Evidence map›Paper›PMID 40830259›Full record

ArticleNPJ digital medicine2025

Specialized curricula for training vision language models in retinal image analysis.

Robbie Holland, Thomas R P Taylor, Christopher Holmes, Sophie Riedl, Julia Mai, Maria Patsiamanidi, Dimitra Mitsopoulou, Paul Hager, Philip Müller, Johannes C Paetzold and 8 more

Abstract read
In one paragraph

Article in NPJ digital medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Article
  2. Article
  3. Review
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

18 authors.

Robbie HollandBiomedical Image Analysis, Department of Computing, Imperial College London, London, United Kingdom. robbie.holland@stanford.edu.
Thomas R P TaylorClinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, United Kingdom.
Christopher HolmesMoorfields Eye Hospital NHS Foundation Trust, London, United Kingdom.
Sophie RiedlOphthalmic Image Analysis Group (OPTIMA), Medical University of Vienna, Vienna, Austria.
Julia MaiOphthalmic Image Analysis Group (OPTIMA), Medical University of Vienna, Vienna, Austria.
Maria PatsiamanidiClinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, United Kingdom.
Dimitra MitsopoulouClinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, United Kingdom.
Paul HagerDepartment of Ophthalmology and Optometry, Medical University of Vienna, Vienna, Austria.
Philip MüllerDepartment of Ophthalmology and Optometry, Medical University of Vienna, Vienna, Austria.
Johannes C PaetzoldBiomedical Image Analysis, Department of Computing, Imperial College London, London, United Kingdom.
Hendrik P N SchollInstitute of Molecular and Clinical Ophthalmology Basel, Basel, Switzerland.
Hrvoje BogunovićInstitute of Artificial Intelligence, Centre for Medical Data Science, Medical University of Vienna, Vienna, Austria.
Ursula Schmidt-ErfurthOphthalmic Image Analysis Group (OPTIMA), Medical University of Vienna, Vienna, Austria.
Daniel Rueckert *Biomedical Image Analysis, Department of Computing, Imperial College London, London, United Kingdom.
Sobha Sivaprasad *Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom.
Andrew J Lotery *Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, United Kingdom.
Martin J Menten *Biomedical Image Analysis, Department of Computing, Imperial College London, London, United Kingdom.
PINNACLE consortium

Funding

Wellcome TrustWellcome Trust Collaborative Award 210572/Z/18/Z
6 · The paper itself

Abstract

Clinicians spend significant time reviewing medical images and transcribing findings. By integrating visual and textual data, foundation models have the potential to reduce workloads and boost efficiency, yet their practical clinical value remains uncertain. In this study, we find that OpenAI's ChatGPT-4o and two medical vision-language models (VLMs) significantly underperform ophthalmologists in key tasks for age-related macular degeneration (AMD). To address this, we developed a dedicated training curriculum, designed by domain specialists, to optimize VLMs for tasks related to clinical decision making. The resulting model, RetinaVLM-Specialist, significantly outperforms foundation medical VLMs and ChatGPT-4o in AMD disease staging (F1: 0.63 vs. 0.33) and referral (0.67 vs. 0.50), achieving performance comparable to junior ophthalmologists. In a reader study, two senior ophthalmologists confirmed that RetinaVLM's reports were substantially more accurate than those written by ChatGPT-4o (64.3% vs. 14.3%). Overall, our curriculum-based approach offers a blueprint for adapting foundation models to real-world medical applications.

Identifiers

PMID40830259
PMCPMC12365215

What OpenQuestion holds

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LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.