Organizations: 1VA Bedford Health Care · 2UMass Amherst · 4Yale University · 5National University of Singapore · 6Yale School of Medicine · 3UMass Lowell
Abstract
Most medical multimodal benchmarks focus on static tasks such as image question answering, report generation, and plain-language rewriting. Patient education is more demanding: systems must identify relevant evidence across images, show patients where to look, explain findings in accessible language, and handle confusion or distress. Yet most patient education work remains text-only, even though combined image-and-text explanations may better support understanding. We introduce MedImageEdu, a benchmark for multi-turn, evidence-grounded radiology patient education. Each case provides a radiology report with report text and case images. A DoctorAgent interacts with a PatientAgent, conditioned on a hidden profile that captures factors such as education level, health literacy, and personality. When a patient question would benefit from visual support, the DoctorAgent can issue drawing instructions grounded in the report, case images, and the current question to a benchmark-provided drawing tool. The tool returns image(s), after which the DoctorAgent produces a final multimodal response consisting of the image(s) and a grounded plain-language explanation. MedImageEdu contains 150 cases from three sources and evaluates both the consultation process and the final multimodal response along five dimensions: Consultation, Safety and Scope, Language Quality, Drawing Quality, and Image-Text Response Quality. Across representative open- and closed-source vision-language model agents, we find three consistent gaps: fluent language often outpaces faithful visual grounding, safety is the weakest dimension across disease categories, and emotionally tense interactions are harder than low education or low health literacy. MedImageEdu provides a controlled testbed for assessing whether multimodal agents can teach from evidence rather than merely answer from text.
Recent advances in large language models and vision-language models have enabled reasoning over multimodal data, offering opportunities for clinical applications such as decision support and triaging. However, existing medical AI benchmarks are fragmented: some support multi-turn dialogues but lack images, while others provide multimodal inputs but focus on single-turn QA tasks. To address this gap, we introduce IMCBench, an image-grounded, multi-turn medical conversation benchmark that pairs real, publicly available clinical images with synthetic patient profiles to simulate realistic patient-clinician interactions. Each conversation is evaluated across three clinical dimensions: safety, accuracy, and appropriate use of uncertainty in diagnosis. We benchmark eight multimodal frontier models across four model families (Claude, GPT, Nova, and Llama), scoring each on a 1-5 scale using LLM-as-Jury scoring calibrated against expert clinician annotations. Our results show that Claude Opus 4.6 achieves the highest overall score (3.61), followed by Claude Sonnet 4.6 (3.30) and GPT-5.2 (3.29), though no model dominates all dimensions and safety degrades for both malignant and rare conditions (Δ = -0.27 each). Ablation studies further reveal that both visual input and EHR context contribute to safe guidance (safety drops of 0.18 and 0.23 on average when each is removed), with stronger models leveraging visual features more effectively. Together, these findings demonstrate that accurate clinical description does not guarantee safe patient guidance, motivating the need for multi-dimensional evaluation frameworks in medical AI.
Maria Xenochristou, Ashutosh Joshi, Korosh Vatanparvar +10
Medical benchmarks are dominated by single-turn, multiple-choice clinical cases that poorly reflect real consultations. Practically, clinicians elicit evidence interactively and patient communication varies widely. We introduce MedRoundsQA, a multi-turn diagnostic benchmark derived from 1,387 board-exam cases across 17 specialties. Each case is converted into a structured 24-slot clinical record, and then instantiated as controlled doctor-patient dual-agent dialogues under varying patient personas, with the underlying clinical content held fixed. We further classify cases by difficulty using model-based uncertainty to enable easy-to-hard analysis. Evaluations of fifteen LLM doctor agents show that (i) moving from a single-turn diagnosis on the standardized records to multi-turn consultations causes large degradations of roughly 13-39 points; (ii) more turns reliably improves question relevance, but diagnostic accuracy exhibits diminishing returns and typically plateaus after 6-12 turns; and (iii) patient persona differences can shift diagnosis accuracy by about 7-8 points (lowest to highest education), highlighting equity risks that single-turn benchmarks miss.
This paper introduces a new benchmark test, Medical-Checklist, for assessing medical multimodal models. The recent advancements in multimodal models have demonstrated significant potential in the field of medical vision-language tasks. However, it is becoming increasingly clear that evaluating these models' performance, whether they are applied to natural or medical images, is challenging. The critical question is whether the models can accurately understand an input image while associating it with relevant input text. To address this, Medical-Checklist imposes a binary test on the models: they are given an image and two captions, where one is correct and the other incorrect, and the model must select the correct one. The incorrect caption contains a single medical concept (word or phrase) that is inaccurately substituted from the correct caption. Although the task is simple, this simplicity enables the unified assessment of diverse multimodal models designed and learned on different principles. It also enables us to verify whether models correctly understand a wide range of medical concepts across various medical sub-domains. Medical-Checklist is designed to reduce potential biases in data and to enable evaluation of the models' ability to handle out-of-distribution inputs, which were difficult in existing datasets. When evaluating four state-of-the-art medical multimodal models with Medical-Checklist, it was revealed that despite their excellent performance in specific tasks such as Med-VQA, they may not correctly understand images, suggesting a long journey ahead for clinical application. The dataset and code will be made public upon acceptance.