{"id":"https://openalex.org/W7134897313","doi":"https://doi.org/10.1109/icdmw69685.2025.00245","title":"Why Text Prevails: Vision May Undermine Multimodal Medical Decision Making","display_name":"Why Text Prevails: Vision May Undermine Multimodal Medical Decision Making","publication_year":2025,"publication_date":"2025-11-12","ids":{"openalex":"https://openalex.org/W7134897313","doi":"https://doi.org/10.1109/icdmw69685.2025.00245"},"language":null,"primary_location":{"id":"doi:10.1109/icdmw69685.2025.00245","is_oa":false,"landing_page_url":"https://doi.org/10.1109/icdmw69685.2025.00245","pdf_url":null,"source":null,"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"2025 IEEE International Conference on Data Mining Workshops (ICDMW)","raw_type":"proceedings-article"},"type":"article","indexed_in":["crossref"],"open_access":{"is_oa":false,"oa_status":"closed","oa_url":null,"any_repository_has_fulltext":false},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5128785103","display_name":"Siyuan Dai","orcid":null},"institutions":[{"id":"https://openalex.org/I170201317","display_name":"University of Pittsburgh","ror":"https://ror.org/01an3r305","country_code":"US","type":"education","lineage":["https://openalex.org/I170201317"]}],"countries":["US"],"is_corresponding":true,"raw_author_name":"Siyuan Dai","raw_affiliation_strings":["University of Pittsburgh,Department of Electrical &; Computer Engineering,Pittsburgh,PA,USA"],"affiliations":[{"raw_affiliation_string":"University of Pittsburgh,Department of Electrical &; Computer Engineering,Pittsburgh,PA,USA","institution_ids":["https://openalex.org/I170201317"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5100361015","display_name":"Li Li","orcid":"https://orcid.org/0000-0001-7108-4115"},"institutions":[{"id":"https://openalex.org/I137902535","display_name":"North Carolina State University","ror":"https://ror.org/04tj63d06","country_code":"US","type":"education","lineage":["https://openalex.org/I137902535"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Lunxiao Li","raw_affiliation_strings":["NC State University,Department of Computer Science,Raleigh,NC,USA"],"affiliations":[{"raw_affiliation_string":"NC State University,Department of Computer Science,Raleigh,NC,USA","institution_ids":["https://openalex.org/I137902535"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5111204631","display_name":"Kun Zhao","orcid":"https://orcid.org/0009-0007-5453-9182"},"institutions":[{"id":"https://openalex.org/I170201317","display_name":"University of Pittsburgh","ror":"https://ror.org/01an3r305","country_code":"US","type":"education","lineage":["https://openalex.org/I170201317"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Kun Zhao","raw_affiliation_strings":["University of Pittsburgh,Department of Electrical &; Computer Engineering,Pittsburgh,PA,USA"],"affiliations":[{"raw_affiliation_string":"University of Pittsburgh,Department of Electrical &; Computer Engineering,Pittsburgh,PA,USA","institution_ids":["https://openalex.org/I170201317"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5093839912","display_name":"Eardi Lila","orcid":null},"institutions":[{"id":"https://openalex.org/I201448701","display_name":"University of Washington","ror":"https://ror.org/00cvxb145","country_code":"US","type":"education","lineage":["https://openalex.org/I201448701"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Eardi Lila","raw_affiliation_strings":["University of Washington,Department of Biostatistics,Seattle,WA,USA"],"affiliations":[{"raw_affiliation_string":"University of Washington,Department of Biostatistics,Seattle,WA,USA","institution_ids":["https://openalex.org/I201448701"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5050170858","display_name":"Paul K. Crane","orcid":"https://orcid.org/0000-0003-4278-7465"},"institutions":[{"id":"https://openalex.org/I201448701","display_name":"University of Washington","ror":"https://ror.org/00cvxb145","country_code":"US","type":"education","lineage":["https://openalex.org/I201448701"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Paul K. Crane","raw_affiliation_strings":["University of Washington,Department of Medicine,Seattle,WA,USA"],"affiliations":[{"raw_affiliation_string":"University of Washington,Department of Medicine,Seattle,WA,USA","institution_ids":["https://openalex.org/I201448701"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5128796410","display_name":"Heng Huang","orcid":null},"institutions":[{"id":"https://openalex.org/I66946132","display_name":"University of Maryland, College Park","ror":"https://ror.org/047s2c258","country_code":"US","type":"education","lineage":["https://openalex.org/I66946132"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Heng Huang","raw_affiliation_strings":["University of Maryland,Department of Computer Science,College Park,MD,USA"],"affiliations":[{"raw_affiliation_string":"University of Maryland,Department of Computer Science,College Park,MD,USA","institution_ids":["https://openalex.org/I66946132"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5100778603","display_name":"Dan Xu","orcid":"https://orcid.org/0000-0003-4602-3550"},"institutions":[{"id":"https://openalex.org/I137902535","display_name":"North Carolina State University","ror":"https://ror.org/04tj63d06","country_code":"US","type":"education","lineage":["https://openalex.org/I137902535"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Dongkuan Xu","raw_affiliation_strings":["NC State University,Department of Computer Science,Raleigh,NC,USA"],"affiliations":[{"raw_affiliation_string":"NC State University,Department of Computer Science,Raleigh,NC,USA","institution_ids":["https://openalex.org/I137902535"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5079922796","display_name":"Haoteng Tang","orcid":"https://orcid.org/0000-0003-0323-1755"},"institutions":[{"id":"https://openalex.org/I2802326326","display_name":"The University of Texas Rio Grande Valley","ror":"https://ror.org/02p5xjf12","country_code":"US","type":"education","lineage":["https://openalex.org/I2802326326"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Haoteng Tang","raw_affiliation_strings":["University of Texas Rio Grande Valley,Department of Computer Science,Edinburg,TX,USA"],"affiliations":[{"raw_affiliation_string":"University of Texas Rio Grande Valley,Department of Computer Science,Edinburg,TX,USA","institution_ids":["https://openalex.org/I2802326326"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5128769570","display_name":"Liang Zhan","orcid":null},"institutions":[{"id":"https://openalex.org/I170201317","display_name":"University of Pittsburgh","ror":"https://ror.org/01an3r305","country_code":"US","type":"education","lineage":["https://openalex.org/I170201317"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Liang Zhan","raw_affiliation_strings":["University of Pittsburgh,Department of Electrical &; Computer Engineering,Pittsburgh,PA,USA"],"affiliations":[{"raw_affiliation_string":"University of Pittsburgh,Department of Electrical &; Computer Engineering,Pittsburgh,PA,USA","institution_ids":["https://openalex.org/I170201317"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":9,"corresponding_author_ids":["https://openalex.org/A5128785103"],"corresponding_institution_ids":["https://openalex.org/I170201317"],"apc_list":null,"apc_paid":null,"fwci":0.0,"has_fulltext":false,"cited_by_count":0,"citation_normalized_percentile":{"value":0.82928164,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":null,"biblio":{"volume":null,"issue":null,"first_page":"2020","last_page":"2024"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T11148","display_name":"Language, Metaphor, and Cognition","score":0.07519999891519547,"subfield":{"id":"https://openalex.org/subfields/3205","display_name":"Experimental and Cognitive Psychology"},"field":{"id":"https://openalex.org/fields/32","display_name":"Psychology"},"domain":{"id":"https://openalex.org/domains/2","display_name":"Social Sciences"}},"topics":[{"id":"https://openalex.org/T11148","display_name":"Language, Metaphor, and Cognition","score":0.07519999891519547,"subfield":{"id":"https://openalex.org/subfields/3205","display_name":"Experimental and Cognitive Psychology"},"field":{"id":"https://openalex.org/fields/32","display_name":"Psychology"},"domain":{"id":"https://openalex.org/domains/2","display_name":"Social Sciences"}},{"id":"https://openalex.org/T10737","display_name":"Health Literacy and Information Accessibility","score":0.05079999938607216,"subfield":{"id":"https://openalex.org/subfields/3600","display_name":"General Health Professions"},"field":{"id":"https://openalex.org/fields/36","display_name":"Health Professions"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T12214","display_name":"Media Influence and Health","score":0.050599999725818634,"subfield":{"id":"https://openalex.org/subfields/1208","display_name":"Literature and Literary Theory"},"field":{"id":"https://openalex.org/fields/12","display_name":"Arts and Humanities"},"domain":{"id":"https://openalex.org/domains/2","display_name":"Social Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/medical-decision-making","display_name":"Medical decision making","score":0.5135999917984009},{"id":"https://openalex.org/keywords/action","display_name":"Action (physics)","score":0.2892000079154968},{"id":"https://openalex.org/keywords/medline","display_name":"MEDLINE","score":0.2847999930381775},{"id":"https://openalex.org/keywords/clinical-decision-making","display_name":"Clinical decision making","score":0.27730000019073486},{"id":"https://openalex.org/keywords/medical-practice","display_name":"Medical practice","score":0.25850000977516174}],"concepts":[{"id":"https://openalex.org/C2983241795","wikidata":"https://www.wikidata.org/wiki/Q6806500","display_name":"Medical decision making","level":2,"score":0.5135999917984009},{"id":"https://openalex.org/C15744967","wikidata":"https://www.wikidata.org/wiki/Q9418","display_name":"Psychology","level":0,"score":0.42160001397132874},{"id":"https://openalex.org/C41008148","wikidata":"https://www.wikidata.org/wiki/Q21198","display_name":"Computer science","level":0,"score":0.3411000072956085},{"id":"https://openalex.org/C2780791683","wikidata":"https://www.wikidata.org/wiki/Q846785","display_name":"Action (physics)","level":2,"score":0.2892000079154968},{"id":"https://openalex.org/C2779473830","wikidata":"https://www.wikidata.org/wiki/Q1540899","display_name":"MEDLINE","level":2,"score":0.2847999930381775},{"id":"https://openalex.org/C2989179672","wikidata":"https://www.wikidata.org/wiki/Q6806500","display_name":"Clinical decision making","level":2,"score":0.27730000019073486},{"id":"https://openalex.org/C39549134","wikidata":"https://www.wikidata.org/wiki/Q133080","display_name":"Public relations","level":1,"score":0.2678000032901764},{"id":"https://openalex.org/C108827166","wikidata":"https://www.wikidata.org/wiki/Q175975","display_name":"Internet privacy","level":1,"score":0.26660001277923584},{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.26600000262260437},{"id":"https://openalex.org/C2993312423","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medical practice","level":2,"score":0.25850000977516174},{"id":"https://openalex.org/C154945302","wikidata":"https://www.wikidata.org/wiki/Q11660","display_name":"Artificial intelligence","level":1,"score":0.25780001282691956},{"id":"https://openalex.org/C539667460","wikidata":"https://www.wikidata.org/wiki/Q2414942","display_name":"Management science","level":1,"score":0.2526000142097473},{"id":"https://openalex.org/C56739046","wikidata":"https://www.wikidata.org/wiki/Q192060","display_name":"Knowledge management","level":1,"score":0.2522999942302704},{"id":"https://openalex.org/C12713177","wikidata":"https://www.wikidata.org/wiki/Q1900281","display_name":"Perspective (graphical)","level":2,"score":0.2500999867916107}],"mesh":[],"locations_count":1,"locations":[{"id":"doi:10.1109/icdmw69685.2025.00245","is_oa":false,"landing_page_url":"https://doi.org/10.1109/icdmw69685.2025.00245","pdf_url":null,"source":null,"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"2025 IEEE International Conference on Data Mining Workshops (ICDMW)","raw_type":"proceedings-article"}],"best_oa_location":null,"sustainable_development_goals":[{"id":"https://metadata.un.org/sdg/16","score":0.6494355201721191,"display_name":"Peace, Justice and strong institutions"}],"awards":[],"funders":[],"has_content":{"pdf":false,"grobid_xml":false},"content_urls":null,"referenced_works_count":28,"referenced_works":["https://openalex.org/W2995225687","https://openalex.org/W3185307588","https://openalex.org/W4225011360","https://openalex.org/W4315433607","https://openalex.org/W4385572077","https://openalex.org/W4387211697","https://openalex.org/W4389849400","https://openalex.org/W4390199335","https://openalex.org/W4392168151","https://openalex.org/W4393080912","https://openalex.org/W4402670791","https://openalex.org/W4402671465","https://openalex.org/W4402683770","https://openalex.org/W4402727764","https://openalex.org/W4403090323","https://openalex.org/W4404724218","https://openalex.org/W4404781082","https://openalex.org/W4407870719","https://openalex.org/W4410525721","https://openalex.org/W4412560184","https://openalex.org/W4412889112","https://openalex.org/W4413147798","https://openalex.org/W4415796712","https://openalex.org/W7133193597","https://openalex.org/W7133197087","https://openalex.org/W7133214447","https://openalex.org/W7133220561","https://openalex.org/W7133224126"],"related_works":[],"abstract_inverted_index":{"With":[0],"the":[1,24,122],"rapid":[2],"progress":[3],"of":[4,121],"large":[5,11],"language":[6,12],"models":[7,13],"(LLMs),":[8],"advanced":[9],"multimodal":[10,89,145],"(MLLMs)":[14],"have":[15],"demonstrated":[16],"impressive":[17],"zero-shot":[18],"capabilities":[19],"on":[20],"vision-language":[21],"tasks.":[22,38],"In":[23],"biomedical":[25],"domain,":[26],"however,":[27],"even":[28],"state-of-the-art":[29],"MLLMs":[30,133],"struggle":[31],"with":[32,70,88,107,125],"basic":[33],"Medical":[34],"Decision":[35],"Making":[36],"(MDM)":[37],"We":[39],"investigate":[40],"this":[41],"limitation":[42],"using":[43],"two":[44],"challenging":[45],"datasets:":[46],"(1)":[47,104],"three-stage":[48],"Alzheimer's":[49],"disease":[50],"(AD)":[51],"classification":[52,69,126],"(normal,":[53],"mild":[54],"cognitive":[55],"impairment,":[56],"dementia),":[57],"where":[58],"category":[59],"differences":[60],"are":[61],"visually":[62],"subtle,":[63],"and":[64,117,138],"(2)":[65,110],"MIMICCXR":[66],"chest":[67],"radiograph":[68],"14":[71],"non-mutually":[72],"exclusive":[73],"conditions.":[74],"Our":[75],"empirical":[76],"study":[77],"shows":[78],"that":[79,131],"text-only":[80,115],"reasoning":[81],"consistently":[82],"outperforms":[83],"vision-only":[84],"or":[85],"vision-text":[86],"settings,":[87],"inputs":[90],"often":[91],"performing":[92],"worse":[93],"than":[94],"text":[95],"alone.":[96],"To":[97],"mitigate":[98],"this,":[99],"we":[100],"explore":[101],"three":[102],"strategies:":[103],"in-context":[105],"learning":[106],"reason-annotated":[108],"exemplars,":[109],"vision":[111,123],"captioning":[112],"followed":[113],"by":[114],"inference,":[116],"(3)":[118],"few-shot":[119],"fine-tuning":[120],"tower":[124],"supervision.":[127],"These":[128],"findings":[129],"reveal":[130],"current":[132],"lack":[134],"grounded":[135],"visual":[136],"understanding":[137],"point":[139],"to":[140],"promising":[141],"directions":[142],"for":[143],"improving":[144],"decision":[146],"making":[147],"in":[148],"healthcare.":[149]},"counts_by_year":[],"updated_date":"2026-03-13T14:20:09.374765","created_date":"2026-03-12T00:00:00"}