Native Intelligence Emerges from Large-Scale Clinical Practice: A Retinal Foundation Model with Deployment Efficiency
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arXiv
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| Main Authors: | , , , , , , , , , , , , , , , , , , , , , , , |
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| Format: | Preprint |
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2025
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| _version_ | 1866909965451526144 |
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| author | Guo, Jia Du, Jiawei Yang, Shengzhu Lu, Shuai Cheng, Wenquan Zhang, Kaiwen Sun, Yihua Yang, Chuhong Zhang, Weihang Chen, Fang Wu, Yilan Ju, Lie Ning, Guochen Ma, Longfei Yao, Huiping Wang, Jinyuan Shi, Peilun Zhou, Yukun Xu, Jie Keane, Pearse A. Liu, Hanruo Liao, Hongen Wang, Ningli Li, Huiqi |
| author_facet | Guo, Jia Du, Jiawei Yang, Shengzhu Lu, Shuai Cheng, Wenquan Zhang, Kaiwen Sun, Yihua Yang, Chuhong Zhang, Weihang Chen, Fang Wu, Yilan Ju, Lie Ning, Guochen Ma, Longfei Yao, Huiping Wang, Jinyuan Shi, Peilun Zhou, Yukun Xu, Jie Keane, Pearse A. Liu, Hanruo Liao, Hongen Wang, Ningli Li, Huiqi |
| contents | Current retinal foundation models remain constrained by curated research datasets that lack authentic clinical context, and require extensive task-specific optimization for each application, limiting their deployment efficiency in low-resource settings. Here, we show that these barriers can be overcome by building clinical native intelligence directly from real-world medical practice. Our key insight is that large-scale telemedicine programs, where expert centers provide remote consultations across distributed facilities, represent a natural reservoir for learning clinical image interpretation. We present ReVision, a retinal foundation model that learns from the natural alignment between 485,980 color fundus photographs and their corresponding diagnostic reports, accumulated through a decade-long telemedicine program spanning 162 medical institutions across China. Through extensive evaluation across 27 ophthalmic benchmarks, we demonstrate that ReVison enables deployment efficiency with minimal local resources. Without any task-specific training, ReVision achieves zero-shot disease detection with an average AUROC of 0.946 across 12 public benchmarks and 0.952 on 3 independent clinical cohorts. When minimal adaptation is feasible, ReVision matches extensively fine-tuned alternatives while requiring orders of magnitude fewer trainable parameters and labeled examples. The learned representations also transfer effectively to new clinical sites, imaging domains, imaging modalities, and systemic health prediction tasks. In a prospective reader study with 33 ophthalmologists, ReVision's zero-shot assistance improved diagnostic accuracy by 14.8% across all experience levels. These results demonstrate that clinical native intelligence can be directly extracted from clinical archives without any further annotation to build medical AI systems suited to various low-resource settings. |
| format | Preprint |
| id |
arxiv_https___arxiv_org_abs_2512_14499 |
| institution | arXiv |
| publishDate | 2025 |
| record_format | arxiv |
| spellingShingle | Native Intelligence Emerges from Large-Scale Clinical Practice: A Retinal Foundation Model with Deployment Efficiency Guo, Jia Du, Jiawei Yang, Shengzhu Lu, Shuai Cheng, Wenquan Zhang, Kaiwen Sun, Yihua Yang, Chuhong Zhang, Weihang Chen, Fang Wu, Yilan Ju, Lie Ning, Guochen Ma, Longfei Yao, Huiping Wang, Jinyuan Shi, Peilun Zhou, Yukun Xu, Jie Keane, Pearse A. Liu, Hanruo Liao, Hongen Wang, Ningli Li, Huiqi Computer Vision and Pattern Recognition Current retinal foundation models remain constrained by curated research datasets that lack authentic clinical context, and require extensive task-specific optimization for each application, limiting their deployment efficiency in low-resource settings. Here, we show that these barriers can be overcome by building clinical native intelligence directly from real-world medical practice. Our key insight is that large-scale telemedicine programs, where expert centers provide remote consultations across distributed facilities, represent a natural reservoir for learning clinical image interpretation. We present ReVision, a retinal foundation model that learns from the natural alignment between 485,980 color fundus photographs and their corresponding diagnostic reports, accumulated through a decade-long telemedicine program spanning 162 medical institutions across China. Through extensive evaluation across 27 ophthalmic benchmarks, we demonstrate that ReVison enables deployment efficiency with minimal local resources. Without any task-specific training, ReVision achieves zero-shot disease detection with an average AUROC of 0.946 across 12 public benchmarks and 0.952 on 3 independent clinical cohorts. When minimal adaptation is feasible, ReVision matches extensively fine-tuned alternatives while requiring orders of magnitude fewer trainable parameters and labeled examples. The learned representations also transfer effectively to new clinical sites, imaging domains, imaging modalities, and systemic health prediction tasks. In a prospective reader study with 33 ophthalmologists, ReVision's zero-shot assistance improved diagnostic accuracy by 14.8% across all experience levels. These results demonstrate that clinical native intelligence can be directly extracted from clinical archives without any further annotation to build medical AI systems suited to various low-resource settings. |
| title | Native Intelligence Emerges from Large-Scale Clinical Practice: A Retinal Foundation Model with Deployment Efficiency |
| topic | Computer Vision and Pattern Recognition |
| url | https://arxiv.org/abs/2512.14499 |