Medical vision-language models (VLMs) are strong zero-shot recognizers for medical imaging, but their reliability under domain shift hinges on calibrated uncertainty with guarantees. Split conformal prediction (SCP) offers finite-sample coverage, yet prediction sets often become large (low efficiency) and class-wise coverage unbalanced--high class-conditioned coverage gap (CCV), especially in few-shot, imbalanced regimes; moreover, naively adapting to calibration labels breaks exchangeability and voids guarantees. We propose LATA (Laplacian-Assisted Transductive Adaptation), a training- and label-free refinement that operates on the joint calibration and test pool by smoothing zero-shot probabilities over an image-image kNN graph using a small number of CCCP mean-field updates, preserving SCP validity via a deterministic transform. We further introduce a failure-aware conformal score that plugs into the vision-language uncertainty (ViLU) framework, providing instance-level difficulty and label plausibility to improve prediction set efficiency and class-wise balance at fixed coverage. LATA is black-box (no VLM updates), compute-light (windowed transduction, no backprop), and includes an optional prior knob that can run strictly label-free or, if desired, in a label-informed variant using calibration marginals once. Across three medical VLMs and nine downstream tasks, LATA consistently reduces set size and CCV while matching or tightening target coverage, outperforming prior transductive baselines and narrowing the gap to label-using methods, while using far less compute. Comprehensive ablations and qualitative analyses show that LATA sharpens zero-shot predictions without compromising exchangeability.
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cs.CV · cs.CL
Proceedings of the IEEE/CVF Conference on Computer Vision and Pattern Recognition · 2026 · 正式发表
Supervised Fine-Tuning (SFT) of the language backbone plays a pivotal role in adapting Vision-Language Models (VLMs) to specialized domains such as medical reasoning. However, existing SFT practices often rely on unfiltered textual datasets that contain redundant and low-quality samples, leading to substantial computational costs and suboptimal performance in complex clinical scenarios. Although existing methods attempt to alleviate this problem by selecting data based on sample difficulty, defined by knowledge and reasoning complexity, they overlook each sample's optimization utility reflected in its gradient. Interestingly, we find that gradient-based influence alone favors easy-to-optimize samples that cause large parameter shifts but lack deep reasoning chains, while difficulty alone selects noisy or overly complex textual cases that fail to guide stable optimization. Based on this observation, we propose a data selection strategy, Difficulty-Influence Quadrant (DIQ), which prioritizes samples in the "high-difficulty-high-influence" quadrant to balance complex clinical reasoning with substantial gradient influence. This enables efficient medical reasoning for VLMs with minimal fine-tuning data. Furthermore, Human and LLM-as-a-judge evaluations show that DIQ-selected subsets demonstrate higher data quality and generate clinical reasoning that is more aligned with expert practices in differential diagnosis, safety check, and evidence citation, as DIQ emphasizes samples that foster expert-like reasoning patterns. Extensive experiments on medical reasoning benchmarks demonstrate that DIQ enables VLM backbones fine-tuned on only 1% of selected data to match full-dataset performance, while using 10% consistently outperforms baseline methods, highlighting the superiority of principled data selection over brute-force scaling. The code is available at https://github.com/mihara-bot/DIQ.
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cs.CV · cs.CL
Proceedings of the IEEE/CVF Conference on Computer Vision and Pattern Recognition · 2026 · 正式发表
Adapting CLIP to vertical domains is typically approached by novel fine-tuning strategies or by continual pre-training (CPT) on large domain-specific datasets. Yet, data itself remains an underexplored factor in this process. We revisit this task from a data-centric perspective: Can effective data selection substitute for large-scale datasets in CPT? We introduce CHIPS (Curvature-aware Hybrid Influence in Projection Subspace), which assigns each image-text pair a utility score that integrates three complementary factors aligned with three goals: faithfulness via a curvature-aware and Newton-style alignment computed in CLIP's end-point subspace; scalability via an InfoNCE-aware curvature estimator with Johnson-Lindenstrauss (JL) sketching; and retention via a selection-aware relevance weight combined with learnability to balance target adaptation against general-domain preservation. We justify this design theoretically by proving a lower-bound guarantee on the proxy's correlation with full-parameter alignment and by characterizing the bias-variance trade-offs introduced by curvature mixing and JL sketching. We evaluate CHIPS empirically across various settings: 1) CHIPS attains state-of-the-art performance among selection baselines on 17 medical benchmarks, matches full-dataset CPT with 30% of the data, and outperforms half-dataset CPT using only 10%; 2) on 31 general-domain benchmarks, CHIPS yields the least performance drop under all retention ratios.
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cs.CV
Proceedings of the IEEE/CVF Conference on Computer Vision and Pattern Recognition · 2026 · 正式发表
Multimodal large language models (MLLMs) have rapidly advanced, yet their adoption in medicine remains limited by gaps in domain coverage, modality alignment, and grounded reasoning. In this work, we introduce MedMO, a medical foundation model built upon a generalized MLLM architecture and trained exclusively on large-scale, domain-specific data. MedMO follows a multi-stage training recipe: (i) cross-modal pretraining to align heterogeneous visual encoders with a medical language backbone; (ii) instruction tuning on multi-task supervision that spans captioning, VQA, report generation, retrieval, and grounded disease localization with bounding boxes; and (iii) reinforcement learning with verifiable rewards that combine factuality checks with a box-level GIoU reward to strengthen spatial grounding and reasoning in complex clinical scenarios. MedMO consistently outperforms strong open-source medical MLLMs across multiple modalities and tasks. On VQA benchmarks, MedMO achieves an average accuracy improvement of +21.3% over the baseline and performs within 0.6% of the SOTA Fleming-VL. For text-based QA, it attains +7.9% over the baseline and +15.6% over Fleming-VL. In medical report generation, MedMO delivers significant gains in both semantic and clinical accuracy. Moreover, it exhibits strong grounding capability, achieving an IoU improvement of +40.4 over the baseline and +37.0% over Fleming-VL, underscoring its robust spatial reasoning and localization performance. Evaluations across radiology, ophthalmology, pathology, and emergency care confirm MedMO's broad cross-modality generalization and reliable spatial reasoning.
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cs.CV · cs.CL
Proceedings of the IEEE/CVF Conference on Computer Vision and Pattern Recognition · 2026 · 正式发表