The rapid advancement of generative AI raises concerns about the misuse of Multimodal LLMs (MLLMs) for large-scale disinformation campaigns on social media. Despite existing research on textual disinformation, a fundamental question remains unanswered: can MLLMs be exploited to fabricate realistic multimodal fake news, and can they reliably detect it? We introduce a multi-agent framework in which a story agent, an image agent, and a critic agent collaborate to produce fake social media posts that plausibly counter true news. We apply the framework to generate over 9,000 paired multimodal news posts across science, health, and entertainment domains, and benchmark 16 open- and closed-source MLLMs for automated detection. We find that most models fall substantially short of human-level accuracy and fail critically on identifying image authenticity. Our research provides a foundation for developing robust defenses against social media fake news. Code and data are available at https://github.com/xiuzhenzhang/Multimodal.

Large vision-language models (LVLMs) are gaining traction in clinical tasks such as diagnostic support, report generation, and medical question answering. Among post-training techniques, Direct Preference Optimization (DPO) has shown promise in aligning model outputs with human preferences, yet its effectiveness in high-stakes medical contexts remains underexplored. In this work, we present the first systematic evaluation of nine DPO variants applied to two leading medical LVLMs, LLaVA-Med and HuatuoGPT-Vision. We benchmark these models on five curated datasets covering diverse clinical tasks. Evaluations include both automated metrics and expert assessments. Our results show that while DPO improves alignment and reduces severe hallucinations, it yields inconsistent gains over supervised fine-tuning. We further introduce DPO variant that better handles visual misinterpretations and enhances clinical understanding. These findings reveal both the potential and limitations of DPO in medical AI. To support future research, we will release all DPO training data, model checkpoints, and expert annotations upon acceptance.

In real clinical practice, clinicians must sift through noisy and often conflicting information, progressively gathering and sequencing evidence before reaching conclusions. However, existing tuning methods for medical AI models are typically monologue-based — that is, models are fine-tuned on static question answering (QA) tasks or medical articles, which fail to reflect the interactive and iterative nature of clinical reasoning. To bridge this gap, we introduce MuddyMaze, a benchmark designed to expose the limitations of current monologue-based tuning, and construct a large dialogue dataset of 22.2k doctor–patient interactions that capture stepwise diagnostic reasoning validated by medical experts. Building on those, we propose dialogue-tuning, a new fine-tuning paradigm that captures the internal reasoning dynamics unfolding across interactions.

To assess the effectiveness of our approach, we evaluated dialogue-tuned models on MuddyMaze, where they outperform monologue-tuned baselines (e.g., MedQA) by +16.1% in one-round and +4.1% in multi-round evidence ranking, while maintaining or even improving accuracy on standard medical QA benchmarks (e.g., PubMedQA). These results indicate that dialogue-tuning not only enhances reasoning robustness and evidence integration but also preserves the factual precision of traditional QA performance.

A medical claim’s correctness often depends not on the claim alone, but on the clinical structure around it. A claim may require a lab reference range, a causal or conditional link, or patient-specific details to be judged correctly, and atom-level decomposition can fragment these dependencies, leaving the verifier with clinically incomplete claims. We reformulate medical fact-checking around snippet-level verification, where clause-grouped units preserve local clinical structure. We introduce MedSNIP-Bench, a human-annotated benchmark for snippet-level medical fact verification, and MedSNIP, an automatic snippet-generation pipeline. MedSNIP-Bench covers 276 consumer-health and clinical-vignette responses, segmented into 2,524 snippets with dual in-general and in-patient-context labels and six structural pattern codes. MedSNIP is evaluated against human snippet boundaries on MedSNIP-Bench and then used to generate snippet-level units for external corpora. Across MedSNIP-Bench, HealthFC, and MedHallu, snippet-level verification preserves or improves false-class F1, with gains concentrated where answers are long enough to fragment and where the verifier is strong enough to exploit the recovered structure. The largest merge-pattern gain is on causal-conditional clinical chains. It also reduces verifier calls by 24-73%, though the saving survives end-to-end only when decomposition is cheap, which an open-weight decomposer makes possible at no loss of chunking fidelity.

While reasoning-enhanced large language models perform strongly on English medical tasks, a persistent multilingual gap remains, with substantially weaker reasoning in local languages, limiting equitable global medical deployment. To bridge this gap, we introduce Med-CoReasoner, a language-informed co-reasoning framework that elicits parallel English and local-language reasoning, abstracts them into structured concepts, and integrates local clinical knowledge into an English logical scaffold via concept-level alignment and retrieval. This design combines the structural robustness of English reasoning with the practice-grounded expertise encoded in local languages. To evaluate multilingual medical reasoning beyond multiple-choice settings, we construct MultiMed-X, a benchmark covering seven languages with expert-annotated long-form question answering and natural language inference tasks, comprising 350 instances per language. Experiments across three benchmarks show that Med-CoReasoner improves multilingual reasoning performance by an average of 5%, with particularly substantial gains in low-resource languages. Moreover, model distillation and expert evaluation analysis further confirm that Med-CoReasoner produces clinically sound and culturally grounded reasoning traces.

The prevalence of vision-threatening eye diseases is a significant global burden, with many cases remaining undiagnosed or diagnosed too late for effective treatment. Large vision-language models (LVLMs) have the potential to assist in understanding anatomical information, diagnosing eye diseases, and drafting interpretations and follow-up plans, thereby reducing the burden on clinicians and improving access to eye care. However, limited benchmarks are available to assess LVLMs’ performance in ophthalmology-specific applications. In this study, we introduce LMOD, a large-scale multimodal ophthalmology benchmark consisting of 21,993 instances across (1) five ophthalmic imaging modalities: optical coherence tomography, color fundus photographs, scanning laser ophthalmoscopy, lens photographs, and surgical scenes; (2) free-text, demographic, and disease biomarker information; and (3) primary ophthalmology-specific applications such as anatomical information understanding, disease diagnosis, and subgroup analysis. In addition, we benchmarked 13 state-of-the-art LVLM representatives from closed-source, open-source, and medical domains. The results demonstrate a significant performance drop for LVLMs in ophthalmology compared to other domains. Systematic error analysis further identified six major failure modes: misclassification, failure to abstain, inconsistent reasoning, hallucination, assertions without justification, and lack of domain-specific knowledge. In contrast, supervised neural networks specifically trained on these tasks as baselines demonstrated high accuracy. These findings underscore the pressing need for benchmarks in the development and validation of ophthalmology-specific LVLMs.

Large language models have shown promise in clinical decision making, but current approaches struggle to localize and correct errors at specific steps of the reasoning process. This limitation is critical in medicine, where identifying and addressing reasoning errors is essential for accurate diagnosis and effective patient care. We introduce Med-PRM, a process reward modeling framework that leverages retrieval-augmented generation to verify each reasoning step against established medical knowledge bases. By verifying intermediate reasoning steps with evidence retrieved from clinical guidelines and literature, our model can precisely assess the reasoning quality in a fine-grained manner. Evaluations on five medical QA benchmarks and two open-ended diagnostic tasks demonstrate that Med-PRM achieves state-of-the-art performance, with improving the performance of base models by up to 13.50% using Med-PRM. Moreover, we demonstrate the generality of Med-PRM by integrating it in a plug-and-play fashion with strong policy models such as Meerkat, achieving over 80% accuracy on MedQA for the first time using small-scale models of 8 billion parameters.

Existing large language model (LLM) evaluation benchmarks primarily focus on English, while current multilingual tasks lack parallel questions that specifically assess cross-lingual reasoning abilities. This dual limitation makes it challenging to assess LLMs’ performance in the multilingual setting comprehensively. To fill this gap, we introduce MMLU-ProX, a comprehensive benchmark covering 29 languages, built on an English benchmark. Each language version consists of 11,829 identical questions, enabling direct cross-lingual comparisons. Additionally, to meet efficient evaluation needs, we provide a lite version containing 658 questions per language. To ensure the high quality of MMLU-ProX, we employ a rigorous development process that involves multiple powerful LLMs for translation, followed by expert review to ensure accurate expression, consistent terminology, and cultural relevance. Building on this, we systematically evaluate 36 state-of-the-art LLMs, including reasoning-enhanced and multilingual-optimized LLMs. The results reveal significant disparities in the multilingual capabilities of LLMs: While they perform well in high-resource languages, their performance declines markedly in low-resource languages, particularly for African languages. Through MMLU-ProX, we aim to advance the development of more inclusive AI systems and promote equitable access to technology across global contexts.

Large language models (LLMs) are widely used, but they often generate subtle factual errors, especially in long-form text. These errors are fatal in some specialized domains such as medicine. Existing fact-checking with grounding documents methods face two main challenges: (1) they struggle to understand complex multihop relations in long documents, often overlooking subtle factual errors; (2) most specialized methods rely on pairwise comparisons, requiring multiple model calls, leading to high resource and computational costs. To address these challenges, we propose GraphCheck, a fact-checking framework that uses extracted knowledge graphs to enhance text representation. Graph Neural Networks further process these graphs as a soft prompt, enabling LLMs to incorporate structured knowledge more effectively. Enhanced with graph-based reasoning, GraphCheck captures multihop reasoning chains that are often overlooked by existing methods, enabling precise and efficient fact-checking in a single inference call. Experimental results on seven benchmarks spanning both general and medical domains demonstrate up to a 7.1% overall improvement over baseline models. Notably, GraphCheck outperforms existing specialized fact-checkers and achieves comparable performance with state-of-the-art LLMs, such as DeepSeek-V3 and OpenAI-o1, with significantly fewer parameters.

The integration of large language model (LLM) techniques in the field of medical analysis has brought about significant advancements, yet the scarcity of large, diverse, and well-annotated datasets remains a major challenge. Medical data and tasks, which vary in format, size, and other parameters, require extensive preprocessing and standardization for effective use in training LLMs. To address these challenges, we introduce MedINST, the Meta Dataset of Biomedical Instructions, a novel multi-domain, multi-task instructional meta-dataset. MedINST comprises 133 biomedical NLP tasks and over 7 million training samples, making it the most comprehensive biomedical instruction dataset to date. Using MedINST as the meta dataset, we curate MedINST32, a challenging benchmark with different task difficulties aiming to evaluate LLMs’ generalization ability. We fine-tune several LLMs on MedINST and evaluate on MedINST32, showcasing enhanced cross-task generalization.