The emergence of groundbreaking large language models capable of performing complex reasoning tasks holds significant promise for addressing various scientific challenges, including those arising in complex clinical scenarios. To enable their safe and effective deployment in real-world healthcare settings, it is urgently necessary to benchmark the diagnostic capabilities of current models systematically. Given the limitations of existing medical benchmarks in evaluating advanced diagnostic reasoning, we present DiagnosisArena, a comprehensive and challenging benchmark designed to rigorously assess professional-level diagnostic competence. DiagnosisArena consists of 1,113 pairs of segmented patient cases and corresponding diagnoses, spanning 28 medical specialties, deriving from clinical case reports published in 10 top-tier medical journals. The benchmark is developed through a meticulous construction pipeline, involving multiple rounds of screening and review by both AI systems and human experts, with thorough checks conducted to prevent data leakage. Our study reveals that even the most advanced reasoning models, o3-mini, o1, and DeepSeek-R1, achieve only 45.82%, 31.09%, and 17.79% accuracy, respectively. This finding highlights a significant generalization bottleneck in current large language models when faced with clinical diagnostic reasoning challenges. Through DiagnosisArena, we aim to drive further advancements in AI’s diagnostic reasoning capabilities, enabling more effective solutions for real-world clinical diagnostic challenges. We openly share the benchmark and evaluation tools for further research and development.

Large vision-language models (LVLMs) have shown great promise in medical applications, particularly in visual question answering (MedVQA) and diagnosis from medical images. However, existing datasets and models often fail to consider critical aspects of medical diagnostics, such as the integration of historical records and the analysis of disease progression over time. In this paper, we introduce MMXU (Multimodal and MultiX-ray Understanding), a novel dataset for MedVQA that focuses on identifying changes in specific regions between two patient visits. Unlike previous datasets that primarily address single-image questions, MMXU enables multi-image questions, incorporating both current and historical patient data. We demonstrate the limitations of current LVLMs in identifying disease progression on MMXU-test, even those that perform well on traditional benchmarks. To address this, we propose a MedRecord-Augmented Generation (MAG) approach, incorporating both global and regional historical records.Our experiments show that integrating historical records significantly enhances diagnostic accuracy by at least 20%, bridging the gap between current LVLMs and human expert performance. Additionally, we fine-tune models with MAG on MMXU-dev, which demonstrates notable improvements. We hope this work could illuminate the avenue of advancing the use of LVLMs in medical diagnostics by emphasizing the importance of historical context in interpreting medical images.Our dataset is released at github.

Large language models (LLMs) have showcased remarkable capabilities as autonomous agents when augmented with external tools. Equipped with fixed tool sets, LLMs struggle with addressing diverse user inquiries in open-world tasks. To evaluate and boost the performance of LLMs in dealing with complex demands in the real-world, we propose open-world function calling, where LLMs need to retrieve suitable tools from a pre-defined external tool library and use retrieved tools to resolve the user’s problem. We introduce Meta-Tool, a versatile and plug-and-play tool retrieval system as the access of LLMs to external tool library. Drawing inspiration from the myriad of enhanced approaches associated with Retrieval-Augmented Generation (RAG), Meta-Tool employs a hypothesize-retrieve-invoke framework. We further propose Meta-Bench, a comprehensive benchmark for evaluating LLMs in open-world function calling and associated tasks. Meta-Bench encompasses 2,800 dialogues and 7,361 tools, spanning ten distinct scenarios to provide robust and diverse test categories. In conjunction, we present MT-LLaMA, a finetuned version of LLaMA-3.1, which exhibits remarkable performance improvements. Our empirical experiments reveal that Meta-Tool significantly enhances the ability of advanced LLMs to retrieve and leverage the most suitable tools compared to previous tool retrieval methods. Moreover, our fine-tuning enables even smaller-sized LLMs to achieve comparable even exceeding results to GPT-4o. Both the benchmark and the model are made publicly available at https://github.com/qinshengqian/Meta-Tool to foster further research and development in the field.