot responses based on large language models (LLMs). We report improvement over the baseline using dynamic few-shot examples from a vector store for the prompts for ChatGPT. We also analyze the performance of the other two approaches and report needed improvements for future work. We developed the three systems over just two weeks, showing the potential of LLMs for this task. An ablation study conducted after the challenge deadline shows that the new Llama 2 models are closing the performance gap between ChatGPT and open-source LLMs. However, we find that the Llama 2 models do not benefit from few-shot examples in the same way as ChatGPT.

Large language models excel at interpreting complex natural language instructions, enabling them to perform a wide range of tasks. In the life sciences, single-cell RNA sequencing (scRNA-seq) data serves as the "language of cellular biology", capturing intricate gene expression patterns at the single-cell level. However, interacting with this "language" through conventional tools is often inefficient and unintuitive, posing challenges for researchers. To address these limitations, we present InstructCell, a multi-modal AI copilot that leverages natural language as a medium for more direct and flexible single-cell analysis. We construct a comprehensive multi-modal instruction dataset that pairs text-based instructions with scRNA-seq profiles from diverse tissues and species. Building on this, we develop a multi-modal cell language architecture capable of simultaneously interpreting and processing both modalities. InstructCell empowers researchers to accomplish critical tasks-such as cell type annotation, conditional pseudo-cell generation, and drug sensitivity prediction-using straightforward natural language commands. Extensive evaluations demonstrate that InstructCell consistently meets or exceeds the performance of existing single-cell foundation models, while adapting to diverse experimental conditions. More importantly, InstructCell provides an accessible and intuitive tool for exploring complex single-cell data, lowering technical barriers and enabling deeper biological insights.

The landscape for building conversational interfaces (chatbots) has witnessed a paradigm shift with recent developments in generative Artificial Intelligence (AI) based Large Language Models (LLMs), such as ChatGPT by OpenAI (GPT3.5 and GPT4), Google's Bard, Large Language Model Meta AI (LLaMA), among others. In this paper, we analyze capabilities and limitations of incorporating such models in conversational interfaces for the telecommunication domain, specifically for enterprise wireless products and services. Using Cradlepoint's publicly available data for our experiments, we present a comparative analysis of the responses from such models for multiple use-cases including domain adaptation for terminology and product taxonomy, context continuity, robustness to input perturbations and errors. We believe this evaluation would provide useful insights to data scientists engaged in building customized conversational interfaces for domain-specific requirements.

Building general-purpose models that can perceive diverse real-world modalities and solve various tasks is an appealing target in artificial intelligence. In this paper, we present ChatBridge, a novel multimodal language model that leverages the expressive capabilities of language as the catalyst to bridge the gap between various modalities. We show that only language-paired two-modality data is sufficient to connect all modalities. ChatBridge leverages recent large language models (LLM) and extends their zero-shot capabilities to incorporate diverse multimodal inputs. ChatBridge undergoes a two-stage training. The first stage aligns each modality with language, which brings emergent multimodal correlation and collaboration abilities. The second stage instruction-finetunes ChatBridge to align it with user intent with our newly proposed multimodal instruction tuning dataset, named MULTIS, which covers a wide range of 16 multimodal tasks of text, image, video, and audio modalities. We show strong quantitative and qualitative results on zero-shot multimodal tasks covering text, image, video, and audio modalities. All codes, data, and models of ChatBridge will be open-sourced.

We introduce the task of Visual Dialog, which requires an AI agent to hold a meaningful dialog with humans in natural, conversational language about visual content. Specifically, given an image, a dialog history, and a question about the image, the agent has to ground the question in image, infer context from history, and answer the question accurately. Visual Dialog is disentangled enough from a specific downstream task so as to serve as a general test of machine intelligence, while being grounded in vision enough to allow objective evaluation of individual responses and benchmark progress. We develop a novel two-person chat data-collection protocol to curate a large-scale Visual Dialog dataset (VisDial). VisDial v0.9 has been released and contains 1 dialog with 10 question-answer pairs on ~120k images from COCO, with a total of ~1.2M dialog question-answer pairs. We introduce a family of neural encoder-decoder models for Visual Dialog with 3 encoders -- Late Fusion, Hierarchical Recurrent Encoder and Memory Network -- and 2 decoders (generative and discriminative), which outperform a number of sophisticated baselines. We propose a retrieval-based evaluation protocol for Visual Dialog where the AI agent is asked to sort a set of candidate answers and evaluated on metrics such as mean-reciprocal-rank of human response. We quantify gap between machine and human performance on the Visual Dialog task via human studies. Putting it all together, we demonstrate the first 'visual chatbot'! Our dataset, code, trained models and visual chatbot are available on https://visualdialog.org

Vision-Language Models (VLM) can support clinicians by analyzing medical images and engaging in natural language interactions to assist in diagnostic and treatment tasks. However, VLMs often exhibit "hallucinogenic" behavior, generating textual outputs not grounded in contextual multimodal information. This challenge is particularly pronounced in the medical domain, where we do not only require VLM outputs to be accurate in single interactions but also to be consistent with clinical reasoning and diagnostic pathways throughout multi-turn conversations. For this purpose, we propose a new alignment algorithm that uses symbolic representations of clinical reasoning to ground VLMs in medical knowledge. These representations are utilized to (i) generate GPT-4-guided visual instruction tuning data at scale, simulating clinician-VLM conversations with demonstrations of clinical reasoning, and (ii) create an automatic reward function that evaluates the clinical validity of VLM generations throughout clinician-VLM interactions. Our algorithm eliminates the need for human involvement in training data generation or reward model construction, reducing costs compared to standard reinforcement learning with human feedback (RLHF). We apply our alignment algorithm to develop Dr-LLaVA, a conversational VLM finetuned for analyzing bone marrow pathology slides, demonstrating strong performance in multi-turn medical conversations.

In recent years, Multimodal Large Language Models (MLLM) have achieved notable advancements, demonstrating the feasibility of developing an intelligent biomedical assistant. However, current biomedical MLLMs predominantly focus on image-level understanding and restrict interactions to textual commands, thus limiting their capability boundaries and the flexibility of usage. In this paper, we introduce a novel end-to-end multimodal large language model for the biomedical domain, named MedPLIB, which possesses pixel-level understanding. Excitingly, it supports visual question answering (VQA), arbitrary pixel-level prompts (points, bounding boxes, and free-form shapes), and pixel-level grounding. We propose a novel Mixture-of-Experts (MoE) multi-stage training strategy, which divides MoE into separate training phases for a visual-language expert model and a pixel-grounding expert model, followed by fine-tuning using MoE. This strategy effectively coordinates multitask learning while maintaining the computational cost at inference equivalent to that of a single expert model. To advance the research of biomedical MLLMs, we introduce the Medical Complex Vision Question Answering Dataset (MeCoVQA), which comprises an array of 8 modalities for complex medical imaging question answering and image region understanding. Experimental results indicate that MedPLIB has achieved state-of-the-art outcomes across multiple medical visual language tasks. More importantly, in zero-shot evaluations for the pixel grounding task, MedPLIB leads the best small and large models by margins of 19.7 and 15.6 respectively on the mDice metric. The codes, data, and model checkpoints will be made publicly available at https://github.com/ShawnHuang497/MedPLIB.

Large-Language Models like GPT-3 have the potential to enable HCI designers and researchers to create more human-like and helpful chatbots for specific applications. But evaluating the feasibility of these chatbots and designing prompts that optimize GPT-3 for a specific task is challenging. We present a case study in tackling these questions, applying GPT-3 to a brief 5-minute chatbot that anyone can talk to better manage their mood. We report a randomized factorial experiment with 945 participants on Mechanical Turk that tests three dimensions of prompt design to initialize the chatbot (identity, intent, and behaviour), and present both quantitative and qualitative analyses of conversations and user perceptions of the chatbot. We hope other HCI designers and researchers can build on this case study, for other applications of GPT-3 based chatbots to specific tasks, and build on and extend the methods we use for prompt design, and evaluation of the prompt design.

Recently, growing interest has been aroused in extending the multimodal capability of large language models (LLMs), e.g., vision-language (VL) learning, which is regarded as the next milestone of artificial general intelligence. However, existing solutions are prohibitively expensive, which not only need to optimize excessive parameters, but also require another large-scale pre-training before VL instruction tuning. In this paper, we propose a novel and affordable solution for the effective VL adaption of LLMs, called Mixture-of-Modality Adaptation (MMA). Instead of using large neural networks to connect the image encoder and LLM, MMA adopts lightweight modules, i.e., adapters, to bridge the gap between LLMs and VL tasks, which also enables the joint optimization of the image and language models. Meanwhile, MMA is also equipped with a routing algorithm to help LLMs achieve an automatic shift between single- and multi-modal instructions without compromising their ability of natural language understanding. To validate MMA, we apply it to a recent LLM called LLaMA and term this formed large vision-language instructed model as LaVIN. To validate MMA and LaVIN, we conduct extensive experiments under two setups, namely multimodal science question answering and multimodal dialogue. The experimental results not only demonstrate the competitive performance and the superior training efficiency of LaVIN than existing multimodal LLMs, but also confirm its great potential as a general-purpose chatbot. More importantly, the actual expenditure of LaVIN is extremely cheap, e.g., only 1.4 training hours with 3.8M trainable parameters, greatly confirming the effectiveness of MMA. Our project is released at https://luogen1996.github.io/lavin.

Large Language Models (LLMs) have unlocked new capabilities and applications; however, evaluating the alignment with human preferences still poses significant challenges. To address this issue, we introduce Chatbot Arena, an open platform for evaluating LLMs based on human preferences. Our methodology employs a pairwise comparison approach and leverages input from a diverse user base through crowdsourcing. The platform has been operational for several months, amassing over 240K votes. This paper describes the platform, analyzes the data we have collected so far, and explains the tried-and-true statistical methods we are using for efficient and accurate evaluation and ranking of models. We confirm that the crowdsourced questions are sufficiently diverse and discriminating and that the crowdsourced human votes are in good agreement with those of expert raters. These analyses collectively establish a robust foundation for the credibility of Chatbot Arena. Because of its unique value and openness, Chatbot Arena has emerged as one of the most referenced LLM leaderboards, widely cited by leading LLM developers and companies. Our demo is publicly available at https://chat.lmsys.org.

As AI chatbots become ubiquitous, voice interaction presents a compelling way to enable rapid, high-bandwidth communication for both semantic and social signals. This has driven research into Large Audio Models (LAMs) to power voice-native experiences. However, aligning LAM development with user goals requires a clear understanding of user needs and preferences to establish reliable progress metrics. This study addresses these challenges by introducing an interactive approach to evaluate LAMs and collecting 7,500 LAM interactions from 484 participants. Through topic modeling of user queries, we identify primary use cases for audio interfaces. We then analyze user preference rankings and qualitative feedback to determine which models best align with user needs. Finally, we evaluate how static benchmarks predict interactive performance - our analysis reveals no individual benchmark strongly correlates with interactive results (tau leq 0.33 for all benchmarks). While combining multiple coarse-grained features yields modest predictive power (R^2=0.30), only two out of twenty datasets on spoken question answering and age prediction show significantly positive correlations. This suggests a clear need to develop LAM evaluations that better correlate with user preferences.

Currently, dialogue systems have achieved high performance in processing text-based communication. However, they have not yet effectively incorporated visual information, which poses a significant challenge. Furthermore, existing models that incorporate images in dialogue generation focus on discussing the image itself. Our proposed approach presents a novel perspective on multi-modal dialogue systems, which interprets the image in the context of the dialogue. By doing so, we aim to expand the capabilities of current dialogue systems and transition them from single modality (text) to multi-modality. However, there is a lack of validated English datasets that contain both images and dialogue contexts for this task. Thus, we propose a two-stage approach to automatically construct a multi-modal dialogue dataset. In the first stage, we utilize text-to-image similarity and sentence similarity to identify which utterances could be replaced with an image. In the second stage, we replace those utterances by selecting a subset of relevant images and filtering them with a visual question answering model. We used this approach, along with additional labeling, to create the IMage Augmented multi-modal Dialogue dataset (IMAD), which can serve as a validated dataset for this task. Furthermore, we propose a baseline model trained on this dataset, which outperforms model trained on the same data without images and BlenderBot.

Driven by the recent advances in deep learning methods and, in particular, by the development of modern self-supervised learning algorithms, increased interest and efforts have been devoted to build foundation models (FMs) for medical images. In this work, we present our scalable training pipeline for large pathology imaging data, and a comprehensive analysis of various hyperparameter choices and training techniques for building pathology FMs. We release and make publicly available the first batch of our pathology FMs (https://github.com/kaiko-ai/towards_large_pathology_fms) trained on open-access TCGA whole slide images, a commonly used collection of pathology images. The experimental evaluation shows that our models reach state-of-the-art performance on various patch-level downstream tasks, ranging from breast cancer subtyping to colorectal nuclear segmentation. Finally, to unify the evaluation approaches used in the field and to simplify future comparisons of different FMs, we present an open-source framework (https://github.com/kaiko-ai/eva) designed for the consistent evaluation of pathology FMs across various downstream tasks.

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.

The previous advancements in pathology image understanding primarily involved developing models tailored to specific tasks. Recent studies has demonstrated that the large vision-language model can enhance the performance of various downstream tasks in medical image understanding. In this study, we developed a domain-specific large language-vision assistant (PA-LLaVA) for pathology image understanding. Specifically, (1) we first construct a human pathology image-text dataset by cleaning the public medical image-text data for domain-specific alignment; (2) Using the proposed image-text data, we first train a pathology language-image pretraining (PLIP) model as the specialized visual encoder for pathology image, and then we developed scale-invariant connector to avoid the information loss caused by image scaling; (3) We adopt two-stage learning to train PA-LLaVA, first stage for domain alignment, and second stage for end to end visual question \& answering (VQA) task. In experiments, we evaluate our PA-LLaVA on both supervised and zero-shot VQA datasets, our model achieved the best overall performance among multimodal models of similar scale. The ablation experiments also confirmed the effectiveness of our design. We posit that our PA-LLaVA model and the datasets presented in this work can promote research in field of computational pathology. All codes are available at: https://github.com/ddw2AIGROUP2CQUPT/PA-LLaVA}{https://github.com/ddw2AIGROUP2CQUPT/PA-LLaVA

Foundation models are reshaping computational pathology by enabling transfer learning, where models pre-trained on vast datasets can be adapted for downstream diagnostic, prognostic, and therapeutic response tasks. Despite these advances, foundation models are still limited in their ability to encode the entire gigapixel whole-slide images without additional training and often lack complementary multimodal data. Here, we introduce Threads, a slide-level foundation model capable of generating universal representations of whole-slide images of any size. Threads was pre-trained using a multimodal learning approach on a diverse cohort of 47,171 hematoxylin and eosin (H&E)-stained tissue sections, paired with corresponding genomic and transcriptomic profiles - the largest such paired dataset to be used for foundation model development to date. This unique training paradigm enables Threads to capture the tissue's underlying molecular composition, yielding powerful representations applicable to a wide array of downstream tasks. In extensive benchmarking across 54 oncology tasks, including clinical subtyping, grading, mutation prediction, immunohistochemistry status determination, treatment response prediction, and survival prediction, Threads outperformed all baselines while demonstrating remarkable generalizability and label efficiency. It is particularly well suited for predicting rare events, further emphasizing its clinical utility. We intend to make the model publicly available for the broader community.

This study evaluates the performance of large language models (LLMs) as medical agents in Portuguese, aiming to develop a reliable and relevant virtual assistant for healthcare professionals. The HealthCareMagic-100k-en and MedQuAD datasets, translated from English using GPT-3.5, were used to fine-tune the ChatBode-7B model using the PEFT-QLoRA method. The InternLM2 model, with initial training on medical data, presented the best overall performance, with high precision and adequacy in metrics such as accuracy, completeness and safety. However, DrBode models, derived from ChatBode, exhibited a phenomenon of catastrophic forgetting of acquired medical knowledge. Despite this, these models performed frequently or even better in aspects such as grammaticality and coherence. A significant challenge was low inter-rater agreement, highlighting the need for more robust assessment protocols. This work paves the way for future research, such as evaluating multilingual models specific to the medical field, improving the quality of training data, and developing more consistent evaluation methodologies for the medical field.

Dialogue-based language models mark a huge milestone in the field of artificial intelligence, by their impressive ability to interact with users, as well as a series of challenging tasks prompted by customized instructions. However, the prevalent large-scale dialogue-based language models like ChatGPT still have room for improvement, such as unstable responses to questions and the inability to think cooperatively like humans. Considering the ability of dialogue-based language models in conversation and their inherent randomness in thinking, we propose ChatLLM network that allows multiple dialogue-based language models to interact, provide feedback, and think together. We design the network of ChatLLMs based on ChatGPT. Specifically, individual instances of ChatGPT may possess distinct perspectives towards the same problem, and by consolidating these diverse viewpoints via a separate ChatGPT, the ChatLLM network system can conduct decision-making more objectively and comprehensively. In addition, a language-based feedback mechanism comparable to backpropagation is devised to update the ChatGPTs within the network. Experiments on two datasets demonstrate that our network attains significant improvements in problem-solving, leading to observable progress amongst each member.

A major barrier to developing vision large language models (LLMs) in dermatology is the lack of large image--text pairs dataset. We introduce DermaSynth, a dataset comprising of 92,020 synthetic image--text pairs curated from 45,205 images (13,568 clinical and 35,561 dermatoscopic) for dermatology-related clinical tasks. Leveraging state-of-the-art LLMs, using Gemini 2.0, we used clinically related prompts and self-instruct method to generate diverse and rich synthetic texts. Metadata of the datasets were incorporated into the input prompts by targeting to reduce potential hallucinations. The resulting dataset builds upon open access dermatological image repositories (DERM12345, BCN20000, PAD-UFES-20, SCIN, and HIBA) that have permissive CC-BY-4.0 licenses. We also fine-tuned a preliminary Llama-3.2-11B-Vision-Instruct model, DermatoLlama 1.0, on 5,000 samples. We anticipate this dataset to support and accelerate AI research in dermatology. Data and code underlying this work are accessible at https://github.com/abdurrahimyilmaz/DermaSynth.

Recent Multimodal Large Language Models (MLLMs) exhibit impressive abilities to perceive images and follow open-ended instructions. The capabilities of MLLMs depend on two crucial factors: the model architecture to facilitate the feature alignment of visual modules and large language models; the multimodal instruction tuning datasets for human instruction following. (i) For the model architecture, most existing models introduce an external bridge module to connect vision encoders with language models, which needs an additional feature-alignment pre-training. In this work, we discover that compact pre-trained vision language models can inherently serve as ``out-of-the-box'' bridges between vision and language. Based on this, we propose Muffin framework, which directly employs pre-trained vision-language models to act as providers of visual signals. (ii) For the multimodal instruction tuning datasets, existing methods omit the complementary relationship between different datasets and simply mix datasets from different tasks. Instead, we propose UniMM-Chat dataset which explores the complementarities of datasets to generate 1.1M high-quality and diverse multimodal instructions. We merge information describing the same image from diverse datasets and transforms it into more knowledge-intensive conversation data. Experimental results demonstrate the effectiveness of the Muffin framework and UniMM-Chat dataset. Muffin achieves state-of-the-art performance on a wide range of vision-language tasks, significantly surpassing state-of-the-art models like LLaVA and InstructBLIP. Our model and dataset are all accessible at https://github.com/thunlp/muffin.

Recent advances in methods focused on the grounding problem have resulted in techniques that can be used to construct a symbolic language associated with a specific domain. Inspired by how humans communicate complex ideas through language, we developed a generalized Symbolic Semantic (S^2) framework for interpretable segmentation. Unlike adversarial models (e.g., GANs), we explicitly model cooperation between two agents, a Sender and a Receiver, that must cooperate to achieve a common goal. The Sender receives information from a high layer of a segmentation network and generates a symbolic sentence derived from a categorical distribution. The Receiver obtains the symbolic sentences and co-generates the segmentation mask. In order for the model to converge, the Sender and Receiver must learn to communicate using a private language. We apply our architecture to segment tumors in the TCGA dataset. A UNet-like architecture is used to generate input to the Sender network which produces a symbolic sentence, and a Receiver network co-generates the segmentation mask based on the sentence. Our Segmentation framework achieved similar or better performance compared with state-of-the-art segmentation methods. In addition, our results suggest direct interpretation of the symbolic sentences to discriminate between normal and tumor tissue, tumor morphology, and other image characteristics.

Multimodal learning significantly benefits cancer survival prediction, especially the integration of pathological images and genomic data. Despite advantages of multimodal learning for cancer survival prediction, massive redundancy in multimodal data prevents it from extracting discriminative and compact information: (1) An extensive amount of intra-modal task-unrelated information blurs discriminability, especially for gigapixel whole slide images (WSIs) with many patches in pathology and thousands of pathways in genomic data, leading to an ``intra-modal redundancy" issue. (2) Duplicated information among modalities dominates the representation of multimodal data, which makes modality-specific information prone to being ignored, resulting in an ``inter-modal redundancy" issue. To address these, we propose a new framework, Prototypical Information Bottlenecking and Disentangling (PIBD), consisting of Prototypical Information Bottleneck (PIB) module for intra-modal redundancy and Prototypical Information Disentanglement (PID) module for inter-modal redundancy. Specifically, a variant of information bottleneck, PIB, is proposed to model prototypes approximating a bunch of instances for different risk levels, which can be used for selection of discriminative instances within modality. PID module decouples entangled multimodal data into compact distinct components: modality-common and modality-specific knowledge, under the guidance of the joint prototypical distribution. Extensive experiments on five cancer benchmark datasets demonstrated our superiority over other methods.

With the rapid development of artificial intelligence, large language models (LLMs) have shown promising capabilities in mimicking human-level language comprehension and reasoning. This has sparked significant interest in applying LLMs to enhance various aspects of healthcare, ranging from medical education to clinical decision support. However, medicine involves multifaceted data modalities and nuanced reasoning skills, presenting challenges for integrating LLMs. This paper provides a comprehensive review on the applications and implications of LLMs in medicine. It begins by examining the fundamental applications of general-purpose and specialized LLMs, demonstrating their utilities in knowledge retrieval, research support, clinical workflow automation, and diagnostic assistance. Recognizing the inherent multimodality of medicine, the review then focuses on multimodal LLMs, investigating their ability to process diverse data types like medical imaging and EHRs to augment diagnostic accuracy. To address LLMs' limitations regarding personalization and complex clinical reasoning, the paper explores the emerging development of LLM-powered autonomous agents for healthcare. Furthermore, it summarizes the evaluation methodologies for assessing LLMs' reliability and safety in medical contexts. Overall, this review offers an extensive analysis on the transformative potential of LLMs in modern medicine. It also highlights the pivotal need for continuous optimizations and ethical oversight before these models can be effectively integrated into clinical practice. Visit https://github.com/mingze-yuan/Awesome-LLM-Healthcare for an accompanying GitHub repository containing latest papers.

In this paper, we introduce a novel Face-to-Face spoken dialogue model. It processes audio-visual speech from user input and generates audio-visual speech as the response, marking the initial step towards creating an avatar chatbot system without relying on intermediate text. To this end, we newly introduce MultiDialog, the first large-scale multimodal (i.e., audio and visual) spoken dialogue corpus containing 340 hours of approximately 9,000 dialogues, recorded based on the open domain dialogue dataset, TopicalChat. The MultiDialog contains parallel audio-visual recordings of conversation partners acting according to the given script with emotion annotations, which we expect to open up research opportunities in multimodal synthesis. Our Face-to-Face spoken dialogue model incorporates a textually pretrained large language model and adapts it into the audio-visual spoken dialogue domain by incorporating speech-text joint pretraining. Through extensive experiments, we validate the effectiveness of our model in facilitating a face-to-face conversation. Demo and data are available at https://multidialog.github.io and https://huggingface.co/datasets/IVLLab/MultiDialog, respectively.

Large language models have already demonstrated their formidable capabilities in general domains, ushering in a revolutionary transformation. However, exploring and exploiting the extensive knowledge of these models to comprehend multi-omics biology remains underexplored. To fill this research gap, we first introduce Biology-Instructions, the first large-scale multi-omics biological sequences-related instruction-tuning dataset including DNA, RNA, proteins, and multi-molecules, designed to bridge the gap between large language models (LLMs) and complex biological sequences-related tasks. This dataset can enhance the versatility of LLMs by integrating diverse biological sequenced-based prediction tasks with advanced reasoning capabilities, while maintaining conversational fluency. Additionally, we reveal significant performance limitations in even state-of-the-art LLMs on biological sequence-related multi-omics tasks without specialized pre-training and instruction-tuning. We further develop a strong baseline called ChatMultiOmics with a novel three-stage training pipeline, demonstrating the powerful ability to understand biology by using Biology-Instructions. Biology-Instructions and ChatMultiOmics are publicly available and crucial resources for enabling more effective integration of LLMs with multi-omics sequence analysis.

Most of the existing multi-modal models, hindered by their incapacity to adeptly manage interleaved image-and-text inputs in multi-image, multi-round dialogues, face substantial constraints in resource allocation for training and data accessibility, impacting their adaptability and scalability across varied interaction realms. To address this, we present the DeepSpeed-VisualChat framework, designed to optimize Large Language Models (LLMs) by incorporating multi-modal capabilities, with a focus on enhancing the proficiency of Large Vision and Language Models in handling interleaved inputs. Our framework is notable for (1) its open-source support for multi-round and multi-image dialogues, (2) introducing an innovative multi-modal causal attention mechanism, and (3) utilizing data blending techniques on existing datasets to assure seamless interactions in multi-round, multi-image conversations. Compared to existing frameworks, DeepSpeed-VisualChat shows superior scalability up to 70B parameter language model size, representing a significant advancement in multi-modal language models and setting a solid foundation for future explorations.

Is it possible to develop an "AI Pathologist" to pass the board-certified examination of the American Board of Pathology? To achieve this goal, the first step is to create a visual question answering (VQA) dataset where the AI agent is presented with a pathology image together with a question and is asked to give the correct answer. Our work makes the first attempt to build such a dataset. Different from creating general-domain VQA datasets where the images are widely accessible and there are many crowdsourcing workers available and capable of generating question-answer pairs, developing a medical VQA dataset is much more challenging. First, due to privacy concerns, pathology images are usually not publicly available. Second, only well-trained pathologists can understand pathology images, but they barely have time to help create datasets for AI research. To address these challenges, we resort to pathology textbooks and online digital libraries. We develop a semi-automated pipeline to extract pathology images and captions from textbooks and generate question-answer pairs from captions using natural language processing. We collect 32,799 open-ended questions from 4,998 pathology images where each question is manually checked to ensure correctness. To our best knowledge, this is the first dataset for pathology VQA. Our dataset will be released publicly to promote research in medical VQA.

Tumor documentation in Germany is largely done manually, requiring reading patient records and entering data into structured databases. Large language models (LLMs) could potentially enhance this process by improving efficiency and reliability. This evaluation tests eleven different open source LLMs with sizes ranging from 1-70 billion model parameters on three basic tasks of the tumor documentation process: identifying tumor diagnoses, assigning ICD-10 codes, and extracting the date of first diagnosis. For evaluating the LLMs on these tasks, a dataset of annotated text snippets based on anonymized doctors' notes from urology was prepared. Different prompting strategies were used to investigate the effect of the number of examples in few-shot prompting and to explore the capabilities of the LLMs in general. The models Llama 3.1 8B, Mistral 7B, and Mistral NeMo 12 B performed comparably well in the tasks. Models with less extensive training data or having fewer than 7 billion parameters showed notably lower performance, while larger models did not display performance gains. Examples from a different medical domain than urology could also improve the outcome in few-shot prompting, which demonstrates the ability of LLMs to handle tasks needed for tumor documentation. Open source LLMs show a strong potential for automating tumor documentation. Models from 7-12 billion parameters could offer an optimal balance between performance and resource efficiency. With tailored fine-tuning and well-designed prompting, these models might become important tools for clinical documentation in the future. The code for the evaluation is available from https://github.com/stefan-m-lenz/UroLlmEval. We also release the dataset as a new valuable resource that addresses the shortage of authentic and easily accessible benchmarks in German-language medical NLP.

The increasing availability of real-world conversation data offers exciting opportunities for researchers to study user-chatbot interactions. However, the sheer volume of this data makes manually examining individual conversations impractical. To overcome this challenge, we introduce WildVis, an interactive tool that enables fast, versatile, and large-scale conversation analysis. WildVis provides search and visualization capabilities in the text and embedding spaces based on a list of criteria. To manage million-scale datasets, we implemented optimizations including search index construction, embedding precomputation and compression, and caching to ensure responsive user interactions within seconds. We demonstrate WildVis's utility through three case studies: facilitating chatbot misuse research, visualizing and comparing topic distributions across datasets, and characterizing user-specific conversation patterns. WildVis is open-source and designed to be extendable, supporting additional datasets and customized search and visualization functionalities.

Language Models (LMs) often cannot be deployed because of their potential to harm users in hard-to-predict ways. Prior work identifies harmful behaviors before deployment by using human annotators to hand-write test cases. However, human annotation is expensive, limiting the number and diversity of test cases. In this work, we automatically find cases where a target LM behaves in a harmful way, by generating test cases ("red teaming") using another LM. We evaluate the target LM's replies to generated test questions using a classifier trained to detect offensive content, uncovering tens of thousands of offensive replies in a 280B parameter LM chatbot. We explore several methods, from zero-shot generation to reinforcement learning, for generating test cases with varying levels of diversity and difficulty. Furthermore, we use prompt engineering to control LM-generated test cases to uncover a variety of other harms, automatically finding groups of people that the chatbot discusses in offensive ways, personal and hospital phone numbers generated as the chatbot's own contact info, leakage of private training data in generated text, and harms that occur over the course of a conversation. Overall, LM-based red teaming is one promising tool (among many needed) for finding and fixing diverse, undesirable LM behaviors before impacting users.

The visual examination of tissue biopsy sections is fundamental for cancer diagnosis, with pathologists analyzing sections at multiple magnifications to discern tumor cells and their subtypes. However, existing attention-based multiple instance learning (MIL) models, used for analyzing Whole Slide Images (WSIs) in cancer diagnostics, often overlook the contextual information of tumor and neighboring tiles, leading to misclassifications. To address this, we propose the Context-Aware Multiple Instance Learning (CAMIL) architecture. CAMIL incorporates neighbor-constrained attention to consider dependencies among tiles within a WSI and integrates contextual constraints as prior knowledge into the MIL model. We evaluated CAMIL on subtyping non-small cell lung cancer (TCGA-NSCLC) and detecting lymph node (CAMELYON16) metastasis, achieving test AUCs of 0.959\% and 0.975\%, respectively, outperforming other state-of-the-art methods. Additionally, CAMIL enhances model interpretability by identifying regions of high diagnostic value.

Gathering histopathology slides from over 100 publicly available cohorts, we compile a diverse dataset of 460 million pathology tiles covering more than 30 cancer sites. Using this dataset, we train a large self-supervised vision transformer using DINOv2 and publicly release one iteration of this model for further experimentation, coined Phikon-v2. While trained on publicly available histology slides, Phikon-v2 surpasses our previously released model (Phikon) and performs on par with other histopathology foundation models (FM) trained on proprietary data. Our benchmarks include eight slide-level tasks with results reported on external validation cohorts avoiding any data contamination between pre-training and evaluation datasets. Our downstream training procedure follows a simple yet robust ensembling strategy yielding a +1.75 AUC increase across tasks and models compared to one-shot retraining (p<0.001). We compare Phikon (ViT-B) and Phikon-v2 (ViT-L) against 14 different histology feature extractors, making our evaluation the most comprehensive to date. Our result support evidences that DINOv2 handles joint model and data scaling better than iBOT. Also, we show that recent scaling efforts are overall beneficial to downstream performance in the context of biomarker prediction with GigaPath and H-Optimus-0 (two ViT-g with 1.1B parameters each) standing out. However, the statistical margins between the latest top-performing FMs remain mostly non-significant; some even underperform on specific indications or tasks such as MSI prediction - deposed by a 13x smaller model developed internally. While latest foundation models may exhibit limitations for clinical deployment, they nonetheless offer excellent grounds for the development of more specialized and cost-efficient histology encoders fueling AI-guided diagnostic tools.

Large language models like ChatGPT have shown substantial progress in natural language understanding and generation, proving valuable across various disciplines, including the medical field. Despite advancements, challenges persist due to the complexity and diversity inherent in medical tasks which often require multi-task learning capabilities. Previous approaches, although beneficial, fall short in real-world applications because they necessitate task-specific annotations at inference time, limiting broader generalization. This paper introduces MING-MOE, a novel Mixture-of-Expert~(MOE)-based medical large language model designed to manage diverse and complex medical tasks without requiring task-specific annotations, thus enhancing its usability across extensive datasets. MING-MOE employs a Mixture of Low-Rank Adaptation (MoLoRA) technique, allowing for efficient parameter usage by maintaining base model parameters static while adapting through a minimal set of trainable parameters. We demonstrate that MING-MOE achieves state-of-the-art (SOTA) performance on over 20 medical tasks, illustrating a significant improvement over existing models. This approach not only extends the capabilities of medical language models but also improves inference efficiency.

Diagnosing and managing a patient is a complex, sequential decision making process that requires physicians to obtain information -- such as which tests to perform -- and to act upon it. Recent advances in artificial intelligence (AI) and large language models (LLMs) promise to profoundly impact clinical care. However, current evaluation schemes overrely on static medical question-answering benchmarks, falling short on interactive decision-making that is required in real-life clinical work. Here, we present AgentClinic: a multimodal benchmark to evaluate LLMs in their ability to operate as agents in simulated clinical environments. In our benchmark, the doctor agent must uncover the patient's diagnosis through dialogue and active data collection. We present two open medical agent benchmarks: a multimodal image and dialogue environment, AgentClinic-NEJM, and a dialogue-only environment, AgentClinic-MedQA. We embed cognitive and implicit biases both in patient and doctor agents to emulate realistic interactions between biased agents. We find that introducing bias leads to large reductions in diagnostic accuracy of the doctor agents, as well as reduced compliance, confidence, and follow-up consultation willingness in patient agents. Evaluating a suite of state-of-the-art LLMs, we find that several models that excel in benchmarks like MedQA are performing poorly in AgentClinic-MedQA. We find that the LLM used in the patient agent is an important factor for performance in the AgentClinic benchmark. We show that both having limited interactions as well as too many interaction reduces diagnostic accuracy in doctor agents. The code and data for this work is publicly available at https://AgentClinic.github.io.

Representation learning of pathology whole-slide images (WSIs) has been has primarily relied on weak supervision with Multiple Instance Learning (MIL). However, the slide representations resulting from this approach are highly tailored to specific clinical tasks, which limits their expressivity and generalization, particularly in scenarios with limited data. Instead, we hypothesize that morphological redundancy in tissue can be leveraged to build a task-agnostic slide representation in an unsupervised fashion. To this end, we introduce PANTHER, a prototype-based approach rooted in the Gaussian mixture model that summarizes the set of WSI patches into a much smaller set of morphological prototypes. Specifically, each patch is assumed to have been generated from a mixture distribution, where each mixture component represents a morphological exemplar. Utilizing the estimated mixture parameters, we then construct a compact slide representation that can be readily used for a wide range of downstream tasks. By performing an extensive evaluation of PANTHER on subtyping and survival tasks using 13 datasets, we show that 1) PANTHER outperforms or is on par with supervised MIL baselines and 2) the analysis of morphological prototypes brings new qualitative and quantitative insights into model interpretability.

The detailed clinical records drafted by doctors after each patient's visit are crucial for medical practitioners and researchers. Automating the creation of these notes with language models can reduce the workload of doctors. However, training such models can be difficult due to the limited public availability of conversations between patients and doctors. In this paper, we introduce NoteChat, a cooperative multi-agent framework leveraging Large Language Models (LLMs) for generating synthetic doctor-patient conversations conditioned on clinical notes. NoteChat consists of Planning, Roleplay, and Polish modules. We provide a comprehensive automatic and human evaluation of NoteChat, comparing it with state-of-the-art models, including OpenAI's ChatGPT and GPT-4. Results demonstrate that NoteChat facilitates high-quality synthetic doctor-patient conversations, underscoring the untapped potential of LLMs in healthcare. This work represents the first instance of multiple LLMs cooperating to complete a doctor-patient conversation conditioned on clinical notes, offering promising avenues for the intersection of AI and healthcare

Conversational AI tools that can generate and discuss clinically correct radiology reports for a given medical image have the potential to transform radiology. Such a human-in-the-loop radiology assistant could facilitate a collaborative diagnostic process, thus saving time and improving the quality of reports. Towards this goal, we introduce RaDialog, the first thoroughly evaluated and publicly available large vision-language model for radiology report generation and interactive dialog. RaDialog effectively integrates visual image features and structured pathology findings with a large language model (LLM) while simultaneously adapting it to a specialized domain using parameter-efficient fine-tuning. To keep the conversational abilities of the underlying LLM, we propose a comprehensive, semi-automatically labeled, image-grounded instruct dataset for chest X-ray radiology tasks. By training with this dataset, our method achieves state-of-the-art clinical correctness in report generation and shows impressive abilities in interactive tasks such as correcting reports and answering questions, serving as a foundational step toward clinical dialog systems. Our code is available on github: https://github.com/ChantalMP/RaDialog.

The development of Open-Domain Dialogue Systems (ODS)is a trending topic due to the large number of research challenges, large societal and business impact, and advances in the underlying technology. However, the development of these kinds of systems requires two important characteristics:1) automatic evaluation mechanisms that show high correlations with human judgements across multiple dialogue evaluation aspects (with explainable features for providing constructive and explicit feedback on the quality of generative models' responses for quick development and deployment)and 2) mechanisms that can help to control chatbot responses,while avoiding toxicity and employing intelligent ways to handle toxic user comments and keeping interaction flow and engagement. This track at the 10th Dialogue System Technology Challenge (DSTC10) is part of the ongoing effort to promote scalable and toxic-free ODS. This paper describes the datasets and baselines provided to participants, as well as submission evaluation results for each of the two proposed subtasks.

Recent breakthroughs in large language models (LLMs) offer unprecedented natural language understanding and generation capabilities. However, existing surveys on LLMs in biomedicine often focus on specific applications or model architectures, lacking a comprehensive analysis that integrates the latest advancements across various biomedical domains. This review, based on an analysis of 484 publications sourced from databases including PubMed, Web of Science, and arXiv, provides an in-depth examination of the current landscape, applications, challenges, and prospects of LLMs in biomedicine, distinguishing itself by focusing on the practical implications of these models in real-world biomedical contexts. Firstly, we explore the capabilities of LLMs in zero-shot learning across a broad spectrum of biomedical tasks, including diagnostic assistance, drug discovery, and personalized medicine, among others, with insights drawn from 137 key studies. Then, we discuss adaptation strategies of LLMs, including fine-tuning methods for both uni-modal and multi-modal LLMs to enhance their performance in specialized biomedical contexts where zero-shot fails to achieve, such as medical question answering and efficient processing of biomedical literature. Finally, we discuss the challenges that LLMs face in the biomedicine domain including data privacy concerns, limited model interpretability, issues with dataset quality, and ethics due to the sensitive nature of biomedical data, the need for highly reliable model outputs, and the ethical implications of deploying AI in healthcare. To address these challenges, we also identify future research directions of LLM in biomedicine including federated learning methods to preserve data privacy and integrating explainable AI methodologies to enhance the transparency of LLMs.

Medicine, by its nature, is a multifaceted domain that requires the synthesis of information across various modalities. Medical generative vision-language models (VLMs) make a first step in this direction and promise many exciting clinical applications. However, existing models typically have to be fine-tuned on sizeable down-stream datasets, which poses a significant limitation as in many medical applications data is scarce, necessitating models that are capable of learning from few examples in real-time. Here we propose Med-Flamingo, a multimodal few-shot learner adapted to the medical domain. Based on OpenFlamingo-9B, we continue pre-training on paired and interleaved medical image-text data from publications and textbooks. Med-Flamingo unlocks few-shot generative medical visual question answering (VQA) abilities, which we evaluate on several datasets including a novel challenging open-ended VQA dataset of visual USMLE-style problems. Furthermore, we conduct the first human evaluation for generative medical VQA where physicians review the problems and blinded generations in an interactive app. Med-Flamingo improves performance in generative medical VQA by up to 20\% in clinician's rating and firstly enables multimodal medical few-shot adaptations, such as rationale generation. We release our model, code, and evaluation app under https://github.com/snap-stanford/med-flamingo.

Recent large language models (LLMs) offer the potential to support public health monitoring by facilitating health disclosure through open-ended conversations but rarely preserve the knowledge gained about individuals across repeated interactions. Augmenting LLMs with long-term memory (LTM) presents an opportunity to improve engagement and self-disclosure, but we lack an understanding of how LTM impacts people's interaction with LLM-driven chatbots in public health interventions. We examine the case of CareCall -- an LLM-driven voice chatbot with LTM -- through the analysis of 1,252 call logs and interviews with nine users. We found that LTM enhanced health disclosure and fostered positive perceptions of the chatbot by offering familiarity. However, we also observed challenges in promoting self-disclosure through LTM, particularly around addressing chronic health conditions and privacy concerns. We discuss considerations for LTM integration in LLM-driven chatbots for public health monitoring, including carefully deciding what topics need to be remembered in light of public health goals.

This study presents an innovative enhancement to retrieval-augmented generation (RAG) systems by seamlessly integrating fine-tuned large language models (LLMs) with vector databases. This integration capitalizes on the combined strengths of structured data retrieval and the nuanced comprehension provided by advanced LLMs. Central to our approach are the LoRA and QLoRA methodologies, which stand at the forefront of model refinement through parameter-efficient fine-tuning and memory optimization. A novel feature of our research is the incorporation of user feedback directly into the training process, ensuring the model's continuous adaptation to user expectations and thus, improving its performance and applicability. Additionally, we introduce a Quantized Influence Measure (QIM) as an innovative "AI Judge" mechanism to enhance the precision of result selection, further refining the system's accuracy. Accompanied by an executive diagram and a detailed algorithm for fine-tuning QLoRA, our work provides a comprehensive framework for implementing these advancements within chatbot technologies. This research contributes significant insights into LLM optimization for specific uses and heralds new directions for further development in retrieval-augmented models. Through extensive experimentation and analysis, our findings lay a robust foundation for future advancements in chatbot technology and retrieval systems, marking a significant step forward in the creation of more sophisticated, precise, and user-centric conversational AI systems.

Personalized dialogue systems aim to endow the chatbot agent with more anthropomorphic traits for human-like interactions. Previous approaches have explored explicitly user profile modeling using text descriptions, implicit derivation of user embeddings, or utilizing handicraft prompts for ChatGPT-like models. However, textual personas are limited in describing multi-faceted attributes (e.g., language style, inner character nuances), implicit embedding suffers from personality sparsity, and handicraft prompts lack fine-grained and stable controllability. Hence, these approaches may struggle with complex personalized dialogue generation tasks that require generating controllable responses with multiple personal attributes. To this end, we propose \textsc{Miracle}, a novel personalized dialogue generation method through MultIple PeRsonal Attributes Control within Latent-Space Energy-based Models. ttributes Control within Latent-Space Energy-based Models. Specifically, our approach first disentangles complex personality into multi-faceted attributes. Subsequently, we employ a conditional variational auto-encoder to align with the dense personalized responses within a latent joint attribute space. We have also tailored a dedicated energy function and customized the ordinary differential equations sampling method to offer flexible attribute composition and precise attribute control. Extensive experiments demonstrate that Miracle outperforms several strong baselines in terms of personality controllability and response generation quality. Our dataset and code are available at https://github.com/LZY-the-boys/MIRACLE

Cell segmentation is a critical step for quantitative single-cell analysis in microscopy images. Existing cell segmentation methods are often tailored to specific modalities or require manual interventions to specify hyperparameters in different experimental settings. Here, we present a multi-modality cell segmentation benchmark, comprising over 1500 labeled images derived from more than 50 diverse biological experiments. The top participants developed a Transformer-based deep-learning algorithm that not only exceeds existing methods, but can also be applied to diverse microscopy images across imaging platforms and tissue types without manual parameter adjustments. This benchmark and the improved algorithm offer promising avenues for more accurate and versatile cell analysis in microscopy imaging.

High-quality conversational datasets are essential for developing AI models that can communicate with users. One way to foster deeper interactions between a chatbot and its user is through personas, aspects of the user's character that provide insights into their personality, motivations, and behaviors. Training Natural Language Processing (NLP) models on a diverse and comprehensive persona-based dataset can lead to conversational models that create a deeper connection with the user, and maintain their engagement. In this paper, we leverage the power of Large Language Models (LLMs) to create a large, high-quality conversational dataset from a seed dataset. We propose a Generator-Critic architecture framework to expand the initial dataset, while improving the quality of its conversations. The Generator is an LLM prompted to output conversations. The Critic consists of a mixture of expert LLMs that control the quality of the generated conversations. These experts select the best generated conversations, which we then use to improve the Generator. We release Synthetic-Persona-Chat, consisting of 20k conversations seeded from Persona-Chat. We evaluate the quality of Synthetic-Persona-Chat and our generation framework on different dimensions through extensive experiments, and observe that the losing rate of Synthetic-Persona-Chat against Persona-Chat during Turing test decreases from 17.2% to 8.8% over three iterations.

Recently, several multi-modal models have been developed for joint image and language understanding, which have demonstrated impressive chat abilities by utilizing advanced large language models (LLMs). The process of developing such models is straightforward yet effective. It involves pre-training an adaptation module to align the semantics of the vision encoder and language model, followed by fine-tuning on the instruction-following data. However, despite the success of this pipeline in image and language understanding, its effectiveness in joint video and language understanding has not been widely explored. In this paper, we aim to develop a novel multi-modal foundation model capable of perceiving video, image, and language within a general framework. To achieve this goal, we introduce Valley: Video Assistant with Large Language model Enhanced ability. Specifically, our proposed Valley model is designed with a simple projection module that bridges video, image, and language modalities, and is further unified with a multi-lingual LLM. We also collect multi-source vision-text pairs and adopt a spatio-temporal pooling strategy to obtain a unified vision encoding of video and image input for pre-training. Furthermore, we generate multi-task instruction-following video data, including multi-shot captions, long video descriptions, action recognition, causal relationship inference, etc. To obtain the instruction-following data, we design diverse rounds of task-oriented conversations between humans and videos, facilitated by ChatGPT. Qualitative examples demonstrate that our proposed model has the potential to function as a highly effective multilingual video assistant that can make complex video understanding scenarios easy. Code, data, and models will be available at https://github.com/RupertLuo/Valley.

Human-AI interactivity is a critical aspect that reflects the usability of multimodal large language models (MLLMs). However, existing end-to-end MLLMs only allow users to interact with them through language instructions, leading to the limitation of the interactive accuracy and efficiency. In this study, we present precise referring instructions that utilize diverse reference representations such as points and boxes as referring prompts to refer to the special region. This enables MLLMs to focus on the region of interest and achieve finer-grained interaction. Based on precise referring instruction, we propose ChatSpot, a unified end-to-end multimodal large language model that supports diverse forms of interactivity including mouse clicks, drag-and-drop, and drawing boxes, which provides a more flexible and seamless interactive experience. We also construct a multi-grained vision-language instruction-following dataset based on existing datasets and GPT-4 generating. Furthermore, we design a series of evaluation tasks to assess the effectiveness of region recognition and interaction. Experimental results showcase ChatSpot's promising performance.

Despite remarkable advances that large language models have achieved in chatbots, maintaining a non-toxic user-AI interactive environment has become increasingly critical nowadays. However, previous efforts in toxicity detection have been mostly based on benchmarks derived from social media content, leaving the unique challenges inherent to real-world user-AI interactions insufficiently explored. In this work, we introduce ToxicChat, a novel benchmark based on real user queries from an open-source chatbot. This benchmark contains the rich, nuanced phenomena that can be tricky for current toxicity detection models to identify, revealing a significant domain difference compared to social media content. Our systematic evaluation of models trained on existing toxicity datasets has shown their shortcomings when applied to this unique domain of ToxicChat. Our work illuminates the potentially overlooked challenges of toxicity detection in real-world user-AI conversations. In the future, ToxicChat can be a valuable resource to drive further advancements toward building a safe and healthy environment for user-AI interactions.

A key component of deep learning (DL) for natural language processing (NLP) is word embeddings. Word embeddings that effectively capture the meaning and context of the word that they represent can significantly improve the performance of downstream DL models for various NLP tasks. Many existing word embeddings techniques capture the context of words based on word co-occurrence in documents and text; however, they often cannot capture broader domain-specific relationships between concepts that may be crucial for the NLP task at hand. In this paper, we propose a method to integrate external knowledge from medical terminology ontologies into the context captured by word embeddings. Specifically, we use a medical knowledge graph, such as the unified medical language system (UMLS), to find connections between clinical terms in cancer pathology reports. This approach aims to minimize the distance between connected clinical concepts. We evaluate the proposed approach using a Multitask Convolutional Neural Network (MT-CNN) to extract six cancer characteristics -- site, subsite, laterality, behavior, histology, and grade -- from a dataset of ~900K cancer pathology reports. The results show that the MT-CNN model which uses our domain informed embeddings outperforms the same MT-CNN using standard word2vec embeddings across all tasks, with an improvement in the overall micro- and macro-F1 scores by 4.97\%and 22.5\%, respectively.

In the diverse field of medical imaging, automatic segmentation has numerous applications and must handle a wide variety of input domains, such as different types of Computed Tomography (CT) scans and Magnetic Resonance (MR) images. This heterogeneity challenges automatic segmentation algorithms to maintain consistent performance across different modalities due to the requirement for spatially aligned and paired images. Typically, segmentation models are trained using a single modality, which limits their ability to generalize to other types of input data without employing transfer learning techniques. Additionally, leveraging complementary information from different modalities to enhance segmentation precision often necessitates substantial modifications to popular encoder-decoder designs, such as introducing multiple branched encoding or decoding paths for each modality. In this work, we propose a simple Multi-Modal Segmentation (MulModSeg) strategy to enhance medical image segmentation across multiple modalities, specifically CT and MR. It incorporates two key designs: a modality-conditioned text embedding framework via a frozen text encoder that adds modality awareness to existing segmentation frameworks without significant structural modifications or computational overhead, and an alternating training procedure that facilitates the integration of essential features from unpaired CT and MR inputs. Through extensive experiments with both Fully Convolutional Network and Transformer-based backbones, MulModSeg consistently outperforms previous methods in segmenting abdominal multi-organ and cardiac substructures for both CT and MR modalities. The code is available in this {https://github.com/ChengyinLee/MulModSeg_2024{link}}.

Humans use different modalities, such as speech, text, images, videos, etc., to communicate their intent and goals with teammates. For robots to become better assistants, we aim to endow them with the ability to follow instructions and understand tasks specified by their human partners. Most robotic policy learning methods have focused on one single modality of task specification while ignoring the rich cross-modal information. We present MUTEX, a unified approach to policy learning from multimodal task specifications. It trains a transformer-based architecture to facilitate cross-modal reasoning, combining masked modeling and cross-modal matching objectives in a two-stage training procedure. After training, MUTEX can follow a task specification in any of the six learned modalities (video demonstrations, goal images, text goal descriptions, text instructions, speech goal descriptions, and speech instructions) or a combination of them. We systematically evaluate the benefits of MUTEX in a newly designed dataset with 100 tasks in simulation and 50 tasks in the real world, annotated with multiple instances of task specifications in different modalities, and observe improved performance over methods trained specifically for any single modality. More information at https://ut-austin-rpl.github.io/MUTEX/

Personalized chatbots focus on endowing chatbots with a consistent personality to behave like real users, give more informative responses, and further act as personal assistants. Existing personalized approaches tried to incorporate several text descriptions as explicit user profiles. However, the acquisition of such explicit profiles is expensive and time-consuming, thus being impractical for large-scale real-world applications. Moreover, the restricted predefined profile neglects the language behavior of a real user and cannot be automatically updated together with the change of user interests. In this paper, we propose to learn implicit user profiles automatically from large-scale user dialogue history for building personalized chatbots. Specifically, leveraging the benefits of Transformer on language understanding, we train a personalized language model to construct a general user profile from the user's historical responses. To highlight the relevant historical responses to the input post, we further establish a key-value memory network of historical post-response pairs, and build a dynamic post-aware user profile. The dynamic profile mainly describes what and how the user has responded to similar posts in history. To explicitly utilize users' frequently used words, we design a personalized decoder to fuse two decoding strategies, including generating a word from the generic vocabulary and copying one word from the user's personalized vocabulary. Experiments on two real-world datasets show the significant improvement of our model compared with existing methods. Our code is available at https://github.com/zhengyima/DHAP

The integration of Large Language Models (LLMs) into healthcare promises to transform medical diagnostics, research, and patient care. Yet, the progression of medical LLMs faces obstacles such as complex training requirements, rigorous evaluation demands, and the dominance of proprietary models that restrict academic exploration. Transparent, comprehensive access to LLM resources is essential for advancing the field, fostering reproducibility, and encouraging innovation in healthcare AI. We present Hippocrates, an open-source LLM framework specifically developed for the medical domain. In stark contrast to previous efforts, it offers unrestricted access to its training datasets, codebase, checkpoints, and evaluation protocols. This open approach is designed to stimulate collaborative research, allowing the community to build upon, refine, and rigorously evaluate medical LLMs within a transparent ecosystem. Also, we introduce Hippo, a family of 7B models tailored for the medical domain, fine-tuned from Mistral and LLaMA2 through continual pre-training, instruction tuning, and reinforcement learning from human and AI feedback. Our models outperform existing open medical LLMs models by a large-margin, even surpassing models with 70B parameters. Through Hippocrates, we aspire to unlock the full potential of LLMs not just to advance medical knowledge and patient care but also to democratize the benefits of AI research in healthcare, making them available across the globe.

Recent research arXiv:2410.15027 arXiv:2410.23775 has highlighted the inherent in-context generation capabilities of pretrained diffusion transformers (DiTs), enabling them to seamlessly adapt to diverse visual tasks with minimal or no architectural modifications. These capabilities are unlocked by concatenating self-attention tokens across multiple input and target images, combined with grouped and masked generation pipelines. Building upon this foundation, we present ChatDiT, a zero-shot, general-purpose, and interactive visual generation framework that leverages pretrained diffusion transformers in their original form, requiring no additional tuning, adapters, or modifications. Users can interact with ChatDiT to create interleaved text-image articles, multi-page picture books, edit images, design IP derivatives, or develop character design settings, all through free-form natural language across one or more conversational rounds. At its core, ChatDiT employs a multi-agent system comprising three key components: an Instruction-Parsing agent that interprets user-uploaded images and instructions, a Strategy-Planning agent that devises single-step or multi-step generation actions, and an Execution agent that performs these actions using an in-context toolkit of diffusion transformers. We thoroughly evaluate ChatDiT on IDEA-Bench arXiv:2412.11767, comprising 100 real-world design tasks and 275 cases with diverse instructions and varying numbers of input and target images. Despite its simplicity and training-free approach, ChatDiT surpasses all competitors, including those specifically designed and trained on extensive multi-task datasets. We further identify key limitations of pretrained DiTs in zero-shot adapting to tasks. We release all code, agents, results, and intermediate outputs to facilitate further research at https://github.com/ali-vilab/ChatDiT

Development of multimodal interactive systems is hindered by the lack of rich, multimodal (text, images) conversational data, which is needed in large quantities for LLMs. Previous approaches augment textual dialogues with retrieved images, posing privacy, diversity, and quality constraints. In this work, we introduce Multimodal Augmented Generative Images Dialogues (MAGID), a framework to augment text-only dialogues with diverse and high-quality images. Subsequently, a diffusion model is applied to craft corresponding images, ensuring alignment with the identified text. Finally, MAGID incorporates an innovative feedback loop between an image description generation module (textual LLM) and image quality modules (addressing aesthetics, image-text matching, and safety), that work in tandem to generate high-quality and multi-modal dialogues. We compare MAGID to other SOTA baselines on three dialogue datasets, using automated and human evaluation. Our results show that MAGID is comparable to or better than baselines, with significant improvements in human evaluation, especially against retrieval baselines where the image database is small.

The emergence of large-scale pretrained language models has revolutionized the capabilities of new AI application, especially in the realm of crafting chatbots with distinct personas. Given the "stimulus-response" nature of chatbots, this paper unveils an innovative open-ended interview-style approach for personality assessment on role-playing chatbots, which offers a richer comprehension of their intrinsic personalities. We conduct personality assessments on 32 role-playing chatbots created by the ChatHaruhi library, across both the Big Five and MBTI dimensions, and measure their alignment with human perception. Evaluation results underscore that modern role-playing chatbots based on LLMs can effectively portray personality traits of corresponding characters, with an alignment rate of 82.8% compared with human-perceived personalities. Besides, we also suggest potential strategies for shaping chatbots' personalities. Hence, this paper serves as a cornerstone study for role-playing chatbots that intersects computational linguistics and psychology. Our resources are available at https://github.com/LC1332/Chat-Haruhi-Suzumiya

Forensic pathology is critical in determining the cause and manner of death through post-mortem examinations, both macroscopic and microscopic. The field, however, grapples with issues such as outcome variability, laborious processes, and a scarcity of trained professionals. This paper presents SongCi, an innovative visual-language model (VLM) designed specifically for forensic pathology. SongCi utilizes advanced prototypical cross-modal self-supervised contrastive learning to enhance the accuracy, efficiency, and generalizability of forensic analyses. It was pre-trained and evaluated on a comprehensive multi-center dataset, which includes over 16 million high-resolution image patches, 2,228 vision-language pairs of post-mortem whole slide images (WSIs), and corresponding gross key findings, along with 471 distinct diagnostic outcomes. Our findings indicate that SongCi surpasses existing multi-modal AI models in many forensic pathology tasks, performs comparably to experienced forensic pathologists and significantly better than less experienced ones, and provides detailed multi-modal explainability, offering critical assistance in forensic investigations. To the best of our knowledge, SongCi is the first VLM specifically developed for forensic pathological analysis and the first large-vocabulary computational pathology (CPath) model that directly processes gigapixel WSIs in forensic science.

Response retrieval is a subset of neural ranking in which a model selects a suitable response from a set of candidates given a conversation history. Retrieval-based chat-bots are typically employed in information seeking conversational systems such as customer support agents. In order to make pairwise comparisons between a conversation history and a candidate response, two approaches are common: cross-encoders performing full self-attention over the pair and bi-encoders encoding the pair separately. The former gives better prediction quality but is too slow for practical use. In this paper, we propose a new cross-encoder architecture and transfer knowledge from this model to a bi-encoder model using distillation. This effectively boosts bi-encoder performance at no cost during inference time. We perform a detailed analysis of this approach on three response retrieval datasets.

Building socialbots that can have deep, engaging open-domain conversations with humans is one of the grand challenges of artificial intelligence (AI). To this end, bots need to be able to leverage world knowledge spanning several domains effectively when conversing with humans who have their own world knowledge. Existing knowledge-grounded conversation datasets are primarily stylized with explicit roles for conversation partners. These datasets also do not explore depth or breadth of topical coverage with transitions in conversations. We introduce Topical-Chat, a knowledge-grounded human-human conversation dataset where the underlying knowledge spans 8 broad topics and conversation partners don't have explicitly defined roles, to help further research in open-domain conversational AI. We also train several state-of-the-art encoder-decoder conversational models on Topical-Chat and perform automated and human evaluation for benchmarking.

While multimodal conversation agents are gaining importance in several domains such as retail, travel etc., deep learning research in this area has been limited primarily due to the lack of availability of large-scale, open chatlogs. To overcome this bottleneck, in this paper we introduce the task of multimodal, domain-aware conversations, and propose the MMD benchmark dataset. This dataset was gathered by working in close coordination with large number of domain experts in the retail domain. These experts suggested various conversations flows and dialog states which are typically seen in multimodal conversations in the fashion domain. Keeping these flows and states in mind, we created a dataset consisting of over 150K conversation sessions between shoppers and sales agents, with the help of in-house annotators using a semi-automated manually intense iterative process. With this dataset, we propose 5 new sub-tasks for multimodal conversations along with their evaluation methodology. We also propose two multimodal neural models in the encode-attend-decode paradigm and demonstrate their performance on two of the sub-tasks, namely text response generation and best image response selection. These experiments serve to establish baseline performance and open new research directions for each of these sub-tasks. Further, for each of the sub-tasks, we present a `per-state evaluation' of 9 most significant dialog states, which would enable more focused research into understanding the challenges and complexities involved in each of these states.

We propose MM-REACT, a system paradigm that integrates ChatGPT with a pool of vision experts to achieve multimodal reasoning and action. In this paper, we define and explore a comprehensive list of advanced vision tasks that are intriguing to solve, but may exceed the capabilities of existing vision and vision-language models. To achieve such advanced visual intelligence, MM-REACT introduces a textual prompt design that can represent text descriptions, textualized spatial coordinates, and aligned file names for dense visual signals such as images and videos. MM-REACT's prompt design allows language models to accept, associate, and process multimodal information, thereby facilitating the synergetic combination of ChatGPT and various vision experts. Zero-shot experiments demonstrate MM-REACT's effectiveness in addressing the specified capabilities of interests and its wide application in different scenarios that require advanced visual understanding. Furthermore, we discuss and compare MM-REACT's system paradigm with an alternative approach that extends language models for multimodal scenarios through joint finetuning. Code, demo, video, and visualization are available at https://multimodal-react.github.io/

Recently, due to COVID-19 and the growing demand for remote work, video conferencing apps have become especially widespread. The most valuable features of video chats are real-time background removal and face beautification. While solving these tasks, computer vision researchers face the problem of having relevant data for the training stage. There is no large dataset with high-quality labeled and diverse images of people in front of a laptop or smartphone camera to train a lightweight model without additional approaches. To boost the progress in this area, we provide a new image dataset, EasyPortrait, for portrait segmentation and face parsing tasks. It contains 20,000 primarily indoor photos of 8,377 unique users, and fine-grained segmentation masks separated into 9 classes. Images are collected and labeled from crowdsourcing platforms. Unlike most face parsing datasets, in EasyPortrait, the beard is not considered part of the skin mask, and the inside area of the mouth is separated from the teeth. These features allow using EasyPortrait for skin enhancement and teeth whitening tasks. This paper describes the pipeline for creating a large-scale and clean image segmentation dataset using crowdsourcing platforms without additional synthetic data. Moreover, we trained several models on EasyPortrait and showed experimental results. Proposed dataset and trained models are publicly available.

Large Language Models (LLMs) have showcased remarkable capabilities in various Natural Language Processing tasks. For automatic open-domain dialogue evaluation in particular, LLMs have been seamlessly integrated into evaluation frameworks, and together with human evaluation, compose the backbone of most evaluations. However, existing evaluation benchmarks often rely on outdated datasets and evaluate aspects like Fluency and Relevance, which fail to adequately capture the capabilities and limitations of state-of-the-art chatbot models. This paper critically examines current evaluation benchmarks, highlighting that the use of older response generators and quality aspects fail to accurately reflect modern chatbot capabilities. A small annotation experiment on a recent LLM-generated dataset (SODA) reveals that LLM evaluators such as GPT-4 struggle to detect actual deficiencies in dialogues generated by current LLM chatbots.

Current medical artificial intelligence systems are often limited to narrow applications, hindering their widespread adoption in clinical practice. To address this limitation, we propose MedVersa, a generalist learner that enables flexible learning and tasking for medical image interpretation. By leveraging a large language model as a learnable orchestrator, MedVersa can learn from both visual and linguistic supervision, support multimodal inputs, and perform real-time task specification. This versatility allows MedVersa to adapt to various clinical scenarios and perform multifaceted medical image analysis. We introduce MedInterp, the largest multimodal dataset to date for medical image interpretation, consisting of over 13 million annotated instances spanning 11 tasks across 3 modalities, to support the development of MedVersa. Our experiments demonstrate that MedVersa achieves state-of-the-art performance in 9 tasks, sometimes outperforming specialist counterparts by over 10%. MedVersa is the first to showcase the viability of multimodal generative medical AI in implementing multimodal outputs, inputs, and dynamic task specification, highlighting its potential as a multifunctional system for comprehensive medical image analysis. This generalist approach to medical image interpretation paves the way for more adaptable and efficient AI-assisted clinical decision-making.

Perception and expression of emotion are key factors to the success of dialogue systems or conversational agents. However, this problem has not been studied in large-scale conversation generation so far. In this paper, we propose Emotional Chatting Machine (ECM) that can generate appropriate responses not only in content (relevant and grammatical) but also in emotion (emotionally consistent). To the best of our knowledge, this is the first work that addresses the emotion factor in large-scale conversation generation. ECM addresses the factor using three new mechanisms that respectively (1) models the high-level abstraction of emotion expressions by embedding emotion categories, (2) captures the change of implicit internal emotion states, and (3) uses explicit emotion expressions with an external emotion vocabulary. Experiments show that the proposed model can generate responses appropriate not only in content but also in emotion.

ChatGPT-like models have revolutionized various applications in artificial intelligence, from summarization and coding to translation, matching or even surpassing human performance. However, the current landscape lacks an accessible, efficient, and cost-effective end-to-end RLHF (Reinforcement Learning with Human Feedback) training pipeline for these powerful models, particularly when training at the scale of billions of parameters. This paper introduces DeepSpeed-Chat, a novel system that democratizes RLHF training, making it accessible to the AI community. DeepSpeed-Chat offers three key capabilities: an easy-to-use training and inference experience for ChatGPT-like models, a DeepSpeed-RLHF pipeline that replicates the training pipeline from InstructGPT, and a robust DeepSpeed-RLHF system that combines various optimizations for training and inference in a unified way. The system delivers unparalleled efficiency and scalability, enabling training of models with hundreds of billions of parameters in record time and at a fraction of the cost. With this development, DeepSpeed-Chat paves the way for broader access to advanced RLHF training, even for data scientists with limited resources, thereby fostering innovation and further development in the field of AI.

Large language models (LLMs) provide a new way to build chatbots by accepting natural language prompts. Yet, it is unclear how to design prompts to power chatbots to carry on naturalistic conversations while pursuing a given goal, such as collecting self-report data from users. We explore what design factors of prompts can help steer chatbots to talk naturally and collect data reliably. To this aim, we formulated four prompt designs with different structures and personas. Through an online study (N = 48) where participants conversed with chatbots driven by different designs of prompts, we assessed how prompt designs and conversation topics affected the conversation flows and users' perceptions of chatbots. Our chatbots covered 79% of the desired information slots during conversations, and the designs of prompts and topics significantly influenced the conversation flows and the data collection performance. We discuss the opportunities and challenges of building chatbots with LLMs.

Application of deep learning on histopathological whole slide images (WSIs) holds promise of improving diagnostic efficiency and reproducibility but is largely dependent on the ability to write computer code or purchase commercial solutions. We present a code-free pipeline utilizing free-to-use, open-source software (QuPath, DeepMIB, and FastPathology) for creating and deploying deep learning-based segmentation models for computational pathology. We demonstrate the pipeline on a use case of separating epithelium from stroma in colonic mucosa. A dataset of 251 annotated WSIs, comprising 140 hematoxylin-eosin (HE)-stained and 111 CD3 immunostained colon biopsy WSIs, were developed through active learning using the pipeline. On a hold-out test set of 36 HE and 21 CD3-stained WSIs a mean intersection over union score of 96.6% and 95.3% was achieved on epithelium segmentation. We demonstrate pathologist-level segmentation accuracy and clinical acceptable runtime performance and show that pathologists without programming experience can create near state-of-the-art segmentation solutions for histopathological WSIs using only free-to-use software. The study further demonstrates the strength of open-source solutions in its ability to create generalizable, open pipelines, of which trained models and predictions can seamlessly be exported in open formats and thereby used in external solutions. All scripts, trained models, a video tutorial, and the full dataset of 251 WSIs with ~31k epithelium annotations are made openly available at https://github.com/andreped/NoCodeSeg to accelerate research in the field.

Multiplex immunofluorescence and immunohistochemistry benefit patients by allowing cancer pathologists to identify several proteins expressed on the surface of cells, enabling cell classification, better understanding of the tumour micro-environment, more accurate diagnoses, prognoses, and tailored immunotherapy based on the immune status of individual patients. However, they are expensive and time consuming processes which require complex staining and imaging techniques by expert technicians. Hoechst staining is much cheaper and easier to perform, but is not typically used in this case as it binds to DNA rather than to the proteins targeted by immunofluorescent techniques, and it was not previously thought possible to differentiate cells expressing these proteins based only on DNA morphology. In this work we show otherwise, training a deep convolutional neural network to identify cells expressing three proteins (T lymphocyte markers CD3 and CD8, and the B lymphocyte marker CD20) with greater than 90% precision and recall, from Hoechst 33342 stained tissue only. Our model learns previously unknown morphological features associated with expression of these proteins which can be used to accurately differentiate lymphocyte subtypes for use in key prognostic metrics such as assessment of immune cell infiltration,and thereby predict and improve patient outcomes without the need for costly multiplex immunofluorescence.

Recent large language models (LLMs) in the general domain, such as ChatGPT, have shown remarkable success in following instructions and producing human-like responses. However, such language models have not been learned individually and carefully for the medical domain, resulting in poor diagnostic accuracy and inability to give correct recommendations for medical diagnosis, medications, etc. To address this issue, we collected more than 700 diseases and their corresponding symptoms, recommended medications, and required medical tests, and then generated 5K doctor-patient conversations. By fine-tuning models of doctor-patient conversations, these models emerge with great potential to understand patients' needs, provide informed advice, and offer valuable assistance in a variety of medical-related fields. The integration of these advanced language models into healthcare can revolutionize the way healthcare professionals and patients communicate, ultimately improving the overall quality of care and patient outcomes. In addition, we will open all source code, datasets and model weights to advance the further development of dialogue models in the medical field. In addition, the training data, code, and weights of this project are available at: https://github.com/Kent0n-Li/ChatDoctor.

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.

With over 85 million CT scans performed annually in the United States, creating tumor-related reports is a challenging and time-consuming task for radiologists. To address this need, we present RadGPT, an Anatomy-Aware Vision-Language AI Agent for generating detailed reports from CT scans. RadGPT first segments tumors, including benign cysts and malignant tumors, and their surrounding anatomical structures, then transforms this information into both structured reports and narrative reports. These reports provide tumor size, shape, location, attenuation, volume, and interactions with surrounding blood vessels and organs. Extensive evaluation on unseen hospitals shows that RadGPT can produce accurate reports, with high sensitivity/specificity for small tumor (<2 cm) detection: 80/73% for liver tumors, 92/78% for kidney tumors, and 77/77% for pancreatic tumors. For large tumors, sensitivity ranges from 89% to 97%. The results significantly surpass the state-of-the-art in abdominal CT report generation. RadGPT generated reports for 17 public datasets. Through radiologist review and refinement, we have ensured the reports' accuracy, and created the first publicly available image-text 3D medical dataset, comprising over 1.8 million text tokens and 2.7 million images from 9,262 CT scans, including 2,947 tumor scans/reports of 8,562 tumor instances. Our reports can: (1) localize tumors in eight liver sub-segments and three pancreatic sub-segments annotated per-voxel; (2) determine pancreatic tumor stage (T1-T4) in 260 reports; and (3) present individual analyses of multiple tumors--rare in human-made reports. Importantly, 948 of the reports are for early-stage tumors.

The explosion of data in recent years is driving individuals to leverage technology to generate insights. Traditional tools bring heavy learning overheads and the requirement for understanding complex charting techniques. Such barriers can hinder those who may benefit from harnessing data for informed decision making. The emerging field of generating data visualisations from natural language text (NL2VIS) addresses this issue. This study showcases Chat2VIS, a state-of-the-art NL2VIS solution. It capitalises on the latest in AI technology with the upsurge in pre-trained large language models (LLMs) such as GPT-3, Codex, and ChatGPT. Furthermore, the rise in natural language interfaces (NLI) and chatbots is taking centre stage. This work illustrates how Chat2VIS leverages similar techniques to fine-tune data visualisation components beyond that demonstrated in previous approaches. In addition, this paper presents the flexibility of Chat2VIS to comprehend multilingual natural language requests. No other NL2VIS system has demonstrated this unique talent. In concluding, this research provides quantitative benchmarking evaluations to contribute to the paucity of NL2VIS standards.

In this study, we aim to initiate the development of Radiology Foundation Model, termed as RadFM.We consider the construction of foundational models from the perspectives of data, model design, and evaluation thoroughly. Our contribution can be concluded as follows: (i), we construct a large-scale Medical Multi-modal Dataset, MedMD, consisting of 16M 2D and 3D medical scans. To the best of our knowledge, this is the first multi-modal dataset containing 3D medical scans. (ii), We propose an architecture that enables visually conditioned generative pre-training, allowing for the integration of text input interleaved with 2D or 3D medical scans to generate response for diverse radiologic tasks. The model was initially pre-trained on MedMD and subsequently domain-specific fine-tuned on RadMD, a radiologic cleaned version of MedMD, containing 3M radiologic visual-language pairs. (iii), we propose a new evaluation benchmark that comprises five tasks, aiming to comprehensively assess the capability of foundation models in handling practical clinical problems. Our experimental results confirm that RadFM significantly outperforms existing multi-modal foundation models. The codes, data, and model checkpoint will all be made publicly available to promote further research and development in the field.

The rise of big data has amplified the need for efficient, user-friendly automated machine learning (AutoML) tools. However, the intricacy of understanding domain-specific data and defining prediction tasks necessitates human intervention making the process time-consuming while preventing full automation. Instead, envision an intelligent agent capable of assisting users in conducting AutoML tasks through intuitive, natural conversations without requiring in-depth knowledge of the underlying machine learning (ML) processes. This agent's key challenge is to accurately comprehend the user's prediction goals and, consequently, formulate precise ML tasks, adjust data sets and model parameters accordingly, and articulate results effectively. In this paper, we take a pioneering step towards this ambitious goal by introducing a ChatGPT-based conversational data-science framework to act as a "personal data scientist". Precisely, we utilize Large Language Models (ChatGPT) to build a natural interface between the users and the ML models (Scikit-Learn), which in turn, allows us to approach this ambitious problem with a realistic solution. Our model pivots around four dialogue states: Data Visualization, Task Formulation, Prediction Engineering, and Result Summary and Recommendation. Each state marks a unique conversation phase, impacting the overall user-system interaction. Multiple LLM instances, serving as "micro-agents", ensure a cohesive conversation flow, granting us granular control over the conversation's progression. In summary, we developed an end-to-end system that not only proves the viability of the novel concept of conversational data science but also underscores the potency of LLMs in solving complex tasks. Interestingly, its development spotlighted several critical weaknesses in the current LLMs (ChatGPT) and highlighted substantial opportunities for improvement.

The introduction of ChatGPT has garnered widespread attention in both academic and industrial communities. ChatGPT is able to respond effectively to a wide range of human questions, providing fluent and comprehensive answers that significantly surpass previous public chatbots in terms of security and usefulness. On one hand, people are curious about how ChatGPT is able to achieve such strength and how far it is from human experts. On the other hand, people are starting to worry about the potential negative impacts that large language models (LLMs) like ChatGPT could have on society, such as fake news, plagiarism, and social security issues. In this work, we collected tens of thousands of comparison responses from both human experts and ChatGPT, with questions ranging from open-domain, financial, medical, legal, and psychological areas. We call the collected dataset the Human ChatGPT Comparison Corpus (HC3). Based on the HC3 dataset, we study the characteristics of ChatGPT's responses, the differences and gaps from human experts, and future directions for LLMs. We conducted comprehensive human evaluations and linguistic analyses of ChatGPT-generated content compared with that of humans, where many interesting results are revealed. After that, we conduct extensive experiments on how to effectively detect whether a certain text is generated by ChatGPT or humans. We build three different detection systems, explore several key factors that influence their effectiveness, and evaluate them in different scenarios. The dataset, code, and models are all publicly available at https://github.com/Hello-SimpleAI/chatgpt-comparison-detection.

Since the advent of chatbots in the commercial sector, they have been widely employed in the customer service department. Typically, these commercial chatbots are retrieval-based, so they are unable to respond to queries absent in the provided dataset. On the contrary, generative chatbots try to create the most appropriate response, but are mostly unable to create a smooth flow in the customer-bot dialog. Since the client has few options left for continuing after receiving a response, the dialog becomes short. Through our work, we try to maximize the intelligence of a simple conversational agent so it can answer unseen queries, and generate follow-up questions or remarks. We have built a chatbot for a jewelry shop that finds the underlying objective of the customer's query by finding similarity of the input to patterns in the corpus. Our system features an audio input interface for clients, so they may speak to it in natural language. After converting the audio to text, we trained the model to extract the intent of the query, to find an appropriate response and to speak to the client in a natural human voice. To gauge the system's performance, we used performance metrics such as Recall, Precision and F1 score.

Large language models like ChatGPT have recently demonstrated impressive capabilities in natural language understanding and generation, enabling various applications including translation, essay writing, and chit-chatting. However, there is a concern that they can be misused for malicious purposes, such as fraud or denial-of-service attacks. Therefore, it is crucial to develop methods for detecting whether the party involved in a conversation is a bot or a human. In this paper, we propose a framework named FLAIR, Finding Large language model Authenticity via a single Inquiry and Response, to detect conversational bots in an online manner. Specifically, we target a single question scenario that can effectively differentiate human users from bots. The questions are divided into two categories: those that are easy for humans but difficult for bots (e.g., counting, substitution, positioning, noise filtering, and ASCII art), and those that are easy for bots but difficult for humans (e.g., memorization and computation). Our approach shows different strengths of these questions in their effectiveness, providing a new way for online service providers to protect themselves against nefarious activities and ensure that they are serving real users. We open-sourced our dataset on https://github.com/hongwang600/FLAIR and welcome contributions from the community to enrich such detection datasets.

Conversation agents fueled by Large Language Models (LLMs) are providing a new way to interact with visual data. While there have been initial attempts for image-based conversation models, this work addresses the underexplored field of video-based conversation by introducing Video-ChatGPT. It is a multimodal model that merges a video-adapted visual encoder with a LLM. The model is capable of understanding and generating human-like conversations about videos. We introduce a new dataset of 100,000 video-instruction pairs used to train Video-ChatGPT acquired via manual and semi-automated pipeline that is easily scalable and robust to label noise. We also develop a quantiative evaluation framework for video-based dialogue models to objectively analyse the strengths and weaknesses of proposed models. Our code, models, instruction-sets and demo are released at https://github.com/mbzuai-oryx/Video-ChatGPT.

ChatGPT is attracting a cross-field interest as it provides a language interface with remarkable conversational competency and reasoning capabilities across many domains. However, since ChatGPT is trained with languages, it is currently not capable of processing or generating images from the visual world. At the same time, Visual Foundation Models, such as Visual Transformers or Stable Diffusion, although showing great visual understanding and generation capabilities, they are only experts on specific tasks with one-round fixed inputs and outputs. To this end, We build a system called Visual ChatGPT, incorporating different Visual Foundation Models, to enable the user to interact with ChatGPT by 1) sending and receiving not only languages but also images 2) providing complex visual questions or visual editing instructions that require the collaboration of multiple AI models with multi-steps. 3) providing feedback and asking for corrected results. We design a series of prompts to inject the visual model information into ChatGPT, considering models of multiple inputs/outputs and models that require visual feedback. Experiments show that Visual ChatGPT opens the door to investigating the visual roles of ChatGPT with the help of Visual Foundation Models. Our system is publicly available at https://github.com/microsoft/visual-chatgpt.

Background: General-purpose large language models that utilize both text and images have not been evaluated on a diverse array of challenging medical cases. Methods: Using 934 cases from the NEJM Image Challenge published between 2005 and 2023, we evaluated the accuracy of the recently released Generative Pre-trained Transformer 4 with Vision model (GPT-4V) compared to human respondents overall and stratified by question difficulty, image type, and skin tone. We further conducted a physician evaluation of GPT-4V on 69 NEJM clinicopathological conferences (CPCs). Analyses were conducted for models utilizing text alone, images alone, and both text and images. Results: GPT-4V achieved an overall accuracy of 61% (95% CI, 58 to 64%) compared to 49% (95% CI, 49 to 50%) for humans. GPT-4V outperformed humans at all levels of difficulty and disagreement, skin tones, and image types; the exception was radiographic images, where performance was equivalent between GPT-4V and human respondents. Longer, more informative captions were associated with improved performance for GPT-4V but similar performance for human respondents. GPT-4V included the correct diagnosis in its differential for 80% (95% CI, 68 to 88%) of CPCs when using text alone, compared to 58% (95% CI, 45 to 70%) of CPCs when using both images and text. Conclusions: GPT-4V outperformed human respondents on challenging medical cases and was able to synthesize information from both images and text, but performance deteriorated when images were added to highly informative text. Overall, our results suggest that multimodal AI models may be useful in medical diagnostic reasoning but that their accuracy may depend heavily on context.

Survival prediction is a complicated ordinal regression task that aims to predict the ranking risk of death, which generally benefits from the integration of histology and genomic data. Despite the progress in joint learning from pathology and genomics, existing methods still suffer from challenging issues: 1) Due to the large size of pathological images, it is difficult to effectively represent the gigapixel whole slide images (WSIs). 2) Interactions within tumor microenvironment (TME) in histology are essential for survival analysis. Although current approaches attempt to model these interactions via co-attention between histology and genomic data, they focus on only dense local similarity across modalities, which fails to capture global consistency between potential structures, i.e. TME-related interactions of histology and co-expression of genomic data. To address these challenges, we propose a Multimodal Optimal Transport-based Co-Attention Transformer framework with global structure consistency, in which optimal transport (OT) is applied to match patches of a WSI and genes embeddings for selecting informative patches to represent the gigapixel WSI. More importantly, OT-based co-attention provides a global awareness to effectively capture structural interactions within TME for survival prediction. To overcome high computational complexity of OT, we propose a robust and efficient implementation over micro-batch of WSI patches by approximating the original OT with unbalanced mini-batch OT. Extensive experiments show the superiority of our method on five benchmark datasets compared to the state-of-the-art methods. The code is released.

Large Language Models (LLMs) and multi-agent systems have shown impressive capabilities in natural language tasks but face challenges in clinical trial applications, primarily due to limited access to external knowledge. Recognizing the potential of advanced clinical trial tools that aggregate and predict based on the latest medical data, we propose an integrated solution to enhance their accessibility and utility. We introduce Clinical Agent System (ClinicalAgent), a clinical multi-agent system designed for clinical trial tasks, leveraging GPT-4, multi-agent architectures, LEAST-TO-MOST, and ReAct reasoning technology. This integration not only boosts LLM performance in clinical contexts but also introduces novel functionalities. The proposed method achieves competitive predictive performance in clinical trial outcome prediction (0.7908 PR-AUC), obtaining a 0.3326 improvement over the standard prompt Method. Publicly available code can be found at https://anonymous.4open.science/r/ClinicalAgent-6671.

Medical image analysis is essential to clinical diagnosis and treatment, which is increasingly supported by multi-modal large language models (MLLMs). However, previous research has primarily focused on 2D medical images, leaving 3D images under-explored, despite their richer spatial information. This paper aims to advance 3D medical image analysis with MLLMs. To this end, we present a large-scale 3D multi-modal medical dataset, M3D-Data, comprising 120K image-text pairs and 662K instruction-response pairs specifically tailored for various 3D medical tasks, such as image-text retrieval, report generation, visual question answering, positioning, and segmentation. Additionally, we propose M3D-LaMed, a versatile multi-modal large language model for 3D medical image analysis. Furthermore, we introduce a new 3D multi-modal medical benchmark, M3D-Bench, which facilitates automatic evaluation across eight tasks. Through comprehensive evaluation, our method proves to be a robust model for 3D medical image analysis, outperforming existing solutions. All code, data, and models are publicly available at: https://github.com/BAAI-DCAI/M3D.

Flattery is an important aspect of human communication that facilitates social bonding, shapes perceptions, and influences behavior through strategic compliments and praise, leveraging the power of speech to build rapport effectively. Its automatic detection can thus enhance the naturalness of human-AI interactions. To meet this need, we present a novel audio textual dataset comprising 20 hours of speech and train machine learning models for automatic flattery detection. In particular, we employ pretrained AST, Wav2Vec2, and Whisper models for the speech modality, and Whisper TTS models combined with a RoBERTa text classifier for the textual modality. Subsequently, we build a multimodal classifier by combining text and audio representations. Evaluation on unseen test data demonstrates promising results, with Unweighted Average Recall scores reaching 82.46% in audio-only experiments, 85.97% in text-only experiments, and 87.16% using a multimodal approach.

An increasing number of public datasets have shown a marked impact on automated organ segmentation and tumor detection. However, due to the small size and partially labeled problem of each dataset, as well as a limited investigation of diverse types of tumors, the resulting models are often limited to segmenting specific organs/tumors and ignore the semantics of anatomical structures, nor can they be extended to novel domains. To address these issues, we propose the CLIP-Driven Universal Model, which incorporates text embedding learned from Contrastive Language-Image Pre-training (CLIP) to segmentation models. This CLIP-based label encoding captures anatomical relationships, enabling the model to learn a structured feature embedding and segment 25 organs and 6 types of tumors. The proposed model is developed from an assembly of 14 datasets, using a total of 3,410 CT scans for training and then evaluated on 6,162 external CT scans from 3 additional datasets. We rank first on the Medical Segmentation Decathlon (MSD) public leaderboard and achieve state-of-the-art results on Beyond The Cranial Vault (BTCV). Additionally, the Universal Model is computationally more efficient (6x faster) compared with dataset-specific models, generalized better to CT scans from varying sites, and shows stronger transfer learning performance on novel tasks.

Responsing with image has been recognized as an important capability for an intelligent conversational agent. Yet existing works only focus on exploring the multimodal dialogue models which depend on retrieval-based methods, but neglecting generation methods. To fill in the gaps, we first present a multimodal dialogue generation model, which takes the dialogue history as input, then generates a textual sequence or an image as response. Learning such a model often requires multimodal dialogues containing both texts and images which are difficult to obtain. Motivated by the challenge in practice, we consider multimodal dialogue generation under a natural assumption that only limited training examples are available. In such a low-resource setting, we devise a novel conversational agent, Divter, in order to isolate parameters that depend on multimodal dialogues from the entire generation model. By this means, the major part of the model can be learned from a large number of text-only dialogues and text-image pairs respectively, then the whole parameters can be well fitted using the limited training examples. Extensive experiments demonstrate our method achieves state-of-the-art results in both automatic and human evaluation, and can generate informative text and high-resolution image responses.

Since the release of ChatGPT, the field of Natural Language Processing has experienced rapid advancements, particularly in Large Language Models (LLMs) and their multimodal counterparts, Large Multimodal Models (LMMs). Despite their impressive capabilities, LLMs often exhibit significant performance disparities across different languages and cultural contexts, as demonstrated by various text-only benchmarks. However, current research lacks such benchmarks for multimodal visio-linguistic settings. This work fills this gap by introducing M5, the first comprehensive benchmark designed to evaluate LMMs on diverse vision-language tasks within a multilingual and multicultural context. M5 includes eight datasets covering five tasks and 41 languages, with a focus on underrepresented languages and culturally diverse images. Furthermore, we introduce two novel datasets, M5-VGR and M5-VLOD, including a new Visio-Linguistic Outlier Detection task, in which all evaluated open-source models fail to significantly surpass the random baseline. Through extensive evaluation and analyses, we highlight substantial task-agnostic performance disparities between high- and low-resource languages. Moreover, we show that larger models do not necessarily outperform smaller ones in a multilingual setting.

Several medical Multimodal Large Languange Models (MLLMs) have been developed to address tasks involving visual images with textual instructions across various medical modalities, achieving impressive results. Most current medical generalist models are region-agnostic, treating the entire image as a holistic representation. However, they struggle to identify which specific regions they are focusing on when generating a sentence. To mimic the behavior of doctors, who typically begin by reviewing the entire image before concentrating on specific regions for a thorough evaluation, we aim to enhance the capability of medical MLLMs in understanding anatomical regions within entire medical scans. To achieve it, we first formulate Region-Centric tasks and construct a large-scale dataset, MedRegInstruct, to incorporate regional information into training. Combining our collected dataset with other medical multimodal corpora for training, we propose a Region-Aware medical MLLM, MedRegA, which is the first bilingual generalist medical AI system to simultaneously handle image-level and region-level medical vision-language tasks across a broad range of modalities. Our MedRegA not only enables three region-centric tasks, but also achieves the best performance for visual question answering, report generation and medical image classification over 8 modalities, showcasing significant versatility. Experiments demonstrate that our model can not only accomplish powerful performance across various medical vision-language tasks in bilingual settings, but also recognize and detect structures in multimodal medical scans, boosting the interpretability and user interactivity of medical MLLMs. Our project page is https://medrega.github.io.

We present an interactive visual framework named InternChat, or iChat for short. The framework integrates chatbots that have planning and reasoning capabilities, such as ChatGPT, with non-verbal instructions like pointing movements that enable users to directly manipulate images or videos on the screen. Pointing (including gestures, cursors, etc.) movements can provide more flexibility and precision in performing vision-centric tasks that require fine-grained control, editing, and generation of visual content. The name InternChat stands for interaction, nonverbal, and chatbots. Different from existing interactive systems that rely on pure language, by incorporating pointing instructions, the proposed iChat significantly improves the efficiency of communication between users and chatbots, as well as the accuracy of chatbots in vision-centric tasks, especially in complicated visual scenarios where the number of objects is greater than 2. Additionally, in iChat, an auxiliary control mechanism is used to improve the control capability of LLM, and a large vision-language model termed Husky is fine-tuned for high-quality multi-modal dialogue (impressing ChatGPT-3.5-turbo with 93.89% GPT-4 Quality). We hope this work can spark new ideas and directions for future interactive visual systems. Welcome to watch the code at https://github.com/OpenGVLab/InternChat.

Conversational LLMs function as black box systems, leaving users guessing about why they see the output they do. This lack of transparency is potentially problematic, especially given concerns around bias and truthfulness. To address this issue, we present an end-to-end prototype-connecting interpretability techniques with user experience design-that seeks to make chatbots more transparent. We begin by showing evidence that a prominent open-source LLM has a "user model": examining the internal state of the system, we can extract data related to a user's age, gender, educational level, and socioeconomic status. Next, we describe the design of a dashboard that accompanies the chatbot interface, displaying this user model in real time. The dashboard can also be used to control the user model and the system's behavior. Finally, we discuss a study in which users conversed with the instrumented system. Our results suggest that users appreciate seeing internal states, which helped them expose biased behavior and increased their sense of control. Participants also made valuable suggestions that point to future directions for both design and machine learning research. The project page and video demo of our TalkTuner system are available at https://bit.ly/talktuner-project-page

The present paper surveys neural approaches to conversational AI that have been developed in the last few years. We group conversational systems into three categories: (1) question answering agents, (2) task-oriented dialogue agents, and (3) chatbots. For each category, we present a review of state-of-the-art neural approaches, draw the connection between them and traditional approaches, and discuss the progress that has been made and challenges still being faced, using specific systems and models as case studies.

While conversational generative AI has shown considerable potential in enhancing decision-making for agricultural professionals, its exploration has predominantly been anchored in text-based interactions. The evolution of multimodal conversational AI, leveraging vast amounts of image-text data from diverse sources, marks a significant stride forward. However, the application of such advanced vision-language models in the agricultural domain, particularly for crop disease diagnosis, remains underexplored. In this work, we present the crop disease domain multimodal (CDDM) dataset, a pioneering resource designed to advance the field of agricultural research through the application of multimodal learning techniques. The dataset comprises 137,000 images of various crop diseases, accompanied by 1 million question-answer pairs that span a broad spectrum of agricultural knowledge, from disease identification to management practices. By integrating visual and textual data, CDDM facilitates the development of sophisticated question-answering systems capable of providing precise, useful advice to farmers and agricultural professionals. We demonstrate the utility of the dataset by finetuning state-of-the-art multimodal models, showcasing significant improvements in crop disease diagnosis. Specifically, we employed a novel finetuning strategy that utilizes low-rank adaptation (LoRA) to finetune the visual encoder, adapter and language model simultaneously. Our contributions include not only the dataset but also a finetuning strategy and a benchmark to stimulate further research in agricultural technology, aiming to bridge the gap between advanced AI techniques and practical agricultural applications. The dataset is available at https: //github.com/UnicomAI/UnicomBenchmark/tree/main/CDDMBench.

People experiencing severe distress increasingly use Large Language Model (LLM) chatbots as mental health support tools. Discussions on social media have described how engagements were lifesaving for some, but evidence suggests that general-purpose LLM chatbots also have notable risks that could endanger the welfare of users if not designed responsibly. In this study, we investigate the lived experiences of people who have used LLM chatbots for mental health support. We build on interviews with 21 individuals from globally diverse backgrounds to analyze how users create unique support roles for their chatbots, fill in gaps in everyday care, and navigate associated cultural limitations when seeking support from chatbots. We ground our analysis in psychotherapy literature around effective support, and introduce the concept of therapeutic alignment, or aligning AI with therapeutic values for mental health contexts. Our study offers recommendations for how designers can approach the ethical and effective use of LLM chatbots and other AI mental health support tools in mental health care.

This paper presents a comprehensive survey of ChatGPT and GPT-4, state-of-the-art large language models (LLM) from the GPT series, and their prospective applications across diverse domains. Indeed, key innovations such as large-scale pre-training that captures knowledge across the entire world wide web, instruction fine-tuning and Reinforcement Learning from Human Feedback (RLHF) have played significant roles in enhancing LLMs' adaptability and performance. We performed an in-depth analysis of 194 relevant papers on arXiv, encompassing trend analysis, word cloud representation, and distribution analysis across various application domains. The findings reveal a significant and increasing interest in ChatGPT/GPT-4 research, predominantly centered on direct natural language processing applications, while also demonstrating considerable potential in areas ranging from education and history to mathematics, medicine, and physics. This study endeavors to furnish insights into ChatGPT's capabilities, potential implications, ethical concerns, and offer direction for future advancements in this field.

At the heart of medicine lies the physician-patient dialogue, where skillful history-taking paves the way for accurate diagnosis, effective management, and enduring trust. Artificial Intelligence (AI) systems capable of diagnostic dialogue could increase accessibility, consistency, and quality of care. However, approximating clinicians' expertise is an outstanding grand challenge. Here, we introduce AMIE (Articulate Medical Intelligence Explorer), a Large Language Model (LLM) based AI system optimized for diagnostic dialogue. AMIE uses a novel self-play based simulated environment with automated feedback mechanisms for scaling learning across diverse disease conditions, specialties, and contexts. We designed a framework for evaluating clinically-meaningful axes of performance including history-taking, diagnostic accuracy, management reasoning, communication skills, and empathy. We compared AMIE's performance to that of primary care physicians (PCPs) in a randomized, double-blind crossover study of text-based consultations with validated patient actors in the style of an Objective Structured Clinical Examination (OSCE). The study included 149 case scenarios from clinical providers in Canada, the UK, and India, 20 PCPs for comparison with AMIE, and evaluations by specialist physicians and patient actors. AMIE demonstrated greater diagnostic accuracy and superior performance on 28 of 32 axes according to specialist physicians and 24 of 26 axes according to patient actors. Our research has several limitations and should be interpreted with appropriate caution. Clinicians were limited to unfamiliar synchronous text-chat which permits large-scale LLM-patient interactions but is not representative of usual clinical practice. While further research is required before AMIE could be translated to real-world settings, the results represent a milestone towards conversational diagnostic AI.

Large language models (LLMs) have exhibited remarkable capabilities across a variety of domains and tasks, challenging our understanding of learning and cognition. Despite the recent success, current LLMs are not capable of processing complex audio information or conducting spoken conversations (like Siri or Alexa). In this work, we propose a multi-modal AI system named AudioGPT, which complements LLMs (i.e., ChatGPT) with 1) foundation models to process complex audio information and solve numerous understanding and generation tasks; and 2) the input/output interface (ASR, TTS) to support spoken dialogue. With an increasing demand to evaluate multi-modal LLMs of human intention understanding and cooperation with foundation models, we outline the principles and processes and test AudioGPT in terms of consistency, capability, and robustness. Experimental results demonstrate the capabilities of AudioGPT in solving AI tasks with speech, music, sound, and talking head understanding and generation in multi-round dialogues, which empower humans to create rich and diverse audio content with unprecedented ease. Our system is publicly available at https://github.com/AIGC-Audio/AudioGPT.

The rapid advancement of large language models (LLMs) has significantly propelled the development of text-based chatbots, demonstrating their capability to engage in coherent and contextually relevant dialogues. However, extending these advancements to enable end-to-end speech-to-speech conversation bots remains a formidable challenge, primarily due to the extensive dataset and computational resources required. The conventional approach of cascading automatic speech recognition (ASR), LLM, and text-to-speech (TTS) models in a pipeline, while effective, suffers from unnatural prosody because it lacks direct interactions between the input audio and its transcribed text and the output audio. These systems are also limited by their inherent latency from the ASR process for real-time applications. This paper introduces Style-Talker, an innovative framework that fine-tunes an audio LLM alongside a style-based TTS model for fast spoken dialog generation. Style-Talker takes user input audio and uses transcribed chat history and speech styles to generate both the speaking style and text for the response. Subsequently, the TTS model synthesizes the speech, which is then played back to the user. While the response speech is being played, the input speech undergoes ASR processing to extract the transcription and speaking style, serving as the context for the ensuing dialogue turn. This novel pipeline accelerates the traditional cascade ASR-LLM-TTS systems while integrating rich paralinguistic information from input speech. Our experimental results show that Style-Talker significantly outperforms the conventional cascade and speech-to-speech baselines in terms of both dialogue naturalness and coherence while being more than 50% faster.

Large language models (LLMs) have demonstrated impressive capabilities in disease diagnosis. However, their effectiveness in identifying rarer diseases, which are inherently more challenging to diagnose, remains an open question. Rare disease performance is critical with the increasing use of LLMs in healthcare settings. This is especially true if a primary care physician needs to make a rarer prognosis from only a patient conversation so that they can take the appropriate next step. To that end, several clinical decision support systems are designed to support providers in rare disease identification. Yet their utility is limited due to their lack of knowledge of common disorders and difficulty of use. In this paper, we propose RareScale to combine the knowledge LLMs with expert systems. We use jointly use an expert system and LLM to simulate rare disease chats. This data is used to train a rare disease candidate predictor model. Candidates from this smaller model are then used as additional inputs to black-box LLM to make the final differential diagnosis. Thus, RareScale allows for a balance between rare and common diagnoses. We present results on over 575 rare diseases, beginning with Abdominal Actinomycosis and ending with Wilson's Disease. Our approach significantly improves the baseline performance of black-box LLMs by over 17% in Top-5 accuracy. We also find that our candidate generation performance is high (e.g. 88.8% on gpt-4o generated chats).

Conventional medical image segmentation methods have been found inadequate in facilitating physicians with the identification of specific lesions for diagnosis and treatment. Given the utility of text as an instructional format, we introduce a novel task termed Medical Image Referring Segmentation (MIRS), which requires segmenting specified lesions in images based on the given language expressions. Due to the varying object scales in medical images, MIRS demands robust vision-language modeling and comprehensive multi-scale interaction for precise localization and segmentation under linguistic guidance. However, existing medical image segmentation methods fall short in meeting these demands, resulting in insufficient segmentation accuracy. In response, we propose an approach named Language-guided Scale-aware MedSegmentor (LSMS), incorporating two appealing designs: (1)~a Scale-aware Vision-Language Attention module that leverages diverse convolutional kernels to acquire rich visual knowledge and interact closely with linguistic features, thereby enhancing lesion localization capability; (2)~a Full-Scale Decoder that globally models multi-modal features across various scales, capturing complementary information between scales to accurately outline lesion boundaries. Addressing the lack of suitable datasets for MIRS, we constructed a vision-language medical dataset called Reference Hepatic Lesion Segmentation (RefHL-Seg). This dataset comprises 2,283 abdominal CT slices from 231 cases, with corresponding textual annotations and segmentation masks for various liver lesions in images. We validated the performance of LSMS for MIRS and conventional medical image segmentation tasks across various datasets. Our LSMS consistently outperforms on all datasets with lower computational costs. The code and datasets will be released.

Immunohistochemical (IHC) staining highlights the molecular information critical to diagnostics in tissue samples. However, compared to H&E staining, IHC staining can be much more expensive in terms of both labor and the laboratory equipment required. This motivates recent research that demonstrates that the correlations between the morphological information present in the H&E-stained slides and the molecular information in the IHC-stained slides can be used for H&E-to-IHC stain translation. However, due to a lack of pixel-perfect H&E-IHC groundtruth pairs, most existing methods have resorted to relying on expert annotations. To remedy this situation, we present a new loss function, Adaptive Supervised PatchNCE (ASP), to directly deal with the input to target inconsistencies in a proposed H&E-to-IHC image-to-image translation framework. The ASP loss is built upon a patch-based contrastive learning criterion, named Supervised PatchNCE (SP), and augments it further with weight scheduling to mitigate the negative impact of noisy supervision. Lastly, we introduce the Multi-IHC Stain Translation (MIST) dataset, which contains aligned H&E-IHC patches for 4 different IHC stains critical to breast cancer diagnosis. In our experiment, we demonstrate that our proposed method outperforms existing image-to-image translation methods for stain translation to multiple IHC stains. All of our code and datasets are available at https://github.com/lifangda01/AdaptiveSupervisedPatchNCE.

Large language models (LLMs), such as ChatGPT, have received substantial attention due to their impressive human language understanding and generation capabilities. Therefore, the application of LLMs in medicine to assist physicians and patient care emerges as a promising research direction in both artificial intelligence and clinical medicine. To reflect this trend, this survey provides a comprehensive overview of the principles, applications, and challenges faced by LLMs in medicine. Specifically, we aim to address the following questions: 1) How can medical LLMs be built? 2) What are the downstream performances of medical LLMs? 3) How can medical LLMs be utilized in real-world clinical practice? 4) What challenges arise from the use of medical LLMs? and 5) How can we better construct and utilize medical LLMs? As a result, this survey aims to provide insights into the opportunities and challenges of LLMs in medicine and serve as a valuable resource for constructing practical and effective medical LLMs. A regularly updated list of practical guides on medical LLMs can be found at https://github.com/AI-in-Health/MedLLMsPracticalGuide.

Artificial Intelligence (AI) has demonstrated significant potential in healthcare, particularly in disease diagnosis and treatment planning. Recent progress in Medical Large Vision-Language Models (Med-LVLMs) has opened up new possibilities for interactive diagnostic tools. However, these models often suffer from factual hallucination, which can lead to incorrect diagnoses. Fine-tuning and retrieval-augmented generation (RAG) have emerged as methods to address these issues. However, the amount of high-quality data and distribution shifts between training data and deployment data limit the application of fine-tuning methods. Although RAG is lightweight and effective, existing RAG-based approaches are not sufficiently general to different medical domains and can potentially cause misalignment issues, both between modalities and between the model and the ground truth. In this paper, we propose a versatile multimodal RAG system, MMed-RAG, designed to enhance the factuality of Med-LVLMs. Our approach introduces a domain-aware retrieval mechanism, an adaptive retrieved contexts selection method, and a provable RAG-based preference fine-tuning strategy. These innovations make the RAG process sufficiently general and reliable, significantly improving alignment when introducing retrieved contexts. Experimental results across five medical datasets (involving radiology, ophthalmology, pathology) on medical VQA and report generation demonstrate that MMed-RAG can achieve an average improvement of 43.8% in the factual accuracy of Med-LVLMs. Our data and code are available in https://github.com/richard-peng-xia/MMed-RAG.

In this paper, we propose Tutoring bot, a generative chatbot trained on a large scale of tutor-student conversations for English-language learning. To mimic a human tutor's behavior in language education, the tutor bot leverages diverse educational instructions and grounds to each instruction as additional input context for the tutor response generation. As a single instruction generally involves multiple dialogue turns to give the student sufficient speaking practice, the tutor bot is required to monitor and capture when the current instruction should be kept or switched to the next instruction. For that, the tutor bot is learned to not only generate responses but also infer its teaching action and progress on the current conversation simultaneously by a multi-task learning scheme. Our Tutoring bot is deployed under a non-commercial use license at https://tutoringai.com.

As sharing images in an instant message is a crucial factor, there has been active research on learning a image-text multi-modal dialogue model. However, training a well-generalized multi-modal dialogue model is challenging because existing multi-modal dialogue datasets contain a small number of data, limited topics, and a restricted variety of images per dialogue. In this paper, we present a multi-modal dialogue dataset creation pipeline that involves matching large-scale images to dialogues based on CLIP similarity. Using this automatic pipeline, we propose a large-scale multi-modal dialogue dataset, DialogCC, which covers diverse real-world topics and various images per dialogue. With extensive experiments, we demonstrate that training a multi-modal dialogue model with our dataset can improve generalization performance. Additionally, existing models trained with our dataset achieve state-of-the-art performance on image and text retrieval tasks. The source code and the dataset will be released after publication.