Medical Adaptation of Large Language and Vision-Language Models: Are We Making Progress?

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Hauptverfasser: Jeong, Daniel P., Garg, Saurabh, Lipton, Zachary C., Oberst, Michael
Format: Preprint
Veröffentlicht: 2024
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author Jeong, Daniel P.
Garg, Saurabh
Lipton, Zachary C.
Oberst, Michael
author_facet Jeong, Daniel P.
Garg, Saurabh
Lipton, Zachary C.
Oberst, Michael
contents Several recent works seek to develop foundation models specifically for medical applications, adapting general-purpose large language models (LLMs) and vision-language models (VLMs) via continued pretraining on publicly available biomedical corpora. These works typically claim that such domain-adaptive pretraining (DAPT) improves performance on downstream medical tasks, such as answering medical licensing exam questions. In this paper, we compare seven public "medical" LLMs and two VLMs against their corresponding base models, arriving at a different conclusion: all medical VLMs and nearly all medical LLMs fail to consistently improve over their base models in the zero-/few-shot prompting regime for medical question-answering (QA) tasks. For instance, across the tasks and model pairs we consider in the 3-shot setting, medical LLMs only outperform their base models in 12.1% of cases, reach a (statistical) tie in 49.8% of cases, and are significantly worse than their base models in the remaining 38.2% of cases. Our conclusions are based on (i) comparing each medical model head-to-head, directly against the corresponding base model; (ii) optimizing the prompts for each model separately; and (iii) accounting for statistical uncertainty in comparisons. While these basic practices are not consistently adopted in the literature, our ablations show that they substantially impact conclusions. Our findings suggest that state-of-the-art general-domain models may already exhibit strong medical knowledge and reasoning capabilities, and offer recommendations to strengthen the conclusions of future studies.
format Preprint
id arxiv_https___arxiv_org_abs_2411_04118
institution arXiv
publishDate 2024
record_format arxiv
spellingShingle Medical Adaptation of Large Language and Vision-Language Models: Are We Making Progress?
Jeong, Daniel P.
Garg, Saurabh
Lipton, Zachary C.
Oberst, Michael
Computation and Language
Artificial Intelligence
Machine Learning
Several recent works seek to develop foundation models specifically for medical applications, adapting general-purpose large language models (LLMs) and vision-language models (VLMs) via continued pretraining on publicly available biomedical corpora. These works typically claim that such domain-adaptive pretraining (DAPT) improves performance on downstream medical tasks, such as answering medical licensing exam questions. In this paper, we compare seven public "medical" LLMs and two VLMs against their corresponding base models, arriving at a different conclusion: all medical VLMs and nearly all medical LLMs fail to consistently improve over their base models in the zero-/few-shot prompting regime for medical question-answering (QA) tasks. For instance, across the tasks and model pairs we consider in the 3-shot setting, medical LLMs only outperform their base models in 12.1% of cases, reach a (statistical) tie in 49.8% of cases, and are significantly worse than their base models in the remaining 38.2% of cases. Our conclusions are based on (i) comparing each medical model head-to-head, directly against the corresponding base model; (ii) optimizing the prompts for each model separately; and (iii) accounting for statistical uncertainty in comparisons. While these basic practices are not consistently adopted in the literature, our ablations show that they substantially impact conclusions. Our findings suggest that state-of-the-art general-domain models may already exhibit strong medical knowledge and reasoning capabilities, and offer recommendations to strengthen the conclusions of future studies.
title Medical Adaptation of Large Language and Vision-Language Models: Are We Making Progress?
topic Computation and Language
Artificial Intelligence
Machine Learning
url https://arxiv.org/abs/2411.04118