Carcinogenesis is a proteiform phenomenon, with tumors emerging in various locations and displaying complex, diverse shapes. At the crucial intersection of research and clinical practice, it demands precise and flexible assessment. However, current biomarkers, such as RECIST 1.1's long and short axis measurements, fall short of capturing this complexity, offering an approximate estimate of tumor burden and a simplistic representation of a more intricate process. Additionally, existing supervised AI models face challenges in addressing the variability in tumor presentations, limiting their clinical utility. These limitations arise from the scarcity of annotations and the models' focus on narrowly defined tasks. To address these challenges, we developed ONCOPILOT, an interactive radiological foundation model trained on approximately 7,500 CT scans covering the whole body, from both normal anatomy and a wide range of oncological cases. ONCOPILOT performs 3D tumor segmentation using visual prompts like point-click and bounding boxes, outperforming state-of-the-art models (e.g., nnUnet) and achieving radiologist-level accuracy in RECIST 1.1 measurements. The key advantage of this foundation model is its ability to surpass state-of-the-art performance while keeping the radiologist in the loop, a capability that previous models could not achieve. When radiologists interactively refine the segmentations, accuracy improves further. ONCOPILOT also accelerates measurement processes and reduces inter-reader variability, facilitating volumetric analysis and unlocking new biomarkers for deeper insights. This AI assistant is expected to enhance the precision of RECIST 1.1 measurements, unlock the potential of volumetric biomarkers, and improve patient stratification and clinical care, while seamlessly integrating into the radiological workflow.

In the expanding field of language model applications, medical knowledge representation remains a significant challenge due to the specialized nature of the domain. Large language models, such as GPT-4, obtain reasonable scores on medical question answering tasks, but smaller models are far behind. In this work, we introduce a method to improve the proficiency of a small language model in the medical domain by employing a two-fold approach. We first fine-tune the model on a corpus of medical textbooks. Then, we use GPT-4 to generate questions similar to the downstream task, prompted with textbook knowledge, and use them to fine-tune the model. Additionally, we introduce ECN-QA, a novel medical question answering dataset containing ``progressive questions'' composed of related sequential questions. We show the benefits of our training strategy on this dataset. The study's findings highlight the potential of small language models in the medical domain when appropriately fine-tuned. The code and weights are available at https://github.com/raidium-med/MQG.

Large Language Models (LLMs) have made the ambitious quest for generalist agents significantly far from being a fantasy. A key hurdle for building such general models is the diversity and heterogeneity of tasks and modalities. A promising solution is unification, allowing the support of a myriad of tasks and modalities within one unified framework. While few large models (e.g., Flamingo (Alayrac et al., 2022), trained on massive datasets, can support more than two modalities, current small to mid-scale unified models are still limited to 2 modalities, usually image-text or video-text. The question that we ask is: is it possible to build efficiently a unified model that can support all modalities? To answer this, we propose UnIVAL, a step further towards this ambitious goal. Without relying on fancy datasets sizes or models with billions of parameters, the ~ 0.25B parameter UnIVAL model goes beyond two modalities and unifies text, images, video, and audio into a single model. Our model is efficiently pretrained on many tasks, based on task balancing and multimodal curriculum learning. UnIVAL shows competitive performance to existing state-of-the-art approaches, across image and video-text tasks. The feature representations learned from image and video-text modalities, allows the model to achieve competitive performance when finetuned on audio-text tasks, despite not being pretrained on audio. Thanks to the unified model, we propose a novel study on multimodal model merging via weight interpolation of models trained on different multimodal tasks, showing their benefits in particular for out-of-distribution generalization. Finally, we motivate unification by showing the synergy between tasks. The model weights and code are released here: https://github.com/mshukor/UnIVAL.

Large Language Models (LLMs) have so far impressed the world, with unprecedented capabilities that emerge in models at large scales. On the vision side, transformer models (i.e., ViT) are following the same trend, achieving the best performance on challenging benchmarks. With the abundance of such unimodal models, a natural question arises; do we need also to follow this trend to tackle multimodal tasks? In this work, we propose to rather direct effort to efficient adaptations of existing models, and propose to augment Language Models with perception. Existing approaches for adapting pretrained models for vision-language tasks still rely on several key components that hinder their efficiency. In particular, they still train a large number of parameters, rely on large multimodal pretraining, use encoders (e.g., CLIP) trained on huge image-text datasets, and add significant inference overhead. In addition, most of these approaches have focused on Zero-Shot and In Context Learning, with little to no effort on direct finetuning. We investigate the minimal computational effort needed to adapt unimodal models for multimodal tasks and propose a new challenging setup, alongside different approaches, that efficiently adapts unimodal pretrained models. We show that by freezing more than 99% of total parameters, training only one linear projection layer, and prepending only one trainable token, our approach (dubbed eP-ALM) significantly outperforms other baselines on VQA and Captioning across Image, Video, and Audio modalities, following the proposed setup. The code is available here: https://github.com/mshukor/eP-ALM.

Foundation models are first pre-trained on vast unsupervised datasets and then fine-tuned on labeled data. Reinforcement learning, notably from human feedback (RLHF), can further align the network with the intended usage. Yet the imperfections in the proxy reward may hinder the training and lead to suboptimal results; the diversity of objectives in real-world tasks and human opinions exacerbate the issue. This paper proposes embracing the heterogeneity of diverse rewards by following a multi-policy strategy. Rather than focusing on a single a priori reward, we aim for Pareto-optimal generalization across the entire space of preferences. To this end, we propose rewarded soup, first specializing multiple networks independently (one for each proxy reward) and then interpolating their weights linearly. This succeeds empirically because we show that the weights remain linearly connected when fine-tuned on diverse rewards from a shared pre-trained initialization. We demonstrate the effectiveness of our approach for text-to-text (summarization, Q&A, helpful assistant, review), text-image (image captioning, text-to-image generation, visual grounding, VQA), and control (locomotion) tasks. We hope to enhance the alignment of deep models, and how they interact with the world in all its diversity.

Learning robust models that generalize well under changes in the data distribution is critical for real-world applications. To this end, there has been a growing surge of interest to learn simultaneously from multiple training domains - while enforcing different types of invariance across those domains. Yet, all existing approaches fail to show systematic benefits under fair evaluation protocols. In this paper, we propose a new learning scheme to enforce domain invariance in the space of the gradients of the loss function: specifically, we introduce a regularization term that matches the domain-level variances of gradients across training domains. Critically, our strategy, named Fishr, exhibits close relations with the Fisher Information and the Hessian of the loss. We show that forcing domain-level gradient covariances to be similar during the learning procedure eventually aligns the domain-level loss landscapes locally around the final weights. Extensive experiments demonstrate the effectiveness of Fishr for out-of-distribution generalization. In particular, Fishr improves the state of the art on the DomainBed benchmark and performs significantly better than Empirical Risk Minimization. The code is released at https://github.com/alexrame/fishr.

We introduce an evaluation methodology for visual question answering (VQA) to better diagnose cases of shortcut learning. These cases happen when a model exploits spurious statistical regularities to produce correct answers but does not actually deploy the desired behavior. There is a need to identify possible shortcuts in a dataset and assess their use before deploying a model in the real world. The research community in VQA has focused exclusively on question-based shortcuts, where a model might, for example, answer "What is the color of the sky" with "blue" by relying mostly on the question-conditional training prior and give little weight to visual evidence. We go a step further and consider multimodal shortcuts that involve both questions and images. We first identify potential shortcuts in the popular VQA v2 training set by mining trivial predictive rules such as co-occurrences of words and visual elements. We then create VQA-CE, a new evaluation set made of CounterExamples i.e. questions where the mined rules lead to incorrect answers. We use this new evaluation in a large-scale study of existing models. We demonstrate that even state-of-the-art models perform poorly and that existing techniques to reduce biases are largely ineffective in this context. Our findings suggest that past work on question-based biases in VQA has only addressed one facet of a complex issue. The code for our method is available at https://github.com/cdancette/detect-shortcuts